A Single-Center Experience on Below-The-Knee Endovascular Treatment in Diabetic Patients

Diabetic ulceration of the foot is a major global medical, social and economic problem and is the most frequent end-point of diabetic complications. A retrospective analysis from February 2017 to May 2019 of diabetic patients presenting below-the-knee artery disease (PAD) was carried out. Only patients treated with endovascular techniques as first choice treatment were evaluated. Outcome measured was perioperative mortality and morbidity. Freedom from occlusion, secondary patency and amputation rate were all registered. Additional maneuvers including stenting or angioplasty with drug eluting balloon (DEB) were reported. A total of 167 (101 male/66 female) patients with a mean age of 71 year…

Endovascular Treatment of Spontaneous Internal Carotid Artery Dissection with Proximal Embolic Protection Device

Background The aim of this study was to report the feasibility and outcomes with the endovascular treatment of spontaneous internal carotid artery dissections (ICADs) using a proximal embolic protection device (EPD). Methods This is a retrospective analysis of patients treated for spontaneous symptomatic ICAD using a proximal EPD from January 2017 to December 2018. Indication for treatment was the presence of neurologic symptoms. Early outcomes measured included technical success, perioperative mortality, and major cardiovascular or cerebrovascular complications. Late outcomes were recurrent neurologic symptoms, patency, and reinterventions. Results A total of 4 male patients with ICAD were…

Endovascular Treatment with Drug-Eluting Balloon for Severe Subclavian Artery Stenosis Involving the Origin of the Vertebral Artery

The first line approach for subclavian steal syndrome is PTA-stenting of subclavian artery. When the ipsilateral vertebral artery origin is involved or in closed proximity of the atherosclerotic lesion in the subclavian artery PTA-stenting is at risk of ipsilateral vertebral artery coverage. Herein we report our experience with DEB to address lesions involving the subclavian artery and the origin of the ipsilateral vertebral artery. From January 2017 to February 2019, patients presenting subclavian artery lesion involving the origin of the ipsilateral vertebral artery and treated using primary DEB, were included. Three patients, with left subclavian steal syndrome, were identified. The peri…

Subintimal stenting for superficial femoral artery long occlusion in patients with critical limb ischemia

Introduction: Subintimal recanalization of chronic totally occluded superficial femoral arteries (SFA) has gained increasing attention as an effective approach for limb salvage in patients with critical limb ischemia (CLI). Use of stents in treating SFA lesions has increased with the intention to improve arterial patency. Our aim was to evaluate the feasibility and mid-term outcomes of subintimal stenting in long occlusions of the SFA in patients presenting CLI. Methods: A retrospective review of consecutive patients admitted to our unit with chronic occlusion of the SFA and CLI between september 2008 and september 2010 was performed. Within this group, the subintimal angioplasty with prima…

carotid endarterectomy versus stenting in patients with contralateral carotid artery occlusion

Arteriopatie viscerali

Le malattie delle arterie viscerali e renali sono sempre di più frequente osservazione per il chirurgo vascolare. Il progressivo invecchiamento della popolazione e il costante progresso tecnologico, in particolare della diagnostica per immagini, sicuramente hanno contribuito a un più frequente riscontro di queste patologie. Per quanto riguarda la patogenesi, la malattia aterosclerotica è la causa più frequente per entrambi i distretti arteriosi analizzati. I recenti progressi delle procedure endovascolari hanno ulteriormente migliorato la prognosi di queste malattie arteriose permettendo di trattare patologie complesse con procedure sempre meno invasive, e la conoscenza di queste moderne te…

THE POSTERIOR APPROACH IN THE REPAIR OF POPLITEAL ARTERY ANEURYSMS: A TWO CENTER EXPERIENCE

Objective: Popliteal artery aneurysms (PAA) are most frequent among peripheral aneurysms. The most commonly performed surgical repair is proximal and distal ligation with a saphenous vein bypass. We aim to report the early and mid-term outcome of surgical repair of popliteal artery aneurysms via a posterior approach. Methods: A retrospective review of consecutive patients who underwent surgical PAA repair in two vascular surgery units between 1998 and 2009 was performed. Within this group, the posterior approach was used in 28 repairs in 26 patients (25 men). All patients had an ultrasound examination. Eighteen patients underwent conventional angiography while CT angiography with 3-D recons…

Managing Peripheral Artery Disease in Diabetic Patients: A Questionnaire Survey from Vascular Centers of the Mediterranean Federation for the Advancing of Vascular Surgery (MeFAVS)

Background The Mediterranean Federation for the Advancing of Vascular Surgery (MeFAVS) was founded on October 1, 2018, to enhance cooperation among vascular professionals within Mediterranean countries. Due to its prominent social and economic impact on national health systems, diabetic arteriopathy has been selected as the very first topic to be investigated by the federation. Methods MeFAVS members were asked to reply to a questionnaire on the management of diabetic ischemic foot. Results were collected and analyzed statistically. The questionnaire consisted of 15 multiple choice answers regarding diabetic foot (DF) diagnosis and treatment. The questionnaire was submitted to 21 centers on…