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Mangiafico S, Bertani H, Pigò F, Russo S, Lupo M, Cocca S, Grande G, Germani U, Manta R, Conigliaro R. A New Step-Up Dual Endoscopic Approach for Large-Size Infected Pancreatic Necrosis: Percutaneous Endoscopic Necrosectomy Followed by Transluminal Endoscopic Drainage/Necrosectomy. Surg Laparosc Endosc Percutan Tech 2024; 34:156-162. [PMID: 38421183 DOI: 10.1097/sle.0000000000001271] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 01/30/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Acute pancreatitis in 10% to 20% of cases can be associated with necrosis of the pancreatic gland, peripancreatic tissue, or both. We report a case series of a new endoscopic approach to treat infected pancreatic necrosis (IPN). PATIENTS AND METHODS Consecutive patients with IPN, extending from the perigastric area up to the paracolic gutters or into the pelvis, were prospectively studied from January 2017 to June 2022. The treatment protocol was radiologic percutaneous drainage as the first step, followed by fully covered metal stent placement (FC-SEMS) in the track of the catheter. Percutaneous endoscopic necrosectomy (PEN) was performed 2 to 4 days later using a flexible endoscope through the percutaneous tract. About 2 to 4 weeks later, when a matured sac was visible, EUS-guided endoscopic transluminal drainage (ETD) with lumen-apposing metal stents (LAMS) was performed. Control of sepsis with resolution of collection(s) was the primary outcome measure. RESULTS We included 18 patients, males in 50% of cases with age 60±12 years old. Most frequent cause of pancreatitis was biliary (7 cases) followed by alcoholic in 6 cases; in 3 cases pancreatitis was caused by hyperlipemia and in 2 cases was idiopathic. Mean size of WON was 18±2 cm. For PEN, SEMSs used were esophageal FC-SEMS. LAMS used for ETD were Hot Axios, Hot Spaxus and Nagistent. Mean time of endoscopic intervention for PEN and ETD was 18±3 and 37±4 days, respectively. In 5 cases adverse events occurred: 3 cases of overinflations resolved with introduction of Verres needles in abdomen. In 2 cases postprocedural GI bleeding required endoscopic intervention. In all cases control of sepsis was reached together with resolution of collections. No cases of deaths were observed. CONCLUSIONS Step-up percutaneous and transluminal endoscopic necrosectomy therapy is an effective strategy for large-size IPN with combined central and peripheral necrosis.
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Affiliation(s)
- Santi Mangiafico
- Gastroenterology and Digestive Endoscopy Unit, University Hospital of Modena (Baggiovara-Policlinico), Modena
| | - Helga Bertani
- Gastroenterology and Digestive Endoscopy Unit, University Hospital of Modena (Baggiovara-Policlinico), Modena
| | - Flavia Pigò
- Gastroenterology and Digestive Endoscopy Unit, University Hospital of Modena (Baggiovara-Policlinico), Modena
| | - Salvatore Russo
- Gastroenterology and Digestive Endoscopy Unit, University Hospital of Modena (Baggiovara-Policlinico), Modena
| | - Marinella Lupo
- Gastroenterology and Digestive Endoscopy Unit, University Hospital of Modena (Baggiovara-Policlinico), Modena
| | - Silvia Cocca
- Gastroenterology and Digestive Endoscopy Unit, University Hospital of Modena (Baggiovara-Policlinico), Modena
| | - Giuseppe Grande
- Gastroenterology and Digestive Endoscopy Unit, University Hospital of Modena (Baggiovara-Policlinico), Modena
| | - Ugo Germani
- Gastroenterology and Digestive Endoscopy Unit, Santa Maria Della Misericordia Hospital of Perugia, Perugia, Italy
| | - Raffaele Manta
- Gastroenterology and Digestive Endoscopy Unit, Santa Maria Della Misericordia Hospital of Perugia, Perugia, Italy
| | - Rita Conigliaro
- Gastroenterology and Digestive Endoscopy Unit, University Hospital of Modena (Baggiovara-Policlinico), Modena
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Russo S, Conigliaro R, Coppini F, Dell'Aquila E, Grande G, Pigò F, Mangiafico S, Lupo M, Marocchi M, Bertani H, Cocca S. Acute left-sided malignant colonic obstruction: Is there a role for endoscopic stenting? World J Clin Oncol 2023; 14:190-197. [PMID: 37275939 PMCID: PMC10236983 DOI: 10.5306/wjco.v14.i5.190] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 11/23/2022] [Accepted: 04/25/2023] [Indexed: 05/19/2023] Open
Abstract
The therapy of left-sided malignant colonic obstruction continues to be one of the largest problems in clinical practice. Numerous studies on colonic stenting for neoplastic colonic obstruction have been reported in the last decades. Thereby the role of self-expandable metal stents (SEMS) in the treatment of malignant colonic obstruction has become better defined. However, numerous prospective and retrospective investigations have highlighted serious concerns about a possible worse outcome after endoscopic colorectal stenting as a bridge to surgery, particularly in case of perforation. This review analyzes the most recent evidence in order to highlight pros and cons of SEMS placement in left-sided malignant colonic obstruction.
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Affiliation(s)
- Salvatore Russo
- Gastroenterology and Digestive Endoscopy Unit, Modena University Hospital, Modena 41126, Italy
| | - Rita Conigliaro
- Gastroenterology and Digestive Endoscopy Unit, Modena University Hospital, Modena 41126, Italy
| | - Francesca Coppini
- Gastroenterology and Digestive Endoscopy Unit, Azienda USL, IRCCs di Reggio Emilia, Reggio Emilia 42122, Italy
| | - Emanuela Dell'Aquila
- Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, Rome 0144, Italy
| | - Giuseppe Grande
- Gastroenterology and Digestive Endoscopy Unit, Modena University Hospital, Modena 41126, Italy
| | - Flavia Pigò
- Gastroenterology and Digestive Endoscopy Unit, Modena University Hospital, Modena 41126, Italy
| | - Santi Mangiafico
- Gastroenterology and Digestive Endoscopy Unit, Modena University Hospital, Modena 41126, Italy
| | - Marinella Lupo
- Gastroenterology and Digestive Endoscopy Unit, Modena University Hospital, Modena 41126, Italy
| | - Margherita Marocchi
- Gastroenterology and Digestive Endoscopy Unit, Modena University Hospital, Modena 41126, Italy
| | - Helga Bertani
- Gastroenterology and Digestive Endoscopy Unit, Modena University Hospital, Modena 41126, Italy
| | - Silvia Cocca
- Gastroenterology and Digestive Endoscopy Unit, Modena University Hospital, Modena 41126, Italy
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Sbrozzzi-Vanni A, Galloro G, Piciucchi M, Castellani D, Germani U, Dell'Amico I, Zito F, Pallio S, Mangiafico S, Zullo A, Manta R. Over-the-scope Technique for Partially Covered Self-expandable Metal Stent Placement to Treat Duodenal Perforation during EUS. J Gastrointestin Liver Dis 2023; 32:65-69. [PMID: 37004238 DOI: 10.15403/jgld-4625] [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] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 12/02/2022] [Indexed: 04/03/2023]
Abstract
BACKGROUND AND AIMS Although endoscopic ultrasound (EUS) is generally safe, duodenal perforation may occur during the procedure. When the iatrogenic break is wide, endoscopic positioning of a covered self- expandable metal stent is indicated to avoid a more invasive surgical approach. We evaluated the efficacy of the 'over-the-scope stenting' (OTSS) technique to treat iatrogenic duodenal perforations occurred during EUS. METHODS Data of patients with large iatrogenic duodenal perforations treated with OTSS procedure were collected in 5 centers. Technical success was defined as a correct stent placement on the perforation site, and clinical success as complete healing of the duodenal leak at stent removal 3 weeks later. RESULTS A total of 15 (7 males; median age: 78 years, range 47-91) patients were included in this series. A correct stent positioning was achieved in all cases (technical success: 100%), and the perforation was healed in all, apart from one patient at stent removal (clinical success: 93%). This patient was successfully treated with a novel stent placement. No immediate post-procedural adverse events occurred, and no need for emergency surgery was recorded. In one (6.7%) patient, stent migration occurred 10 days after positioning, and it was spontaneously expulsed with stool movement without complications two days later. CONCLUSIONS Our data showed that the OTTS technique for partially covered self-expandable metal stent placement is feasible, safe and effective to tread large iatrogenic duodenal perforation occuring during EUS.
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Affiliation(s)
- Andrea Sbrozzzi-Vanni
- Gastroenterology and Digestive Endoscopy, 'San Camillo Forlanini' Hospital, Rome, Italy. .
| | - Giuseppe Galloro
- Department of Clinical Medicine and Surgery, Endoscopic Surgery Unit, University Federico II - School of Medicine, Naples, Italy.
| | - Matteo Piciucchi
- Gastroenterology and Digestive Endoscopy Unit, 'Santa Maria della Stella' Hospital, Orvieto, Italy.
| | - Danilo Castellani
- Digestive Endoscopy Unit, 'Spedali Riuniti' Hospital, Livorno, Italy.
| | - Ugo Germani
- Digestive Endoscopy Unit, 'Spedali Riuniti' Hospital, Livorno, Italy.
| | | | - Francesco Zito
- Department of General, Geriatric, Oncologic Surgery and Advanced Technologies, Unit of Surgical Digestive Endoscopy, University of Naples 'Federico II', Naples.
| | - Socrate Pallio
- Digestive Endoscopy Unit, 'G. Martino' Hospital, Messina, Italy.
| | - Santi Mangiafico
- Gastroenterology and Digestive Endoscopy Unit, 'S. Agostino Estense' Hospital, Baggiovara, Italy.
| | - Angelo Zullo
- Gastroenterology and Digestive Endoscopy, 'Nuovo Regina Margherita' Hospital, Rome, Italy.
| | - Raffaele Manta
- Digestive Endoscopy Unit, 'Spedali Riuniti' Hospital, Livorno, Italy.
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Bala F, Kim BJ, Najm M, Thornton J, Fainardi E, Michel P, Alpay K, Herlihy D, Goyal M, Casetta I, Nannoni S, Ylikotila P, Power S, Saia V, Hegarty A, Pracucci G, Rautio R, Ademola A, Demchuk A, Mangiafico S, Boyle K, Hill MD, Toni D, Murphy S, Menon BK, Almekhlafi MA. Outcomes with Endovascular Treatment of Patients with M2 Segment MCA Occlusion in the Late Time Window. AJNR Am J Neuroradiol 2023; 44:447-452. [PMID: 36958801 PMCID: PMC10084904 DOI: 10.3174/ajnr.a7833] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 02/23/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND AND PURPOSE Randomized trials in the late window have demonstrated the efficacy and safety of endovascular thrombectomy in large-vessel occlusions. Patients with M2-segment MCA occlusions were excluded from these trials. We compared outcomes with endovascular thrombectomy in patients with M2-versus-M1 occlusions presenting 6-24 hours after symptom onset. MATERIALS AND METHODS Analyses were on pooled data from studies enrolling patients with stroke treated with endovascular thrombectomy 6-24 hours after symptom onset. We compared 90-day functional independence (mRS ≤ 2), mortality, symptomatic intracranial hemorrhage, and successful reperfusion (expanded TICI = 2b-3) between patients with M2 and M1 occlusions. The benefit of successful reperfusion was then assessed among patients with M2 occlusion. RESULTS Of 461 patients, 367 (79.6%) had M1 occlusions and 94 (20.4%) had M2 occlusions. Patients with M2 occlusions were older and had lower median baseline NIHSS scores. Patients with M2 occlusion were more likely to achieve 90-day functional independence than those with M1 occlusion (adjusted OR = 2.13; 95% CI, 1.25-3.65). There were no significant differences in the proportion of successful reperfusion (82.9% versus 81.1%) or mortality (11.2% versus 17.2%). Symptomatic intracranial hemorrhage risk was lower in patients with M2-versus-M1 occlusions (4.3% versus 12.2%, P = .03). Successful reperfusion was independently associated with functional independence among patients with M2 occlusions (adjusted OR = 2.84; 95% CI, 1.11-7.29). CONCLUSIONS In the late time window, patients with M2 occlusions treated with endovascular thrombectomy achieved better clinical outcomes, similar reperfusion, and lower symptomatic intracranial hemorrhage rates compared with patients with M1 occlusion. These results support the safety and benefit of endovascular thrombectomy in patients with M2 occlusions in the late window.
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Affiliation(s)
- F Bala
- From the Calgary Stroke Program (F.B., M.N., M.G., A.D., M.D.H., B.K.M., M.A.A.), Departments of Clinical Neurosciences and Radiology, University of Calgary, Calgary, Alberta, Canada
- Diagnostic and Interventional Neuroradiology Department (F.B.), University Hospital of Tours, Tours, France
| | - B J Kim
- Department of Neurology and Cerebrovascular Center (B.J.K.), Seoul National University Bundang Hospital, Seoul, Republic of Korea
| | - M Najm
- From the Calgary Stroke Program (F.B., M.N., M.G., A.D., M.D.H., B.K.M., M.A.A.), Departments of Clinical Neurosciences and Radiology, University of Calgary, Calgary, Alberta, Canada
| | - J Thornton
- Neuroradiology Department (J.T., D.H., S.P.)
- Royal College of Surgeons in Ireland (J.T., A.H.), Dublin, Ireland
| | - E Fainardi
- Neuroradiology Unit (E.F.), Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - P Michel
- Stroke Center (P.M., S.N.), Neurology Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - K Alpay
- Department of Radiology (K.A., R.R.), Turku University Hospital, Turku, Finland
| | - D Herlihy
- Neuroradiology Department (J.T., D.H., S.P.)
| | - M Goyal
- From the Calgary Stroke Program (F.B., M.N., M.G., A.D., M.D.H., B.K.M., M.A.A.), Departments of Clinical Neurosciences and Radiology, University of Calgary, Calgary, Alberta, Canada
| | - I Casetta
- Clinica Neurologica (I.C.), University of Ferrara, Ferrara, Italy
| | - S Nannoni
- Stroke Center (P.M., S.N.), Neurology Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - P Ylikotila
- Neurocenter (P.Y.), Turku University Hospital, University of Turku, Turku, Finland
| | - S Power
- Neuroradiology Department (J.T., D.H., S.P.)
| | - V Saia
- Stroke Unit (V.S.), Santa Corona Hospital, Pietra Ligure, Italy
| | - A Hegarty
- Royal College of Surgeons in Ireland (J.T., A.H.), Dublin, Ireland
| | - G Pracucci
- Stroke Unit (G.P.), Careggi University Hospital, Florence, Italy
| | - R Rautio
- Department of Radiology (K.A., R.R.), Turku University Hospital, Turku, Finland
| | - A Ademola
- Department of Community Health Sciences (A.A., M.D.H., B.K.M., M.A.A.), University of Calgary, Calgary, Alberta, Canada
| | - A Demchuk
- From the Calgary Stroke Program (F.B., M.N., M.G., A.D., M.D.H., B.K.M., M.A.A.), Departments of Clinical Neurosciences and Radiology, University of Calgary, Calgary, Alberta, Canada
| | - S Mangiafico
- Interventional Neuroradiology Unit (S. Mangiafico), Institute for Hospitalization and Healthcare Neuromed, Pozzilli, Italy
| | - K Boyle
- Department of Geriatric and Stroke Medicine (K.B.), Beaumont Hospital, Dublin, Ireland
| | - M D Hill
- From the Calgary Stroke Program (F.B., M.N., M.G., A.D., M.D.H., B.K.M., M.A.A.), Departments of Clinical Neurosciences and Radiology, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences (A.A., M.D.H., B.K.M., M.A.A.), University of Calgary, Calgary, Alberta, Canada
| | - D Toni
- Emergency Department (D.T.), Stroke Unit, Sapienza University Hospital, Rome, Italy
| | - S Murphy
- Department of Geriatric and Stroke Medicine (S. Murphy), The Mater Misericordiae University Hospital, Dublin, Ireland
- School of Medicine (S. Murphy), Royal College of Surgeons in Ireland, Dublin, Ireland
- School of Medicine (S. Murphy), University College Dublin, Dublin, Ireland
| | - B K Menon
- From the Calgary Stroke Program (F.B., M.N., M.G., A.D., M.D.H., B.K.M., M.A.A.), Departments of Clinical Neurosciences and Radiology, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences (A.A., M.D.H., B.K.M., M.A.A.), University of Calgary, Calgary, Alberta, Canada
| | - M A Almekhlafi
- From the Calgary Stroke Program (F.B., M.N., M.G., A.D., M.D.H., B.K.M., M.A.A.), Departments of Clinical Neurosciences and Radiology, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences (A.A., M.D.H., B.K.M., M.A.A.), University of Calgary, Calgary, Alberta, Canada
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Manta R, Zito FP, Pugliese F, Caruso A, Mangiafico S, D'Alessandro A, Castellani D, Germani U, Mutignani M, Conigliaro RL, Bonetti LR, Matsuda T, De Francesco V, Zullo A, Galloro G. Endoscopic Submucosal Dissection for Subepithelial Tumor Treatment in the Upper Digestive Tract: A Western, Multicenter Study. GE Port J Gastroenterol 2022; 30:115-120. [PMID: 37008525 PMCID: PMC10050838 DOI: 10.1159/000525993] [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] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 02/11/2022] [Indexed: 11/19/2022]
Abstract
<b><i>Background/Aims:</i></b> Endoscopic submucosal dissection (ESD) has been proposed for removal of gastrointestinal subepithelial tumors (GI-SETs), but data are still scanty. This study aimed to report a case series from a western country. <b><i>Patients and Methods:</i></b> Data of patients with upper GI-SETs suitable for ESD removal observed in 4 centers were retrospectively reviewed. Before endoscopic procedure, the lesion was characterized by endosonographic evaluation, histology, and CT scan. The <i>en bloc</i> resection and the R0 resection rates were calculated, as well as incidence of complications, and the 1-year follow-up was reported. <b><i>Results:</i></b> Data of 84 patients with esophageal (<i>N</i> = 13), gastric (<i>N</i> = 61), and duodenal (<i>N</i> = 10) GI-SETs were collected. The mean diameter of lesions was 26 mm (range: 12–110 mm). There were 17 gastrointestinal stromal tumors, 12 neuroendocrine tumors, 35 leiomyomas, 18 lipomas, and 2 hamartomas. <i>En bloc</i> and R0 resection were achieved in 83 (98.8%) and in 80 (95.2%) patients, respectively. Overall, a complication occurred in 11 (13.1%) patients, including bleeding (<i>N</i> = 7) and perforation (<i>N</i> = 4). Endoscopic approach was successful in all bleedings, but 1 patient who required radiological embolization, and in 2 perforations, while surgery was performed in the other patients. Overall, a surgical approach was eventually needed in 5 (5.9%), including 3 in whom R0 resection failed and 2 with perforation. <b><i>Conclusions:</i></b> Our study found that ESD may be an effective and safe alternative to surgical intervention for both benign and localized malignant GI-SETs.
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Affiliation(s)
- Raffaele Manta
- Gastroenterology and Digestive Endoscopy, General Hospital, Perugia, Italy
| | | | | | - Angelo Caruso
- Gastroenterology and Digestive Endoscopy Unit, NOCSAE Baggiovara, Modena, Italy
| | - Santi Mangiafico
- Gastroenterology and Digestive Endoscopy Unit, NOCSAE Baggiovara, Modena, Italy
| | | | - Danilo Castellani
- Gastroenterology and Digestive Endoscopy, General Hospital, Perugia, Italy
| | - Ugo Germani
- Gastroenterology and Digestive Endoscopy, General Hospital, Perugia, Italy
| | | | | | | | - Takahisa Matsuda
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | | | - Angelo Zullo
- Gastroenterology Unit, Nuovo Regina Margherita Hospital, Rome, Italy
| | - Giuseppe Galloro
- Surgical Digestive Endoscopy, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
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Russo S, Grande G, Manta R, Mangiafico S, Bertani H, Pigò F, Conigliaro R. Large iatrogenic sigmoid colon perforation treated with endoloop-assisted clip closure and over-the-scope clip: a case report. Endoscopy 2021; 53:E433-E434. [PMID: 33506466 DOI: 10.1055/a-1333-0620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Salvatore Russo
- Azienda Ospedaliero-Universitaria di Modena, Gastroenterology and Digestive Endoscopy Unit
| | - Giuseppe Grande
- Azienda Ospedaliero-Universitaria di Modena, Gastroenterology and Digestive Endoscopy Unit
| | - Raffaele Manta
- Azienda Ospedaliera di Perugia, Gastroenterology and Digestive Endoscopy Unit
| | - Santi Mangiafico
- Azienda Ospedaliero-Universitaria di Modena, Gastroenterology and Digestive Endoscopy Unit
| | - Helga Bertani
- Azienda Ospedaliero-Universitaria di Modena, Gastroenterology and Digestive Endoscopy Unit
| | - Flavia Pigò
- Azienda Ospedaliero-Universitaria di Modena, Gastroenterology and Digestive Endoscopy Unit
| | - Rita Conigliaro
- Azienda Ospedaliero-Universitaria di Modena, Gastroenterology and Digestive Endoscopy Unit
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Grande G, Cocca S, Bertani H, Caruso A, Pigo' F, Mangiafico S, Russo S, Lupo M, Masciangelo G, Cantu' P, Manta R, Conigliaro R. Dilation assisted stone extraction for complex biliary lithiasis: Technical aspects and practical principles. World J Gastrointest Endosc 2021; 13:33-44. [PMID: 33623638 PMCID: PMC7890407 DOI: 10.4253/wjge.v13.i2.33] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 12/27/2020] [Accepted: 01/22/2021] [Indexed: 02/06/2023] Open
Abstract
Common bile duct stones are frequently diagnosed worldwide and are one of the main indications for endoscopic retrograde cholangio-pancreatography. Endoscopic sphincterotomy (EST) has been used for the removal of bile duct stones for the past 40 years, providing a wide opening to allow extraction. Up to 15% of patients present with complicated choledocholithiasis. In this context, additional therapeutic approaches have been proposed such as endoscopic mechanical lithotripsy, intraductal or extracorporeal lithotripsy, or endoscopic papillary large balloon dilation (EPLBD). EPLBD combined with EST was introduced in 2003 to facilitate the passage of large or multiple bile duct stones using a balloon greater than 12 mm in diameter. EPLBD without EST was introduced as a simplified technique in 2009. Dilation-assisted stone extraction (DASE) is the combination of two techniques: EPLBD and sub-maximal EST. Several studies have reported this technique as safe and effective in patients with large bile duct stones, without any increased risk of adverse events such as pancreatitis, bleeding, or perforation. Nevertheless, it is difficult to analyze the outcomes of DASE because there are no standard techniques and definitions between studies. The purpose of this paper is to provide technical guidance and specific information about the main issues regarding DASE, based on current literature and daily clinical experience in biliary referral centers.
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Affiliation(s)
- Giuseppe Grande
- Gastroenterology and Digestive Endoscopy Unit, Azienda Ospedaliero Universitaria di Modena, Modena 41126, Italy
| | - Silvia Cocca
- Gastroenterology and Digestive Endoscopy Unit, Azienda Ospedaliero Universitaria di Modena, Modena 41126, Italy
| | - Helga Bertani
- Gastroenterology and Digestive Endoscopy Unit, Azienda Ospedaliero Universitaria di Modena, Modena 41126, Italy
| | - Angelo Caruso
- Gastroenterology and Digestive Endoscopy Unit, Azienda Ospedaliero Universitaria di Modena, Modena 41126, Italy
| | - Flavia Pigo'
- Gastroenterology and Digestive Endoscopy Unit, Azienda Ospedaliero Universitaria di Modena, Modena 41126, Italy
| | - Santi Mangiafico
- Gastroenterology and Digestive Endoscopy Unit, Azienda Ospedaliero Universitaria di Modena, Modena 41126, Italy
| | - Salvatore Russo
- Gastroenterology and Digestive Endoscopy Unit, Azienda Ospedaliero Universitaria di Modena, Modena 41126, Italy
| | - Marinella Lupo
- Gastroenterology and Digestive Endoscopy Unit, Azienda Ospedaliero Universitaria di Modena, Modena 41126, Italy
| | - Graziella Masciangelo
- Gastroenterology and Digestive Endoscopy Unit, Azienda Ospedaliero Universitaria di Modena, Modena 41126, Italy
| | - Paolo Cantu'
- Gastroenterology and Endoscopy Unit, Department of Pathophysiology and Transplantation, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico and Università degli Studi di Milano, Milano 20122, Italy
| | - Raffaele Manta
- Gastroenterology and Digestive Endoscopy Unit, General Hospital of Perugia, Perugia 06129, Italy
| | - Rita Conigliaro
- Gastroenterology and Digestive Endoscopy Unit, Azienda Ospedaliero Universitaria di Modena, Modena 41126, Italy
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Caggegi AM, Capranzano P, Scandura S, Mangiafico S, Castania G, Salerno T, Milici A, De Sanctis J, Bentivegna A, Frazzetto M, Sardone A, Di Salvo ME, Grasso C, Capodanno D, Tamburino C. Residual mitral regurgitation impact on outcomes after mitraclip therapy: five-year follow-up from the GRASP registry. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.220] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background – Although percutaneous mitral valve repair is an attractive alternative treatment option for patients with severe mitral regurgitation (MR) at high surgical risk, residual MR is commonly observed after the procedure and little is known about its impact on outcomes after MitraClip therapy, expecially in patients with severe left ventricular (LV) impairment.
Purpose – The aim of this prospective, observational study was to evaluate the impact of residual MR (MR ≤1+ vs. MR >1+) on long-term outcomes of mitral valve repair with the MitraClip System in high surgical risk patients presenting with moderate-to-severe or severe MR and with severe reduction of LV ejection fraction (EF).
Methods – Patients enrolled in the prospective Getting Reduction of Mitral Insufficiency by Percutaneous Clip Implantation (GRASP) with functional MR and EF ≤30% who were eligible at almost five-year follow-up were included in the present analysis. The primary endpoint was death at 5-year follow-up. Also echocardiographic parameters at baseline and 5-year follow-up and rehospitalization rates were assessed.
Results – A total of 139 patients were included: 92 (66.2%) with post-procedural residual MR ≤1+ and 47 (33.8%) with residual MR > 1+ (41 patients with residual MR 2+, 5 with residual MR 3+, 1 with residual MR 4+). Comparable clinical and echocardiographic baseline characteristics were observed between the two groups except for NYHA functional class IV and implanted pace-maker (more frequent in patients with residual MR >1+) and previous myocardial infarction (more frequent in patients with residual MR ≤1+). At 5-year follow-up, no significant differences were reported in the primary endpoint (49.6% in patients with residual MR ≤ 1+ vs. 65.3% in patients with residual MR > 1+, p 0.203) and in cardiac death (37.8% in patients with residual MR ≤ 1+ vs. 42.6% in patients with residual MR > 1+, p 0.921). Cox regression analysis identified residual MR > 1+ as an independent predictor of re-hospitalization (HR 0.51, 95% CI 0.28-0.92, p =0.026). At 5-year follow-up, a significant reduction in left ventricular end-systolic volume was observed in patients with residual MR ≤ 1+.
Conclusions – At 5-year follow no significant differences in survival emerged in patients with severe LV dysfunction undergoing MitraClip therapy regardless residual MR. Nevertheless residual MR > 1+ emerged as an indipendent predictor of re-hospitalization.
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Affiliation(s)
- AM Caggegi
- University Policlinic of Catania, Catania, Italy
| | - P Capranzano
- University Policlinic of Catania, Catania, Italy
| | - S Scandura
- University Policlinic of Catania, Catania, Italy
| | - S Mangiafico
- University Policlinic of Catania, Catania, Italy
| | - G Castania
- University Policlinic of Catania, Catania, Italy
| | - T Salerno
- University Policlinic of Catania, Catania, Italy
| | - A Milici
- University Policlinic of Catania, Catania, Italy
| | - J De Sanctis
- University Policlinic of Catania, Catania, Italy
| | - A Bentivegna
- University Policlinic of Catania, Catania, Italy
| | - M Frazzetto
- University Policlinic of Catania, Catania, Italy
| | - A Sardone
- University Policlinic of Catania, Catania, Italy
| | - ME Di Salvo
- University Policlinic of Catania, Catania, Italy
| | - C Grasso
- University Policlinic of Catania, Catania, Italy
| | - D Capodanno
- University Policlinic of Catania, Catania, Italy
| | - C Tamburino
- University Policlinic of Catania, Catania, Italy
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Cappellari M, Saia V, Pracucci G, Sallustio F, Gandini R, Nappini S, Nencini P, Vallone S, Zini A, Bigliardi G, Granata F, Grillo F, Cioni S, Tassi R, Bergui M, Cerrato P, Saletti A, De Vito A, Gasparotti R, Magoni M, Taglialatela F, Ruggiero M, Longoni M, Castellan L, Malfatto L, Menozzi R, Castellini P, Cosottini M, Mancuso M, Comai A, Franchini E, Lozupone E, Della Marca G, Ciceri EFM, Bonetti B, Zampieri P, Inzitari D, Mangiafico S, Toni D. Functional and radiological outcomes after bridging therapy versus direct thrombectomy in stroke patients with unknown onset: Bridging therapy versus direct thrombectomy in unknown onset stroke patients with 10-point ASPECTS. Eur J Neurol 2020; 28:209-219. [PMID: 32924246 DOI: 10.1111/ene.14529] [Citation(s) in RCA: 5] [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] [Received: 08/07/2020] [Revised: 09/03/2020] [Accepted: 09/05/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND PURPOSE The aim was to assess functional and radiological outcomes after bridging therapy (intravenous thrombolysis plus mechanical thrombectomy) versus direct mechanical thrombectomy (MT) in unknown onset stroke patients. METHODS A cohort study was conducted on prospectively collected data from unknown onset stroke patients who received endovascular procedures at ≤6 h from symptom recognition or awakening time. RESULTS Of the 349 patients with a 10-point Alberta Stroke Program Early Computed Tomography Score (ASPECTS), 248 received bridging and 101 received direct MT. Of the 134 patients with 6-9-point ASPECTS, 123 received bridging and 111 received direct MT. Each patient treated with bridging was propensity score matched with a patient treated with direct MT for age, sex, study period, pre-stroke disability, stroke severity, type of stroke onset, symptom recognition to groin time (or awakening to groin time), ASPECTS and procedure time. In the two matched groups with 10-point ASPECTS (n = 73 vs. n = 73), bridging was associated with higher rates of excellent outcome (46.6% vs. 28.8%; odds ratio 2.302, 95% confidence interval 1.010-5.244) and successful recanalization (83.6% vs. 63%; odds ratio 3.028, 95% confidence interval 1.369-6.693) compared with direct MT; no significant association was found between bridging and direct MT with regard to rate of symptomatic intracerebral hemorrhage (0% vs. 1.4%). In the two matched groups with 6-9-point ASPECTS (n = 45 vs. n = 45), no significant associations were found between bridging and direct MT with regard to rates of excellent functional outcome (44.4% vs. 31.1%), successful recanalization (73.3% vs. 76.5%) and symptomatic intracerebral hemorrhage (0% vs. 0%). CONCLUSIONS Bridging at ≤ 6 h of symptom recognition or awakening time was associated with better functional and radiological outcomes in unknown onset stroke patients with 10-point ASPECTS.
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Affiliation(s)
- M Cappellari
- Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - V Saia
- Santa Corona Hospital, Pietra Ligure, Italy
| | | | | | - R Gandini
- Policlinico Tor Vergata, Roma, Italy
| | - S Nappini
- Careggi University Hospital, Firenze, Italy
| | - P Nencini
- Careggi University Hospital, Firenze, Italy
| | - S Vallone
- Ospedale Civile S. Agostino-Estense-University Hospital, Modena, Italy
| | - A Zini
- IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | - G Bigliardi
- Ospedale Civile S. Agostino-Estense-University Hospital, Modena, Italy
| | - F Granata
- Policlinico G. Martino, Messina, Italy
| | - F Grillo
- Policlinico G. Martino, Messina, Italy
| | - S Cioni
- Ospedale S. Maria delle Scotte-University Hospital, Siena, Italy
| | - R Tassi
- Ospedale S. Maria delle Scotte-University Hospital, Siena, Italy
| | - M Bergui
- Città della Salute e della Scienza-Molinette, Torino, Italy
| | - P Cerrato
- Città della Salute e della Scienza-Molinette, Torino, Italy
| | - A Saletti
- Arcispedale S. Anna-University Hospital, Ferrara, Italy
| | - A De Vito
- Arcispedale S. Anna-University Hospital, Ferrara, Italy
| | | | | | - F Taglialatela
- IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | | | | | | | | | - R Menozzi
- Ospedale Universitario, Parma, Italy
| | | | | | | | - A Comai
- Ospedale Provinciale, Bolzano, Italy
| | | | | | | | - E F M Ciceri
- Fondazione IRCSS-Istituto Neurologico Carlo Besta, Milano, Italy
| | - B Bonetti
- Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - P Zampieri
- Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | | | | | - D Toni
- Sapienza University Hospital, Roma, Italy
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Caruso A, Russo S, Grande G, Pigò F, Mangiafico S, Bertani H, Conigliaro R. Endoscopic full-thickness resection in a recurrent perianastomotic esophagojejunal cancer followed by fully covered metal stent placement for lumen occlusion. Endoscopy 2020; 52:E337-E338. [PMID: 32187625 DOI: 10.1055/a-1113-7001] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Angelo Caruso
- Azienda Ospedaliero-Universitaria di Modena, Ospedale Civile di Baggiovara, Endoscopia Digestiva, Baggiovara, Italy
| | - Salvatore Russo
- Azienda Ospedaliero-Universitaria di Modena, Ospedale Civile di Baggiovara, Endoscopia Digestiva, Baggiovara, Italy
| | - Giuseppe Grande
- Azienda Ospedaliero-Universitaria di Modena, Ospedale Civile di Baggiovara, Endoscopia Digestiva, Baggiovara, Italy
| | - Flavia Pigò
- Azienda Ospedaliero-Universitaria di Modena, Ospedale Civile di Baggiovara, Endoscopia Digestiva, Baggiovara, Italy
| | - Santi Mangiafico
- Azienda Ospedaliero-Universitaria di Modena, Ospedale Civile di Baggiovara, Endoscopia Digestiva, Baggiovara, Italy
| | - Helga Bertani
- Azienda Ospedaliero-Universitaria di Modena, Ospedale Civile di Baggiovara, Endoscopia Digestiva, Baggiovara, Italy
| | - Rita Conigliaro
- Azienda Ospedaliero-Universitaria di Modena, Ospedale Civile di Baggiovara, Endoscopia Digestiva, Baggiovara, Italy
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Grande G, Cocca S, Russo S, Mangiafico S, Caruso A, Pigò F, Conigliaro R, Bertani H. COVID-19 and the Gastrointestinal System: Lesions Beyond the Symptoms? ACG Case Rep J 2020; 7:e00464. [PMID: 33062797 PMCID: PMC7523829 DOI: 10.14309/crj.0000000000000464] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 07/17/2020] [Indexed: 12/17/2022] Open
Abstract
The outbreak of the COVID-19 pandemic has radically changed the daily hospital care activity for all medical specialists. Although the predominant symptoms of this new coronavirus infection are respiratory, the gastrointestinal tract is also significantly involved. In this short report, we will discuss a new and unexpected clinical presentation related to COVID-19 colonization of upper gastrointestinal tract.
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Affiliation(s)
- Giuseppe Grande
- Gastroenterology and Digestive Endoscopy Unit, Azienda Ospedaliero, Universitaria di Modena, Modena, Italy
| | - Silvia Cocca
- Gastroenterology and Digestive Endoscopy Unit, Azienda Ospedaliero, Universitaria di Modena, Modena, Italy
| | - Salvatore Russo
- Gastroenterology and Digestive Endoscopy Unit, Azienda Ospedaliero, Universitaria di Modena, Modena, Italy
| | - Santi Mangiafico
- Gastroenterology and Digestive Endoscopy Unit, Azienda Ospedaliero, Universitaria di Modena, Modena, Italy
| | - Angelo Caruso
- Gastroenterology and Digestive Endoscopy Unit, Azienda Ospedaliero, Universitaria di Modena, Modena, Italy
| | - Flavia Pigò
- Gastroenterology and Digestive Endoscopy Unit, Azienda Ospedaliero, Universitaria di Modena, Modena, Italy
| | - Rita Conigliaro
- Gastroenterology and Digestive Endoscopy Unit, Azienda Ospedaliero, Universitaria di Modena, Modena, Italy
| | - Helga Bertani
- Gastroenterology and Digestive Endoscopy Unit, Azienda Ospedaliero, Universitaria di Modena, Modena, Italy
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Manta R, Galloro G, Pugliese F, Angeletti S, Caruso A, Zito FP, Mangiafico S, Marmo R, Zullo A, Esposito G, Annibale B, Mutignani M, Conigliaro R. Endoscopic Submucosal Dissection of Gastric Neoplastic Lesions: An Italian, Multicenter Study. J Clin Med 2020; 9:jcm9030737. [PMID: 32182894 PMCID: PMC7141243 DOI: 10.3390/jcm9030737] [Citation(s) in RCA: 8] [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: 01/30/2020] [Revised: 03/02/2020] [Accepted: 03/06/2020] [Indexed: 02/06/2023] Open
Abstract
Endoscopic submucosal dissection (ESD) allows removing neoplastic lesions on gastric mucosa, including early gastric cancer (EGC) and dysplasia. Data on ESD from Western countries are still scanty. We report results of ESD procedures performed in Italy. Data of consecutive patients who underwent ESD for gastric neoplastic removal were analyzed. The en bloc resection rate and the R0 resection rates for all neoplastic lesions were calculated, as well as the curative rate (i.e., no need for surgical treatment) for EGC. The incidence of complications, the one-month mortality, and the recurrence rate at one-year follow-up were computed. A total of 296 patients with 299 gastric lesions (80 EGC) were treated. The en bloc resection was successful for 292 (97.6%) and the R0 was achieved in 266 (89%) out of all lesions. In the EGC group, the ESD was eventually curative in 72.5% (58/80) following procedure. A complication occurred in 30 (10.1%) patients. Endoscopic treatment was successful in all 3 perforations, whereas it failed in 2 out of 27 bleeding patients who were treated with radiological embolization (1 case) or surgery (1 case). No procedure-related deaths at one-month follow-up were observed. Lesion recurrence occurred in 16 (6.2%) patients (6 EGC and 10 dysplasia). In conclusion, the rate of both en bloc and R0 gastric lesions removal was very high in Italy. However, the curative rate for EGC needs to be improved. Complications were acceptably low and amenable at endoscopy.
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Affiliation(s)
- Raffaele Manta
- Gastroenterology and Digestive Endoscopy, General Hospital, 06129 Perugia, Italy
- Correspondence: ; Tel.: +39-075-5784480; Fax: +39-075-5784479
| | - Giuseppe Galloro
- Surgical Digestive Endoscopy, Department of Clinical Medicine and Surgery, Federico II University, 80055 Naples, Italy;
| | - Francesco Pugliese
- Digestive Endoscopy Unit, Niguarda Hospital, 20162 Milan, Italy; (F.P.); (M.M.)
| | - Stefano Angeletti
- Department of Clinical Sciences and Translational Medicine, Sant’Andrea Hospital, Sapienza University. 00189 Rome, Italy; (S.A.); (G.E.); (B.A.)
| | - Angelo Caruso
- Digestive Endoscopy Unit, S. Agostino-Estense Hospital, 41126 Modena, Italy; (A.C.); (F.P.Z.); (S.M.); (R.C.)
| | - Francesco P. Zito
- Digestive Endoscopy Unit, S. Agostino-Estense Hospital, 41126 Modena, Italy; (A.C.); (F.P.Z.); (S.M.); (R.C.)
| | - Santi Mangiafico
- Digestive Endoscopy Unit, S. Agostino-Estense Hospital, 41126 Modena, Italy; (A.C.); (F.P.Z.); (S.M.); (R.C.)
| | - Riccardo Marmo
- Gastroenterology and Digestive Endoscopy, L. Curto Hospital, Polla, 84036 Salerno, Italy;
| | - Angelo Zullo
- Gastroenterology and Digestive Endoscopy, Nuovo Regina Margherita Hospital, 00153 Rome, Italy;
| | - Gianluca Esposito
- Department of Clinical Sciences and Translational Medicine, Sant’Andrea Hospital, Sapienza University. 00189 Rome, Italy; (S.A.); (G.E.); (B.A.)
| | - Bruno Annibale
- Department of Clinical Sciences and Translational Medicine, Sant’Andrea Hospital, Sapienza University. 00189 Rome, Italy; (S.A.); (G.E.); (B.A.)
| | | | - Rita Conigliaro
- Digestive Endoscopy Unit, S. Agostino-Estense Hospital, 41126 Modena, Italy; (A.C.); (F.P.Z.); (S.M.); (R.C.)
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Caruso A, Sgamato C, Bertani H, Pigò F, Mangiafico S, Grande G, Conigliaro RL. Underwater endoscopic submucosal dissection of an obstructing giant colonic lipoma. Endoscopy 2020; 52:E90-E91. [PMID: 31561257 DOI: 10.1055/a-1011-3617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Angelo Caruso
- Digestive Endoscopy Unit, Ospedale Civile di Baggiovara, Azienda Ospedaliero-Universitaria di Modena, Baggiovara, Italy
| | - Costantino Sgamato
- Gastroenterology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Helga Bertani
- Digestive Endoscopy Unit, Ospedale Civile di Baggiovara, Azienda Ospedaliero-Universitaria di Modena, Baggiovara, Italy
| | - Flavia Pigò
- Digestive Endoscopy Unit, Ospedale Civile di Baggiovara, Azienda Ospedaliero-Universitaria di Modena, Baggiovara, Italy
| | - Santi Mangiafico
- Digestive Endoscopy Unit, Ospedale Civile di Baggiovara, Azienda Ospedaliero-Universitaria di Modena, Baggiovara, Italy
| | - Giuseppe Grande
- Digestive Endoscopy Unit, Ospedale Civile di Baggiovara, Azienda Ospedaliero-Universitaria di Modena, Baggiovara, Italy
| | - Rita Luisa Conigliaro
- Digestive Endoscopy Unit, Ospedale Civile di Baggiovara, Azienda Ospedaliero-Universitaria di Modena, Baggiovara, Italy
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14
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Mangiafico S, Pigò F, Bertani H, Caruso A, Grande G, Sgamato C, Manta R, Conigliaro R. Over-the-scope clip vs epinephrine with clip for first-line hemostasis in non-variceal upper gastrointestinal bleeding: a propensity score match analysis. Endosc Int Open 2020; 8:E50-E58. [PMID: 31921984 PMCID: PMC6949178 DOI: 10.1055/a-1005-6401] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 07/29/2019] [Indexed: 02/07/2023] Open
Abstract
Background and study aims The over-the-scope clip (OTSC) is a novel tool used to improve the maintenance of hemostasis for non-variceal upper gastrointestinal bleeding (NVUGIB); however, studies on the comparison with "conventional" techniques are lacking. In this study, we aimed to compare first-line endoscopic hemostasis achieved using conventional techniques with that achieved using OTSC placement for NVUGIB. Patients and methods From January 2007 to March 2018, 793 consecutive patients underwent upper endoscopy with the hemostasis procedure. Among them, 327 patients were eligible for inclusion (112 patients had OTSC placement and 215 underwent conventional hemostasis). After propensity score matching and adjustment for confounding factors, 84 patients were stratified into the "conventional" group and 84 into the OTSC group. Patient characteristics and outcomes (rebleeding rate, mortality rate within 30 days, and adverse events) were compared between the two groups. Results In the unmatched cohort, hemostasis with OTSC was more frequent in cases of duodenal ulcers with Forrest Ia to IIa and in patients with a higher Rockall score compared with the "conventional group". In the matched cohort, 93 % of the patients in the "conventional group" underwent hemostasis with epinephrine + through-the-scope clip. Rebleeding events were significantly less frequent in the OTSC group (8 % vs 20 %, 95 %CI 3 - 16 vs 12 - 30; P = 0.02); however, the mortality rate in the two groups was not significantly different (6 % vs 2 %, 95 %CI 1 - 8 vs 2 - 13; P = 0.4). Conclusions OTSC is a safe and effective tool for achieving hemostasis, and we recommend its use as the first-line therapy for lesions with a high risk of rebleeding and in patients with a high risk Rockall score.
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Affiliation(s)
- Santi Mangiafico
- Azienda Ospedaliero-Universitaria di Modena Ospedale Civile di Baggiovara, Gastroenterology and Digestive Endoscopy Unit, Modena, Italy
| | - Flavia Pigò
- Azienda Ospedaliero-Universitaria di Modena Ospedale Civile di Baggiovara, Gastroenterology and Digestive Endoscopy Unit, Modena, Italy
| | - Helga Bertani
- Azienda Ospedaliero-Universitaria di Modena Ospedale Civile di Baggiovara, Gastroenterology and Digestive Endoscopy Unit, Modena, Italy
| | - Angelo Caruso
- Azienda Ospedaliero-Universitaria di Modena Ospedale Civile di Baggiovara, Gastroenterology and Digestive Endoscopy Unit, Modena, Italy
| | - Giuseppe Grande
- Azienda Ospedaliero-Universitaria di Modena Ospedale Civile di Baggiovara, Gastroenterology and Digestive Endoscopy Unit, Modena, Italy
| | - Costantino Sgamato
- University of Naples Federico II, Department of Clinical Medicine and Surgery, Gastroenterology Unit, Naples, Italy
| | - Raffaele Manta
- Azienda Ospedaliera di Perugia, Gastroenterology and Digestive Endoscopy Unit, Perugia, Italy
| | - Rita Conigliaro
- Azienda Ospedaliero-Universitaria di Modena Ospedale Civile di Baggiovara, Gastroenterology and Digestive Endoscopy Unit, Modena, Italy
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Cagnazzo F, Limbucci N, Nappini S, Renieri L, Rosi A, Laiso A, Tiziano di Carlo D, Perrini P, Mangiafico S. Flow-Diversion Treatment of Unruptured Saccular Anterior Communicating Artery Aneurysms: A Systematic Review and Meta-Analysis. AJNR Am J Neuroradiol 2019; 40:497-502. [PMID: 30765379 DOI: 10.3174/ajnr.a5967] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Accepted: 12/23/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND Flow diversion for anterior communicating artery aneurysms required further investigation. PURPOSE Our aim was to analyze outcomes after treatment of anterior communicating artery aneurysms with flow-diverter stents. DATA SOURCES A systematic search of 3 data bases was performed for studies published from 2008 to 2018. STUDY SELECTION According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we included studies reporting anterior communicating artery aneurysms treated with flow diversion. DATA ANALYSIS Random-effects meta-analysis was used to pool the following: aneurysm occlusion rate, complications, and factors influencing the studied outcomes. DATA SYNTHESIS We included 14 studies and 148 unruptured saccular anterior communicating artery aneurysms treated with flow diversion. The long-term complete/near-complete (O'Kelly-Marotta C-D) occlusion rate was 87.4% (91/105; 95% CI, 81.3%-93.6%; I2 = 0%) (mean radiologic follow-up of 11 months). The treatment-related complication rate was 8.6% (14/126; 95% CI, 4%-13.1%; I2 = 0%), with morbidity and mortality rates of 3.5% (5/126; 95% CI, 2%-7%; I2 = 0%) and 2.5% (2/148; 95% CI, 0.3%-5%; I2 = 0%), respectively. Most complications were periprocedural (12/126 = 7%; 95% CI, 3%-11%; I2 = 0%). Thromboembolic events were slightly higher compared with hemorrhagic complications (10/126 = 6%; 95% CI, 2%-10%; I2 = 0% and 4/126 = 3%; 95% CI, 1%-6%; I2 = 0%). Branching arteries (A2 or the recurrent artery of Heubner) covered by the stent were occluded in 16% (7/34; 95% CI, 3.5%-28%; I2 = 25%) of cases. Pre- and posttreatment low-dose and high-dose of antiplatelet therapy was not associated with significantly different complication and occlusion rates. LIMITATIONS We reviewed small and retrospective series. CONCLUSIONS Flow diversion for unruptured saccular anterior communicating artery aneurysms appears to be an effective alternative treatment for lesions difficult to treat with coiling or microsurgical clipping. The treatment-related complication rate was relatively low. However, larger studies are needed to confirm these results.
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Affiliation(s)
- F Cagnazzo
- From the Interventional Neuroradiology Unit (F.C., N.L., S.N., L.R., A.R., A.L., S.M.), Careggi University Hospital, Florence, Italy
| | - N Limbucci
- From the Interventional Neuroradiology Unit (F.C., N.L., S.N., L.R., A.R., A.L., S.M.), Careggi University Hospital, Florence, Italy
| | - S Nappini
- From the Interventional Neuroradiology Unit (F.C., N.L., S.N., L.R., A.R., A.L., S.M.), Careggi University Hospital, Florence, Italy
| | - L Renieri
- From the Interventional Neuroradiology Unit (F.C., N.L., S.N., L.R., A.R., A.L., S.M.), Careggi University Hospital, Florence, Italy
| | - A Rosi
- From the Interventional Neuroradiology Unit (F.C., N.L., S.N., L.R., A.R., A.L., S.M.), Careggi University Hospital, Florence, Italy
| | - A Laiso
- From the Interventional Neuroradiology Unit (F.C., N.L., S.N., L.R., A.R., A.L., S.M.), Careggi University Hospital, Florence, Italy
| | - D Tiziano di Carlo
- Department of Neurosurgery (D.T.d.C., P.P.), Cisanello Hospital, University of Pisa, Pisa, Italy
| | - P Perrini
- Department of Neurosurgery (D.T.d.C., P.P.), Cisanello Hospital, University of Pisa, Pisa, Italy
| | - S Mangiafico
- From the Interventional Neuroradiology Unit (F.C., N.L., S.N., L.R., A.R., A.L., S.M.), Careggi University Hospital, Florence, Italy
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16
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Cagnazzo F, Limbucci N, Nappini S, Renieri L, Rosi A, Laiso A, Tiziano di Carlo D, Perrini P, Mangiafico S. Y-Stent-Assisted Coiling of Wide-Neck Bifurcation Intracranial Aneurysms: A Meta-Analysis. AJNR Am J Neuroradiol 2018; 40:122-128. [PMID: 30523146 DOI: 10.3174/ajnr.a5900] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 10/15/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND Y-stent-assisted coiling for wide-neck intracranial aneurysms required further investigation. PURPOSE Our aim was to analyze outcomes after Y-stent placement in wide-neck aneurysms. DATA SOURCES We performed a systematic search of 3 data bases for studies published from 2000 to 2018. STUDY SELECTION According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we included studies reporting Y-stent-assisted coiling of wide-neck aneurysms. DATA ANALYSIS Random-effects meta-analysis was used to pool the following: aneurysm occlusion rate, complications, and factors influencing the studied outcomes. DATA SYNTHESIS We included 27 studies and 750 aneurysms treated with Y-stent placement. The immediate complete/near-complete occlusion rate was 82.2% (352/468; 95% CI, 71.4%-93%; I2 = 92%), whereas the long-term complete/near-complete occlusion rate was 95.4% (564/598; 95% CI, 93.7%-97%; I2 = 0%) (mean radiologic follow-up of 14 months). The aneurysm recanalization rate was 3% (20/496; 95% CI, 1.5%-4.5%; I2 = 0%), and half of the recanalized aneurysms required retreatment. The treatment-related complication rate was 8.9% (63/614; 95% CI, 5.8%-12.1%; I2 = 44%). Morbidity and mortality after treatment were 2.4% (18/540; 95% CI, 1.2%-3.7%; I2 = 0%) and 1.1% (5/668; 95% CI, 0.3%-1.9%; I2 = 0%), respectively. Crossing Y-stent placement was associated with a slightly lower complication rate compared with the kissing configuration (56/572 = 8.4%; 95% CI, 5%-11%; I2 = 46% versus 4/30 = 12.7%; 95% CI, 3%-24%; I2 = 0%). Occlusion rates were quite comparable among Enterprise, Neuroform, and LVIS stents, whereas the Enterprise stent was associated with lower rates of complications (8/89 = 6.5%; 95% CI, 1.6%-11%; I2 = 0%) compared with the others (20/131 = 14%; 95% CI, 5%-26%; I2 = 69% and 9/64 = 11%; 95% CI, 3%-20%; I2 = 18%). LIMITATIONS This was a small, retrospective series. CONCLUSIONS Y-stent-assisted coiling yields high rates of long-term angiographic occlusion, with a relatively low rate of treatment-related complications. Y-stent placement with a crossing configuration appears to be associated with better outcomes. Although Y-configuration can be obtained using many types of stents with comparable occlusion rates, the Enterprise stent is associated with lower complication rates.
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Affiliation(s)
- F Cagnazzo
- From the Interventional Neuroradiology Unit (F.C., N.L., S.N., L.R., A.R., A.L., S.M.), Careggi University Hospital, Florence, Italy
| | - N Limbucci
- From the Interventional Neuroradiology Unit (F.C., N.L., S.N., L.R., A.R., A.L., S.M.), Careggi University Hospital, Florence, Italy
| | - S Nappini
- From the Interventional Neuroradiology Unit (F.C., N.L., S.N., L.R., A.R., A.L., S.M.), Careggi University Hospital, Florence, Italy
| | - L Renieri
- From the Interventional Neuroradiology Unit (F.C., N.L., S.N., L.R., A.R., A.L., S.M.), Careggi University Hospital, Florence, Italy
| | - A Rosi
- From the Interventional Neuroradiology Unit (F.C., N.L., S.N., L.R., A.R., A.L., S.M.), Careggi University Hospital, Florence, Italy
| | - A Laiso
- From the Interventional Neuroradiology Unit (F.C., N.L., S.N., L.R., A.R., A.L., S.M.), Careggi University Hospital, Florence, Italy
| | - D Tiziano di Carlo
- Department of Neurosurgery (D.T.d.C., P.P.), Cisanello Hospital, University of Pisa, Pisa, Italy
| | - P Perrini
- Department of Neurosurgery (D.T.d.C., P.P.), Cisanello Hospital, University of Pisa, Pisa, Italy
| | - S Mangiafico
- From the Interventional Neuroradiology Unit (F.C., N.L., S.N., L.R., A.R., A.L., S.M.), Careggi University Hospital, Florence, Italy
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Manta R, Mangiafico S, Zullo A, Bertani H, Caruso A, Grande G, Zito FP, Mangiavillano B, Pasquale L, Parodi A, Germanà B, Bassotti G, Monica F, Zilli M, Pisani A, Mutignani M, Conigliaro R, Galloro G. First-line endoscopic treatment with over-the-scope clips in patients with either upper or lower gastrointestinal bleeding: a multicenter study. Endosc Int Open 2018; 6:E1317-E1321. [PMID: 30410951 PMCID: PMC6221819 DOI: 10.1055/a-0746-8435] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 08/06/2018] [Indexed: 02/07/2023] Open
Abstract
Background and study aims Endoscopic treatment is the mainstay approach for gastrointestinal bleeding, in either upper (UGIB) or lower (LGIB) tract. The over-the-scope clip (OTSC) may overcome limitations of standard clips or thermocoagulation in high-risk bleeding lesions. We evaluate the main clinically relevant outcomes following endoscopic hemostasis with OTSC in high-risk lesions and/or patients. Patients and methods This was a retrospective analysis of prospectively collected databases including all patients with UGIB and LGIB who underwent OTCS placement as first-line treatment in eleven tertiary endoscopic referral centers. Technical success, primary hemostasis, rebleeding, blood transfusion, hospital stay, and hemorrhage-related mortality rates were evaluated. Results Data from 286 patients, with either UGIB (N = 214) or LGIB (N = 72) were available. Overall, 112 patients (39.2 %) were receiving antithrombotic therapy. Technical success and primary hemostasis rates were 97.9 % and 96.4 %, respectively. Early rebleeding occurred in 4.4 %, more frequently in those on antithrombotic therapy, and no late rebleeding was observed. Following a successful primary haemostasis, only 5.2 % patients needed blood transfusions, and the median hospital stay was 4 days (range: 3 - 11). Eighteen patients with either technical failure (N = 6) or rebleeding (N = 12) underwent radiological or surgical approaches. Overall, bleeding-related deaths occurred in 5 (1.7 %) patients, including 3 patients with technical procedural failure, and 2 in the rebleeding group. Conclusions Data from our large, multicenter study show that OTSC placement is an effective first-line treatment for hemostasis in high-risk patients and/or lesions both in upper and lower gastrointestinal tract.
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Affiliation(s)
- Raffaele Manta
- Digestive Endoscopy Unit, S.Agostino-Estense Hospital, Modena, Italy,Corresponding author Raffaele Manta, MD Gastroenterologia ed Endoscopia DigestivaAzienda Ospedaliera Universitaria di ModenaOspedale S.Agostino-EstenseViale Giardini Nord 1355Baggiovara, ModenaItaly+0039 059 3961216
| | - Santi Mangiafico
- Digestive Endoscopy Unit, S.Agostino-Estense Hospital, Modena, Italy
| | - Angelo Zullo
- Gastroenterology Unit, Nuovo Regina Margherita Hospital, Rome, Italy
| | - Helga Bertani
- Digestive Endoscopy Unit, S.Agostino-Estense Hospital, Modena, Italy
| | - Angelo Caruso
- Digestive Endoscopy Unit, S.Agostino-Estense Hospital, Modena, Italy
| | - Giuseppe Grande
- Digestive Endoscopy Unit, S.Agostino-Estense Hospital, Modena, Italy
| | | | | | - Luigi Pasquale
- Gastroenterology Unit, San Giuseppe Moscati Hospital, Avellino, Italy
| | - Andrea Parodi
- Gastroenterology Unit, Galliera Hospital, Genova, Italy
| | - Bastianello Germanà
- Gastroenterology and Digestive Endoscopy Unit, Belluno Hospital, Belluno, Italy
| | - Gabrio Bassotti
- Gastroenterology Unit, Department of Medicine, Perugia University, Perugia, Italy
| | - Fabio Monica
- Gastroenterology Unit, Azienda Sanitaria Universitaria Integrata, Trieste, Italy
| | - Maurizio Zilli
- Gastroenterology Unit, Azienda Sanitaria Universitaria Integrata, Udine, Italy
| | - Antonio Pisani
- Gastroenterology Section, Department of Emergency and Organ Transplantation, Bari University, Bari, Italy
| | | | - Rita Conigliaro
- Digestive Endoscopy Unit, S.Agostino-Estense Hospital, Modena, Italy
| | - Giuseppe Galloro
- Surgical Digestive Endoscopy, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
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18
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Caggegi AM, Scandura S, Capranzano P, Mangiafico S, Castania G, Salerno T, Farruggio S, Popolo Rubbio A, Ludanyiova Z, De Santis J, Sanalitro S, Di Salvo ME, Grasso C, Capodanno D, Tamburino C. P1671Impact of chronic kidney disease on mitral valve repair with the mitraclip system: one-year outcomes frome the GRASP registry stratified by left ventricular dysfunction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1671] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A M Caggegi
- Ferrarotto Hospital - Institute for Cardiology, Department of Cardiovascular, Catania, Italy
| | - S Scandura
- Ferrarotto Hospital - Institute for Cardiology, Department of Cardiovascular, Catania, Italy
| | - P Capranzano
- Ferrarotto Hospital - Institute for Cardiology, Department of Cardiovascular, Catania, Italy
| | - S Mangiafico
- Ferrarotto Hospital - Institute for Cardiology, Department of Cardiovascular, Catania, Italy
| | - G Castania
- Ferrarotto Hospital - Institute for Cardiology, Department of Cardiovascular, Catania, Italy
| | - T Salerno
- Ferrarotto Hospital - Institute for Cardiology, Department of Cardiovascular, Catania, Italy
| | - S Farruggio
- Ferrarotto Hospital - Institute for Cardiology, Department of Cardiovascular, Catania, Italy
| | - A Popolo Rubbio
- Ferrarotto Hospital - Institute for Cardiology, Department of Cardiovascular, Catania, Italy
| | - Z Ludanyiova
- Ferrarotto Hospital - Institute for Cardiology, Department of Cardiovascular, Catania, Italy
| | - J De Santis
- Ferrarotto Hospital - Institute for Cardiology, Department of Cardiovascular, Catania, Italy
| | - S Sanalitro
- Ferrarotto Hospital - Institute for Cardiology, Department of Cardiovascular, Catania, Italy
| | - M E Di Salvo
- Ferrarotto Hospital - Institute for Cardiology, Department of Cardiovascular, Catania, Italy
| | - C Grasso
- Ferrarotto Hospital - Institute for Cardiology, Department of Cardiovascular, Catania, Italy
| | - D Capodanno
- Ferrarotto Hospital - Institute for Cardiology, Department of Cardiovascular, Catania, Italy
| | - C Tamburino
- Ferrarotto Hospital - Institute for Cardiology, Department of Cardiovascular, Catania, Italy
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Adeeb N, Griessenauer CJ, Dmytriw AA, Shallwani H, Gupta R, Foreman PM, Shakir H, Moore J, Limbucci N, Mangiafico S, Kumar A, Michelozzi C, Zhang Y, Pereira VM, Matouk CC, Harrigan MR, Siddiqui AH, Levy EI, Renieri L, Marotta TR, Cognard C, Ogilvy CS, Thomas AJ. Risk of Branch Occlusion and Ischemic Complications with the Pipeline Embolization Device in the Treatment of Posterior Circulation Aneurysms. AJNR Am J Neuroradiol 2018; 39:1303-1309. [PMID: 29880475 DOI: 10.3174/ajnr.a5696] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 04/10/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Flow diversion with the Pipeline Embolization Device is increasingly used for endovascular treatment of intracranial aneurysms due to high reported obliteration rates and low associated morbidity. While obliteration of covered branches in the anterior circulation is generally asymptomatic, this has not been studied within the posterior circulation. The aim of this study was to evaluate the association between branch coverage and occlusion, as well as associated ischemic events in a cohort of patients with posterior circulation aneurysms treated with the Pipeline Embolization Device. MATERIALS AND METHODS A retrospective review of prospectively maintained databases at 8 academic institutions from 2009 to 2016 was performed to identify patients with posterior circulation aneurysms treated with the Pipeline Embolization Device. Branch coverage following placement was evaluated, including the posterior inferior cerebellar artery, anterior inferior cerebellar artery, superior cerebellar artery, and posterior cerebral artery. If the Pipeline Embolization Device crossed the ostia of the contralateral vertebral artery, its long-term patency was assessed as well. RESULTS A cohort of 129 consecutive patients underwent treatment of 131 posterior circulation aneurysms with the Pipeline Embolization Device. Adjunctive coiling was used in 40 (31.0%) procedures. One or more branches were covered in 103 (79.8%) procedures. At a median follow-up of 11 months, 11% were occluded, most frequently the vertebral artery (34.8%). Branch obliteration was most common among asymptomatic aneurysms (P < .001). Ischemic complications occurred in 29 (22.5%) procedures. On multivariable analysis, there was no significant difference in ischemic complications in cases in which a branch was covered (P = .24) or occluded (P = .16). CONCLUSIONS There was a low occlusion incidence in end arteries following branch coverage at last follow-up. The incidence was higher in the posterior cerebral artery and vertebral artery where collateral supply is high. Branch occlusion was not associated with a significant increase in ischemic complications.
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Affiliation(s)
- N Adeeb
- From the Beth Israel Deaconess Medical Center (N.A., C.J.G., A.A.D., R.G., J.M., C.S.O., A.J.T.), Harvard Medical School, Boston, Massachusetts
| | - C J Griessenauer
- From the Beth Israel Deaconess Medical Center (N.A., C.J.G., A.A.D., R.G., J.M., C.S.O., A.J.T.), Harvard Medical School, Boston, Massachusetts
- Department of Neurosurgery (C.J.G.), Geisinger Medical Center, Geisinger Commonwealth School of Medicine, Danville, Pennsylvania
| | - A A Dmytriw
- From the Beth Israel Deaconess Medical Center (N.A., C.J.G., A.A.D., R.G., J.M., C.S.O., A.J.T.), Harvard Medical School, Boston, Massachusetts
- Department of Medical Imaging (A.A.D., Y.Z., V.M.P.), Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
- Division of Diagnostic and Therapeutic Neuroradiology (A.A.D., A.K., T.R.M.), St. Michael's Hospital, Toronto, Ontario, Canada
| | - H Shallwani
- Department of Neurosurgery (H. Shallwani, H. Shakir, A.H.S., E.I.L.), State University of New York at Buffalo, Buffalo, New York
| | - R Gupta
- From the Beth Israel Deaconess Medical Center (N.A., C.J.G., A.A.D., R.G., J.M., C.S.O., A.J.T.), Harvard Medical School, Boston, Massachusetts
| | - P M Foreman
- Department of Neurosurgery (P.M.F., M.R.H.), University of Alabama at Birmingham, Birmingham, Alabama
| | - H Shakir
- Department of Neurosurgery (H. Shallwani, H. Shakir, A.H.S., E.I.L.), State University of New York at Buffalo, Buffalo, New York
| | - J Moore
- From the Beth Israel Deaconess Medical Center (N.A., C.J.G., A.A.D., R.G., J.M., C.S.O., A.J.T.), Harvard Medical School, Boston, Massachusetts
| | - N Limbucci
- Department of Interventional Neuroradiology (N.L., S.M., L.R.), University of Florence, Florence, Italy
| | - S Mangiafico
- Department of Interventional Neuroradiology (N.L., S.M., L.R.), University of Florence, Florence, Italy
| | - A Kumar
- Division of Diagnostic and Therapeutic Neuroradiology (A.A.D., A.K., T.R.M.), St. Michael's Hospital, Toronto, Ontario, Canada
| | - C Michelozzi
- Department of Diagnostic and Therapeutic Neuroradiology (C.M., C.C.), Toulouse University Hospital, Toulouse, France
| | - Y Zhang
- Department of Medical Imaging (A.A.D., Y.Z., V.M.P.), Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - V M Pereira
- Department of Medical Imaging (A.A.D., Y.Z., V.M.P.), Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - C C Matouk
- Department of Neurosurgery (C.C.M.), Yale School of Medicine, New Haven, Connecticut
| | - M R Harrigan
- Department of Neurosurgery (P.M.F., M.R.H.), University of Alabama at Birmingham, Birmingham, Alabama
| | - A H Siddiqui
- Department of Neurosurgery (H. Shallwani, H. Shakir, A.H.S., E.I.L.), State University of New York at Buffalo, Buffalo, New York
| | - E I Levy
- Department of Neurosurgery (H. Shallwani, H. Shakir, A.H.S., E.I.L.), State University of New York at Buffalo, Buffalo, New York
| | - L Renieri
- Department of Interventional Neuroradiology (N.L., S.M., L.R.), University of Florence, Florence, Italy
| | - T R Marotta
- Division of Diagnostic and Therapeutic Neuroradiology (A.A.D., A.K., T.R.M.), St. Michael's Hospital, Toronto, Ontario, Canada
| | - C Cognard
- Department of Diagnostic and Therapeutic Neuroradiology (C.M., C.C.), Toulouse University Hospital, Toulouse, France
| | - C S Ogilvy
- From the Beth Israel Deaconess Medical Center (N.A., C.J.G., A.A.D., R.G., J.M., C.S.O., A.J.T.), Harvard Medical School, Boston, Massachusetts
| | - A J Thomas
- From the Beth Israel Deaconess Medical Center (N.A., C.J.G., A.A.D., R.G., J.M., C.S.O., A.J.T.), Harvard Medical School, Boston, Massachusetts
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Gory B, Haussen DC, Piotin M, Steglich-Arnholm H, Holtmannspötter M, Labreuche J, Kyheng M, Taschner C, Eiden S, Nogueira RG, Papanagiotou P, Boutchakova M, Siddiqui AH, Lapergue B, Dorn F, Cognard C, Killer M, Mangiafico S, Ribo M, Psychogios MN, Spiotta AM, Labeyrie MA, Biondi A, Mazighi M, Turjman F. Impact of intravenous thrombolysis and emergent carotid stenting on reperfusion and clinical outcomes in patients with acute stroke with tandem lesion treated with thrombectomy: a collaborative pooled analysis. Eur J Neurol 2018; 25:1115-1120. [DOI: 10.1111/ene.13633] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 02/26/2018] [Indexed: 11/29/2022]
Affiliation(s)
- B. Gory
- Department of Diagnostic and Interventional Neuroradiology; INSERM U947; University Hospital of Nancy; Nancy France
| | - D. C. Haussen
- Department of Neurology; Emory University/Grady Memorial Hospital; Atlanta GA USA
| | - M. Piotin
- Department of Interventional Neuroradiology; Rothschild Foundation; Paris France
| | | | | | - J. Labreuche
- Department of Biostatistics; EA2694-Santé Publique: Epidémiologie et Qualité Des Soins; Lille University; Lille France
| | - M. Kyheng
- Department of Biostatistics; EA2694-Santé Publique: Epidémiologie et Qualité Des Soins; Lille University; Lille France
| | - C. Taschner
- Department of Neuroradiology; Medical Center-University of Freiburg; Freiburg
| | - S. Eiden
- Department of Neuroradiology; Medical Center-University of Freiburg; Freiburg
| | - R. G. Nogueira
- Department of Neurology; Emory University/Grady Memorial Hospital; Atlanta GA USA
| | - P. Papanagiotou
- Department of Diagnostic and Interventional Neuroradiology; Klinikum Bremen-Mitte/Bremen-Ost; Bremen Germany
| | - M. Boutchakova
- Department of Diagnostic and Interventional Neuroradiology; Klinikum Bremen-Mitte/Bremen-Ost; Bremen Germany
| | - A. H. Siddiqui
- Department of Neurosurgery; University at Buffalo; State University of New York; Buffalo NY USA
| | - B. Lapergue
- Department of Neurology; Stroke Center; Foch Hospital; Suresnes France
| | - F. Dorn
- Department of Neuroradiology; University Hospital of Munich; Munich Germany
| | - C. Cognard
- Department of Neuroradiology; University Hospital of Toulouse; Toulouse France
| | - M. Killer
- Department of Neuroradiology; Christian Doppler Clinic; Research Institute for Neurointervention; Paracelsus Medical University; Salzburg Austria
| | - S. Mangiafico
- Department of Interventional Neuroradiology; Careggi University Hospital; Florence Italy
| | - M. Ribo
- Department of Neurology; Hospital Vall D'Hebron; Barcelona Spain
| | - M. N. Psychogios
- Department of Neuroradiology; University Medical Center Göttingen; Göttingen Germany
| | - A. M. Spiotta
- Department of Neurosurgery; Medical University of South Carolina; Charleston SC USA
| | - M. A. Labeyrie
- Department of Interventional Neuroradiology; Lariboisière Hospital; Paris
| | - A. Biondi
- Department of Neuroradiology and Endovascular Therapeutic; University Hospital of Besançon; Besançon
| | - M. Mazighi
- Department of Interventional Neuroradiology; Rothschild Foundation; Paris France
| | - F. Turjman
- Department of Interventional Neuroradiology; Hospices Civils de Lyon; Lyon France
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Martinelli C, Grippo A, Ammannati A, Gabbanini S, Boccardi C, Caramelli R, Carrai R, de Scisciolo G, Romoli S, Mangiafico S, Amantini A. 19. Intraoperative neurophysiological monitoring of spinal dural arteriovenous fistula. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2017.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Grande G, Manno M, Zulli C, Barbera C, Mangiafico S, Alberghina N, Conigliaro RL. An alternative endoscopic treatment for massive gastric bezoars: Ho:YAG laser fragmentation. Endoscopy 2017; 48 Suppl 1:E217. [PMID: 27310895 DOI: 10.1055/s-0042-109057] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Giuseppe Grande
- Gastrointestinal Endoscopy Unit, NOCSAE Baggiovara Hospital, Modena, Italy
| | - Mauro Manno
- Gastrointestinal Endoscopy Unit, NOCSAE Baggiovara Hospital, Modena, Italy
| | - Claudio Zulli
- Gastrointestinal Endoscopy Unit, NOCSAE Baggiovara Hospital, Modena, Italy
| | - Carmelo Barbera
- Gastrointestinal Endoscopy Unit, NOCSAE Baggiovara Hospital, Modena, Italy
| | - Santi Mangiafico
- Gastrointestinal Endoscopy Unit, NOCSAE Baggiovara Hospital, Modena, Italy
| | - Nadia Alberghina
- Gastrointestinal Endoscopy Unit, NOCSAE Baggiovara Hospital, Modena, Italy
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Mangiafico S, Caruso A, Manta R, Grande G, Bertani H, Mirante V, Pigò F, Magnano L, Manno M, Conigliaro R. Over-the-scope clip closure for treatment of post-pancreaticogastrostomy pancreatic fistula: A case series. Dig Endosc 2017; 29:602-607. [PMID: 28095614 DOI: 10.1111/den.12806] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 11/24/2016] [Accepted: 01/11/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIM The over-the-scope clip (OTSC) system is a recently developed endoscopic device. In the last few years, it has been successfully used for severe bleeding or deep wall lesions, or perforations of the gastrointestinal (GI) tract. We hereby report a series of patients with post-pancreaticogastrostomy pancreatic fistula in whom OTSC were used as endoscopic treatment. METHODS From January 2012 to July 2015, we prospectively collected data on cases of postoperative pancreatic fistula. These patients underwent pancreaticoduodenectomy in a high-volume center of hepatobiliopancreatic surgery. After conservative management, OTSC closure was done by single skilled operators in anesthesiologist-assisted deep sedation. RESULTS A total of seven patients were enrolled. According to the International Study Group of Pancreatic Surgery criteria, we observed grade B postoperative pancreatic fistula in all cases. All patients were treated with 12/6 t-type OTSC. In two cases, a second clip was successfully applied to a second site adjacent to the original closure site. In all cases, subsequent fluoroscopy showed no contrastographic spreading through the wall. There were no complications related to the procedure itself, not from the endoscopy point of view, nor from the anesthesiological perspective. There were no device malfunctions. Further clinical and endoscopic evaluation was made 8 weeks later and showed no fistula or anastomotic defect recurrence. No patients required additional endoscopic or interventional procedures. CONCLUSION In consideration of clinical and technical success, OTSC placement in POPF seems to be effective, safe and technically relatively easy to carry out.
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Affiliation(s)
- Santi Mangiafico
- Gastroenterology and Digestive Endoscopy Unit, New Civil S. Agostino Estense Hospital, Modena, Italy
| | - Angelo Caruso
- Gastroenterology and Digestive Endoscopy Unit, New Civil S. Agostino Estense Hospital, Modena, Italy
| | - Raffaele Manta
- Gastroenterology and Digestive Endoscopy Unit, New Civil S. Agostino Estense Hospital, Modena, Italy
| | - Giuseppe Grande
- Gastroenterology and Digestive Endoscopy Unit, New Civil S. Agostino Estense Hospital, Modena, Italy
| | - Helga Bertani
- Gastroenterology and Digestive Endoscopy Unit, New Civil S. Agostino Estense Hospital, Modena, Italy
| | - Vincenzo Mirante
- Gastroenterology and Digestive Endoscopy Unit, New Civil S. Agostino Estense Hospital, Modena, Italy
| | - Flavia Pigò
- Gastroenterology and Digestive Endoscopy Unit, New Civil S. Agostino Estense Hospital, Modena, Italy
| | - Luigi Magnano
- Plastic and Reconstructive Surgery, Chelsea and Westminster Hospital, London, UK
| | - Mauro Manno
- Digestive Endoscopy Unit-Northern Area, Ospedale di Carpi, Carpi, Italy
| | - Rita Conigliaro
- Gastroenterology and Digestive Endoscopy Unit, New Civil S. Agostino Estense Hospital, Modena, Italy
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Pigò F, Bertani H, Manno M, Mirante VG, Caruso A, Mangiafico S, Manta R, Rebecchi AM, Conigliaro RL. Colonic Postpolypectomy Bleeding Is Related to Polyp Size and Heparin Use. Clin Endosc 2017; 50:287-292. [PMID: 28183158 PMCID: PMC5475522 DOI: 10.5946/ce.2016.126] [Citation(s) in RCA: 7] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 09/15/2016] [Accepted: 10/04/2016] [Indexed: 12/16/2022] Open
Abstract
Background/Aims We studied factors influencing colon postpolypectomy bleeding (PPB), with a focus on antithrombotic and anticoagulation therapy. Methods We conducted a retrospective case-control study of all patients who underwent polypectomy at our tertiary referral center in Italy between 2007 and 2014. Polyp characteristics (number of polyps removed per patient, size, morphology, location, resection technique, prophylactic hemostasis methods) and patient characteristics (age, sex, comorbidities, medication) were analyzed. Results The case and control groups included 118 and 539 patients, respectively. The two groups differed in the frequency of comorbidities (69% vs. 40%, p=0.001), polyps removed (27% vs. 18%, p=0.02), and use of heparin therapy (23% vs. 1%, p<0.001). A total of 279 polyps in the case group and 966 in the control group were nonpedunculated (69% vs. 81%, p=0.01) and measured ≥10 mm (78% vs. 32%, p=0.001). Multivariate analysis showed that polyps ≥10 mm (odds ratio [OR], 6.1; 95% confidence interval [CI], 2.3–15.5), administration of heparin (OR, 16.5; 95% CI, 6.2–44), comorbidity (OR, 2.3; 95% CI, 1.4–3.9), and presence of ≥2 risk factors (OR, 3.2; 95% CI, 1.7–6.0) were associated with PPB. Conclusions The incidence of PPB increases with polyp size ≥10 mm, heparin use, comorbidity, and presence of ≥2 risk factors.
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Affiliation(s)
- Flavia Pigò
- Digestive Endoscopic Unit, New Civil Hospital S. Agostino Estense, Baggiovara, Vignola Hospital, Vignola, Modena, Italy
| | - Helga Bertani
- Digestive Endoscopic Unit, New Civil Hospital S. Agostino Estense, Baggiovara, Vignola Hospital, Vignola, Modena, Italy
| | - Mauro Manno
- Digestive Endoscopic Unit, New Civil Hospital S. Agostino Estense, Baggiovara, Vignola Hospital, Vignola, Modena, Italy
| | - Vincenzo Giorgio Mirante
- Digestive Endoscopic Unit, New Civil Hospital S. Agostino Estense, Baggiovara, Vignola Hospital, Vignola, Modena, Italy
| | - Angelo Caruso
- Digestive Endoscopic Unit, New Civil Hospital S. Agostino Estense, Baggiovara, Vignola Hospital, Vignola, Modena, Italy
| | - Santi Mangiafico
- Digestive Endoscopic Unit, New Civil Hospital S. Agostino Estense, Baggiovara, Vignola Hospital, Vignola, Modena, Italy
| | - Raffaele Manta
- Digestive Endoscopic Unit, New Civil Hospital S. Agostino Estense, Baggiovara, Vignola Hospital, Vignola, Modena, Italy
| | | | - Rita Luisa Conigliaro
- Digestive Endoscopic Unit, New Civil Hospital S. Agostino Estense, Baggiovara, Vignola Hospital, Vignola, Modena, Italy
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Bertani H, Grande G, Mirante VG, Franco I, Mangiafico S, Manta R, Conigliaro RL. Multimodal endoscopic treatment of primary esophago-pleural fistula. Endoscopy 2016; 48:E298-E299. [PMID: 27669530 DOI: 10.1055/s-0042-115940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Helga Bertani
- Gastroenterology and Digestive Endoscopy Unit, NOCSAE Hospital, Modena, Italy
| | - Giuseppe Grande
- Gastroenterology and Digestive Endoscopy Unit, NOCSAE Hospital, Modena, Italy
| | | | - Isabella Franco
- Gastroenterology and Digestive Endoscopy Unit, NOCSAE Hospital, Modena, Italy
| | - Santi Mangiafico
- Gastroenterology and Digestive Endoscopy Unit, NOCSAE Hospital, Modena, Italy
| | - Raffaele Manta
- Gastroenterology and Digestive Endoscopy Unit, NOCSAE Hospital, Modena, Italy
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Abstract
Viene preso in esame il gruppo di 20 neoplasie intrarachidee in età infantile osservate presso la Clinica Neurochirurgica dell'Università di Firenze e si sottolinea la frequenza di alterazioni morfologiche riscontrate all'esame radiografico nei casi di compressioni spinali. In un'epoca in cui gli esami neuroradiologici più complessi (TC ed RM) hanno in gran parte risolto il quesito diagnostico delle compressioni spinali, gli autori sottolineato l'importanza di una accurata valutazione dell'esame radiografico diretto della colonna che potrà meglio indirizzare gli esami neuroradiologici più fini per giungere ad una diagnosi precoce delle compressioni spinali.
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Affiliation(s)
| | | | | | | | - G.A. Pellicano
- Dipartimento di Fisiopatologia Clinica dell'Università, Sezione di Radiodiagnostica. Firenze
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Mirante V, Bertani H, Grande G, Manno M, Caruso A, Mangiafico S, Conigliaro R. Effective endoscopic holmium laser lithotripsy in the treatment of a large impacted gallstone in the duodenum. Endoscopy 2016; 47 Suppl 1 UCTN:E485. [PMID: 26479297 DOI: 10.1055/s-0034-1393150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Vincenzo Mirante
- U.O.C. Gastroenterology and Digestive Endoscopy Unit, Nuovo Ospedale Civile Sant'Agostino Estense, Modena, Italy
| | - Helga Bertani
- U.O.C. Gastroenterology and Digestive Endoscopy Unit, Nuovo Ospedale Civile Sant'Agostino Estense, Modena, Italy
| | - Giuseppe Grande
- U.O.C. Gastroenterology and Digestive Endoscopy Unit, Nuovo Ospedale Civile Sant'Agostino Estense, Modena, Italy
| | - Mauro Manno
- U.O.C. Gastroenterology and Digestive Endoscopy Unit, Nuovo Ospedale Civile Sant'Agostino Estense, Modena, Italy
| | - Angelo Caruso
- U.O.C. Gastroenterology and Digestive Endoscopy Unit, Nuovo Ospedale Civile Sant'Agostino Estense, Modena, Italy
| | - Santi Mangiafico
- U.O.C. Gastroenterology and Digestive Endoscopy Unit, Nuovo Ospedale Civile Sant'Agostino Estense, Modena, Italy
| | - Rita Conigliaro
- U.O.C. Gastroenterology and Digestive Endoscopy Unit, Nuovo Ospedale Civile Sant'Agostino Estense, Modena, Italy
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Gory B, Spiotta AM, Mangiafico S, Consoli A, Biondi A, Pomero E, Killer-Oberpfalzer M, Weber W, Riva R, Labeyrie PE, Turjman F. PulseRider Stent-Assisted Coiling of Wide-Neck Bifurcation Aneurysms: Periprocedural Results in an International Series. AJNR Am J Neuroradiol 2016; 37:130-5. [PMID: 26338920 DOI: 10.3174/ajnr.a4506] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 06/08/2015] [Indexed: 11/07/2022]
Abstract
The PulseRider is a novel endovascular device specifically designed to treat bifurcation intracranial aneurysms with wide necks. In an international series, we report the results of PulseRider stent-assisted coiling of 15 patients (9 women and 6 men; mean age, 62.6 years) with 15 unruptured wide-neck (median dome size, 8 mm; median neck size, 5 mm) bifurcation aneurysms. Failure of PulseRider treatment occurred in 1 case, and 1 intraprocedural thromboembolic complication was observed. There was no mortality or neurologic permanent morbidity at discharge and at 1 month. Immediate angiographic outcome showed 12 complete occlusions and 2 neck remnants. Follow-up at 6 months was available for 3 aneurysms and demonstrated 2 complete aneurysm occlusions and 1 growing neck remnant. In this small series of selected patients, PulseRider stent-assisted coiling of wide-neck bifurcation aneurysms was feasible with low procedural complication rates. Angiographic follow-up will be required to evaluate the efficacy of the PulseRider device.
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Affiliation(s)
- B Gory
- From the DHU IRIS, Department of Interventional Neuroradiology (B.G., R.R., P.E.L., F.T.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
| | - A M Spiotta
- Department of Neurosciences (A.M.S.), Division of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina
| | - S Mangiafico
- Department of Neuroradiology (S.M., A.C.), Careggi University Hospital, Florence, Italy
| | - A Consoli
- Department of Neuroradiology (S.M., A.C.), Careggi University Hospital, Florence, Italy
| | - A Biondi
- Department of Neuroradiology and Endovascular Therapy (A.B., E.P.), Jean-Minjoz Hospital, Franche-Comté University, Besançon, France
| | - E Pomero
- Department of Neuroradiology and Endovascular Therapy (A.B., E.P.), Jean-Minjoz Hospital, Franche-Comté University, Besançon, France
| | - M Killer-Oberpfalzer
- Neuroscience Institute/Department of Neurology (M.K.-O.), Paracelsus Medical University, Christian Doppler Clinic, Salzburg, Austria
| | - W Weber
- Department of Neuroradiology (W.W.), Knappschaftskrankenhaus, Recklinghausen, Germany
| | - R Riva
- From the DHU IRIS, Department of Interventional Neuroradiology (B.G., R.R., P.E.L., F.T.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
| | - P E Labeyrie
- From the DHU IRIS, Department of Interventional Neuroradiology (B.G., R.R., P.E.L., F.T.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
| | - F Turjman
- From the DHU IRIS, Department of Interventional Neuroradiology (B.G., R.R., P.E.L., F.T.), Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
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Giuffrida G, Lombardo R, Parrinello N, Di Francesco E, Scandura S, Mangiafico S, Arcidiacono AA, Di Raimondo F. Percutaneous transluminal aortic valve implantation for severe aortic valve stenosis in a patient with severe haemophilia A. Haemophilia 2015; 21:e500-3. [PMID: 26228898 DOI: 10.1111/hae.12771] [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] [Accepted: 06/14/2015] [Indexed: 11/29/2022]
Affiliation(s)
- G Giuffrida
- Divisione Clinicizzata di Ematologia con Trapianto di Midollo Osseo, Centro di riferimento regionale per la prevenzione, diagnosi e cura delle malattie rare della coagulazione nel bambino e nell'adulto, Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele", Ospedale Ferrarotto, Università di Catania, Catania, Italy
| | - R Lombardo
- Divisione Clinicizzata di Ematologia con Trapianto di Midollo Osseo, Centro di riferimento regionale per la prevenzione, diagnosi e cura delle malattie rare della coagulazione nel bambino e nell'adulto, Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele", Ospedale Ferrarotto, Università di Catania, Catania, Italy
| | - N Parrinello
- Divisione Clinicizzata di Ematologia con Trapianto di Midollo Osseo, Centro di riferimento regionale per la prevenzione, diagnosi e cura delle malattie rare della coagulazione nel bambino e nell'adulto, Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele", Ospedale Ferrarotto, Università di Catania, Catania, Italy
| | - E Di Francesco
- Divisione Clinicizzata di Ematologia con Trapianto di Midollo Osseo, Centro di riferimento regionale per la prevenzione, diagnosi e cura delle malattie rare della coagulazione nel bambino e nell'adulto, Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele", Ospedale Ferrarotto, Università di Catania, Catania, Italy
| | - S Scandura
- Interventional Structural and Congenital Heart Disease Programme, Invasive Cardiology, Istituto di Cardiologia, Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele", Ospedale Ferrarotto, Università di Catania, Catania, Italy
| | - S Mangiafico
- Interventional Structural and Congenital Heart Disease Programme, Invasive Cardiology, Istituto di Cardiologia, Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele", Ospedale Ferrarotto, Università di Catania, Catania, Italy
| | - A A Arcidiacono
- Interventional Structural and Congenital Heart Disease Programme, Invasive Cardiology, Istituto di Cardiologia, Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele", Ospedale Ferrarotto, Università di Catania, Catania, Italy
| | - F Di Raimondo
- Divisione Clinicizzata di Ematologia con Trapianto di Midollo Osseo, Centro di riferimento regionale per la prevenzione, diagnosi e cura delle malattie rare della coagulazione nel bambino e nell'adulto, Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele", Ospedale Ferrarotto, Università di Catania, Catania, Italy
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Manno M, Mangiafico S, Caruso A, Barbera C, Bertani H, Mirante VG, Pigò F, Amardeep K, Conigliaro R. First-line endoscopic treatment with OTSC in patients with high-risk non-variceal upper gastrointestinal bleeding: preliminary experience in 40 cases. Surg Endosc 2015. [PMID: 26201415 DOI: 10.1007/s00464-015-4436-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [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: 12/13/2022]
Abstract
BACKGROUND AND STUDY AIMS The over-the-scope clip (OTSC; Ovesco, Tübingen, Germany) is a novel endoscopic clipping device designed for tissue approximation. The device has been used in the closure of fistulas and perforations. We hereby report a series of patients with high-risk non-variceal upper gastrointestinal bleeding (NVUGIB) lesions in whom OTSCs were used as first-line endoscopic treatment. PATIENTS AND METHODS We prospectively collected and retrospectively analysed data over a period of 12 months from October 2013 to November 2014 from all consecutive patients who underwent emergency endoscopy for acute severe high-risk NVUGIB and were treated with OTSC as primary first-line therapy. RESULTS We included forty consecutive patients with mean age 69 years (range 25-94 years). All patients were treated with the non-traumatic version of the OTSC system (23 with the 11 mm version and 17 with the 12 mm version). Indications for OTSC treatment included gastric ulcer with large vessel (Forrest IIa) (n = 8, 20 %), duodenal ulcer (Forrest Ib) (n = 7, 18 %), duodenal ulcer with large vessel (Forrest IIa) (n = 6, 15 %), Dieulafoy's lesion (n = 6, 15 %) and other secondary indications (n = 13, 32 %). Technical success and primary haemostasis were achieved in all patients (100 %). No re-bleeding, need for surgical or radiological embolization treatment or other complications were observed during the follow-up period of 30 days. CONCLUSIONS We conclude OTSC placement as a first-line endoscopic treatment seems to be effective, safe and easy to perform and should be considered in patients with high-risk NVUGIB lesions.
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Affiliation(s)
- Mauro Manno
- Digestive Endoscopy Unit-Northern Area, Ospedale di Carpi, Azienda USL di Modena, Via G. Molinari, 2, 41012, Carpi, Italy.
| | - Santi Mangiafico
- Digestive Endoscopy Unit-Northern Area, Ospedale di Carpi, Azienda USL di Modena, Via G. Molinari, 2, 41012, Carpi, Italy
| | - Angelo Caruso
- Gastroenterology and Digestive Endoscopy Unit, Nuovo Ospedale Civile S. Agostino-Estense, Baggiovara di Modena, MO, Italy
| | - Carmelo Barbera
- Digestive Endoscopy Unit-Northern Area, Ospedale di Carpi, Azienda USL di Modena, Via G. Molinari, 2, 41012, Carpi, Italy
| | - Helga Bertani
- Gastroenterology and Digestive Endoscopy Unit, Nuovo Ospedale Civile S. Agostino-Estense, Baggiovara di Modena, MO, Italy
| | - Vincenzo G Mirante
- Gastroenterology and Digestive Endoscopy Unit, Nuovo Ospedale Civile S. Agostino-Estense, Baggiovara di Modena, MO, Italy
| | - Flavia Pigò
- Digestive Endoscopy Unit-Northern Area, Ospedale di Carpi, Azienda USL di Modena, Via G. Molinari, 2, 41012, Carpi, Italy
| | - Khanna Amardeep
- Gastroenterology and Digestive Endoscopy Unit, Queens Medical Centre, Derby Road, Nottingham, UK
| | - Rita Conigliaro
- Gastroenterology and Digestive Endoscopy Unit, Nuovo Ospedale Civile S. Agostino-Estense, Baggiovara di Modena, MO, Italy
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Manta R, Conigliaro R, Mangiafico S, Forti E, Bertani H, Frazzoni M, Galloro G, Mutignani M, Zullo A. A multimodal, one-session endoscopic approach for management of patients with advanced pancreatic cancer. Surg Endosc 2015; 30:1863-8. [PMID: 26194252 DOI: 10.1007/s00464-015-4403-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 01/07/2015] [Accepted: 07/02/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND A number of patients with inoperable pancreatic cancer may concurrently complain of pain, biliary obstruction, and duodenal stenosis. Endoscopic palliative treatments and opioid therapy are generally performed in these patients. The study aimed to assess the efficacy and safety of a multimodal 'one-Session Three Endoscopic Procedures' (one-STEP) to simultaneously treat cholestasis, restore duodenal transit, and achieve pain relief in selected patients with advanced pancreatic cancer. METHODS Selected patients diagnosed with an advanced pancreatic cancer presenting with biliary obstruction, duodenal stenosis, and severe pain treated with the one-STEP were considered. The one-STEP endoscopic approach included biliary and duodenal stenting, and EUS-guided celiac plexus neurolysis. The technical success rate, complications, pain relief, and opioid use at follow-up were assessed. RESULTS A total of 15 patients were treated. The one-STEP was successful in 13 (87 %) cases, while it failed in two patients due to the impossibility of dilating the neoplastic mass for creating a fistula. No endoscopy-related complications occurred. The median of pain intensity was 8 (range 7-10) at entry and significantly decreased to 2 (range 2-4) 72 h following celiac plexus neurolysis. At follow-up (median survival 4 months; range 3-8), only 3 (20 %) needed of narcotic treatment in the last period. CONCLUSIONS The multimodal one-STEP is an effective and safe endoscopic approach for palliative treatment of biliary and duodenal stenosis, and for relieving chronic pain in patients with advanced pancreatic cancer.
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Affiliation(s)
- Raffaele Manta
- Interventional Digestive Endoscopy, "Niguarda Ca' Granda" Hospital, Milan, Italy.,Gastroenterology and Digestive Endoscopy Unit, "Nuovo Civile Sant'Agostino - Estense" Hospital, Baggiovara, Modena, Italy
| | - Rita Conigliaro
- Gastroenterology and Digestive Endoscopy Unit, "Nuovo Civile Sant'Agostino - Estense" Hospital, Baggiovara, Modena, Italy
| | - Santi Mangiafico
- Gastroenterology and Digestive Endoscopy Unit, "Nuovo Civile Sant'Agostino - Estense" Hospital, Baggiovara, Modena, Italy
| | - Edoardo Forti
- Gastroenterology and Digestive Endoscopy Unit, "Nuovo Civile Sant'Agostino - Estense" Hospital, Baggiovara, Modena, Italy
| | - Helga Bertani
- Gastroenterology and Digestive Endoscopy Unit, "Nuovo Civile Sant'Agostino - Estense" Hospital, Baggiovara, Modena, Italy
| | - Marzio Frazzoni
- Gastroenterology and Digestive Endoscopy Unit, "Nuovo Civile Sant'Agostino - Estense" Hospital, Baggiovara, Modena, Italy
| | - Giuseppe Galloro
- Department of Clinical Medicine and Surgery, Surgical Digestive Endoscopy Unit, Federico II University, Naples, Italy
| | | | - Angelo Zullo
- Gastroenterology and Digestive Endoscopy, "Nuovo Regina Margherita" Hospital, Rome, Italy.
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Piotin M, Biondi A, Sourour N, Mounayer C, Söderman M, Andersson T, Mangiafico S, Jaworski M, Anxionnat R, Goffette P, Blanc R. O-025 the luna aneurysm embolization system: immediate and 12 month follow-up of the european pmcf study: Abstract O-025 Table 1. J Neurointerv Surg 2015. [DOI: 10.1136/neurintsurg-2015-011917.25] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Bertani H, Frazzoni M, Mangiafico S, Caruso A, Manno M, Mirante VG, Pigò F, Barbera C, Manta R, Conigliaro R. Cholangiocarcinoma and malignant bile duct obstruction: A review of last decades advances in therapeutic endoscopy. World J Gastrointest Endosc 2015; 7:582-592. [PMID: 26078827 PMCID: PMC4461933 DOI: 10.4253/wjge.v7.i6.582] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 01/20/2015] [Accepted: 03/18/2015] [Indexed: 02/05/2023] Open
Abstract
In the last decades many advances have been achieved in endoscopy, in the diagnosis and therapy of cholangiocarcinoma, however blood test, magnetic resonance imaging, computed tomography scan may fail to detect neoplastic disease at early stage, thus the diagnosis of cholangiocarcinoma is achieved usually at unresectable stage. In the last decades the role of endoscopy has moved from a diagnostic role to an invaluable therapeutic tool for patients affected by malignant bile duct obstruction. One of the major issues for cholangiocarcinoma is bile ducts occlusion, leading to jaundice, cholangitis and hepatic failure. Currently, endoscopy has a key role in the work up of cholangiocarcinoma, both in patients amenable to surgical intervention as well as in those unfit for surgery or not amenable to immediate surgical curative resection owing to locally advanced or advanced disease, with palliative intention. Endoscopy allows successful biliary drainage and stenting in more than 90% of patients with malignant bile duct obstruction, and allows rapid reduction of jaundice decreasing the risk of biliary sepsis. When biliary drainage and stenting cannot be achieved with endoscopy alone, endoscopic ultrasound-guided biliary drainage represents an effective alternative method affording successful biliary drainage in more than 80% of cases. The purpose of this review is to focus on the currently available endoscopic management options in patients with cholangiocarcinoma.
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Turco A, Duchenne J, Nuyts J, Gheysens O, Voigt JU, Claus P, Vunckx K, Muhtarov K, Ozer N, Turk G, Sunman H, Karakulak U, Sahiner L, Kaya B, Yorgun H, Hazirolan T, Aytemir K, Warita S, Kawasaki M, Tanaka R, Houle H, Yagasaki H, Nagaya M, Ono K, Noda T, Watanabe S, Minatoguchi S, Kyle A, Dauphin C, Lusson JR, Dragoi Galrinho R, Rimbas R, Ciobanu A, Marinescu B, Cinteza M, Vinereanu D, Dragoi Galrinho R, Ciobanu A, Rimbas R, Marinescu B, Cinteza M, Vinereanu D, Aparina O, Stukalova O, Butorova E, Makeev M, Bolotova M, Parkhomenko D, Golitsyn S, Zengin E, Hoffmann BA, Ramuschkat M, Ojeda F, Weiss C, Willems S, Blankenberg S, Schnabel RB, Sinning CR, Schubert U, Suhai FI, Toth A, Kecskes K, Czimbalmos C, Csecs I, Maurovich-Horvat P, Simor T, Merkely B, Vago H, Slawek D, Chrzanowski L, Krecki R, Binkowska A, Kasprzak JD, Palombo C, Morizzo C, Kozakova M, Charisopoulou D, Koulaouzidis G, Rydberg A, Henein M, Kovacs A, Olah A, Lux A, Matyas C, Nemeth B, Kellermayer D, Ruppert M, Birtalan E, Merkely B, Radovits T, Henri C, Dulgheru R, Magne J, Kou S, Davin L, Nchimi A, Oury C, Pierard L, Lancellotti P, Sahin ST, Cengiz B, Yurdakul S, Altuntas E, Aytekin V, Aytekin S, Bajraktari G, Ibrahimi P, Bytyci I, Ahmeti A, Batalli A, Elezi S, Henein M, Pavlyukova E, Tereshenkova E, Karpov R, Barbier P, Mirea O, Guglielmo M, Savioli G, Cefalu C, Maltagliati M, Tumasyan L, Adamyan K, Chilingaryan A, Tunyan L, Kowalik E, Klisiewicz A, Biernacka E, Hoffman P, Park C, Yi J, Cho J, Ihm S, Kim H, Cho E, Jeon H, Jung H, Youn H, Mcghie J, Menting M, Vletter W, Roos-Hesselink J, Geleijnse M, Van Der Zwaan H, Van Den Bosch A, Spethmann S, Baldenhofer G, Stangl V, Baumann G, Stangl K, Laule M, Dreger H, Knebel F, Erdei T, Edwards J, Braim D, Yousef Z, Fraser A, Keramida K, Kouris N, Kostopoulos V, Kostakou P, Petrogiannos C, Olympios C, Bajraktari G, Berisha G, Bytyci I, Ibrahimi P, Rexhepaj N, Henein M, Wdowiak-Okrojek K, Shim A, Wejner-Mik P, Szymczyk E, Michalski B, Kasprzak J, Lipiec P, Tarr 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Ferreira R, Al-Mallah M, Alsaileek A. Poster session 5: Friday 5 December 2014, 14:00-18:00 * Location: Poster area. Eur Heart J Cardiovasc Imaging 2014. [DOI: 10.1093/ehjci/jeu257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Pasi M, Nappini S, Salvadori E, Mangiafico S, Limbucci N, Pantoni L. Rapidly progressive cognitive impairment in a patient with high flow dural arteriovenous fistulas, cerebral sinus thrombosis and protein S deficiency. J Clin Neurosci 2014; 21:1654-6. [DOI: 10.1016/j.jocn.2013.12.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2013] [Revised: 12/10/2013] [Accepted: 12/19/2013] [Indexed: 10/25/2022]
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Ohno Y, Attizzani GF, Capodanno D, Cannata S, Dipasqua F, Imme S, Barbanti M, Ministeri M, Caggegi A, Pistritto AM, Chiaranda M, Ronsivalle G, Giaquinta S, Farruggio S, Mangiafico S, Scandura S, Tamburino C, Capranzano P, Grasso C. Association of tricuspid regurgitation with clinical and echocardiographic outcomes after percutaneous mitral valve repair with the MitraClip System: 30-day and 12-month follow-up from the GRASP Registry. Eur Heart J Cardiovasc Imaging 2014; 15:1246-55. [DOI: 10.1093/ehjci/jeu114] [Citation(s) in RCA: 112] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Seifert B, Faeh-Gunz A, Naegeli B, Candinas R, Medeiros-Domingo A, Wierzbowska-Drabik K, Roszczyk N, Sobczak M, Plewka M, Krecki R, Kasprzak J, Ikonomidis I, Varoudi M, Papadavid E, Theodoropoulos K, Papadakis I, Pavlidis G, Triantafyllidi H, Anastasiou - Nana M, Rigopoulos D, Lekakis J, Tereshina O, Surkova E, Vachev A, Merchan Ortega G, Bonaque Gonzalez J, Sanchez Espino A, Bolivar Herrera N, Bravo Bustos D, Ikuta I, Aguado Martin M, Navarro Garcia F, Ruiz Lopez F, Gomez Recio M, Merchan Ortega G, Bonaque Gonzalez J, Bravo Bustos D, Sanchez Espino A, Bolivar Herrera N, Bonaque Gonzalez J, Navarro Garcia F, Aguado Martin M, Ruiz Lopez M, Gomez Recio M, Eguchi H, Maruo T, Endo K, Nakamura K, Yokota K, Fuku Y, Yamamoto H, Komiya T, Kadota K, Mitsudo K, Nagy AI, Manouras A, Gunyeli E, Shahgaldi K, Winter R, Hoffmann R, Barletta G, Von Bardeleben S, Kasprzak J, Greis C, Vanoverschelde J, Becher H, Hu K, Liu D, Niemann M, Herrmann S, Cikes M, Gaudron P, Knop S, Ertl G, Bijnens B, Weidemann F, Di Salvo G, Al Bulbul Z, Issa Z, Khan A, Faiz A, Rahmatullah S, Fadel B, Siblini G, Al Fayyadh M, Menting ME, Van Den Bosch A, Mcghie J, Cuypers J, Witsenburg M, Van Dalen B, Geleijnse M, Roos-Hesselink J, Olsen F, Jorgensen P, Mogelvang R, Jensen J, Fritz-Hansen T, Bech J, Biering-Sorensen T, Agoston G, Pap R, Saghy L, Forster T, Varga A, Scandura S, Capodanno D, Dipasqua F, Mangiafico S, Caggegi AM, Grasso C, Pistritto AM, Imme' S, Ministeri M, Tamburino C, Cameli M, Lisi M, D'ascenzi F, Cameli P, Losito M, Sparla S, Lunghetti S, Favilli R, Fineschi M, Mondillo S, Ojaghihaghighi Z, Javani B, Haghjoo M, Moladoust H, Shahrzad S, Ghadrdoust B, Altman M, Aussoleil A, Bergerot C, Bonnefoy-Cudraz E, Derumeaux GA, Thibault H, Shkolnik E, Vasyuk Y, Nesvetov V, Shkolnik L, Varlan G, Gronkova N, Kinova E, Borizanova A, Goudev A, Saracoglu E, Ural D, Sahin T, Al N, Cakmak H, Akbulut T, Akay K, Ural E, Mushtaq S, Andreini D, Pontone G, Bertella E, Conte E, Baggiano A, Annoni A, Formenti A, Fiorentini C, Pepi M, Cosgrove C, Carr L, Chao C, Dahiya A, Prasad S, Younger J, Biering-Sorensen T, Christensen L, Krieger D, Mogelvang R, Jensen J, Hojberg S, Host N, Karlsen F, Christensen H, Medressova A, Abikeyeva L, Dzhetybayeva S, Andossova S, Kuatbayev Y, Bekbossynova M, Bekbossynov S, Pya Y, Farsalinos K, Tsiapras D, Kyrzopoulos S, Spyrou A, Stefopoulos C, Romagna G, Tsimopoulou K, Tsakalou M, Voudris V, Cacicedo A, Velasco Del Castillo S, Anton Ladislao A, Aguirre Larracoechea U, Onaindia Gandarias J, Romero Pereiro A, Arana Achaga X, Zugazabeitia Irazabal G, Laraudogoitia Zaldumbide E, Lekuona Goya I, Varela A, Kotsovilis S, Salagianni M, Andreakos V, Davos C, Merchan Ortega G, Bonaque Gonzalez J, Sanchez Espino A, Bolivar Herrera N, Macancela Quinones J, Ikuta I, Ferrer Lopez R, Munoz Troyano S, Bravo Bustos D, Gomez Recio M. Poster session Friday 13 December - PM: 13/12/2013, 14:00-18:00 * Location: Poster area. Eur Heart J Cardiovasc Imaging 2013. [DOI: 10.1093/ehjci/jet206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Muraru D, Addetia K, Veronesi F, Corsi C, Mor-Avi V, Yamat M, Weinert L, Lang R, Badano L, Faita F, Di Lascio N, Bruno R, Bianchini E, Ghiadoni L, Sicari R, Gemignani V, Angelis A, Ageli K, Ioakimidis N, Chrysohoou C, Agelakas A, Felekos I, Vaina S, Aznaourides K, Vlachopoulos C, Stefanadis C, Nemes A, Szolnoky G, Gavaller H, Gonczy A, Kemeny L, Forster T, Ramalho A, Placido R, Marta L, Menezes M, Magalhaes A, Cortez Dias N, Martins S, Almeida A, Pinto F, Nunes Diogo A, Botezatu CD, Enache R, Popescu B, Nastase O, Coman M, Ghiorghiu I, Calin A, Rosca M, Beladan C, Ginghina C, Grapsa J, Cabrita I, Durighel G, O'regan D, Dawson D, Nihoyannopoulos P, Pellicori P, Kallvikbacka-Bennett A, Zhang J, Lukaschuk E, Joseph A, Bourantas C, Loh H, Bragadeesh T, Clark A, Cleland J, Kallvikbacka-Bennett A, Pellicori P, Lomax S, Putzu P, Diercx R, Parsons S, Dicken B, Zhang J, Clark A, Cleland J, Vered Z, Adirevitz L, Dragu R, Blatt A, Karev E, Malca Y, Roytvarf A, Marek D, Sovova E, Berkova M, Cihalik C, Taborsky M, Lindqvist P, Tossavainen E, Soderberg S, Gonzales M, Gustavsson S, Henein M, Sonne C, Bott-Fluegel L, Hauck S, Lesevic H, Hadamitzky M, Wolf P, Kolb C, Bandera F, Pellegrino M, Generati G, Donghi V, Alfonzetti E, Castelvecchio S, Menicanti L, Guazzi M, Buchyte S, Rinkuniene D, Jurkevicius R, Smarz K, Zaborska B, Jaxa-Chamiec T, Maciejewski P, Budaj A, Santoro A, Federico Alvino F, Giovanni Antonelli G, Roberta Molle R, Matteo Bertini M, Stefano Lunghetti S, Sergio Mondillo S, Henri C, Magne J, Dulgheru R, Laaraibi S, Voilliot D, Kou S, Pierard L, Lancellotti P, Szulik M, Stabryla-Deska J, Kalinowski M, Sliwinska A, Szymala M, Lenarczyk R, Kalarus Z, Kukulski T, Yiangou K, Azina C, Yiangou A, Ioannides M, Chimonides S, Baysal S, Pirat B, Okyay K, Bal U, Muderrisoglu H, Popovic D, Ostojic M, Petrovic M, Vujisic-Tesic B, Arandjelovic A, Petrovic I, Banovic M, Popovic B, Vukcevic V, Damjanovic S, Velasco Del Castillo S, Onaindia Gandarias J, Arana Achaga X, Laraudogoitia Zaldumbide E, Rodriguez Sanchez I, Cacicedo De Bobadilla A, Romero Pereiro A, Aguirre Larracoechea U, Salinas T, Subinas A, Elzbieciak M, Wita K, Grabka M, Chmurawa J, Doruchowska A, Turski M, Filipecki A, Wybraniec M, Mizia-Stec K, Varho V, Karjalainen P, Lehtinen T, Airaksinen J, Ylitalo A, Kiviniemi T, Gargiulo P, Galderisi M, D' Amore C, Lo Iudice F, Savarese G, Casaretti L, Pellegrino A, Fabiani I, La Mura L, Perrone Filardi P, Kim JY, Chung W, Yu J, Choi Y, Park C, Youn H, Lee M, Nagy A, Manouras A, Gunyeli E, Gustafsson U, Shahgaldi K, Winter R, Johnsson J, Zagatina A, Krylova L, Zhuravskaya N, Vareldzyan Y, Tyurina T, Clitsenko O, Khalifa EA, Ashour Z, Elnagar W, Jung I, Seo H, Lee S, Lim D, Mizariene V, Verseckaite R, Janenaite J, Jonkaitiene R, Jurkevicius R, Sanchez Espino A, Bonaque Gonzalez J, Merchan Ortega G, Bolivar Herrera N, Ikuta I, Macancela Quinones J, Gomez Recio M, Silva Fazendas Adame PR, Caldeira D, Stuart B, Almeida S, Cruz I, Ferreira A, Freire G, Lopes L, Cotrim C, Pereira H, Mediratta A, Addetia K, Moss J, Nayak H, Yamat M, Weinert L, Mor-Avi V, Lang R, Al Amri I, Debonnaire P, Van Der Kley F, Schalij M, Bax J, Ajmone Marsan N, Delgado V, Schmidt FP, Gniewosz T, Jabs A, Munzel T, Jansen T, Kaempfner D, Hink U, Von Bardeleben R, Jose J, George O, Joseph G, Jose J, Adawi S, Najjar R, Ahronson D, Shiran A, Van Riel A, Boerlage - Van Dijk K, De Bruin - Bon H, Araki M, Meregalli P, Koch K, Vis M, Mulder B, Baan J, Bouma B, Marciniak A, Elton D, Glover K, Campbell I, Sharma R, Batalha S, Lourenco C, Oliveira Da Silva C, Manouras A, Shahgaldi K, Caballero L, Garcia-Lara J, Gonzalez-Carrillo J, Oliva M, Saura D, Garcia-Navarro M, Espinosa M, Pinar E, Valdes M, De La Morena G, Barreiro Perez M, Lopez Perez M, Roy D, Brecker S, Sharma R, Venkateshvaran A, Dash PK, Sola S, Barooah B, Govind SC, Winter R, Shahgaldi K, Brodin LA, Manouras A, Saura Espin D, Caballero Jimenez L, Gonzalez Carrillo J, Oliva Sandoval M, Lopez Ruiz M, Garcia Navarro M, Espinosa Garcia M, Valdes Chavarri M, De La Morena Valenzuela G, Gatti G, Dell'angela L, Pinamonti B, Benussi B, Sinagra G, Pappalardo A, Hernandez V, Saavedra J, Gonzalez A, Iglesias P, Civantos S, Guijarro G, Monereo S, Ikeda M, Toh N, Oe H, Tanabe Y, Watanabe N, Ito H, Ciampi Q, Cortigiani L, Pratali L, Rigo F, Villari B, Picano E, Sicari R, Yoon J, Sohn J, Kim Y, Chang H, Hong G, Kim T, Ha J, Choi B, Rim S, Choi E, Tibazarwa K, Sliwa K, Wonkam A, Mayosi B, Oryshchyn N, Ivaniv Y, Pavlyk S, Lourenco MR, Azevedo O, Moutinho J, Nogueira I, Fernandes M, Pereira V, Quelhas I, Lourenco A, Sunbul M, Tigen K, Karaahmet T, Dundar C, Ozben B, Guler A, Cincin A, Bulut M, Sari I, Basaran Y, Baydar O, Kadriye Kilickesmez K, Ugur Coskun U, Polat Canbolat P, Veysel Oktay V, Umit Yasar Sinan U, Okay Abaci O, Cuneyt Kocas C, Sinan Uner S, Serdar Kucukoglu S, Zaroui A, Mourali M, Ben Said R, Asmi M, Aloui H, Kaabachi N, Mechmeche R, Saberniak J, Hasselberg N, Borgquist R, Platonov P, Holst A, Edvardsen T, Haugaa K, Lourenco MR, Azevedo O, Nogueira I, Moutinho J, Fernandes M, Pereira V, Quelhas I, Lourenco A, Eran A, Yueksel D, Er F, Gassanov N, Rosenkranz S, Baldus S, Guedelhoefer H, Faust M, Caglayan E, Matveeva N, Nartsissova G, Chernjavskij A, Ippolito R, De Palma D, Muscariello R, Santoro C, Raia R, Schiano-Lomoriello V, Gargiulo F, Galderisi M, Lipari P, Bonapace S, Zenari L, Valbusa F, Rossi A, Lanzoni L, Canali G, Molon G, Campopiano E, Barbieri E, Ikonomidis I, Varoudi M, Papadavid E, Theodoropoulos K, Papadakis I, Pavlidis G, Triantafyllidi H, Anastasiou - Nana M, Rigopoulos D, Lekakis J, Sunbul M, Tigen K, Ozen G, Durmus E, Kivrak T, Cincin A, Ozben B, Atas H, Direskeneli H, Basaran Y, Stevanovic A, Dekleva M, Trajic S, Paunovic N, Simic A, Khan S, Mushemi-Blake S, Jouhra F, Dennes W, Monaghan M, Melikian N, Shah A, Maceira Gonzalez AM, Lopez-Lereu M, Monmeneu J, Igual B, Estornell J, Boraita A, Kosmala W, Rojek A, Bialy D, Mysiak A, Przewlocka-Kosmala M, Popescu I, Mancas S, Mornos C, Serbescu I, Ionescu G, Ionac A, Gaudron P, Niemann M, Herrmann S, Hu K, Liu D, Wojciech K, Frantz S, Bijnens B, Ertl G, Weidemann F, Maceira Gonzalez AM, Cosin-Sales J, Ruvira J, Diago J, Aguilar J, Igual B, Lopez-Lereu M, Monmeneu J, Estornell J, Cruz C, Pinho T, Madureira A, Lebreiro A, Dias C, Ramos I, Silva Cardoso J, Julia Maciel M, De Meester P, Van De Bruaene A, Herijgers P, Voigt JU, Budts W, Franzoso F, Voser E, Wohlmut C, Kellenberger C, Valsangiacomo Buechel E, Carrero C, Benger J, Parcerisa M, Falconi M, Oberti P, Granja M, Cagide A, Del Pasqua A, Secinaro A, Antonelli G, Iacomino M, Toscano A, Chinali M, Esposito C, Carotti A, Pongiglione G, Rinelli G, Youssef Moustafa A, Al Murayeh M, Al Masswary A, Al Sheikh K, Moselhy M, Dardir M, Deising J, Butz T, Suermeci G, Liebeton J, Wennemann R, Tzikas S, Van Bracht M, Prull M, Trappe HJ, Martin Hidalgo M, Delgado Ortega M, Ruiz Ortiz M, Mesa Rubio D, Carrasco Avalos F, Seoane Garcia T, Pan Alvarez-Ossorio M, Lopez Aguilera J, Puentes Chiachio M, Suarez De Lezo Cruz Conde J, Petrovic MT, Giga V, Stepanovic J, Tesic M, Jovanovic I, Djordjevic-Dikic A, Generati G, Pellegrino M, Bandera F, Donghi V, Alfonzetti E, Guazzi M, Piatkowski R, Kochanowski J, Scislo P, Opolski G, Zagatina A, Zhuravskaya N, Krylova L, Vareldzhyan Y, Tyurina T, Clitsenko O, Bombardini T, Gherardi S, Leone O, Picano E, Michelotto E, Ciccarone A, Tarantino N, Ostuni V, Rubino M, Genco W, Santoro G, Carretta D, Romito R, Colonna P, Cameli M, Lunghetti S, Lisi M, Curci V, Cameli P, Focardi M, Favilli R, Galderisi M, Mondillo S, Hoffmann R, Barletta G, Von Bardeleben S, Kasprzak J, Greis C, Vanoverschelde J, Becher H, Machida T, Izumo M, Suzuki K, Kaimijima R, Mizukoshi K, Manabe-Uematsu M, Takai M, Harada T, Akashi Y, Martin Garcia A, Arribas-Jimenez A, Cruz-Gonzalez I, Nieto F, Iscar A, Merchan S, Martin-Luengo C, Brecht A, Theres L, Spethmann S, Dreger H, Baumann G, Knebel F, Jasaityte R, Heyde B, Rademakers F, Claus P, D'hooge J, Lervik Nilsen LC, Lund J, Brekke B, Stoylen A, Giraldeau G, Duchateau N, Gabrielli L, Penela D, Evertz R, Mont L, Brugada J, Berruezo A, Bijnens B, Sitges M, Kordybach M, Kowalski M, Hoffman P, Pilichowska E, Zaborska B, Baran J, Kulakowski P, Budaj A, Wahi S, Vollbon W, Leano R, Thomas A, Bricknell K, Holland D, Napier S, Stanton T, Teferici D, Qirko S, Petrela E, Dibra A, Bajraktari G, Bara P, Sanchis Ruiz L, Gabrielli L, Andrea R, Falces C, Duchateau N, Perez-Villa F, Bijnens B, Sitges M, Sulemane S, Panoulas V, Bratsas A, Tam F, Nihoyannopoulos P, Abduch M, Alencar A, Coracin F, Barban A, Saboya R, Dulley F, Mathias W, Vieira M, Buccheri S, Mangiafico S, Arcidiacono A, Bottari V, Leggio S, Tamburino C, Monte IP, Cruz C, Lebreiro A, Pinho T, Dias C, Silva Cardoso J, Julia Maciel M, Spitzer E, Beitzke D, Kaneider A, Pavo N, Gottsauner-Wolf M, Wolf F, Loewe C, Mushtaq S, Andreini D, Pontone G, Bertella E, Conte E, Baggiano A, Annoni A, Cortinovis S, Fiorentini C, Pepi M, Gustafsson M, Alehagen U, Dahlstrom U, Johansson P, Faden G, Faggiano P, Albertini L, Reverberi C, Gaibazzi N, Taylor RJ, Moody W, Umar F, Edwards N, Townend J, Steeds R, Leyva F, Mihaila S, Muraru D, Piasentini E, Peluso D, Casablanca S, Naso P, Puma L, Iliceto S, Vinereanu D, Badano L, Ciciarello FL, Agati L, Cimino S, De Luca L, Petronilli V, Fedele F, Tsverava M. Poster Session Saturday 14 December - AM: 14/12/2013, 08:30-12:30 * Location: Poster area. Eur Heart J Cardiovasc Imaging 2013. [DOI: 10.1093/ehjci/jet207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Muraru D, Mihaila S, Piasentini E, Casablanca S, Naso P, Puma L, Ermacora D, Zoppellaro G, Iliceto S, Badano L, Farsalinos K, Daraban A, Unlu S, Pellikka P, Lancellotti P, Thomas J, Badano L, Voigt JU, Antoine C, Dadfarin-Bejou A, Gallet R, Bremont C, Dubois-Rande J, Lim P, Acosta Martinez J, Lopez-Haldon J, Rodriguez-Rodriguez J, Lopez-Pardo F, Martinez-Martinez A, Nylander E, Hard L, Andersson J, Lindqvist P, Remmets J, Winter R, Andersson B, Roijer A, Gao S, Maret E, Esposito R, Santoro C, Raia R, Schiano-Lomoriello V, Lauria R, Arpino G, De Simone G, Galderisi M, El Ghannudi S, Samet H, Germain P, Jeung MY, Gangi A, Roy C, Marta L, Placido R, Ramalho A, Cortez-Dias N, Nobre Menezes M, Santos L, Infante Oliveira E, Martins S, Almeida A, Nunes Diogo A, Bech-Hanssen O, Pergola V, Fadel B, Di Salvo G, Buccheri S, Mangiafico S, Lavanco V, Bottari V, Arcidiacono A, Tamburino C, Monte IP. Moderated Posters session * The emerging role of 2-dimensional strain in clinical practice: 13/12/2013, 14:00-18:00 * Location: Moderated Poster area. Eur Heart J Cardiovasc Imaging 2013. [DOI: 10.1093/ehjci/jet211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Mangiafico S, Guarnieri G, Consoli A, Ambrosanio G, Muto M. Endovascular strategy for unruptured cerebral aneurysms. Eur J Radiol 2013; 82:1638-45. [DOI: 10.1016/j.ejrad.2012.11.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Accepted: 11/02/2012] [Indexed: 11/24/2022]
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Grasso C, Capodanno D, Scandura S, Cannata S, Imme S, Mangiafico S, Pistritto A, Ministeri M, Giaquinta S, Tamburino C. One and twelve month safety and efficacy outcomes of patients undergoing edge-to-edge percutaneous mitral valve repair: the GRASP registry. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Andersen IA, Mangiafico S, Huntley BK, Boerrigter G, Harty G, Cataliotti A, Burnett JC. Chronic uninephrectomy in a large animal is characterized by preservation of cardiovascular homeostasis but with cardiorenal activation of the cGMP system together with atrial fibrosis. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Piotin M, Biondi A, Sourour N, Mounayer C, Andersson T, Söderman M, Mangiafico S, Jaworski M, Anxionnat R, Blanc R. O-016 Treatment of Intracranial Aneurysms with the LUNA AES Updated. J Neurointerv Surg 2013. [DOI: 10.1136/neurintsurg-2013-010870.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Consoli A, Grazzini G, Renieri L, Rosi A, De Renzis A, Vignoli C, Nappini S, Ammannati F, Capaccioli L, Mangiafico S. Effects of hyper-early (<12 hours) endovascular treatment of ruptured intracranial aneurysms on clinical outcome. Interv Neuroradiol 2013; 19:195-202. [PMID: 23693043 DOI: 10.1177/159101991301900208] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 03/09/2013] [Indexed: 11/17/2022] Open
Abstract
Despite the encouraging results obtained with the endovascular treatment of ruptured intracranial aneurysms, few data are available on the effects of the timing of this approach on clinical outcome. The aim of our study was to evaluate the effects of the hyper-early timing of treatment and of pre-treatment and treatment-related variables on the clinical outcome of patients with ruptured intracranial aneurysms. Five hundred and ten patients (167 M, 343 F; mean age 56.45 years) with 557 ruptured intracranial aneurysms were treated at our institution from 2000 to 2011 immediately after their admission. The total population was divided into three groups: patients treated within 12 hours (hyper-early, group A), between 12-48 hours (early, group B) and after 48 hours (delayed, group C). A statistical analysis was carried out for global population and subgroups. Two hundred and thirty-four patients (46%) were included in group A, 172 (34%) in group B and 104 (20%) in group C. Pre-treatment variables (Hunt&Hess, Fisher grades, older age) and procedure-related variable (ischaemic/haemorrhagic complications) showed a significant correlation with worse clinical outcomes. The hyper-early treatment showed no correlation with good clinical outcomes. The incidence of intra-procedural complications was not significantly different between the three groups; 1.2% of pre-treatment rebleedings were observed. The hyper-early endovascular treatment of ruptured intracranial aneurysm does not seem to be statistically correlated with good clinical outcomes although it may reduce the incidence of pre-treatment spontaneous rebleedings without being associated with a higher risk of intra-procedural complications. However, since no significant differences in terms of clinical outcome and pre-treatment rebleeding rate were observed, a hyper-early treatment is not be supported by our data.
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Affiliation(s)
- A Consoli
- Interventional Neuroradiology Unit, Careggi University Hospital, Florence, Italy.
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Consoli A, Renieri L, Nappini S, Limbucci N, Mangiafico S. Endovascular treatment of deep hemorrhagic brain arteriovenous malformations with transvenous onyx embolization. AJNR Am J Neuroradiol 2013; 34:1805-11. [PMID: 23557955 DOI: 10.3174/ajnr.a3497] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
SUMMARY Brain AVMs are a rare cause of cerebral hemorrhage and SAH, and their treatment is still debated. The aim of this study was to describe a novel endovascular approach with transvenous embolization of deep hemorrhagic brain AVMs. Five patients (3 females, 2 males; mean age, 33.2 years) underwent a transvenous embolization of a deep hemorrhagic brain AVM at our institution between February and April 2012. Clinical and angiographic data at the end of the procedure and after 6 months are reported. All the AVMs were completely obliterated, and no intra- or postprocedural complications occurred. The clinical outcome was unchanged or improved in all patients. Transvenous endovascular treatment may be considered in small, hemorrhagic, and deep AVMs with single deep drainage in those cases in which neurosurgical and radiosurgical treatment might not be indicated.
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Affiliation(s)
- A Consoli
- Interventional Neuroradiology Unit, Careggi University Hospital, Florence, Italy
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Consoli A, Renieri L, Mura R, Nappini S, Ricciardi F, Pecchioli G, Ammannati F, Mangiafico S. Five to ten years follow-up after coiling of 241 patients with acutely ruptured aneurysms. A single centre experience. Interv Neuroradiol 2012; 18:5-13. [PMID: 22440595 DOI: 10.1177/159101991201800101] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2011] [Accepted: 11/19/2011] [Indexed: 11/17/2022] Open
Abstract
Endovascular treatment has assumed a role of first choice in the management of ruptured intracranial aneurysms. We describe the clinical and morphological data after the treatment of 258 ruptured intracranial aneurysms in 241 patients, in order to evaluate the safety and the efficacy of the endovascular treatment. Two hundred and forty-one patients with saccular ruptured aneurysms were treated at our institution between 2000 and 2005. After the endovascular treatment a clinical and angiographic follow-up was conducted. The clinical follow-up was carried out with a medical examination and telephonic interviews and mRS was used for evaluation. Two hundred and forty-nine acutely ruptured aneurysms were successfully treated and immediately after the endovascular procedure 81.9% of the aneurysms resulted completely occluded, 12.1% had a residual neck and 6% revealed a residual sac. The evolution of each grade was evaluated at six months and two years. During the follow-up we observed five early and one late re-bleedings. Twenty-four patients underwent a second procedure. After the discharge and up to ten years 73.1% of patients had a good clinical outcome (mRS0-1), 8.9% died and the remainder showed moderate-severe disability (mRS2-3). The long-term stability of the anatomical result is a critic-al issue of this approach because eventual re-bleedings may occur even after several months or years. A careful clinical and radiological follow-up for up to two years after the embolization may prevent recurrences but may not be sufficient.
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Affiliation(s)
- A Consoli
- Interventional Neuroradiology Unit, Careggi University Hospital, Florence, Italy.
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Scandura S, Mangiafico S, Capodanno D, Varone E, Castello C, Ctamburino C, Calafiore A. Surgical thromboembolectomy for a massive pulmonary embolism after several venous thromboembolic episodes caused by congenital antithrombin III deficiency. J Cardiovasc Surg (Torino) 2011; 52:899-900. [PMID: 22051999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Gong L, Ye Z, Zeng Z, Xia M, Zhong Y, Yao Y, Lee E, Ionescu A, Dwivedi G, Mahadevan G, Jiminez D, Frenneaux M, Steeds R, Moore C, Samad Z, Jackson K, Castellucci J, Kisslo J, Von Ramm O, D'ascenzi F, Zaca' V, Cameli M, Lisi M, Natali B, Malandrino A, Mondillo S, Barbier P, Guerrini U, Franzosi M, Castiglioni L, Nobili E, Colazzo F, Li Causi T, Sironi L, Tremoli E, Clausen H, Macdonald S, Basaggianis C, Newton J, Cameli M, Lisi M, Bennati E, Reccia R, Malandrino A, Bigio E, Maccherini M, Chiavarelli M, Henein M, Mondillo S, Floria M, Jamart J, Arsenescu Georgescu C, Mantovani F, Barbieri A, Bursi F, Valenti C, Quaglia M, Modena M, Kutty S, Gribben P, Padiyath A, Polak A, Scott C, Waiss M, Danford D, Bech-Hanssen O, Selimovic N, Rundqvist B, Schmiedel L, Hohmann C, Katzke S, Haacke K, Rauwolf T, Strasser R, Tumasyan LR, Adamyan K, Kosmala W, Derzhko R, Przewlocka-Kosmala M, Mysiak A, Stachowska B, Jedrzejuk D, Bednarek-Tupikowska G, Chrzanowski L, Kasprzak J, Wojciechowska C, Wita K, Busz-Papiez B, Gasior Z, Mizia-Stec K, Kukulski T, Gosciniak P, Sinkiewicz W, Moelmen H, Stoylen A, Thorstensen A, Torp H, Dalen H, Groves A, Nicholson G, Lopez L, Goh CW, Ahn H, Byun Y, Kim J, Park J, Lee J, Park J, Kim B, Rhee K, Kim K, Park J, Yoon H, Hong Y, Park H, Kim J, Ahn Y, Jeong M, Cho J, Kang J, Grapsa J, Dawson D, Karfopoulos K, Jakaj G, Punjabi P, Nihoyannopoulos P, Ruisanchez Villar C, Lerena Saenz P, Gonzalez Vilchez F, Gonzalez Fernandez C, Zurbano Goni F, Cifrian Martinez J, Mons Lera R, Ruano Calvo J, Martin Duran R, Vazquez De Prada Tiffe J, Pietrzak R, Werner B, Voillot D, Huttin O, Zinzius P, Schwartz J, Sellal J, Lemoine S, Christophe C, Popovic B, Juilliere Y, Selton-Suty C, Ishii K, Furukawa A, Nagai T, Kataoka K, Seino Y, Shimada K, Yoshikawa J, Tekkesin A, Yildirimturk O, Tayyareci Y, Yurdakul S, Aytekin S, Jaroch J, Loboz-Grudzien K, Bociaga Z, Kowalska A, Kruszynska E, Wilczynska M, Dudek K, Kakihara R, Naruse C, Hironaka H, Tsuzuku T, Cucchini U, Muraru D, Badano L, Solda' E, Tuveri M, Al Nono O, Sarais C, Iliceto S, Santos L, Cortez-Dias N, Ribeiro S, Goncalves S, Jorge C, Carrilho-Ferreira P, Silva D, Silva-Marques J, Lopes M, Diogo A, Hristova K, Vassilev D, Pavlov P, Katova T, Simova I, Kostova V, Esposito R, Santoro A, Schiano Lomoriello V, Raia R, De Palma D, Dores E, De Simone G, Galderisi M, Zaborska B, Makowska E, Pilichowska E, Maciejewski P, Bednarz B, Wasek W, Stec S, Budaj A, Spinelli L, Morisco C, Assante Di Panzillo E, Crispo S, Di Marino S, Trimarco B, Santoro A, Schiano Lomoriello V, Esposito R, Farina F, Innelli P, Rapacciuolo A, Galderisi M, Polgar B, Banyai F, Rokusz L, Tomcsanyi I, Vaszily M, Nieszner E, Borsanyi T, Kerecsen G, Preda I, Kiss RG, Bull S, Suttie J, Augustine D, Francis J, Karamitsos T, Becher H, Prendergast B, Neubauer S, Myerson S, Lodge F, Broyd C, Milton P, Mikhail G, Mayet J, Davies J, Francis D, Clavel MA, Ennezat PV, Marechaux S, Dumesnil J, Bellouin A, Bergeron S, Meimoun P, Le Tourneau T, Pasquet A, Pibarot P, Herrmann S, Stoerk S, Niemann M, Hu K, Voelker W, Ertl G, Weidemann F, Tayyareci Y, Yurdakul S, Yildirimturk O, Aytekin V, Aytekin S, Kogoj P, Ambrozic J, Bunc M, Di Salvo G, Rea A, Castaldi B, Gala S, D'aiello A, Mormile A, Pisacane F, Pacileo G, Russo M, Calabro R, Nguyen L, Ricksten SE, Jeppsson A, Schersten H, Bech-Hanssen O, Boerlage-Van Dijk K, Yong Z, Bouma B, Koch K, Vis M, Piek J, Baan J, Scandura S, Ussia G, Caggegi A, Cammalleri V, Sarkar K, Mangiafico S, Chiaranda' M, Imme' S, Pistritto A, Tamburino C, Ring L, Nair S, Wells F, Shapiro L, Rusk R, Rana B, Madrid Marcano G, Solis Martin J, Gonzalez Mansilla A, Bravo L, Menarguez Palanca C, Munoz P, Bouza E, Yotti R, Bermejo Thomas J, Fernandez Aviles F, Tamayo T, Denes M, Balint O, Csepregi A, Csillik A, Erdei T, Temesvari A, Fernandez-Pastor J, Linde-Estrella A, Cabrera-Bueno F, Pena-Hernandez J, Barrera-Cordero A, Alzueta-Rodriguez F, De Teresa-Galvan E, Merlo M, Pinamonti M, Finocchiaro G, Pyxaras S, Barbati G, Buiatti A, Dilenarda A, Sinagra G, Kuperstein R, Freimark D, Hirsch S, Feinberg M, Arad M, Mitroi C, Garcia Lunar I, Monivas Palomero V, Mingo Santos S, Beltran Correas P, Gonzalez Lopez E, Garcia Pavia P, Gonzalez Mirelis J, Cavero Gibanel M, Alonso Pulpon L, Finocchiaro G, Pinamonti B, Merlo M, Barbati G, Dilenarda A, Sinagra G, Zaidi A, Ghani S, Sheikh N, Gati S, Howes R, Sharma R, Sharma S, Calcagnino M, O'mahony C, Coats C, Cardona M, Garcia A, Murphy E, Lachmann R, Mehta A, Hughes D, Elliott P, Di Bella G, Madaffari A, Donato R, Mazzeo A, Casale M, Zito C, Vita G, Carerj S, Marek D, Indrakova J, Rusinakova Z, Skala T, Kocianova E, Taborsky M, Musca F, De Chiara B, Belli O, Cataldo S, Brunati C, Colussi G, Quattrocchi G, Santambrogio G, Spano F, Moreo A, Rustad L, Nytroen K, Gullestad L, Amundsen B, Aakhus S, Maroz-Vadalazhskaya N, Shumavetc V, Kurganovich S, Seljun Y, Ostrovskiy A, Ostrovskiy Y, Rustad L, Nytroen K, Segers P, Amundsen B, Aakhus S, Przewlocka-Kosmala M, Orda A, Karolko B, Mysiak A, Driessen MMP, Eising JB, Uiterwaal C, Van Der Ent CK, Meijboom FJ, Shang Q, Tam L, Sun J, Sanderson J, Zhang Q, Li E, Yu C, Arroyo Ucar E, De La Rosa Hernandez A, Hernandez Garcia C, Jorge Perez P, Lacalzada Almeida J, Jimenez Rivera J, Duque Garcia A, Barragan Acea A, Laynez Cerdena I, Kaldararova M, Simkova I, Pacak J, Tittel P, Masura J, Tadic M, Ivanovic B, Zlatanovic M, Damjanov N, Maggiolini S, Gentile G, Bozzano A, Suraci S, Meles E, Carbone C, Tempesta A, Malafronte C, Piatti L, Achilli F, Luijendijk P, Stevens A, De Bruin-Bon H, Vriend J, Van Den Brink R, Vliegen H, Mulder B, Bouma B, Chow V, Ng A, Chung T, Kritharides L, Iancu M, Serban M, Craciunescu I, Hodo A, Ghiorghiu I, Popescu B, Ginghina C, Styczynski G, Szmigielski CA, Kaczynska A, Leszczynski J, Rosinski G, Kuch-Wocial A, Slavich M, Ancona M, Fisicaro A, Oppizzi M, Marone E, Bertoglio L, Melissano G, Margonato A, Chiesa R, Agricola E, Zito C, Mohammed M, Cusma-Piccione M, Piluso S, Arcidiaco S, Nava R, Giuffre R, Ciraci L, Ferro M, Carerj S, Uusitalo V, Luotolahti M, Pietila M, Wendelin-Saarenhovi M, Hartiala J, Saraste M, Knuuti J, Saraste A, Kochanowski J, Scislo P, Piatkowski R, Grabowski M, Marchel M, Roik M, Kosior D, Opolski G, Bartko PE, Graf S, Khorsand A, Rosenhek R, Burwash I, Beanlands R, Clavel MA, Baumgartner H, Pibarot P, Mundigler G, Kudrnova S, Apor A, Huttl H, Kudrnova S, Apor A, Huttl H, Mori F, Santoro G, Oddo A, Rosso G, Meucci F, Pieri F, Squillantini G, Gensini G, Scislo P, Kochanowski J, Piatkowski R, Roik M, Postula M, Opolski G, Park DG, Hong JY, Kim SE, Lee JH, Han KR, Oh DJ, Muraru D, Dal Bianco L, Beraldo M, Solda' E, Cucchini U, Peluso D, Tuveri M, Al Mamary A, Badano L, Iliceto S, Aggeli C, Felekos I, Poulidakis E, Pietri P, Roussakis G, Siasos G, Stefanadis C, Furukawa A, Hoshiba H, Miyasaka C, Sato H, Nagai T, Yamanaka A, Kataoka K, Seino Y, Ishii K, Lilli A, Baratto M, Magnacca M, Comella A, Poddighe R, Talini E, Canale M, Chioccioli M, Del Meglio J, Casolo G, Kuznetsov VA, Melnikov NN, Krinochkin DV, Calin A, Enache R, Popescu B, Beladan C, Rosca M, Lupascu L, Purcarea F, Calin C, Gurzun M, Ginghina C, Dulgheru R, Ciobanu A, Magda S, Mihaila S, Rimbas R, Margulescu A, Cinteza M, Vinereanu D, Sumin AN, Arhipov O, Yoon J, Moon J, Rim S, Nyktari E, Patrianakos A, Solidakis G, Psathakis E, Parthenakis F, Vardas P, Kordybach M, Kowalski M, Kowalik E, Hoffman P, Nagy KV, Kutyifa V, Edes E, Apor A, Merkely B, Gerlach A, Rost C, Schmid M, Rost M, Flachskampf F, Daniel W, Breithardt O, Altekin E, Karakas S, Yanikoglu A, Er A, Baktir A, Demir I, Deger N, Klitsie L, Hazekamp M, Roest A, Van Der Hulst A, Gesink- Van Der Veer B, Kuipers I, Blom N, Ten Harkel A, Farsalinos K, Tsiapras D, Kyrzopoulos S, Avramidou E, Vasilopoulou D, Voudris V, Werner B, Florianczyk T, Ivanovic B, Tadic M, Kalinowski M, Szulik M, Streb W, Rybus-Kalinowska B, Sliwinska A, Stabryla J, Kukla M, Nowak J, Kukulski T, Kalarus Z, Florescu M, Mihalcea D, Magda L, Suran B, Enescu O, Mincu R, Cinteza M, Vinereanu D, Salerno G, Scognamiglio G, D'andrea A, Dinardo G, Gravino R, Sarubbi B, Disalvo G, Pacileo G, Russo M, Calabro R, Liao JN, Sung S, Chen C, Park S, Shin S, Kim M, Shim S, Yildirimturk O, Helvacioglu F, Ulusoy O, Duran C, Tayyareci Y, Yurdakul S, Aytekin S, Kirschner R, Simor T, Moreo A, Ambrosio G, De Chiara B, Tran T, Raman S, Vidal Perez RC, Carreras F, Leta R, Pujadas S, Barros A, Hidalgo A, Alomar X, Pons-Llado G, Olofsson M, Boman K, Ledakowicz-Polak A, Polak L, Zielinska M, Fontana A, Schirone V, Mauro A, Zambon A, Giannattasio C, Trocino G, Dekleva M, Dungen H, Inkrot S, Gelbrich G, Suzic Lazic J, Kleut M, Markovic Nikolic N, Waagstein F, Khoor S, Balogh N, Simon I, Fugedi K, Kovacs I, Khoor M, Florian G, Kocsis A, Szuszai T, O'driscoll J, Saha A, Smith R, Gupta S, Sharma R, Lenkey Z, Gaszner B, Illyes M, Sarszegi Z, Horvath IG, Magyari B, Molnar F, Cziraki A, Elnoamany MF, Badran H, Ebraheem H, Reda A, Elsheekh N. Poster Session 5: Saturday 10 December 2011, 08:30-12:30 * Location: Poster Area. European Journal of Echocardiography 2011. [DOI: 10.1093/ejechocard/jer218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Tamburino C, Immè S, Barbanti M, Mulè M, Pistritto AM, Aruta P, Cammalleri V, Scarabelli M, Mangiafico S, Scandura S, Ussia GP. Reduction of mitral valve regurgitation with Mitraclip® percutaneous system. Minerva Cardioangiol 2010; 58:589-598. [PMID: 20948505] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Mitral regurgitation (MR) is the second most common heart valve disease worldwide and the current gold-standard treatment is surgical repair or replacement. Nevertheless, many patients do not undergo surgical intervention due to several comorbidities. Percutaneous "edge-to-edge" mitral valve repair using the MitraClip System is an emerging and effective option to this subset of patients. This device has been used to treat both functional and degenerative mitral valve regurgitation and has been compared to surgery in the Endovascular Valve Edge-to-Edge Repair Study II (EVEREST II) randomized trial. Although the field of percutaneous management of MR is at an early stage, it has been demonstrated that percutaneous approaches can reduce MR, suggesting there is a great deal of potential for clinical benefit to patients with MR.
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Affiliation(s)
- C Tamburino
- Division of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy
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Mangiafico S, Scandura S, Capodanno D, Arcidiacono AA, Santonoceto L, Cilia G, Ussiac Tamburino GP. Contrast transesophageal echocardiography using the Acunav ultrasound catheter through the mouth way as a guide to percutaneous closure of patent foramen ovale. Minerva Cardioangiol 2010; 58:285-289. [PMID: 20485235] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
AIM Contrast-enhanced transesophageal echo-cardiography (c-TEE) represents the gold standard in the diagnosis of patent foramen ovale (PFO) but it is not always well tolerated by the patient, and it is influenced by his cooperation. Purpose of the present study was to assess feasibility and safety of c-TEE through the oral way using a miniaturized 10-Fr, monoplane probe (Acunav-TEE) and establish its utility in the diagnosis or PFO when compared with c-TEE using the traditional multiplane probe (standard-TEE). METHODS From January 2008 to September 2008, 54 consecutive patients with presumed paradoxical cerebrovascular events and a suspected PFO were prospectively enrolled in this study. After signing a consensus form, these patients underwent both standard-TEE and Acunav-TEE in the same day by two independent operators. RESULTS Feasibility of standard-TEE in our study was 96.3% (52/54) while feasibility of Acunav-TEE was 100% (54/54). When compared to standard-TEE, Acunav-TEE required shorter average time to insert the probe (1.0+/-0.2 vs. 4.1+/-1.1 minutes, P<0.001) but longer average time to look for the best projection and start the examination (13.8+/-2.4 vs. 9.1+/-2.7 minutes, P<0.001). Using standard-TEE as gold standard we defined a sensitivity of 100% (20/20) and a specificity of 97% (31/32) for Acunav-TEE. The positive predictive value, the negative predictive value and the global diagnostic accuracy were 95% (20/21), 100% (31/31) and 98% (51/52), respectively. CONCLUSION Consistent with our experience, Acunav-TEE seems to be a feasible and safe technique when used for the diagnosis of PFO, with excellent sensitivity and specificity as compared with standard-TEE.
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Affiliation(s)
- S Mangiafico
- Department of Internal Medicine and Systemic Disease, Clinical Division of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy
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