PubMed Health⌕ Search

Biomedical subjects

Massimo Medda

Publications and source records attributed to Massimo Medda.

7 recordsLinked to original sources
PubMed2006

Antegrade access in a stented common femoral artery: feasible but with a real bleeding risk.

Antegrade femoral artery access is often used for diagnostic and interventional purposes in patients with critical limb ischemia, given its potential advantages in terms of visualization and back-up. However, it may be associated with an increased risk of local vascular complications, especially in the presence of common femoral artery atherosclerosis. We hereby report a case of antegrade femoral access in a previously stented common artery, which enabled successful recanalization of a totally occluded superficial femoral artery. Despite the procedural success, retroperitoneal bleeding occurred after sheath removal, which was nonetheless effectively managed with prolonged balloon inflations by means of contralateral femoral artery access. This clinical vignette, the first to date to report on antegrade access in a stented femoral artery, supports its feasibility despite the presence of a real bleeding risk.

Aged↗
PubMed2006

Angioseal use after antegrade femoral arteriotomy in patients undergoing percutaneous revascularization for critical limb ischemia: a case series.

Antegrade femoral artery access is commonly used for percutaneous transluminal revascularization of ipsilateral lower limbs in patients with critical limb ischemia. While hemostasis at the end of the procedure can be achieved by manual compression, this may lead to an increase in local vascular complications. Femoral artery closure devices, such as the Angioseal collagen plug and anchor device, have been approved and shown of benefit after retrograde femoral artery catheterization. To date, there are however no data on the use of such arteriotomy closure device after antegrade femoral access. We hereby report a case series of five patients in whom Angioseal was successfully used after antegrade femoral puncture and below-the-knee percutaneous transluminal angioplasty. In all cases the device enabled immediate and complete hemostasis without major complications, despite the intense antithrombotic regimen, including heparin, aspirin, and clopidogrel in all patients, as well as glycoprotein IIb/IIIa inhibitors (in two patients) and fibrinolytic therapy (in one).

Aged↗
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↗
PubMed2002

Successful concomitant treatment of a coronary-to-pulmonary artery fistula and a left anterior descending artery stenosis using a single covered stent graft: a case report and literature review.

This report describes a case of a 47-year-old man who presented with early post-Q wave myocardial infarction angina and an atherosclerotic left anterior descending stenosis associated to a coronary-to-pulmonary artery fistula. Both coronary stenosis and fistula were successfully treated with a single polytetrafluoroethylene-covered stent graft implantation by intravascular ultrasound-guided procedure.

Angina Pectoris↗
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↗