Mauriziano Umberto Hospital

Sant'Ambrogio di Torino, Italy

Mauriziano Umberto Hospital

Sant'Ambrogio di Torino, Italy
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Tuthill E.,University College Dublin | O'Hora L.,Materials Misericordiae University Hospital | O'Donohoe M.,Materials Misericordiae University Hospital | Panci S.,San Giovanni Of Dio Hospital | And 6 more authors.
European Radiology | Year: 2017

Objectives: Endovascular aneurysm repair (EVAR) is considered the treatment of choice for abdominal aortic aneurysms with suitable anatomy. In order to improve radiation safety, European Directive (2013/59) requires member states to implement diagnostic reference levels (DRLs) in radio-diagnostic and interventional procedures. This study aimed to determine local DRLs for EVAR across five European centres and identify an interim European DRL, which currently remains unestablished. Methods: Retrospective data was collected for 180 standard EVARs performed between January 2014 and July 2015 from five specialist centres in Ireland (n=2) and Italy (n=3). Data capture included: air kerma-area product (PKA), total air kerma at the reference point (Ka,r), fluoroscopic time (FT), number of acquisitions, frame rate of acquisition, type of acquisition, patient height, weight, and gender. Results: The mean values for each site A, B, C, D, and E were: PKAs of 4343 ± 994 μGym2, 18,200 ± 2141 μGym2, 11,423 ± 1390 μGym2, 7796 ± 704 μGym2, 31,897 ± 5798 μGym2; FTs of 816 ± 92 s, 950 ± 150 s, 708 ± 70 s, 972 ± 61 s, 827 ± 118 s; and number of acquisitions of 6.72 ± 0.56, 10.38 ± 1.54, 4.74 ± 0.19, 5.64 ± 0.36, 7.28 ± 0.65, respectively. The overall pooled 75th percentile PKA was 15,849 μGym2. Conclusion: Local reference levels were identified. The pooled data has been used to establish an interim European DRL for EVAR procedures. Key Points: • Abdominal endovascular aneurysm repair (EVAR) requires the use of ionising radiation.• EVAR is a minimally invasive procedure for the treatment of abdominal aortic aneurysms.• Diagnostic reference levels (DRLs) are used to monitor patient radiation exposure.• Radiation dose data was collected from five European centres for EVAR procedures.• Local DRLs have been determined and an interim European DRL is proposed. © 2017 European Society of Radiology


Tolva V.,Policlinico Of Monza Hospital | Tolva V.,IRCCS Instituto Auxologico Italiano | Casana R.,IRCCS Instituto Auxologico Italiano | Huibers A.,University of Oxford | And 7 more authors.
Vascular and Endovascular Surgery | Year: 2016

Rationale: Restenosis due to intimal hyperplasia (IH) is a major clinical issue that affects the success of lower limb endovascular surgery. After 1 year, restenosis occurs in 40% to 60% of the treated vessels. The possibility to reduce IH using local antiproliferative drugs, such as taxols, has been the rationale for the clinical applications of drug-eluting stents and drug-eluting balloons (DEBs). The purpose of this study was to evaluate the clinical and instrumental efficacy of DEBs versus simple percutaneous transluminal angioplasty (PTA) in patients affected by chronic limb ischemia (CLI) with tibial artery "de novo" lesions. Methods: A retrospective analysis was performed and included all consecutive patients who underwent endovascular treatment for CLI in our centers between January 2011 and March 2013. Inclusion criteria were (1) "de novo" tibial artery stenosis and (2) Rutherford class >4. Lesions were further divided by TransAtlantic Inter-Societal Consensus (TASC) classification into groups A, B, C, and D. Results: Between January 2010 and March 2013, a total of 138 patients underwent simple PTA or DEB for CLI, and the groups were clinically and demographically homogenous. We decided to use DEBs in 70 cases. An improvement in the Rutherford Scale in cumulative and single TASC lesions classification was better in the DEB group (74% vs 51%; P =.024) at 24 months than in the PTA group. In the DEB group, the increase in ankle-brachial index was significantly higher than in the PTA group (P =.039). Conclusions: Our experience in addition to the existing literature supports the use of DEB in patients with CLI Rutherford class >3. © SAGE Publications.


PubMed | University Utrecht, Mauriziano Umberto Hospital, University of Milan Bicocca, IRCCS Instituto Auxologico Italiano and 2 more.
Type: Journal Article | Journal: Vascular and endovascular surgery | Year: 2016

Restenosis due to intimal hyperplasia (IH) is a major clinical issue that affects the success of lower limb endovascular surgery. After 1 year, restenosis occurs in 40% to 60% of the treated vessels. The possibility to reduce IH using local antiproliferative drugs, such as taxols, has been the rationale for the clinical applications of drug-eluting stents and drug-eluting balloons (DEBs). The purpose of this study was to evaluate the clinical and instrumental efficacy of DEBs versus simple percutaneous transluminal angioplasty (PTA) in patients affected by chronic limb ischemia (CLI) with tibial artery de novo lesions.A retrospective analysis was performed and included all consecutive patients who underwent endovascular treatment for CLI in our centers between January 2011 and March 2013. Inclusion criteria were (1) de novo tibial artery stenosis and (2) Rutherford class >4. Lesions were further divided by TransAtlantic Inter-Societal Consensus (TASC) classification into groups A, B, C, and D.Between January 2010 and March 2013, a total of 138 patients underwent simple PTA or DEB for CLI, and the groups were clinically and demographically homogenous. We decided to use DEBs in 70 cases. An improvement in the Rutherford Scale in cumulative and single TASC lesions classification was better in the DEB group (74% vs 51%; P = .024) at 24 months than in the PTA group. In the DEB group, the increase in ankle-brachial index was significantly higher than in the PTA group (P = .039).Our experience in addition to the existing literature supports the use of DEB in patients with CLI Rutherford class >3.

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