Carlo M Ferro - Academia.edu (original) (raw)
Papers by Carlo M Ferro
Clinical Anatomy, 2006
... How to Cite. Rossi, UG, Romano, M. and Ferro, C. (2006), Seven renal arteries. ... Correspond... more ... How to Cite. Rossi, UG, Romano, M. and Ferro, C. (2006), Seven renal arteries. ... Correspondence: Umberto G. Rossi, Department of Diagnostic and Interventional Radiology, San Martino University, Hospital Genoa, Largo Rosanna Benzi 10, 16132 Genoa, Italy. ...
CardioVascular and Interventional Radiology, 2006
Percutaneous transcatheter embolization has become the treatment of choice for pulmonary arteriov... more Percutaneous transcatheter embolization has become the treatment of choice for pulmonary arteriovenous fistulas (PAVFs), in most cases replacing surgical intervention. However, while "classic" devices, such as intravascular coils and detachable balloons, have proved to be successful for interventional occlusions of small or medium-sized PAVFs, they are not ideal in larger fistulas because of the risk for embolization to the systemic circulation. We describe the case of a 61-year-old woman with a symptomatic huge solitary pulmonary arteriovenous fistula (4.5 cm in diameter), occupying part of the lung in the lower right lobe with two feeding arteries (10 and 4 mm in diameter, respectively), who underwent successful transcatheter closure with an Amplatzer Vascular Plug, a new device designed for the occlusion of vascular abnormalities.
The Annals of Thoracic Surgery, 2014
The Annals of Thoracic Surgery, 2010
We report a patient affected by complicated retrograde type A aortic dissection (DeBakey type I) ... more We report a patient affected by complicated retrograde type A aortic dissection (DeBakey type I) with false lumen rupture and acute right lower limb ischemia treated with fenestration at the aortic bifurcation followed by a hybrid approach, consisting of an elephant trunk procedure and the placement of endoluminal stent graft for the treatment of descending thoracic aorta dissection. In our patient, in spite of the closure of the primary entry site, false lumen failed to remodel in the abdominal aorta, therefore the positioning of the bare stents and aortobisiliac endoprosthesis of the abdominal aorta were performed. Visceral blood flow was preserved and the postoperative course was uneventful at the 6-month follow-up.
American Journal of Kidney Diseases, 2012
We describe a case of nonocclusive mesenteric ischemia in a 37-year-old man with hemodialysis-dep... more We describe a case of nonocclusive mesenteric ischemia in a 37-year-old man with hemodialysis-dependent chronic kidney disease due to diabetes who was admitted to our hospital with abdominal pain. A plain radiograph of the abdomen showed distended loops of small bowel and gas in the hepatic portal vein. Multidetector computed tomography showed massive wall calcification of the superior mesenteric artery and its collaterals, pneumatosis intestinalis of a segment of the jejunum, and porto-mesenteric vein gas. Urgent laparotomy confirmed segmental necrosis of the jejunum, which was resected. Pathologic examination showed whole-layer necrosis of the resected bowel without arterial or venous thrombosis. Nonocclusive mesenteric ischemia is an increasingly recognized and potentially lethal complication in hemodialysis patients. In the present case, critical factors for the development of nonocclusive mesenteric ischemia may have included prolonged hypotension during hemodialysis treatments that reduced blood flow to the small bowel and massive vascular calcification that negatively affected compliance of the superior mesenteric artery and its branches.
CardioVascular and Interventional Radiology, 2009
The purpose of this communication is to describe our preliminary experience with the AMPLAT-ZER V... more The purpose of this communication is to describe our preliminary experience with the AMPLAT-ZER Vascular Plug 4 (AVP 4) in peripheral vascular embolization. The AVP 4 was used for peripheral vascular embolization in five patients with renal pseudoaneurysm (n = 2), postsurgical peritoneal bleeding (n = 1), posttraumatic gluteal hemorrhage (n = 1), and intercostal pseudoaneurysm (n = 1). Occlusion time was recorded. Patients were followed up clinically and by imaging for 1 month after the procedure. All treated vessels or vascular abnormalities were successfully occluded within 3 min for low-flow circulation and over 8 min for high-flow circulation. At 1-month follow-up, all patients were symptomfree. All deployed devices remained in the original locations and desirable configurations. In conclusion, the AVP 4 seems to be safe and effective for occluding peripheral vessels and vascular abnormalities. Because of its compatibility with 0.038-in. catheters, it can be deployed through a diagnostic catheter following angiography without exchanging a sheath or guiding catheter. Compared with the previous generation of vascular plugs, the AVP 4 allows for faster procedure times and decreased exposure to radiation.
Cardiovascular and Interventional Radiology, Apr 1, 2011
The purpose of this report is to describe deployment of the Relay NBS Thoracic Stent Graft with t... more The purpose of this report is to describe deployment of the Relay NBS Thoracic Stent Graft with the Plus Delivery System (Bolton Medical, Sunrise, FL) in a flexible resin arch model with a 15-mm radius curve as well as our preliminary clinical results. The Relay NBS graft with the Plus Delivery System was evaluated by way of bench testing, which was performed with stent grafts with diameters ranging from 24 to 46 mm and lengths ranging from 100 to 250 mm in flexible resin arch models with a 15-mm arch radius of curvature. The deployment sequence was analyzed. The Relay NBS graft with the Plus Delivery System was deployed in two patients, respectively, having a 6.5-cm penetrating aortic ulcer of the proximal third of the descending thoracic aorta and a DeBakey type-I aortic dissection with chronic false lumen dilatation after surgery due to an entry site at the distal thoracic aorta. Bench tests showed proper conformation and apposition of the Relay NBS graft with the Plus Delivery System in the flexible resin model. This stent graft was deployed successfully into the two patients with a correct orientation of the first stent and without early or late complications. The Relay NBS graft with the Plus Delivery System ensures an optimal conformation and apposition of the first stent in the aortic arch with a small radius of curvature.
Cardiovasc Interven Radiol, 1999
A 71-year-old woman presented with a life-threatening thyroid hemorrhage after US-guided chemical... more A 71-year-old woman presented with a life-threatening thyroid hemorrhage after US-guided chemical parathyroidectomy. The diagnosis was made by angiography followed by immediate embolization of a pseudoaneurysm of the left superior thyroid artery. Embolization controlled the hemorrhage, obviating the need for surgery. The patient made a full recovery with no evidence of further hemorrhage. Pseudoaneurysm of the superior thyroid artery is a rare cause of hemorrhage and percutaneous embolization is an effective method of treatment.
Journal of Nuclear Cardiology, 2016
Recent technical advances in multi-detector computed tomography (MDCT) allow for assessment of co... more Recent technical advances in multi-detector computed tomography (MDCT) allow for assessment of coronary flow reserve (CFR). We compared regional CFR by dynamic SPECT and by dynamic MDCT in patients with suspected or known coronary artery disease (CAD). Thirty-five patients, (29 males, mean age 69 years) with greater than average Framingham risk of CAD, underwent dipyridamole vasodilator stress imaging. CFR was estimated using dynamic SPECT and dynamic MDCT imaging in the same patients. Myocardial perfusion findings were correlated with obstructive CAD (≥50% luminal narrowing) on CT coronary angiography (CA). Mean CFR estimated by SPECT and MDCT in 595 myocardial segments was not different (1.51 ± 0.46 vs. 1.50 ± 0.37, p = NS). Correlation of segmental CFR by SPECT and MDCT was fair (r (2) = 0.39, p < 0.001). Bland-Altman analysis revealed that MDCT in comparison to SPECT systematically underestimated CFR in higher CFR ranges. By CTCA, 12 patients had normal CA, 11 had non-obstructive, and 12 had obstructive CAD. CFR by both techniques was significantly higher in territories of normal CA than in territories subtended by non-obstructive or obstructive CAD. SPECT CFR was also significantly different in territories subtended by non-obstructive and obstructive CAD, whereas MDCT CFR was not. Despite relative underestimation of high CFR values, MDCT CFR shows promise for assessing the pathophysiological significance of anatomic CAD.
Revista Española de Cardiología (English Edition), 2016
Since its introduction about 15 years ago, coronary computed tomography angiography has become to... more Since its introduction about 15 years ago, coronary computed tomography angiography has become today the most accurate clinical instrument for noninvasive assessment of coronary atherosclerosis. Important technical developments have led to a continuous stream of new clinical applications together with a significant reduction in radiation dose exposure. Latest generation computed tomography scanners (≥ 64 slices) allow the possibility of performing static or dynamic perfusion imaging during stress by using coronary vasodilator agents (adenosine, dipyridamole, or regadenoson), combining both functional and anatomical information in the same examination. In this article, the emerging role and state-of-the-art of myocardial computed tomography perfusion imaging are reviewed and are illustrated by clinical cases from our experience with a second-generation dual-source 128-slice scanner (Somatom Definition Flash, Siemens; Erlangen, Germany). Technical aspects, data analysis, diagnostic accuracy, radiation dose and future prospects are reviewed.
Hepato Gastroenterology, 2002
Recent experiences suggest that interferon may significantly decrease the incidence of hepatocell... more Recent experiences suggest that interferon may significantly decrease the incidence of hepatocellular carcinoma. We conducted a randomized study with interferon versus no therapy in hepatitis C virus Child A cirrhosis with abnormal alanine aminotransferase and HCV-RNA positive serum with the aim to investigate the incidence of hepatocellular carcinoma, worsening of cirrhosis's stage and death or orthotopic liver transplantation. A cohort of 122 patients prospectively followed was analyzed retrospectively to assess the effect of interferon therapy (mean follow-up: 96 +/- 18.3 months). We only chose patients with hepatitis C virus infection who had undergone blood transfusion before 1980. Hepatitis C virus serotype was determined by hepatitis C virus serotyping 1-6 assay (Murex Biothec Limited Temple Hill, Dartford, Kent, UK). HCV-RNA level was determined by bDNA, Chiron Corporation Emeryville, CA. Diagnosis of hepatocellular carcinoma was made on the basis of the appearance of local lesions at periodic ultrasound examination of the liver and confirmed with spiral computed tomography. Fine needle biopsy under sonographic guidance was effected. Fifty-nine patients (mean age: 55.3 +/- 7) received interferon (3MU three times a week for 12 months), 8 stopped therapy for side effects, 71 did not receive interferon (mean age: 56.8 +/- 8). Baseline characteristics were similar. It emerges how interferon does not reduce the risk of hepatocellular carcinoma in compensated cirrhosis. In interferon treated patients an improvement in relation with worsening and death/orthotopic liver transplantation has been noted. The use of the interferon seems to be scarcely useful when structural alterations of the cirrhotic kind show up, as cirrhosis represents by itself a risk factor for hepatocellular carcinoma. Nevertheless, in relation to the worsening of cirrhosis's stage the interferon therapy can be useful in compensated cirrhosis.
Italian Journal of Vascular and Endovascular Surgery
ABSTRACT
The Annals of thoracic surgery, 2015
Cardiovascular and interventional radiology
A patient was admitted because of severe abdominal pain, anorexia, and intestinal bleeding. Contr... more A patient was admitted because of severe abdominal pain, anorexia, and intestinal bleeding. Contrast-enhanced multidetector computed tomography demonstrated acute portal and superior mesenteric vein thrombosis (PSMVT). The patient was treated percutaneously with transjugular intrahepatic portosystemic shunt (TIPS), mechanical aspiration thrombectomy, and direct thrombolysis, and 1 week after the procedure, complete patency of the portal and superior mesenteric veins was demonstrated. TIPS, mechanical aspiration thrombectomy, and direct thrombolysis together are promising endovascular techniques for the treatment of symptomatic acute PSMVT.
Hepato-gastroenterology
Hepatorenal Syndrome (HRS) is a serious and life-threatening complication of portal hypertension ... more Hepatorenal Syndrome (HRS) is a serious and life-threatening complication of portal hypertension and end stage liver disease. The cornerstone of treatment is liver transplantation, since renal dysfunction is usually reversible and disappears with the correction of the underlying cause. It is established that HRS has a functional nature and that it is related to renal vasoconstriction. Rapid diagnosis and management are important. Vasoconstrictors together with albumin can ameliorate the effective arterial blood volume and increase renal perfusion pressure. The lack of effective alternative treatment modalities in non responding patients to medical therapy and the almost universally fatal outcome of HRS make transjugular intrahepatic portosystemic stent shunt as a bridge to liver transplantation.
Interactive cardiovascular and thoracic surgery, 2011
Two adult patients were diagnosed with extralobar and intralobar pulmonary sequestration. One pat... more Two adult patients were diagnosed with extralobar and intralobar pulmonary sequestration. One patient presented with haemoptysis. Both patients suffered from recurrent episodes of severe pulmonary infections. Both patients were treated by means of endovascular embolization using Amplatzer(®) vascular plugs (AVPs). They were discharged from hospital after 48 and 24 h and then followed up for 24 and six months, respectively. No recurrence of symptoms was observed. Computed tomography scans were obtained every six months. Persistent occlusion of vascular supply and moderate regression of the sequestered lung tissue are evident after 24 and six months in both patients. Just one case of an adult patient affected by pulmonary sequestration and treated by endovascular embolization has been reported to date. The present report is the first on the use of the AVPs in adults for this condition. The potential advantages and drawbacks of this treatment modality in adults are discussed, as well t...
Minerva urologica e nefrologica = The Italian journal of urology and nephrology, 1998
The function of vascular shunts in hemodialysis plays a vital role for the efficiency and effecti... more The function of vascular shunts in hemodialysis plays a vital role for the efficiency and effectiveness of replacement therapy. A study was performed in 147 patients undergoing periodical hemodialysis with distal FAV (no = 86), proximal FAV (no = 33), PTFE grafts (no = 23), Canaud-Tesio catheters (no = 7). A protocol for function evaluation was developed which also included the calculation of overall recirculation (R), that was found to be 10.8 + 7% (using the three blood sample method). In 28/143 patients the monitoring protocol recommended the use of angiography which identified abnormalities in 78% of cases, before the onset of thrombotic phenomena. In particular, surgical radiology was able to resolve 94% of cases in which angiography revealed a stenosis using percutaneous transluminal angioplasty and/or the insertion of one or more stents.
Clinical Anatomy, 2006
... How to Cite. Rossi, UG, Romano, M. and Ferro, C. (2006), Seven renal arteries. ... Correspond... more ... How to Cite. Rossi, UG, Romano, M. and Ferro, C. (2006), Seven renal arteries. ... Correspondence: Umberto G. Rossi, Department of Diagnostic and Interventional Radiology, San Martino University, Hospital Genoa, Largo Rosanna Benzi 10, 16132 Genoa, Italy. ...
CardioVascular and Interventional Radiology, 2006
Percutaneous transcatheter embolization has become the treatment of choice for pulmonary arteriov... more Percutaneous transcatheter embolization has become the treatment of choice for pulmonary arteriovenous fistulas (PAVFs), in most cases replacing surgical intervention. However, while "classic" devices, such as intravascular coils and detachable balloons, have proved to be successful for interventional occlusions of small or medium-sized PAVFs, they are not ideal in larger fistulas because of the risk for embolization to the systemic circulation. We describe the case of a 61-year-old woman with a symptomatic huge solitary pulmonary arteriovenous fistula (4.5 cm in diameter), occupying part of the lung in the lower right lobe with two feeding arteries (10 and 4 mm in diameter, respectively), who underwent successful transcatheter closure with an Amplatzer Vascular Plug, a new device designed for the occlusion of vascular abnormalities.
The Annals of Thoracic Surgery, 2014
The Annals of Thoracic Surgery, 2010
We report a patient affected by complicated retrograde type A aortic dissection (DeBakey type I) ... more We report a patient affected by complicated retrograde type A aortic dissection (DeBakey type I) with false lumen rupture and acute right lower limb ischemia treated with fenestration at the aortic bifurcation followed by a hybrid approach, consisting of an elephant trunk procedure and the placement of endoluminal stent graft for the treatment of descending thoracic aorta dissection. In our patient, in spite of the closure of the primary entry site, false lumen failed to remodel in the abdominal aorta, therefore the positioning of the bare stents and aortobisiliac endoprosthesis of the abdominal aorta were performed. Visceral blood flow was preserved and the postoperative course was uneventful at the 6-month follow-up.
American Journal of Kidney Diseases, 2012
We describe a case of nonocclusive mesenteric ischemia in a 37-year-old man with hemodialysis-dep... more We describe a case of nonocclusive mesenteric ischemia in a 37-year-old man with hemodialysis-dependent chronic kidney disease due to diabetes who was admitted to our hospital with abdominal pain. A plain radiograph of the abdomen showed distended loops of small bowel and gas in the hepatic portal vein. Multidetector computed tomography showed massive wall calcification of the superior mesenteric artery and its collaterals, pneumatosis intestinalis of a segment of the jejunum, and porto-mesenteric vein gas. Urgent laparotomy confirmed segmental necrosis of the jejunum, which was resected. Pathologic examination showed whole-layer necrosis of the resected bowel without arterial or venous thrombosis. Nonocclusive mesenteric ischemia is an increasingly recognized and potentially lethal complication in hemodialysis patients. In the present case, critical factors for the development of nonocclusive mesenteric ischemia may have included prolonged hypotension during hemodialysis treatments that reduced blood flow to the small bowel and massive vascular calcification that negatively affected compliance of the superior mesenteric artery and its branches.
CardioVascular and Interventional Radiology, 2009
The purpose of this communication is to describe our preliminary experience with the AMPLAT-ZER V... more The purpose of this communication is to describe our preliminary experience with the AMPLAT-ZER Vascular Plug 4 (AVP 4) in peripheral vascular embolization. The AVP 4 was used for peripheral vascular embolization in five patients with renal pseudoaneurysm (n = 2), postsurgical peritoneal bleeding (n = 1), posttraumatic gluteal hemorrhage (n = 1), and intercostal pseudoaneurysm (n = 1). Occlusion time was recorded. Patients were followed up clinically and by imaging for 1 month after the procedure. All treated vessels or vascular abnormalities were successfully occluded within 3 min for low-flow circulation and over 8 min for high-flow circulation. At 1-month follow-up, all patients were symptomfree. All deployed devices remained in the original locations and desirable configurations. In conclusion, the AVP 4 seems to be safe and effective for occluding peripheral vessels and vascular abnormalities. Because of its compatibility with 0.038-in. catheters, it can be deployed through a diagnostic catheter following angiography without exchanging a sheath or guiding catheter. Compared with the previous generation of vascular plugs, the AVP 4 allows for faster procedure times and decreased exposure to radiation.
Cardiovascular and Interventional Radiology, Apr 1, 2011
The purpose of this report is to describe deployment of the Relay NBS Thoracic Stent Graft with t... more The purpose of this report is to describe deployment of the Relay NBS Thoracic Stent Graft with the Plus Delivery System (Bolton Medical, Sunrise, FL) in a flexible resin arch model with a 15-mm radius curve as well as our preliminary clinical results. The Relay NBS graft with the Plus Delivery System was evaluated by way of bench testing, which was performed with stent grafts with diameters ranging from 24 to 46 mm and lengths ranging from 100 to 250 mm in flexible resin arch models with a 15-mm arch radius of curvature. The deployment sequence was analyzed. The Relay NBS graft with the Plus Delivery System was deployed in two patients, respectively, having a 6.5-cm penetrating aortic ulcer of the proximal third of the descending thoracic aorta and a DeBakey type-I aortic dissection with chronic false lumen dilatation after surgery due to an entry site at the distal thoracic aorta. Bench tests showed proper conformation and apposition of the Relay NBS graft with the Plus Delivery System in the flexible resin model. This stent graft was deployed successfully into the two patients with a correct orientation of the first stent and without early or late complications. The Relay NBS graft with the Plus Delivery System ensures an optimal conformation and apposition of the first stent in the aortic arch with a small radius of curvature.
Cardiovasc Interven Radiol, 1999
A 71-year-old woman presented with a life-threatening thyroid hemorrhage after US-guided chemical... more A 71-year-old woman presented with a life-threatening thyroid hemorrhage after US-guided chemical parathyroidectomy. The diagnosis was made by angiography followed by immediate embolization of a pseudoaneurysm of the left superior thyroid artery. Embolization controlled the hemorrhage, obviating the need for surgery. The patient made a full recovery with no evidence of further hemorrhage. Pseudoaneurysm of the superior thyroid artery is a rare cause of hemorrhage and percutaneous embolization is an effective method of treatment.
Journal of Nuclear Cardiology, 2016
Recent technical advances in multi-detector computed tomography (MDCT) allow for assessment of co... more Recent technical advances in multi-detector computed tomography (MDCT) allow for assessment of coronary flow reserve (CFR). We compared regional CFR by dynamic SPECT and by dynamic MDCT in patients with suspected or known coronary artery disease (CAD). Thirty-five patients, (29 males, mean age 69 years) with greater than average Framingham risk of CAD, underwent dipyridamole vasodilator stress imaging. CFR was estimated using dynamic SPECT and dynamic MDCT imaging in the same patients. Myocardial perfusion findings were correlated with obstructive CAD (≥50% luminal narrowing) on CT coronary angiography (CA). Mean CFR estimated by SPECT and MDCT in 595 myocardial segments was not different (1.51 ± 0.46 vs. 1.50 ± 0.37, p = NS). Correlation of segmental CFR by SPECT and MDCT was fair (r (2) = 0.39, p < 0.001). Bland-Altman analysis revealed that MDCT in comparison to SPECT systematically underestimated CFR in higher CFR ranges. By CTCA, 12 patients had normal CA, 11 had non-obstructive, and 12 had obstructive CAD. CFR by both techniques was significantly higher in territories of normal CA than in territories subtended by non-obstructive or obstructive CAD. SPECT CFR was also significantly different in territories subtended by non-obstructive and obstructive CAD, whereas MDCT CFR was not. Despite relative underestimation of high CFR values, MDCT CFR shows promise for assessing the pathophysiological significance of anatomic CAD.
Revista Española de Cardiología (English Edition), 2016
Since its introduction about 15 years ago, coronary computed tomography angiography has become to... more Since its introduction about 15 years ago, coronary computed tomography angiography has become today the most accurate clinical instrument for noninvasive assessment of coronary atherosclerosis. Important technical developments have led to a continuous stream of new clinical applications together with a significant reduction in radiation dose exposure. Latest generation computed tomography scanners (≥ 64 slices) allow the possibility of performing static or dynamic perfusion imaging during stress by using coronary vasodilator agents (adenosine, dipyridamole, or regadenoson), combining both functional and anatomical information in the same examination. In this article, the emerging role and state-of-the-art of myocardial computed tomography perfusion imaging are reviewed and are illustrated by clinical cases from our experience with a second-generation dual-source 128-slice scanner (Somatom Definition Flash, Siemens; Erlangen, Germany). Technical aspects, data analysis, diagnostic accuracy, radiation dose and future prospects are reviewed.
Hepato Gastroenterology, 2002
Recent experiences suggest that interferon may significantly decrease the incidence of hepatocell... more Recent experiences suggest that interferon may significantly decrease the incidence of hepatocellular carcinoma. We conducted a randomized study with interferon versus no therapy in hepatitis C virus Child A cirrhosis with abnormal alanine aminotransferase and HCV-RNA positive serum with the aim to investigate the incidence of hepatocellular carcinoma, worsening of cirrhosis's stage and death or orthotopic liver transplantation. A cohort of 122 patients prospectively followed was analyzed retrospectively to assess the effect of interferon therapy (mean follow-up: 96 +/- 18.3 months). We only chose patients with hepatitis C virus infection who had undergone blood transfusion before 1980. Hepatitis C virus serotype was determined by hepatitis C virus serotyping 1-6 assay (Murex Biothec Limited Temple Hill, Dartford, Kent, UK). HCV-RNA level was determined by bDNA, Chiron Corporation Emeryville, CA. Diagnosis of hepatocellular carcinoma was made on the basis of the appearance of local lesions at periodic ultrasound examination of the liver and confirmed with spiral computed tomography. Fine needle biopsy under sonographic guidance was effected. Fifty-nine patients (mean age: 55.3 +/- 7) received interferon (3MU three times a week for 12 months), 8 stopped therapy for side effects, 71 did not receive interferon (mean age: 56.8 +/- 8). Baseline characteristics were similar. It emerges how interferon does not reduce the risk of hepatocellular carcinoma in compensated cirrhosis. In interferon treated patients an improvement in relation with worsening and death/orthotopic liver transplantation has been noted. The use of the interferon seems to be scarcely useful when structural alterations of the cirrhotic kind show up, as cirrhosis represents by itself a risk factor for hepatocellular carcinoma. Nevertheless, in relation to the worsening of cirrhosis's stage the interferon therapy can be useful in compensated cirrhosis.
Italian Journal of Vascular and Endovascular Surgery
ABSTRACT
The Annals of thoracic surgery, 2015
Cardiovascular and interventional radiology
A patient was admitted because of severe abdominal pain, anorexia, and intestinal bleeding. Contr... more A patient was admitted because of severe abdominal pain, anorexia, and intestinal bleeding. Contrast-enhanced multidetector computed tomography demonstrated acute portal and superior mesenteric vein thrombosis (PSMVT). The patient was treated percutaneously with transjugular intrahepatic portosystemic shunt (TIPS), mechanical aspiration thrombectomy, and direct thrombolysis, and 1 week after the procedure, complete patency of the portal and superior mesenteric veins was demonstrated. TIPS, mechanical aspiration thrombectomy, and direct thrombolysis together are promising endovascular techniques for the treatment of symptomatic acute PSMVT.
Hepato-gastroenterology
Hepatorenal Syndrome (HRS) is a serious and life-threatening complication of portal hypertension ... more Hepatorenal Syndrome (HRS) is a serious and life-threatening complication of portal hypertension and end stage liver disease. The cornerstone of treatment is liver transplantation, since renal dysfunction is usually reversible and disappears with the correction of the underlying cause. It is established that HRS has a functional nature and that it is related to renal vasoconstriction. Rapid diagnosis and management are important. Vasoconstrictors together with albumin can ameliorate the effective arterial blood volume and increase renal perfusion pressure. The lack of effective alternative treatment modalities in non responding patients to medical therapy and the almost universally fatal outcome of HRS make transjugular intrahepatic portosystemic stent shunt as a bridge to liver transplantation.
Interactive cardiovascular and thoracic surgery, 2011
Two adult patients were diagnosed with extralobar and intralobar pulmonary sequestration. One pat... more Two adult patients were diagnosed with extralobar and intralobar pulmonary sequestration. One patient presented with haemoptysis. Both patients suffered from recurrent episodes of severe pulmonary infections. Both patients were treated by means of endovascular embolization using Amplatzer(®) vascular plugs (AVPs). They were discharged from hospital after 48 and 24 h and then followed up for 24 and six months, respectively. No recurrence of symptoms was observed. Computed tomography scans were obtained every six months. Persistent occlusion of vascular supply and moderate regression of the sequestered lung tissue are evident after 24 and six months in both patients. Just one case of an adult patient affected by pulmonary sequestration and treated by endovascular embolization has been reported to date. The present report is the first on the use of the AVPs in adults for this condition. The potential advantages and drawbacks of this treatment modality in adults are discussed, as well t...
Minerva urologica e nefrologica = The Italian journal of urology and nephrology, 1998
The function of vascular shunts in hemodialysis plays a vital role for the efficiency and effecti... more The function of vascular shunts in hemodialysis plays a vital role for the efficiency and effectiveness of replacement therapy. A study was performed in 147 patients undergoing periodical hemodialysis with distal FAV (no = 86), proximal FAV (no = 33), PTFE grafts (no = 23), Canaud-Tesio catheters (no = 7). A protocol for function evaluation was developed which also included the calculation of overall recirculation (R), that was found to be 10.8 + 7% (using the three blood sample method). In 28/143 patients the monitoring protocol recommended the use of angiography which identified abnormalities in 78% of cases, before the onset of thrombotic phenomena. In particular, surgical radiology was able to resolve 94% of cases in which angiography revealed a stenosis using percutaneous transluminal angioplasty and/or the insertion of one or more stents.