Carotid artery stenting with flow inversion cerebral protection and MicroNet-covered stent.

Background: The study aims to evaluate the association of proximal flow-inversion cerebral protection and MicroNet-covered CGuard stents in reducing early and late embolic events in carotid artery stenting procedures.

Methods: From 2018 to 2023, we performed 204 procedures in 180 patients with flow inversion cerebral protection and CGuard stents at the Vascular Surgery Unit of Sant'Eugenio Hospital in Rome. Cerebral protection was achieved with a Flow-Gate2 catheter connected to a peripheral vein.

Simultaneous aortoiliac kissing Endovascular stenting for management of isolated monolateral common iliac artery aneurysm with no proximal landing zone.

Background: Isolated iliac artery aneurysm (IIAA) is an uncommon finding. It, accounts for 0.03% of all patients and 2% of all abdominal aneurysm.

Carotid Artery Stenting versus Carotid Endarterectomy in Terms of Neuroprotection DW-MRI Detected and Neuropsychological Assessment Impairment.

Background: Carotid artery stenting (CAS) versus carotid endarterectomy (CEA) is well issue known, but the purpose of this study is to compare CAS versus CEA in terms of asymptomatic Diffusion-weighted magnetic resonance imaging (DW-MRI) demonstrated microembolic scattering of infarction and neuropsychological assessment impairment.

Methods: We performed a prospective, observational, cohort study on 211 consecutive carotid revascularizations at our institution. Patients were divided into 2 different cohorts: CEA was performed in n = 116 patients (Group A); CAS was performed in n = 95 (Group B).

Role of mini access during carotid endarterectomy: a prospective observational study.

Background: Data from literature confirmed the non-trivial risk associated with carotid revascularization. The purpose of this study is to evaluate carotid endarterectomy (CEA) via a mini-invasive access (3-6 cm longitudinal) incision as a viable alternative to the traditional access via a cutaneous incision (˃6 cm) in terms of nerve sparing and neck pain/disability for patients.

Methods: We performed a prospective, observational, cohort study on 796 consecutive patients who underwent CEAs.

Isolated popliteal artery lesion due to giant cell vasculitis post COVID-19 mRNA vaccine and COVID-19 asymptomatic infection.

Objective: Giant cell arteritis (GCA) is a rare granulomatous vasculitis, affecting medium and large vessels, usually in old patients. The incidence of GCA has been higher during current COVID-19 pandemia and COVID-19 is recognized for its immune dysregulation. Lower limbs involvement is uncommon but can be limb threatening, resulting in limb loss.

Are Small Popliteal Aneurysm so Innocent?

Background: We recently recorded 5 lower limb ischemia related to a small (diameter≤20 mm) popliteal artery aneurysm (PAA) thrombosis hence we performed a retrospective data analysis on small symptomatic PAA management from our database.

Methods: We performed a retrospective cohort study on 48 acute leg ischemia from aneurysm's thrombosis. All of them underwent surgical distal thrombectomy and bypass creation.

Common carotid artery endovascular clamping for neuroprotection during carotid stenting: Flow-gate system as an innovative treatment approach.

Objectives: We here report our clinical experience in CAS management through common carotid artery endovascular clamping with FlowGate2 system.

Methods: Forty-five patients were enrolled with de novo asymptomatic internal carotid artery stenosis ≥70%. Cerebral protection during the stenting procedure was achieved using a unique endovascular clamping technique developed in our Institution which includes: (a) the occlusion of the common carotid artery only, through inflatable balloons integrated in the FlowGate2 Balloon Guide Catheter system; (b) flow inversion connecting catheter to 16 G blood cannula previously placed in arm vein; (c) after the placement of the stent, the flow inversion is maintained for 30 s to allow debris washout.

Retroperitoneal Hematoma Caused by Suprarenal Stent Perforation Two Years after Ovation Abdominal Stent-Graft Implantation.

Retroperitoneal hematoma due to late perforation of aortic wall endograft deployment is a rare but, potentially, fatal event. We report a case of symptomatic retroperitoneal hematoma due to aortic perforation by free flow barbs of Ovation Prime stent graft. The patient was successfully treated by celiac trunk embolization and aortic cuff placement.

Endovascular Treatment with Two Overlapping Micromesh-Covered Stents and Balloon Guide Catheter for Symptomatic Carotid Pseudoaneurysm Ten Years after Eversion Endarterectomy.

Pseudoaneurysm is a rare complication after carotid endarterectomy. Herein, we report a successful endovascular exclusion of a symptomatic carotid pseudoaneurysm occurred ten years after an eversion carotid endarterectomy by means of 2 overlapping micromesh stents (InspireMD C-Guard™) and balloon guide catheter (FlowGate Balloon Guide Catheter) used as a proximal protection device.

Type 2 Endoleak Incidence and Fate After Endovascular Aneurysms Repair in a Multicentric Series: Different Results with Different Devices?

Background: The aim of this work is describing incidence and fate of type 2 endoleaks (T2ELs) in a multicentric cohort of patients treated by endovascular aneurysms repair using the Ovation device (Endologix) and comparing them with a group treated using the Excluder (W. L. Gore & Associates).

Real-Life Experience with Ovation Stent Graft: Lesson Learned from the First One Hundred Fifty Treated Patients.

Background: The objective of the study was to report immediate and midterm results of an unselected population of patients treated for abdominal aortic aneurysms (AAAs) by endovascular aneurysm repair (EVAR) using the Ovation stent graft.

Methods: A double-center retrospective study was conducted on a prospectively collected database between 2012 and 2015. One hundred fifty-six elective patients were included.

Thirty-day results from prospective multi-specialty evaluation of carotid artery stenting using the CGuard MicroNet-covered Embolic Prevention System in real-world multicentre clinical practice: the IRON-Guard study.

Aims: The aim of the present study was to evaluate periprocedural and 30-day outcomes in a prospective series of patients treated with the CGuard Embolic Prevention System (EPS).

Methods And Results: From April 2015 to June 2016, a physician-initiated prospective multicentre study was performed in 200 consecutive patients admitted for protected carotid artery stenting (CAS) and treated using the CGuard EPS in twelve vascular centres. Outcome measures were: technical success, periprocedural (0-24 hours) and post-procedural (24 hours-30 days) major and minor strokes, death, acute myocardial infarction (AMI), transient ischaemic attack (TIA), and external carotid occlusion.

Successful covered stent-graft repair in symptomatic renal artery aneurysm early after childbirth.

Renal artery aneurysm (RAA) rupture during pregnancy is a rare but life-threatening event and few cases have been reported in literature. Currently the best approach, endovascular or surgical, seems to be under discussion. A case of a 31-year-old woman with a symptomatic right RAA detected three days after childbirth is reported.

Combined brachial embolectomy and stent graft endovascular exclusion in the treatment of acute arm ischemia due to subclavian artery aneurysms thrombosis or distal embolization.

Aim: Purpose of this study is to report our results after simultaneous transbrachial embolectomy and endovascular aneurysm exclusion with stentgraft in the treatment of upper limb acute ischemia due to subclavian artery aneurysm thrombosis and embolization .

Methods: From January 2010 to December 2015, seven consecutive patients (6 men; mean age 71.5, range 44-85) underwent to emergent revascularization for upper limb ischemia due to thrombosis/embolization of SAA by means of brachial embolectomy and endovascular exclusion.

Anaphylactic Reaction during Implantation of Ovation Abdominal Stent Graft in Patients with Abdominal Aortic Aneurysm.

The Ovation Abdominal Stent Graft System is a trimodular endoprosthesis planned to overcome the limitations of currently available stent grafts, allowing complex iliac and femoral access and providing a proximal seal in challenge infrarenal neck morphology. The proximal sealing is achieved by means of a network of inflatable rings filled with low-viscosity radiopaque polyethylene glycol-based polymer during stent-graft deployment. The leakage of polymer outside the channel to fill the rings into the vascular system may induce an hypersensitivity reaction and anaphylactic shock.

Endovascular Treatment of Symptomatic Thrombus of the Descending Thoracic Aorta.

Thoracic aorta mural thrombosis (TAMT) is uncommon pathology with potentially catastrophic complications due to recurrent spontaneous distal embolization. Best treatment, medical or surgical, is still under debate especially in high-risk patients. Endovascular approach by means of thoracic endoprosthesis seems to be a feasible and minimally invasive treatment option.

Thrombin injection and compression with removable guidewire in the treatment of postcatheterization femoral pseudoaneurysm.

Background: The purpose of our study was to determine the efficacy of percutaneous thrombin treatment for iatrogenic femoral artery pseudoaneurysms (FAP) and to identify those criteria that may help to predict increased treatment failure risk and complications.

Methods: A number of 32 iatrogenic femoral pseudoaneurysms were treated with US-guided thrombin injection (group A), while four elderly patient with complex femoral pseudoaneurysm underwent compression assisted by removable "guidewire" (group B). Twenty-five were classified as simple (single lobe) and 11 as complex (at least two lobes with a single neck to the native vessel).

Suprarenal fixation resulting in intestinal malperfusion after endovascular aortic aneurysm repair.

Superior mesenteric artery (SMA) and coeliac axis (CA) occlusion after endovascular abdominal aneurysm aortic repair (EVAR-AAA), using endograft with suprarenal fixation, are uncommon. However, we are reporting a case of visceral malperfusion, which occurred 7 days after successful EVAR with suprarenal fixation for symptomatic AAA. Endograft metal stent barbs caused severe stenosis of SMA and CA.

First clinical experience with the Innova versus the Protege EverFlex self-expanding bare metal stents in superficial femoral artery occlusions.

Background: To evaluate outcomes of superficial femoral artery (SFA) stenting with Boston Scientific Innova stent system (Boston Scientific Corporation Place, Natick, Massachusetts, United States) compared with ev3 Protege stent system (Endovascular, Inc., Plymouth, Minnesota, United States) in terms of safety and effectiveness and to identify factors predictive of restenosis.

Methods: From March 2012 to January 2013, 71 patients with SFA TASC (Trans Atlantic Inter-Societal Consensus)-II B and C occlusive lesions were treated by percutaneous transluminal angioplasty with stenting (30 patients in the Innova group and 41 cases in the Protege group) and were evaluated by retrospective observational data analysis.

Outcome after preoperative or intraoperative use of intra-arterial urokinase thrombolysis for acute popliteal artery thrombosis and leg ischemia.

Objectives: To evaluate the outcome of acute popliteal artery aneurysm (PAA) thrombosis and leg ischemia after preoperative or intraoperative use of intra-arterial urokinase thrombolysis.

Materials And Methods: From 2000 to 2009, 86 patients with acute leg ischemia (Rutherford grade IB to IIA) from PAA thrombosis were treated by immediate surgery including intraoperative thrombolysis (group A: 47 cases) or preoperative thrombolysis (group B: 39 cases) followed by acute (<24 hours) or elective surgery. Chi-square tests for categorical data and time to event provided two-sided p values with a level of significance at 0.

Is the chimney graft technique a safe and feasible approach to treat urgent aneurysm and pseudoaneurysm of the abdominal aorta? An analysis of our experience and technical considerations.

The chimney graft (CG) technique, based on the deployment of a covered stent parallel to the aortic endograft, has been proposed to achieve a safe proximal fixation extending the sealing zone. We report our experience with the CG technique in an emergency setting. Between December 2010 and April 2012, 4 patients underwent the CG technique.

Randomized controlled trial of remote endarterectomy versus endovascular intervention for TransAtlantic Inter-Society Consensus II D femoropopliteal lesions.

Objective: This study evaluated outcomes of remote endarterectomy (RE) vs endovascular (ENDO) interventions on TransAtlantic Inter-Societal Consensus (TASC)-II D femoropopliteal lesions and identified factors predictive of restenosis.

Methods: From October 2004 to December 2008, 95 patients with TASC-II D lesions were randomized 1:1 to receive RE of the superficial femoral artery (SFA) with end point stenting (51 patients) or ENDO, consisting of subintimal angioplasty with stenting (44 patients). The groups were balanced for age, sex, atherosclerotic risk factors, and comorbidities.

Hybrid procedure for celiac trunk aneurysm repair via left reno-splenic bypass and stent-graft deployment.

Celiac trunk aneurysm is one of the rarest forms of splanchnic artery aneurysm. Conventional open vascular surgery is associated with increased rates of morbidity and mortality and can require complex vascular reconstruction.We describe the case of a 42-year-old patient with celiac trunk aneurysm whom we treated by means of a hybrid surgical-endovascular procedure.