Paediatric Hospital Regina Margherita

Sant'Ambrogio di Torino, Italy

Paediatric Hospital Regina Margherita

Sant'Ambrogio di Torino, Italy
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Corrao G.,University of Milan Bicocca | Soranna D.,University of Milan Bicocca | Casula M.,University of Milan | Merlino L.,Operative Unit of Territorial Health Services | And 2 more authors.
Atherosclerosis | Year: 2014

Objective: To assess the association between acute kidney injury and exposure to either high-potency statins or low-potency statins. Design: A population-based, nested case-control study was performed on a cohort of 316,449 patients from Lombardy (Italy) newly treated with statins between 2007 and 2010 aged 40 years or older. 458 patients experienced acute kidney injury within six months after initial statin prescription. Up to four controls were randomly selected for each case. Logistic regression was used to model the outcome risk associated with high-potency contrasted with low-potency statins dispensed at starting therapy, and during follow-up. Results: Patients at whom high-potency statins were initially dispensed were more likely to be hospitalized for acute kidney injury within six months after starting treatment than those on low-potency statins (adjusted OR 1.54, 95% confidence interval 1.25-1.91). Patients receiving high-potency statins within three weeks before the outcome onset had a significant increased risk respect to those who did not receive statins during the same time-window (adjusted OR 1.45, 95% confidence interval 1.04-2.03). When follow-up was extended from 6 months to 12 months the difference was not significant anymore (adjusted OR 1.17, 95% confidence interval 0.89-1.54). Conclusions: Use of high-potency statins is associated with an increased risk of acute kidney injury compared with low-potency statins in the first 6 months after starting therapy. © 2014 Elsevier Ireland Ltd.


Agnoletti G.,Paediatric Hospital Regina Margherita | Marini D.,Paediatric Hospital Regina Margherita | Villar A.M.,Paediatric Hospital Regina Margherita | Bordese R.,Paediatric Hospital Regina Margherita | Gabbarini F.,Paediatric Hospital Regina Margherita
Catheterization and Cardiovascular Interventions | Year: 2012

Objective: The objective of this study was to evaluate the technical feasibility, safety, and efficacy of the new device Amplatzer duct occluder II additional sizes (ADO II AS) for closure of patent ductus arteriosus (PDA). Background: Transcatheter device closure is the standard care for PDA. Currently available technology is not designed for closure of small PDA in young children. Methods: From April to July 2011, seven children (five females, median age 1.5 years, median weight 11.4 kg) underwent PDA closure with the ADO II AS. Six had isolated PDA, one had PDA associated with preductal coarctation. We evaluated early and short-term results. Results: All but one PDA was closed via an antegrade approach. Mean fluoroscopy and procedural times were 8.0 ± 3.9 and 49.8 ± 27.9 min, respectively. No complications occurred. Immediate trivial residual shunt was present in one patient. In all devices, the retention disks laid flat against the walls of the pulmonary artery and aorta, without protrusion into the vessel lumen. The echocardiography performed after 24 hr did not show any residual shunt. At a median follow-up of 2 months, the PDAs were completely occluded without obstruction of the pulmonary arteries or aorta. Conclusions: The new device ADO II AS was safely deployed with complete resolution of the PDA shunt. The lower profile and symmetry of this device allows for venous or arterial approach and smaller delivery catheter size. The ADO II AS might be a preferable alternative for closure of small-moderate PDAs. © 2012 Wiley Periodicals, Inc.


Agnoletti G.,Paediatric Hospital Regina Margherita | Marini D.,Paediatric Hospital Regina Margherita | Bordese R.,Paediatric Hospital Regina Margherita | Villar A.M.,Paediatric Hospital Regina Margherita | Gabbarini F.,Paediatric Hospital Regina Margherita
EuroIntervention | Year: 2012

Aims: Limited data exists on midterm results concerning paediatric interventions on stenotic or occluded systemic veins following in dwelling lines, cardiac surgery, or catheterisations. The purpose of this study was to report our acute and intermediate results concerning patients with (Group A) and without (Group B) congenital heart diseases (CHD) over a 10-year period. Methods and results: From January 2000 to December 2010, 32 patients (23 in Group A and nine in Group B, respectively) underwent 39 interventional catheterisations aimed to dilate or recanalise occluded iliofemoral veins, inferior or superior venae cavae. Initial and follow-up catheterisation data were reviewed retrospectively. Midterm results were evaluated by means of echography, angiography, and CT scan; in all 15 and 17 patients, respectively. Median age and weight of all patients at catheterisation were five years (range 0.1-18) and 15 kg (range 2-60), respectively. Fifty-two stents were implanted in 29 patients (32 vessels). In 25 patients 28 vessels were occluded and required recanalisation. There were no major complications. In all but three patients it was possible to treat the lesion. There were two procedural complications (5.1%): one acute stent occlusion and one local dissection. At a median follow-up of 2.5 years (range 1-10) we observed six complications of stenting (11.5%): two fractures, two occlusions and two restenoses. Conclusions: Interventional catheterisation of stenotic or occluded systemic veins grants good immediate results at a low rate of complication. Stent dilatation or recanalisation may open the vessel for use during future procedures. However, long-term results are yet to be established. © Europa Edition 2012. All rights reserved.


PubMed | Paediatric Hospital Regina Margherita
Type: Clinical Trial | Journal: EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology | Year: 2012

Limited data exists on midterm results concerning paediatric interventions on stenotic or occluded systemic veins following indwelling lines, cardiac surgery, or catheterisations. The purpose of this study was to report our acute and intermediate results concerning patients with (Group A) and without (Group B) congenital heart diseases (CHD) over a 10-year period.From January 2000 to December 2010, 32 patients (23 in Group A and nine in Group B, respectively) underwent 39 interventional catheterisations aimed to dilate or recanalise occluded iliofemoral veins, inferior or superior venae cavae. Initial and follow-up catheterisation data were reviewed retrospectively. Midterm results were evaluated by means of echography, angiography, and CT scan in all 15 and 17 patients, respectively. Median age and weight of all patients at catheterisation were five years (range 0.1-18) and 15 kg (range 2-60), respectively. Fifty-two stents were implanted in 29 patients (32 vessels). In 25 patients 28 vessels were occluded and required recanalisation. There were no major complications. In all but three patients it was possible to treat the lesion. There were two procedural complications (5.1%): one acute stent occlusion and one local dissection. At a median follow-up of 2.5 years (range 1-10) we observed six complications of stenting (11.5%): two fractures, two occlusions and two restenoses.Interventional catheterisation of stenotic or occluded systemic veins grants good immediate results at a low rate of complication. Stent dilatation or recanalisation may open the vessel for use during future procedures. However, long-term results are yet to be established.


PubMed | Paediatric Hospital Regina Margherita
Type: Evaluation Studies | Journal: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions | Year: 2012

The objective of this study was to evaluate the technical feasibility, safety, and efficacy of the new device Amplatzer duct occluder II additional sizes (ADO II AS) for closure of patent ductus arteriosus (PDA).Transcatheter device closure is the standard care for PDA. Currently available technology is not designed for closure of small PDA in young children.From April to July 2011, seven children (five females, median age 1.5 years, median weight 11.4 kg) underwent PDA closure with the ADO II AS. Six had isolated PDA, one had PDA associated with preductal coarctation. We evaluated early and short-term results.All but one PDA was closed via an antegrade approach. Mean fluoroscopy and procedural times were 8.0 3.9 and 49.8 27.9 min, respectively. No complications occurred. Immediate trivial residual shunt was present in one patient. In all devices, the retention disks laid flat against the walls of the pulmonary artery and aorta, without protrusion into the vessel lumen. The echocardiography performed after 24 hr did not show any residual shunt. At a median follow-up of 2 months, the PDAs were completely occluded without obstruction of the pulmonary arteries or aorta.The new device ADO II AS was safely deployed with complete resolution of the PDA shunt. The lower profile and symmetry of this device allows for venous or arterial approach and smaller delivery catheter size. The ADO II AS might be a preferable alternative for closure of small-moderate PDAs.

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