Publications by authors named "D'Oria Mario"

Objectives: A multicentre European randomized control trial - European Uncomplicated Type B Aortic Repair (EU-TBAR) is being developed to compare pre-emptive TEVAR with custom-made devices vs conventional OMT. The pre-trial set-up is confluent on different pillars, including evaluation of 1) European activity, trends, and governance, 2) outcome reporting, and 3) cost evaluation. This article aimed to demonstrate the observational cross-sectional survey results from participating centres and highlight the risk assessment, activity, practices, and governance of uncomplicated type B aortic dissection (uTBAD).

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Type II endoleaks after endovascular aortic repair are a common scenario that, although infrequently, may sometimes require secondary interventions when leading to significant enlargement of the aneurysm sac. Herein, we present the perioperative and mid-term results of one of our endovascular aortic repair cases with type II endoleak from the hypogastric artery, whose ostium was covered by the prior stent graft limbs and that were successfully treated with a novel technique employing re-entry catheters in an off-label fashion. This technique may represent a valid alternative solution when conventional access between artery and prosthesis is laborious or impossible to achieve.

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Background: There are no clinical or laboratory markers that can diagnose acute mesenteric ischemia (AMI) accurately. This study aimed to find differences in clinical and laboratory markers between arterial occlusive AMI and other acute abdominal diseases where AMI was initially suspected.

Methods: This was a post hoc study of an international prospective multicenter study where data on patients with suspected AMI were collected.

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Article Synopsis
  • - This article reviews current literature and expert opinions on using iliac branch endoprosthesis (IBE) for treating complex abdominal aortic aneurysms (AAA) that also involve the iliac arteries.
  • - Around 25% of AAA patients have aneurysms that extend into ilac vessels, complicating standard endovascular aortic repair (EVAR) procedures and requiring careful assessment to ensure proper treatment.
  • - The IBE is shown to be an effective and durable treatment option for complex aorto-iliac aneurysms, offering results comparable to open surgery but with lower risks, while also preserving pelvic circulation to avoid potential complications.
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Vascular graft infections (VGIs) represent a life-threatening complication, occurring in 0.2-6% of patients following aortic prosthetic placements. Historically, the primary focus for reducing VGIs has been on prevention.

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Objective: Knowledge of hostile factors and their influence on long-term seal in the iliac landing zone is limited. Currently endorsed clinical practice guidelines lack structural evidence on how the iliac landing zone should be assessed in the pre-, intra-, and postoperative phases. The goal of this study was to obtain an international, expert-based consensus on the definition of a hostile iliac landing zone, on how to size and plan stent-grafts to optimize sustainable distal seal, and on the postprocedural follow-up protocol.

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Objective: Prior studies suggest an association of anemia and blood transfusion with increased morbidity and mortality in patients undergoing cardiac surgery. However, the impact of perioperative anemia and blood transfusion on clinical outcomes in patients undergoing major vascular surgery has been poorly defined yet. The primary objectives of this scoping review were to determine the extent of the evidence base that links anemia and blood transfusions to mortality and cardiovascular outcomes in patients undergoing major vascular surgery, and identify recurring themes or gaps in the literature to guide future research.

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Article Synopsis
  • A study evaluated how the inner vessel diameter and vertical distance between renal arteries affect renal artery instability and complications in patients undergoing fenestrated endovascular aortic repair.
  • The research included data from 260 patients across six hospitals, analyzing outcomes and categorizing them based on measurements of their vessel characteristics.
  • Results showed a high technical success rate and low mortality, with factors like a smaller inner vessel diameter linked to higher risks of certain complications, particularly renal artery stenosis or occlusion.
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Purpose: To evaluate retrospectively the 2-year outcomes of the Gore Excluder Iliac Branch Endoprosthesis (IBE) in patients with and without coexisting hypogastric artery (HA) aneurysms in a large contemporary multicentric European experience using dedicated bridging devices.

Methods: The study included all consecutive patients treated at participating institutions with the Gore Excluder IBE device who received a covered stent (i.e.

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Introduction: Nailfold video-capillaroscopy (NVC) is a non-invasive cost-effective technique involving the microscopic examination of small blood vessels of the distal nailfold with a magnification device. It provides valuable information regarding the microcirculation including anomalies such as tortuous or dilated capillaries, hemorrhages, and avascular areas, which can characterize connective tissue diseases. The utility of NVC in the diagnosis and monitoring of systemic sclerosis (SSc) has been investigated in numerous studies allowing the distinction of the specific microvascular pattern of scleroderma from different conditions other than scleroderma (non-scleroderma pattern).

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Objectives: Thoracic/abdominal aortic aneurysms and aortic stenosis may be concomitant diseases requiring both transcatheter aortic valve implantation (TAVI) and endovascular aneurysm repair (T/EVAR) in high-risk patients for surgical approaches, but temporal management is not clearly defined yet. The aim of the study was to analyse outcomes of simultaneous versus staged TAVI and T/EVAR.

Methods: Retrospective observational multicentre study was performed on patients requiring TAVI and T/EVAR from 2016 to 2022.

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Background: The neutrophil-to-lymphocyte ratio (NLR) is a simple and routinely obtained parameter reflecting systemic inflammation, including in peripheral artery disease (PAD).

Methods: This systematic review aimed to assess the role of NLR as a prognostic biomarker in patients with PAD. A systematic search was conducted across PubMed, ScienceDirect, Web of Science, Scopus, ProQuest, EBSCO, and Cochrane.

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Objective: Large language models and artificial intelligence (AI) based chatbots have brought new insights in healthcare, but they also raise major concerns. Their applications in vascular surgery have scarcely been investigated to date. This international survey aimed to evaluate the perceptions and feedback from vascular surgeons on the use of AI chatbots in vascular surgery.

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Background: The arteriovenous access stage (AVAS) classification provides evaluation of upper extremity vessels for vascular access (VA) suitability. It divides patients into classes within three main groups: suitable for native fistula (AVAS1) or prosthetic graft (AVAS2), and patients not suitable for conventional native or prosthetic VA (AVAS3). We validated this system on a prospective dataset.

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Computational surgery (CS) is an interdisciplinary field that uses mathematical models and algorithms to focus specifically on operative planning, simulation, and outcomes analysis to improve surgical care provision. As the digital revolution transforms the surgical work environment through broader adoption of artificial intelligence and machine learning, close collaboration between surgeons and computational scientists is not only unavoidable, but will become essential. In this review, the authors summarize the main advances, as well as ongoing challenges and prospects, that surround the implementation of CS techniques in vascular surgery, with a particular focus on the care of patients affected by abdominal aortic aneurysms (AAAs).

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Purpose: The aim of this project is to explore practice patterns of experienced vascular specialists involved in the treatment of patients with arterial femoro-popliteal in-stent occlusion (ISO) and to understand key concepts and shared thoughts, throughout an international cross-sectional survey.

Materials And Methods: The web-based survey was in English and included 31 questions. One-hundred experts were invited by email to fill in the survey anonymously on Google Forms using a dedicated link.

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Introduction: Developed by the Global Vascular Guidelines committee, the Global Limb Anatomic Staging System (GLASS) is an angiographic scoring system used for quantifying infrainguinal disease extent and predicting treatment success with endovascular techniques (EVT). Currently, no other risk prediction model is available for patients with chronic limb threatening ischemia (CLTI) undergoing EVT. GLASS' validation and adoption outside academic institutions for research are limited.

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Background: Excessive perioperative bleeding is associated with major complications in cardiac surgery, resulting in increased morbidity, mortality, and cost.

Methods: An international expert panel was convened to develop consensus statements on the control of bleeding and management of transfusion and to suggest key quality metrics for cardiac surgical bleeding. The panel reviewed relevant literature from the previous 10 years and used a modified RAND Delphi methodology to achieve consensus.

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Article Synopsis
  • The Delphi consensus aimed to clarify management practices for abdominal aortic aneurysms (AAAs) due to conflicting data in previous literature.
  • A group of 44 experts anonymously discussed six key topics over three rounds, achieving a 100% response rate.
  • Key findings included the agreement on minimum case volume for AAA repairs, the effectiveness of screening programs, lifelong surveillance after repair, and the consideration of screening for women smokers at 65, but no consensus on certain repair thresholds or thrombosis prevention was reached.
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Objectives: The aim of this cross-sectional survey was to gather attitudes and practices of physicians from different countries regarding the implementation of contrast-enhanced ULTRAsound (CEUS) for vascular diseases in clinical practice as well as in academic research.

Methods: A web-based survey was developed in English, including 35 questions. Two-hundred sixty physicians were invited by email to fill in the survey anonymously on Google Forms using a dedicated link.

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Ruptured abdominal aortic aneurysms (rAAAs) are life-threatening and require emergent surgical therapy. Endovascular aortic repair for rupture (rEVAR) has become the leading strategy due to its minimal invasive approach with expected lower morbidity and mortality, especially in patients presenting with hemodynamic instability and relevant comorbidities. Following rEVAR, intraoperative angiography or early postinterventional computed tomography angiography have to exclude early type 1 or 3 endoleaks requiring immediate reintervention.

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Objective: This study aimed to analyze early and midterm results of custom-made proximal scallop and fenestrated stent grafts for thoracic endovascular aortic repair (TEVAR) with a proximal landing zone (PLZ) in the aortic arch.

Methods: All consecutive patients treated with the custom made proximal scalloped and fenestrated Relay stent grafts (Terumo Aortic Bolton Medical Inc.) in 10 Italian centers between January 2014 and December 2022 were included.

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Background: Spinal cord ischemia (SCI) is a potentially devastating complication of thoracic endovascular aortic repair (TEVAR) and fenestrated-branched endovascular aortic repair (F-BEVAR). The aim of this systematic review was to evaluate the efficacy of neuromonitoring modalities to mitigate the risk of SCI during TEVAR and F-BEVAR procedures.

Methods: Following the PRISMA guidelines, we conducted a detailed literature search of databases including PubMed, MEDLINE via Ovid, Embase, Scopus, and Cochrane CENTRAL, from 1998 to the present.

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Article Synopsis
  • * A systematic review analyzed 27 studies involving 1,498 BTAI patients treated with TEVAR, finding an overall mortality rate of 12% and long-term survival rates of around 90% at 1 year post-treatment.
  • * The findings suggest that while BTAI carries significant risks, TEVAR offers a safe and effective management option with a low likelihood of needing additional procedures, emphasizing the importance of timely diagnosis and transfer to trauma centers.
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