Publications by authors named "Ettore Dinoto"

Endovascular aneurysm repair (EVAR) has become the preferred approach over open repair for abdominal aortic aneurysms (AAAs) due to its minimally invasive nature. The common femoral artery (CFA) is the main access vessel for EVAR, with both surgical exposure and percutaneous access being utilized. However, in emergent cases, percutaneous access can be challenging and may result in complications such as bleeding or dissection thrombosis, leading to the need for surgical conversion.

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  • - In patients with end-stage renal failure needing hemodialysis, creating an arteriovenous fistula (AVF) is favored over using tunneled dialysis catheters due to lower complications and costs, but AVF maturation failure is a common issue.
  • - This study explores the effectiveness of using intraoperative Doppler ultrasound (DUS)-guided Balloon-Assisted Maturation (BAM) with drug-eluting balloons (DEB) to enhance AVF maturation following initial creation, using data from 114 procedures.
  • - Results showed that BAM led to successful AVF maturation with minimal early complications, no AVF thrombosis, and an average maturation time of 15 days, highlighting the potential to reduce reinterventions by
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  • Endovascular aortic repair (EVAR) typically involves a technique called contralateral gate cannulation (CGC), but tricky cases can lead to longer procedures and higher radiation exposure.
  • A study analyzed 371 patients, narrowing down to 172 who met criteria for comparing traditional CGC with a new method called speed gate cannulation (SGC).
  • Results indicated that SGC significantly reduced both CGC time and fluoroscopy time without major complications, suggesting it is an efficient option worth considering in standard EVAR procedures, particularly in emergencies.
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  • The study evaluated the safety and effectiveness of a rotational mechanical thrombectomy device (Rotarex S) in patients experiencing iliac limb occlusion after abdominal endovascular aneurysm repair (EVAR).
  • A retrospective analysis involved 23 male patients, averaging 74.5 years, who underwent thrombectomy for symptoms ranging from acute limb ischemia to chronic limb-threatening ischemia between 2017 to 2021.
  • Results showed 100% technical success without any post-procedural deaths, with most patients receiving endograft relining; follow-up indicated low rates of reocclusion and no further interventions needed.
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Background: The aim of study was to assess the safety and effectiveness of 3 different commercial iliac branch devices (IBDs): the Zenith Branch Iliac Endovascular Graft; the Gore Excluder Iliac Branch System and the E-liac Stent Graft System for the treatment of aorto-iliac or iliac aneurysms.

Methods: From January 2017 to February 2020, a retrospective reviewed was conducted on a total of 96 patients. Primary endpoint was IBD instability rate at 24 months.

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The intima-media thickness (IMT) and its irregularities or ulcerations in the common carotid artery (CCA) are useful tools as sentinel biomarkers for the integrity of the cardiovascular system. Total homocysteine and lipoprotein levels are the most commonly used elements in cardiovascular risk stratification. Duplex ultrasound (DUS), associated with serum biomarkers, can be used simply to assess the degree of atherosclerotic disease and cardiovascular risk.

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Aims: In the Sars-Cov-2 pandemic era, patients with diabetes mellitus (DM) manifested more severe forms of Sars-Cov-2 with greater mortality than non-diabetic patients. Several studies documented more aggressive forms of diabetic foot ulcers (DFU) during the pandemic period even though the results were not unanimously confirmed. The aim of this study was to evaluate the clinical-demographic differences between a cohort of Sicilian diabetic patients hospitalised for DFU in the pre-pandemic 3 years and a cohort of patients hospitalised in the pandemic 2 years.

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Purpose: This study reports the outcomes from a Multicenter Registry on unibody stent-graft system for the treatment of spontaneous infrarenal acute aortic syndrome (MURUSSIAS registry).

Materials And Methods: The retrospective MURUSSIAS registry included spontaneous infrarenal acute aortic dissection (IAAS) managed with the unibody stent-graft system (AFX endovascular AAA system; Endologix Inc., Irvine, California) outside the current instruction for use.

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  • * This study analyzed how revascularization procedures impacted amputation rates in infected DFU patients, revealing a major amputation rate of 6.2% and a minor amputation rate of 17% among 267 patients treated between 2016 and 2021.
  • * The findings suggest that aggressive revascularization techniques can lower amputation rates and improve ulcer healing, while also emphasizing the importance of biomarkers for early diagnosis and treatment monitoring.
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Endovascular aneurysm repair (EVAR) is a minimally invasive treatment proposed as an alternative to open repair in patients with abdominal aortic aneurysms. EVAR consists in a stent-graft placement within the aorta in order to exclude the aneurysm from arterial circulation and reduce the risk of rupture. Knowledge of the various types of devices is mandatory because some stents/grafts are more frequently associated with complications.

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The Mediterranean Federation for the Advancing of Vascular Surgery (MeFAVS) was founded in 2018, with the aim to promote cooperation among vascular professionals within Mediterranean countries. Due to its prominent social and economic impact on national health systems, diabetic peripheral artery was selected as the very first topic to be investigated by the federation. In this second paper, different experiences from delegates of participating countries were shared to define common strategies to harmonize, standardize, and optimize education and training in the Vascular Surgery specialty.

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Background: Hybrid treatments (HT) aim to reduce conventional open surgery invasiveness and address multilevel peripheral arterial disease (PAD). Herein, the simultaneous HT treatment in patients with chronic limb-threatening ischemia (CLTI) is reported.

Methods: Retrospective analysis, for the period from May 2012 to April 2018, of patients presenting multilevel PAD with CLTI addressed with simultaneous HT.

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  • *Methods*: Data were collected from patients with significant popliteal artery stenosis who underwent treatment with the Luminor® balloon, measuring various outcomes including technical success, complications, and long-term patency over a median follow-up of about 22 months.
  • *Results*: The treatment showed a 100% technical success rate with acceptable safety; after 24 months, survival was 97%, and primary patency was 96.9%, indicating the Luminor® is effective, although larger studies
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  • Multilevel peripheral arterial disease (MPAD) leads to critical limb ischemia (CLI) and often requires vascular interventions to improve blood flow and prevent amputations.
  • A case report details a successful hybrid revascularization procedure in a patient with advanced MPAD affecting multiple vascular segments, which included endovascular stenting and surgical bypass in one operation.
  • Hybrid techniques, combining surgical and endovascular approaches, have shown high efficacy and safety, resulting in reduced hospital stays and favorable outcomes for treating both MPAD and renal artery stenosis.
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Introduction: Data from the literature suggest that in patients with acute type B aortic dissection (ATBAD), associated with AAA, rupture risk is higher at the confluence tract than isolated lessions. Herein, we report a case of ATBAD and AAA managed with simultaneous intervention.

Case Presentation: We report a complicated case of a symptomatic patient presenting with a type B aortic dissection and false lumen extension into superior mesenteric artery (SMA) with an infrarenal abdominal aortic aneurysm (AAA).

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Introduction: Infrarenal abdominal aortic coarctation (AAC) is an extremely rare disease. It can be associated with renal artery stenosis determining secondary renal hypertension.

Presentation Of Case: We report a case of AAC in young female patient presenting systemic hypertension non-responder to medical treatment.

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Introduction: The autologous arteriovenous fistula (AVF) is considered the best vascular access for haemodialysis in patients with chronic kidney disease but in time can lead to several complications.

Presentation Of A Case: Herein we describe a case of a large cephalic vein aneurysm causing heart failure in a renal transplant patient being treated with radio-cephalic AVF for haemodialysis. The patient was judged to be at very high risk for potential catastrophic rupture of the aneurysm and his cardiac function was deteriorating so a surgical resection was offered.

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Introduction: Spontaneous acute aortic syndrome (IAAS) is rarely localized in the infrarenal aorta. The endovascular approach is preferred over conventional open surgery with fewer complications. However, dedicated endovascular devices for IAAS treatment are unavailable.

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  • * Researchers analyzed data from four male patients treated between January 2017 and December 2018, all of whom had neurological symptoms and successful treatment outcomes with no complications reported.
  • * The findings suggest that using proximal EPDs can improve safety during the procedure by minimizing stroke risks, but further research with more patients is needed to confirm these results.
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  • In this study, researchers compared conventional endovascular aneurysm repair (EVAR) with EVAR using intravascular ultrasound (IVUS) in patients with infrarenal abdominal aortic aneurysm.
  • They analyzed data from 221 patients and found that using IVUS resulted in significantly lower use of contrast medium and radiation exposure, without increasing any major complications or affecting kidney function.
  • Both methods showed similar survival rates and freedom from reintervention at 36 months, indicating that IVUS is a safe and effective adjunct in EVAR procedures.
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Deep femoral artery pseudoaneurysms (DFAPs) are rare and generally occur after penetrating trauma or surgical procedures. A 36-year-old obese man presented with pain in correspondence of the anterior-lateral thigh after 6 months from gunshot wound. Duplex and computed tomography (CT) showed a bilobed right DFAP (maximal diameter 12.

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  • The study investigates the safety and effectiveness of directional atherectomy (DCA) in treating femoro-popliteal obstructive disease for patients with critical limb ischemia, finding high success rates.
  • All 18 patients treated with DCA achieved both technical and procedural success, with no significant adverse cardiovascular events during hospitalization.
  • Results showed complete freedom from amputation and improvements in clinical and hemodynamic measures at one year, suggesting DCA could be a preferable option over conventional percutaneous treatments.
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Renal artery aneurysms (RAAs) are rare with an estimated incidence of 0.1% in the general population, and they represent approximately 25% of all visceral aneurysms. The gold standard of treatment is open surgery, but it is associated with a high risk of nephrectomy, mortality, and morbidity.

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Purpose: We aimed to compare the outcomes of the Endurant II (Medtronic) stent-graft used under instructions for use versus off-label in high-risk patients considered unfit for conventional surgery.

Methods: Data from patients treated with the Endurant II stent-graft between December 2012 and March 2015 were retrospectively analyzed. Sixty-four patients were included.

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