Biomedical subjects

Giannignazio Luigi Carbone

Publications and source records attributed to Giannignazio Luigi Carbone.

3 recordsLinked to original sources

PubMed2004

Axillary artery access for interventional procedures.

PURPOSE: To evaluate axillary artery access for the interventional treatment of carotid or splanchnic arteries that have angulated takeoff or complex anatomy when larger catheters (up to 9 F) are needed. TECHNIQUE: The axillary artery approach was used to treat the left internal carotid artery (ICA) in 3 patients (2 angulated takeoffs and 1 bovine arch) and a celiac axis aneurysm. An 8-F, 45-cm-long introducer sheath was inserted for the carotid procedures, whereas a 9-F, 90-cm sheath was chosen for the celiac aneurysm. Cerebral protection and stenting were successfully performed in all carotid patients; an 8x40-mm stent-graft was implanted to exclude the celiac artery aneurysm. An 8-F vascular closure device was used in the axillary arteries; hemostasis was immediate, and no hematoma or other complications were recorded in follow-up. CONCLUSIONS: This preliminary experience revisits the axillary approach as an alternative access route for interventional procedures. In association with a vascular closure device, this approach should be considered as a useful and safe option for those interventional procedures in which larger sheaths or catheters are required to cope with difficult arterial anatomies.

Aneurysm↗

PubMed2003

Echocardiographic assessment of overt or latent unexplained pulmonary hypertension.

Primary (idiopathic or unexplained) pulmonary hypertension is a rare disease of the pulmonary vasculature characterized by sustained elevation of pulmonary artery pressure, normal pulmonary artery wedge pressure and absence of secondary causes. Because of the nonspecific nature of early symptoms and physical findings, the diagnosis, essentially one of exclusion, is often made in the later stages of primary pulmonary hypertension. Echocardiography, providing an accurate noninvasive estimate of pulmonary pressure at rest and during exercise, is an essential component in the initial assessment and serial evaluation of patients with primary pulmonary hypertension. Furthermore, it is important to monitor the efficacy of specific therapeutic interventions, to estimate the prognosis and to detect preclinical stages of this disease.

Echocardiography↗

PubMed2003

[Unstable carotid plaque: biochemical and cellular marker of vulnerability].

Stroke is the second most common cause of death in developed countries. Carotid plaque disruption and distal embolization of atheromatous debris are the most common pathogenic mechanisms for cerebral ischemia from carotid atherosclerotic disease. Morphologic composition of the atherosclerotic plaque, rather than the stenotic severity, appears to be central in determining the risk of both plaque rupture and subsequent thrombosis. Histologic features of vulnerable plaques include a large lipid core, a thin fibrous cap, intraplaque hemorrhage, and an increased number of inflammatory cells, mostly monocyte-macrophages. Due to the catastrophic implications of thrombus formation and embolization on the arterial plaque, detection before major neurologic events occur is now a major goal of cardiovascular clinicians and researchers. New detection imaging techniques such as intravascular thermography, optical coherence tomography, photonic spectroscopy, and elastography have been developed in order to document atherosclerotic lesion composition. This review will focus on the new possibilities under investigation for vulnerable atherosclerotic carotid plaque detection by means of the serologic markers of plaque instability. New markers, such as pregnancy-associated protein A, P-selectin, interleukin-6 and interleukin-12, metalloproteinases, lipoprotein(a), and oxidation products have been reviewed. Most of the promising serologic markers in this article are still in a nascent phase of development and remain to be validated in clinical settings. However, these biohumoral markers, and their potential combination of techniques, may hold promise for the future characterization of the vulnerable plaque and moreover of the vulnerable patient.

Biomarkers↗