M Garofalo

European Hospital, Roma, Latium, Italy

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Publications (27)20.86 Total impact

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    ABSTRACT: Aims: This prospective registry was designed to evaluate the early and long-term incidence of clinical events in patients with carotid obstructive disease (COD), after carotid artery revascularisation selected by consensus of a cardiovascular team. Methods and results: 403 consecutive patients with COD scheduled for carotid revascularisation were included: 130 were treated with carotid endarterectomy (CEA) and 273 with carotid artery stenting (CAS). Propensity score matching was performed to assemble a cohort of patients in whom all baseline covariates would be well balanced. The occurrence of major adverse cardiac and cerebrovascular events (MACCE), including any death, non-fatal myocardial infarction or stroke, was assessed at 30 days and at long-term follow-up. The incidence of MACCE at 30 days was 4.0% (95% confidence interval: 2.1 to 6.0), without any significant difference between the CAS and CEA groups in unmatched and matched populations. The cumulative freedom from MACCE at two-year follow-up was 80.5%±0.94%, with no statistically significant differences between the CAS and CEA groups, both in the total population and in the matched cohort. Conclusions: In this registry of patients undergoing carotid artery revascularisation selected by consensus of a cardiovascular team, the early and long-term incidence of clinical events is up to standard.
    EuroIntervention: journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology 03/2014; 9(11):1294-300. · 3.17 Impact Factor
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    ABSTRACT: Purpose. The present report describes a full endovascular treatment of a multiple anomalous (Splenic artery aneurysms) SAA with combination of coils embolization and proximal occlusion of the splenic artery with the Amplatzer vascular plug. Case report. A 53-year-old Jehovah witness woman presented with multiple aneurysms arising from an anomalous splenic artery. An endovascular treatment was performed by implantation of multiple coils and an Amplatzer Vascular Plug. A CT scan 2 months after the procedure showed complete thrombosis of the aneurysms. Discussion. Aneurysms involving an anomalous or aberrant splenic artery are rarely reported in the literature. Their surgical treatment involves potential difficulties as a consequence of anatomical position and vascular anomalies. A fully endovascular technique can be much more attractive compared to any surgical management, providing an effective and minimally invasive option.
    Il Giornale di chirurgia 01/2013; 34(1-2):42-5.
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    ABSTRACT: This study reports results of synchronous carotid endarterectomy (CEA) and off-pump coronary artery bypass grafting (CABG) in further support of the hypothesis that carotid and coronary artery revascularization can be safely performed in most patients. The series includes 74 consecutive patients underwent synchronous CEA and off-pump CABG (group A) compared with 50 patients undergoing synchronous CEA and on-pump CABG (group B). Primary endpoint of this study are death, stroke, perioperative myocardial infarction and need for repeated revascularization within 30 days of the procedures. The secondary endpoint includes local and systemic complications. No stroke was observed in group A. Ipsilateral minor stroke occurred in two patients of group B (4%). Two deaths within 30 days were observed in group A (2.7%) compared with 4 deaths in group B (8%). Combined stroke/death rate at 30 days was 2.7% in group A compared with 12% in group B (P< 0.05). No significant differences in myocardial infarction, local and systemic complications were observed. Synchronous CEA and off-pump CABG may reduce the high surgical risk of patients who actually require combined carotid and coronary revascularization. This opinion has to be substantiated by larger studies and randomized trial.
    The Journal of cardiovascular surgery 01/2012; 53(3):363-7. · 1.51 Impact Factor
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    ABSTRACT: To report surgical treatment of a ruptured abdominal aortic aneurysm (AAA) associated with spondylodiscitis due to Salmonella in emergency setting. A 69-year-old male with an history of hypertension, presented with a ruptured AAA infected by nontyphoidal Salmonella (type H), associated with spondylodiscitis. Patient underwent an emergency operation consisting in surgical debridment of infected tissue and aortic replacement with a prosthetic Dacron graft impregnated with Gentamycine. The postoperative course was uneventful and the patient was discharged at day 20 after the index procedure in good clinical condition. antimicrobial therapy was continued for 8 weeks. A CT scan and nuclear medicine studies performed two months later demonstrated minimal sign of residual aortitis. A CT scan 21 months after the procedure showed complete anatomic resolution of the disease. A rare but increasing number of aneurysms as a consequence of Salmonellosis can be observed with a high rate of morbidity and mortality, mainly in patients with a concurrent infection of the spine and paravertebral tissue. Combined antimicrobial therapy and one-stage surgical treatment can be associated with good outcome. KEY WORDS: Abdominal aorta aneurysm, Mycotic aortic aneurysms, Salmonellosis, Spondylodiscitis.
    Annali italiani di chirurgia 01/2012; 83(4):343-6. · 0.29 Impact Factor
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    ABSTRACT: Hospitals without percutaneous coronary intervention (PCI) capabilities are used to transfer patients who need coronary angiography and/or PCI to other centers. In order to optimize economic resources and hospital bed management, PCIs might be performed with an in-service organization, with re-transfer to the community hospital immediately after the procedure. The aim of our study was to evaluate the safety of a consecutive, unselected series of in-service PCIs compared to PCIs performed in patients admitted to hospitals with cath-lab capabilities. During 2008, 1030 PCI procedures were performed at the European Hospital and Aurelia Hospital: 905 in patients admitted to a hospital with PCI capabilities (Group I) and 125 (12%) with an in-service strategy (Group II) referring from the Città di Roma Hospital. All treatment protocols were preventively uniformed and standardized. The two groups were statistically comparable in terms of baseline clinical characteristics and/or procedural findings, with the exception for older age (66 +/- 10 vs 70 +/- 10 years, p = 0.004) and a higher prevalence of acute coronary syndromes (56 vs 88%, p < 0.001) and femoral vascular access (94 vs 98%, p = 0.03) in Group II. The rate of left ventricular ejection fraction < or = 35% (20 vs 13%, p = 0.06), multivessel PCI (23 vs 19%, p = 0.4), and glycoprotein IIb/IIIa inhibitor use (15 vs 13%, p = 0.5) was similar between the two groups. Among patients treated with an in-service strategy, 2 (1.6%) were not transferred to the community hospital, because of hemodynamic instability. The in-hospital rate of major clinical events (death for cardiovascular causes, cerebrovascular events, urgent revascularization, stent thrombosis) was 0.75% and 0.8% (p = 0.8), 1.8% and 1% (p = 0.4) for periprocedural myocardial infarction, 1.7% and 1.9% (p = 0.5) for major bleeding, 1.1% and 1.6% (p = 0.6) for vascular complications, in Group I and II, respectively. Left ventricular dysfunction was the only independent predictor of major clinical events (p = 0.003). A strategy of in-service organization for PCI presents a similar rate of in-hospital clinical events and complications compared to an overnight stay into a hospital with PCI capabilities. Such a strategy may be utilized in order to optimize economic resources and hospital bed management.
    Giornale italiano di cardiologia (2006) 10/2010; 11(10):783-8.
  • R Borioni, R De Paulis, F Tomai, M Garofalo
    European journal of vascular and endovascular surgery: the official journal of the European Society for Vascular Surgery 02/2010; 39(4):516-7; author reply 517. · 2.92 Impact Factor
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    ABSTRACT: The purpose of this report is to describe the endovascular exclusion of an internal iliac artery (IIA) aneurysm in emergency setting, long after abdominal aortic aneurysm surgical repair. An 85-year-old male presented with a contained rupture of a huge IIA aneurysm, ten years after aortoiliac bifurcated grafting. Because of poor clinical conditions an emergency endovascular treatment was planned. A stent-graft was positioned from the proximal right branch of the bifurcated surgical prosthesis to the distal external iliac artery, covering the hypogastric aneurysm neck. One month after the procedure, CT scan demonstrated the complete exclusion of the aneurysm. Endovascular treatment of IIA aneurysms is an excellent option to reduce perioperative morbidity and mortality in high risk patients, particularly in an emergency setting.
    VASA.: Zeitschrift für Gefässkrankheiten. Journal for vascular diseases 03/2009; 38(1):91-3. · 1.01 Impact Factor
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    ABSTRACT: To report a clinical experience about surgical treatment of iatrogenic peripheral artery pseudoaneurysms (FPA). This is a retrospective review of 90 consecutive patients (46 males, 44 females, mean age 66.2 years, range 33-86) with FPA complicating coronary angiography or angioplasty, observed between October 1990 through June 2006. A 3 cm pseudoaneurysm or larger was confirmed by duplex ultrasound scanning in 90 out of 21 454 cardiac patients (0.42%), occurring more frequently in interventional (59/3 983) rather than diagnostic (31/17 471) procedures (1.48% vs 0.17%). The surgical treatment consisted in direct closure with polypropilene suture and occasionally, patch angioplasty or bypass. No limb loss occurred. There were 4 wound complications (4.4%), one pulmonary embolism (1.1%), 3 deaths (3.3%). Classical results reported in literature demonstrate that the surgical repair of femoral pseudoaneurysms following cardiac catheterization is safe, effective and durable. In these series, although low major morbidity (1.1%) and no cases of limb loss were reported, the authors observed 3 death (4.4%), resulting from the severity of cardiac disease in 2 cases and from the vascular repair itself in one case (femoral endoarteritis). These results substantiate the common observation that patients who actually require invasive coronary diagnosis and treatment are often affected by advanced cardiovascular disease and suffer the occurrence of complications, having a high risk of death. Therefore, any surgical treatment should be performed with strict adherence to sound vascular surgical principles.
    Minerva chirurgica 09/2008; 63(4):277-82. · 0.39 Impact Factor
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    ABSTRACT: The presence of significant carotid artery disease in patients undergoing coronary artery bypass grafting has been reported to be as high as 17%. The optimal management of patients with significant coronary and carotid artery disease remains controversial. In this study, we analyze our recent experience with patients who underwent synchronous carotid endarterectomy (CEA) and coronary artery bypass grafting. We reviewed the early outcome of 68 patients (56 males, 12 females, mean age 71.1 years, range 53-88 years) who underwent simultaneous CEA and coronary artery revascularization between January 2005 and June 2007. The frequency of unstable or ulcerated plaques was determined in symptomatic and asymptomatic patients. Death for myocardial infarction occurred in 3 patients (4.4%). Stroke was found in 1 patient (1.4%). Combined 30-day stroke/mortality rate was 5.8%. The frequency of unstable or ulcerated plaques was 60.3% (41/68). An unstable stenosis was present in 23 out of 42 asymptomatic patients (54.7%). Patients suffering from a concomitant coronary and carotid artery occlusive disease represent a high-risk population whose management is still controversial. A modern approach to combined CEA and coronary artery bypass grafting may be safe. The high frequency of unstable carotid lesions in asymptomatic patients suggests to treat every stenosis > 75% in candidates to coronary artery bypass grafting. Carotid artery stenting should be avoided in the majority of cases, considering the possibility of unstable carotid stenosis and the atherosclerotic involvement of aortic arch.
    Giornale italiano di cardiologia (2006) 03/2008; 9(3):194-8.
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    ABSTRACT: Background. The presence of significant carotid artery disease in patients undergoing coronary artery bypass grafting has been reported to be as high as 17%. The optimal management of patients with significant coronary and carotid artery disease remains controversial. In this study, we analyze our recent experience with patients who underwent synchronous carotid endarterectomy (CEA) and coronary artery bypass grafting. Methods. We reviewed the early outcome of 68 patients (56 males, 12 females, mean age 71.1 years, range 53-88 years) who underwent simultaneous CEA and coronary artery revascularization be- tween January 2005 and June 2007. The frequency of unstable or ulcerated plaques was determined in symptomatic and asymptomatic patients. Results. Death for myocardial infarction occurred in 3 patients (4.4%). Stroke was found in 1 pa- tient (1.4%). Combined 30-day stroke/mortality rate was 5.8%. The frequency of unstable or ulcer- ated plaques was 60.3% (41/68). An unstable stenosis was present in 23 out of 42 asymptomatic pa- tients (54.7%). Conclusions. Patients suffering from a concomitant coronary and carotid artery occlusive disease represent a high-risk population whose management is still controversial. A modern approach to combined CEA and coronary artery bypass grafting may be safe. The high frequency of unstable carotid lesions in asymptomatic patients suggests to treat every stenosis >75% in candidates to coro- nary artery bypass grafting. Carotid artery stenting should be avoided in the majority of cases, con- sidering the possibility of unstable carotid stenosis and the atherosclerotic involvement of aortic arch.
    01/2008;
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    ABSTRACT: The aim of the study was to report our clinical experience with the surgical treatment of iatrogenic pseudoaneurysms of the peripheral arteries. The study is a retrospective review of 101 consecutive patients (52 males, 49 females, mean age 66.2 years, range 33-86), with iatrogenic pseudoaneurysms of the peripheral arteries, surgically treated in a vascular unit from October 1990 to June 2006. Duplex ultrasound scanning was employed to support the clinical findings. The surgical treatment consisted in direct closure with polypropylene sutures and, occasionally, patch angioplasty or bypass. Ultrasound compression was effective in one of 4 small aneurysms (< 2.5). No limb loss occurred. There were 4 wound complications (3.9%), one pulmonary embolism (0.99%), and 3 deaths (2.9%), 2 of which not related to vascular repair and one secondary to femoral endoarteritis and septic shock, unrelated to previous implantation of a percutaneous femoral closure device. Although iatrogenic pseudoaneurysms of the peripheral arteries are rarely observed in clinical practice, a significant number of peripheral artery complications may occur after cardiac catheterisation and coronary angioplasty. Failure of conservative treatment requires a traditional surgical repair. The results of our series included a significant mortality rate (2.9%), resulting from the severity of cardiac disease in 2 cases and from the vascular repair itself in one case (femoral endoarteritis). These results substantiate the common observation that patients who require surgery for an iatrogenic pseudoaneurysm are often affected by advanced cardiovascular disease and are liable to suffer the occurrence of complications, with a high risk of death. Therefore, any surgical treatment should be performed with strict adherence to sound vascular surgical principles.
    Chirurgia italiana 01/2008; 60(1):103-11.
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    ABSTRACT: Complications due to undetectable coronary artery disease are the major causes of morbidity and mortality in the surgical treatment of abdominal aortic aneurysm (AAA). The aim of our study was to evaluate the importance of significant coronary artery disease identification and the impact of coronary revascularization on early and late outcomes after surgical repair of AAA. Between January 1994 and July 2004, 210 patients (204 males and 6 females, mean age 68 +/- 12 years) were candidates to elective surgical repair of AAA. Coronary angiography was performed in 122 patients (58%) in presence of angina symptoms, previous myocardial infarction, echocardiographic or scinti-scan evidence of myocardial ischemia. Coronary revascularization was performed in 83 patients (39.5%). The population was divided into two groups: coronary artery bypass graft/coronary angioplasty (CABG/PTCA) + AAA group (83 patients submitted to CABG surgery [n = 61], or PTCA [n = 22], for significant coronary artery disease before surgical repair of AAA), AAA group (127 patients without significant coronary artery disease, operated for AAA). Follow-up (90% complete) had a mean duration of 42 +/- 23 months. CABG/PTCA + AAA group compared to AAA group presented major symptoms of angina (p = 0.001), higher incidence of previous myocardial infarction (67 vs 10%, p < 0.0001), lower mean value of left ventricular ejection fraction (50 vs 54%, p = 0.01). Operative mortality was 0.95%, and was not related to any cardiac morbidity: operative mortality was observed in the AAA group (2 patients died of anossic cerebral damage and respiratory failure) and was absent in the CABG/PTCA + AAA group (p = 0.8). The overall 8-year survival in the AAA group and in the CABG/PTCA + AAA group was 80 +/- 11 vs 95 +/- 2.8%, respectively (p = 0.7). Freedom from cardiac late death and freedom from cardiac events (recurrence of angina, myocardial infarction, congestive heart failure) were high in both groups (93 +/- 6.4 vs 97 +/- 2.3%, p = 0.6; and 91 +/- 6.6 vs 89 +/- 6.7%, p = 0.5, respectively). In the CABG/PTCA + AAA group symptoms for angina (p = 0.0002) and dyspnea (p < 0.0001) significantly improved during the follow-up. Significant coronary artery disease was not negligible (39.5%) in patients candidates to surgical repair of AAA. Identification and correction of coronary artery disease prior to AAA surgery is the most important strategy to reduce the risk of vascular procedure. The beneficial impact of coronary revascularization on early and late outcomes is evident, in terms of satisfactory survival and freedom from cardiac adverse events. Therefore, coronary angiography is strongly suggested to optimize early and long-term results.
    Italian heart journal. Supplement: official journal of the Italian Federation of Cardiology 07/2005; 6(6):369-74.
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    ABSTRACT: Isolated abdominal aortic dissections are rare events. Their anatomic and clinical features are different from those of atherosclerotic aneurysms. We report 4 cases of isolated abdominal aortic dissection that were successfully treated with surgical or endovascular intervention. The anatomic and clinical features and a review of the literature are also presented.
    Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital 02/2005; 32(1):70-3. · 0.67 Impact Factor
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    ABSTRACT: Surgical repair of popliteal artery aneurysms is usually performed by vascular exclusion and femoro-popliteal bypass grafting via a medial route. The vascular exclusion of a popliteal artery aneurysm may, however, prove ineffective long-term. We report on a patient with a large popliteal artery aneurysm observed twelve years after conventional surgical treatment and discuss alternative surgical options to be considered for long-lasting effective popliteal artery aneurysm treatment.
    Chirurgia italiana 01/2005; 57(4):505-7.
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    ABSTRACT: The aim of this study was to evaluate the incidence of late cardiac events in patients submitted to carotid endarterectomy (CEA), asymptomatic for coronary artery disease during the carotid surgical procedure. During a period of 11 years, 162 patients (122 males, 40 females, mean age 68 +/- 12 years), asymptomatic for coronary artery disease and/or without sings of coronary artery disease at the cardiological screening, were submitted to CEA for symptomatic or severe (> or = 70%) carotid stenoses. Clinical follow-up was performed on 151 patients (93%), to identify the incidence of cardiac and neurological events and freedom from late death. The results of this group of patients (group A) were compared to those obtained during follow-up of 147 patients (133 males, 14 females, mean age 69 +/- 15 years) (group B) affected by coronary artery disease and submitted to combined CEA and coronary artery bypass grafting (CABG). During follow-up, in group A freedom from late death, cardiac death and adverse neurological events were 77 +/- 4.8, 86 +/- 4.4 and 87.3 +/- 4.5% at 9 years, respectively. Freedom from adverse neurological events in group A was similar to that registered in group B (86.4 +/- 5.6%, p = NS). The incidence of cumulative cardiac events and fatal cardiac events (myocardial infarction, sudden death, congestive heart failure) on the contrary, was higher in group A than in group B (13.2 vs 6.8%, p = 0.0424, and 7.9 vs 3.4%, p = 0.0446, respectively). In patients submitted to isolated CEA, although without symptoms or signs of coronary artery disease at the timing of the carotid procedure, the possibility of a severe coronary disease development during follow-up is not negligible: the incidence of late cardiac events may be higher than in patients with coronary artery disease corrected at the same time of the CEA procedure. These data suggest the opportunity of a systematic cardiological screening during follow-up in patients submitted to isolated CEA, although clinically asymptomatic for coronary artery disease at the timing of the vascular procedure, to improve the long-term survival.
    Italian heart journal. Supplement: official journal of the Italian Federation of Cardiology 08/2004; 5(7):534-8.
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    ABSTRACT: The aim of this study is to identify significant risk factors and eventual clinical markers associated with acute mesenteric ischemia (AMI) after cardiopulmonary bypass. The study was retrospectively performed on a group of 19 patients (group A) undergoing cardiac surgery between January 1991 and December 1999, who developed AMI within 30 days of their hospitalization. A control group of 48 patients (group B) was compared in order to define preoperative and operative risk factors for AMI. At the abdominal operation, a non-occlusive mesenteric ischemia was found in every case. In-hospital mortality was 84.2% (16/19). Compared to the control, there was a significant difference in aortic cross-clamp time (p<0.001) and use of inotropic drugs (p<0.01). Postoperatively, the studied group (group A) had a significantly higher mean value of the enzymatic serum levels at any time. A high index of suspicion for mesenteric ischemia after cardiopulmonary bypass should be considered in patients with conditions of hypoperfusion. The early laboratory signs of AMI might be searched during the first postoperative hours.
    The Journal of cardiovascular surgery 09/2002; 43(4):455-9. · 1.51 Impact Factor
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    ABSTRACT: The Fogarty thromboembolectomy (TE) has been considered for a long time the best treatment for acute peripheral arterial occlusion. However, recently new therapeutic options like thrombolytic agents (local or systemic) have been introduced. A total of 66 patients who underwent Fogarty TE for acute thromboembolic limb ischemia has been retrospectively studied. Patients with documented atherosclerotic pathology who were treated with other revascularization procedures were excluded. Patients were divided into four groups: 1) upper limb embolism, 2) lower limb embolism, 3) thrombosis on atherosclerotic plaque or on a graft, 4) post-traumatic thrombosis. Twelve patients underwent Fogarty TE for upper limb thromboembolic ischemia and 54 for lower limb; 57.5% of patients had atrial fibrillation. Procedures were successful in 59 patients (89.4%). Further surgical procedures (bypass, arterioplasty, further embolectomy) were performed in 35.1% (19/54) of patients of groups 2 and 3 with acute lower limb ischemia. Results were very good in group 1 and 4. Seven of the 54 patients treated for lower limb ischemia underwent limb amputation (12.9%), while hospital mortality was similar for lower and upper limb (31.4 and 33.3% respectively). The Fogarty TE is still a good option to revascularize acute ischemic peripheral arteries with good results in a high number of patients and should be particularly used where it is possible to perform additional techniques in case of failure.
    Minerva cardioangiologica 01/2000; 48(4-5):111-6. · 0.43 Impact Factor
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    ABSTRACT: The presence of coronary artery disease (CAD) evaluated with coronary angiography and eventual correction of CAD in abdominal aortic aneurysm (AAA) patients has been considered the main determinant of early and late outcome after AAA repair. This study reports our experience in CAD and AAA patients in terms of diagnosis and therapy of CAD. In a population of 126 patients (122 males, 4 females, mean age 67.5 years, range 37-81) who were candidates to elective repair for AAA with a diameter > or = 5 centimeters, we included coronary arteriography in 1) patients who were symptomatic for angina (15.9%); 2) patients with previous myocardial infarction (33.3%); 3) patients with previous coronary artery bypass (4%). We identified a group of 45 patients (35.7%) with significant CAD who had been treated before AAA surgery by coronary artery bypass grafting (CABG) in 37 cases or percutaneous coronary angioplasty (PTCA) in 8 cases. AAA repair was performed during the same hospital stay or at a later date. We did not report any morbidity and mortality related to cardiac or vascular procedures. We believe that among patients reporting cardiac symptoms (previous myocardial infarction, angina) the incidence of surgically-correctable CAD is not negligible (45/67, 67.2%). Therefore, invasive coronary study is strongly suggested in such cases to reveal and treat an eventual coronary artery stenosis prior to AAA repair. The absence of cardiac morbidity and mortality related to cardiac and vascular procedures supports this approach.
    Giornale italiano di cardiologia 06/1999; 29(6):658-61.
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    ABSTRACT: Carotid endarterectomy (CEA) is often carried out to prevent cerebrovascular strokes. It is obviously important that neurological morbidity of the procedure is contained within acceptable limits (< 2%). Between January 1991 and December 1997 a total of 239 CEA were performed in 216 patients (169 males and 47 females, mean age 66.6 +/- 14.2 years; range 43-81). Angioplasty was carried out using a precoagulated Dacron patch, except in cases in which the residual diameter of the internal carotid artery was greater than 5 mm. A Javid shunt was used selectively if stump pressure < 50 mmHg. No major neurological complications were observed. A reversible focal neurological deficit was reported in 3 cases (1.2%). Neurological morbidity correlated to peripheral arterial occlusive disease appears to be correlated mainly with technical reasons or cerebral ischemia following clamping. The extensive use of angioplasty with patch and the selective use of a protective shunt improve the technical success rate of surgery, significantly helping to limit morbidity.
    Minerva cardioangiologica 04/1999; 47(4):121-6. · 0.43 Impact Factor
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    ABSTRACT: We report the case of a woman, age 65 years, who was admitted to our hospital for intense abdominal pain. Hemoglobin was 9.7 g/100 ml and computed tomography (CT) confirmed the hemorrhagic state showing intraperitoneal blood. After laparotomy a ruptured aneurysm of the left gastroepiploic artery was diagnosed. Ligation of the artery was performed with good results. This case is reported because the situs of this aneurysm is very rare.
    The Journal of cardiovascular surgery 03/1999; 40(1):63-4. · 1.51 Impact Factor

Publication Stats

53 Citations
20.86 Total Impact Points

Institutions

  • 2004–2012
    • European Hospital
      Roma, Latium, Italy
  • 1999–2012
    • Aurelia Hospital
      Roma, Latium, Italy
  • 1994–2005
    • University of Rome Tor Vergata
      • Dipartimento di Biopatologia e Diagnostica per Immagini
      Roma, Latium, Italy