المؤلفون: Broccolini, Aldobrando, Brunetti, Valerio, Colò, Francesca, Alexandre, Andrea M, Valente, Iacopo, Falcou, Anne, Frisullo, Giovanni, Pedicelli, Alessandro, Scarcia, Luca, Scala, Irene, Rizzo, Pier Andrea, Bellavia, Simone, Camilli, Arianna, Milonia, Luca, Piano, Mariangela, Macera, Antonio, Commodaro, Christian, Ruggiero, Maria, Da Ros, Valerio, Bellini, Luigi, Lazzarotti, Guido A, Cosottini, Mirco, Caragliano, Armando A, Vinci, Sergio L, Gabrieli, Joseph D, Causin, Francesco, Panni, Pietro, Roveri, Luisa, Limbucci, Nicola, Arba, Francesco, Pileggi, Marco, Bianco, Giovanni, Romano, Daniele G, Frauenfelder, Giulia, Semeraro, Vittorio, Ganimede, Maria P, Lozupone, Emilio, Fasano, Antonio, Lafe, Elvis, Cavallini, Anna, Russo, Riccardo, Bergui, Mauro, Calabresi, Paolo, Della Marca, Giacomo

مصطلحات موضوعية: Ischemic stroke

الوصف: Background Patients with minor stroke and M2 occlusion undergoing best medical management (BMM) may face early neurological deterioration (END) that can lead to poor long-term outcome. In case of END, rescue mechanical thrombectomy (rMT) seems beneficial. Our study aimed to define factors relevant to clinical outcome in patients undergoing BMM with the possibility of rMT on END, and find predictors of END. Methods Patients with M2 occlusion and a baseline National Institutes of Health Stroke Scale (NIHSS) score≤5 that received either BMM only or rMT on END after BMM were extracted from the databases of 16 comprehensive stroke centers. Clinical outcome measures were a 90-day modified Rankin Scale (mRS) score of 0–1 or 0–2, and occurrence of END. Results Among 10 169 consecutive patients with large vessel occlusion admitted between 2016 and 2021, 208 patients were available for analysis. END was reported in 87 patients that were therefore all subjected to rMT. In a logistic regression model, END (OR 3.386, 95% CI 1.428 to 8.032), baseline NIHSS score (OR 1.362, 95% CI 1.004 to 1.848) and a pre-event mRS score=1 (OR 3.226, 95% CI 1.229 to 8.465) were associated with unfavorable outcome. In patients with END, successful rMT was associated with favorable outcome (OR 4.549, 95% CI 1.098 to 18.851). Among baseline clinical and neuroradiological features, presence of atrial fibrillation was a predictor of END (OR 3.547, 95% CI 1.014 to 12.406). Conclusion Patients with minor stroke due to M2 occlusion and atrial fibrillation should be closely monitored for possible worsening during BMM and, in this case, promptly considered for rMT.

وصف الملف: text/html

العلاقة: http://jnis.bmj.com/cgi/content/short/16/1/38Test; http://dx.doi.org/10.1136/jnis-2023-020118Test

الإتاحة: https://doi.org/10.1136/jnis-2023-020118Test
http://jnis.bmj.com/cgi/content/short/16/1/38Test

المؤلفون: Alexandre, Andrea M, Monforte, Mauro, Brunetti, Valerio, Scarcia, Luca, Cirillo, Luigi, Zini, Andrea, Scala, Irene, Nardelli, Vincenzo, Arbia, Francesco, Arbia, Giuseppe, Frisullo, Giovanni, Kalsoum, Erwah, Camilli, Arianna, De Leoni, Davide, Colò, Francesca, Abruzzese, Serena, Piano, Mariangela, Rollo, Claudia, Macera, Antonio, Ruggiero, Maria, Lafe, Elvis, Gabrieli, Joseph D, Cester, Giacomo, Limbucci, Nicola, Arba, Francesco, Ferretti, Simone, Da Ros, Valerio, Bellini, Luigi, Salsano, Giancarlo, Mavilio, Nicola, Russo, Riccardo, Bergui, Mauro, Caragliano, Antonio A, Vinci, Sergio L, Romano, Daniele G, Frauenfelder, Giulia, Semeraro, Vittorio, Ganimede, Maria P, Lozupone, Emilio, Romi, Andrea, Cavallini, Anna, Milonia, Luca, Muto, Massimo, Candelaresi, Paolo, Calabresi, Paolo, Pedicelli, Alessandro, Broccolini, Aldobrando

المساهمون: Ricerca Corrente Reti IRCCS 2022, Rete IRCCS delle Neuroscienze e della Neuroriabilitazione – RIN, Istituto Virtuale Nazionale Malattie Cerebrovascolari

المصدر: International Journal of Stroke ; ISSN 1747-4930 1747-4949

مصطلحات موضوعية: Neurology, Neurology (clinical)

الوصف: Background: Recent randomized trials have shown the benefit of mechanical thrombectomy (MT) also in patients with an established large ischemic core. Aims: The purpose of this study was to define baseline predictors of clinical outcome in patients with large vessel occlusion (LVO) in the anterior circulation and an Alberta Stroke Program Early CT score (ASPECTS) ⩽ 5, undergoing MT. Material and methods: The databases of 16 comprehensive stroke centers were retrospectively screened for patients with LVO and ASPECTS ⩽5 that received MT. Baseline clinical and neuroradiological features, including the differential contribution of all ASPECTS regions to the composite score, were collected. Primary clinical outcome measure was a 90-day modified Rankin Scale (mRS) score of 0–2. Statistical analysis used a logistic regression model and random forest algorithm. Results: A total of 408 patients were available for analysis. In multivariate model, among baseline features, lower age (odd ratio (OR) = 0.962, 95% confidence interval (CI) = 0.943–0.982) and lower National Institute of Health Stroke Scale (NIHSS) score (OR = 0.911, 95% CI = 0.862–0.963) were associated with the mRS score 0–2. Involvement of the M2 (OR = 0.398, 95% CI = 0.206–0.770) or M4 (OR = 0.496, 95% CI = 0.260–0.945) ASPECTS regions was associated with an unfavorable outcome. Random forest analysis confirmed that age and baseline NIHSS score are the most important variables influencing clinical outcome, whereas involvement of cortical regions M5, M4, M2, and M1 can have a negative impact. Conclusion: Our retrospective analysis shows that, along with age and baseline clinical impairment, presence of early ischemic changes involving cortical areas has a role in clinical outcome in patients with large ischemic core undergoing MT. Data access statement: The data that support the findings of this study are available upon reasonable request.

الإتاحة: https://doi.org/10.1177/17474930241245828Test

المؤلفون: Valente, Iacopo, Alexandre, Andrea M., Colò, Francesca, Brunetti, Valerio, Frisullo, Giovanni, Camilli, Arianna, Falcou, Anne, Scarcia, Luca, Gigli, Riccardo, Scala, Irene, Rizzo, Pier A., Abruzzese, Serena, Milonia, Luca, Piano, Mariangela, Macera, Antonio, Ruggiero, Maria, Da Ros, Valerio, Bellini, Luigi, Lazzarotti, Guido A., Cosottini, Mirco, Caragliano, Antonio A., Vinci, Sergio L., Gabrieli, Joseph D., Causin, Francesco, Panni, Pietro, Roveri, Luisa, Limbucci, Nicola, Arba, Francesco, Renieri, Leonardo, Ferretti, Simone, Pileggi, Marco, Bianco, Giovanni, Romano, Daniele G., Frauenfelder, Giulia, Semeraro, Vittorio, Ganimede, Maria P., Lozupone, Emilio, Fasano, Antonio, Lafe, Elvis, Cavallini, Anna M., Mazzacane, Federico, Russo, Riccardo, Bergui, Mauro, Broccolini, Aldobrando, Pedicelli, Alessandro

المساهمون: Catholic University of the Sacred Heart

المصدر: World Neurosurgery ; volume 183, page e432-e439 ; ISSN 1878-8750

مصطلحات موضوعية: Neurology (clinical), Surgery

الإتاحة: https://doi.org/10.1016/j.wneu.2023.12.117Test
https://api.elsevier.com/content/article/PII:S1878875023018508?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S1878875023018508?httpAccept=text/plainTest

المؤلفون: Alexandre, Andrea M., Scarcia, Luca, Clarençon, Frédéric, Camilli, Arianna, Bartolo, Andrea, Incandela, Francesca, Mele, Dario Antonio, Rigante, Mario, Natola, Marco, Valente, Iacopo, D'Argento, Francesco, Galli, Jacopo, Tshomba, Yamume, Pedicelli, Alessandro

المصدر: Clinical Neuroradiology; Jun2024, Vol. 34 Issue 2, p307-314, 8p

مستخلص: Purpose: This retrospective study aimed to assess the safety and technical efficacy of preoperative direct puncture embolization using a nonadhesive ethylene vinyl alcohol (EVOH) copolymer-based liquid embolic agent (LEA) combined with balloon occlusion at the origin of the external carotid artery for head and neck paragangliomas (HNP). Methods: We conducted a review of all consecutive cases of HNPs treated with direct puncture embolization using EVOH-based LEAs between 2017 and 2022 in 2 tertiary high-volume hospitals. Results: A total of 25 cases of HNPs in 24 patients underwent direct puncture embolization (12 males, 12 females, mean age 50.9 ± 15.6 years). The average lesion volume was 299.95 mm³. The mean procedure time was 139.11 min, and the mean volume of EVOHs used per case was 19.38 mL. Successful complete devascularization was achieved in all cases, with a homogeneous and deep penetration of the embolic agent into the tumor vessel bed regardless of the LEA type. Conclusion: Preoperative embolization of HNPs using a direct puncture technique and EVOHs is a safe, efficient, and feasible treatment option with a low risk of complications. This procedure facilitates surgery by transforming tumors into avascular masses that are well-delineated against the surrounding normal tissue. [ABSTRACT FROM AUTHOR]

: Copyright of Clinical Neuroradiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Alexandre, Andrea, Gaudino, Simona, Gessi, Marco, Frassanito, Paolo, Camilli, Arianna, Pedicelli, Alessandro

المساهمون: Alexandre, Andrea, Romi, Andrea, Gaudino, Simona, Gessi, Marco, Frassanito, Paolo, Camilli, Arianna, Luca, Scarcia, Pedicelli, Alessandro

مصطلحات موضوعية: congenital intraosseous hemangioma, endovascular treatment, fetal MR, neonatal neurosurgery, personalized medicine, Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA

الوصف: Introduction: calvarial capillary hemangiomas are vascular tumors rarely seen in newborns. Differential diagnosis may be not straightforward on imaging studies and the management depends on patient and lesion characteristics. Case report: we present the case of a large congenital intracranial extra-axial lesion detected by routine prenatal US screening, a giant calvarial congenital hemangioma, treated with a multimodal strategy. Neonatal MR showed a hemorrhagic solid lesion, causing compression of brain tissue. Conservative treatment was attempted, but a one-month follow-up MR showed growth of the lesion with increased mass effect. Pre-operative endovascular embolization and surgical resection were performed. The pathology was consistent with intraosseous capillary hemangioma. The post-operative course was uneventful. At the 8-month follow-up, the patient had no clinical deficits and MR showed complete resection of the lesion. At the 13-month follow-up, the patient was asymptomatic, showing normal neurological examination and psychophysical development. Conclusions: although wait-and-see policy is feasible for small and asymptomatic lesions, radical resection is indicated when the mass is large, thus causing severe mass effect on the brain. Hypervascularization of the tumor may be responsible for hemorrhagic complications and severe anemia. On these grounds, endovascular treatment is feasible and effective to reduce hemorrhagic complications.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/38256405; info:eu-repo/semantics/altIdentifier/wos/WOS:001151545800001; volume:60; issue:1; firstpage:N/A; lastpage:N/A; issueyear:2024; journal:MEDICINA; https://hdl.handle.net/10807/271344Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85183177607

الإتاحة: https://doi.org/10.3390/medicina60010145Test
https://hdl.handle.net/10807/271344Test

المؤلفون: Pedicelli, Alessandro, Trombatore, Pietro, Bartolo, Andrea, Camilli, Arianna, Rossi, Esther Diana, Scarcia, Luca, Alexandre, Andrea M.

المصدر: Current Oncology; Apr2024, Vol. 31 Issue 4, p2047-2056, 10p

مصطلحات موضوعية: CASTLEMAN'S disease, PAROTID gland diseases, PAROTID gland tumors, PAROTID glands, LYMPHOPROLIFERATIVE disorders, OPERATIVE surgery

مستخلص: Background: Castleman disease (CD) is an uncommon benign lymphoproliferative disease characterized by hypervascular lymphoid hyperplasia. We present a unique case of unicentric CD of the parotid gland treated by preoperative direct puncture embolization. Case presentation: A 27-year-old female patient was admitted for a right neck mass. Ultrasound examination and MRI scan documented a hypervascular mass within the right parotid gland. Preoperative embolization was performed by direct puncture technique: a needle was inserted into the core of the mass under both ultrasound and fluoroscopic guidance and SQUID 12 was injected into the mass under fluoroscopic control, achieving a total devascularization. Conclusion: Preoperative direct puncture embolization was safe and effective and provides excellent hemostatic control during the surgical operation, limiting the amount of intraoperative bleeding. [ABSTRACT FROM AUTHOR]

: Copyright of Current Oncology is the property of MDPI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Alexandre, Andrea M., Romi, Andrea, Gaudino, Simona, Gessi, Marco, Frassanito, Paolo, Camilli, Arianna, Luca, Scarcia, Pedicelli, Alessandro

المصدر: Medicina (1010660X); Jan2024, Vol. 60 Issue 1, p145, 9p

مصطلحات موضوعية: ENDOVASCULAR surgery, PRENATAL diagnosis, HEMANGIOMAS, SKULL, SURGICAL excision, ASYMPTOMATIC patients

مستخلص: Introduction: calvarial capillary hemangiomas are vascular tumors rarely seen in newborns. Differential diagnosis may be not straightforward on imaging studies and the management depends on patient and lesion characteristics. Case report: we present the case of a large congenital intracranial extra-axial lesion detected by routine prenatal US screening, a giant calvarial congenital hemangioma, treated with a multimodal strategy. Neonatal MR showed a hemorrhagic solid lesion, causing compression of brain tissue. Conservative treatment was attempted, but a one-month follow-up MR showed growth of the lesion with increased mass effect. Pre-operative endovascular embolization and surgical resection were performed. The pathology was consistent with intraosseous capillary hemangioma. The post-operative course was uneventful. At the 8-month follow-up, the patient had no clinical deficits and MR showed complete resection of the lesion. At the 13-month follow-up, the patient was asymptomatic, showing normal neurological examination and psychophysical development. Conclusions: although wait-and-see policy is feasible for small and asymptomatic lesions, radical resection is indicated when the mass is large, thus causing severe mass effect on the brain. Hypervascularization of the tumor may be responsible for hemorrhagic complications and severe anemia. On these grounds, endovascular treatment is feasible and effective to reduce hemorrhagic complications. [ABSTRACT FROM AUTHOR]

: Copyright of Medicina (1010660X) is the property of MDPI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Broccolini, Aldobrando, Brunetti, Valerio, Colò, Francesca, Alexandre, Andrea M, Valente, Iacopo, Falcou, Anne, Frisullo, Giovanni, Pedicelli, Alessandro, Scarcia, Luca, Scala, Irene, Rizzo, Pier Andrea, Bellavia, Simone, Camilli, Arianna, Milonia, Luca, Piano, Mariangela, Macera, Antonio, Commodaro, Christian, Ruggiero, Maria, Da Ros, Valerio, Bellini, Luigi, Lazzarotti, Guido A, Cosottini, Mirco, Caragliano, Armando A, Vinci, Sergio L, Gabrieli, Joseph D, Causin, Francesco, Panni, Pietro, Roveri, Luisa, Limbucci, Nicola, Arba, Francesco, Pileggi, Marco, Bianco, Giovanni, Romano, Daniele G, Frauenfelder, Giulia, Semeraro, Vittorio, Ganimede, Maria P, Lozupone, Emilio, Fasano, Antonio, Lafe, Elvis, Cavallini, Anna, Russo, Riccardo, Bergui, Mauro, Calabresi, Paolo, Della Marca, Giacomo

المساهمون: Broccolini, Aldobrando, Brunetti, Valerio, Colò, Francesca, Alexandre, Andrea M, Valente, Iacopo, Falcou, Anne, Frisullo, Giovanni, Pedicelli, Alessandro, Scarcia, Luca, Scala, Irene, Rizzo, Pier Andrea, Bellavia, Simone, Camilli, Arianna, Milonia, Luca, Piano, Mariangela, Macera, Antonio, Commodaro, Christian, Ruggiero, Maria, Da Ros, Valerio, Bellini, Luigi, Lazzarotti, Guido A, Cosottini, Mirco, Caragliano, Armando A, Vinci, Sergio L, Gabrieli, Joseph D, Causin, Francesco, Panni, Pietro, Roveri, Luisa, Limbucci, Nicola, Arba, Francesco, Pileggi, Marco, Bianco, Giovanni, Romano, Daniele G, Frauenfelder, Giulia, Semeraro, Vittorio, Ganimede, Maria P, Lozupone, Emilio, Fasano, Antonio, Lafe, Elvi, Cavallini, Anna, Russo, Riccardo, Bergui, Mauro, Calabresi, Paolo, Della Marca, Giacomo

مصطلحات موضوعية: stroke, thrombectomy, thrombolysis

الوصف: BackgroundPatients with minor stroke and M2 occlusion undergoing best medical management (BMM) may face early neurological deterioration (END) that can lead to poor long-term outcome. In case of END, rescue mechanical thrombectomy (rMT) seems beneficial. Our study aimed to define factors relevant to clinical outcome in patients undergoing BMM with the possibility of rMT on END, and find predictors of END.MethodsPatients with M2 occlusion and a baseline National Institutes of Health Stroke Scale (NIHSS) score <= 5 that received either BMM only or rMT on END after BMM were extracted from the databases of 16 comprehensive stroke centers. Clinical outcome measures were a 90-day modified Rankin Scale (mRS) score of 0-1 or 0-2, and occurrence of END.ResultsAmong 10 169 consecutive patients with large vessel occlusion admitted between 2016 and 2021, 208 patients were available for analysis. END was reported in 87 patients that were therefore all subjected to rMT. In a logistic regression model, END (OR 3.386, 95% CI 1.428 to 8.032), baseline NIHSS score (OR 1.362, 95% CI 1.004 to 1.848) and a pre-event mRS score=1 (OR 3.226, 95% CI 1.229 to 8.465) were associated with unfavorable outcome. In patients with END, successful rMT was associated with favorable outcome (OR 4.549, 95% CI 1.098 to 18.851). Among baseline clinical and neuroradiological features, presence of atrial fibrillation was a predictor of END (OR 3.547, 95% CI 1.014 to 12.406).ConclusionPatients with minor stroke due to M2 occlusion and atrial fibrillation should be closely monitored for possible worsening during BMM and, in this case, promptly considered for rMT.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/36977569; info:eu-repo/semantics/altIdentifier/wos/WOS:000969282300001; journal:JOURNAL OF NEUROINTERVENTIONAL SURGERY; https://hdl.handle.net/11568/1185087Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85152678255

الإتاحة: https://doi.org/10.1136/jnis-2023-020118Test
https://hdl.handle.net/11568/1185087Test

المؤلفون: Brunetti, Valerio, Scala, Irene, Valente, Iacopo, Camilli, Arianna, De Leoni, Davide, Frisullo, Giovanni, Lozupone, Emilio, Calabresi, Paolo, Pedicelli, Alessandro, Broccolini, Aldobrando

المساهمون: Alexandre, Andrea M, Scarcia, Luca, Brunetti, Valerio, Scala, Irene, Kalsoum, Erwah, Valente, Iacopo, Camilli, Arianna, De Leoni, Davide, Colò, Francesca, Frisullo, Giovanni, Piano, Mariangela, Rollo, Claudia, Macera, Antonio, Ruggiero, Maria, Lafe, Elvi, Gabrieli, Joseph D, Cester, Giacomo, Limbucci, Nicola, Arba, Francesco, Ferretti, Simone, Da Ros, Valerio, Bellini, Luigi, Salsano, Giancarlo, Mavilio, Nicola, Russo, Riccardo, Bergui, Mauro, Caragliano, Antonio A, Vinci, Sergio L, Romano, Daniele G, Frauenfelder, Giulia, Semeraro, Vittorio, Ganimede, Maria P, Lozupone, Emilio, Romi, Andrea, Cavallini, Anna, Milonia, Luca, Muto, Massimo, Giordano, Flavio, Cirillo, Luigi, Calabresi, Paolo, Pedicelli, Alessandro, Broccolini, Aldobrando

مصطلحات موضوعية: Intervention, Stroke, Settore MED/26 - NEUROLOGIA

الوصف: BackgroundThe aim of our study was to find predictors of parenchymal hematoma (PH) and clinical outcome after mechanical thrombectomy (MT) in patients with large vessel occlusion (LVO) and baseline large infarct.MethodsThe databases of 16 stroke centers were retrospectively screened for patients with anterior circulation LVO and baseline Alberta Stroke Program Early CT Score (ASPECTS) <= 5 that received MT. Procedural parameters, including the number of passes during first and second technique of MT, were recorded. Outcome measures were occurrence of PH type 2 and any type of PH after MT, and the 90-day modified Rankin Scale (mRS) score of 0-3 and 0-2.ResultsIn total, 408 patients were available for analysis. A higher number of passes in the second technique was predictive of PH type 2 (odds ratio (OR) - 3.204, 95% confidence interval (CI) 1.140 to 9.005), whereas procedure conducted under general anesthesia was associated with lower risk (OR 0.127, 95% CI 0.002 to 0.808). The modified thrombolysis in cerebral infarction grade 2c-3 was associated with the mRS score 0-3 (OR 3.373, 95% CI 1.891 to 6.017), whereas occurrence of PH type 2 was predictive of unfavorable outcome (OR 0.221, 95% CI 0.063 to 0.773). Similar results were found for the mRS score 0-2 outcome measure.ConclusionIn patients with large ischemic core, a higher number of passes during MT and procedure not conducted under general anesthesia are associated with increased rate of PH type 2, that negatively impact the clinical outcome. Our data outline a delicate balance between the need of a complete recanalization and the risk of PH following MT.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/38129110; info:eu-repo/semantics/altIdentifier/wos/WOS:001142634900001; issue:December; firstpage:N/A; lastpage:N/A; issueyear:2023; journal:JOURNAL OF NEUROINTERVENTIONAL SURGERY; https://hdl.handle.net/10807/262400Test

الإتاحة: https://doi.org/10.1136/jnis-2023-021146Test
https://hdl.handle.net/10807/262400Test

المؤلفون: Alexandre, Andrea M., Scarcia, Luca, Clarençon, Frédéric, Camilli, Arianna, Bartolo, Andrea, Incandela, Francesca, Mele, Dario Antonio, Rigante, Mario, Natola, Marco, Valente, Iacopo, D’Argento, Francesco, Galli, Jacopo, Tshomba, Yamume, Pedicelli, Alessandro

المصدر: Clinical Neuroradiology ; ISSN 1869-1439 1869-1447

مصطلحات موضوعية: Neurology (clinical), Radiology, Nuclear Medicine and imaging

الإتاحة: https://doi.org/10.1007/s00062-023-01364-1Test