Publications by authors named "V I Bova"

15 Publications

[Surgical treatment of a patient with traumatic rupture of the aortic arch and late oesophageal perforation].

Angiol Sosud Khir 2020 ;26(2):175-182

Department of Vascular Surgery, Municipal Multimodality Hospital #2, Saint Petersburg, Russia.

Described herein is a clinical case report regarding a patient presenting with traumatic rupture of the aortic isthmus with the development of a pseudoaneurysm occupying virtually the entire posterior mediastinum and measuring 20?10 cm in size. He was immediately treated as an emergency to undergo prosthetic reconstruction of the portion of the aortic arch and descending thoracic aorta by means of temporary bypass grafting with a synthetic graft in order to protect the visceral organs. The postoperative period was complicated by oesophageal perforation with the formation of an oesophago-paraprosthetic fistula, infection of the vascular graft, accompanied by the development of pleural empyema and mediastinitis. A second operative procedure was performed, consisting of subclavian-iliac bypass grafting on the right with a polytetrafluoroethylene graft measuring 20 mm in diameter, exclusion of the intrathoracic portion of the oesophagus, creation of a gastro- and oesophagostoma, retrieval of the vascular graft followed by suturing of the aorta, pleurectomy, decortication of the lung, and removal of the empyemic sac on the left. There was no evidence of ischaemia of the spinal cord or visceral arteries. One month postoperatively, he underwent a traumatological stage and 4 months thereafter plasty of the oesophagus with an isoperistaltic gastric pedicle, extirpation of the thoracic portion of the oesophagus, to be later on followed by closure of the oesophagostoma. The patient experienced no difficulties either while walking or during other physical activities, with the ankle-brachial index amounting to 0.9. With time, he developed difficult-to-correct pulmonary hypertension. Unfortunately, the patient eventually died of acute cardiopulmonary insufficiency 9 years after right-sided extra-anatomical subclavian-iliac bypass grafting.
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http://dx.doi.org/10.33529/ANGIO2020219DOI Listing
September 2020

Self-induced psychogenic non-epileptic seizure. A case report.

Seizure 2020 08 17;80:159-160. Epub 2020 Jun 17.

Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Italy; Regional Epilepsy Centre, Great Metropolitan "Bianchi-Melacrino-Morelli" Hospital, Reggio Calabria, Italy; Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy. Electronic address:

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http://dx.doi.org/10.1016/j.seizure.2020.06.026DOI Listing
August 2020

Superior Mesenteric Artery Syndrome: Clinical, Endoscopic, and Radiological Findings.

Gastroenterol Res Pract 2018 27;2018:1937416. Epub 2018 Aug 27.

Department of Radiology, DIBIMED, University of Palermo, Via del Vespro 127, 90127 Palermo, Italy.

Background: The superior mesenteric artery (SMA) syndrome is a rare entity presenting with upper gastrointestinal tract obstruction and weight loss. Studies to determine the optimal methods of diagnosis and treatment are required.

Aims And Methods: This study aims at analyzing the clinical presentation, diagnosis, and management of SMA syndrome. Ten cases of SMA syndrome out of 2074 esophagogastroduodenoscopies were suspected. A contrast-enhanced computed tomography (CECT) scan was performed to confirm the diagnosis. After, a gastroenterologist and a nutritionist personalized the therapy. Furthermore, we compared the demographical, clinical, endoscopic, and radiological parameters of these cases with a control group consisting of 10 cases out of 2380 EGDS of initially suspected (but not radiologically confirmed) SMA over a follow-up 2-year period (2015-2016).

Results: The prevalence of SMA syndrome was 0.005%. Median age and body mass index were 23.5 years and 21.5 kg/m, respectively. Symptoms developed between 6 and 24 months. Median aortomesenteric angle and aorta-SMA distance were 22 and 6 mm, respectively. All patients improved on conservative treatment. In our series, a marked (>5 kg) weight loss ( = 0.006) and a long-standing presentation (more than six months in 80% of patients) ( = 0.002) are significantly related to a diagnosis of confirmed SMA syndrome at CECT after an endoscopic suspicion. A "resembling postprandial distress syndrome dyspepsia" presentation may be helpful to the endoscopist in suspecting a latent SMA syndrome ( = 0.02). The narrowing of both the aortomesenteric angle ( = 0.001) and the aortomesenteric distance ( < 0.001) was significantly associated with the diagnosis of SMA after an endoscopic suspicion; however, the narrowing of the aortomesenteric distance seemed to be more accurate, rather than the narrowing of the aortomesenteric angle.

Conclusion: SMA syndrome represents a diagnostic and therapeutic challenge. Our results show the following findings: the importance of the endoscopic suspicion of SMA syndrome; the preponderance of a long-standing and chronic onset; a female preponderance; the importance of the nutritional counseling for the treatment; no need of surgical intervention; and better diagnostic accuracy of the narrowing of the aorta-SMA distance. Larger prospective studies are needed to clarify the best diagnosis and management of the SMA syndrome.
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http://dx.doi.org/10.1155/2018/1937416DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6129792PMC
August 2018

A comparison between ¹⁸F-FDG PET/CT imaging and biological and radiological findings in restaging of hepatoblastoma patients.

Biomed Res Int 2013 26;2013:709037. Epub 2013 Aug 26.

Positron Emission Tomography Centre, IRMET S.p.A., Euromedic Inc., 10136 Turin, Italy ; Co-ordinator of PET Pediatric AIMN InterGroup, 10136 Turin, Italy ; Associate researcher of Institute of Cognitive Sciences and Technologies, National Research Council, 00185 Rome, Italy.

Background: In this study we retrospectively evaluated if ¹⁸F-FDG-PET/CT provided incremental diagnostic information over CI in a group of hepatoblastoma patients performing restaging.

Procedure: Nine patients (mean age: 5.9 years; range: 3.1-12 years) surgically treated for hepatoblastoma were followed up by clinical examination, serum α-FP monitoring, and US. CI (CT or MRI) and PET/CT were performed in case of suspicion of relapse. Fine-needle aspiration biopsies (FNAB) were carried out for final confirmation if the results of CI, PET/CT, and/or α-FP levels were suggestive of relapse. PET/CT and CI findings were analyzed for comparison purposes, using FNAB as reference standard.

Results: α-FP level was suggestive of disease recurrence in 8/9 patients. Biopsy was performed in 8/9 cases. CI and PET/CT resulted to be concordant in 5/9 patients (CI identified recurrence of disease, but ¹⁸F-FDG-PET/CT provided a better definition of disease extent); in 4/9 cases, CI diagnostic information resulted in negative findings, whereas PET/CT correctly detected recurrence of disease. ¹⁸F-FDG-PET/CT showed an agreement of 100% (8/8) with FNAB results.

Conclusions: ¹⁸F-FDG-PET/CT scan seems to better assess HB patients with respect to CI and may provide incremental diagnostic value in the restaging of this group of patients.
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http://dx.doi.org/10.1155/2013/709037DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3770017PMC
April 2014

Predictive factors of downstaging of hepatocellular carcinoma beyond the Milan criteria treated with intra-arterial therapies.

Cardiovasc Intervent Radiol 2013 Apr 4;36(2):433-9. Epub 2012 Aug 4.

Department of Diagnostic and Interventional Radiology, Mediterranean Institute for Transplantation and Advanced Specialized Therapies, (ISMETT), Via Tricomi 1, 90100, Palermo, Italy.

Purpose: This study was designed to analyze the clinical results in patients suitable for liver transplantation with hepatocellular carcinoma (HCC) who exceeded Milan criteria, which underwent intra-arterial therapies (IAT), to determine predictive factors of successful downstaging.

Methods: A total of 277 consecutive patients with cirrhosis and HCC were treated by IAT (transarterial oily chemoembolization, transarterial chemoembolization, transarterial embolization) in a single center. Eighty patients exceed the Milan criteria. Patients with infiltrative HCC, hypovascular HCC, and portal vein thrombosis were excluded, with a final study population of 48 patients. Tumor response to IAT was evaluated with CT and/or MRI according to modified RECIST criteria. Successful downstaging was defined as a reduction in the number and size of viable tumors to within the Milan criteria, and serum alpha-fetoprotein (AFP) <100 ng/mL, for at least 6 months.

Results: Nineteen patients (39 %) had their tumors successfully downstaged; 29 patients (61 %) did not. Multivariate analysis showed that AFP level <100 ng/mL and 3-year calculated survival probability using the Metroticket calculator were the only independent predictors of successful downstaging (p < 0.023 and p < 0.049 respectively).

Conclusions: Biological characteristics of HCC as AFP levels <100 ng/mL and high 3-year calculated survival probability may predict a good response to downstage after IAT.
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http://dx.doi.org/10.1007/s00270-012-0458-1DOI Listing
April 2013