Relationship between Syntax Score and prognostic localization of coronary artery lesions with conventional risk factors, plasma profile markers, and carotid atherosclerosis (CAPP Study 2).

Background: Data concerning the relationship between cardiovascular risk factors, plasmatic markers, carotid disease and extent of coronary lesions are lacking.

Objectives: To evaluate the role of cardiovascular risk factors, plasmatic levels of high sensitivity C-reactive protein (hs-CRP), fibrinogen, lipoprotein(a), and carotid plaque extension in predicting the severity of coronary artery disease (CAD).

Methods: We analyzed 574 subjects undergoing first coronary angiography.

Predictors of improved quality of life and claudication in patients undergoing spinal cord stimulation for critical lower limb ischemia.

Background: The aim of this study was to determine predictors of improved quality of life and claudication in patients undergoing spinal cord stimulation (SCS) for critical lower limb ischemia.

Methods: We retrospectively analyzed 101 consecutive patients with few meter claudication and nonhealing ulcer who underwent definitive SCS. These patients were selected among 274 SCS patients treated at our center from 1995 to 2012.

Outcome in cirrhotic patients after elective surgical repair of infrarenal aortic aneurysm.

Objective: Abdominal surgery in patients with advanced liver disease has been reported to be associated with high morbidity and mortality rates. However, the surgical risk of infrarenal abdominal aortic aneurysm (AAA) repair in cirrhotics remains ill-defined. We reviewed our experience to investigate the predictors of the outcome in cirrhotic patients after elective AAA open repair.

Carotid Endarterectomy: experience in 8743 cases.

Introduction: Recently published case series of patients undergoing carotid endarterectomy suggested a reduction in the rate of perioperative neurologic events when compared to those reported in the large randomized trials performed in the 1990s, without great differences between high and low risk patients.

Methods: As a major center of Vascular Surgery we prospectively collected data on 8743 carotid endarterectomy procedures (eversion technique 75%, patch closure 17.5%) performed in the period 1992-2009.

Endovascular treatment of ruptured penetrating aortic ulcers.

Penetrating aortic ulcer (PAU) is a potentially lethal lesion that should be promptly diagnosed and treated. Because of the older age and serious comorbidity of these patients, outcome with rupture of the ulcer is often ominous, even when appropriate conventional surgical treatment is given. In this study we report our experience with two cases of endovascular treatment of ruptured PAU in two elderly female patients who had evident signs of intrathoracic bleeding.

Visceral artery aneurysms.

Visceral artery aneurysms (VAA) frequently present as life-threatening emergencies. The purpose of this study was to review our experience with VAA treatment. Between 1988 and April 2002, 31 VAA were treated in 28 patients (14 males, 14 females) with average age of 55 +/- 15 years.

Carotid endarterectomy in the octogenarian: outcomes of 345 procedures performed from 1995-2000.

The purpose of this study is to evaluate the efficacy and the safety of carotid endarterectomy (CEA) in the octogenarian patient. From January 1995 to December 2000, we have performed 3430 CEAs in 2743 patients: 345 CEAs in 269 octogenarian patients (Group 1) and 3085 CEAs in 2474 younger patients (Group 2). Age was the only selection criteria for including patients in Group 1.

Vascular prosthetic graft infection: epidemiology, bacteriology, pathogenesis and treatment.

Unlabelled: Vascular prosthetic graft infection remains a major surgical challenge. Prevention of risk factors and antibiotic therapy can reduced but not eradicate it. Management of infected vascular grafts depends on several factors, including the location of the infected prosthesis, the extent of infection, and the underlying micro-organism.

Hyperammonemia and chronic hepatic encephalopathy: an in vivo PMRS study of the rat brain.

The brain energy metabolism of rats affected by chronic hepatic encephalopathy due to portacaval shunting was monitored by in vivo 31P-nuclear magnetic resonance spectroscopy before and after ammonium acetate administration. With respect to healthy unoperated and to sham operated controls, portacaval shunting decreased the levels of the nuclear magnetic resonance (NMR) visible brain phosphocreatine and nucleoside phosphates, and the intracellular [free Mg(2+)]. Ammonium acetate induced a further decrease of the levels of the NMR detectable phosphocreatine and nucleoside triphosphates and of the [free Mg(2+)], while the PMR spectra of the brain of non-shunted rats did not show any significant change even after treatment with ammonium acetate.

Intraoperative stenting of the internal carotid artery after unsuccessful eversion endarterectomy.

Stenting of the internal carotid artery (ICA) has been shown to be feasible in atherosclerotic lesions, in restenosis after carotid endarterectomy, and in spontaneous carotid dissections. To correct an intimal flap that detached distal occlusion of the ICA after eversion carotid endarterectomy, as shown with intraoperative completion angiography, we successfully used stenting of the ica with a self-expandable stainless steel stent placed during surgery through the common carotid artery.

Fresh and cryopreserved arterial homografts in the treatment of prosthetic graft infections: experience of the Italian Collaborative Vascular Homograft Group.

Following the experience of cardiac surgeons with homografts in the treatment of infective aortic valve endocarditis, cardiovascular surgeons have investigated in situ revascularization by means of homografts in the management of vascular prosthetic graft infections. Preliminary results are encouraging, but their late fate in long-term follow-up and the influence of preservation techniques are still under investigation. This article reports the experience of the Italian Collaborative Vascular Homograft Group, with the use of fresh and cryopreserved arterial homografts for the treatment of prosthetic graft infections.

Biomechanics of abdominal aortic aneurysm in the presence of endoluminal thrombus: experimental characterisation and structural static computational analysis.

Objectives: To evaluate the role played by biomechanical and geometrical parameters of endoluminal thrombus and of aortic wall on abdominal aortic aneurysm (AAA) behaviour.

Materials And Methods: Tensile tests on 21 AAA thrombus specimens from six patients undergoing AAA repair and numerical evaluation of aneurysmal aortic wall stress and strain distribution. Parameters of the analysis were lumen eccentricity, thrombus Young's Modulus and the aortic wall constitutive equation.

In search of biological markers of high-risk carotid artery atherosclerotic plaque: enhanced LDL oxidation.

The oxidation of low density lipoprotein (LDL) is a key event in the development and progression of atherosclerosis because it generates molecular epitopes that are more atherogenic than parent LDL. We found previously that patients with carotid atherosclerosis have a significantly higher titer of autoantibodies against oxidatively modified LDL than normal subjects. The aim of this study is to correlate biological markers of in vivo LDL oxidation with the degree of carotid stenosis and of plaque ulceration (PU) in a series of patients undergoing carotid endoarteriectomy (CEA).

Avidin and 111In-labelled biotin scan: a new radioisotopic method for localising vascular graft infection.

Objectives: To evaluate a new imaging technique, for diagnosis of prosthetic vascular graft infection. Avidin is a protein which accumulates nonspecifically at sites of inflammation or infection. Due to its extremely low dissociation constant with biotin sites of infection can be imaged, using avidin as a pre-target, followed by injection of 111In-labelled biotin.

Mural thrombi in abdominal aortic aneurysms: MR imaging characterization--useful before endovascular treatment?

Purpose: To evaluate magnetic resonance (MR) imaging accuracy in the characterization of mural thrombi in abdominal aortic aneurysms (AAAs).

Materials And Methods: Forty-five patients (37 men, eight women; mean age, 68 years) with an AAA with mural thrombus thicker than 1 cm at sonography underwent T1- and T2-weighted spin-echo MR imaging. The thrombi were prospectively classified as one of three signal intensity (SI) categories: category 1 corresponds to low SI on both T1- and T2-weighted images; category 2, high SI on T1-and T2-weighted images; and category 3, inhomogeneous SI with hyperintense areas on both T1- and T2-weighted images.

A new ePTFE stretch graft for aorto-iliac reconstructions. Surgical evaluation and one year follow-up with magnetic resonance imaging.

Since its introduction at the beginning of the 60s Dacron has proved to be a reliable and durable substitute for aortic reconstructions. It is however susceptible to late thrombosis, infection and aneurysmal dilatation in a significant number of cases. ePTFE vascular prosthesis, introduced in 1972, have proved to perform well for peripheral reconstructions and was used in aortoiliac position since 1980.

LDL oxidation in patients with severe carotid atherosclerosis. A study of in vitro and in vivo oxidation markers.

Among the various risk factors involved in the development and progression of carotid atherosclerosis, the oxidation of LDL has been proposed to play a relevant role. LDL oxidation has been investigated in 94 patients with severe carotid atherosclerosis undergoing elective carotid artery endarterectomy and in 42 matched control subjects. LDL oxidation was evaluated in all patients as (1) the susceptibility to in vitro oxidation, (2) vitamin E concentration and its efficiency in LDL, and (3) the presence of autoantibodies against oxidatively modified lipoprotein to monitor the occurrence of the oxidative processes taking place in vivo.

Neuroendocrine carcinoma of the skin (Merkel cell carcinoma): immunocytochemical study of a case.

The immunocytochemical phenotype was evaluated in a case of Merkel cell carcinoma of the skin. Intermediate filaments, i.e.