New technologies in vascular surgery: San Donato's experience in the last decades.

The Department of Vascular Surgery I at IRCCS Policlinico San Donato has been part of the Cardiovascular Center "Edmondo Malan" since the end of the 1980s. Surgical activity of the Department has always been designed to prevent and treat vascular diseases such as aneurysms of the thoracic and abdominal aorta and peripheral vessels, carotid artery stenosis, peripheral arterial disease, and chronic venous insufficiency. Excellent results have been achieved with the endovascular treatment of both symptomatic and asymptomatic carotid artery stenosis also by using innovative devices.

Appropriateness of Duplex ultrasound assessment on venous system of the legs: a two-month preliminary analysis.

Aim: The goal of this study is to evaluate the appropriateness to prescribe venous ultrasound of lower limbs.

Material Of Study: Over a two months period, 1005 Duplex scans were performed by our Vascular Surgery Unit; out of the total, 225 exams were conducted on venous system of lower limbs. We retrospectively analyzed appropriateness of prescription (according to Lombardy District indications), urgency of prescription, time-lapse between application for the exams and its execution, positive or negative results, National Health System's sustained cost.

A 16-year experience of carotid artery stenting for carotid artery stenosis.

Aim: We report our experience of carotid artery stenting (CAS) for the endovascular treatment of significant carotid stenosis over 16 years.

Materials And Methods: Data of all consecutive patients who came for a significant carotid artery stenosis from January 1st 1999 to August 31st 2015 were retrospectively collected and analyzed. Primary outcomes were the occurrence of death and major cerebrovascular events (MCE) both at 30-day and at long-term.

Varicose veins: new trends in treatment in a Vascular Surgery Unit.

Aim: Less invasive techniques such as foam sclerotherapy, endovenous laser or radiofrequency ablation have recently been introduced as a valid alternative to surgery for the treatment of varicose veins (VVs). We retrospectively reviewed our experience in the treatment of VVs with particular attention to how our therapeutic approach has changed over the last years.

Material Of Study: Data of all patients consecutively treated from September 1st 2013 to July 31st 2015 for both primitive and recurrent VVs were retrospectively collected and analyzed.

Tips About the Cordis INCRAFT Endograft.

Background: Recently, the new Cordis INCRAFT abdominal aortic aneurysm (AAA) Stent-Graft System ultra low-profile device has been introduced in the clinical practice of endovascular aortic repair (EVAR) for the treatment of infrarenal AAAs (iAAAs). In our operative unit, it has been used since November 2014. We report our initial experience with the use of this novel device.

Early experience with Ovation endograft system in abdominal aortic disease.

Objective: We describe our initial experience with the use of the TriVascular Ovation endograft system for the treatment of abdominal aortic aneurysms (AAA).

Methods: We retrospectively reviewed data from patients treated for AAA using the Ovation endograft at two institutions from January 2011 to September 2012. Main outcomes included primary success, survival, complications, and device-related events.

Hybrid endovascular and surgical approach for mycotic pseudoaneurysms of the extracranial internal carotid artery.

Objectives: Mycotic pseudoaneurysms of the extracranial internal carotid artery are rare, and their management often represents a challenge, but treatment is necessary due to the high risk of rupture and distal brain embolization. Systemic antibiotics associated with open surgical excision of the infected tissues and carotid reconstruction using autologous grafts are the treatment of choice. The use of endovascular techniques still remains controversial in infective fields; however, it can be an attractive alternative in high-risk patients or more often as a "temporary" solution to achieve immediate bleeding control for a safe surgical reconstruction.

Straight aortic endograft in abdominal aortic disease.

Background: We describe our 8-year experience with the use of endovascular techniques (ET) for the treatment of abdominal aortic aneurysms (AAA) through a straight endograft.

Methods: We retrospectively reviewed data of all patients who were treated for AAA using ET in two centres from 1998 to 2012 and who received a single straight endograft (group A) or a double straight tube (group B). Outcomes were analyzed to assess survival, absence of endoleak and absence of reintervention for both groups.

Long-term results of carotid artery stenting in patients 80 years and older.

Introduction: We report our experience about carotid artery stenting (CAS) in patients 80 years and older.

Materials And Methods: Out of 582 patients who underwent CAS at our institution from January 1999 to June 2010, 102 patients (group A) were 80 years or older. The clinical data of these patients were retrospectively reviewed, outcomes analyzed, and compared with those of younger patients who underwent CAS during the same period (group B).

Ruptured hemiarch and descending thoracic aorta aneurysm: hybrid treatment.

Ruptured aortic arch aneurysm is a life threatening disease. Surgical repair has an high perioperative mortality rate and totally endovascular treatment is a challenge. Hybrid repair has been proposed as a valuable approach.

Delayed endovascular treatment of descending aorta stent graft collapse in a patient treated for post- traumatic aortic rupture: a case report.

Background: We report a case of delayed endovascular correction of graft collapse occurred after emergent Thoracic Endovascular Aortic Repair (TEVAR) for traumatic aortic isthmus rupture.

Case Presentation: In 7th post-operative day after emergent TEVAR for traumatic aortic isthmus rupture (Gore TAG® 28-150), a partial collapse of the endoprosthesis at the descending tract occurred, with no signs of visceral ischemia. Considering patient's clinical conditions, the graft collapse wasn't treated at that time.

Endovascular treatment of thoracic aortic floating thrombus in patients presenting with acute lower limb ischemia.

We report two cases of descending thoracic aorta floating thrombus treated with Bolton Relay thoracic free-flow stent graft. The patients had symptoms of lower limb ischemia; they underwent preoperative angiography and CTscan, then we proceeded with endovascular exclusion of the thrombus from the systemic circulation. At 12 months, the graft was still patent in both patients, without any signs of endoleak.