Antonio Bozzani - Academia.edu (original) (raw)

Papers by Antonio Bozzani

Research paper thumbnail of Autologous endothelial progenitor cells derived from peripheral blood for the treatment of critical limb ischemia in no-option patients: pilot study

Italian Journal of Vascular and Endovascular Surgery

Aim. Endothelial Progenitor Cells (EPCs) muscle implant effectiveness is demonstrated in animal m... more Aim. Endothelial Progenitor Cells (EPCs) muscle implant effectiveness is demonstrated in animal models and in humans in case of post miocardial ischemia damage. Moreover, peripheral blood EPCs number is lower both in several disease and after several factors, exogens and endogens, exposition, but the concentration is increased by agents like endothelial growth factor. These observations lead to think EPCs play an important role in neovascularization process. The aim of this study was to assess the safety, feasibility and effectiveness of local intramuscular administration of autologous EPCs derived from peripheral blood in critical limb ischemia (rest pain and/or ischemic lesions) in no-options patients in association with standard medical and physical therapy. No-options patients are defined as without possibility of endovascular or surgical revascularization. Methods. Between September 2008 and June 2009 were enrolled 3 male patients with age of 56, 38 and 37 years (mean 43.7). Al...

Research paper thumbnail of G Ital Cardiol | Vol 13 | Luglio-Agosto 2012

528 Stent coronarico e chirurgia: la gestione perioperatoria della terapia antiaggregante nel paz... more 528 Stent coronarico e chirurgia: la gestione perioperatoria della terapia antiaggregante nel paziente portatore di stent coronarico candidato a intervento chirurgico

Research paper thumbnail of Endovascular Stent for Iatrogenic Penetrating Injury of the Thoracic Aorta

Vascular and Endovascular Surgery, 2014

This is a report of the endovascular management of an iatrogenic descending thoracic aortic injur... more This is a report of the endovascular management of an iatrogenic descending thoracic aortic injury with long-term follow-up. A 74-year-old medically complex female underwent the inadvertent percutaneous placement of a 6F sheath directly into the descending thoracic aorta during an attempted pericardiocentesis at an outside hospital. Upon transfer, the patient underwent endovascular placement of a thoracic stent graft to cover the entry site and recovered without incidence. The patient has remained free of complications for nearly 8 years of follow-up care. Endovascular stent graft utilization of the thoracic aorta has increased the treatment scope for the management of emergent and elective aortic pathology. This is particularly useful in clinical scenarios deemed too high an open surgical risk secondary to significant comorbidities.

Research paper thumbnail of Perioperative Approach in the Surgical Management of Carotid Body Tumors

Annals of Vascular Surgery, 2013

Research paper thumbnail of Thoracic Aorta Coarctation in the Adults: Open Surgery is Still the Gold Standard

Vascular and Endovascular Surgery

Aortic coarctation (CoA) is the fifth most common congenital heart defect, accounting for 6% to 8... more Aortic coarctation (CoA) is the fifth most common congenital heart defect, accounting for 6% to 8% of live births with congenital heart disease. Traditional treatment for CoA consists of open surgical repair, and the endovascular procedures have been proposed as an alternative treatment. We describe the case of a 50-year-old man presented to our department with mild lower limbs claudication and hypertension. The computed tomography scan diagnosed an aortic postductal coarctation, which we treated with aortoplasty with Dacron patch. The open surgery, in our opinion, is nowadays still preferable due to the time-stable and effective outcome.

Research paper thumbnail of Posttraumatic Internal Iliac Arteriovenous Fistula

Vascular and Endovascular Surgery, 2012

Research paper thumbnail of Perioperative approach in the surgical management of carotid body tumors

Annals of vascular surgery, 2012

Now, surgical resection still remains the gold standard for the treatment of carotid body tumors ... more Now, surgical resection still remains the gold standard for the treatment of carotid body tumors (CBTs). Although advances in surgical techniques and the introduction of sensitive imaging modalities have significantly reduced mortality, the incidence of perioperative neurovascular complications, especially cranial nerve deficit and intraoperative hemorrhage, remains considerable. To solve these problems, preoperative embolization has been suggested; the reported benefits of preoperative embolization performed <48 hours before surgery include a reduction in tumor size, decreased blood loss, and improved visualization, theoretically reducing neurologic morbidity by lessening the risk of stroke and damage to cranial nerves. The purpose of this study was to review our experience in the surgical management of CBTs with preoperative embolization and evaluate the outcomes and complications according to the Shamblin classification. Thirty-two patients who had been diagnosed with and surg...

Research paper thumbnail of Clinical Presentation and Evidence-based Indications to Treatment

Thoraco-Abdominal Aorta, 2011

Thoraco-abdominal aortic diseases (TADs) include degenerative descending thoracic (DTAA) and thor... more Thoraco-abdominal aortic diseases (TADs) include degenerative descending thoracic (DTAA) and thoraco-abdominal aortic aneurysm (TAAA), post-dissection aneurysms, acute aortic dissections (AADs), intramural hematoma (IMH), and penetrating aortic ulcer (PAU). Each of these pathologies shows particular patterns of clinical presentation in acute or elective form. Patients with DTAA and TAAA are often asymptomatic at the time of diagnosis, while all TADs present

Research paper thumbnail of Allogeneic Lethally Irradiated Cord Blood Mononuclear Cells in No-Option Critical Limb Ischemia: A “Box of Rain”

Stem Cells and Development, 2013

Critical limb ischemia (CLI) is burdened by a 40% major amputation rate, and a 5-year life expect... more Critical limb ischemia (CLI) is burdened by a 40% major amputation rate, and a 5-year life expectancy < 50%. We report the first in-human injection of lethally g-irradiated non-human leukocyte antigen (HLA)-matched cord blood (CB)-derived mononuclear cells in a no-option CLI patient, to induce therapeutic neo-angiogenesis, with evidence of successful outcome supported by clinical findings (ulcer healing and pain relief), instrumental assessment (transcutaneous O 2 pressure, ankle/brachial index, and contrast-enhanced ultrasonography), and histological demonstration of muscular tissue repair and capillary network expansion. If our approach will be confirmed, the huge number of CB units currently discarded might be redirected toward regenerative medicine purposes, leading to cutting-edge solutions for important unmet clinical needs, such as ischemic diseases, which remain the main cause of disability and mortality in western countries.

Research paper thumbnail of Echo-Free Space and Intimal Micro-Tear: Initiating Event or Decompression Rent of Intramural Haematoma?

EJVES Extra, 2009

A 52-year-old man with hypertension and prior ascending aorta reconstruction presented with an ac... more A 52-year-old man with hypertension and prior ascending aorta reconstruction presented with an acute, type B intramural haematoma. The patient was managed by medical therapy and was closely followed up with trans-oesophageal echocardiography. At 36 months, we observed an asymptomatic echo-free space across the aortic, isthmic intramural haematoma associated with single 'intimal micro-tear'. At 1-month follow-up, the echo-free space had been completely absorbed. ª

Research paper thumbnail of Re: Acute aortic syndrome: CT findings

Research paper thumbnail of Covered Carotid Stents

Research paper thumbnail of Is Focal Contrast Enhancement at CT Still a Predictor of Poor Clinical Outcome in Patients With Aortic Intramural Hematoma?

American Journal of Roentgenology, 2010

Research paper thumbnail of Endovascular Repair of Abdominal Aortic Aneurysm

American Journal of Nursing, 2001

Research paper thumbnail of What is the real risk of stent-graft infection in the treatment of aortobronchial fistulas?

The Journal of Thoracic and Cardiovascular Surgery, 2010

Research paper thumbnail of Modified “Stent-Graft Sandwich” Technique for Treatment of Isolated Common Iliac Artery Aneurysm in Patient With Marfan Syndrome

Annals of Vascular Surgery, 2012

Isolated iliac artery aneurysms are rare in the general population (0.03%) and represent 2% of al... more Isolated iliac artery aneurysms are rare in the general population (0.03%) and represent 2% of all abdominal aneurysms, and the association with Marfan syndrome is even rarer. We report a Marfan syndrome case with an isolated common iliac artery aneurysm treated by using a modified &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;stent-graft sandwich&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; technique, with preservation of the internal iliac artery perfusion. The modified &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;stent-graft sandwich&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; technique involves building an appropriate proximal neck just in the common iliac artery for fittingly housing two new stent-grafts inside, both deployed simultaneously and each one going to both distal iliac arteries (internal and external).

Research paper thumbnail of Autologous immuno magnetically selected CD133+ stem cells in the treatment of no-option critical limb ischemia: clinical and contrast enhanced ultrasound assessed results in eight patients

Journal of translational medicine, 2015

Demonstrate the safety and effectiveness of highly purified CD133+ autologous stem cells in criti... more Demonstrate the safety and effectiveness of highly purified CD133+ autologous stem cells in critical limb ischemia (CLI). Prospective single-center not randomized. Clinicaltrials.gov identifier: NCT01595776 METHODS: Eight patients with a history of stable CLI were enrolled in a period of 2 years. After bone marrow stimulation and single leukapheresis collection, CD133+ immunomagnetic cell selection was performed. CD133+ cells in buffer phosphate suspension was administered intramuscularly. Muscular and arterial contrast enhanced ultra sound (CEUS), lesion evolution and pain management were assessed preoperatively and 3, 6 and 12 months after the implant. No patient had early or late complications related to the procedure. Two patients (25 %) didn't get any relief from the treatment and underwent major amputation. Six patients (75 %) had a complete healing of the wounds, rest pain cessation and walking recovery. An increase in CEUS values was shown in all eight patients at 6 mont...

Research paper thumbnail of Massive Vertebral Destruction Associated With Chronic Rupture of Infrarenal Aortic Aneurysm

Spine, 2012

Case report and review of literature. To highlight the specific features of a rare, life-threaten... more Case report and review of literature. To highlight the specific features of a rare, life-threatening, clinical picture. Vertebral erosion (VE) is rarely associated with contained rupture of an abdominal aortic aneurysm. The involvement of radicular nerves can mimic a discus hernia syndrome; eventually vertebral erosion induces isolated lower back pain. These features often lead to a delayed or wrong diagnosis of a life-threatening condition. Forty-two complete similar case reports have been published in the English literature since 1962. The most prevalent symptoms are low back pain and neurological signs due to compression of radicular nerves. A 73-year-old man presented to Vascular Surgery department complaining of continuous pain in the lumbar region during the previous 6 months. The duplex examination revealed a huge infrarenal aortic aneurysm with an undefined posterior wall. Spiral CT and MR scan confirmed the aneurysm and a scalloping of the second and third lumbar vertebral bodies. A double-team intervention, vascular and orthopedic, consisted in aneurysm graft replacement; vertebral bodies excision and anterior and posterior spinal stabilization. Postoperatively the patient experienced reversible respiratory and renal failure and was discharged home in good health after 30 days. The presence of aortic abdominal aneurysm is always to be considered in the evaluation of an elderly patient complaining lower back pain or lower limb neuropathy of recent onset, especially in the presence of a degenerative process of the spine.

Research paper thumbnail of Antiplatelet therapy management in patients with coronary stent undergoing vascular surgery

The Journal of cardiovascular surgery, Jan 10, 2014

Research paper thumbnail of Re: “Endovascular repair of a right-sided thoracic aortic aneurysm with Kommerell diverticulum and aberrant left subclavian artery”

Annals of Vascular Surgery, 2014

Research paper thumbnail of Autologous endothelial progenitor cells derived from peripheral blood for the treatment of critical limb ischemia in no-option patients: pilot study

Italian Journal of Vascular and Endovascular Surgery

Aim. Endothelial Progenitor Cells (EPCs) muscle implant effectiveness is demonstrated in animal m... more Aim. Endothelial Progenitor Cells (EPCs) muscle implant effectiveness is demonstrated in animal models and in humans in case of post miocardial ischemia damage. Moreover, peripheral blood EPCs number is lower both in several disease and after several factors, exogens and endogens, exposition, but the concentration is increased by agents like endothelial growth factor. These observations lead to think EPCs play an important role in neovascularization process. The aim of this study was to assess the safety, feasibility and effectiveness of local intramuscular administration of autologous EPCs derived from peripheral blood in critical limb ischemia (rest pain and/or ischemic lesions) in no-options patients in association with standard medical and physical therapy. No-options patients are defined as without possibility of endovascular or surgical revascularization. Methods. Between September 2008 and June 2009 were enrolled 3 male patients with age of 56, 38 and 37 years (mean 43.7). Al...

Research paper thumbnail of G Ital Cardiol | Vol 13 | Luglio-Agosto 2012

528 Stent coronarico e chirurgia: la gestione perioperatoria della terapia antiaggregante nel paz... more 528 Stent coronarico e chirurgia: la gestione perioperatoria della terapia antiaggregante nel paziente portatore di stent coronarico candidato a intervento chirurgico

Research paper thumbnail of Endovascular Stent for Iatrogenic Penetrating Injury of the Thoracic Aorta

Vascular and Endovascular Surgery, 2014

This is a report of the endovascular management of an iatrogenic descending thoracic aortic injur... more This is a report of the endovascular management of an iatrogenic descending thoracic aortic injury with long-term follow-up. A 74-year-old medically complex female underwent the inadvertent percutaneous placement of a 6F sheath directly into the descending thoracic aorta during an attempted pericardiocentesis at an outside hospital. Upon transfer, the patient underwent endovascular placement of a thoracic stent graft to cover the entry site and recovered without incidence. The patient has remained free of complications for nearly 8 years of follow-up care. Endovascular stent graft utilization of the thoracic aorta has increased the treatment scope for the management of emergent and elective aortic pathology. This is particularly useful in clinical scenarios deemed too high an open surgical risk secondary to significant comorbidities.

Research paper thumbnail of Perioperative Approach in the Surgical Management of Carotid Body Tumors

Annals of Vascular Surgery, 2013

Research paper thumbnail of Thoracic Aorta Coarctation in the Adults: Open Surgery is Still the Gold Standard

Vascular and Endovascular Surgery

Aortic coarctation (CoA) is the fifth most common congenital heart defect, accounting for 6% to 8... more Aortic coarctation (CoA) is the fifth most common congenital heart defect, accounting for 6% to 8% of live births with congenital heart disease. Traditional treatment for CoA consists of open surgical repair, and the endovascular procedures have been proposed as an alternative treatment. We describe the case of a 50-year-old man presented to our department with mild lower limbs claudication and hypertension. The computed tomography scan diagnosed an aortic postductal coarctation, which we treated with aortoplasty with Dacron patch. The open surgery, in our opinion, is nowadays still preferable due to the time-stable and effective outcome.

Research paper thumbnail of Posttraumatic Internal Iliac Arteriovenous Fistula

Vascular and Endovascular Surgery, 2012

Research paper thumbnail of Perioperative approach in the surgical management of carotid body tumors

Annals of vascular surgery, 2012

Now, surgical resection still remains the gold standard for the treatment of carotid body tumors ... more Now, surgical resection still remains the gold standard for the treatment of carotid body tumors (CBTs). Although advances in surgical techniques and the introduction of sensitive imaging modalities have significantly reduced mortality, the incidence of perioperative neurovascular complications, especially cranial nerve deficit and intraoperative hemorrhage, remains considerable. To solve these problems, preoperative embolization has been suggested; the reported benefits of preoperative embolization performed <48 hours before surgery include a reduction in tumor size, decreased blood loss, and improved visualization, theoretically reducing neurologic morbidity by lessening the risk of stroke and damage to cranial nerves. The purpose of this study was to review our experience in the surgical management of CBTs with preoperative embolization and evaluate the outcomes and complications according to the Shamblin classification. Thirty-two patients who had been diagnosed with and surg...

Research paper thumbnail of Clinical Presentation and Evidence-based Indications to Treatment

Thoraco-Abdominal Aorta, 2011

Thoraco-abdominal aortic diseases (TADs) include degenerative descending thoracic (DTAA) and thor... more Thoraco-abdominal aortic diseases (TADs) include degenerative descending thoracic (DTAA) and thoraco-abdominal aortic aneurysm (TAAA), post-dissection aneurysms, acute aortic dissections (AADs), intramural hematoma (IMH), and penetrating aortic ulcer (PAU). Each of these pathologies shows particular patterns of clinical presentation in acute or elective form. Patients with DTAA and TAAA are often asymptomatic at the time of diagnosis, while all TADs present

Research paper thumbnail of Allogeneic Lethally Irradiated Cord Blood Mononuclear Cells in No-Option Critical Limb Ischemia: A “Box of Rain”

Stem Cells and Development, 2013

Critical limb ischemia (CLI) is burdened by a 40% major amputation rate, and a 5-year life expect... more Critical limb ischemia (CLI) is burdened by a 40% major amputation rate, and a 5-year life expectancy < 50%. We report the first in-human injection of lethally g-irradiated non-human leukocyte antigen (HLA)-matched cord blood (CB)-derived mononuclear cells in a no-option CLI patient, to induce therapeutic neo-angiogenesis, with evidence of successful outcome supported by clinical findings (ulcer healing and pain relief), instrumental assessment (transcutaneous O 2 pressure, ankle/brachial index, and contrast-enhanced ultrasonography), and histological demonstration of muscular tissue repair and capillary network expansion. If our approach will be confirmed, the huge number of CB units currently discarded might be redirected toward regenerative medicine purposes, leading to cutting-edge solutions for important unmet clinical needs, such as ischemic diseases, which remain the main cause of disability and mortality in western countries.

Research paper thumbnail of Echo-Free Space and Intimal Micro-Tear: Initiating Event or Decompression Rent of Intramural Haematoma?

EJVES Extra, 2009

A 52-year-old man with hypertension and prior ascending aorta reconstruction presented with an ac... more A 52-year-old man with hypertension and prior ascending aorta reconstruction presented with an acute, type B intramural haematoma. The patient was managed by medical therapy and was closely followed up with trans-oesophageal echocardiography. At 36 months, we observed an asymptomatic echo-free space across the aortic, isthmic intramural haematoma associated with single 'intimal micro-tear'. At 1-month follow-up, the echo-free space had been completely absorbed. ª

Research paper thumbnail of Re: Acute aortic syndrome: CT findings

Research paper thumbnail of Covered Carotid Stents

Research paper thumbnail of Is Focal Contrast Enhancement at CT Still a Predictor of Poor Clinical Outcome in Patients With Aortic Intramural Hematoma?

American Journal of Roentgenology, 2010

Research paper thumbnail of Endovascular Repair of Abdominal Aortic Aneurysm

American Journal of Nursing, 2001

Research paper thumbnail of What is the real risk of stent-graft infection in the treatment of aortobronchial fistulas?

The Journal of Thoracic and Cardiovascular Surgery, 2010

Research paper thumbnail of Modified “Stent-Graft Sandwich” Technique for Treatment of Isolated Common Iliac Artery Aneurysm in Patient With Marfan Syndrome

Annals of Vascular Surgery, 2012

Isolated iliac artery aneurysms are rare in the general population (0.03%) and represent 2% of al... more Isolated iliac artery aneurysms are rare in the general population (0.03%) and represent 2% of all abdominal aneurysms, and the association with Marfan syndrome is even rarer. We report a Marfan syndrome case with an isolated common iliac artery aneurysm treated by using a modified &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;stent-graft sandwich&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; technique, with preservation of the internal iliac artery perfusion. The modified &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;stent-graft sandwich&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; technique involves building an appropriate proximal neck just in the common iliac artery for fittingly housing two new stent-grafts inside, both deployed simultaneously and each one going to both distal iliac arteries (internal and external).

Research paper thumbnail of Autologous immuno magnetically selected CD133+ stem cells in the treatment of no-option critical limb ischemia: clinical and contrast enhanced ultrasound assessed results in eight patients

Journal of translational medicine, 2015

Demonstrate the safety and effectiveness of highly purified CD133+ autologous stem cells in criti... more Demonstrate the safety and effectiveness of highly purified CD133+ autologous stem cells in critical limb ischemia (CLI). Prospective single-center not randomized. Clinicaltrials.gov identifier: NCT01595776 METHODS: Eight patients with a history of stable CLI were enrolled in a period of 2 years. After bone marrow stimulation and single leukapheresis collection, CD133+ immunomagnetic cell selection was performed. CD133+ cells in buffer phosphate suspension was administered intramuscularly. Muscular and arterial contrast enhanced ultra sound (CEUS), lesion evolution and pain management were assessed preoperatively and 3, 6 and 12 months after the implant. No patient had early or late complications related to the procedure. Two patients (25 %) didn't get any relief from the treatment and underwent major amputation. Six patients (75 %) had a complete healing of the wounds, rest pain cessation and walking recovery. An increase in CEUS values was shown in all eight patients at 6 mont...

Research paper thumbnail of Massive Vertebral Destruction Associated With Chronic Rupture of Infrarenal Aortic Aneurysm

Spine, 2012

Case report and review of literature. To highlight the specific features of a rare, life-threaten... more Case report and review of literature. To highlight the specific features of a rare, life-threatening, clinical picture. Vertebral erosion (VE) is rarely associated with contained rupture of an abdominal aortic aneurysm. The involvement of radicular nerves can mimic a discus hernia syndrome; eventually vertebral erosion induces isolated lower back pain. These features often lead to a delayed or wrong diagnosis of a life-threatening condition. Forty-two complete similar case reports have been published in the English literature since 1962. The most prevalent symptoms are low back pain and neurological signs due to compression of radicular nerves. A 73-year-old man presented to Vascular Surgery department complaining of continuous pain in the lumbar region during the previous 6 months. The duplex examination revealed a huge infrarenal aortic aneurysm with an undefined posterior wall. Spiral CT and MR scan confirmed the aneurysm and a scalloping of the second and third lumbar vertebral bodies. A double-team intervention, vascular and orthopedic, consisted in aneurysm graft replacement; vertebral bodies excision and anterior and posterior spinal stabilization. Postoperatively the patient experienced reversible respiratory and renal failure and was discharged home in good health after 30 days. The presence of aortic abdominal aneurysm is always to be considered in the evaluation of an elderly patient complaining lower back pain or lower limb neuropathy of recent onset, especially in the presence of a degenerative process of the spine.

Research paper thumbnail of Antiplatelet therapy management in patients with coronary stent undergoing vascular surgery

The Journal of cardiovascular surgery, Jan 10, 2014

Research paper thumbnail of Re: “Endovascular repair of a right-sided thoracic aortic aneurysm with Kommerell diverticulum and aberrant left subclavian artery”

Annals of Vascular Surgery, 2014