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J Cardiovasc Surg (Torino) 2018 Dec;59(6):844-845

Department of Vascular Surgery, Imelda Hospital, Bonheiden, Belgium -

J Cardiovasc Surg (Torino) 2018 Nov 20. Epub 2018 Nov 20.

CHU Limoges, Service of Cardiology, Dupuytren Hospital, Limoges, France -

Background: Among patients with coronary artery disease (CAD), around 25% have multisite artery disease (MSAD). Patients with CAD and MSAD are at higher risk of peri-operative and long-term cardiovascular events. Whether off-pump coronary bypass grafting (CABG) can improve their prognosis is unknown. Read More

J Cardiovasc Surg (Torino) 2018 Nov 20. Epub 2018 Nov 20.

Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Centre Essen, University Hospital Essen, Essen, Germany.

Background: Valve sparing root replacement differs in specific points. The main target remains to achieve a perfect intraoperative result and long-term stability. We aimed in this study to present our modified sizing technique for valve-sparing "David" procedure and its mid-term results. Read More

J Cardiovasc Surg (Torino) 2018 Nov 20. Epub 2018 Nov 20.

Department of Cardiac Surgery, Euroclinic of Athens, Athens, Greece.

Introduction: We sought to systematically review the existing literature reporting on patients recruited during the past twenty years regarding the role of left ventricular (LV) reconstruction in ischemic cardiomyopathy in terms of efficacy and mortality and provide an updated overview of the current evidence.

Evidence Acquisition: The PubMed and Cochrane bibliographical databases were thoroughly searched for the following MeSH terms: "ventricular reconstruction" OR ventriculoplasty OR "ventricular aneurysm" OR "ventricular restoration". Original studies -recruiting patients during the past twenty years- on LV reconstruction surgery in more than five cases and reporting on the associated peri- or post-operative mortality were deemed eligible. Read More

J Cardiovasc Surg (Torino) 2018 Nov 20. Epub 2018 Nov 20.

Department of Cardiovascular Surgery, Hiroshima University School of Medicine, Hiroshima, Japan.

Background: Spinal cord ischemia (SCI) and paraplegia are complications of surgery for type A acute aortic dissection (TAAAD). Since the segmental arteries play a key role in SCI, this study evaluated the association between SCI and false lumen segmental arteries (FLSAs: segmental arteries originating from the false lumen).

Methods: The study included 101 consecutive TAAAD patients (mean age, 66±13; range, 34-89 years) who underwent surgery from January 2011 to April 2017. Read More

J Cardiovasc Surg (Torino) 2018 Nov 20. Epub 2018 Nov 20.

Department of Surgery, Amphia Hospital, Breda, The Netherlands.

Background: One of the main drawbacks of endovascular aortic aneurysm repair (EVAR) compared to open aortic surgery is the possibility of developing endoleaks and secondary aneurysm rupture, requiring frequent imaging follow-up. This study aims to identify prognostic factors that could be incorporated in follow-up protocols, which might lead to better personalized, lower cost and safe EVAR follow-up.

Methods: A retrospective study was performed including all patients who underwent elective EVAR from January 2000 to December 2015. Read More

J Cardiovasc Surg (Torino) 2018 Nov 12. Epub 2018 Nov 12.

Department of Vascular Surgery, AZ Sint Blasius, Dendermonde, Belgium.

Common femoral artery (CFA) atherosclerotic lesions currently remain one of the last limitations for adoption of endovascular repair as the first-line treatment. The bulky, eccentric, heavily calcified character of the CFA plaques, frequent involvement of the femoral bifurcation, easy surgical accessibility and last but not least, favorable long-term outcomes (1,2) still make CFA disease treatment part of the surgical domain. In the last 5 years, improvement of the endovascular equipment and technical skills of the operators have led to an increase in percutaneous CFA procedures. Read More

J Cardiovasc Surg (Torino) 2018 Nov 7. Epub 2018 Nov 7.

Division of Vascular and Endovascular Surgery, Aortic Center, Mayo Clinic, Rochester MN, USA.

J Cardiovasc Surg (Torino) 2018 Nov 7. Epub 2018 Nov 7.

Department of Surgery, Prince of Wales Hospital, Sydney, Australia -

J Cardiovasc Surg (Torino) 2018 Nov 7. Epub 2018 Nov 7.

Division of Vascular Surgery, University of Cincinnati Medical Center, Cincinnati, OH, USA -

Background: Although aortoiliac occlusive disease (AIOD) is preferentially treated endovascularly, some patients are still better served with an aortobifemoral bypass (ABF). For those patients, surgical treatment options include both standard open operations as well as laparoscopic ABF (LapABF). Several European centers perform LapABF with favorable results instead of open surgery, but this has not been widely embraced in the United States. Read More

J Cardiovasc Surg (Torino) 2018 Oct 31. Epub 2018 Oct 31.

Auckland City Hospital, Auckland, New Zealand -

The endovascular management of complex lower limb arterial occlusive disease is generally associated with poorer acute results, a higher incidence of provisional stenting and subsequent restenosis compared to more simple arterial lesions. Even more challenging results can be expected when two complex features are combined such as chronic total occlusion (CTO) and severe calcification. Intravascular lithotripsy (IVL) with the Shockwave system has recently been evaluated as a familiar angioplasty balloon based but effective technique for the management of arterial calcification. Read More

J Cardiovasc Surg (Torino) 2018 Oct 29. Epub 2018 Oct 29.

Clinic for Vascular and Endovascular Surgery, St. Franziskus Hospital, Münster, Germany.

Background: The iliac side branch device (IBD) is a valid method for the treatment of abdominal aorto-iliac aneurysms. However there is still a lack of evidence regarding the optimal length of the bridging stent graft (BSG) since aneurysmal degeneration of the hypogastric artery (HA) is an exclusion criterion. The aim of this study was to analyse the impact of longer BSG compared to the widely used 38mm stent-grafts in terms of reintervention rate and primary patency. Read More

J Cardiovasc Surg (Torino) 2018 Oct 23. Epub 2018 Oct 23.

Auckland City Hospital, Auckland, New Zealand.

Despite recent advances in endovascular therapy of lower extremity atherosclerotic disease, mainly driven through drug eluting balloon angioplasty, treatment of complex lesions remains challenging. Drug eluting balloons work less well in heavily calcified lesions and in particular long lesions often require bail-out stenting. Lesion preparation, as a stand-alone treatment or before delivering antiproliferative therapy or scaffolding, has gained increased recognition in recent years. Read More

J Cardiovasc Surg (Torino) 2018 Oct 5. Epub 2018 Oct 5.

Department of Cardiology, Clinic of Internal Medicine II, Paracelsus Medical University of Salzburg, Salzburg, Austria -

Background: Aortic valve stenosis is the most common valvulopathy in developed countries. Transcatheter aortic valve implantation (TAVI) is a therapeutic alternative in symptomatic patients at high or prohibitive perioperative risk. Predilatation by balloon aortic valvuloplasty (BAV) under rapid ventricular pacing (RVP) has been a routine part of TAVI. Read More

J Cardiovasc Surg (Torino) 2018 Sep 26. Epub 2018 Sep 26.

Division of Vascular and Endovascular Surgery, Mayo Clinic Aortic Center and Advanced Endovascular Aortic Research Program, Rochester, MN, USA -

Spinal cord injury is the most devastating complication after aortic surgery. Rates of spinal cord injury vary from 0% up to 40%. Predictive factors include extent of coverage, hypogastric artery occlusion, prior aortic repair and perioperative hypotension. Read More

J Cardiovasc Surg (Torino) 2018 Sep 12. Epub 2018 Sep 12.

Mayo Clinic Aortic Center and Advanced Endovascular Aortic Research Program, Division of Vascular and Endovascular Surgery, Rochester, MN, USA -

Fenestrated and branched endovascular repair (F-BEVAR) has been increasingly used to treat patients with complex aortic aneurysms involving the renal-mesenteric arteries. As with any new procedure, there is a learning curve associated with mastering the technique. However, proficiency with deployment is only one aspect of the learning process, and ultimately, this curve is defined not by one quality parameter, but by patient selection, the performance of the entire team, the surgeons ability to adapt to unexpected events, and the durability of the repair. Read More

J Cardiovasc Surg (Torino) 2018 Oct;59(5):753-754

th Department of Surgery, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.

J Cardiovasc Surg (Torino) 2018 Aug 29. Epub 2018 Aug 29.

Department of Vascular and Endovascular Surgery, The Royal Oldham Hospital, Pennine Acute Hospitals NHS Trust, Manchester, UK.

Introduction: Endovascular methods have emerged as an appealing alternative to bypass for the treatment of patients not suitable for surgery. Drug eluting stents (DES) have been developed to address the limitations of angioplasty and stenting. There is a paucity of data in the literature on their performance for the treatment of patients with long femoro- popliteal segment lesions. Read More

J Cardiovasc Surg (Torino) 2018 Aug 29. Epub 2018 Aug 29.

Department of Vascular Surgery, Jikei University School of Medicine, Minato-ku, Tokyo, Japan.

Background: Percutaneous endovascular aortic repair (PEVAR) is widespread for the treatment of abdominal aortic aneurysm (AAA). The purpose of this study is to present outcomes of PEVAR using simultaneous angiography via microsheath.

Methods: There were 100 punctures in 50 patients undergoing PEVAR for AAA. Read More

J Cardiovasc Surg (Torino) 2018 Aug 29. Epub 2018 Aug 29.

Department of Surgery, Division of Cardiothoracic Surgery, University of California San Diego, Sulpizio Cardiovascular Center, La Jolla, California.

Background: The optimal advanced heart failure (HF) therapy strategy for patients aged 60 or older with end-stage HF refractory to optimal medical therapy remains uncertain. This study compares outcomes of three advanced HF therapy strategies in this patient population.

Methods: A single-center retrospective study was conducted in 95 patients between the age of 60-73 years who had undergone isolated heart transplantation (HTx) or continuous flow left ventricular assist device (LVAD) implantation from 2010 to 2017. Read More

J Cardiovasc Surg (Torino) 2018 Aug 29. Epub 2018 Aug 29.

Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Centre Essen, University Hospital Essen, Essen, Germany.

Background: Transit-time flow measurement (TTFM) should be routinely used in CABG surgery to verify graft function. Most recently, a 2D high-frequency-ultrasound (HF-US) epi-cardiac imaging probe has been released (MiraQTM, Medistim, Oslo, Norway), which allows to evaluate the cannulation/clamping site of the aorta morphologically and to evaluate the completed anastomosis. We aimed to evaluate the use of TTFM and HF-US on surgical strategy during CABG surgery. Read More

J Cardiovasc Surg (Torino) 2018 Aug 29. Epub 2018 Aug 29.

Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands.

Background: Chordal replacement techniques are progressively used to treat posterior mitral valve leaflet (PMVL) prolapse while leaflet resection remains commonly in use to address excessive leaflet tissue. For excessive tissue in height, shortening neochords can be used alternatively. Use of chordal replacement techniques has been suggested to result in lower diastolic transvalvular gradients, higher freedom from reoperation and improved left ventricular function. Read More

J Cardiovasc Surg (Torino) 2018 Aug 28. Epub 2018 Aug 28.

Aortic Centre, Hôpital Marie Lannelongue, Le Plessis-Robinson, France -

Improvements in endovascular technologies and development of custom-made fenestrated and branched endografts currently allow clinicians to treat complex aortic lesions such as thoraco-abdominal and aortic arch aneurysms once treatable with open repair only. These advances are leading to an increase in the complexity of endovascular procedures which can cause long operation times and high levels of radiation exposure. This in turn places pressure on the vascular surgery community to display more superior interventional skills and radiological practices. Read More

J Cardiovasc Surg (Torino) 2018 Aug 28. Epub 2018 Aug 28.

Department of Vascular Surgery, Ospedale Civile S. Agostino-Estense, Azienda Ospedaliero-Universitaria di Modena, University of Modena and Reggio Emilia, Modena, Italy.

Background: To assess immediate and midterm outcomes of hemodynamically-unstable patients with ruptured abdominal aortic aneurysm (rAAA) treated with the Nellix endovascular sealing system (EVAS).

Methods: From June 2014 to June 2017, 21 hemodynamically-unstable rAAA patients with challenging anatomies were treated with EVAS. The mean AAA diameter and neck length measured 73±15mm and 14±10mm, respectively. Read More

J Cardiovasc Surg (Torino) 2018 Jul 9. Epub 2018 Jul 9.

Department of Radiology, CHU Rangueil, Toulouse, France.

Introduction: Endovascular treatment of aortic arch pathologies is challenging due to its complex anatomical architecture and the presence of vital collateral branches. This paper aims to provide an overview of the currently available and future endovascular options for these diseases, particularly regarding branched stent-grafts and the Mona-LSA device.

Evidence Acquisition And Evidence Synthesis: After discussing the indications for revascularization of supra-aortic trunks in endovascular aortic repair, we present the principles, benefits and drawbacks of the main modern methods to overcome an insufficient proximal landing zone, ie. Read More

J Cardiovasc Surg (Torino) 2018 Aug;59(4):493-494

Centro Vascolare Ticino, Ospedale Regionale di Lugano, Lugano, Switzerland -

J Cardiovasc Surg (Torino) 2018 Jul 3. Epub 2018 Jul 3.

University of Texas McGovern School of Medicine, Houston, Texas, USA.

Background: The data on the trends and comparative outcomes after isolated and concomitant tricuspid valve repair/replacement (TVR) is scarce.

Methods: The International Classification of Diseases - 9th version was used to identify the patients who underwent TVR, using the National Inpatient Sample. Outcomes were evaluated using the analysis of variance and Chi-square test, and trends across the years were tested via Cochran-Armitage test. Read More

J Cardiovasc Surg (Torino) 2018 Oct 27;59(5):653-654. Epub 2018 Jun 27.

Unit of Interventional Radiology, Abano Terme Polyclinic, Abano Terme, Padua, Italy -

J Cardiovasc Surg (Torino) 2018 Dec 26;59(6):759-766. Epub 2018 Jun 26.

Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA -

Despite successful repair of acute type A aortic dissection (TAAD), the distal false lumen may remain patent resulting in progressive degeneration of the remaining distal aorta. This can lead to aneurysmal dilatation and risk of rupture. Open distal reoperation to replace the residually dissected thoraco-abdominal aorta may be accomplished with acceptable morbidity and mortality in experienced hands. Read More

J Cardiovasc Surg (Torino) 2018 Jun 26. Epub 2018 Jun 26.

Department of Vascular and Endovascular Surgery, General Hospital Nuremberg, Paracelsus Medical University, Nuremberg, Germany -

To address target vessels in pararenal and thoracoabdominal aortic aneurysms with fenestrated and branched grafts, two solutions are available: fenestrations (holes in the graft) and directional side-branches. Fenestrations work well for target vessels that have a close to 90-degree take-off from the aorta, and when the main graft at the level of the target vessel is adjacent or close to the aortic wall. Directional side-branches work well when target vessels have a steeper take-off angle and when there is a larger gap to be bridged. Read More

J Cardiovasc Surg (Torino) 2018 Dec 26;59(6):784-788. Epub 2018 Jun 26.

Department of Vascular Medicine, German Aortic Center, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.

Endovascular strategies have been increasingly used for the treatment of chronic type B aortic dissection (cTBAD) offering better outcomes in terms of mortality and morbidity compared to open surgical repair. Aortic remodeling after standard TEVAR is less likely in cTBAD due to rigidity of the dissection membrane. Another limitation of endovascular therapy is continued retrograde false lumen perfusion with back-flow from distal entry tears. Read More

J Cardiovasc Surg (Torino) 2018 Jun 26. Epub 2018 Jun 26.

Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia.

J Cardiovasc Surg (Torino) 2018 Jun 26. Epub 2018 Jun 26.

Faculty of Medicine, University of Belgrade, Belgrade, Serbia.

J Cardiovasc Surg (Torino) 2018 Jun 26. Epub 2018 Jun 26.

Aortic Centre, Hôpital Marie Lannelongue, Le Plessis Robinson, INSERM UMR_S 999, Université Paris Sud, Paris, France.

Connective Tissue Disease (CTD) represents a group of genetic conditions characterized by disruptive matrix remodeling. When this process involves aortic and vascular wall, patients with CTD have a high risk of developing arterial aneurysms, dissections and ruptures. Open surgical repair is still the gold standard therapy for patients with CTD with reasonable morbidity and mortality risk. Read More

J Cardiovasc Surg (Torino) 2018 Oct 14;59(5):685-691. Epub 2018 Jun 14.

Division of Interventional Radiology, Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

Pedal access has become an indispensable technique for endovascular therapy of complex lower extremity peripheral vascular disease. From an option as a single access in a patient lacking traditional access approaches to a critical maneuver in combined antegrade-retrograde approaches during the treatment of complex chronic total occlusions, pedal access is an essential tool for any endovascular physician treating peripheral arterial disease. Anticipatory planning is critical in the successful utilization of pedal access. Read More

J Cardiovasc Surg (Torino) 2018 Oct 11;59(5):699-706. Epub 2018 Jun 11.

IRCCS Multimedica, Sesto S. Giovanni, Milan, Italy.

Background: The treatment of complex aortic diseases has known in the last years an extraordinary improvement, thanks to the development of new devices and techniques, especially concerning endovascular surgery. In this field, technological evolution has enabled vascular surgeons to overcome anatomical concerns and impairments that in the past made endovascular treatment unfeasible in many cases. However, the full exploitation of the devices offered by medical industry requires more and more powerful and accurate tools for case-by-case analysis and preoperative planning. Read More

J Cardiovasc Surg (Torino) 2018 Aug 31;59(4):526-528. Epub 2018 May 31.

UNC School of Medicine, Chapel Hill, NC, USA.

Peripheral Artery disease (PAD) is a cause of significant morbidity and mortality, affecting over 200 million people world-wide. Many exciting technologies have emerged to address the unique challenges endovascular specialists face when treating lesions in this vascular bed. One of the enduring challenges has been restenosis after initial intervention. Read More

J Cardiovasc Surg (Torino) 2018 Oct 29;59(5):670-684. Epub 2018 May 29.

Department of Orthopedic Surgery, Foot and Ankle Clinic, Abano Terme Polyclinic, Abano Terme, Padua, Italy.

The diabetic foot is a complication of diabetes affecting 15% of diabetics in their lives. It is associated to diabetic neuropathy and peripheral vascular disease and its incidence has increased. The ulceration is the initial cause of a dramatic process leading, if not correctly treated, to amputations. Read More

J Cardiovasc Surg (Torino) 2018 Aug 29;59(4):538-539. Epub 2018 May 29.

Department of Cardiothoracic and Vascular Surgery, West German Heart and Vascular Center Essen, University of Essen, Essen, Germany -

J Cardiovasc Surg (Torino) 2018 Aug 25;59(4):512-525. Epub 2018 May 25.

Division of Cardiovascular Medicine, Department of Interventional Cardiology, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA -

While the field of endovascular interventions has evolved in the last decade, technological advancements have rendered drug-coated balloons (DCBs) to be the first line therapy for femoropopliteal artery disease. As the knowledge continues to advance, the application of DCB to the infrapopliteal segments as well as its role in in conjunction with plaque modification to minimize stent utilization, will be further elucidated. Read More

J Cardiovasc Surg (Torino) 2018 08 25;59(4):540-546. Epub 2018 May 25.

Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center Essen, University of Duisburg-Essen, Essen, Germany.

Background: Frozen elephant trunk (FET) is considered to be the treatment of choice in complex multi-segmental thoracic aortic disease involving the distal arch. Institutional results of FET technique are presented.

Methods: From January 2005 to October 2017, 286 patients underwent FET surgery in our department. Read More

J Cardiovasc Surg (Torino) 2018 Dec 25;59(6):845-847. Epub 2018 May 25.

Cardiovascular Center Tokeidai Memorial Hospital, Sapporo, Japan.

J Cardiovasc Surg (Torino) 2018 Dec 23;59(6):767-774. Epub 2018 May 23.

Department of Vascular and Endovascular Surgery, Klinikum Nuremberg, Paracelsus Medical University, Nuremberg, Germany.

Postdissection aortic aneurysms (PDAA) affect 20-40% of patients with aortic dissection. Open repair remains the first line therapy of PDAA, but is still associated with high mortality and morbidity rates. Endovascular repair is increasingly being used as a less invasive treatment option. Read More

J Cardiovasc Surg (Torino) 2018 Aug 23;59(4):529-537. Epub 2018 May 23.

SoundBite Medical Solutions Inc., Montreal, QC, Canada -

Background: The aim of this study was to examine the safety and efficacy of the SoundBite™ Crossing System for the recanalization of infrainguinal chronic total occlusion (CTO) lesions. CTOs are frequent among patients with severe claudication or critical limb ischemia. Failure to recanalize CTOs remains common and is associated with poor prognosis. Read More

J Cardiovasc Surg (Torino) 2018 Aug 23;59(4):495-503. Epub 2018 May 23.

Department of Vascular Surgery, Sint-Blasius Hospital, Dendermonde, Belgium.

Although evidence supports that the performance of drug coated balloons seems to be lesion complexity independent, it is quite clear that in long lesions, severe calcified lesions and chronic total occlusions, the bail out stent ratio is very high and that the "leaving nothing behind" strategy remains a dream in a lot of our daily cases. On the other side of the spectrum, "full metal jackets" of nitinol stents are creating even more problems. Stent fractures, intimal hyperplasia and reintervention difficulties complicate the recurrent vascular disease treatment. Read More

J Cardiovasc Surg (Torino) 2018 Dec 22;59(6):775-783. Epub 2018 May 22.

Aortic Center, Marie Lannelongue Hospital, Le Plessis Robinson, Paris Sud University, Paris, France -

Chronic aortic dissecting aneurysms (TAAD) presenting after acute Stanford type A or B dissection includes both arch and/or thoracoabdominal aortic aneurysms (TAAA). Approximately 60% of patients who survive surgical treatment of acute type A aortic dissections will require another aortic procedure. Similarly, more than 70% of patients with chronic type B aortic dissections will experience false lumen dilation at 5-year follow-up, often requiring intervention. Read More

J Cardiovasc Surg (Torino) 2018 Aug 22;59(4):504-511. Epub 2018 May 22.

Department of Radiology, Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Aylesbury, UK -

Percutaneous transluminal angioplasty and stenting is becoming increasingly the first-line treatment for patients with both claudication and critical limb ischemia instead of surgery, with the aim of returning the patient's quality of life in the former and preventing amputation. Drug-eluting technologies have seen a large surge in popularity in recent years, and significant patient benefits have been seen with the use of drug-eluting stents and balloons over the use of plain balloon angioplasty. Unfortunately, in many patients with arterial disease there is significant vessel wall calcification - this can theoretically be a barrier to drug delivery and can also be a contributing factor to flow limiting dissection and the subsequent need for bail out stenting. Read More

J Cardiovasc Surg (Torino) 2018 Oct 22;59(5):655-664. Epub 2018 May 22.

Department of Clinical and Community Sciences, University of Milan, Milan, Italy.

Background: Most of the studies on peripheral artery disease (PAD) focused on above-the-ankle artery disease, while less is known about foot artery disease. We hypothesize a scenario were two different diseases can be present in PAD patients, big artery disease (BAD) and small artery disease (SAD), overlapping at the foot level; the aim of this study is to evaluate their prevalence and their correlation with risk factors and critical limb ischemia (CLI) in a large cohort of patients with symptomatic PAD.

Methods: We retrospectively reviewed 1915 limbs of 1613 patients (502 females, mean age 72. Read More

J Cardiovasc Surg (Torino) 2018 Oct 22;59(5):665-669. Epub 2018 May 22.

Department of Interventional Radiology, St. Antonius Hospital, Nieuwegein, The Netherlands.

Background: Critical limb ischemia (CLI) is the presentation of end stage peripheral arterial disease and typically presents with rest pain, ulceration and gangrene. The outcome of conservative treatment is poor and often leads to amputations. Arterial revascularization plays an important role in amputation prevention. Read More

J Cardiovasc Surg (Torino) 2018 May 22. Epub 2018 May 22.

Department of Vascular and Endovascular Surgery, University of L'Aquila, "San Salvatore Hospital", L'Aquila, Italy.