PubMed Health⌕ Search

Biomedical subjects

Giorgio M Biasi

Publications and source records attributed to Giorgio M Biasi.

7 recordsLinked to original sources
PubMed2006

Rationale and design of a multidisciplinary national real-world registry on carotid stenting: the Italian Registry for Carotid Stenting (RISC).

The Registro Italiano per lo Stenting Carotideo (RISC, Italian Registry for Carotid Stenting) has been organized by Italian specialists from different disciplines directly involved in the prevention of stroke due to carotid plaques through stenting of carotid lesions. The Registry has been endorsed by the national societies of 4 different specialties: vascular surgery, interventional cardiology, radiology, and neuroradiology. Each society contributed in the planning stage. The basis for the registry is to collect data on carotid stenting procedures performed by different specialists with different techniques in a "real-world" setting without the limitations of a randomized clinical trial. The Registry was funded to enroll at least 1200 patients over a minimum period of 36 months. The results will be analyzed using the intention-to-treat principle and are anticipated in late 2006. Primary endpoints of the registry are the 30-day combined death and stroke rate and the occurrence of restenosis and ipsilateral neurological deficit at 12 and 24 months. Considerable attention has been paid to the registry's quality control program to ensure scientific validation. An online database facilitates the collection of data with speed and accuracy.

Carotid Stenosis↗
PubMed2004

Carotid plaque echolucency increases the risk of stroke in carotid stenting: the Imaging in Carotid Angioplasty and Risk of Stroke (ICAROS) study.

BACKGROUND: Carotid artery stenting (CAS) has recently emerged as a potential alternative to carotid endarterectomy. Cerebral embolization is the most devastating complication of CAS, and the echogenicity of carotid plaque has been indicated as one of the risk factors involved. This is the first study to analyze the role of a computer-assisted highly reproducible index of echogenicity, namely the gray-scale median (GSM), on the risk of stroke during CAS. METHODS AND RESULTS: The Imaging in Carotid Angioplasty and Risk of Stroke (ICAROS) registry included 418 cases of CAS collected from 11 international centers. An echographic evaluation of carotid plaque with GSM measurement was made preprocedurally. The onset of neurological deficits during the procedure and the postprocedural period was recorded. The overall rate of neurological complications was 3.6%: minor strokes, 2.2%, and major stroke, 1.4%. There were 11 of 155 strokes (7.1%) in patients with GSM < or =25 and 4 of 263 (1.5%) in patients with GSM >25 (P=0.005). Patients with severe stenosis (> or =85%) had a higher rate of stroke (P=0.03). The effectiveness of brain protection devices was confirmed in those with GSM >25 (P=0.01) but not in those with GSM < or =25. Multivariate analysis revealed that GSM (OR, 7.11; P=0.002) and rate of stenosis (OR, 5.76; P=0.010) are independent predictors of stroke. CONCLUSIONS: Carotid plaque echolucency, as measured by GSM < or =25, increases the risk of stroke in CAS. The inclusion of echolucency measured as GSM in the planning of any endovascular procedure of carotid lesions allows stratification of patients at different risks of complications in CAS.

Aged↗
PubMed2004

What have we learned from the Imaging in Carotid Angioplasty and Risk of Stroke (ICAROS) study?

Carotid artery stenting (CAS) is used widely to treat carotid lesions. Indication to CAS is mostly based, both in trial and in clinical practice, on the percentage of stenosis and the presence or absence of preprocedural neurologic symptoms, whereas the features of the plaque are somehow disregarded and ignored. The most severe complication of CAS is stroke, related to cerebral embolization from carotid plaque. Several studies showed that echolucent plaques generate a higher number of embolic particles following carotid stenting. Echolucency can be measured using the gray scale median, which is an objective and quantitative computer-assisted grading of the echogenicity of carotid plaques. As previously demonstrated in the ICAROS study, carotid plaque echolucency is an independent risk factor for stroke in carotid stenting. Carotid plaque echolucency is one of the parameters that should be mandatory to be considered for indication to treatment.

Angioplasty, Balloon↗
PubMed2002

Nine-year experience of bovine pericardium patch angioplasty during carotid endarterectomy.

PURPOSE: This paper examines the clinical results of a 9-year experience in which the incidence of major (stroke and death) perioperative events and of recurrent stenosis (>60%) after carotid endarterectomy performed with a direct suture (DS) of the arteriotomy versus bovine pericardium patch angioplasty (BPPA) are compared. METHODS AND MATERIALS: A total of 517 carotid endarterectomies were included in this nonrandomized study and were divided into two groups: group DS with 194 procedures and group BPPA with 323 procedures. All patients were entered in a follow-up program that ranged from 1 to 108 months (mean, 56.4 months) and included color duplex scan examinations at 1, 3, 6, and 12 months after surgery and every year thereafter. RESULTS: The number of major (stroke and death) perioperative cerebrovascular accidents was eight (4.1%) in the DS Group and five (1.5%) in the BPPA group (P =.066). One death occurred in the DS group, and three occurred in the BPPA Group (P =.517). The four deaths in both groups were the result of strokes. No statistically significant difference was found in terms of early neurologic complications between the two groups. During the first year of follow-up study, the rate of restenosis >60% and occlusion was significantly lower in the BPPA group. Thereafter, the difference was not significant. CONCLUSION: In our experience, the use of BPPA or DS during carotid endarterectomy procedure does not cause a significantly different rate of perioperative major events (stroke or death) in the two groups. The incidence rate of restenosis is lower in the first year after surgery with BPPA, but in subsequent years, no significant difference in restenosis is seen. The early and late postoperative results with BPPA compare favorably with the reported data from literature with the use of other patch materials.

Aged↗
PubMed2002

Renal artery aneurysm: improved renal function after coil embolization.

PURPOSE: To describe a case of improved renal function and renovascular hypertension after percutaneous treatment of a renal artery aneurysm. CASE REPORT: A 72-year-old hypertensive woman with a hilar saccular aneurysm of the right renal artery underwent percutaneous coil embolization under local anesthesia. Four individual, soft, detachable platinum embolization coils were successfully inserted in the aneurysm with incomplete aneurysm exclusion. Nonetheless, the patient's blood pressure and renal function returned to normal. The arteriogram at 3 months demonstrated complete exclusion of the lesion and good renal perfusion. The patient remains normotensive with documented improved renal function at 18 months after treatment. CONCLUSIONS: Superselective coil embolization is an effective treatment for renal artery aneurysms that display proper morphological features. The long-term outcome of this less invasive therapy still must be assessed, but it appears plausible that embolotherapy of renal artery aneurysms can correct secondary hypertension and deteriorating renal function.

Aged↗