Giuseppe M Sangiorgi

University of Rome Tor Vergata | UNIROMA2 · Department of Cardiology

Background: The distal radial represents an evolution of the standard radial approach. Distal radial arterial access (DRA) in the so-called "anatomical snuffbox" is technically more difficult but offers potential advantages for patients. Moreover, the use of the distal radial would preserve the proximal radial from the risk of arterial occlusion a...

Funding Acknowledgements Type of funding sources: None. INTRODUCTION the prevalence of right ventricular (RV) involvement in acute myocarditis (aMY) has been poorly investigated. Actually, RV evaluation may be difficult in echocardiography and scar detection as well as the presence of edema in cardiovascular magnetic resonance (CMR) may be challen...

Background: Despite unanimous calls for more equitable access and support to female researchers, there are persistent barriers to women's career progression and professional fulfillment. These discriminative hurdles undermine female gender in science and have detrimental effects on research activities and female professionals and patients. There i...

Hypertension is associated with more severe disease and adverse outcomes in COVID-19 patients. Recent investigations have indicated that hypertension might be an independent predictor of outcomes in COVID-19 patients regardless of other cardiovascular and noncardiovascular comorbidities. We explored the significance of coronary calcifications in 69...

Chapter of the book "Erectile Dysfunction" by Sangiorgi et Al: Econometrics and cardio-health evaluations

At the beginning of the COVID-19 pandemic, the lung was recognized as the main target organ; now, new evidence suggests that SARS-CoV-2 infection leads to vascular disease. In a previous review, we supposed a bidirectional link between endothelial dysfunction and COVID-19, identifying atherosclerosis as having a crucial role in its pathogenesis. At...

Cardiovascular medicine is facing several challenges in the current era, dominated by the rapid spread of a previously unknown virus around the world. Indeed, the 2020 COVID-19 pandemic set the course of cardiovascular science and education in an extraordinary way, hogging the attention of the medical community. Notably, while COVID-19 impacted res...

COVID-19 is an acute respiratory disease of viral origin caused by SARS-CoV-2. This disease is associated with a hypercoagulable state resulting in arterial and venous thrombotic events. The latter are more frequent, especially in patients who develop a severe form of the disease and are associated with an increased mortality rate. It is therefore...

A 19-year-old patient presented for syncope with third-degree AV block (TDAVB) at ECG. A chest-CT showed a thymic mass that could be responsible for TDAVB due to extrinsic vagal nerve compression. Thymectomy led to complete AV block resolution. An extrinsic vagal compression mechanism should be considered among causes of complete atrioventricular b...

Background: The radial artery is recommended by international guidelines as the default vascular access in patients with acute coronary syndromes (ACS) managed invasively. However, crossover from radial to femoral access is required in 4-10% of cases and has been associated with worse outcomes. No standardised algorithm exists to predict the risk...

Background Erectile dysfunction (ED) is a prevalent health problem that seriously impacts men's quality of life. The potential treatment of ED by percutaneous approach has emerged with valid angiographic results and a significant improvement in symptoms and quality of life. In addition, cell-based regenerative therapies aiming at enhancing neovascu...

Nowadays, obesity represents one of the most unresolved global pandemics, posing a critical health issue in developed countries. According to the World Health Organization, its prevalence has tripled since 1975, reaching a prevalence of 13% of the world population in 2016. Indeed, as obesity increases worldwide, novel strategies to fight this condi...

Recent clinical and demographical studies on COVID-19 patients have demonstrated that men experience worse outcomes than women. However, in most cases, the data were not stratified according to gender, limiting the understanding of the real impact of gender on outcomes. This study aimed to evaluate the disaggregated in-hospital outcomes and explore...

Background: Penile curvature (PC) can be surgically corrected by plication techniques or Nesbit corporoplasty. These shortening techniques can be complicated by post-operative: penile shortening, recurrent PC, palpable suture knots and erectile dysfunction. Furthermore, Nesbit procedures require the use of a penile tourniquet to avoid intraoperati...

Stenting of coronary bifurcation lesions represents a challenge for the interventional cardiologist. A bifurcation lesion could be treated with several techniques. Therefore, it is of paramount importance to decide the strategical approach at the beginning of the procedure evaluating the patient’s bifurcation anatomy, the angle between main and sid...

Plaque prolapse (PP) is commonly defined as tissue extrusion through the stent strut. It is not a rare event, frequently detected by intravascular ultrasound, and it is associated with stent thrombosis and adverse outcomes. We present a case of PP after stenting of the left anterior descending coronary artery.

In the presence of an equivocal culprit lesion in the context of an acute coronary syndrome, the optical coherence tomography (OCT) scan defines the severity and composition of the plaque, elucidating (as in this pathognomonic case) the mechanism related to plaque rupture. Furthermore, OCT analysis allowed stent implantation with adequate sizing an...

Case Report Treatment of a psuedoaneurysm of the ascending aorta with a new technique using a coronary stent and coils embolization.

Streptococcus bovis/Streptococcus equinus complex (SBSEC) is a group of non-enterococcal group D Streptococci that colonizes both humans and animals. Due to gastrointestinal disease, they can switch in opportunistic pathogens passing through intestinal mucosal barrier and may cause bacteremia and distant organs damage. Despite infective endocarditi...

Erectile dysfunction (ED) has been defined as the inability to attain or maintain penile erection sufficient for successful sexual intercourse. ED carries a notable influence on life quality, with significant implications for family and social relationships. Because atherosclerosis of penile arteries represents one of the most frequent ED causes, p...

Background: The in-hospital management of patients with cardiac implantable electronic devices (CIEDs) changed early in the COVID-19 pandemic. Routine in-hospital controls of CIEDs were converted into remote home monitoring (HM). The aim of our study was to investigate the impact of the lockdown period on CIEDs patients and its influence on in-hos...

Iatrogenic dissection during PCI represents one of the most fearing complication of interventional cardiology, since abrupt hemodynamic instability and patient compromise may occur related to coronary occlusion. In this emergency situation, different hemodynamic support devices and interventional skills, are needed in order to promptly recover the...

Among drug-eluting stents (DESs), the durable polymer everolimus-eluting stent (EES) and resolute zotarolimus-eluting stent (R-ZES) are widely used in clinical practice and have contributed to improve the outcomes of patients undergoing percutaneous coronary intervention (PCI). Few studies addressed their long-term comparative performance in patien...

Background: The extent of arterial disease in patients with erectile dysfunction (ED) non-responsive to intracavernosal injection of Alprostadil is of importance for therapeutic options. However, published evidence, in particular angiographically validated is scarce. Here we investigated arterial lesion patterns in this specific patient cohort by s...

A 52-year-old man with multiple cardiovascular risk factors, including arterial hypertension and diabetes mellitus type II, was referred to our interventional cardiology unit because of a poor response to year-long treatment with different phosphodiesterase type 5 inhibitors (PDE5i) taken for severe erectile disfunction (International Index of Erec...

Objectives and Background Iatrogenic aorto‐coronary dissection (ICD) is one of the most feared complications of interventional cardiology. Although rare, it is characterized by anterograde coronary ischemia and a concomitant aortic dissection, with potentially fatal consequences. Methods We present an example case of IACD and an accurate case‐seri...

Stenting of coronary bifurcation lesions represents a challenge for the interventional cardiologist. A bifurcation lesion could be treated with several techniques. Therefore, it is of paramount importance to decide the strategical approach at the beginning of the procedure evaluating the patient's bifurcation anatomy, the angle between main and sid...

Erectile dysfunction (ED) is defined as the inability to attain or maintain penile erection sufficient for successful sexual intercourse. ED carries a notable influence on quality of life, with significant implications for family and social relationships. Because atherosclerosis of penile arteries represents one of the most frequent causes of ED, p...

HEALTH ECONOMIC EVALUATION OF NEW SECONDARY PREVENTION STRATEGIES: AN ITALIAN PERSPECTIVE

Abstract: Surgical endarterectomy for common femoral artery bifurcation obstructive atherosclerotic disease represents the "gold standard" therapy, with excellent long-term results and minimal complications. On the other hand, recent advances in endovascular therapy have led to a safer and similar effective results, with a potential reduction in ho...

Background: Limb graft occlusion (LGO) is the third reason for hospital readmission after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm. We reviewed the clinical features, incidence, anatomical and devices related predictive factors for LGO after EVAR, and compared them with our experience. Methods: EVAR between 2010-2017 wer...

Rationale: Endovascular treatment of renal artery aneurysms has offered a viable alternative with a high success rate and low procedure-related morbidity and mortality. Patient concerns: A 60-year-old man, having a right renal artery aneurysm involving the main vessel with two arteries (supplying the inferior and superior lobes of the kidney) or...

Objectives Left atrial dissection (LatD) is a rare and heterogeneous condition affecting many cardiovascular areas. The present article, by the means of personal case report illustration and systemic review of different clinical management, is aimed to give to clinicians further knowledge on this controversial topic. Background LatD is an exceedin...

Background Albeit DES might be considered as a breakthrough against neointimal hyperplasia, concerns on stent thrombosis and increase incidence of in-stent restenosis after multiple DES implantations in complex, long lesions still exist. Hereby, we tried to test efficacy and safety of using PEB in long lesions followed by focal BMS implantation in...

Erectile dysfunction (ED) is defined as the inability to get and maintain a sufficient erection to ensure an acceptable sexual activity for the subject and the partner. Although ED does not represent per se a serious disease, it carries a notable and severe influence on quality of life, with significant implications on familiar and social relations...

Background The Cappella Sideguard (CS) sidebranch stent is a self-expanding, thin-strut, nitinol device with anatomic flaring at the sidebranch ostium designed to treat bifurcation lesions. Objective To evaluate the mechanism of long-term lumen patency of the novel, self-expanding CS sidebranch stent compared with a balloon-expandable stent in the...

Objectives: To obtain further, and more focused, information on the efficacy and safety of the antithrombotic regimens, including triple therapy (TT) of warfarin, aspirin, and clopidogrel; dual therapy (DT) of warfarin and single antiplatelet agent (aspirin or clopidogrel); and dual-antiplatelet therapy (DAPT) of aspirin and clopidogrel, prescribe...

I n patients on oral anticoagulation (OAC) undergoing per-cutaneous coronary intervention with stent (PCI-S), triple therapy (TT) of warfarin, aspirin, and clopidogrel is cur-rently recommended throughout the period most vulnerable to stent thrombosis and recurrent coronary events (ie, 1 to 3-6 months) to prevent a major adverse cardiovascular even...

To analyze the effect of paclitaxel-coated balloon (PCB) treatment on patients with drug-eluting stent (DES) restenosis. In the Valentines I trial, treatment of coronary in-stent restenosis was effective and safe with the second-generation DIOR® PCB. Valentines I prospectively enrolled 250 patients with in-stent restenosis (ISR); 76 patients (30.4%...

The role of intraaortic balloon pump (IABP) during percutaneous coronary intervention (PCI) in high-risk acute patients remains debated. Device-related complications and the more complex patient management could explain such lack of clinical benefit. We aimed to assess the impact of transradial versus transfemoral access for PCI requiring IABP supp...

Bifurcations remain a challenging subset for percutaneous coronary intervention (PCI). Specifically, it is unclear whether bifurcations on left anterior descending (LAD) coronary arteries have the same prognosis of bifurcations on left circumflex (LCX) or right coronary arteries (RCA). We compared the results of PCI for bifurcation lesions, focusin...

Objectives We compared the mechanisms of lumen gain after Cappella Sideguard (CS) side branch (SB) bifurcation stent deployment versus a balloon-expandable stent in the corresponding main vessel (MV). Background The novel CS SB bifurcation stent is a self-expanding, thin-strut, nitinol device with anatomic flaring at the SB ostium. Methods In 28 bi...

Objective To evaluate the in-hospital resource consumption and to estimate the costs of patients treated with percutaneous coronary angioplasty at 6 months from the procedure. Design and methods Prospective cohort study. Data from 143 patients enrolled from 13 hospitals across Italy, which participated in the RISICO study, were analyzed. Informati...

Final kissing-balloon inflation is often recommended for percutaneous coronary intervention (PCI) of bifurcation lesions. However, randomized trials focusing on kissing inflation have not confirmed its beneficial impact. We compared outcomes of kissing inflation for PCI of bifurcation lesions, explicitly stratifying results according to stenting st...

The number of percutaneous revascularization procedures performed for symptomatic peripheral arterial disease (PAD) has significantly increased over the past several years. Traditionally, the use of percutaneous techniques were limited to certain anatomic subsets, such as stenosis or focal occlusions, with surgical treatment preferred for more exte...

The implementation of methods of the coronary angioplasty was one of the most important achievement in the field of treatment of coronary artery disease. Abluminal biodegradable polymer stents (BDS) and polymer free stent are the newest and the most promising research concerning coronary stent technology. In this article we discuss the perceived ne...

Background: Percutaneous patent foramen ovale (PFO) closure is accepted as treatment for cryptogenic ischemic stroke/transient ischemic attack in young subjects. However, a thorough evaluation of residual right-to-left shunt (rRLS) after PFO closure is needed. Our aims were to analyze the characteristics related to PFO diagnosis and closure, focus...

For over a decade, coronary angiography has been the gold standard in the appraisal of the coronary anatomy and the diagnosis of coronary artery disease. However, the introduction of percutaneous coronary revascularization, along with increasing evidence of the prognostic importance of atherosclerotic plaque composition, has fostered the concept th...

Endovascular aneurysm repair is becoming the treatment of choice for elderly patients bearing abdominal aortic aneurysms with particular anatomical characteristics. Endovascular grafts are usually oversized to achieve sealing and minimize graft migration, the likelihood of which is also reduced by fixation hooks and barbs in the newer generation gr...

Giant vein graft aneurysms occur infrequently after coronary artery bypass graft surgery and are most often detected incidentally during coronary angiography for suspected angina or as a mediastinal mass on chest radiographs. Hereby, we describe the percutaneous treatment of a huge right coronary artery saphenous vein bypass graft aneurysm by using...

Objective: Severe carotid stenosis is a frequent cause of stroke in both men and women. Whereas several sex-related comparisons are available on coronary atherosclerosis, there are few data appraising gender-specific features of carotid plaques. We aimed to systematically compare the pathology and inflammatory features of carotid plaques in men vs...

Background: Coronary artery disease is most common in older patients, but may occur in younger subjects. The outlook of young patients after percutaneous coronary intervention (PCI) of challenging lesion subsets such as coronary bifurcations, is not established. We thus aimed to appraise the early and long-term results of PCI for bifurcations in y...

Percutaneous patent foramen ovale (PFO) closure is gaining wide acceptance. Aims of the study were to analyse clinical practice regarding PFO closure in Italy, to study indications, devices, results, and the follow-up of large series of patients treated by percutaneous PFO closure.Methods and patientsItalian patent foramen ovale survey (IPOS) is a...

Objectives: The purpose of this study was to assess whether transradial access for ST-segment elevation acute coronary syndrome undergoing early invasive treatment is associated with better outcome compared with conventional transfemoral access. Background: In patients with acute coronary syndrome, bleeding is a significant predictor of worse ou...