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Berchiolli R, Troisi N, Bertagna G, D’Oria M, Mezzetto L, Malquori V, Artini V, Motta D, Grosso L, Grando B, Badalamenti G, Calvagna C, Mastrorilli D, Veraldi GF, Adami D, Lepidi S. Intraoperative Predictors and Proposal for a Novel Prognostic Risk Score for In-Hospital Mortality after Open Repair of Ruptured Abdominal Aortic Aneurysms (SPARTAN Score). J Clin Med 2024; 13:1384. [PMID: 38592197 PMCID: PMC10934212 DOI: 10.3390/jcm13051384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/30/2024] [Accepted: 02/23/2024] [Indexed: 04/10/2024] Open
Abstract
(1) Background: Several mortality risk scores have been developed to predict mortality in ruptured abdominal aortic aneurysms (rAAAs), but none focused on intraoperative factors. The aim of this study is to identify intraoperative variables affecting in-hospital mortality after open repair and develop a novel prognostic risk score. (2) Methods: The analysis of a retrospectively maintained dataset identified patients who underwent open repair for rAAA from January 2007 to October 2023 in three Italian tertiary referral centers. Multinomial logistic regression was used to calculate the association between intraoperative variables and perioperative mortality. Independent intraoperative factors were used to create a prognostic score. (3) Results: In total, 316 patients with a mean age of 77.3 (SD ± 8.5) were included. In-hospital mortality rate was 30.7%. Hemoperitoneum (p < 0.001), suprarenal clamping (p = 0.001), and operation times of >240 min (p = 0.008) were negative predictors of perioperative mortality, while the patency of at least one hypogastric artery had a protective role (p = 0.008). Numerical values were assigned to each variable based on the respective odds ratio to create a risk stratification for in-hospital mortality. (4) Conclusions: rAAA represents a major cause of mortality. Intraoperative variables are essential to estimate patients' risk in surgically treated patients. A prognostic risk score based on these factors alone may be useful to predict in-hospital mortality after open repair.
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Affiliation(s)
- Raffaella Berchiolli
- Vascular Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (R.B.); (N.T.); (G.B.); (V.M.); (V.A.); (D.M.); (D.A.)
| | - Nicola Troisi
- Vascular Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (R.B.); (N.T.); (G.B.); (V.M.); (V.A.); (D.M.); (D.A.)
| | - Giulia Bertagna
- Vascular Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (R.B.); (N.T.); (G.B.); (V.M.); (V.A.); (D.M.); (D.A.)
| | - Mario D’Oria
- Vascular and Endovascular Surgery Unit, Cardio-Thoraco-Vascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, 34148 Trieste, Italy; (B.G.); (G.B.); (C.C.); (S.L.)
| | - Luca Mezzetto
- Unit of Vascular Surgery, Department of Cardio-Thoraco-Vascular Surgery, University Hospital and Trust of Verona, University of Verona School of Medicine, 37134 Verona, Italy; (L.M.); (L.G.); (D.M.); (G.F.V.)
| | - Vittorio Malquori
- Vascular Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (R.B.); (N.T.); (G.B.); (V.M.); (V.A.); (D.M.); (D.A.)
| | - Valerio Artini
- Vascular Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (R.B.); (N.T.); (G.B.); (V.M.); (V.A.); (D.M.); (D.A.)
| | - Duilio Motta
- Vascular Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (R.B.); (N.T.); (G.B.); (V.M.); (V.A.); (D.M.); (D.A.)
| | - Lorenzo Grosso
- Unit of Vascular Surgery, Department of Cardio-Thoraco-Vascular Surgery, University Hospital and Trust of Verona, University of Verona School of Medicine, 37134 Verona, Italy; (L.M.); (L.G.); (D.M.); (G.F.V.)
| | - Beatrice Grando
- Vascular and Endovascular Surgery Unit, Cardio-Thoraco-Vascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, 34148 Trieste, Italy; (B.G.); (G.B.); (C.C.); (S.L.)
| | - Giovanni Badalamenti
- Vascular and Endovascular Surgery Unit, Cardio-Thoraco-Vascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, 34148 Trieste, Italy; (B.G.); (G.B.); (C.C.); (S.L.)
| | - Cristiano Calvagna
- Vascular and Endovascular Surgery Unit, Cardio-Thoraco-Vascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, 34148 Trieste, Italy; (B.G.); (G.B.); (C.C.); (S.L.)
| | - Davide Mastrorilli
- Unit of Vascular Surgery, Department of Cardio-Thoraco-Vascular Surgery, University Hospital and Trust of Verona, University of Verona School of Medicine, 37134 Verona, Italy; (L.M.); (L.G.); (D.M.); (G.F.V.)
| | - Gian Franco Veraldi
- Unit of Vascular Surgery, Department of Cardio-Thoraco-Vascular Surgery, University Hospital and Trust of Verona, University of Verona School of Medicine, 37134 Verona, Italy; (L.M.); (L.G.); (D.M.); (G.F.V.)
| | - Daniele Adami
- Vascular Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy; (R.B.); (N.T.); (G.B.); (V.M.); (V.A.); (D.M.); (D.A.)
| | - Sandro Lepidi
- Vascular and Endovascular Surgery Unit, Cardio-Thoraco-Vascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, 34148 Trieste, Italy; (B.G.); (G.B.); (C.C.); (S.L.)
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Bozzani A, Rossini R, Arici V. Searching for the reason why the results of infrarenal AAA open surgery are worsening. J Vasc Surg 2022; 76:1427. [DOI: 10.1016/j.jvs.2022.03.898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 02/22/2022] [Accepted: 03/04/2022] [Indexed: 11/20/2022]
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Bozzani A, Arici V, Ragni F, Sterpetti AV, Quaretti P, Arbustini E. Re: "The Impact of Degenerative Connective Tissue Disorders on Outcomes Following Endovascular Aortic Intervention in the Global Registry for Endovascular Aortic Treatment". Ann Vasc Surg 2022; 83:e3-e4. [PMID: 35337929 DOI: 10.1016/j.avsg.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 03/04/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Antonio Bozzani
- Vascular and Endovascular Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, ITALY.
| | - Vittorio Arici
- Vascular and Endovascular Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, ITALY
| | - Franco Ragni
- Vascular and Endovascular Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, ITALY
| | | | - Pietro Quaretti
- Interventional Radiology, Fondazione IRCCS Policlinico San Matteo, Pavia, ITALY
| | - Eloisa Arbustini
- Transplant Research Area and Centre for Inherited Cardiovascular Diseases, Department of Medical Sciences and Infectious Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, ITALY
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Arici V, Boschini S, Fellegara R, Carando S, Rossi M, Ragni F, Bozzani A. "Re: "Outcomes and Predictors of Mortality in a Belgian Population of Patients Admitted With Ruptured Abdominal Aortic Aneurysm and Treated by Open Repair in the Contemporary Era". Ann Vasc Surg 2021; 79:e7-e8. [PMID: 34648857 DOI: 10.1016/j.avsg.2021.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 08/29/2021] [Indexed: 11/16/2022]
Affiliation(s)
- Vittorio Arici
- Vascular and Endovascular Surgery, Foundation I.R.C.C.S., Pavia, Italy
| | - Stefano Boschini
- Vascular and Endovascular Surgery, Foundation I.R.C.C.S., Pavia, Italy
| | | | - Simona Carando
- Vascular and Endovascular Surgery, Foundation I.R.C.C.S., Pavia, Italy
| | - Mauro Rossi
- Vascular and Endovascular Surgery, Foundation I.R.C.C.S., Pavia, Italy
| | - Franco Ragni
- Vascular and Endovascular Surgery, Foundation I.R.C.C.S., Pavia, Italy
| | - Antonio Bozzani
- Vascular and Endovascular Surgery, Foundation I.R.C.C.S., Pavia, Italy.
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Franciscone MM, Danesino V, Arici V, Bozzani A, Ragni F. Re: "Off-Label Use of a Flared Endograft Limb for Treatment of a Complicated Anastomotic Abdominal Aortic Pseudoaneurysm: Reverse Deployment Throught Axillary Artery". Ann Vasc Surg 2021; 75:e4. [PMID: 33901615 DOI: 10.1016/j.avsg.2021.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 04/14/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Mila Maria Franciscone
- Vascular and Endovascular Surgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Vittorio Danesino
- Vascular and Endovascular Surgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Vittorio Arici
- Vascular and Endovascular Surgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Antonio Bozzani
- Vascular and Endovascular Surgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
| | - Franco Ragni
- Vascular and Endovascular Surgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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Bozzani A, Arici V, Ticozzelli G, Boschini S, Franciscone MM, Danesino V, Brunetto MB, Rossi M, Sterpetti AV, Ragni F. The Fate of Open Surgery in the EVAR Era. Ann Vasc Surg 2021; 73:e8-e9. [PMID: 33549773 DOI: 10.1016/j.avsg.2021.01.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Antonio Bozzani
- Vascular and Endovascular Surgery, Foundation I.R.C.C.S. Policlinico San Matteo, Pavia, Italy.
| | - Vittorio Arici
- Vascular and Endovascular Surgery, Foundation I.R.C.C.S. Policlinico San Matteo, Pavia, Italy
| | - Giulia Ticozzelli
- Anesthesiology and Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Stefano Boschini
- Vascular and Endovascular Surgery, Foundation I.R.C.C.S. Policlinico San Matteo, Pavia, Italy
| | - Mila Maria Franciscone
- Vascular and Endovascular Surgery, Foundation I.R.C.C.S. Policlinico San Matteo, Pavia, Italy
| | - Vittorio Danesino
- Vascular and Endovascular Surgery, Foundation I.R.C.C.S. Policlinico San Matteo, Pavia, Italy
| | - Massimo Borri Brunetto
- Vascular and Endovascular Surgery, Foundation I.R.C.C.S. Policlinico San Matteo, Pavia, Italy
| | - Mauro Rossi
- Vascular and Endovascular Surgery, Foundation I.R.C.C.S. Policlinico San Matteo, Pavia, Italy
| | | | - Franco Ragni
- Vascular and Endovascular Surgery, Foundation I.R.C.C.S. Policlinico San Matteo, Pavia, Italy
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Rota M, Arici V, Franciscone MM, Danesino V, Rossini R, Ticozzelli G, Sterpetti AV, D'Ercole L, Ragni F, Bozzani A. Abdominal Aorta Angiosarcoma after Endovascular Aneurysm Repair. Ann Vasc Surg 2021; 73:525-528. [PMID: 33503501 DOI: 10.1016/j.avsg.2020.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/29/2020] [Accepted: 12/05/2020] [Indexed: 11/29/2022]
Abstract
Primary tumors originating within the wall of the arteries are rare and they frequently manifest late, making effective treatment a challenge. We describe here a case of Abdominal Aorta AngioSarcoma masqueraded as an infected EndoVascular Aortic Repair. The knowledge of this pathology from vascular surgeons and radiologist is crucial, because a prompt diagnosis and treatment can improve the prognosis.
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Affiliation(s)
- Monica Rota
- Vascular and Endovascular Surgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Vittorio Arici
- Vascular and Endovascular Surgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Mila Maria Franciscone
- Vascular and Endovascular Surgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Vittorio Danesino
- Vascular and Endovascular Surgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Rosa Rossini
- Vascular and Endovascular Surgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Giulia Ticozzelli
- Anesthesiology and Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Loredana D'Ercole
- Department of Medical Physics, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Franco Ragni
- Vascular and Endovascular Surgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Antonio Bozzani
- Vascular and Endovascular Surgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
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Bozzani A, Arici V, Franciscone MM, Danesino V, Rota M, Rossini R, Ticozzelli G, Ragni F. The Off-Label Use of a Leg Endoprosthesis for Internal Iliac Artery Aneurysm Treatment. Ann Vasc Surg 2021; 71:535.e17-20. [PMID: 33160053 DOI: 10.1016/j.avsg.2020.09.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/16/2020] [Accepted: 09/17/2020] [Indexed: 11/20/2022]
Abstract
The 10-30% of iliac aneurysms involve the internal iliac arteries (IIAs), and their repair still remains a challenge. The endovascular techniques have become the treatment of choice in relation to the improvement of materials, techniques, and less morbidity/mortality compared with open surgery. Regardless of the use of open or endovascular surgery, the preservation of hypogastric blood flow is strongly recommended in the case of occlusion of the contralateral. We describe a case of the use over the instructions for use (IFU), of the GORE Excluder iliac extension for the total successful endovascular exclusion of a voluminous IIA aneurysm in chronic contralateral occlusion. This use over the IFU is applicable and effective in selected patients.
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Bozzani A, Arici V, Rota M, Ticozzelli G, Ragni F. Case Study of Giant unruptured infrarenal abdominal aortic aneurysms. J Vasc Nurs 2020; 38:191-192. [PMID: 33279109 DOI: 10.1016/j.jvn.2020.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/19/2020] [Accepted: 09/22/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Antonio Bozzani
- Vascular and Endovascular Surgery Unit, Fondazione I.R.C.C.S. Policlinico San Matteo, Pavia, Italy.
| | - Vittorio Arici
- Vascular and Endovascular Surgery Unit, Fondazione I.R.C.C.S. Policlinico San Matteo, Pavia, Italy
| | - Monica Rota
- Vascular and Endovascular Surgery Unit, Fondazione I.R.C.C.S. Policlinico San Matteo, Pavia, Italy
| | - Giulia Ticozzelli
- Anesthesiology and Intensive Care Unit, Fondazione I.R.C.C.S. Policlinico San Matteo, Pavia, Italy
| | - Franco Ragni
- Vascular and Endovascular Surgery Unit, Fondazione I.R.C.C.S. Policlinico San Matteo, Pavia, Italy
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