Marco Artico’s research while affiliated with Sapienza University of Rome and other places

Background: The basal vein of Rosenthal (BVR) is a venous structure in the deep cerebral venous system. It plays an important role in cerebral hemorrhages, particularly subarachnoid hemorrhages and perimesencephalic hemorrhages. The aim of this paper was to evaluate the BVR’s anatomical and functional classification and its role in various clinical situations. Aim of the study: The review was conducted from inception to September 27, 2024. It was made according to the PRISMA Statement 2020 and using the following databases: Scopus, Pubmed and Web of Science. Studies were considered eligible if they provided precise data and information on the anatomical variation of the basal vein of Rosenthal. The quality assessment was assessed using the Newcastle-Ottawa Quality Assessment Scale. Materials and methods: A total of 12 articles, whose studies were conducted in different countries were included. Data on the classification of the basal vein of Rosenthal, surgical or radiological, and the outcome, mainly haemorrhagic, were reported. BVR type b or c correlates with increased venous fragility and an outcome of idiopathic haemorrhage. Conclusions: The anatomical classification of the BVR highlights the importance of careful surgical planning and prophylactic measures while providing valuable insights into idiopathic cerebral hemorrhages.

Background: The genitofemoral nerve is the most variable nerve of the lumbar plexus, in terms of its course and bifurcation, thus it must be taken into consideration during extended pelvic lymph node dissection. Its borders, during robotic, laparoscopic or open radical prostatectomy for intermediate or high-grade prostate cancer, have long been defined and must be usually respected; the genitofemoral nerve represents the extended pelvic lymph-node dissection lateral boundary and may vary from case to case putting its integrity at risk. Materials and methods: For the first time, here the authors report genitofemoral nerve branching pattern data obtained extended pelvic lymph node dissection during videolaparoscopic radical prostatectomyand propose a further sub-classification to identify the exact genitofemoral nerve bifurcation point in correlation with the injury risk. Results: The surgical results show the prevalence of a genitofemoral nerve originating as a single trunk which divides into two branches and highlight how this condition occurs at external iliac artery upper third in more than 75% of cases. Furthermore, at the femoral canal inlet the genitofemoral nerve two branches were mainly seen lying laterally sided and below the external iliac artery, or in the middle of external iliac artery and external iliac vein. Conclusions: Knowledge and recognition of the genitofemoral nerve course and bifurcation points deduced from the extended pelvic lymph node dissection and, in any case, applicable to all major pelvic surgery, can prove helpful in avoiding iatrogenic nerve injuries during extended pelvic lymph node dissection.

Background Laparoscopic cholecystectomy is the gold standard in the treatment of symptomatic gallstones. The large number of gallbladders removed every year is not fully consistent with the excessively high incidence of iatrogenic bile duct injury (IBDI). Several strategies have been suggested to reduce this risk. Among them, the use of extra biliary anatomic structures, such as the Rouvière’s sulcus, as a landmark to guide the surgeon during dissection has been proposed as a means to prevent IBDI. The main aim of the present paper is the evaluation of the prevalence of Rouvière’s sulcus (RS) and its anatomic variants in a given population. Materials and Methods This observational, cross-sectional, and multicenter study has been conducted at the Department of Digestive and Emergency Surgery of the “Azienda Ospedaliera Santa Maria,” Terni (Italy), at the Department of Surgical Sciences of the “Azienda Ospedaliera Perugia,” Perugia (Italy) and at the Department of Emergency and Trauma Surgery of the “Policlinico Umberto I,” Rome (Italy). Intraoperative images of 111 patients undergoing laparoscopic cholecystectomy were analyzed to identify the presence and type of RS, according to the Singh-Prasad classification and the Dahmane classification. Results RS was present in 93 (83.8%) patients. Singh-Prasad type 1A is present in 48.4% of patients, type 1B in 25.8%, type 2 in 12.9% and type 3 in 12.9%. Dahmane’s open type is present in 48.4% of patients and fused type in 51.6%. Conclusion Due to its high prevalence, RS can be used as an anatomic landmark and probably reduces the incidence of IBDI during laparoscopic cholecystectomy.

This article offers for the first time a facial approximation of the Ancient Egyptian Pharaoh Amenhotep III (reigned ca. 1388–1351 BC) based on photographic material of his mortal remains and anthropometric data collected at the time, and by adopting a novel technique previously used in similar research by our team. A comprehensive discussion of the mummy attributed to Pharaoh Amenhotep III is also annexed to the study, focusing on the bioarcheological and embalming aspects.

Objectives: Our objective was to investigate the prevalence of macular complications detected by spectral-domain optical coherence tomography (SD-OCT) in a large Caucasian cohort of RP patients, highlight the major alterations in chorioretinal structure, and compare the macular structural changes in eyes affected by retinal dystrophies with those in healthy controls. Methods: This was an observational, retrospective, and cross-sectional study. Three hundred and seven patients with RP were consecutively enrolled and underwent clinical assessment. In particular, SD-OCT images were used to ascertain the morphology of the posterior pole of patients with RP by evaluating the residual ellipsoid zone (EZ), the volume and thickness of the outer nuclear layer (ONLT), and subfoveal choroid thickness (SCT). At the same time, the pathological finding that the patients’ vision was reduced under treatment was analyzed. Results: A total of 436 eyes of 218 patients with RP were studied. Considering all of the eyes studied, 103 had cystoid macular edema (CME) (23.62%), 123 (28.21%) had vitreomacular traction (VMT), and 199 (45.75%) had epiretinal membranes (ERMs). There were also 12 (2.75%) cases of lamellar macular holes (LMHs), of which 3 (1.38% of all patients) cases were bilateral. Only 137 eyes (31.42%) did not have the above-mentioned alterations. SCT was significantly reduced compared to that of the control group (193.03 µm ± 67.90 SD vs. 295 µm ± 69.04 SD), while the foveal central macular thickness (FCMT) was greater (270.91 μm ± 74.04 SD vs. 221 µm ± 37.25 SD). Conclusions: This research highlights the high incidence of macular complications. The results of our study indicate the importance of regular monitoring of RP patients and early intervention to avoid further complications in this group of subjects with severe visual field impairment to avoid further central vision loss.

Background To assess the prevalence of spectral domain-optical coherence tomography (SD-OCT) macular findings in patients affected by retinitis pigmentosa (RP), and to compare choroidal and macular structural changes in eyes affected by retinal dystrophies with healthy controls. Observational, retrospective, and cross-sectional study. Three hundred seven patients with RP were consecutively enrolled and underwent clinical assessment. In particular, the SD-OCT images were used to ascertain the morphology of the posterior pole of patients with RP by evaluating the residual ellipsoid zone (EZ), volume and thickness of the outer nuclear layer (ONL), and subfoveal choroid thickness (SCT). At the same time, the pathological findings that reduce the vision of the patients under treatment were analyzed, such as cystoid macular edema (CME), lamellar macular hole (LMH), vitreomacular traction (VMT), epiretinal membranes (ERM), and the presence of full-thickness macular hole (FTMH). Results Four hundred thirty-six eyes of 218 patients with RP were studied. The mean age was 52.17 years (±17.25 SD). The mean of foveal central macular thickness (FCMT) was 270.91 µm (± 74.04 SD). The macular overall area was divided into four sections and for each section thickness and volume were noted. Considering all eyes, 103 had CME (23.62%), whose 37 (16.97% of all patients) were bilateral; 123 (28.21%) of the eyes had VMT and 36 (16.51% of all patients) of them were bilateral; ERM were found in 199 (45.75%) eyes and in 67 (30.73% of all patients) cases were bilateral. There were also found 12 (2.75%) cases of LMH, whose 3 (1.38% of all patients) cases were bilateral. Only 137 eyes (31.42%) didn’t have the alterations described above. SCT was significantly reduced compared to that of the group of control (193.03 µm ± 67.90 SD vs. 295 um ± 69.04 SD); while FCMT was higher (270.91 µm ± 74.04 SD vs. 221 um ± 37,25 SD). Conclusions The causes of the pathologies found are discussed after a careful evaluation of the most recent international scientific bibliography. The structural tests, in addition to the objective, subjective, and psychophysical ones, will be very useful for the monitoring and treatment of patients affected by a serious tapeto-retinal rare hereditary disease, currently the most widespread in the world.

https://www.thelancet.com/journals/landia/article/PIIS2213-8587(24)00185-2/fulltext

Objectives The aim of this study was to investigate the retinal morpho‐functional characteristics of patients with neovascular wet age‐related macular degeneration (nAMD) treated with intravitreal injection (IV) of aflibercept (AFL). Methods The study was conducted on 35 patients previously diagnosed with type 1 nAMD who received a fixed‐dosing regimen of aflibercept injections over 12 months. The goal was to assess trends in visual abilities over time by measuring visual acuity (VA), contrast sensitivity (CS), visual evoked potentials (VEPs), and spectral domain‐optical coherence tomography (SD‐OCT). The same psychophysical, electro‐functional, and morphological tests administered at baseline (T0) were repeated 4 to 8 weeks after the last aflibercept injection (Tn), resulting in a total of six examinations. Results At Tn, all subjects exhibited improved VA for both far and near distances compared to values detected at T0. Similarly, VEP amplitude and latency values at Tn showed a greater P100 improvement than those observed at T0. Additionally, the CS examination at Tn demonstrated improvement, particularly at high spatial stimulation frequencies. The Tn SD‐OCT results highlighted a reduction in macular thickness compared to T0 values. Conclusions This exploratory research indicates that intravitreal injections of AFL, following a fixed‐dosing regimen, represent a valuable therapeutic approach for enhancing visual performance. This conclusion is supported by comprehensive statistical analysis of psychophysical, electro‐functional, and morphological examinations within the same group of patients with nAMD, as demonstrated for the first time.