Abstract:
AIM:We report our experience of carotid artery stenting (CAS) for the endovascular treatment of significant carotid stenosis over 16 years. MATERIALS AND METHODS:Data of all consecutive patients who came for a significant carotid artery stenosis from January 1st 1999 to August 31st 2015 were retrospectively collected and analyzed. Primary outcomes were the occurrence of death and major cerebrovascular events (MCE) both at 30-day and at long-term. RESULTS:In our experience CAS was a safe and effective technique, with acceptable mortality and neurological complication rates, both at 30 days and in the long term. KEY WORDS:Carotid stenting, Carotid stenosis, Long-term follow-up. :Da più di 50 anni l’endoarteriectomia carotidea (CEA) è stata considerata il trattamento standard per le stenosi carotidee gravi asintomatiche e sintomatiche. Lo stenting carotideo (CAS) è progressivamente emerso negli ultimi 15 anni come alternativa alla chirurgia, specialmente nei pazienti ad alto rischio. Da allora, molti studi clinici randomizzati sono stati pubblicati per valutare la superiorità di un metodo rispetto all’altro, tuttavia i risultati dei trials hanno generato più dubbi che certezze nell’interpretazione dei loro risultati, gravati come sono da diverse limitazioni: la principale riguarda la ridotta competenza endovascolare richiesta per gli operatori che hanno eseguito lo stenting carotideo e partecipato ai trials. Inoltre questi trials sono stati eseguiti circa 10 anni fa, con materiali e farmaci differenti rispetto a quelli usati attualmente. Attualmente i registri su larga scala e le casistiche che riportano risultati a lungo termine sono maggiormente rappresentativi di una esperienza reale, che riflette ciò che accade di routine nella pratica clinica. Nella nostra Unità Operativa di Chirurgia Vascolare, il CAS è stato offerto dal 1999 come alternativa alla CEA per il trattamento delle stenosi carotidee sintomatiche e asintomatiche nei pazienti a rischio moderato-alto. Scopo del nostro lavoro è di riportare la nostra esperienza retrospettiva, con alcuni consigli e suggerimenti che derivano da ciò che abbiamo imparato in più di 16 anni. Abbiamo pertanto raccolto e analizzato retrospettivamente i dati di tutti i pazienti consecutivi che sono venuti per una stenosi carotidea significativa dal 1 ° gennaio 1999 al 31 agosto 2015. I risultati basilari sono stati la mortalità e la morbilità cerebrovascolare maggiore (MCE) sia a 30 giorni che a lungo termine. Lo studio è stato condotto su 1017 pazienti (677 maschi, 66.6%, età media 74 anni, IQR 69-79 anni) trattati sia per stenosi carotidea sintomatica (n=392, 38.5%) che asintomatica. Il successo tecnico è stato raggiunto nel 99% delle procedure. A 30 giorni abbiamo osservato 3 decessi (0.3%) e 12 MCE (1.2%, 7 dei quali minor stroke e 5 stroke maggiori). A 5 e 10 anni, la sopravvivenza è stata rispettivamente dell’86.3%±1.5% e del 73.5%±2.3%, significativamente influenzata dall’età (P=.04), dalla sintomatologia neurologica preoperatoria (P=.04) e da una durata della procedura maggiore di 60 minuti (P =.0017). La libertà da ictus è stata del 97.1%±0.8% a 5 anni e del 91.2%±1.9% a 10 anni rispettivamente per i pazienti asintomatici, e del 95.7%±1.9% a 5 anni e dell’81.7%±5% a 10 anni rispettivamente per i pazienti sintomatici (P=.008). Il verificarsi di MCE è stato significativamente influenzato dalla sintomatologia neurologica preoperatoria (P=.01) e da una durata della procedura maggiore di 60 minuti (P <.001). Nella nostra esperienza il CAS è risultato sicuro ed efficace, con tassi di mortalità e di complicanze neurologiche accettabili, sia a 30 giorni che a lungo termine.
journal_name
Ann Ital Chirjournal_title
Annali italiani di chirurgiaauthors
Nano G,Stegher S,Occhiuto MT,Muzzarelli L,Malacrida G,Mazzaccaro DPsubject
Has Abstractpub_date
2016-01-01 00:00:00pages
502-508eissn
0003-469Xissn
2239-253Xpii
S0003469X16026233journal_volume
87pub_type
杂志文章abstract::Meckel's diverticulum (MD ) is the most common congenital anomaly of the gastrointestinal tract. We revalued clinical records of patients discharged from Unit of Urgent and General Surgery of Highly Specialized Hospital "A.O.R.N. Antonio Cardarelli" of Naples with diagnosis of acute pathology associated to complicated...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2014-03-01 00:00:00
abstract::21 patients (19 women) who underwent rectal prolapse repair were prospectively studied. At the one year follow-up, 6 of the eleven incontinent patients (54 per cent) regained full continence and while three of the remaining 5 patients improved they still referred occasional imperfection of continence. Resting anal pre...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
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更新日期:1994-03-01 00:00:00
abstract::Hereditary spherocytosis (HS) is a common inherited hemolytic anemia caused by a defective erythrocyte cellular membrane. Irrespective of type of surgery performed, several case reports comparing the two type of procedures, have not proven any significant difference between serum bilirubin, serum hemoglobin, red blood...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2018-07-11 00:00:00
abstract:INTRODUCTION:Isolated pancreatic trauma is a rare condition and commonly come up in children or young adults.The poor initial symptoms lead to delay diagnosis and treatment. The treatment of isolated distal pancreatic trauma including the Wirsung's duct is generally distal pancreatectomy. In an emergency setting, splen...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2017-09-12 00:00:00
abstract::Hepatic surgery has been undergoing progressive modifications in surgical approach to liver, passing through tohraco-phrenolaparotomy to bilateral subcostal incision and current Makuuchi's. Laparoscopic liver surgery should not be considered a new surgery, but simply a new surgical approach, with difficulties but adva...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章,评审
doi:
更新日期:1997-11-01 00:00:00
abstract::Anal stenosis is a fibrous narrowing of the anal channel. It develops, in most cases, in the aftermath of proctologic surgical procedures with extensive anoderm excision or in the presence of chronic anal inflammation in patients with Crohn Disease. However rare, this condition is thoroughly debilitating for the patie...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章,评审
doi:
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:Hyperthyroidism is a group of diseases with many different etiologies and clinical manifestations. The most common causes include toxic multi-nodular goiter, Graves' disease and toxic adenoma. The prevalence of thyroid cancer developing in patients with hyperthyroidism has gradually increased in recent years....
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2020-01-01 00:00:00
abstract::The surgery of the thyroid pathologies in Day and/or One-Day-Surgery requires a thorough choice former of the surgery of the patients and the availability of the team specialist that could guarantee an adequate nursing after surgery. The authors describe the advantages and the limits of the short confined to stay in h...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2002-09-01 00:00:00
abstract::Tumors occurring in the retrorectal space are heterogeneous and uncommon. Multiple embryologie remnants derived from a variety of tissues are found in this space and this explains the heterogeneous pathology of cysts and tumors that arise in retrorectal space. Presacral cysts are rare in adults. Most of the lesions ar...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章,评审
doi:
更新日期:2015-06-24 00:00:00
abstract::Breast cancer is a rare, but frequently hidden pathology. A woman, 36 years old, during the early months of pregnancy found a little tumor in her right breast. A fine needle biopsy was negative for cancer. Despite this, the tumor rose and two months after delivery (the patient breast-fed her daughter for a month), she...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2002-05-01 00:00:00
abstract:AIM:To evaluate accuracy of endorectal ultrasonography (ERUS) both in staging and restaging rectal cancer after neoadjuvant chemoradiotherapy treatment. METHODS:In a group of 80 patients with rectal cancer, we retrospectively selected 67 patients and divided in two groups: 41 patients affected by a stage I were invest...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2014-11-01 00:00:00
abstract:AIM:This study aims to verify if the duration of postoperative ileus (POI), in patients undergoing abdominal surgery, is related to the surgical approach used (open or laparoscopic) or rather to the manipulation of bowel loops. MATERIALS AND METHODS:Ninety patients, undergoing elective colon resection for cancer, were...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Gastro Intestinal Stromal Tumors (GISTs) are defined as mesenchymal tumours that develop within the wall of the gastrointestinal tract. Surgery is the treatment of choice and may be indicated for locally advanced or previously non resectable disease after a favorable response to preoperative therapy with tyr...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2016-01-01 00:00:00
abstract::The intraoperative localization of residual parathyroid tissue during re-operations for persistent or recurrent secondary hyperparathyroidism (HPT) could have difficult due to cicatricial phenomena, anatomic modifications, ectopic or super-numerous glands. The use of intraoperative localisatin methods, as ultrasonogra...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2006-11-01 00:00:00
abstract:AIM OF THE STUDY:To define the characteristics of Crohn's disease in the elderly, basing on our own and other Authors' experience. CASISTIC: During last 10 years, 46 patients affected by Crohn's disease were observed at Emergency Surgery Unit of "Vittorio Emanuele" Hospital in Catania (Italy). Of these patients, 4 (8,6...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章,评审
doi:
更新日期:2006-05-01 00:00:00
abstract:INTRODUCTION:The Authors present their experience with laparoscopic total or subtotal colectomy (TC or SC) in three patients operated for intractable chronic slow transit constipation (STC), together with a review of literature. MATERIAL AND METHODS:From July 2005 to July 2009 three young patients affected by STC, aft...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章,评审
doi:
更新日期:2012-03-01 00:00:00
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journal_title:Annali italiani di chirurgia
pub_type: 杂志文章,评审
doi:
更新日期:2016-01-01 00:00:00
abstract::The aim of pancreas and islet transplantation is to establish the same status of glucose control that is provided by endogenous secretion of insulin from a healthy native pancreas in order to improve the quality of life and ameliorate secondary diabetic complications in patients with type I insulin-dependent diabetes ...
journal_title:Annali italiani di chirurgia
pub_type: 社论,评审
doi:
更新日期:2004-01-01 00:00:00
abstract:AIM:The aim of our study was to evaluate the efficacy of a new treatment of recurrent varicose vein after stripping of the great saphenous vein with rigid radiofrequency needles. MATERIAL OF STUDY:37 patients enrolled (11 males and 26 females). 10 patients had recurrent varicose veins for the presence of residual refl...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Acute appendicitis is the most common abdominal emergency. Its etiopathogenesis appears to be multifactorial. Several studies suggested a relationship between the development of acute appendicitis and some environmental factors. Air pollution predisposes some people to develop perforated appendicitis. Howeve...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2018-01-01 00:00:00
abstract:INTRODUCTIONS:Thyroid cancer is the most common endocrine malignancy with an incidence equal to 1% of all malignant tumors. Prognostic factors affecting survival are manifold, including in several classifications (AMES, AGES, CORN and TNM). In this sense, the invasion of adjacent structures is one of the most important...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2012-11-01 00:00:00
abstract:AIM OF THE STUDY:To evaluate the role of nuclear medicine techniques in the management of patients with thymoma. MATERIALS AND METHODS:The Authors performed a review of the literature about the usefulness of traditional nuclear medicine and positron emission tomography in patients with thymic tumours. RESULTS AND DIS...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章,评审
doi:
更新日期:2007-09-01 00:00:00
abstract::Hepatocellular carcinoma mainly affects patients with cirrhosis or with various degrees of fibrosis. From 1979 to 1990, among 87 patients who underwent hepatic resection for non fibrolamellar hepatocellular carcinoma, 12 (14%) had a non fibrolamellar hepatocellular carcinoma developed in a normal liver. There were 8 m...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:1991-11-01 00:00:00
abstract:AIM:Solid pseudopapillary tumor (SPT) of the pancreas is a rare neoplasm, its preoperative diagnosis is difficult and therefore inappropriate therapy or postoperative complications are frequent. Reviewing the literature, the purpose of this article was to identify guidelines to improve diagnosis and treatment of SPT. ...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章,评审
doi:
更新日期:2009-01-01 00:00:00
abstract:INTRODUCTION:Lichtenstein hernia repair made revolutionary progress in hernia treatment. Since that a lot of modifications have been proposed. In a few of them attention is drawn to spermatic cord isolation from a mesh for prevention of spermatic cord involvement into inflammatory process which may lead to disturbances...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:The treatment of acute diverticulitis is a matter of debate and has undergone significant changes. Currently the main focus of surgical treatment is a more conservative and less invasive management. AIMS AND METHODS:To focus the role of surgery in the treatment of acute diverticulitis, the Authors have cond...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章,评审
doi:
更新日期:2019-01-01 00:00:00
abstract::Multiple percutaneous interstitial systems to induce intrahepatic tumor necrosis are classifiable in two major groups: those using chemical agents (ethanol and acetic acid) and those adopting thermal effects (hot saline, radiofrequency, laser and microwave). Indication, technique and results of percutaneous ethanol in...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章,评审
doi:
更新日期:1999-03-01 00:00:00
abstract::The acute acalculous cholecystitis (A.A.C.) is a disease with high rates of morbidity and mortality and risk and promoting factors are very important. Pathogenesis has not completely explained, diagnosis is difficult, and there is no agreement on the more effective therapy. The authors present two cases of A.A.C. and ...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:1997-05-01 00:00:00
abstract::Multiple symmetric lipomatosis (MSL) is a rare condition of the fatty tissue affecting mostly white men between 20 and 65 years old especially in the mediterranean region. The disease is characterized by a massive development of large unencapsulated lipomas mainly located on the subcutaneous tissue of the cervical, de...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章,评审
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更新日期:1999-03-01 00:00:00
abstract::Carotid restenosis is defined as a new > 50% diameter-reducing lesion present in sites of previous surgery. The clinical aspects of this complication are strongly connected with their anatomopathologic evolution: fibromuscular hyperplasia in early recurrent disease, atherosclerotic degeneration in the later lesions. R...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:1997-07-01 00:00:00