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Lucatelli P, Ciaglia S, Rocco B, De Rubeis G, Bolognesi G, Damato E, Corona M, Nardis PG, Cannavale A, Ricci P, Catalano C. Two-dimensional perfusion angiography permits direct visualization of redistribution of flow in hepatocellular carcinoma during b-TACE. Radiol Med 2024:10.1007/s11547-024-01816-9. [PMID: 38637490 DOI: 10.1007/s11547-024-01816-9] [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] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 04/04/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVES To demonstrate in vivo redistribution of the blood flow towards HCC's lesions by utilizing two-dimensional perfusion angiography in b-TACE procedures. MATERIAL AND METHODS In total, 30 patients with 35 HCC nodules treated in the period between January 2019 and November 2021. For each patient, a post-processing software leading to a two-dimensional perfusion angiography was applied on each angiography performed via balloon microcatheter, before and after inflation. On the colour map obtained, reflecting the evolution of contrast intensity change over time, five regions of interests (ROIs) were assessed: one on the tumour (ROI-t), two in the immediate peritumoural healthy liver parenchyma (ROI-ihl) and two in the peripheral healthy liver parenchyma (ROI-phl). The results have been interpreted with a novel in silico model that simulates the hemodynamics of the hepatic arterial system. RESULTS Among the ROIs drawn inside the same segment of target lesion, the time-to-peak of the ROI-t and of the ROI-ihl have a significantly higher mean value when the balloon was inflated compared with the ROIs obtained with deflated balloon (10.33 ± 3.66 s vs 8.87 ± 2.60 s (p = 0.015) for ROI-t; 10.50 ± 3.65 s vs 9.23 ± 2.70 s (p = 0.047) for ROI-ihl). The in silico model prediction time-to-peak delays when balloon was inflated, match with those observed in vivo. The numerical flow analysis shows how time-to-peak delays are caused by the obstruction of the balloon-occluded artery and the opening of intra-hepatic collateral. CONCLUSION The measurements identify predictively the flow redistribution in the hepatic arteries during b-TACE, supporting a proper positioning of the balloon microcatheter.
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Affiliation(s)
- Pierleone Lucatelli
- Unit of Vascular and Interventional Radiology, Department of Radiological Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Simone Ciaglia
- Unit of Vascular and Interventional Radiology, Department of Radiological Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Bianca Rocco
- Unit of Vascular and Interventional Radiology, Department of Radiological Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Gianluca De Rubeis
- Department of Diagnostic, UOC of Diagnostic and Interventional Neuroradiology, San Camillo-Forlanini Hospital, Rome, Italy
| | - Guido Bolognesi
- Department of Chemical Engineering, Loughborough University, Loughborough, LE11 3TU, UK
- Department of Chemistry, University College London, London, WC1H 0AJ, UK
| | - Elio Damato
- Unit of Vascular and Interventional Radiology, Department of Radiological Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Mario Corona
- Unit of Vascular and Interventional Radiology, Department of Radiological Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Pier Giorgio Nardis
- Unit of Vascular and Interventional Radiology, Department of Radiological Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Alessandro Cannavale
- Unit of Vascular and Interventional Radiology, Department of Radiological Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Paolo Ricci
- Unit of Emergency Radiology, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale del Policlinico 155, 00161, SapienzaRome, Italy.
| | - Carlo Catalano
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I Hospital, Sapienza University of Rome, Viale del Policlinico 155, 00161, SapienzaRome, Italy
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Patrone L, Pasqui E, Conte MS, Farber A, Ferraresi R, Menard M, Mills JL, Rundback J, Schneider P, Ysa A, Abhishek K, Adams GL, Ahmad N, Ahmed I, Alexandrescu VA, Amor M, Alper D, Andrassy M, Attinger C, Baadh A, Barakat H, Biasi L, Bisdas T, Bhatti Z, Blessing E, Bonaca MP, Bonvini S, Bosiers M, Bradbury AW, Beasley R, Behrendt CA, Brodmann M, Cabral G, Cancellieri R, Casini A, Chandra V, Chisci E, Chohan O, Choke ETC, Chong PFS, Clerici G, Coscas R, Costantino M, Dalla Paola L, Dand S, Davies RSM, D'Oria M, Diamantopoulos A, Debus S, Deloose K, Del Giudice C, Donato GD, Rubertis BD, Paul De Vries J, Dias NV, Diaz-Sandoval L, Dick F, Donas K, Dua A, Fanelli F, Fazzini S, Foteh M, Gandini R, Gargiulo M, Garriboli L, Genovese EA, Gifford E, Goueffic Y, Goverde P, Chand Gupta P, Hinchliffe R, Holden A, Houlind KC, Howard DP, Huasen B, Isernia G, Katsanos K, Katzen B, Kolh P, Koncar I, Korosoglou G, Krishnan P, Kroencke T, Krokidis M, Kumarasamy A, Hayes P, Iida O, Alejandre Lafont E, Langhoff R, Lecis A, Lessne M, Lichaa H, Lichtenberg M, Lobato M, Lopes A, Loreni G, Lucatelli P, Madassery S, Maene L, Manzi M, Maresch M, Santhosh Mathews J, McCaslin J, Micari A, Michelagnoli S, Migliara B, Morgan R, Morelli L, Morosetti D, Mouawad N, Moxey P, Müller-Hülsbeck S, Mustapha J, Nakama T, Nasr B, N'dandu Z, Neville R, Noory E, Nordanstig J, Noronen K, Mariano Palena L, Parlani G, Patel AS, Patel P, Patel R, Patel S, Pena C, Perkov D, Portou M, Pratesi G, Rammos C, Reekers J, Riambau V, Roy T, Rosenfield K, Antonella Ruffino M, Saab F, Saratzis A, Sbarzaglia P, Schmidt A, Secemsky E, Siah M, Sillesen H, Simonte G, Sirvent M, Sommerset J, Steiner S, Sakr A, Scheinert D, Shishebor M, Spiliopoulos S, Spinelli A, Stravoulakis K, Taneva G, Teso D, Tessarek J, Theivacumar S, Thomas A, Thomas S, Thulasidasan N, Torsello G, Tripathi R, Troisi N, Tummala S, Tummala V, Twine C, Uberoi R, Ucci A, Valenti D, van den Berg J, van den Heuvel D, Van Herzeele I, Varcoe R, Vega de Ceniga M, Veith FJ, Venermo M, Vijaynagar B, Virdee S, Von Stempel C, Voûte MT, Khee Yeung K, Zeller T, Zayed H, Montero Baker M. The "Woundosome" Concept and Its Impact on Procedural Outcomes in Patients With Chronic Limb-Threatening Ischemia. J Endovasc Ther 2024:15266028241231745. [PMID: 38523459 DOI: 10.1177/15266028241231745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Affiliation(s)
- Lorenzo Patrone
- West London Vascular and Interventional Center, London North West University Healthcare NHS Trust, London, UK
| | - Edoardo Pasqui
- Vascular Surgery Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Michael S Conte
- Division of Vascular and Endovascular Surgery, University of California, San Francisco, CA, USA
| | - Alik Farber
- Boston Medical Center, Boston University School of Medicine, Boston, MA
| | - Roberto Ferraresi
- Diabetic Foot Unit, Clinica San Carlo, Paderno Dugnano, Milan, Italy
| | - Matthew Menard
- Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Joseph L Mills
- Baylor College of Medicine, Michael E. DeBakey Department of Surgery, Houston, Texas, USA
| | - John Rundback
- Advanced Interventional and Vascular Services, LLP, Teaneck, New Jersey
| | - Peter Schneider
- Division of Vascular and Endovascular Surgery, University of California San Francisco, San Francisco, CA, USA
| | - August Ysa
- Department of Vascular Surgery, Hospital Universitario Cruces, Barakaldo, Spain
| | - Kumar Abhishek
- Department of Radiology, University Hospital, Newark, NJ
| | | | - Naseer Ahmad
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Irfan Ahmed
- Department of Interventional Radiology, Guys' and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | - Vlad A Alexandrescu
- Department of Thoracic and Vascular Surgery, Princess Paola Hospital, MarcheenFamenne, Belgium
| | - Max Amor
- Department of Interventional Cardiology, U.C.C.I. Polyclinique d'Essey, Nancy, France
| | | | | | - Christopher Attinger
- Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, United States
| | - Andy Baadh
- Regions Hospital, Saint Paul, Minnesota, USA
| | - Hashem Barakat
- University Hospitals Plymouth NHS Trust; Plymouth; United Kingdom
| | - Lukla Biasi
- Cardiovascular Division, Academic Department of Surgery, Guy's and St Thomas' Hospital NHS Trust, London, United Kingdom
| | - Theodosios Bisdas
- Department of Vascular Surgery, Athens Medical Center, Athens, Greece
| | | | | | - Marc P Bonaca
- Division of Cardiology, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, United States
| | - Stefano Bonvini
- Department of Vascular Surgery, Santa Chiara Hospital, Trento, Italy
| | - Michel Bosiers
- Department of Vascular Surgery, University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Andrew W Bradbury
- Department of Vascular Surgery, University of Birmingham, Birmingham, United Kingdom
| | | | - Christian-Alexander Behrendt
- Center for Population Health Innovation (POINT), University Heart and Vascular Center Hamburg, University Medical Center HamburgEppendorf, Hamburg, Germany
| | | | | | | | - Andrea Casini
- Diabetic Foot Unit, Clinica San Carlo, Paderno Dugnano, Milan, Italy
| | - Venita Chandra
- Stanford Health Care, Division of Vascular & Endovascular Surgery, Stanford, CA, United States
| | - Emiliano Chisci
- Vascular and Endovascular Surgery Unit, San Giovanni di Dio Hospital, Florence, Italy
| | - Omar Chohan
- Great Lakes Medical Imaging, Buffalo, NY, United States
| | - Edward T C Choke
- Department of Vascular Surgery, Seng Kang General Hospital, Singapore
| | | | | | - Raphael Coscas
- Department of Vascular Surgery, Ambroise Paré University Hospital, Assistance PubliqueHôpitaux de Paris, BoulogneBillancourt, France
| | | | | | - Sabeen Dand
- Los Angeles Imaging and Interventional Consultants, PIH Health, Whittier, CA
| | - Robert S M Davies
- Leicester Vascular Institute, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Mario D'Oria
- Division of Vascular and Endovascular Surgery, CardioThoracoVascular Department, University Hospital of Trieste ASUGI, Trieste, Italy
| | - Athanasios Diamantopoulos
- Department of Interventional Radiology, Guys' and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | - Sebastian Debus
- Department of Vascular Medicine, Vascular Surgery-Angiology-Endovascular Therapy, University Heart & Vascular Center, University of HamburgEppendorf, Hamburg, Germany
| | - Koen Deloose
- Department of Vascular Surgery, AZ Sint Blasius, Dendermonde, Belgium
| | - Costantino Del Giudice
- Department of Radiology, Interventional Radiology, Institut Mutualiste Montsouris, Paris, France
| | - Gianmarco de Donato
- Vascular Surgery Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Brian De Rubertis
- New York Presbyterian Weill Cornell Medical Center, Mount Sinai Hospital, Columbia University Irving Medical Center and Columbia Vagelos College of Physicians and Surgeons, New York, United States
| | - Jean Paul De Vries
- Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Nuno V Dias
- Department of Thoracic Surgery and Vascular Diseases, Vascular Center, Skåne University Hospital, Malmö, Sweden
| | | | - Florian Dick
- Kantonsspital St. Gallen, St. Gallen, and University of Bern, Bern, Switzerland
| | - Konstantinos Donas
- Department of Vascular Surgery, Asklepios Clinic Langen, University of Frankfurt, Langen, Germany
| | - Anahita Dua
- Division of Vascular Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Fabrizio Fanelli
- Interventional Radiology Unit, Azienda OspedalieroUniversitaria Careggi, Florence, Italy
| | - Stefano Fazzini
- Division of Vascular Surgery, Tor Vergata University of Rome, Rome, Italy
| | - Mazin Foteh
- Baylor Scott & White Heart Hospital, Plano, TX, United States
| | - Roberto Gandini
- UOSD Radiologia Interventistica, University Hospital Policlinico Tor Vergata, Roma, Italy
| | - Mauro Gargiulo
- Vascular Surgery, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, IRCCS Sant'OrsolaMalpighi Hospital, Bologna, Italy
| | - Luca Garriboli
- Vascular Surgery Divisoin, IRCCS Sacro Cuore Don Calabria" Negrar, Verona, Italy
| | - Elizabeth A Genovese
- Division of Vascular Surgery and Endovascular Therapy, University of Pennsylvania, Philadelphia, PA, United States
| | - Edward Gifford
- Division of Vascular Surgery, Hartford Hospital, Hartford, CT, United States
| | - Yann Goueffic
- Vascular Center, Groupe Hospitalier Paris Saint Joseph, Paris, France
| | - Peter Goverde
- Department of Vascular Surgery, ZNA Stuivenberg, Antwerp, Belgium
| | - Prem Chand Gupta
- Department of Vascular and Endovascular Surgery, Care Hospitals, Banjara Hills, Hyderabad, India
| | - Robert Hinchliffe
- Department of Vascular Surgery, North Bristol NHS Trust, Bristol, United Kingdom
| | - Andrew Holden
- Auckland City Hospital, School of Medicine, University of Auckland, Auckland, New Zealand
| | - Kim C Houlind
- Department of Vascular Surgery, Hospital Lillebaelt, University of Southern Denmark, Odense, Denmark
| | - Dominic Pj Howard
- Nuffield Department of Clinical Neurosciences, Centre for Prevention of Stroke and Dementia, University of Oxford, Oxford, United Kingdom
| | - Bella Huasen
- Department of Interventional Radiology, Lancashire University Teaching Hospitals, Lancashire Care NHS Foundation Trust, Preston, United Kingdom
| | - Giacomo Isernia
- Vascular and Endovascular Surgery Unit, S. Maria Della Misericordia University Hospital, Perugia, Italy
| | | | - Barry Katzen
- Miami Cardiac and Vascular Institute, Baptist Health South Florida, Miami, FL, United States
| | - Philippe Kolh
- Department of Biomedical and Preclinical Sciences, University of Liège, Liège, Belgium
| | - Igor Koncar
- Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia
| | - Grigorios Korosoglou
- Departments of Cardiology, Vascular Medicine and Pneumology, GRN Academic Teaching Hospital Weinheim, Weinheim, Germany
| | - Prakash Krishnan
- The Zena and Michael A Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Thomas Kroencke
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Augsburg, Germany
| | - Miltiadis Krokidis
- National and Kapodistrian University of Athens, Areteion Hospital, Athens, Greece
| | - Arun Kumarasamy
- European Vascular Centre AachenMaastricht, Department of Vascular Surgery, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany
| | - Paul Hayes
- St John's Innovation Centre, Cambridge, United Kingdom
| | - Osamu Iida
- Cardiovascular Center, Kansai Rosai Hospital, Inabaso, Hyogo, Amagasaki, Japan
| | | | - Ralf Langhoff
- Department of Angiology, St. Gertrauden Hospital, Berlin, Germany
| | | | - Mark Lessne
- Vascular and Interventional Specialists, Charlotte Radiology, Charlotte, NC, United States
| | - Hady Lichaa
- Ascension Saint Thomas Heart, Ascension Saint Thomas Rutherford, Murfreesboro, TN, United States
| | | | - Marta Lobato
- Department of Vascular Surgery, Hospital Universitario Cruces, Barakaldo, Spain
| | - Alice Lopes
- Department of Vascular Surgery, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Giorgio Loreni
- UOC Radiologia Interventistica, ASL Roma 2, Ospedale S. Pertini, Rome, Italy
| | - Pierleone Lucatelli
- Vascular and Interventional Radiology Unit, Department of Radiological, Oncological, and AnatomoPathological Sciences, Sapienza University of Rome, Rome, Italy
| | | | - Lieven Maene
- Department of Vascular and Thoracic Surgery, OnzeLieveVrouwziekenhuis Aalst, Aalst, Belgium
| | | | - Martin Maresch
- Department of Vascular and Endovascular Surgery, BDF Hospital Royal Medical Services, Bahrain
| | - Jay Santhosh Mathews
- Bradenton Cardiology Center, Manatee Memorial Hospital, Bradenton, FL, United States
| | - James McCaslin
- The Northern Vascular Centre, Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - Antonio Micari
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy
| | - Stefano Michelagnoli
- Vascular and Endovascular Surgery Unit, San Giovanni di Dio Hospital, Florence, Italy
| | - Bruno Migliara
- Vascular and Endovascular Surgery Unit, Pederzoli Hospital, Peschiera del Garda, Italy
| | - Robert Morgan
- Diagnostic, Vascular & Interventional Radiology, St George's University Hospitals NHS Foundation Trust and St George's, University of London, United Kingdom
| | - Luis Morelli
- Diabetic Foot Unit and Limb Salvage, Hospital San Juan de Dios, San Jose, Costa Rica
| | | | - Nicolas Mouawad
- Department of Surgery, McLaren Health System, Grand Blanc, MI, United States
| | - Paul Moxey
- St George's Vascular Institute, St George's University Hospital, London, United Kingdom
| | | | - Jihad Mustapha
- Advanced Cardiac and Vascular Centers for Amputation Prevention, Grand Rapids, MI, United States
| | - Tatsuya Nakama
- Jikei University Hospital, Department of Surgery, Division of Vascular Surgery, Tokyo, Japan
| | - Bahaa Nasr
- CHU Cavale Blanche Brest, Vascular and Endovascular Surgery Department, Brest, France
| | | | - Richard Neville
- Inova Schar Heart and Vascular, Inova Fairfax Medical Campus, Falls Church, VA, United States
| | - Elias Noory
- Department of Cardiology and Angiology, Medical Center, University of Freiburg, Bad Krozingen, Germany
| | - Joakim Nordanstig
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Göteborg, Sweden
| | - Katariina Noronen
- Department of Vascular Surgery, Abdominal Center, Helsinki University Hospital, Helsinki, Finland
| | - Luis Mariano Palena
- Department of Vascular and Thoracic Surgery, OnzeLieveVrouwziekenhuis Aalst, Aalst, Belgium
| | - Gianbattista Parlani
- Department of Interventional Radiology, Lancashire University Teaching Hospitals, Lancashire Care NHS Foundation Trust, Preston, United Kingdom
| | - Ashish S Patel
- Cardiovascular Division, Academic Department of Surgery, Guy's and St Thomas' Hospital NHS Trust, London, United Kingdom
| | - Parag Patel
- Department of Radiology, Vascular and Interventional Radiology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Rafiuddin Patel
- Department of Interventional Radiology, Oxford University Hospitals NHS Foundation Trust, Headley Way, Oxford, United Kingdom
| | - Sanjay Patel
- Cardiovascular Division, Academic Department of Surgery, Guy's and St Thomas' Hospital NHS Trust, London, United Kingdom
| | | | - Drazen Perkov
- Department of Diagnostic and Interventional Radiology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Mark Portou
- Royal Free Vascular, Division of Surgery and Interventional Science, Royal Free Campus, UCL, London, UK
| | - Giovanni Pratesi
- Unit of Vascular and Endovascular Surgery-IRCCS Ospedale Policlinico San Martino, Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Christos Rammos
- Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University of DuisburgEssen, Germany
| | - Jim Reekers
- Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, Netherlands
| | - Vicente Riambau
- Vascular Surgery Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Trisha Roy
- DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, TX, United States
| | - Kenneth Rosenfield
- Department of Cardiology, Massachusetts General Hospital, Boston, MA, United States
| | - Maria Antonella Ruffino
- Department of Interventional Radiology, Ticino Vascular Center, Institute of Imaging of Southern Switzerland, Lugano Regional Hospital, Lugano, Switzerland
| | - Fadi Saab
- ACV Centers, Grand Rapids, MI, United States
| | - Athanasios Saratzis
- University Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
| | - Paolo Sbarzaglia
- Interventional cardiology, Maria Cecilia Hospital, Ravenna, Italy
| | - Andrej Schmidt
- Department of Angiology, University Hospital Leipzig, Leipzig, Germany
| | - Eric Secemsky
- Smith Center for Cardiovascular Outcomes Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Michael Siah
- Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Henrik Sillesen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Gioele Simonte
- Department of Interventional Radiology, Lancashire University Teaching Hospitals, Lancashire Care NHS Foundation Trust, Preston, United Kingdom
| | - Marc Sirvent
- Department General, University Hospital of Granollers, CIBERCV, ISCIII, Granollers, Spain
| | | | - Sabine Steiner
- Department of Angiology, University Hospital Leipzig, Leipzig, Germany
| | - Ahmed Sakr
- Saudi German Hospital, Jeddah, Saudi Arabia
| | - Dierk Scheinert
- Department of Angiology, University Hospital Leipzig, Leipzig, Germany
| | - Mehdi Shishebor
- University Hospitals Cleveland Medical Centre and Case Western Reserve University School of Medicine, Cleveland, OH, United States
| | - Stavros Spiliopoulos
- 2nd Department of Radiology, Interventional Radiology Unit, Medical School, National and Kapodistrian University of Athens, Attikon, University General Hospital, Athens, Greece
| | | | | | - Gergana Taneva
- Kantonsspital St. Gallen, St. Gallen, and University of Bern, Bern, Switzerland
| | | | - Joerg Tessarek
- Department Vascular and Endovascular Surgery, Bonifatius Hospital, Lingen, Germany
| | - Selva Theivacumar
- West London Vascular and Interventional Center, London North West University Healthcare NHS Trust, London, UK
| | - Anish Thomas
- Mercy Clinic Heart And Vascular LLC, Saint Louis, MO
| | | | - Narayan Thulasidasan
- Department of Interventional Radiology, Guys' and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | - Giovanni Torsello
- University Hospital Münster, Institute for Vascular Research, Franziskus Hospital, Münster, Germany
| | | | - Nicola Troisi
- Vascular Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Srini Tummala
- Department of Interventional Radiology, University of Miami Health System, UM Miller School of Medicine, Miami, FL, United States
| | | | - Christopher Twine
- Bath and Weston Vascular Network, Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom
| | - Raman Uberoi
- John Radcliffe Hospital, Oxford University Hospitals, Oxford, United Kingdom
| | - Alessandro Ucci
- Unit of Vascular Surgery, Department of Medicine and Surgery, Azienda OspedalieroUniversitaria di Parma, Parma, Italy
| | - Domenico Valenti
- Department of Vascular Surgery, King's College Hospital, London, United Kingdom
| | - Jos van den Berg
- Universitätsinstitut für Diagnostische, Interventionelle und Pädiatrische Radiologie, Inselspital, Universitätsspital Bern, Bern, Switzerland
| | | | - Isabelle Van Herzeele
- Department of Thoracic and Vascular Surgery, Ghent University Hospital, Ghent, Belgium
| | - Ramon Varcoe
- Prince of Wales Hospital, Sydney, NSW, Australia
| | - Melina Vega de Ceniga
- Department of Angiology and Vascular Surgery, University Hospital of GaldakaoUsansolo, Bizkaia, Spain
| | - Frank J Veith
- New York University Medical Centre, New York, NY and The Cleveland Clinic, Cleveland, OH, United States
| | - Maarit Venermo
- Department of Vascular Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | | | - Sanjiv Virdee
- The University of Rochester Medical Faculty Group, NY, United States
| | - Conrad Von Stempel
- Department of Radiology, University College London Hospitals, London, United Kingdom
| | - Michiel T Voûte
- Department of Surgery, Prince of Wales Hospital, Sydney, Australia
| | - Kak Khee Yeung
- Department of Vascular Surgery, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centres, Amsterdam, Netherlands
| | - Thomas Zeller
- Department of Cardiology and Angiology, Medical Center, University of Freiburg, Bad Krozingen, Germany
| | - Hany Zayed
- Cardiovascular Division, Academic Department of Surgery, Guy's and St Thomas' Hospital NHS Trust, London, United Kingdom
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Giurazza F, Ierardi A, Marra P, Lucatelli P, Corvino F, Pane F, Sironi S, Carrafiello G, Loffroy R, Niola R. Pseudoaneurysms embolization with glue via percutaneous direct puncture: a multicenter experience on 54 patients. CVIR Endovasc 2024; 7:11. [PMID: 38221592 PMCID: PMC10788324 DOI: 10.1186/s42155-024-00426-w] [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: 10/31/2023] [Accepted: 01/04/2024] [Indexed: 01/16/2024] Open
Abstract
BACKGROUND This retrospective multicentric study aims to report on technical safety and effectiveness of pseudoaneurysms embolization with glue (N-butyl cyanoacrylate) adopting a percutaneous direct puncture approach. RESULTS Fifty-four patients data were collected from five centers. All patients at the time of treatment presented with unruptured PAs and were hemodynamically stable. True aneurysms and lesions treated with embolics other than glue were excluded. Pseudoaneurysms diagnosis was based on CT and anamnestic data; initial investigation with digital-subtracted arteriography was acquired in all cases; then, percutaneous embolizations were performed in the angio-suite (ultrasound, fluoroscopy, ConeBeam CT guidance) or in CT. Technical success was considered as complete pseudoaneurysm embolization at final imaging with sole percutaneous strategy, without need for additional endovascular embolization. Clinical success was intended as pseudoaneurysm resolution within one week follow-up with stabilization or restored clinical conditions. Pseudoaneurysms origins were traumatic (57.4%), inflammatory (24.1%) or spontaneous (18.5%); 39 patients (72.2%) were symptomatic, presenting with pain and/or pulsatile mass. Mean lesions diameter was 19.3 mm (range: 7-30); pseudoaneurysms were located in abdomen (48.1%), limbs (42.6%) and thorax (9.3%). Coagulation function was impaired in 16.6% and 48.1% was under antiplatelets/anticoagulation therapy. In 16.6% the percutaneous approach followed previous treatments failure. The image-guidance modality for percutaneous puncture was most often ultrasound combined with fluoroscopy (38%). Clinical success was obtained in all patients while technical success occurred in 94.4% because 3 patients required an additional endovascular embolization. Complications were registered in 14.8%, all of low grade without clinical sequelae neither prolonged recovery (7 non target embolizations, 1 post-embolization syndrome). CONCLUSIONS In this study, pseudoaneurysms embolization with glue via percutaneous direct puncture was safe and effective with a low rate of minor complications.
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Affiliation(s)
- Francesco Giurazza
- Vascular and Interventional Radiology Department, Cardarelli Hospital, Via A. Cardarelli 9, Naples, 80131, Italy.
| | - Annamaria Ierardi
- Radiology Department, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan, 20122, Italy
| | - Paolo Marra
- Department of Radiology, ASST Papa Giovanni XXIII Hospital, University of Milano Bicocca, Piazza OMS 1, Bergamo, 24127, Italy
| | - Pierleone Lucatelli
- Vascular and Interventional Radiology Unit, Department of Radiological, Oncological, and Anatomo-Pathological Sciences, Sapienza University of Rome, Roma, 00161, Italy
| | - Fabio Corvino
- Vascular and Interventional Radiology Department, Cardarelli Hospital, Via A. Cardarelli 9, Naples, 80131, Italy
| | - Francesco Pane
- Vascular and Interventional Radiology Department, Cardarelli Hospital, Via A. Cardarelli 9, Naples, 80131, Italy
| | - Sandro Sironi
- Department of Radiology, ASST Papa Giovanni XXIII Hospital, University of Milano Bicocca, Piazza OMS 1, Bergamo, 24127, Italy
| | - Gianpaolo Carrafiello
- Radiology Department, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan, 20122, Italy
- Department of Health Sciences, Università degli Studi di Milano, Via F. Sforza 35, Milan, 20122, Italy
| | - Romaric Loffroy
- Image-Guided Therapy Center, ICMUB Laboratory, Department of Vascular and Interventional Radiology, François-Mitterrand University Hospital, BP 77908, 14 Rue Paul Gaffarel, Dijon, 21079, France
| | - Raffaella Niola
- Vascular and Interventional Radiology Department, Cardarelli Hospital, Via A. Cardarelli 9, Naples, 80131, Italy
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4
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Ginanni Corradini L, Maresca L, Lucatelli P, Balocco S, D'Onofrio A, Stefanini M. The role of post-dilatation in carotid MicroNet-covered stent implantation, evaluated using 3D cone-beam CT angiography. J Cardiovasc Surg (Torino) 2023; 64:608-614. [PMID: 38015552 DOI: 10.23736/s0021-9509.23.12756-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
BACKGROUND This study aims to assess the role and safety of post-dilatation in protected carotid artery stenting (PCAS) using the new MicroNet-covered 2nd-generation stent assessed by cone beam CT scans. METHODS From March 2020 to March 2022, patients were enrolled in the study according to CT angiography results based on the following criteria: Evidence of 70% to 99% carotid stenosis in asymptomatic patients and 50% to 99% in symptomatic patients, per the NASCET index. Using a FilterWire EZ™ (Boston Scientific, Natick, MA, USA) embolic protection system (EPS), MicroNet-covered stent PCAS was performed by two interventional radiologists with at least 8 years of experience in endovascular intervention. Each patient underwent post-dilatation following stent placement. Finally, a third radiologist (not participating in the interventional procedures) evaluated the cone beam CT scans and calculated residual stenosis. Major and minor complications were recorded in the 30 days following the procedure. RESULTS A total of 192 patients (121 male, mean age 73±10 years) were included in the study, and all patients received post-dilatation following stent implantation. Technical successes were achieved in all procedures. Adverse events noted in this study were limited to periprocedural transient ischemic attacks that occurred in three out of 192 patients (1.6%) and showed a swift complete recovery. The post-dilatation balloon diameters used in the study were: 5.0 mm (30.3%), 5.5 mm (39.3%) and 6 mm (30.3%). Optimized postdilatation resulted in a significant increase in the final luminal area. Similar improvements were observed in all subtypes of plaque. CONCLUSIONS Post-dilatation in protected CAS is safe and induces a significant improvement in the cross-sectional area regardless of the stenotic plaque.
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Affiliation(s)
| | - Luciano Maresca
- Department of Radiology and Interventional Radiology, Casilino Hospital, Rome, Italy
| | | | - Simone Balocco
- Department of Mathematics and Informatics, University of Barcelona, Barcelona, Spain
- Computer Vision Center, Bellaterra, Spain
| | - Adolfo D'Onofrio
- Department of Radiology and Interventional Radiology, Casilino Hospital, Rome, Italy
| | - Matteo Stefanini
- Department of Radiology and Interventional Radiology, Casilino Hospital, Rome, Italy
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5
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Tiralongo F, Giurazza F, Di Pietro S, Lucatelli P, Mosconi C, Contegiacomo A, Vacirca F, Ciaglia S, Cocozza MA, Castiglione DG, Falsaperla D, Ini' C, Zanghì GN, Granata A, Venturini M, Basile A. Spontaneous Abdominal Wall Hematoma Treated with Percutaneous Transarterial Embolization: Diagnostic Findings, Procedural Outcome, and Efficacy-A Multicenter Study. J Clin Med 2023; 12:4779. [PMID: 37510894 PMCID: PMC10381274 DOI: 10.3390/jcm12144779] [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: 06/01/2023] [Revised: 06/29/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
Endovascular management of abdominal wall hematomas (AWHs) is now the primary treatment option in hemodynamically stable patients, and it is often preferred to surgical interventions. The purpose of this multicentric study was to assess the safety, technical, and clinical success of percutaneous transarterial embolization (PTAE) of spontaneous AWHs to evaluate the efficacy of blind or empiric embolization compared to targeted embolization and to compare the outcome of the endovascular treatment approach in patients affected by COVID-19 and non-COVID-19 patients. We retrospectively enrolled 112 patients with spontaneous AWHs who underwent PTAE, focusing on signs of bleeding at pre-procedural CTA and DSA. Patients were separated into two groups depending on whether a blind or targeted embolization approach was used. We also divided patients into COVID-19 and non-COVID-19 groups. The mean age of the study population was 68.6 ± 15.8 years. CTA and DSA revealed signs of active bleeding in 99 and 88 patients, respectively. In 21 patients, blind embolization was performed. The overall technical success rate was 99%. Clinical success was obtained in 96 patients (86%), while 16 (14%) re-bled within 96 h. One patient reported a major peri-procedural complication. The comparison between blind and targeted embolization approaches showed no statistically significant differences in the characteristics of groups and technical and clinical success rates. No significant differences were found in the procedural outcome between COVID-19 and non-COVID-19 groups. Our study confirmed that PTAE is effective for treating spontaneous AWHs, even in COVID-19 patients. It suggests that the efficacy and safety of blind embolization are comparable to targeted embolization.
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Affiliation(s)
- Francesco Tiralongo
- Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies "GF Ingrassia", University Hospital Policlinico "G. Rodolico-San Marco", University of Catania, 95123 Catania, Italy
| | - Francesco Giurazza
- Interventional Radiology Department, Cardarelli Hospital of Naples, 80131 Naples, Italy
| | - Stefano Di Pietro
- Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies "GF Ingrassia", University Hospital Policlinico "G. Rodolico-San Marco", University of Catania, 95123 Catania, Italy
| | - Pierleone Lucatelli
- Vascular and Interventional Radiology Unit, Department of Radiological, Oncological, and Anatomo-Pathological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Cristina Mosconi
- Department of Radiology, IRCCS, Azienda Ospedaliero-Universitaria Di Bologna, Sant'Orsola-Malpighi Hospital, 40138 Bologna, Italy
| | - Andrea Contegiacomo
- Department of Radiological Sciences, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Francesco Vacirca
- Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies "GF Ingrassia", University Hospital Policlinico "G. Rodolico-San Marco", University of Catania, 95123 Catania, Italy
| | - Simone Ciaglia
- Vascular and Interventional Radiology Unit, Department of Radiological, Oncological, and Anatomo-Pathological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Maria Adriana Cocozza
- Department of Radiology, IRCCS, Azienda Ospedaliero-Universitaria Di Bologna, Sant'Orsola-Malpighi Hospital, 40138 Bologna, Italy
| | - Davide Giuseppe Castiglione
- Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies "GF Ingrassia", University Hospital Policlinico "G. Rodolico-San Marco", University of Catania, 95123 Catania, Italy
| | - Daniele Falsaperla
- Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies "GF Ingrassia", University Hospital Policlinico "G. Rodolico-San Marco", University of Catania, 95123 Catania, Italy
| | - Corrado Ini'
- Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies "GF Ingrassia", University Hospital Policlinico "G. Rodolico-San Marco", University of Catania, 95123 Catania, Italy
| | | | - Antonio Granata
- Nephrology and Dialysis Unit, "Cannizzaro" Hospital, 95123 Catania, Italy
| | - Massimo Venturini
- Department of Diagnostic and Interventional Radiology, Circolo Hospital, Insubria University, 21100 Varese, Italy
| | - Antonio Basile
- Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies "GF Ingrassia", University Hospital Policlinico "G. Rodolico-San Marco", University of Catania, 95123 Catania, Italy
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6
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Lucatelli P, Rocco B, Ciaglia S, Teodoli L, Argirò R, Guiu B, Saba L, Vallati G, Spiliopoulos S, Patrone L, Gyánó M, Góg I, Osváth S, Szigeti K, Kiss JP, Catalano C. Possible use of Digital Variance Angiography in Liver Transarterial Chemoembolization: A Retrospective Observational Study. Cardiovasc Intervent Radiol 2023; 46:635-642. [PMID: 37076552 PMCID: PMC10156832 DOI: 10.1007/s00270-023-03420-2] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 03/11/2023] [Indexed: 04/21/2023]
Abstract
PURPOSE Digital variance angiography (DVA), a recently developed image processing technology, provided higher contrast-to-noise ratio (CNR) and better image quality (IQ) during lower limb interventions than digital subtraction angiography (DSA). Our aim was to investigate whether this quality improvement can be observed also during liver transarterial chemoembolization (TACE). MATERIALS AND METHODS We retrospectively compared the CNR and IQ parameters of DSA and DVA images from 25 patients (65% male, mean ± SD age: 67.5 ± 11.2 years) underwent TACE intervention at our institute. CNR was calculated on 50 images. IQ of every image set was evaluated by 5 experts using 4-grade Likert scales. Both single image evaluation and paired image comparison were performed in a blinded and randomized manner. The diagnostic value was evaluated based on the possibility to identify lesions and feeding arteries. RESULTS DVA provided significantly higher CNR (mean CNRDVA/CNRDSA was 1.33). DVA images received significantly higher individual Likert score (mean ± SEM 3.34 ± 0,08 vs. 2.89 ± 0.11, Wilcoxon signed-rank p < 0.001) and proved to be superior also in paired comparisons (median comparison score 1.60 [IQR:2.40], one sample Wilcoxon p < 0.001 compared to equal quality level). DSA could not detect lesion and feeding artery in 28 and 36% of cases, and allowed clear detection only in 22% and 16%, respectively. In contrast, DVA failed only in 8 and 18% and clearly revealed lesions and feeding arteries in 32 and 26%, respectively. CONCLUSION In our study, DVA provided higher quality images and better diagnostic insight than DSA; therefore, DVA could represent a useful tool in liver TACE interventions. LEVEL OF EVIDENCE III Non-consecutive study.
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Affiliation(s)
- Pierleone Lucatelli
- University Hospital "Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Bianca Rocco
- University Hospital "Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
| | - Simone Ciaglia
- University Hospital "Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Leonardo Teodoli
- University Hospital "Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Renato Argirò
- Department of Interventional Radiology, University of Rome Tor Vergata, Rome, Italy
| | - Boris Guiu
- Montpellier University Hospital, Montpellier, France
| | - Luca Saba
- Department of Medical Sciences, University of Cagliari, Cagliari, Italy
| | - Giulio Vallati
- Interventional Radiology Unit of "IRCCS Istituto Nazionale Tumori Regina Elena", Rome, Italy
| | - Stavros Spiliopoulos
- Department of Radiology, Interventional Radiology Unit, National and Kapodistrian University of Athens, Athens, Greece
| | - Lorenzo Patrone
- West London Vascular and Interventional Centre, Northwick Park Hospital, London, UK
| | - Marcell Gyánó
- Department of Interventional Radiology, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
- Kinepict Health Ltd, Budapest, Hungary
| | - István Góg
- Department of Interventional Radiology, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
- Department of Vascular and Endovascular Surgery, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Szabolcs Osváth
- Kinepict Health Ltd, Budapest, Hungary
- Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary
| | - Krisztian Szigeti
- Kinepict Health Ltd, Budapest, Hungary
- Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary
| | | | - Carlo Catalano
- University Hospital "Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
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7
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Carconi C, Cerreti M, Roberto M, Arrivi G, D'Ambrosio G, De Felice F, Di Civita MA, Iafrate F, Lucatelli P, Magliocca FM, Picchetto A, Picone V, Catalano C, Cortesi E, Tombolini V, Mazzuca F, Tomao S. The Management of Oligometastatic Disease in Colorectal Cancer: Present Strategies and Future Perspectives. Crit Rev Oncol Hematol 2023; 186:103990. [PMID: 37061075 DOI: 10.1016/j.critrevonc.2023.103990] [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: 10/13/2022] [Revised: 03/29/2023] [Accepted: 04/11/2023] [Indexed: 04/17/2023] Open
Abstract
Oligometastatic disease has been described as an intermediate clinical state between localized cancer and systemically metastasized disease. Recent clinical studies have shown prolonged survival when aggressive locoregional approaches are added to systemic therapies in patients with oligometastases. The aim of this review is to outline the newest options to treat oligometastatic colorectal cancer (CRC), also considering its molecular patterns. We present an overview of the available local treatment strategies, including surgical procedures, stereotactic body radiation therapy (SBRT), thermal ablation, as well as trans-arterial chemoembolization (TACE) and selective internal radiotherapy (SIRT). Moreover, since imaging methods provide crucial information for the early diagnosis and management of oligometastatic CRC, we discuss the role of modern radiologic techniques in selecting patients that are amenable to potentially curative locoregional treatments.
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Affiliation(s)
- Catia Carconi
- Sant'Andrea University Hospital, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Micaela Cerreti
- Sant'Andrea University Hospital, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Michela Roberto
- UOC Oncologia A, Department of radiological, Oncological and Anathomo-patological Science, Policlinico Umberto I, "Sapienza" University of Rome, 00161 Rome, Italy.
| | - Giulia Arrivi
- Oncology Unit, Sant' Andrea University Hospital, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Giancarlo D'Ambrosio
- Department of General Surgery, Surgical Specialties and Organ Transplantation, Policlinico Umberto I, "Sapienza" University of Rome, 00161 Rome, Italy
| | - Francesca De Felice
- Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy
| | - Mattia Alberto Di Civita
- UOC Oncologia A, Department of radiological, Oncological and Anathomo-patological Science, Policlinico Umberto I, "Sapienza" University of Rome, 00161 Rome, Italy
| | - Franco Iafrate
- Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Pierleone Lucatelli
- Vascular and Interventional radiology Unit, Department of radiological, Oncological and Anathomo-patological Science, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Fabio Massimo Magliocca
- Vascular and Interventional radiology Unit, Department of radiological, Oncological and Anathomo-patological Science, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Andrea Picchetto
- Emergency Department, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Vincenzo Picone
- UOC Oncologia B, Department of radiological, Oncological and Anathomo-patological Science, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Carlo Catalano
- Vascular and Interventional radiology Unit, Department of radiological, Oncological and Anathomo-patological Science, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Enrico Cortesi
- UOC Oncologia B, Department of radiological, Oncological and Anathomo-patological Science, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Vincenzo Tombolini
- Department of Radiotherapy, Policlinico Umberto I "Sapienza" University of Rome, Rome, Italy
| | - Federica Mazzuca
- Oncology Unit, Sant' Andrea University Hospital, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Silverio Tomao
- Oncology Unit, Sant' Andrea University Hospital, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
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8
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Parisse S, Carnevale S, Di Bartolomeo F, Poli E, Miceli F, Ferri F, Mischitelli M, Rocco B, Lai Q, Lucatelli P, Corona M, Mennini G, De Santis A, Rossi M, Muscaritoli M, Cantafora A, Ginanni Corradini S. A Low Daily Intake of Simple Sugars in the Diet Is Associated with Improved Liver Function in Cirrhotic Liver Transplant Candidates. Nutrients 2023; 15:nu15071575. [PMID: 37049416 PMCID: PMC10097197 DOI: 10.3390/nu15071575] [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: 02/28/2023] [Revised: 03/19/2023] [Accepted: 03/21/2023] [Indexed: 04/14/2023] Open
Abstract
(1) Background: We investigated, for the first time, whether dietary simple sugar intake affects MELD score changes over time in a cohort of cirrhotic liver transplant candidates. (2) Methods: the MELD score, dietary habits using a 3-day food diary, and visceral adipose tissue index (VATI) measured with CT scan were assessed in 80 consecutive outpatient cirrhotic patients at baseline, after counseling to follow current nutritional guidelines. The MELD score was reassessed after six months and the DELTA-MELD was calculated as the MELD at the second assessment minus the MELD at baseline. (3) Results: Compared with the baseline, the MELD score of cirrhotic patients at the end of the study was decreased, stable, or increased in 36%, 8% and 56% of patients, respectively. In separate multiple linear regression models, DELTA-MELD was positively and independently correlated with the daily intake of simple sugars expressed in g/kg body weight (p = 0.01) or as a percentage of total caloric intake (p = 0.0004) and with the number of daily portions of fruit, added sugar, jam, and honey (p = 0.003). These associations were present almost exclusively in patients with VATI above the median value. (4) Conclusions: In cirrhotic patients with high amounts of visceral adipose tissue the consumption of simple sugars and fructose should be limited to improve their clinical outcome.
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Affiliation(s)
- Simona Parisse
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | | | - Francesca Di Bartolomeo
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Edoardo Poli
- Centre Hépato-Biliaire, Hôpital Paul Brousse, AP-HP, 94800 Villejuif, France
| | - Francesca Miceli
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Flaminia Ferri
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Monica Mischitelli
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Bianca Rocco
- Department of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Quirino Lai
- General Surgery and Organ Transplantation Unit, Department of Surgery, Sapienza University of Rome, 00161 Rome, Italy
| | - Pierleone Lucatelli
- Department of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Mario Corona
- Department of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Gianluca Mennini
- General Surgery and Organ Transplantation Unit, Department of Surgery, Sapienza University of Rome, 00161 Rome, Italy
| | - Adriano De Santis
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Massimo Rossi
- General Surgery and Organ Transplantation Unit, Department of Surgery, Sapienza University of Rome, 00161 Rome, Italy
| | - Maurizio Muscaritoli
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Alfredo Cantafora
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
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9
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Lucatelli P, Rocco B, Ciaglia S, Damato E, Mosconi C, Argirò R, Catalano C. Microballoon Interventions for Liver Tumors: Review of Literature and Future Perspectives. J Clin Med 2022; 11:jcm11185334. [PMID: 36142980 PMCID: PMC9505296 DOI: 10.3390/jcm11185334] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 09/06/2022] [Accepted: 09/09/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Microballoon interventions (MBIs) have been proposed as useful tools to improve the efficacy of locoregional liver treatments. The aim of this systematic review was to summarize the existing evidence on procedural characteristics, safety, and efficacy of MBIs. Methods: PubMed and Cochrane Central Register of Controlled Trials were queried for original research articles evaluating MBIs in patients with liver malignancies from 2012 to August 2022. Search terms employed were liver malignancies, hepatocellular carcinoma, cholangiocarcinoma, liver metastases, microballoon transarterial chemoembolization, balloon-occluded trans-arterial chemoembolization, balloon-occluded selective internal radiation therapies, balloon-occluded TACE and ablation, and safety or oncological results or efficacy. Merely technical studies and animal studies were excluded. Results: Thirty-four original research studies and one abstract involving 744 patients treated with MBIs were included; 76% of the studies were retrospective, with low risk of bias and moderate-to-poor levels of evidence. Heterogeneity precluded meta-analysis. All studies proved MBI safety, which was not inferior to non-occlusive procedures. Balloon employment ameliorates oncological results, improving time to recurrence, objective response rate, and lowers need for retreatment. Conclusions: MBIs appear to be potential game changers in the treatment of liver malignancies. Multicentric, prospective and randomized studies are necessary to confirm these findings.
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Affiliation(s)
- Pierleone Lucatelli
- Vascular and Interventional Radiology Unit, Department of Radiological, Oncological, and Anatomo-Pathological Sciences, Sapienza University of Rome, 00161 Roma, Italy
- Correspondence:
| | - Bianca Rocco
- Vascular and Interventional Radiology Unit, Department of Radiological, Oncological, and Anatomo-Pathological Sciences, Sapienza University of Rome, 00161 Roma, Italy
| | - Simone Ciaglia
- Vascular and Interventional Radiology Unit, Department of Radiological, Oncological, and Anatomo-Pathological Sciences, Sapienza University of Rome, 00161 Roma, Italy
| | - Elio Damato
- Vascular and Interventional Radiology Unit, Department of Radiological, Oncological, and Anatomo-Pathological Sciences, Sapienza University of Rome, 00161 Roma, Italy
| | - Cristina Mosconi
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy
| | - Renato Argirò
- Diagnostic Imaging and Interventional Radiology, University Hospital of Rome Tor Vergata, 00133 Rome, Italy
| | - Carlo Catalano
- Vascular and Interventional Radiology Unit, Department of Radiological, Oncological, and Anatomo-Pathological Sciences, Sapienza University of Rome, 00161 Roma, Italy
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10
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Abstract
Interventional radiologists now perform spinal interventions routinely for diagnostic and therapeutic purposes. New technologies for the management of spine pathologies have emerged with promising results in terms of safety and efficacy. Interventional radiology techniques in the spine include percutaneous biopsy and therapies for intervertebral disk herniation or spinal stenosis, facet and sacroiliac joint pathologies, vertebral and sacral fractures, and metastases. These techniques can also be easily combined one with the other or to further therapeutic approaches including systemic therapies, surgical approaches, and radiotherapy. This review provides a comprehensive overview of current percutaneous imaging-guided interventional radiology techniques in the spine. It will help readers become familiar with the most common indications, learn about different technical considerations during performance, and review the available evidence. Controversies concerning new products and technical approaches are also addressed.
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Affiliation(s)
- Dimitrios K Filippiadis
- 2nd Department of Radiology, University General Hospital "ATTIKON," Medical School, National and Kapodistrian University of Athens, Haidari/Athens, Greece
| | - Salvatore Masala
- Diagnostic Imaging and Interventional Radiology, University of Rome Tor Vergata, Rome, Italy
| | - Pierleone Lucatelli
- Diagnostic Imaging and Interventional Radiology, Vascular and Interventional Radiology Unit, Sapienza University of Rome, Rome, Italy
| | - Alexis Kelekis
- 2nd Department of Radiology, University General Hospital "ATTIKON," Medical School, National and Kapodistrian University of Athens, Haidari/Athens, Greece
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11
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Nardis PG, Cipollari S, Lucatelli P, Basilico F, Rocco B, Corona M, Cannavale A, Leonardo C, Flammia RS, Proietti F, Vallati G, Gallucci M, Catalano C. Cone-beam CT-guided tagging of endophytic renal tumors with indocyanine green via trans-arterial selective delivery in patients undergoing robot-assisted partial nephrectomy with near infrared fluorescence imaging. J Vasc Interv Radiol 2022; 33:934-941. [PMID: 35487346 DOI: 10.1016/j.jvir.2022.04.016] [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: 09/15/2021] [Revised: 03/26/2022] [Accepted: 04/17/2022] [Indexed: 10/18/2022] Open
Abstract
PURPOSE To evaluate the safety, efficacy, and clinical impact of pre-operative cone-beam CT (CBCT)-guided selective embolization of endophytic renal tumors with the fluorescent dye indocyanine green (ICG) and lipiodol in patients undergoing robot-assisted partial nephrectomy (RAPN) using near infrared fluorescent imaging (NIFI). MATERIALS AND METHODS Patients with renal endophytic tumors eligible for RAPN and trans-arterial embolization with ICG and lipiodol were prospectively included. Technical success was defined as the completion of the embolization procedure. Radiographic success, defined as the lipiodol accumulation into the nodule, was classified as poor, moderate, good, and optimal based on post-embolization CBCT. Surgical visibility of the tumors during RAPN with the use of NIFI was classified as: not visible, visible with poorly defined margins, and visible with well-defined margins. RESULTS Forty-one patients underwent pre-operative selective embolization. Technical success was 100%. Lipiodol accumulation at CBCT was poor in 2/41 (4.9%), moderate in 6/41 (14.6%), good in 25/41 (61.0%), and optimal in 8/41 patients (19.5%). During RAPN with NIFI, tumors were visible with well-defined margins in 26/41 (63.4%), visible with blurred margins in 14/41 (34.1%) and not visible in 1/41 (2.4%) of cases. There were no adverse events following endovascular embolization. CONCLUSION Pre-operative trans-arterial super-selective embolization of endophytic renal tumors with ICG and lipiodol in patients undergoing RAPN is safe and effective, allowing accurate intraoperative visualization and resection of endophytic tumors.
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Affiliation(s)
- Pier Giorgio Nardis
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University/Policlinico Umberto I, Rome, Italy
| | - Stefano Cipollari
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University/Policlinico Umberto I, Rome, Italy
| | - Pierleone Lucatelli
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University/Policlinico Umberto I, Rome, Italy
| | - Fabrizio Basilico
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University/Policlinico Umberto I, Rome, Italy
| | - Bianca Rocco
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University/Policlinico Umberto I, Rome, Italy
| | - Mario Corona
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University/Policlinico Umberto I, Rome, Italy
| | - Alessandro Cannavale
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University/Policlinico Umberto I, Rome, Italy
| | - Costantino Leonardo
- Department of Maternal-Infant and Urological Sciences, Sapienza/Policlinico Umberto I, Rome, Italy
| | - Rocco Simone Flammia
- Department of Maternal-Infant and Urological Sciences, Sapienza/Policlinico Umberto I, Rome, Italy
| | - Flavia Proietti
- Department of Maternal-Infant and Urological Sciences, Sapienza/Policlinico Umberto I, Rome, Italy
| | - Giulio Vallati
- Department of Radiology, IRCCS "Regina Elena" National Cancer Institute, Rome, Italy
| | - Michele Gallucci
- Department of Maternal-Infant and Urological Sciences, Sapienza/Policlinico Umberto I, Rome, Italy
| | - Carlo Catalano
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University/Policlinico Umberto I, Rome, Italy
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Granata A, Rahbari E, Di Nicolò P, Battaglia Y, Campo I, Fresilli D, Pacini P, Lucatelli P, Barr RG, Cantisani V, Zeiler M. The Underrated Role of Ultrasound in Peritoneal Dialysis. J Ultrasound Med 2022; 41:301-310. [PMID: 33780019 DOI: 10.1002/jum.15710] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 03/08/2021] [Accepted: 03/14/2021] [Indexed: 06/12/2023]
Abstract
Ultrasound is very effective in performing procedures and assessment of complications in peritoneal dialysis. The ultrasound examination can be applied for preoperative assessment, during the peritoneal catheter placement, for the detection and monitoring of infection, as well as for the evaluation of the catheter malfunction. Despite being not only a cost- and time-saving technique but also a bedside procedure, ultrasonography remains an underrated clinical tool in the field of peritoneal dialysis. This publication wants to explain and reinforce the clinical utility of US in PD and to expand the diagnostic equipment for the clinician.
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Affiliation(s)
- Antonio Granata
- Nephrology and Dialysis Unit, "Cannizzaro" Hospital, Catania, Italy
| | - Elnaz Rahbari
- Nephrology and Dialysis Unit, "Cannizzaro" Hospital, Catania, Italy
| | - Pierpaolo Di Nicolò
- Nephrology and Dialysis Unit, "Santa Maria della Scaletta" Hospital, Imola, Italy
| | - Yuri Battaglia
- Nephrology and Dialysis Unit, "St. Anna" University Hospital, Ferrara, Italy
| | - Irene Campo
- Department of Radiology, "Civile di Conegliano" Hospital, Conegliano, Italy
| | - Daniele Fresilli
- Department of Radiology, "Sapienza" University of Rome, Rome, Italy
| | - Patrizia Pacini
- Department of Radiology, "Sapienza" University of Rome, Rome, Italy
| | | | - Richard G Barr
- Department of Radiology, Northeastern Ohio Medical University, Rootstown, Ohio, USA
- Southwoods Imaging, Youngstown, Ohio, USA
| | - Vito Cantisani
- Department of Radiology, "Sapienza" University of Rome, Rome, Italy
| | - Matthias Zeiler
- Nephrology and Dialysis Unit, "Carlo Urbani" Hospital, Jesi, Italy
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Lucatelli P, Burrel M, Guiu B, de Rubeis G, van Delden O, Helmberger T. CIRSE Standards of Practice on Hepatic Transarterial Chemoembolisation. Cardiovasc Intervent Radiol 2021; 44:1851-1867. [PMID: 34694454 DOI: 10.1007/s00270-021-02968-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [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: 01/02/2021] [Accepted: 09/04/2021] [Indexed: 12/15/2022]
Abstract
This CIRSE Standards of Practice document is aimed at interventional radiologists and provides best practices for performing transarterial chemoembolisation. It has been developed by an expert writing group under the guidance of the CIRSE Standards of Practice Committee. It will encompass all technical details reflecting European practice of different TACE procedures (Lp-TACE, DEM-TACE, DSM-TACE, b-TACE) as well as revising the existing literature on the various clinical indications (HCC, mCRC, ICC, NET). Finally, new frontiers of development will also be discussed.
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Affiliation(s)
- Pierleone Lucatelli
- Vascular and Interventional Radiology Unit, Department of Radiological Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Rome, Italy.
| | - Marta Burrel
- Radiology Department, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Boris Guiu
- Department of Radiology, Montpellier School of Medicine, St-Eloi University Hospital, Montpellier, France
| | - Gianluca de Rubeis
- Vascular and Interventional Radiology Unit, Department of Radiological Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Rome, Italy
- Department of Diagnostic Radiology, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
| | - Otto van Delden
- Department of Interventional Radiology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Thomas Helmberger
- Institute for Diagnostic and Interventional Radiology and Neuroradiology, Bogenhausen Hospital, Munich, Germany
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14
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Balestrieri A, Lucatelli P, Suri HS, Montisci R, Suri JS, Wintermark M, Serra A, Cheng X, Jinliang C, Sanfilippo R, Saba L. Volume of White Matter Hyperintensities, and Cerebral Micro-Bleeds. J Stroke Cerebrovasc Dis 2021; 30:105905. [PMID: 34107418 DOI: 10.1016/j.jstrokecerebrovasdis.2021.10590521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 05/11/2021] [Accepted: 05/15/2021] [Indexed: 05/20/2023] Open
Abstract
PURPOSE In the past years the significance of white matter hyperintensities (WMH) has gained raising attention because it is considered a marker of severity of different pathologies. Another condition that in the last years has been assessed in the neuroradiology field is cerebral microbleeds (CMB). The purpose of this work was to evaluate the association between the volume of WMH and the presence and characteristics of CMB. MATERIAL AND METHODS Sixty-five consecutive (males 45; median age 70) subjects were retrospectively analyzed with a 1.5 Tesla scanner. WMH volume was quantified with a semi-automated procedure considering the FLAIR MR sequences whereas the CMB were studied with the SWI technique and CMBs were classified as absent (grade 1), mild (grade 2; total number of CMBs: 1-2), moderate (grade 3; total number of CMBs: 3-10), and severe (grade 4; total number of CMBs: >10). Moreover, overall number of CMBs and the maximum diameter were registered. RESULTS Prevalence of CMBs was 30.76% whereas WMH 81.5%. Mann-Whitney test showed a statistically significant difference in WMH volume between subjects with and without CMBs (p < 0.001). Pearson analysis showed significant correlation between CMB grade, number and maximum diameter and WMH. The better ROC area under the curve (Az) was obtained by the hemisphere volume with a 0.828 (95% CI from 0.752 to 0,888; SD = 0.0427; p value = 0.001). The only parameters that showed a statistically significant association in the logistic regression analysis were Hemisphere volume of WMH (p = 0.001) and Cholesterol LDL (p = 0.0292). CONCLUSION In conclusion, the results of this study suggest the presence of a significant correlation between CMBs and volume of WMH. No differences were found between the different vascular territories.
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Affiliation(s)
- Antonella Balestrieri
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045, Italy
| | | | - Harman S Suri
- Stroke Diagnosis and Monitoring Division, AtheroPoint™, Roseville, CA, USA; Point-of-Care Devices, Global Biomedical Technologies, Inc., Roseville, CA, USA; Department of Electrical Engineering, University of Idaho (Affl.), ID, USA
| | - Roberto Montisci
- Department of Vascular Surgery, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato, s.s. 554 Monserrato Cagliari 09045, Italy
| | - Jasjit S Suri
- Stroke Diagnosis and Monitoring Division, AtheroPoint™, Roseville, CA, USA; Point-of-Care Devices, Global Biomedical Technologies, Inc., Roseville, CA, USA; Department of Electrical Engineering, University of Idaho (Affl.), ID, USA
| | | | - Alessandra Serra
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045, Italy
| | | | - Cheng Jinliang
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
| | - Roberto Sanfilippo
- Department of Vascular Surgery, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato, s.s. 554 Monserrato Cagliari 09045, Italy
| | - Luca Saba
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045, Italy.
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15
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Vallati GE, Trobiani C, Teodoli L, Lai Q, Cappelli F, Ungania S, Catalano C, Lucatelli P. Sarcopenia Worsening One Month after Transarterial Radioembolization Predicts Progressive Disease in Patients with Advanced Hepatocellular Carcinoma. Biology (Basel) 2021; 10:biology10080728. [PMID: 34439960 PMCID: PMC8389627 DOI: 10.3390/biology10080728] [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] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/15/2021] [Accepted: 07/27/2021] [Indexed: 11/30/2022]
Abstract
Simple Summary Sarcopenia measured at one-month CT follow up after TARE (transarterial radioembolization) treatment is a predictive factor for the best tumor response in patients with locally advanced HCC. Abstract (1) Background: To demonstrate correlation between skeletal muscle depletion measured before and after one month of TARE treatment and its induced local response rate. (2) Material and methods: For this retrospective, single center study, we evaluated 86 patients with HCC treated with TARE. Sarcopenia status was measured using the psoas muscle index (PMI). The PMI was calculated according to the formula: PMI [mm/m2]: [(minor diameter of left psoas + major diameter of left psoas + minor diameter of right psoas + major diameter of right psoas)/4]/height in m2. Population was divided in two groups according to the delta value of PMI measured at the time of TARE and one month after TARE, a group in which the delta PMI was stable or increased (No-Sarcopenia group; n = 42) vs. a group in which the delta-PMI decreased (Sarcopenia group; n = 44). Patient response was evaluated at 1, 3 and 6 months after TARE treatment with CT/MRI. (3) Results: When the radiological response of the tumor was evaluated according to the mRECIST criteria, the two groups were similar in terms of rates of complete response (p = 0.42), partial response (p = 0.26) and stable disease (p = 0.59). Progressive disease (PD) was more commonly observed in the Sarcopenia group (38.6% vs. 11.9%; p = 0.006). (4) Conclusions: Worsening of sarcopenia status measured one month after TARE is able to predict patients who will undergo disease progression.
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Affiliation(s)
- Giulio Eugenio Vallati
- Interventional Radiology Unit of “IRCCS Istituto Nazionale Tumori Regina Elena”, 00138 Rome, Italy; (G.E.V.); (F.C.)
| | - Claudio Trobiani
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Policlinico Umberto I, University of Rome “Sapienza”, 00161 Rome, Italy; (L.T.); (C.C.); (P.L.)
- Correspondence:
| | - Leonardo Teodoli
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Policlinico Umberto I, University of Rome “Sapienza”, 00161 Rome, Italy; (L.T.); (C.C.); (P.L.)
| | - Quirino Lai
- Department of General Surgery and Organ Transplantation, Sapienza University of Rome, 00161 Rome, Italy;
| | - Federico Cappelli
- Interventional Radiology Unit of “IRCCS Istituto Nazionale Tumori Regina Elena”, 00138 Rome, Italy; (G.E.V.); (F.C.)
| | - Sara Ungania
- Physics Department of “Istituto Regina Elena, Istituto di Ricovero e Cura a Carattere Scientifico”, 00138 Rome, Italy;
| | - Carlo Catalano
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Policlinico Umberto I, University of Rome “Sapienza”, 00161 Rome, Italy; (L.T.); (C.C.); (P.L.)
| | - Pierleone Lucatelli
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Policlinico Umberto I, University of Rome “Sapienza”, 00161 Rome, Italy; (L.T.); (C.C.); (P.L.)
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Golfieri R, Bezzi M, Verset G, Fucilli F, Mosconi C, Cappelli A, Paccapelo A, Lucatelli P, Magand N, Rode A, De Baere T. Balloon-Occluded Transarterial Chemoembolization: In Which Size Range Does It Perform Best? A Comparison of Its Efficacy versus Conventional Transarterial Chemoembolization, Using Propensity Score Matching. Liver Cancer 2021; 10:522-534. [PMID: 34721513 PMCID: PMC8529335 DOI: 10.1159/000516613] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 04/15/2021] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION The aim of this multicenter comparison of balloon-occluded transarterial chemoembolization (B-TACE) versus conventional TACE (cTACE) in treating hepatocellular carcinoma (HCC) was to assess in which size range the 2 techniques offered higher complete response (CR) and objective response (OR) rates in a single session, and to evaluate the possibility of using B-TACE to reduce the need for re-treatment. METHODS 325 patients were retrospectively evaluated: 91 patients in the B-TACE group (22 with cTACE [B-cTACE] and 69 with drug-eluting microsphere TACE [B-DEM-TACE]) and 234 in the cTACE group. The results were compared according to tumor size: (A) <30 mm, (B) 30-50 mm, and (C) >50 mm; OR and CR rates after the first session and the number of TACE re-interventions within a 6-month period were also evaluated using propensity score matching (PSM). RESULTS The best target ORs were very high (93.2%) and similar between the 2 treatments both before (94.4% for cTACE and 90.1% for B-TACE) and after PSM (94.5% for cTACE and 90.1%; p = 0.405), with slightly better results for the cTACE cohort probably due to better cTACE effectiveness in smaller lesions. In lesions <30 mm, cTACE obtained a slightly higher CR rate than B-TACE (61.9 vs. 56.3%, p = 0.680), whereas in intermediate-sized HCCs (30-50 mm), B-TACE showed a significant superiority in achieving a CR (72.3 vs. 54.1%, respectively; p = 0.047). In larger lesions (>50 mm), cTACE and B-TACE performed equally, with a poor CR rate (22.6 vs. 23.1%, respectively; p = 1.000). These results were additionally confirmed using PSM. The patients treated with B-TACE had a significantly lower re-treatment rate than the cTACE cohort (12.1 vs. 26.9%, respectively; p = 0.005). B-cTACE and B-DEM-TACE demonstrated similar ORs, with a slightly better CR rate for B-cTACE (68.2 vs. 56.5%, respectively; p = 0.456). CONCLUSION In HCCs of 30-50 mm, B-TACE should be preferred to cTACE, whereas in smaller nodules (<30 mm), cTACE can suffice in achieving a good CR rate. The statistically significant lower re-treatment rate of the B-TACE cohort after a single procedure reduced the risk of complications due to multiple TACE, which could worsen the patient prognosis.
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Affiliation(s)
- Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy,*Rita Golfieri,
| | - Mario Bezzi
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Rome, Italy
| | - Gontran Verset
- Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Fabio Fucilli
- Radiology Unit, “S. De Bellis” National Institute of Gastroenterology Research Hospital, Bari, Italy
| | - Cristina Mosconi
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Alberta Cappelli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Alexandro Paccapelo
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Pierleone Lucatelli
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Rome, Italy
| | - Nicolas Magand
- Diagnostic and Interventional radiology Department, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Agnes Rode
- Diagnostic and Interventional radiology Department, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Thierry De Baere
- Department of Interventional Radiology, Gustave Roussy Cancer Center, Villejuif, France
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Lucatelli P, De Rubeis G, Rocco B, Basilico F, Cannavale A, Abbatecola A, Nardis PG, Corona M, Brozzetti S, Catalano C, Bezzi M. Correction to: Balloon occluded TACE (B-TACE) vs DEM-TACE for HCC: a single center retrospective case control study. BMC Gastroenterol 2021; 21:282. [PMID: 34243723 PMCID: PMC8272269 DOI: 10.1186/s12876-021-01861-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Pierleone Lucatelli
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
| | - Gianluca De Rubeis
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Bianca Rocco
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Fabrizio Basilico
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Alessandro Cannavale
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Aurelio Abbatecola
- Gastroenterology Division, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
| | - Pier Giorgio Nardis
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Mario Corona
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Stefania Brozzetti
- Pietro Valdoni Surgery Department, Sapienza" University of Rome, Rome, Italy
| | - Carlo Catalano
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Mario Bezzi
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
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Brozzetti S, Tancredi M, Bini S, De Lucia C, Antimi J, D’Alterio C, De Sanctis GM, Furlan C, Malpassuti VC, Lucatelli P, Di Martino M, Bezzi M, Ciardi A, Pascale RM. HCC in the Era of Direct-Acting Antiviral Agents (DAAs): Surgical and Other Curative or Palliative Strategies in the Elderly. Cancers (Basel) 2021; 13:3025. [PMID: 34204186 PMCID: PMC8235445 DOI: 10.3390/cancers13123025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 04/29/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 01/10/2023] Open
Abstract
Hepatocellular carcinoma (HCC) accounts for 75-85% of primary liver malignancies, and elderlies have the highest incidence rates. Direct-acting antiviral agents (DAAs) have shown satisfying results in terms of HCV sustained viral response (SVR). However, data regarding HCC risk post-DAA-SVR is still conflicting. This study aims to consider HCC onset in moderate underlying liver disease. We conducted a retrospective study on 227 chronically infected patients (cHCV), treated with DAAs. Patients were divided into three groups: "de novo occurrent HCC", "recurrent HCC", and "without HCC". Fifty-six patients aged <65 years (yDAA) were studied separately. HCC patients aged ≥65 years (DAA-HCC) were compared to a historical group of 100 elderly HCC patients, treated with peginterferon (Peg-IFN) ± ribavirin antiviral agents, non-SVR (hHCC). The HCC prevalence in DAA patients was 32.75%: "de novo occurrent'' 18.13% and "recurrent'' 14.62%, despite 42.85% of them having no fibrosis to mild or moderate fibrosis (F0-F1-F2). yDAA showed 5.36% "de novo occurrent" HCC. Curative procedure rates were compared between DAA-HCC and hHCC at the first and at recurrent presentation (22 (39.29%) vs. 72 (72%); 17 (30.36%) vs. 70 (70%), respectively (p < 0.001)). No significant difference was found in 3-year OS (p = 0.6). However, in cause-specific mortality analysis, HCC-related death was higher in the DAA-treated group, whereas cirrhosis-related death was more common in the historical group (p = 0.0288), considering together the two causes of death. A more accurate patient stratification according to multifactorial and new diagnostic investigations identifying HCC risk might allow an improvement in management and access to curative therapies.
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Affiliation(s)
- Stefania Brozzetti
- Department of Surgery “Pietro Valdoni”, Policlinico Umberto I, University of Rome La Sapienza, 00161 Rome, Italy; (S.B.); (M.T.); (C.D.L.); (J.A.); (C.D.)
| | - Marsia Tancredi
- Department of Surgery “Pietro Valdoni”, Policlinico Umberto I, University of Rome La Sapienza, 00161 Rome, Italy; (S.B.); (M.T.); (C.D.L.); (J.A.); (C.D.)
| | - Simone Bini
- Department of Translational and Precision Medicine, Policlinico Umberto I, University of Rome La Sapienza, 00161 Rome, Italy
| | - Chiara De Lucia
- Department of Surgery “Pietro Valdoni”, Policlinico Umberto I, University of Rome La Sapienza, 00161 Rome, Italy; (S.B.); (M.T.); (C.D.L.); (J.A.); (C.D.)
| | - Jessica Antimi
- Department of Surgery “Pietro Valdoni”, Policlinico Umberto I, University of Rome La Sapienza, 00161 Rome, Italy; (S.B.); (M.T.); (C.D.L.); (J.A.); (C.D.)
| | - Chiara D’Alterio
- Department of Surgery “Pietro Valdoni”, Policlinico Umberto I, University of Rome La Sapienza, 00161 Rome, Italy; (S.B.); (M.T.); (C.D.L.); (J.A.); (C.D.)
| | - Giuseppe Maria De Sanctis
- Department of Tropical and Infectious Diseases, Policlinico Umberto I, University of Rome La Sapienza, 00161 Rome, Italy; (G.M.D.S.); (C.F.)
| | - Caterina Furlan
- Department of Tropical and Infectious Diseases, Policlinico Umberto I, University of Rome La Sapienza, 00161 Rome, Italy; (G.M.D.S.); (C.F.)
| | | | - Pierleone Lucatelli
- Department of Radiological Sciences Policlinico Umberto I, University of Rome La Sapienza, 00161 Rome, Italy; (P.L.); (M.D.M.); (M.B.)
| | - Michele Di Martino
- Department of Radiological Sciences Policlinico Umberto I, University of Rome La Sapienza, 00161 Rome, Italy; (P.L.); (M.D.M.); (M.B.)
| | - Mario Bezzi
- Department of Radiological Sciences Policlinico Umberto I, University of Rome La Sapienza, 00161 Rome, Italy; (P.L.); (M.D.M.); (M.B.)
| | - Antonio Ciardi
- Department of Radiological, Oncological, Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, 00161 Rome, Italy;
| | - Rosa Maria Pascale
- Department of Medical, Surgery and Experimental Sciences, Division of Experimental Pathology and Oncology, University of Sassari, 07100 Sassari, Italy;
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Balestrieri A, Lucatelli P, Suri HS, Montisci R, Suri JS, Wintermark M, Serra A, Cheng X, Jinliang C, Sanfilippo R, Saba L. Volume of White Matter Hyperintensities, and Cerebral Micro-Bleeds. J Stroke Cerebrovasc Dis 2021; 30:105905. [PMID: 34107418 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105905] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 12/07/2020] [Revised: 05/11/2021] [Accepted: 05/15/2021] [Indexed: 11/26/2022] Open
Abstract
PURPOSE In the past years the significance of white matter hyperintensities (WMH) has gained raising attention because it is considered a marker of severity of different pathologies. Another condition that in the last years has been assessed in the neuroradiology field is cerebral microbleeds (CMB). The purpose of this work was to evaluate the association between the volume of WMH and the presence and characteristics of CMB. MATERIAL AND METHODS Sixty-five consecutive (males 45; median age 70) subjects were retrospectively analyzed with a 1.5 Tesla scanner. WMH volume was quantified with a semi-automated procedure considering the FLAIR MR sequences whereas the CMB were studied with the SWI technique and CMBs were classified as absent (grade 1), mild (grade 2; total number of CMBs: 1-2), moderate (grade 3; total number of CMBs: 3-10), and severe (grade 4; total number of CMBs: >10). Moreover, overall number of CMBs and the maximum diameter were registered. RESULTS Prevalence of CMBs was 30.76% whereas WMH 81.5%. Mann-Whitney test showed a statistically significant difference in WMH volume between subjects with and without CMBs (p < 0.001). Pearson analysis showed significant correlation between CMB grade, number and maximum diameter and WMH. The better ROC area under the curve (Az) was obtained by the hemisphere volume with a 0.828 (95% CI from 0.752 to 0,888; SD = 0.0427; p value = 0.001). The only parameters that showed a statistically significant association in the logistic regression analysis were Hemisphere volume of WMH (p = 0.001) and Cholesterol LDL (p = 0.0292). CONCLUSION In conclusion, the results of this study suggest the presence of a significant correlation between CMBs and volume of WMH. No differences were found between the different vascular territories.
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Affiliation(s)
- Antonella Balestrieri
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045, Italy
| | | | - Harman S Suri
- Stroke Diagnosis and Monitoring Division, AtheroPoint™, Roseville, CA, USA; Point-of-Care Devices, Global Biomedical Technologies, Inc., Roseville, CA, USA; Department of Electrical Engineering, University of Idaho (Affl.), ID, USA
| | - Roberto Montisci
- Department of Vascular Surgery, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato, s.s. 554 Monserrato Cagliari 09045, Italy
| | - Jasjit S Suri
- Stroke Diagnosis and Monitoring Division, AtheroPoint™, Roseville, CA, USA; Point-of-Care Devices, Global Biomedical Technologies, Inc., Roseville, CA, USA; Department of Electrical Engineering, University of Idaho (Affl.), ID, USA
| | | | - Alessandra Serra
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045, Italy
| | | | - Cheng Jinliang
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
| | - Roberto Sanfilippo
- Department of Vascular Surgery, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato, s.s. 554 Monserrato Cagliari 09045, Italy
| | - Luca Saba
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045, Italy.
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20
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Kitrou PM, Steinke T, El Hage R, Ponce P, Lucatelli P, Katsanos K, Spiliopoulos S, Spinelli A, Bisdas T, Stavroulakis K, Jaffer O, Mallios A, Zilahi de Gyurgyokai S, Cancellieri R, Coscas R, Karnabatidis D. Paclitaxel-Coated Balloons for the Treatment of Symptomatic Central Venous Stenosis in Vascular Access: Results From a European, Multicenter, Single-Arm Retrospective Analysis. J Endovasc Ther 2021; 28:442-451. [PMID: 33834905 DOI: 10.1177/15266028211007471] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION This was a European, multicenter, investigator-initiated and run, single-arm retrospective analysis to assess the safety and the clinical benefit of the use of paclitaxel-coated balloon (PCB) for the treatment of symptomatic central venous stenosis (CVS). MATERIALS AND METHODS Eleven centers from 7 countries across Europe, submitted 86 cases performed during the period between October 2015 and June 2018. Minimum follow-up was 6 months. Patient baseline demographics and procedural details were collected. Mean age was 62.6 years (SD 15.2 years). Median vascular access age was 3.0 years (IQR 1.2-4.8 years). A total of 55 were arteriovenous fistulas (64%) the rest arteriovenous grafts (31/86, 36%). Vessels treated were 43 subclavian veins, 42 brachiocephalic veins and 1 superior vena cava. Median drug-coated balloon diameter was 10 mm (IQR 8-12 mm). Primary outcome measures were clinically assessed intervention-free period (IFP) of the treated segment at 6 months and procedure-related minor and major complications. Secondary outcome measures included access circuit survival, patient survival, and the investigation of independent factors that influence the IFP. RESULTS IFP was 62.7% at 6 months. Median patient follow-up time was 1.0 year (IQR 0.5-2.2 years). There was 1 minor complication (1/86; 1.2%) and no major complications. Access circuit survival was 87.7% at 6 months. Patient survival was 79.7% at 2 years according to Kaplan-Meier survival analysis. Higher balloon diameters significantly favored IFP [HR 0.71 (0.55-0.92), p=0.006; 5-7 mm group vs 8-12 mm group, p=0.025]. CONCLUSION In this analysis, use of PCBs for the treatment of symptomatic CVS was safe. Efficacy was comparable to previous trials. Increased balloon size had a significant effect on patency rates.
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Affiliation(s)
| | - Tobias Steinke
- Fachzentrum für Gefäßchirurgie, Schön Klinik Düsseldorf SE & Co. KG, Düsseldorf, Germany
| | - Rami El Hage
- Vasular Surgery, Paris Saint Joseph Hospital, Paris, France
| | - Pedro Ponce
- Fresenius Medical Care Portugal/Nephrocare, Lisbon, Portugal
| | - Pierleone Lucatelli
- Vascular and Interventional Radiology Unit, Department of Radiological Oncological and Anatomopathological Sciences, Sapienza University of Rome, Italy
| | | | - Stavros Spiliopoulos
- Second Department of Radiology, Interventional Radiology Unit, School of Medicine, National and Kapodistrian University of Athens, "Attikon" University General Hospital, Athens, Greece
| | - Alessio Spinelli
- U.O.S.D. of Interventional Radiology, Hospital "S. Eugenio" Rome, ASL Roma, Italy
| | - Theodosios Bisdas
- Third Clinic of Vascular Surgery, Athens Medical Center, Athens, Greece
| | - Konstantinos Stavroulakis
- Department of Vascular and Endovascular Surgery, Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Ounali Jaffer
- Department of Diagnostic and International Radiology, Barts NHS Trust, Royal London Hospital, London, UK
| | | | - Simone Zilahi de Gyurgyokai
- Vascular and Interventional Radiology Unit, Department of Radiological Oncological and Anatomopathological Sciences, Sapienza University of Rome, Italy
| | - Roberto Cancellieri
- Vascular and Interventional Radiology Unit, Department of Radiological Oncological and Anatomopathological Sciences, Sapienza University of Rome, Italy
| | - Raphael Coscas
- Department of Vascular Surgery, Ambroise Paré University Hospital, Boulogne-Billancourt, France
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21
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Ruffino MA, Fronda M, Bergamasco L, Natrella M, Fanelli G, Bellosta R, Pegorer M, Attisani L, Ruggiero M, Malfa P, Patane' D, Lucatelli P, Corona M, Ricci C, Candeloro L, Ferri M, Varello S, Gibello L, Veraldi GF, Mezzetto L, Fonio P. Prognostic risk factors for loss of patency after femoropopliteal bailout stenting with dual-component stent: results from the TIGRIS Italian Multicenter Registry. Radiol Med 2021; 126:1129-1137. [PMID: 34057667 DOI: 10.1007/s11547-021-01373-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 06/30/2020] [Accepted: 05/12/2021] [Indexed: 01/20/2023]
Abstract
PURPOSE To identify the risk factors associated with patency loss after bailout stenting with third-generation hybrid heparin-bonded nitinol stent of the femoropopliteal segment. METHODS Prospective, multicenter, single-arm registry including 156 patients (50 females, mean age 72 ± 11 years) subjected, from February 2017 to December 2018, to provisional stenting with Gore Tigris vascular stent of the distal superficial femoral artery, with or without involvement of the popliteal artery, in 9 different centers. The 194 lesions, with Rutherford score ≥ 3, were stented in case of recoil, dissection or residual stenosis not responding to percutaneous trans-luminal angioplasty (PTA). The follow-up (FU) was performed with clinical evaluation and duplex ultrasound (DUS) at 1, 6 and 12 months. RESULTS The primary patency rate was 99(95%CI 98-100)% at 1 month, 86(80-92)% at 6 months and 81(74-88)% at-12 months. After patency loss, 13/23 (56.5%) patients were re-treated, yielding a primary assisted patency of 91(86-96)% at 6 months and 88(82-94)% at 12 months and a secondary patency of 94(90-98)% at 6 months and 90(84-95)% at 12 months. Rutherford score ≥ 4 (p = 0.03) and previous severe treatments (p = 0.01) were identified as risk factors for early patency loss during FU. The involvement of the popliteal artery was not an independent risk factor for loss of patency. CONCLUSIONS The bailout stenting of the femoropopliteal segment with third-generation nitinol stents is a safe and effective option in case of recoil, dissection or residual stenosis not responding to PTA. Critical limb ischemia and history of previous major treatment at the same level are significant prognostic factors for patency loss during FU.
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Affiliation(s)
- Maria Antonella Ruffino
- Department of Diagnostic Imaging and Radiotherapy, Vascular Radiology, A.O.U. Città Della Salute e Della Scienza di Torino, Corso Bramante 88, Turin, Italy
| | - Marco Fronda
- Radiology Unit, Department of Surgical Sciences, A.O.U. Città Della Salute e Della Scienza di Torino, Via Genova 3, Turin, Italy.
| | - Laura Bergamasco
- Department of Surgical Sciences, University of Turin-A.O.U. Città della Salute e della Scienza di Torino, Via Genova 3, Turin, Italy
| | - Massimiliano Natrella
- Department of Diagnostic and Interventional Radiology, Interventional Radiology, U. Parini Hospital, Via Ginevra 3, Aosta, Italy
| | - Gianluca Fanelli
- Department of Diagnostic and Interventional Radiology, Interventional Radiology, U. Parini Hospital, Via Ginevra 3, Aosta, Italy
| | - Raffaello Bellosta
- Cardiovascular Department, Vascular and Endovascular Surgery, Poliambulanza Foundation Hospital, Via Bissolati 57, Brescia, Italy
| | - Matteo Pegorer
- Cardiovascular Department, Vascular and Endovascular Surgery, Poliambulanza Foundation Hospital, Via Bissolati 57, Brescia, Italy
| | - Luca Attisani
- Cardiovascular Department, Vascular and Endovascular Surgery, Poliambulanza Foundation Hospital, Via Bissolati 57, Brescia, Italy
| | - Massimo Ruggiero
- Endovascular Surgery-Vascular Surgery Unit, ASL BR1-Ospedale "A. Perrino", Strada per lo Spada 5, Brindisi, Italy
| | - Pierantonio Malfa
- UOC Diagnostic Imaging and Interventional Radiology, A.O. Per L'emergenza "Cannizzaro", Via Messina 829, Catania, Italy
| | - Domenico Patane'
- UOC Diagnostic Imaging and Interventional Radiology, A.O. Per L'emergenza "Cannizzaro", Via Messina 829, Catania, Italy
| | - Pierleone Lucatelli
- Department of Radiological Oncological and Anatomo-Pathological Sciences, Vascular and Interventional Radiology, Sapienza University of Rome, Viale del Policlinico 155, Roma, Italy
| | - Mario Corona
- Department of Radiological Oncological and Anatomo-Pathological Sciences, Vascular and Interventional Radiology, Sapienza University of Rome, Viale del Policlinico 155, Roma, Italy
| | - Carmelo Ricci
- Interventional Radiology Unit, Radiology Department, A.O.U. Senese, Viale Bracci 16, Siena, Italy
| | - Laura Candeloro
- Interventional Radiology Unit, Radiology Department, A.O.U. Senese, Viale Bracci 16, Siena, Italy
| | - Michelangelo Ferri
- S.C. Vascular and Endovascular Surgery, Ospedale Umberto I, Largo Filippo Turati 62, Turin, Italy
| | - Sara Varello
- Radiology Unit, Department of Surgical Sciences, A.O.U. Città Della Salute e Della Scienza di Torino, Via Genova 3, Turin, Italy
| | - Lorenzo Gibello
- Vascular Surgery Unit, Department of Surgical Sciences, University of Torino-A.O.U. Città Della Salute E Della Scienza Di Torino, Corso Bramante 88, Turin, Italy
| | - Gian Franco Veraldi
- Department of Vascular Surgery, Integrated University Hospital of Verona, Piazzale Aristide Stefani 1, Verona, Italy
| | - Luca Mezzetto
- Department of Vascular Surgery, Integrated University Hospital of Verona, Piazzale Aristide Stefani 1, Verona, Italy
| | - Paolo Fonio
- Radiology Unit, Department of Surgical Sciences, A.O.U. Città Della Salute e Della Scienza di Torino, Via Genova 3, Turin, Italy
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22
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Cannavale A, Nardis P, Lucatelli P, Corona M, Santoni M, Cannavale G, Teodoli L, Bezzi M, Catalano C. Percutaneous spine biopsy under cone beam computed tomography guidance for spondylodiscitis: Time is diagnosis. Neuroradiol J 2021; 34:607-614. [PMID: 34028300 DOI: 10.1177/19714009211017799] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND AND PURPOSE Percutaneous spine biopsies for spondylodiscitis have been long discussed due to the low microbiologic yield. This retrospective study evaluated factors of cone beam computed tomography-guided spine biopsies that may affect microbiologic yield. METHODS We retrospectively reviewed percutaneous spine biopsies under cone beam computed tomography for spondylodiscitis performed from January 2015-December 2020. Clinical and technical features such as the time from initial symptoms to biopsy, level biopsied, biopsy needle type/gauge, technical approach, radiation dose, technical success and microbiologic yield were recorded. Pre-procedure magnetic resonance imaging findings were also recorded such as the number of vertebral bodies involved, and disc morphology. Univariate logistic regression analysis and Receiver operating characteristic analysis were performed to assess any relationship between relevant factors and positive cultures. RESULTS A total of 50 patients underwent cone beam computed tomography-guided biopsies for spondylodiscitis, with resulted positive cultures in 18 patients (36%). The mean time from the initial referral of spinal symptoms to procedure in the positive culture group was the most influential finding for positive cultures (odds ratio 56.3, p < 0.001). Among magnetic resonance imaging findings, thin or degenerated intervertebral disc was a negative factor for positive cultures (odds ratio 0.09, p = 0.006). Univariate analysis showed that percutaneous approach (transpedicular vs posterolateral/interlaminar) needle size (11-13 g vs 16-18G, odds ratio 1.2, p = 0.7) and site of biopsy (disc vs bone vs disc plus endplate) did not significantly affect the microbiologic yield of spine biopsy. CONCLUSION Percutaneous cone beam computed tomography-guided biopsy for spondylodiscitis is a reliable and safe technique and its microbiologic yield may increase if biopsy is performed within the acute phase of infection.
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Affiliation(s)
| | - Piergiorgio Nardis
- Department of Radiological Sciences, Umberto I Policlinico di Roma, Italy
| | | | - Mario Corona
- Department of Radiological Sciences, Umberto I Policlinico di Roma, Italy
| | - Mariangela Santoni
- Department of Radiological Sciences, Umberto I Policlinico di Roma, Italy
| | - Giuseppe Cannavale
- Department of Radiological Sciences, Umberto I Policlinico di Roma, Italy
| | - Leonardo Teodoli
- Department of Radiological Sciences, Umberto I Policlinico di Roma, Italy
| | - Mario Bezzi
- Department of Radiological Sciences, Umberto I Policlinico di Roma, Italy
| | - Carlo Catalano
- Department of Radiological Sciences, Umberto I Policlinico di Roma, Italy
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Shao G, Zou Y, Lucatelli P, Tsilimigras DI, Shimise S, Kawaguchi T. Chinese expert consensus on technical recommendations for the standard operation of drug-eluting beads for transvascular embolization. Ann Transl Med 2021; 9:714. [PMID: 33987412 PMCID: PMC8106009 DOI: 10.21037/atm-21-1678] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Liver cancer is among the 10 most common tumors globally. In China, liver cancer ranks 4th for prevalence and 3rd for mortality among all malignant tumors. With respect to the treatment of primary liver cancer, there are a number of therapies currently available, including surgical resection, liver transplantation, ablation, transarterial chemoembolization (TACE), systemic chemotherapy, radiation therapy, targeted drug therapy and immunotherapy. Clinical practice and research have shown that, compared with conventional TACE (cTACE), drug-eluting bead TACE (DEB-TACE) can achieve a higher response rate and longer survival time in patients with primary liver cancer. Compared with that of cTACE, DEB-TACE has more favorable basic conditions for achieving uniformity, which could facilitate the standardization of operation techniques. China is the country with the highest incidence of primary liver cancer, accounting for more than 50% of the global patients, and its etiology and epidemiology in Chinese patients differ from those in Europeans and Americans. Therefore, experts in China have drafted these technical recommendations for the standard operation of drug-eluting beads for the treatment of liver cancer on the basis of accumulated abundant clinical experience and evidence-based medical data.
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Affiliation(s)
- Guoliang Shao
- Department of Intervention, Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China
| | - Yinghua Zou
- Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, China
| | - Pierleone Lucatelli
- Vascular and Interventional Radiology Unit, Sapienza University of Rome, Rome, Italy
| | - Diamantis I Tsilimigras
- Department of Surgery, Division of Surgical Oncology, The Ohio State University, Wexner Medical Center, Columbus, OH, USA
| | - Shigeo Shimise
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Takumi Kawaguchi
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
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24
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Golfieri R, Bezzi M, Verset G, Fucilli F, Mosconi C, Cappelli A, Paccapelo A, Lucatelli P, Magand N, Rode A, De Baere T. Retrospective European Multicentric Evaluation of Selective Transarterial Chemoembolisation with and without Balloon-Occlusion in Patients with Hepatocellular Carcinoma: A Propensity Score Matched Analysis. Cardiovasc Intervent Radiol 2021; 44:1048-1059. [PMID: 33709273 PMCID: PMC8189964 DOI: 10.1007/s00270-021-02805-5] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 02/10/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE The aim of this retrospective multicentric study was to compare the tumour response rates of Balloon-occluded Transarterial Chemoembolisation (B-TACE) to non-B-TACE using propensity score matching (PSM) in patients with hepatocellular carcinoma and to investigate the clinical benefit, such as lower rates of TACE re-intervention achieved using B-TACE. MATERIAL AND METHODS The B-TACE procedures (n = 96 patients) were compared with a control group of non-B-TACE treatments (n = 434 pts), performed with conventional (cTACE) or drug-eluting microspheres TACE (DEM-TACE). Data were collected from six European centres from 2015 to 2019. Objective responses (OR) and complete response (CR) rates after the first session and the number of TACE re-interventions were evaluated using PSM (91 patients per arm). RESULTS The best target OR after PSM were similar for both B-TACE and non-B-TACE (90.1% and 86.8%, p = 0.644); however, CR at 1-6 months was significantly higher for B-TACE (59.3% vs. 41.8%, p = 0.026). Patients treated with B-TACE had a significantly lower retreatment rate during the first 6 months (9.9%% vs. 22.0%, p = 0.041). Post-embolisation syndrome (PES) rates were 8.8% in non-B-TACE and 41.8% in B-TACE (p < 0.001), with no significant differences between groups regarding major adverse events. CONCLUSION B-TACE is safe and effective, achieving higher CR rates than non-B-TACE. Patients undergoing B-TACE had a significantly lower retreatment rate within the first 6 months but higher PES rates. LEVEL OF EVIDENCE III Level 3, retrospective study.
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Affiliation(s)
- Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, via Albertoni 15, 40138, Bologna, Italy. .,Università Degli Studi Di Bologna, Bologna, Italy.
| | - Mario Bezzi
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Rome, Italy
| | - Gontran Verset
- Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Fabio Fucilli
- Radiology Unit, S. De Bellis National Institute of Gastroenterology Research Hospital, Castellana Grotte (BARI), Bari, Italy
| | - Cristina Mosconi
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, via Albertoni 15, 40138, Bologna, Italy
| | - Alberta Cappelli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, via Albertoni 15, 40138, Bologna, Italy
| | - Alexandro Paccapelo
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, via Albertoni 15, 40138, Bologna, Italy
| | - Pierleone Lucatelli
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Rome, Italy
| | - Nicolas Magand
- Diagnostic and Interventional Radiology Department, Croix Rousse Hospital, Hospices Civils de, Lyon, France
| | - Agnes Rode
- Diagnostic and Interventional Radiology Department, Croix Rousse Hospital, Hospices Civils de, Lyon, France
| | - Thierry De Baere
- Department of Interventional Radiology, Gustave Roussy Cancer Center, Villejuif, France
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25
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Lucatelli P, Corona M, Teodoli L, Nardis P, Cannavale A, Rocco B, Trobiani C, Cipollari S, Zilahi de Gyurgyokai S, Bezzi M, Catalano C. Use of Phil Embolic Agent for Bleeding in Non-Neurological Interventions. J Clin Med 2021; 10:jcm10040701. [PMID: 33670124 PMCID: PMC7916888 DOI: 10.3390/jcm10040701] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 12/31/2020] [Revised: 02/03/2021] [Accepted: 02/04/2021] [Indexed: 01/26/2023] Open
Abstract
Objective: To evaluate the safety and efficacy of the Phil liquid embolic agent in non-neurological embolization procedures. M&M: Thirty-five patients with a mean age of 62.5 years underwent percutaneous embolization using Phil for the treatment of visceral arterial bleedings in 20/35 patients (including three gluteal, one bladder, two superior mesenteric, three epigastric, one deep femoral, five internal iliac, four intercostal, and one lingual arteries), splanchnic pseudoaneurysms in 11/35 patients (including three hepatic, five splenic, and three renal arteries), pancreatic bleeding metastasis in 1/35 patient, and gastric bleeding varices in 3/35 patients. Phil is composed of a non-adhesive copolymer dissolved in DMSO (Anhydrous Dimethyl Sulfoxide) with different viscosity. Procedures were performed slowly under continuous fluoroscopic guidance to avoid embolization of non-target vessels. Results: Clinical success was obtained with a single intervention in 34 cases (97.15%), while a repeated procedure was required in one case (2.85%). No technical complications nor non-target embolization occurred. A case of post-embolic syndrome was noted (2.85%) in one patient. DMSO administration-related pain was successfully controlled by medical therapy. Conclusion: Phil can be considered a safe and effective embolic agent for the treatment of non-neurologic bleeding.
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Lucatelli P, De Rubeis G, Rocco B, Basilico F, Cannavale A, Abbatecola A, Nardis PG, Corona M, Brozzetti S, Catalano C, Bezzi M. Balloon occluded TACE (B-TACE) vs DEM-TACE for HCC: a single center retrospective case control study. BMC Gastroenterol 2021; 21:51. [PMID: 33535972 PMCID: PMC7860015 DOI: 10.1186/s12876-021-01631-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 01/27/2021] [Indexed: 01/27/2023] Open
Abstract
Background To compare oncological results and safety profile of balloon micro-catheter trans-arterial chemoembolization (b-TACE) and drug-eluting-microsphere (DEM-TACE) in patients with hepatocellular-carcinoma (HCC).
Methods This is a case–control, retrospective, single-center study. Between January-2015/March-2019, 149 patients (131 males [87.9%]) with 226 HCC were treated, 22 patients (35 HCC; 19 [86.4%] males) with b-TACE and 127 with DEM-TACE (191 HCC, 112 [88.2%] males). Embolization protocol was standardized (sequential 100 ± 25 and 200 ± 25 μm microspheres). Results were evaluated by modified-response-evaluation-criteria-in-solid-tumor [mRECIST] at 1, 3–6 and 9–12 months and time to recurrence after complete response [TTR] at 1 years. Cox’s regression weighted with tumor dimensions was performed. Adverse events (AEs) were recorded. Results mRECIST oncological response at all time points (1, 3–6 and 9–12 months) for both treatments were similar, with the exception of Objective response rate at 9-12 months. Objective response at 1 and 3–6 months between b-TACE vs DEM-TACE [23/35 (65.7%) vs 119/191 (62.3%), 21/29 (72.4%) vs 78/136 (57.4%) (p > 0.05), respectively]. On the contrary, at 9–12 months, it was significantly higher in b-TACE subgroup than DEM-TACE (15/19 [78.9%] vs 48/89 [53.9%], p = 0.05). TTR for complete response at 1 year had a better trend for b-TACE vs DEM-TACE (278.0 days [196.0–342.0] vs 219.0 days [161.0–238.0], OR 0.68 [0.4–1.0], p = 0.10). The use of balloon micro-catheter reduced the relative risk of the event of recurrence by 0.63 [CI95% 0.38–1.04]; p = 0.07). No significant differences were found in AEs rate. Conclusion b-TACE showed a trend of better oncological response over DEM-TACE with and longer TTR with a similar adverse events rate, in patients presenting with larger tumors.
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Affiliation(s)
- Pierleone Lucatelli
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
| | - Gianluca De Rubeis
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Bianca Rocco
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Fabrizio Basilico
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Alessandro Cannavale
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Aurelio Abbatecola
- Gastroenterology Division, Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
| | - Pier Giorgio Nardis
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Mario Corona
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Stefania Brozzetti
- Pietro Valdoni Surgery Department, Sapienza" University of Rome, Rome, Italy
| | - Carlo Catalano
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Mario Bezzi
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
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Lucatelli P, Rocco B, Nardis PG, Cannavale A, Bezzi M, Catalano C, Corona M. Bleeding in COVID Patients: What We Have Understood So Far. Cardiovasc Intervent Radiol 2021; 44:666-668. [PMID: 33511426 PMCID: PMC7843001 DOI: 10.1007/s00270-021-02775-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 01/13/2021] [Indexed: 12/15/2022]
Affiliation(s)
- Pierleone Lucatelli
- Vascular and Interventional Radiology Unit, Department of Radiological Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy.
| | - Bianca Rocco
- Vascular and Interventional Radiology Unit, Department of Radiological Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy
| | - Pier Giorgio Nardis
- Vascular and Interventional Radiology Unit, Department of Radiological Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy
| | - Alessandro Cannavale
- Vascular and Interventional Radiology Unit, Department of Radiological Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy
| | - Mario Bezzi
- Vascular and Interventional Radiology Unit, Department of Radiological Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy
| | - Carlo Catalano
- Vascular and Interventional Radiology Unit, Department of Radiological Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy
| | - Mario Corona
- Vascular and Interventional Radiology Unit, Department of Radiological Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Viale Regina Elena, 324, 00161, Rome, Italy
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Tipaldi MA, Pisano A, Krokidis M, Laurino F, Corradini LG, Lucatelli P, Venturini M, Laghi A, Rossi M. Extravascular Migration of Thrombosed Covered Stents after Endovascular Exclusion of Splenic or Hepatic Artery Aneurysms and Pseudoaneurysms: An Underestimated Phenomenon. J Vasc Interv Radiol 2020; 32:317-320. [PMID: 33272816 DOI: 10.1016/j.jvir.2020.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 10/07/2020] [Accepted: 10/08/2020] [Indexed: 10/22/2022] Open
Affiliation(s)
- Marcello Andrea Tipaldi
- Department of Surgical and Medical Sciences, and Translational Medicine, School of Medicine, and Psychology, Sapienza University of Rome, Rome, Italy
| | - Andrea Pisano
- Department of Surgical and Medical Sciences, and Translational Medicine, School of Medicine, and Psychology, Sapienza University of Rome, Rome, Italy
| | - Miltiadis Krokidis
- National and Kapodistrian University of Athens, Areteion Hospital, Athens, Greece
| | - Florindo Laurino
- Department of Surgical and Medical Sciences, and Translational Medicine, School of Medicine, and Psychology, Sapienza University of Rome, Rome, Italy
| | | | | | - Massimo Venturini
- Department of Radiology, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Hospital, Vita-Salute University, Via Olgettina 60, 20132, Milan, Italy
| | - Andrea Laghi
- Department of Surgical and Medical Sciences, and Translational Medicine, School of Medicine, and Psychology, Sapienza University of Rome, Rome, Italy
| | - Michele Rossi
- Department of Surgical and Medical Sciences, and Translational Medicine, School of Medicine, and Psychology, Sapienza University of Rome, Rome, Italy
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Lucatelli P, Iezzi R, De Rubeis G, Goldberg SN, Bilbao JI, Sami A, Akhan O, Giuliante F, Pompili M, Tagliaferri L, Valentini V, Gasbarrini A, Colosimo C, Bezzi M, Manfredi R. Immuno-oncology and interventional oncology: a winning combination. The latest scientific evidence. Eur Rev Med Pharmacol Sci 2020; 23:5343-5350. [PMID: 31298386 DOI: 10.26355/eurrev_201906_18201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Interventional oncology (IO) is an emergent field in interventional radiology that can be considered the fourth pillar of oncology. Interventional oncology has the unique capability to treat malignancy in a loco-regional fashion enabling curative (percutaneous ablation), disease stabilization (intra-arterial chemo/radioembolization), and palliative treatment (such as biliary drainage or nephrostomy). The whole arsenal of IO acts by inducing necrosis and apoptosis, with interactions with the tumour's microenvironment potentially crucial for oncological outcomes. Considering that tumour's microenvironment is a pivotal target for both immuno-oncology and interventional-oncology, the interactions between these two anti-tumour weapons must be investigated to understand their synergy. Interestingly, substantial efforts have been directed to understand which technique combinations are best for specific tumours. This review article summarizes the latest scientific evidence highlighting the future prospective of this winning combination, integrating evidence-reported literature and experience-based perceptions.
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Affiliation(s)
- P Lucatelli
- Department of Radiological, Oncological and Anatomopathological Sciences, Interventional and Vascular Division, "Sapienza" University of Rome, Rome, Italy.
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Medda E, Fagnani C, Alessandri G, Baracchini C, Hernyes A, Lucatelli P, Pucci G, Tarnoki AD, Tarnoki DL, Stazi MA. Association between personality profile and subclinical atherosclerosis: The role of genes and environment. Int J Cardiol 2020; 316:236-239. [PMID: 32442593 DOI: 10.1016/j.ijcard.2020.05.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 04/30/2020] [Accepted: 05/13/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND The mechanism underlying the association between personality profile and subclinical atherosclerosis is poorly understood. This study explores the association between personality, carotid atherosclerosis and arterial stiffness, and the contribution of genes and environment to this association. METHODS Early atherosclerotic traits, including carotid intima-media thickness (CCA-IMT), aortic pulse wave velocity (PWVao) and heart rate, were assessed in 318 adult twins, who also completed a Big Five personality questionnaire. Using the co-twin control approach, the association between intra-pair differences in clinical and personality scores was assessed in dizygotic (DZ) and monozygotic (MZ) twins separately. RESULTS An association between CCA-IMT and extroverted personality, as well as between PWVao and openness to experience was detected. The inverse association between CCA-IMT and extraversion was persistent in DZ and disappeared in MZ twins, suggesting genetic confounding. In contrast, the association between PWVao and openness to experience was of the same magnitude in DZ and MZ twins, thus surviving the adjustment for genetic and shared environmental factors. CONCLUSIONS This study highlights that the association between some psychological factors and cardiovascular traits may be partly explained by genetic factors. This result may provide support for the feasibility of prevention programs based on assessing familiarity for personality disorders to detect genetic risk for subclinical cardiovascular disease.
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Affiliation(s)
- Emanuela Medda
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
| | - Corrado Fagnani
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
| | - Guido Alessandri
- Department of Psychology, University of Rome "Sapienza", Via dei Marsi 78, 00185 Rome, Italy.
| | - Claudio Baracchini
- Department of Neuroscience, University of Padua School of Medicine, Via Giustiniani 5, 35128 Padua, Italy
| | - Anita Hernyes
- Medical Imaging Centre, Semmelweis University, Üllői út 26, H-1085 Budapest, Hungary
| | - Pierleone Lucatelli
- Department of Radiological Oncological and Anatomo-Pathological Sciences, University of Rome "Sapienza", Viale del Policlinico 155, 00161 Rome, Italy
| | - Giacomo Pucci
- Department of Medicine, University of Perugia, Piazzale Tristano di Joannuccio, 1, Terni, Italy
| | - Adam D Tarnoki
- Medical Imaging Centre, Semmelweis University, Üllői út 26, H-1085 Budapest, Hungary
| | - David L Tarnoki
- Medical Imaging Centre, Semmelweis University, Üllői út 26, H-1085 Budapest, Hungary
| | - Maria Antonietta Stazi
- Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
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Lucatelli P, Del Monte M, De Rubeis G, Cundari G, Francone M, Panebianco V, Catalano C. Did we turn a blind eye? The answer is simply there. Peripheral pulmonary vascular thrombosis in COVID-19 patients explains sudden worsening of clinical conditions. Imaging 2020. [DOI: 10.1556/1647.2020.00002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
AbstractCOVID-19 patients suffering sudden worsening of clinical conditions have an atypical peripheral pulmonary arterial obstruction at computed tomography pulmonary angiogram (CTPA), poorly associated to deep venous thrombosis (DVT), suspicious for thrombotic in situ nature rather than embolic.
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Affiliation(s)
- Pierleone Lucatelli
- Department of Radiological, Oncological and Pathological Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Maurizio Del Monte
- Department of Radiological, Oncological and Pathological Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Gianluca De Rubeis
- Department of Radiological, Oncological and Pathological Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Giulia Cundari
- Department of Radiological, Oncological and Pathological Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Marco Francone
- Department of Radiological, Oncological and Pathological Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Valeria Panebianco
- Department of Radiological, Oncological and Pathological Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Carlo Catalano
- Department of Radiological, Oncological and Pathological Sciences, “Sapienza” University of Rome, Rome, Italy
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Murgia A, Balestrieri A, Francone M, Lucatelli P, Scapin E, Buckler A, Micheletti G, Faa G, Conti M, Suri JS, Guglielmi G, Carriero A, Saba L. Plaque imaging volume analysis: technique and application. Cardiovasc Diagn Ther 2020; 10:1032-1047. [PMID: 32968659 PMCID: PMC7487381 DOI: 10.21037/cdt.2020.03.01] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 12/23/2019] [Accepted: 02/15/2020] [Indexed: 12/12/2022]
Abstract
The prevention and management of atherosclerosis poses a tough challenge to public health organizations worldwide. Together with myocardial infarction, stroke represents its main manifestation, with up to 25% of all ischemic strokes being caused by thromboembolism arising from the carotid arteries. Therefore, a vast number of publications have focused on the characterization of the culprit lesion, the atherosclerotic plaque. A paradigm shift appears to be taking place at the current state of research, as the attention is gradually moving from the classically defined degree of stenosis to the identification of features of plaque vulnerability, which appear to be more reliable predictors of recurrent cerebrovascular events. The present review will offer a perspective on the present state of research in the field of carotid atherosclerotic disease, focusing on the imaging modalities currently used in the study of the carotid plaque and the impact that such diagnostic means are having in the clinical setting.
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Affiliation(s)
- Alessandro Murgia
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari – Polo di Monserrato, s.s. 554 Monserrato (Cagliari) 09045, Italy
| | - Antonella Balestrieri
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari – Polo di Monserrato, s.s. 554 Monserrato (Cagliari) 09045, Italy
| | - Marco Francone
- Department of Radiological, Oncological and Anatomopathological Sciences-Radiology, ‘Sapienza’ University of Rome, Rome, Italy
| | - Pierleone Lucatelli
- Department of Radiological, Oncological and Anatomopathological Sciences-Radiology, ‘Sapienza’ University of Rome, Rome, Italy
| | - Elisa Scapin
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari – Polo di Monserrato, s.s. 554 Monserrato (Cagliari) 09045, Italy
| | | | - Giulio Micheletti
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari – Polo di Monserrato, s.s. 554 Monserrato (Cagliari) 09045, Italy
| | - Gavino Faa
- Department of Pathology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari – Polo San Giovanni di Dio, Cagliari (Cagliari) 09045, Italy
| | - Maurizio Conti
- Diagnostic and Monitoring Division, AtheroPoint™ LLC, Roseville, CA, USA
- Department of Electrical Engineering, U of Idaho (Affl.), Idaho, USA
| | - Jasjit S. Suri
- Diagnostic and Monitoring Division, AtheroPoint™ LLC, Roseville, CA, USA
- Department of Electrical Engineering, U of Idaho (Affl.), Idaho, USA
| | | | - Alessandro Carriero
- Department of Radiology, Maggiore della Carità Hospital, Università del Piemonte Orientale, Novara, Italy
| | - Luca Saba
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari – Polo di Monserrato, s.s. 554 Monserrato (Cagliari) 09045, Italy
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Cannavale A, Lucatelli P, Corona M, Nardis P, Cannavale G, De Rubeis G, Santoni M, Maher B, Catalano C, Bezzi M. Current assessment and management of endoleaks after advanced EVAR: new devices, new endoleaks? Expert Rev Cardiovasc Ther 2020; 18:465-473. [PMID: 32634069 DOI: 10.1080/14779072.2020.1792294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
INTRODUCTION In recent years there has been an increasing application of advanced EVAR techniques to tackle complex clinical and anatomical scenarios. In a bid to overcome the limitations of the traditional stent-grafts, newer EVAR endografts and techniques have been developed and introduced into clinical practice, permitting endovascular management of difficult infrarenal, juxta-renal and thoracoabdominal aneurysms for which previously there was no endovascular solution. As a consequence, we are now confronted with unique patterns of endoleak requiring customized clinical-radiological assessment and treatment. Despite the increasing body of evidence regarding new EVAR techniques and related endoleaks, current guidelines do not specifically address these issues. OBJECTIVES Our review aims to assess risk factors, development, and management strategies of these endoleaks, in the most recent infrarenal EVAR devices and in more complex fenestrated EVAR (FEVAR) and Chimney EVAR (Ch-EVAR). EXPERT OPINION Most new devices have demonstrated types of endoleaks that need specific imaging and treatment, as in EVAS, FEVAR, and ChEVAR. Knowledge of specific stent-graft characteristics and the nature of endoleaks associated with the various procedures facilitates the application of relevant useful imaging. In addition, it should aid development of a customized and practically relevant approach to patient management during intervention and follow-up.
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Affiliation(s)
- Alessandro Cannavale
- Vascular and Interventional Unit, Department of Radiological Sciences, Policlinico Umberto I, "Sapienza" University of Rome , Rome, Italy
| | - Pierleone Lucatelli
- Vascular and Interventional Unit, Department of Radiological Sciences, Policlinico Umberto I, "Sapienza" University of Rome , Rome, Italy
| | - Mario Corona
- Vascular and Interventional Unit, Department of Radiological Sciences, Policlinico Umberto I, "Sapienza" University of Rome , Rome, Italy
| | - Piergiorgio Nardis
- Vascular and Interventional Unit, Department of Radiological Sciences, Policlinico Umberto I, "Sapienza" University of Rome , Rome, Italy
| | - Giuseppe Cannavale
- Department of Radiological Sciences, "Sapienza" University of Rome , Rome, Italy
| | - Gianluca De Rubeis
- Vascular and Interventional Unit, Department of Radiological Sciences, Policlinico Umberto I, "Sapienza" University of Rome , Rome, Italy
| | - Mariangela Santoni
- Department of Radiological Sciences, "Sapienza" University of Rome , Rome, Italy
| | - Ben Maher
- Department of Interventional Radiology, University Hospital Southampton NHS Foundation Trust , Southampton, UK
| | - Carlo Catalano
- Department of Radiological Sciences, "Sapienza" University of Rome , Rome, Italy
| | - Mario Bezzi
- Vascular and Interventional Unit, Department of Radiological Sciences, Policlinico Umberto I, "Sapienza" University of Rome , Rome, Italy
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Lucatelli P, De Rubeis G, Citone M, Lucarelli NM, Pasqualini V, Sturiale M, Giuliani S, Rosati M, Ceccherini C, Corona M, Mosconi C, Utili A, Argirò R. Heparin-Related Major Bleeding in Covid-19-Positive Patient: Perspective from the Outbreak. Cardiovasc Intervent Radiol 2020; 43:1216-1217. [PMID: 32468143 PMCID: PMC7255445 DOI: 10.1007/s00270-020-02532-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 05/15/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Pierleone Lucatelli
- Department of Radiological Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Gianluca De Rubeis
- Department of Radiological Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Michele Citone
- Vascular and Interventional Radiology Department, Careggi University Hospital, Florence, Italy
| | | | | | | | - Silvia Giuliani
- Radiologia Interventistica, Ospedale San Camillo, Rome, Italy
| | | | | | - Mario Corona
- Department of Radiological Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Cristina Mosconi
- Department of Diagnostic Medicine and Prevention, Radiology Unit, S.Orsola Malpighi, University of Bologna, Bologna, Italy
| | - Alice Utili
- Ospedale Policlinico San Martino, Genova, Italy
| | - Renato Argirò
- Diagnostic Imaging and Interventional Radiology, University Hospital of Rome Tor Vergata, Rome, Italy
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Sansone A, Fegatelli DA, Pozza C, Fattorini G, Lauretta R, Minnetti M, Romanelli F, Lucatelli P, Corona M, Bezzi M, Lombardo F, Lenzi A, Gianfrilli D. Effects of percutaneous varicocele repair on testicular volume: results from a 12-month follow-up. Asian J Androl 2020; 21:408-412. [PMID: 30604693 PMCID: PMC6628742 DOI: 10.4103/aja.aja_102_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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] [Indexed: 12/16/2022] Open
Abstract
Varicocele is a common finding in men. Varicocele correction has been advocated for young patients with testicular hypotrophy, but there is a lack of morphofunctional follow-up data. We assessed whether percutaneous treatment of left varicocele is associated with testicular "catch-up growth" in the following 12 months by retrospectively reviewing data from an electronic database of 10 656 patients followed up in our clinic between 2006 and 2016. We selected all young adults (<35 years) with left varicocele who underwent percutaneous treatment, had a minimum of 12 months' ultrasound imaging follow-up, and had no other conditions affecting testicular volume. One hundred and fourteen men (mean±standard deviation [s.d.] of age: 22.8 ± 5.4 years) met the inclusion and exclusion criteria. Left testicular hypotrophy (LTH), defined as a ≥20% difference between left and right testicular volume at baseline, was observed in 26 (22.8%) men. Participants with LTH (mean±s.d.: 14.5 ± 2.7 ml) had lower baseline testicular volume compared to those without LTH (mean±s.d.: 15.7 ± 3.8 ml; P = 0.032). Repeated measures mixed models showed a significant interaction between LTH and time posttreatment when correcting for baseline left testicular volume (β = 0.114, 95% confidence interval [CI]: 0.018-0.210, P = 0.020), resulting in a catch-up growth of up to 1.37 ml per year (95% CI: 0.221-2.516). Age at intervention was also associated with reduced testicular volume (-0.072 ml per year, 95% CI: -0.135--0.009; P = 0.024). Percutaneous treatment of left varicocele in young adults with LTH can result in catch-up growth over 1 year of follow-up. The reproductive and psychological implications of these findings need to be confirmed in longer and larger prospective studies.
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Affiliation(s)
- Andrea Sansone
- Department of Experimental Medicine, Sapienza University of Rome, Rome 00161, Italy
| | - Danilo Alunni Fegatelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome 00161, Italy
| | - Carlotta Pozza
- Department of Experimental Medicine, Sapienza University of Rome, Rome 00161, Italy
| | - Giorgio Fattorini
- Department of Experimental Medicine, Sapienza University of Rome, Rome 00161, Italy
| | - Rosa Lauretta
- Unit of Endocrinology, Regina Elena National Cancer Institute, Rome 00144, Italy
| | - Marianna Minnetti
- Department of Experimental Medicine, Sapienza University of Rome, Rome 00161, Italy
| | - Francesco Romanelli
- Department of Experimental Medicine, Sapienza University of Rome, Rome 00161, Italy
| | - Pierleone Lucatelli
- Vascular and Interventional Radiology Unit, Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza - University of Rome, Rome 00161, Italy
| | - Mario Corona
- Vascular and Interventional Radiology Unit, Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza - University of Rome, Rome 00161, Italy
| | - Mario Bezzi
- Vascular and Interventional Radiology Unit, Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza - University of Rome, Rome 00161, Italy
| | - Francesco Lombardo
- Department of Experimental Medicine, Sapienza University of Rome, Rome 00161, Italy
| | - Andrea Lenzi
- Department of Experimental Medicine, Sapienza University of Rome, Rome 00161, Italy
| | - Daniele Gianfrilli
- Department of Experimental Medicine, Sapienza University of Rome, Rome 00161, Italy
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Lucatelli P, De Rubeis G, Ginnani Corradini L, Basilico F, Di Martino M, Lai Q, Ginanni Corradini S, Cannavale A, Nardis PG, Corona M, Saba L, Catalano C, Bezzi M. Intra-procedural dual phase cone beam computed tomography has a better diagnostic accuracy over pre-procedural MRI and MDCT in detection and characterization of HCC in cirrhotic patients undergoing TACE procedure. Eur J Radiol 2019; 124:108806. [PMID: 31945673 DOI: 10.1016/j.ejrad.2019.108806] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 09/18/2019] [Revised: 11/28/2019] [Accepted: 12/19/2019] [Indexed: 02/08/2023]
Abstract
PURPOSE This study was directed to compare diagnostic accuracy of dual-phase cone beam computed tomography (DP-CBCT) vs pre-procedural second line imaging modality (SLIM [multidetector computed tomography and magnetic resonance imaging]) to detect and characterize hepatocellular carcinoma (HCC) in cirrhotic patients with indication for trans-arterial chemoembolization (TACE). METHODS This is a single centre, retrospective, and observational study. Exclusion criteria were not-assisted DP-CBCT TACE, and unavailable follow-up SLIM. We evaluated 280 consecutive patients (January/2015-Febraury/2019). Seventy-two patients were eligible. Three radiologists in consensus reviewed: pre-procedural SLIM, DP-CBCT, and SLIM at follow-up, with 4 months of interval between each reading. Hyper-vascular foci (HVF) were detected and characterized. Diameter was recorded. Radiological behaviour, according to LI-RADS criteria, of HFV throughout follow-up time was the reference standard. Diagnostic accuracy was calculated for pre-procedural SLIM and DP-CBCT and evaluated through receiver operating characteristic curve. HVF only visible on DP-CBCT (defined as occult) were analysed. Tumour diameters were compared. RESULTS Median time between pre-procedural SLIM and DP-CBCT and between DP-CBCT and definitive radiological diagnosis of HVF were 46.0 days (95%CI 36.5-55.0) and 30.5 days (95%CI 29.0-33.0), respectively. DP-CBCT had a better diagnostic performance than pre-examination SLIM (sensitivity 99%vs78%; specificity 89%vs85%; PPV 99%vs99%; NPV 92%vs30%; and accuracy 94%vs79%). DP-CBCT diagnosed 63 occult HVF. Occult HCC were 54/243 (22.2%). Six were occult angiomas. Three were false positive. Mean diameter was significantly higher in DP-CBCT vs pre-procedural SLIM (+7.5% [95%CI 3.7-11.3], p < 0.05). CONCLUSIONS DP-CBCT has a better diagnostic accuracy and NPV than pre-procedural SLIM in cirrhotic patients with indication for TACE.
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Affiliation(s)
- Pierleone Lucatelli
- Vascular and Interventional Radiology Unit, Department of Diagnostic of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Viale Del Policlinico, 155, 00161 Rome RM, Italy.
| | - Gianluca De Rubeis
- Vascular and Interventional Radiology Unit, Department of Diagnostic of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Viale Del Policlinico, 155, 00161 Rome RM, Italy.
| | - Luca Ginnani Corradini
- Vascular and Interventional Radiology Unit, Department of Diagnostic of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Viale Del Policlinico, 155, 00161 Rome RM, Italy.
| | - Fabrizio Basilico
- Vascular and Interventional Radiology Unit, Department of Diagnostic of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Viale Del Policlinico, 155, 00161 Rome RM, Italy.
| | - Michele Di Martino
- Vascular and Interventional Radiology Unit, Department of Diagnostic of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Viale Del Policlinico, 155, 00161 Rome RM, Italy.
| | - Quirino Lai
- Department of General Surgery and Organ Transplantation, Sapienza University of Rome, Viale Del Policlinico, 155, 00161 Rome RM, Italy.
| | - Stefano Ginanni Corradini
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale Del Policlinico, 155, 00161 Rome RM, Italy.
| | - Alessandro Cannavale
- Vascular and Interventional Radiology Unit, Department of Diagnostic of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Viale Del Policlinico, 155, 00161 Rome RM, Italy.
| | - Pier Giorgio Nardis
- Vascular and Interventional Radiology Unit, Department of Diagnostic of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Viale Del Policlinico, 155, 00161 Rome RM, Italy.
| | - Mario Corona
- Vascular and Interventional Radiology Unit, Department of Diagnostic of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Viale Del Policlinico, 155, 00161 Rome RM, Italy.
| | - Luca Saba
- Department of Medical Imaging, Azienda Ospedaliero Universitaria (A.O.U.) of Cagliari-Polo Di Monserrato, Via Ospedale, 54, 09124 Cagliari CA, Italy.
| | - Carlo Catalano
- Vascular and Interventional Radiology Unit, Department of Diagnostic of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Viale Del Policlinico, 155, 00161 Rome RM, Italy.
| | - Mario Bezzi
- Vascular and Interventional Radiology Unit, Department of Diagnostic of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Viale Del Policlinico, 155, 00161 Rome RM, Italy.
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Cannavale A, Lucatelli P, Corona M, Nardis P, Basilico F, De Rubeis G, Santoni M, Catalano C, Bezzi M. Evolving concepts and management of endoleaks after endovascular aneurysm repair: where do we stand in 2019? Clin Radiol 2019; 75:169-178. [PMID: 31810539 DOI: 10.1016/j.crad.2019.10.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 10/31/2019] [Indexed: 11/27/2022]
Abstract
In recent years, there has been tremendous progress in endovascular aneurysm repair (EVAR) techniques and devices. This process has seen a change in incidence, risk factors, and treatment of endoleaks as well as in follow-up protocols after EVAR. In particular, recent literature has highlighted new concepts in the evaluation and prevention/treatment of type I and II endoleak after standard EVAR. There is also recent evidence regarding new imaging protocols for follow-up after EVAR, which include magnetic resonance imaging and contrast-enhanced ultrasound. This comprehensive review aims to outline the most recent concepts on imaging follow-up, pathophysiology/risk factors, and management of endoleaks.
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Affiliation(s)
- A Cannavale
- Vascular and Interventional Unit, Department of Radiological Sciences, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.
| | - P Lucatelli
- Vascular and Interventional Unit, Department of Radiological Sciences, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - M Corona
- Vascular and Interventional Unit, Department of Radiological Sciences, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - P Nardis
- Vascular and Interventional Unit, Department of Radiological Sciences, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - F Basilico
- Vascular and Interventional Unit, Department of Radiological Sciences, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - G De Rubeis
- Vascular and Interventional Unit, Department of Radiological Sciences, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - M Santoni
- Department of Radiological Sciences, "Sapienza" University of Rome, Rome, Italy
| | - C Catalano
- Department of Radiological Sciences, "Sapienza" University of Rome, Rome, Italy
| | - M Bezzi
- Vascular and Interventional Unit, Department of Radiological Sciences, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
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Orgera G, Tipaldi MA, Laurino F, Lucatelli P, Rebonato A, Paraskevopoulos I, Rossi M, Krokidis M. Techniques and future perspectives for the prevention and treatment of endoleaks after endovascular repair of abdominal aortic aneurysms. Insights Imaging 2019; 10:91. [PMID: 31549250 PMCID: PMC6757092 DOI: 10.1186/s13244-019-0774-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 12/14/2018] [Accepted: 07/22/2019] [Indexed: 12/04/2022] Open
Abstract
The presence of endoleaks remains one of the main drawbacks of endovascular repair of abdominal aortic aneurysms leading to the increase of the size of the aneurysmal sac and in most of the cases to repeated interventions. A variety of devices and percutaneous techniques have been developed so far to prevent and treat this phenomenon, including sealing of the aneurysmal sac, endovascular embolisation, and direct sac puncture. The aim of this review is to analyse the indications, the effectiveness, and the future perspectives for the prevention and treatment of endoleaks after endovascular repair of abdominal aortic aneurysms.
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Affiliation(s)
- Gianluigi Orgera
- Department of Radiology, Sant' Andrea University Hospital La Sapienza, Rome, Italy
| | | | - Florindo Laurino
- Department of Radiology, Sant' Andrea University Hospital La Sapienza, Rome, Italy
| | - Pierleone Lucatelli
- Department of Radiological Sciences, Sapienza University of Rome, Rome, Italy
| | - Alberto Rebonato
- The Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy
| | | | - Michele Rossi
- Department of Radiology, Sant' Andrea University Hospital La Sapienza, Rome, Italy
| | - Miltiadis Krokidis
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK.
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Tarnoki AD, Szalontai L, Fagnani C, Tarnoki DL, Lucatelli P, Maurovich-Horvat P, Jermendy AL, Kovacs A, Molnar AA, Godor E, Fejer B, Hernyes A, Cirelli C, Fanelli F, Farina F, Baracchini C, Meneghetti G, Gyarmathy AV, Jermendy G, Merkely B, Pucci G, Schillaci G, Stazi MA, Medda E. Genetic and environmental factors on heart rate, mean arterial pressure and carotid intima-media thickness: A longitudinal twin study. Cardiol J 2019; 28:431-438. [PMID: 31489962 DOI: 10.5603/cj.a2019.0089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 12/06/2018] [Revised: 03/14/2019] [Accepted: 05/03/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Heart rate (HR), mean arterial pressure (MAP) and carotid intima-media thickness (cIMT) are moderately heritable cardiovascular traits, but the environmental effects on the longitudinal change of their heritability have never been investigated. METHODS 368 Italian and Hungarian twins (107 monozygotic, 77 dizygotic) underwent oscillometric measurement and B-mode sonography of bilateral carotid arteries in 2009/2010 and 2014. Within- -individual/cross-study wave, cross-twin/within-study wave and cross-twin/cross-study wave correlations were estimated, and bivariate Cholesky models were fitted to decompose the total variance at each wave and covariance between study waves into additive genetic, shared and unique environmental components. RESULTS For each trait, a moderate longitudinal stability was observed, with within-individual/crosswave correlations of 0.42 (95% CI: 0.33-0.51) for HR, 0.34 (95% CI: 0.24-0.43) for MAP, and 0.23 (95% CI: 0.12-0.33) for cIMT. Cross-twin/cross-wave correlations in monozygotic pairs were all significant and substantially higher than the corresponding dizygotic correlations. Genetic continuity was the main source of longitudinal stability, with across-time genetic correlations of 0.52 (95% CI: 0.29-0.71) for HR, 0.56 (95% CI: 0.31-0.81) for MAP, and 0.36 (95% CI: 0.07-0.64) for cIMT. Overlapping genetic factors explained respectively 57%, 77%, and 68% of the longitudinal covariance of the HR, MAP and cIMT traits. CONCLUSIONS Genetic factors have a substantial role in the longitudinal change of HR, MAP and cIMT; however, the influence of unique environmental factors remains relevant. Further studies should better elucidate whether epigenetic mechanisms have a role in influencing the stability of the investigated traits over time.
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Affiliation(s)
- Adam D Tarnoki
- Department of Radiology, Semmelweis University, 78/a Ulloi street, H-1082 Budapest, Hungary.,Hungarian Twin Registry, 29 Erdélyi street, 1212 Budapest, Hungary
| | - Laszlo Szalontai
- Department of Radiology, Semmelweis University, 78/a Ulloi street, H-1082 Budapest, Hungary.
| | - Corrado Fagnani
- Italian Twin Registry, Centre for Behavioural Sciences and Mental Health; Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - David L Tarnoki
- Department of Radiology, Semmelweis University, 78/a Ulloi street, H-1082 Budapest, Hungary.,Hungarian Twin Registry, 29 Erdélyi street, 1212 Budapest, Hungary
| | - Pierleone Lucatelli
- Vascular and Interventional Radiology Unit, Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Pal Maurovich-Horvat
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 18 Hataror street, 1122 Budapest, Hungary
| | - Adam L Jermendy
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 18 Hataror street, 1122 Budapest, Hungary
| | - Attila Kovacs
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 18 Hataror street, 1122 Budapest, Hungary
| | - Andrea Agnes Molnar
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 18 Hataror street, 1122 Budapest, Hungary
| | - Erika Godor
- Department of Radiology, Semmelweis University, 78/a Ulloi street, H-1082 Budapest, Hungary
| | - Bence Fejer
- Department of Radiology, Semmelweis University, 78/a Ulloi street, H-1082 Budapest, Hungary
| | - Anita Hernyes
- Department of Radiology, Semmelweis University, 78/a Ulloi street, H-1082 Budapest, Hungary
| | - Carlo Cirelli
- Vascular and Interventional Radiology Unit, Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Fabrizio Fanelli
- Vascular and Interventional Radiology Unit, Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Filippo Farina
- Department of Neurosciences, University of Padua School of Medicine, Via Giustiniani 5, 35128 Padova, Italy
| | - Claudio Baracchini
- Department of Neurosciences, University of Padua School of Medicine, Via Giustiniani 5, 35128 Padova, Italy
| | - Giorgio Meneghetti
- Department of Neurosciences, University of Padua School of Medicine, Via Giustiniani 5, 35128 Padova, Italy
| | - Anna V Gyarmathy
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, MD 21205 Baltimore, United States
| | - Gyorgy Jermendy
- 3rd Department of Internal Medicine, Bajcsy Zsilinszky Hospital, 89-91 Maglódi street, 1106 Budapest, Hungary
| | - Bela Merkely
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 18 Hataror street, 1122 Budapest, Hungary
| | - Giacomo Pucci
- Università di Perugia, Unità di Medicina Interna, Ospedale, Viale Tristano di Joannuccio 1, 05100 Terni, Italy.,Struttura Complessa di Medicina Interna, Azienda Ospedaliero-Universitaria di Terni, Terni, Italy
| | - Giuseppe Schillaci
- Università di Perugia, Unità di Medicina Interna, Ospedale, Viale Tristano di Joannuccio 1, 05100 Terni, Italy
| | - Maria A Stazi
- Italian Twin Registry, Centre for Behavioural Sciences and Mental Health; Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Emanuela Medda
- Italian Twin Registry, Centre for Behavioural Sciences and Mental Health; Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
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Lucatelli P, De Rubeis G, Basilico F, Ginanni Corradini L, Corona M, Bezzi M, Catalano C. Sequential dual-phase cone-beam CT is able to intra-procedurally predict the one-month treatment outcome of multi-focal HCC, in course of degradable starch microsphere TACE. Radiol Med 2019; 124:1212-1219. [PMID: 31473930 DOI: 10.1007/s11547-019-01076-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 08/23/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To evaluate the prognostic value of sequential dual-phase CBCT (DP-CBCT) imaging performed during degradable starch microsphere TACE (DSM-TACE) session in predicting the HCC's response to treatment, evaluate with modify response evaluation criteria in solid tumours (mRECIST) at 1-month multi-detector CT (MDCT) follow-up. MATERIALS AND METHODS Between January and May 2018, 24 patients (68.5 ± 8.5 year [45-85]) with HCC lesions (n = 96 [average 4/patient]) were prospectively enrolled. Imaging assessment included: pre-procedural MDCT, intra-procedural DP-CBCT performed before first and second DSM-TACEs and 1-month follow-up MDCT. Lesions' attenuation/pseudo-attenuation was defined as average value measured on ROIs (HU for MDCT; arbitrary unit called HU* for CBCT). Lesions' attenuation modification was correlated with the post-procedural mRECIST criteria at 1-month MDCT. RESULTS Eighty-two DSM-TACEs were performed. Lesion's attenuation values were: pre-procedural MDCT arterial phase (AP) 107.00 HU (CI 95% 100.00-115.49), venous phase (VP) 85.00 HU (CI 95% 81.13-91.74); and lesion's pseudo-attenuation were: first CBCT-AP 305.00 HU* (CI 95% 259.77-354.04), CBCT-VP 155.00 HU* (CI 95% 135.00-163.34). For second CBCT were: -AP 210.00 HU* (CI 95% 179.47-228.58), -VP 141.00 HU* (CI 95% 125.47-158.11); and for post-procedural MDCT were: -AP 95.00 HU (CI 95% 81.35-102.00), -VP 83.00 HU (CI 95% 78.00-88.00). ROC curve analysis showed that a higher difference pseudo-attenuation between first and second DP-CBCTs is related to treatment response. The optimal cut-off value of the difference between first and second CBCT-APs to predict complete response, objective response (complete + partial response) and overall disease control (objective response + stable disease) were > 206 HU* (sensitivity 80.0%, specificity 81.7%), > 72 HU* (sensitivity 79.5%, specificity 83.0%) and > - 7 HU* (sensitivity 91.6%, specificity 65.4%), respectively. CONCLUSIONS DP-CBCT can predict intra-procedurally, by assessing lesion pseudo-attenuation modification, the DSM-TACE 1-month treatment outcome.
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Affiliation(s)
- Pierleone Lucatelli
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
| | - Gianluca De Rubeis
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Fabrizio Basilico
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Luca Ginanni Corradini
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Mario Corona
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Mario Bezzi
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Carlo Catalano
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
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De Rubeis G, Corona M, Bezzi M, Ricci C, Lucatelli P. Commentary: Endovascular Peripheral Artery Disease Treatment: “Leaving Nothing Behind”? J Endovasc Ther 2019; 26:643-644. [DOI: 10.1177/1526602819871581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Gianluca De Rubeis
- Vascular and Interventional Radiology Unit, Department of Radiological, Oncological and Anatomo-pathological Science, Sapienza University of Rome, Italy
| | - Mario Corona
- Vascular and Interventional Radiology Unit, Department of Radiological, Oncological and Anatomo-pathological Science, Sapienza University of Rome, Italy
| | - Mario Bezzi
- Vascular and Interventional Radiology Unit, Department of Radiological, Oncological and Anatomo-pathological Science, Sapienza University of Rome, Italy
| | - Carmelo Ricci
- Vascular and Interventional Radiology Unit, University of Siena, Italy
| | - Pierleone Lucatelli
- Vascular and Interventional Radiology Unit, Department of Radiological, Oncological and Anatomo-pathological Science, Sapienza University of Rome, Italy
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Saba L, Lanzino G, Lucatelli P, Lavra F, Sanfilippo R, Montisci R, Suri JS, Yuan C. Carotid Plaque CTA Analysis in Symptomatic Subjects with Bilateral Intraparenchymal Hemorrhage: A Preliminary Analysis. AJNR Am J Neuroradiol 2019; 40:1538-1545. [PMID: 31395662 DOI: 10.3174/ajnr.a6160] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 06/28/2019] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND PURPOSE The presence of IPH is considered the most dangerous feature because it is significantly associated with clinical ipsilateral cerebrovascular events. Our aim was to explore the characterization of plaque with CT in symptomatic subjects with bilateral intraplaque hemorrhage. MATERIALS AND METHODS Three-hundred-forty-three consecutive patients with recent anterior circulation ischemic events (<2 weeks) and CT of the carotid arteries (performed within 14 days of the cerebrovascular event) evaluated between June 2012 and September 2017 were analyzed for plaque volume composition to identify all subjects with bilateral intraplaque hemorrhage. Plaque volume was semiautomatically measured, and tissue components were classified according to the attenuation values such as the following: calcified (for values of ≥130 HU), mixed (for values of ≥60 and <130 HU), lipid (for values of ≥25 and <60 HU), and intraplaque hemorrhage (for values of <25 HU). Twenty-one subjects (15 men; mean age, 70 ± 11 years; range, 44-87 years) had bilateral intraplaque hemorrhage and were included in the analysis. RESULTS Volume measurement revealed significantly larger plaques on the symptomatic side compared with the asymptomatic one (mean, 28 ± 9 versus 22 ± 8 mm, P = .007). Intraplaque hemorrhage volume and percentage were also significantly higher in the plaque ipsilateral to the cerebrovascular event (P < .001 and < .001, respectively). The volume of other plaque components did not show a statically significant association except for lipid and lipid + intraplaque hemorrhage percentages (23% versus 18% and 11% versus 15%), which were significantly different between the symptomatic and the asymptomatic sides (.016 and .011, respectively). The intraplaque hemorrhage/lipid ratio was higher on the symptomatic side (0.596 versus 0.171, P = .001). CONCLUSIONS In patients with bilateral intraplaque hemorrhage and recent ischemic symptoms, the plaque ipsilateral to the symptomatic side has significantly larger volume and a higher percentage of intraplaque hemorrhage compared with the contralateral, asymptomatic side.
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Affiliation(s)
- L Saba
- From the Department of Radiology (L.S., F.L., R.S., R.M.), Azienda Ospedaliero Universitaria di Cagliari, Monserrato (Cagliari), Italy
| | - G Lanzino
- Department of Neurologic Surgery (G.L.), Mayo Clinic, Rochester, Minnesota
| | - P Lucatelli
- Department of Radiological, Oncological and Anatomopathological Sciences-Radiology (P.L.), Sapienza University of Rome, Rome, Italy
| | - F Lavra
- From the Department of Radiology (L.S., F.L., R.S., R.M.), Azienda Ospedaliero Universitaria di Cagliari, Monserrato (Cagliari), Italy
| | - R Sanfilippo
- From the Department of Radiology (L.S., F.L., R.S., R.M.), Azienda Ospedaliero Universitaria di Cagliari, Monserrato (Cagliari), Italy
| | - R Montisci
- From the Department of Radiology (L.S., F.L., R.S., R.M.), Azienda Ospedaliero Universitaria di Cagliari, Monserrato (Cagliari), Italy
| | - J S Suri
- Diagnostic and Monitoring Division (J.S.S.), Atheropoint, Roseville, California.,Department of Electrical Engineering (J.S.S.), University of Idaho, Moscow, Idaho
| | - C Yuan
- Center for Biomedical Imaging Research (C.Y.), Department of Biomedical Engineering, Tsinghua University School of Medicine, Beijing, China.,Department of Radiology (C.Y.), University of Washington, Seattle, Washington
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D'Alessandris N, Lucatelli P, Tripodi D, Amabile MI, Ascoli V. Cytological features of breast implant-associated anaplastic large cell lymphoma in pleural effusion. Diagn Cytopathol 2019; 47:1213-1217. [PMID: 31348611 DOI: 10.1002/dc.24287] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 05/23/2019] [Revised: 07/03/2019] [Accepted: 07/15/2019] [Indexed: 11/12/2022]
Abstract
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a very rare CD30-positive ALK-negative T-cell non-Hodgkin lymphoma included as a provisional entity in the 2017 WHO classification of lymphoid neoplasms. BIA-ALCL arises as proliferating cells over the surface of the implant. It is generally an indolent disease if confined within the fibrous capsule. In contrast, mass and/or infiltration beyond the capsule is much more aggressive. This report describes a case of infiltrative BIA-ALCL with massive pleural effusion containing hallmark BIA-ALCL cells showing the characteristic morphologic appearance of high-grade anaplastic lymphoma, CD30-positive but ALK-negative with variable staining for T-cell antigens. Detailed cytological features of BIA-ALCL in pleural fluid are described along with the results of a literature search performed for BIA-ALCL cases with pleural effusion. This report expands the spectrum of BIA-ALCL pathology to include chest wall involvement and pleural effusion.
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Affiliation(s)
- Nicoletta D'Alessandris
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Pierleone Lucatelli
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Domenico Tripodi
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Maria Ida Amabile
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Valeria Ascoli
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
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Saba L, Balestrieri A, Serra A, Garau R, Politi C, Lucatelli P, Murgia A, Suri JS, Mannelli L. FOCUS trial: results, potentialities and limits. Ann Transl Med 2019; 7:S152. [PMID: 31576359 DOI: 10.21037/atm.2019.06.37] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Luca Saba
- Department of Radiology, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy
| | - Antonella Balestrieri
- Department of Radiology, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy
| | - Alessandra Serra
- Department of Nuclear Medicine, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy
| | - Raimondo Garau
- Department of Radiology, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy
| | - Carola Politi
- Department of Radiology, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy
| | - Pierleone Lucatelli
- Vascular and Interventional Radiology Unit, Department of Radiological Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Alessandro Murgia
- Department of Radiology, Azienda Ospedaliero Universitaria di Cagliari, Cagliari, Italy
| | - Jasjit S Suri
- Stroke Monitoring and Diagnostic Division, AtheroPoint™, Roseville, CA, USA
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So YH, Choi YH, Oh S, Jung IM, Chung JK, Lucatelli P. Thrombosed native hemodialysis fistulas: Technical and clinical outcomes of endovascular recanalization and factors influencing patency. J Vasc Access 2019; 20:725-732. [DOI: 10.1177/1129729819848931] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Purpose: To evaluate the technical and clinical results of endovascular recanalization of thrombosed native hemodialysis fistula and the factors influencing patency. Methods: A retrospective study was conducted with 73 patients who had thrombosed arteriovenous fistulas and were treated with endovascular methods. Patient characteristics, arteriovenous fistula-related characteristics, and endovascular procedures were analyzed. Technical and clinical results and patency rates were evaluated. The factors influencing patency were analyzed using a univariate and multivariate Cox proportional hazards model. Results: Technical and clinical success rates were 93% (68/73) and 85% (62/73), respectively. At 3, 6, and 12 months, the primary patency rates were 87.9%, 73.3%, and 64.8%; assisted primary patency rates were 89.2%, 78.6%, and 70.7%; and secondary patency rates were 90.8%, 87.2%, and 83.1%, respectively. Previous intervention and cephalic arch stenosis were risk factors for lower primary and assisted primary patency ( p < 0.05 for all). Cephalic arch stenosis was the only risk factor for lower secondary patency ( p < 0.05). No major complications associated with the procedures were noticed. Conclusion: Endovascular treatment was effective for the immediate recanalization of thrombosed arteriovenous fistula. In addition, previous intervention and cephalic arch stenosis were significantly related to lower arteriovenous fistula patency.
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Affiliation(s)
- Young Ho So
- Department of Radiology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Young Ho Choi
- Department of Radiology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Sohee Oh
- Department of Biostatistics, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - In Mok Jung
- Department of Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Jung Kee Chung
- Department of Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Pierleone Lucatelli
- Vascular and Interventional Radiology Unit, Department of Radiological Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, Rome, Italy
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Porcu M, Anzidei M, Suri JS, A Wasserman B, Anzalone N, Lucatelli P, Loi F, Montisci R, Sanfilippo R, Rafailidis V, Saba L. Carotid artery imaging: The study of intra-plaque vascularization and hemorrhage in the era of the "vulnerable" plaque. J Neuroradiol 2019; 47:464-472. [PMID: 30954549 DOI: 10.1016/j.neurad.2019.03.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 02/04/2019] [Accepted: 03/04/2019] [Indexed: 01/01/2023]
Abstract
Intraplaque hemorrhage (IPH) is one of the main factors involved in atherosclerotic plaque (AP) instability. Its recognition is crucial for the correct staging and management of patients with carotid artery plaques to limit ischemic stroke. Imaging plays a crucial role in identifying IPH, even if the great variability of intraplaque vascularization and the limitations of our current imaging technologies make it difficult. The intent of this review is to give a general overview of the main features of intraplaque vascularization and IPH on Ultrasound (US), Computed Tomography (CT), Magnetic Resonance (MR) and Nuclear Medicine, and a brief description on the future prospectives.
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Affiliation(s)
- Michele Porcu
- Department of Medical Imaging, AOU of Cagliari, University of Cagliari, Cagliari, Italy.
| | - Michele Anzidei
- Department of Radiological, Oncological and Anatomo-pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Jasjit S Suri
- Monitoring and Diagnostic Division, AtheroPoint, Roseville, CA, USA
| | - Bruce A Wasserman
- The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Nicoletta Anzalone
- Neuroradiology Unit and CERMAC, San Raffaele Scientific Institute and Vita-Salute San Raffaele University, via Olgettina 60, 20132, Milan, Italy
| | - Pierleone Lucatelli
- Department of Radiological, Oncological and Anatomo-pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Federico Loi
- Department of Biomedial Sciences, Unit of Oncology and Molecular Pathology, University of Cagliari, Cagliari, Italy
| | - Roberto Montisci
- Department of Vascular Surgery, AOU of Cagliari, University of Cagliari, Cagliari, Italy
| | - Roberto Sanfilippo
- Department of Vascular Surgery, AOU of Cagliari, University of Cagliari, Cagliari, Italy
| | - Vasileios Rafailidis
- Department of Radiology, AHEPA University General Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636 Thessaloníki, Greece
| | - Luca Saba
- Department of Medical Imaging, AOU of Cagliari, University of Cagliari, Cagliari, Italy
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Lucatelli P, Ginnani Corradini L, De Rubeis G, Rocco B, Basilico F, Cannavale A, Nardis PG, Corona M, Saba L, Catalano C, Bezzi M. Balloon-Occluded Transcatheter Arterial Chemoembolization (b-TACE) for Hepatocellular Carcinoma Performed with Polyethylene-Glycol Epirubicin-Loaded Drug-Eluting Embolics: Safety and Preliminary Results. Cardiovasc Intervent Radiol 2019; 42:853-862. [PMID: 30843093 PMCID: PMC6502778 DOI: 10.1007/s00270-019-02192-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 02/21/2019] [Indexed: 12/26/2022]
Abstract
Purpose To report technical success, safety profile and oncological results of balloon-occluded transcatheter arterial chemoembolization using a balloon micro-catheter and epirubicin-loaded polyethylene-glycol (PEG) microsphere (100 ± 25 µm and 200 ± 50 µm) in patients with hepatocellular carcinoma (HCC). Materials and Methods This is a single-centre, single-arm, retrospective study with 6-month follow-up. Twenty-two patients (Child–Pugh A 68% [15/22], B in 32% [7/22]; age 67.05 ± 14 years) with 29 HCC were treated in 24 procedures. Technical success is defined: ability to place the balloon micro-catheter within the required vascular segment, balloon-occluded arterial stump pressure drops and assessment of microsphere deposition. Laboratory assessment pre/post-procedural and complications were analysed, respectively, according to Common Terminology Criteria for Adverse Events (CTCAEv5) and CIRSE system. Postembolization syndrome (PES) was defined as fever and/or nausea and/or pain onset. Oncological results were evaluated using m-RECIST criteria with CT/MRI imaging at 1 and 3–6 months. In partial responder patients, pre/post-procedural tumour volume was compared. Results Pre-planned feeder was reached in all cases. Pressure drop average was 51.1 ± 21.6 mmHg. Exclusive target embolization was achieved in 14/24 procedures (58.3%). Laboratory test modifications were all grade 1. 4/24 adverse events occurred (17%): pseudo-aneurysm of the feeder (grade 3), liver abscess (grade 2) and 2 asymptomatic segmentary biliary tree dilatations (grade 2). PES occurred in 8/24 (33%). The complete response at 1 and 3–6 months was 44.8% (13/29) and 52.9% (9/17), respectively. The partial response at 1 and 3–6 months was 55% (16/29) and 4/17 (23.5%), respectively. Among partial responder patients, the average percentage of tumour volume reduction was 64.9 ± 27.3%. Conclusion Epirubicin-loaded PEG microsphere b-TACE is technically feasible, safe and effective procedure for HCC treatment.
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Affiliation(s)
- Pierleone Lucatelli
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
| | - Luca Ginnani Corradini
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Gianluca De Rubeis
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Bianca Rocco
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Fabrizio Basilico
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Alessandro Cannavale
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Pier Giorgio Nardis
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Mario Corona
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Luca Saba
- Department of Medical Imaging, Azienda Ospedaliero Universitaria (A.O.U.) of Cagliari-Polo di Monserrato, Cagliari, Italy
| | - Carlo Catalano
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Mario Bezzi
- Vascular and Interventional Radiology Unit, Department of Diagnostic Service, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
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Lucatelli P, Argirò R, De Rubeis G, Rocco B, Corradini SG, Corona M, Nardis PG, Saba L, Mennini G, Fiorentino F, Corsi A, Catalano C, Bezzi M. Polyethylene Glycol Epirubicin-Loaded Transcatheter Arterial Chemoembolization Procedures Utilizing a Combined Approach with 100 and 200 μm Microspheres: A Promising Alternative to Current Standards. J Vasc Interv Radiol 2019; 30:305-313. [DOI: 10.1016/j.jvir.2018.10.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 10/21/2018] [Accepted: 10/22/2018] [Indexed: 02/06/2023] Open
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Lucatelli P, De Rubeis G, Rocco B, Bezzi M. Are Radiopaque Beads a Real Advantage? Radiology 2019; 290:852-853. [PMID: 30720406 PMCID: PMC6394816 DOI: 10.1148/radiol.2019182655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Affiliation(s)
- Pierleone Lucatelli
- Vascular and Interventional Radiology Unit, Department of Radiological, Oncological and Pathologic Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Gianluca De Rubeis
- Vascular and Interventional Radiology Unit, Department of Radiological, Oncological and Pathologic Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Bianca Rocco
- Vascular and Interventional Radiology Unit, Department of Radiological, Oncological and Pathologic Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
| | - Mario Bezzi
- Vascular and Interventional Radiology Unit, Department of Radiological, Oncological and Pathologic Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy
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Saba L, Lai L, Lucatelli P, Sanfilippo R, Montisci R, S Suri J, Faa G. Association between carotid artery plaque inflammation and brain MRI. J Neuroradiol 2018; 47:203-209. [PMID: 30439395 DOI: 10.1016/j.neurad.2018.10.004] [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: 05/25/2018] [Revised: 09/10/2018] [Accepted: 10/29/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE To explore the association between presence of inflammatory cells in the carotid plaques surgically treated and brain MRI findings. MATERIAL AND METHODS Forty consecutive patients were prospectively analyzed. Brain MRI was performed with a 1.5 Tesla scanner and infacts (lacuna and non-lacunar) pertinence of the anterior circulation were recorded. All patients underwent carotid endarterectomy "en bloc"; carotid plaques histological sections were prepared and immuno-cytochemical analysis was performed to characterize and quantify the presence of inflammatory cells. ROC curve analysis, Pearson Rho correlation and Mann-Whitney test were applied. RESULTS The immuno-cytochemical analysis demonstrated that plaques of symptomatic patients (stroke\TIA; n = 25) had more inflammatory cells, mainly macrophages (CD68) compared with plaques of patients without symptoms (Mann-Whitney = P < 0.001, ROC curve area = 0.901). Correlation analysis showed a statistically significant association between the number of brain non-lacunar infarcts and the entity of macrophages (P < 0.001); whereas no association with lacunar infarcts (P = 0.1934) was found. CONCLUSION Results of this preliminary study suggest that the presence and amount of inflammatory cells within carotid artery plaque is associated with cerebrovascular events and with the number of MRI brain detectable infarct.
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Affiliation(s)
- Luca Saba
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari, Polo di Monserrato, ss. 554 Monserrato (Cagliari) 09045, Italy.
| | - Letizia Lai
- Department of Pathology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari, Polo di Monserrato. ss. 554 Monserrato (Cagliari) 09045, Italy
| | | | - Roberto Sanfilippo
- Department of Vascular Surgery, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari, Polo di Monserrato, ss. 554 Monserrato (Cagliari) 09045, Italy
| | - Roberto Montisci
- Department of Vascular Surgery, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari, Polo di Monserrato, ss. 554 Monserrato (Cagliari) 09045, Italy
| | - Jasjit S Suri
- Diagnostic and monitoring division AtheroPoint, Roseville, CA, USA
| | - Gavino Faa
- Department of Pathology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari, Polo di Monserrato. ss. 554 Monserrato (Cagliari) 09045, Italy
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