Faggioli, Gianluca
https://orcid.org/0000-0002-0768-245X
Mayo Clinic
IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola
Citations 2
Outcomes of Elective and Non-elective Fenestrated-branched Endovascular Aortic Repair for Treatment of Thoracoabdominal Aortic Aneurysms
Dias‐Neto, Marina , Vacirca, Andrea , Huang, Ying , Baghbani‐Oskouei, Aidin , Jakimowicz, Tomasz , Mendes, Bernardo C. , Bertoglio, Luca , Gargiulo, Mauro , Dias, Nuno , Schanzer, Andres , Gasper, Warren J. , Mani, Kevin , Timaran, Carlos H. , Schneider, Darren B. , Pedro, Luís Mendes , Tsilimparis, Nikolaos , Sweet, Matthew P. , Eagleton, Matthew J. , Khashram, Manar, Jama, Katarzyna , Panuccio, Giuseppe , Rohlffs, Fiona, Chiesa, Roberto , Kahlberg, Andrea , Schurink, Geert Willem H. , Lemmens, Charlotte , Karelis, Angelos , Parodi, Ezequiel, Habib, Mohammed , Cólon, Jesus Porras, Pavarino, Felipe, Baig, Mirza S. , Crawford, Sean A. , Garcia, Rita , Ribeiro, Tiago , Alves, Gonçalo, Gonçalves, Frederico Bastos , Kappe, Kaj O. , Knippenberg, Samira Elize Mariko van , Tran, Bich L. , Gormley, Sinead , Oderich, Gustavo S. , Baghbani, Aidin , Panuccio, Giuseppe , Dias-Neto, Marina , Schneider, Darren B , Kölbel, Tilo , Sobocinski, Jonathan , Mees, Barend M.E. , Dias, Nuno , Beck, Adam W , Farber, Mark , Haulon, Stéphan , Ferreira, Emília, Yeung, Kak Khee , Khashram, Manar , Rohlffs, Fiona , Mésnard, Thomas , Gallitto, Enrico , Faggioli, Gianluca , Gomes, Vivian Carla , Wanhainen, Anders , Habib, Mohammed, Colon, Jesus Porras, Baig, Mirza S., Melo, Ryan Gouveia e , Zettervall, Sara L , Oderich, Gustavo S.
Annals of Surgery | July 3, 2023 | Volume: 278 | Issue: 4 | Pages: 568-577
Objective: To describe outcomes after elective and non-elective fenestrated-branched endovascular aortic repair (FB-EVAR) for thoracoabdominal aortic aneurysms (TAAAs). Background: FB-EVAR has been increasingly utilized to treat TAAAs; however, outcomes after non-elective versus elective repair are not well described. Methods: Clinical data of consecutive patients undergoing FB-EVAR for TAAAs at 24 centers (2006–2021) were reviewed. Endpoints including early mortality and major adverse events (MAEs), all-cause mortality, and aortic-related mortality (ARM), were analyzed and compared in patients who had non-elective versus elective repair. Results: A total of 2603 patients (69% males; mean age 72±10 year old) underwent FB-EVAR for TAAAs. Elective repair was performed in 2187 patients (84%) and non-elective repair in 416 patients [16%; 268 (64%) symptomatic, 148 (36%) ruptured]. Non-elective FB-EVAR was associated with higher early mortality (17% vs 5%, P<0.001) and rates of MAEs (34% vs 20%, P<0.001). Median follow-up was 15 months (interquartile range, 7–37 months). Survival and cumulative incidence of ARM at 3 years were both lower for non-elective versus elective patients (50±4% vs 70±1% and 21±3% vs 7±1%, P<0.001). On multivariable analysis, non-elective repair was associated with increased risk of all-cause mortality (hazard ratio, 1.92; 95% CI] 1.50–2.44; P<0.001) and ARM (hazard ratio, 2.43; 95% CI, 1.63–3.62; P<0.001). Conclusions: Non-elective FB-EVAR of symptomatic or ruptured TAAAs is feasible, but carries higher incidence of early MAEs and increased all-cause mortality and ARM than elective repair. Long-term follow-up is warranted to justify the treatment.
Comparison of Recent Practice Guidelines for the Management of Patients With Asymptomatic Carotid Stenosis
Paraskevas, Kosmas I. , Mikhailidis, Dimitri P. , Ascher, Enrico, Baradaran, Hediyeh , Bokkers, Reinoud P.H. , Cambria, Richard P., Comerota, Anthony J. , Dardik, Alan , Davies, Alun H. , Faggioli, Gianluca , Fraedrich, Gustav , Geroulakos, George , Gloviczki, Péter , Golledge, Jonathan , Gupta, Ajay , Ježovnik, Mateja K. , Kakkos, Stavros K. , Katsiki, Niki , Knoflach, Michael , Kooi, M. Eline , Lavenson, George S., Loftus, Ian , Millon, Antoine , Poredoš, Pavel , Proczka, Robert M. , Riles, Thomas S., Saba, Luca , Schlachetzki, Felix , Silvestrini, Mauro , Spinelli, Francesco , Stilo, Francesco , Suri, Jasjit S. , Zeebregts, Clark J. , Jezovnik, Mateja K , Katsiki, Niki , Pini, Rodolfo , Poredos, Pavel , Svetlikov, Alexei V , Paraskevas, Kosmas I , Davies, Alun H , Kooi, Marianne Eline , Antignani, Pier Luigi , Eckstein, Hans‐Henning , Fernandes, José Fernandes e , Lanza, Gaetano A , Liapis, Christos D. , Mansilha, Armando , Nicolaides, Andrew , Ricco, Jean‐Baptiste , Ringleb, Peter Arthur , Rundek, Tatjana , Saba, Luca , Sultan, Sherif A. H. , Suri, Jasjit S. , Chaturvedi, Seemant , Gloviczki, Péter
Angiology | April 12, 2022 | Volume: 73 | Issue: 10 | Pages: 903-910
Despite the publication of several national/international guidelines, the optimal management of patients with asymptomatic carotid stenosis (AsxCS) remains controversial. This article compares 3 recently released guidelines (the 2020 German–Austrian, the 2021 European Stroke Organization [ESO], and the 2021 Society for Vascular Surgery [SVS] guidelines) vs the 2017 European Society for Vascular Surgery (ESVS) guidelines regarding the optimal management of AsxCS patients. The 2017 ESVS guidelines defined specific imaging/clinical parameters that may identify patient subgroups at high future stroke risk and recommended that carotid endarterectomy (CEA) should or carotid artery stenting (CAS) may be considered for these individuals. The 2020 German–Austrian guidelines provided similar recommendations with the 2017 ESVS Guidelines. The 2021 ESO Guidelines also recommended CEA for AsxCS patients at high risk for stroke on best medical treatment (BMT), but recommended against routine use of CAS in these patients. Finally, the SVS guidelines provided a strong recommendation for CEA+BMT vs BMT alone for low-surgical risk patients with >70% AsxCS. Thus, the ESVS, German–Austrian, and ESO guidelines concurred that all AsxCS patients should receive risk factor modification and BMT, but CEA should or CAS may also be considered for certain AsxCS patient subgroups at high risk for future ipsilateral ischemic stroke.