Publications by authors named "Filippo Piacentino"

Background: Venous outflow is the favored access for endovascular management of dialysis fistulas. However, transradial access (TRA) offers advantages in specific clinical scenarios. The study aims to compare the efficacy, feasibility, and safety of TRA and transvenous access (TVA) in the endovascular management of malfunctioning dialysis fistulas, addressing the existing gap in comprehensive literature.

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Background: This study aims to evaluate the feasibility, efficacy, and safety of distal transradial access (dRA) for the endovascular management of malfunctioning dialysis fistulas. This study also compares dRA with conventional access techniques, such as proximal radial and transvenous access, focusing on technical success, clinical outcomes, and vascular access site complications (VASCs).

Methods: A retrospective multicenter study was conducted across four hospitals, including 292 patients treated between January 2019 and June 2024.

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Objective: To investigate the potential role of dual-energy spectral computer tomography (CT) quantitative parameters in the definition of bladder cancer (BCa) pathological grading.

Methods: This retrospective study evaluated the use of spectral CT imaging features for BCa. From 2021 to 2023, 63 patients with histologically-confirmed BCa diagnosis were examined at our Institution.

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Article Synopsis
  • Dual-Energy computed tomography (DECT) offers advanced techniques like Virtual Non-Contrast (VNC) and Iodine Density Index (IDI) for better diagnosis of urogenital tumors.
  • The review discusses how DECT can enhance lesion characterization, staging accuracy, and treatment response evaluations for urological cancers.
  • The technology is seen as a promising tool in improving both diagnosis and treatment management of these tumors.
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Inflammation-based scores are biomarkers of the crosstalk between the tumor microenvironment and the immune response. Investigating the intricate relationship between the tumor stromal microenvironment, biomarkers, and the response to transcatheter arterial chemoembolization (TACE) is essential for early identification of TACE refractoriness or failure, providing insights into tumor biology and facilitating personalized therapeutic interventions. This study addresses a dearth of recent literature exploring the prognostic significance of the preoperative LMR in individuals from western countries diagnosed with stage B hepatocellular carcinoma (HCC) undergoing drug eluting microspheres TACE (DEM-TACE) or conventional TACE (cTACE).

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Computed tomography (CT)-guided lung biopsy is one of the oldest and most widely known minimally invasive percutaneous procedures. Despite being conceptually simple, this procedure needs to be performed rapidly and can be subject to meaningful complications that need to be managed properly. Therefore, knowledge of principles and techniques is required by every general or interventional radiologist who performs the procedure.

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Background: The utilization of inflammation-based scores, such as the Neutrophil-to-Lymphocyte Ratio (NLR), Lymphocyte-to-Monocyte Ratio (LMR), and Platelet-to-Lymphocyte Ratio (PLR), has garnered attention for their potential as prognostic indicators in various cancers. However, their predictive role in patients with intermediate-stage HCC undergoing transcatheter arterial chemoembolization (TACE) remains an area that requires further investigation, as early recognition of TACE refractoriness holds the potential to guide tailored therapeutic interventions.

Methods: This multicenter international retrospective study analyzed data from patients with intermediate-stage HCC undergoing TACE between 2018 and 2024.

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Transcatheter aortic valve implantation (TAVI) is a less invasive alternative to surgical implantation and its implementation is progressively increasing worldwide. We routinely perform pre-procedural aortic angiography CT to assess aortic dimensions and vascular anatomy. This study aims to evaluate the image quality of CTA for TAVI planning using dual-layer spectral CT, with virtual monoenergetic image reconstructions at 40 keV.

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Objectives: To evaluate the feasibility of thoracic endovascular aortic repair (TEVAR) using the Ankura™ device (Lifetech Scientific, Shenzhen, China) with left subclavian artery (LSA) in-situ fenestration (ISF) using an adjustable puncture device system.

Methods: It is a single center, retrospective, financially unsupported cohort study of TEVAR performed from 16 February 2007 to 10 January 2023. Inclusion criteria were isolate LSA revascularization for elective or urgent/emergent "zone 2" TEVAR, and the availability of the preoperative computed tomography angiography.

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Pancreatic ductal adenocarcinoma (PDAC) is a cancer with one of the highest mortality rates in the world. Several studies have been conductedusing preclinical experiments in mice to find new therapeutic strategies. Experimental ultrasound, in expert hands, is a safe, multifaceted, and relatively not-expensive device that helps researchers in several ways.

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The aim of the study was to try to obtain more information on diagnostic samplings and biomarkers using dual-layer spectral CT in lung biopsies. Lung biopsies were performed by merging images obtained with CBCT with those from spectral CT to use them as functional guidance, experimenting with double sampling to determine the difference between the area with a higher Z-effective number and that with a lower Z-effective number. Ten patients with large lung lesions on spectral CT were selected and underwent percutaneous transthoracic lung mass biopsy.

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The objective of these Guidelines is to provide recommendations for the classification, indication, treatment and management of patients suffering from aneurysmal pathology of the visceral and renal arteries. The methodology applied was the GRADE-SIGN version, and followed the instructions of the AGREE quality of reporting checklist. Clinical questions, structured according to the PICO (Population, Intervention, Comparator, Outcome) model, were formulated, and systematic literature reviews were carried out according to them.

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: We present a case series of Neuroendocrine Carcinoma of the Urinary Bladder (NECB) to analyse their radiologic appearance on CT, find a "Radiomic signature", and review the current literature. : 14 CT cases of NECB were reviewed and compared with a control group of 42 patients with high-grade non-neuroendocrine bladder neoplasm for the following parameters: ring enhancement; implantation site; dimensions; density; margins; central necrosis; calcifications; number of lesions; wall thickness; depth of invasion in the soft tissue; invasion of fat tissue; invasion of adjacent organs; lymph-node involvement; abdominal organ metastasis. To extract radiomic features, volumes of interest of bladder lesions were manually delineated on the portal-venous phase.

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: Treatment of visceral artery pseudoaneurysms (VAPs) is always indicated regardless of their diameters, as their risk of rupture is significantly higher than that of visceral artery aneurysms. The invasiveness of surgery and its associated complications have led to a shift in favor of radiological interventions as the initial treatment of choice. However, there are still some unanswered questions on endovascular treatment of VAPs regarding the optimal endovascular technique and the efficacy and safety outcomes.

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Background: Endovascular intervention is now the primary line of therapy for arterial injury brought on by pelvic trauma since it can significantly reduce considerable morbidity associated with surgery and can swiftly access and control bleeding sites. Despite international guidelines and widespread awareness of the role of angioembolization in clinical practice, robust evidence comparing the outcomes of angioembolization in hemodynamically stable and unstable patients is still lacking. This study aims to directly compare the outcomes of angioembolization for the treatment of pelvic traumatic arterial injury in patients with hemodynamic stability vs.

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Objective: The aim of this study is to evaluate the feasibility, safety, and short-term effectiveness of a high-power (150 W) microwave ablation (MWA) device for tumor ablation in the lung, liver, and kidney.

Methods: Between December 2021 and June 2022, patients underwent high-power MWA for liver, lung, and kidney tumors. A retrospective observational study was conducted in accordance with the Declaration of Helsinki.

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Article Synopsis
  • Transcatheter arterial embolization (TAE) is a special medical treatment used to stop severe bleeding, even in patients who have a blood clotting issue called coagulopathy.
  • A study looked at 120 patients with coagulopathy who had TAE for sudden bleeding from January 2018 to May 2023, finding that most bleeding happened in the abdominal wall and that the treatment was mostly successful.
  • The study showed that TAE is safe and effective, and patients had better outcomes if their coagulopathy was treated within 24 hours of the TAE procedure.
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: Roughly 10% of cancer patients experience an episode of bleeding. The bleeding severity can range from occasional trivial bleeds to major bleeding. The treatment for the bleeding may vary, depending on the clinical condition and anatomical site, and may include various strategies, among which TAE is a cornerstone of major bleeding management.

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Dual-layer Dual-Energy CT (dl-DECT) allows one to create virtual non-contrast (VNC) reconstructions from contrast-enhanced CT scans, with a consequent decrease of the radiation dose. This study aims to assess the reliability of VNC for the diagnostic evaluation of renal masses in comparison with true non-contrast (TNC) images. The study cohort included 100 renal masses in 40 patients who underwent dl-DECT between June and December 2021.

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: Increasing attention is being paid to the coagulation disorders associated with SARS-CoV-2 infection. Bleeding accounts for 3-6% of COVID-19 patient deaths, and is often a forgotten part of the disease. The bleeding risk is enhanced by several factors, including spontaneous heparin-induced thrombocytopenia, thrombocytopenia, the hyperfibrinolytic state, the consumption of coagulation factors, and thromboprophylaxis with anticoagulants.

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Objectives: The aim of this study was to evaluate the incidence and outcomes of ischaemic organ complications after thoracic endovascular aortic repair (TEVAR).

Methods: This is a multicentre, retrospective, observational cohort study. We analysed data from patients treated with TEVAR between 22 June 2001 and 10 December 2022.

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The purpose of this bicentric case series was to report the safety, efficacy, and clinical outcome of transcatheter embolization in pulmonary artery pseudoaneurysms (PAPAs). Between January 2016 and June 2021, eight patients with PAPA were subjected to transcatheter embolization. The total number of patients was eight, of which five were female, with a mean age of 62 ± 14 years (average ± standard deviation).

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Background: To analyze clinical outcomes and perform a macro-costing evaluation of endovascular aortic repair (EVAR) for aorto-iliac aneurysms.

Methods: This is a retrospective, financially unsupported, physician-initiated observational cohort study. Patients with iliac artery involvement treated with EVAR between January 1st, 2014 and December 31st, 2021 were identified.

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Article Synopsis
  • The study aimed to compare the effectiveness and safety of two types of vascular closure devices (VCDs): balloon-based and non-balloon-based.
  • Conducted between March 2021 and May 2022, it involved 2,373 participants and focused on 1,672 patients, evaluating successful hemostasis, failure management, and safety rates of complications.
  • Results indicated that non-balloon VCDs had a higher rate of successful hemostasis (96.5%) compared to balloon VCDs (85.9%), although non-balloon devices had a higher incidence of arteriovenous fistulas (1.57% vs. 0%).
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