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Giovanni Nano

Publications and source records attributed to Giovanni Nano.

At least 19 recordsLinked to original sources
PubMed2006

Ballooning-induced bradycardia during carotid stenting in primary stenosis and restenosis.

INTRODUCTION: We compared the incidence of intraprocedural bradycardia and hypotension during carotid artery stenting in patients with primary carotid artery stenosis and those with prior ipsilateral carotid endarterectomy. METHODS: A total of 213 carotid stenting procedures were performed in our institution in a 4-year period. The mean degree of stenosis was 78% (range 60-99%). Of these 213 procedures, 43 were performed for carotid restenosis, 9 after stenting and 34 after endarterectomy, and 170 for primary stenosis. Atropine was selectively administrated if patients suffered bradycardia (a decrease in heart rate to <50% or an absolute heart rate of <40 bpm) or hypotension (systolic blood pressure <90 mmHg). We compared the group of patients with primary stenosis (n=170) and the group of patients with restenosis after carotid endarterectomy (n=34) in relation to intraprocedural hypotension or bradycardia/need for atropine administration. RESULTS: Hypotension occurred in 49 patients with primary stenosis and 2 patients with restenosis. The difference was statistically significant. Atropine was administered for bradycardia to 58 patients with primary stenosis and 3 patients with restenosis. The difference was statistically significant. CONCLUSION: Intraprocedural bradycardia and hypotension occur more frequently in patients with primary carotid artery stenosis.

Aged↗
PubMed2006

Endovascular techniques for the treatment of ruptured abdominal aortic aneurysms: 7-year intention-to-treat results.

OBJECTIVES: The purpose of this single-institution study was to describe our 7-year intention-to-treat results, obtained with the use of endovascular techniques for the treatment of ruptured abdominal aortic aneurysms (rAAA). PATIENTS AND METHODS: From October 1998 until March 2005, a total of 28 patients were admitted or transferred to our department with an rAAA. They were all treated according to a management protocol of intention-to-treat with endovascular techniques. Twenty of the patients received endovascular treatment and the remaining 8 underwent an open surgery procedure. RESULTS: The mortality rate of the endovascularly treated patients was 40% (8 in 20), whereas of the 8 surgical patients 3 survived (mortality = 62.5%). The overall mortality rate of the 28 patients admitted with an rAAA was 46.4% (13 of 28 patients). CONCLUSIONS: In our experience the intension-to-treat protocol for rAAA offered acceptable results in terms of mortality rates. Multi-center studies are necessary to establish the role of endovascular treatment in patients with rAAA.

Aortic Aneurysm, Abdominal↗
PubMed2006

Endovascular repair of an abdominal aortic aneurysm in a patient with horseshoe kidney: report of a case.

A horseshoe kidney poses special problems during treatment of an abdominal aortic aneurysm (AAA), and there is much controversy about the most suitable method of repair. We report the case of a 65-year-old man with a horseshoe kidney, in whom an AAA was treated with a unibody bifurcated endograft. During the procedure, the two anomalous renal arteries were sacrificed. Although there was transient elevation of the creatinine levels, the patient was discharged with normal renal function and no endoleak from the accessory renal arteries. Thus, when two normal and two accessory renal arteries arise from the non-aneurysmatic proximal aortic neck, providing that preoperative kidney function is normal, it seems that the treatment can be safely carried out using an endovascular technique and excluding the accessory renal arteries. This case supports the feasibility of endovascular surgery for the treatment of AAA in the presence of a horseshoe kidney.

Aged↗
PubMed2006

Sac enlargement due to seroma after endovascular abdominal aortic aneurysm repair with the Endologix PowerLink device.

A patient who had undergone endovascular repair of an abdominal aortic aneurysm with the Endologix PowerLink bifurcated system presented with delayed aortic aneurysm enlargement due to assumed endotension. He was treated with aortic sac evacuation and wrapping of the endograft. This is the first report of endotension and aneurysm sac enlargement after implantation of the PowerLink endograft.

Aged↗
PubMed2006

Endovascular treatment of the descending thoracic aorta in a patient with a hydatid pseudoaneurysm.

We present a patient affected by systemic hydatidosis with an unusual localization in the thoracic aorta. The pseudoaneurysm, which was treated 8 years ago with conventional surgery, was retreated with an endovascular procedure. The particular evolution of the pathology needed further endovascular intervention. Endovascular exclusion is not the final solution of the disease but protects against rupture of the vessel and systemic dissemination of the disease.

Aneurysm, False↗
PubMed2006

False endoleak image.

Explore the source record for details and available documents.

Aortic Aneurysm, Abdominal↗
PubMed2005

Thrombolytic therapy followed by stenting for renal artery dissection secondary to blunt trauma.

A 18-year-old man presented at our clinic with pain in the right flank following a motorbike accident. The diagnosis of renal artery dissection followed by thrombosis was made by computed tomography and confirmed by angiography. Successful revascularization was performed by means of repeated transcatheter injection of small doses of thrombolytic agents within the vessel, followed by deployment of a self-expandable stent. There were no complications, and the patient recovered well. Six months after stent placement, a selective renal angiogram showed excellent flow through the stented portion of the artery and normal parenchyma enhancement in the right kidney.

Adult↗
PubMed2005

Bronchoesophageal fistula after endovascular repair of ruptured aneurysm of the descending thoracic aorta.

Aortoesophageal fistula secondary to thoracic aneurysm is rare and is usually fatal without prompt surgical intervention. A 79-year-old man with significant comorbidities and previous cancer surgery was admitted on an emergency basis because of the suspicion of a ruptured thoracic aortic aneurysm. Computed tomographic scan followed by angiography demonstrated a ruptured thoracic aneurysm with aortoesophageal fistula. An endovascular stent graft repair was performed with successful exclusion of both aneurysm and fistula. On postoperative day 6, dyspnea and an isolated episode of hemoptysis occurred. Endoscopy revealed the presence of a bronchoesophageal fistula, which necessitated double exclusion of the esophagus and feeding jejunostomy. At 6 months, clinical, bronchoscopic, and computed tomographic scan follow-up showed complete sealing of the aneurysm and resolution of the bronchoesophageal fistula. At 9 months, the patient was still alive but refused to undergo substernal gastric bypass in an attempt to restore oral feeding. Endovascular repair seems promising as an emergent and palliative treatment of aortoesophageal fistula. To the best of our knowledge, this is the first case in which a bronchoesophageal fistula developed after successful endovascular repair of aortoesophageal fistula. The pathogenesis of this complications remains unclear.

Aged↗
PubMed2005

A variant deployment technique for the powerlink bifurcated endograft.

PURPOSE: To report an alternative technique to the dual-lumen catheter for deployment of the Powerlink stent-graft in patients with angulated sacs and calcified aortic bifurcations. A maneuver is also presented to retrieve the delivery system when it is snagged on the stent. TECHNIQUE: After cutdown of the right common femoral artery (CFA), a 9-F introducer sheath is placed percutaneously into the left CFA. A gooseneck catheter is introduced from the right CFA to capture a 0.035-inch hydrophilic guidewire inserted from the left. A 5-F straight catheter is passed over this guidewire from the left to the right CFA. In angulated aneurysm sacs, a 5-F Hunter catheter is introduced from the right femoral access to support a guidewire through the aneurysm to the suprarenal aorta. Then the guidewire is exchanged with a 0.035-inch Amplatz extra stiff wire, and the Hunter catheter is removed. In other cases, a 0.035-inch Amplatz extra stiff guidewire is placed up to the suprarenal aorta. The endograft delivery system is then deployed in the usual manner. A gooseneck snare is also useful in retrieving the delivery system when it is snagged on the stent at the endograft bifurcation. CONCLUSIONS: This variant technique facilitates the deployment of the Powerlink stent-graft when faced with angulated aneurysms or acute and calcified aortic bifurcations. A gooseneck catheter is helpful in retrieving the delivery system's "olive" after endograft placement.

Aortic Aneurysm, Abdominal↗
PubMedDate not supplied

Endovascular treatment of the carotid stump syndrome.

In patients with an occluded internal carotid artery, the carotid stump syndrome is a potential source of microemboli that pass through the ipsilateral external carotid artery and the ophthalmic artery to the territory of the middle cerebral artery. Thus, the syndrome is associated with carotid territory symptoms although the internal carotid artery is occluded. Surgical exclusion of the internal carotid artery associated with endarterectomy of the external carotid artery has been described as the gold standard of treatment by many authors. This report is the second case, to our knowledge, of endovascular treatment of the carotid stump syndrome with the use of a stent-graft.

Aged↗
PubMedDate not supplied

Dual antiplatelet regime versus acetyl-acetic acid for carotid artery stenting.

Carotid artery stenting has been proposed as an option treatment of carotid artery stenosis. The aim of this single-institution study is to compare the dual-antiplatelet treatment and heparin combined with acetyl-acetic acid, in patients who underwent carotid artery stenting. We compared 2 groups of 50 patents each who underwent carotid artery stenting for primary atherosclerotic disease. Group A received heparin for 24 h combined with 325 mg acetyl-acetic acid and group B received 250 mg ticlopidine twice a day combined with 325 mg acetyl-acetic acid. Outcome measurements included 30-day bleeding and neurological complications and 30-day thrombosis/occlusion rates. The neurological complications were 16% in group A and 2% in group B (p < 0.05). Bleeding complications occurred in 4% in group A and 2% in group B (p > 0.05). The 30-day thrombosis/occlusion rate was 2% in group A and 0% in group B (p > 0.05). Dual antiplatelet treatment is recommended in all patients undergoing carotid artery stenting.

Aged↗
PubMedDate not supplied

Endovascular treatment of ruptured iliac aneurysm previously treated by endovascular means.

A patient with a ruptured iliac aneurysm was admitted to the Emergency Department in hypovolemic shock. He had previously undergone surgical treatment for an infrarenal abdominal aortic aneurysm, which was managed with a terminal-terminal Dacron tube graft. Subsequently, he developed two iliac aneurysms, which were treated endovascularly with two wall-grafts in the right and one wall-graft in the left iliac arteries. He suffered chronic renal failure and arterial hypertension. Contrast-enhanced computed tomography showed rupture of the right iliac aneurysm and dislocation of the two wall-grafts. He was treated in an emergency situation with the implantation of an iliac endograft that bridged the two wall-grafts, which resulted in hemostasis and stabilization of his condition. Five days later, in an elective surgical situation, he was treated with the implantation of an aorto-uni-iliac endograft combined with a femoral-femoral bypass. He was discharged 5 days later in good condition. At the 4 year follow-up visit, the endoprosthesis remained in place with no evidence of an endoleak. In conclusion, overlapping of endografts should be avoided, if possible. Strict surveillance of the endovascularly treated patient remains mandatory.

Aged↗
PubMedDate not supplied

Endovascular treatment of a renal artery branch aneurysm.

A 58-year-old woman was admitted to our institution because of a left renal artery branch saccular aneurysm with a 2 cm diameter. Due to a hostile abdomen and the infrarenal location, an endovascular approach was chosen. A Jostent Peripheral Stent-Graft was placed under angiographic control, excluding the aneurysm from the circulation. No peri- or postprocedural complications were observed. At 6 months follow-up, the endograft is patent, excluding the aneurysm. Endovascular treatment may represent an alternative to surgery, especially in the distal infraparenchymal location.

Aneurysm↗
PubMedDate not supplied

Stent explantation from an arteriovenous fistula for hemodialysis: a case report.

Percutaneous transluminal angioplasty is the first treatment of a dysfunctional vascular access for hemodialysis. A case of stenting of a native arteriovenous hemodialysis fistula is reported that was treated with a stent placement at the anastomosis level, with explantation of the stent after complete thrombosis of the fistula 48 hours after the procedure. It is preferable to treat arteriovenous fistulas with simple balloon dilatation, avoiding stenting of the fistula, especially in the anastomosis site.

Adult↗