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Sökning: WFRF:(Mazzolai Lucia)

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  • Constans, Joël, et al. (författare)
  • Urgent need to clarify the definition of chronic critical limb ischemia – a position paper from the european society for vascular medicine
  • 2019
  • Ingår i: Vasa - European Journal of Vascular Medicine. - : Hans Huber. - 0301-1526. ; 48:3, s. 223-227
  • Tidskriftsartikel (refereegranskat)abstract
    • Summary: Chronic critical lower limb ischemia (CLI) has been defined as ischemia that endangers the leg. An attempt was made to give a precise definition of CLI, based on clinical and hemodynamic data (Second European Consensus). CLI may be easily defined from a clinical point of view as rest pain of the distal foot or gangrene or ulceration. It is probably useful to add leg ulcers of other origin which do not heal because of severe ischemia, and to consider the impact of frailty on adverse outcome. From a hemodynamic viewpoint there is no consensus and most of the existing classifications are not based upon evidence. We should thus propose a definition and then validate it in a prospective cohort in order to define the patients at major risk of amputation, and also to define the categories of patients whose prognosis is improved by revascularisation. From to-day’s available data, it seems clear that the patients with a systolic toe pressure (STP) below 30 mmHg must be revascular-ised whenever possible. However other patients with clinically suspected CLI and STP above 30 mmHg must be evaluated and treated in specialised vascular units and revascularisation has to be discussed on a case by case basis, taking into account other data such as the WiFi classification for ulcers.In conclusion, many useful but at times contradictory definitions of CLI have been suggested. Only a few have taken into account evidence, and none have been validated prospectively. This paper aims to address this and to give notice that a CLI registry within Europe will be set up to prospectively validate, or not, the previous and suggested definitions of CLI.
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  • Heiss, Christian, et al. (författare)
  • The compelling arguments for the need of medical vascular physicians in Europe
  • 2019
  • Ingår i: Vasa - European Journal of Vascular Medicine. - : Hans Huber. - 0301-1526. ; 48:6
  • Tidskriftsartikel (refereegranskat)abstract
    • The burden of vascular diseases is growing worldwide, as the population ages, prompting a call to action not only in terms of awareness but also and most urgently in recognizing the need for vascular physicians, also called angiologists. Vascular medicine views the vascular system (arteries, veins, and lymphatics) as a whole, unique, and independent entity requiring specialized competencies. Vascular physicians offer a holistic and comprehensive approach to vascular patients including provision of interventional procedures, management of a heterogeneous group of multi-morbid and frail patients affected by multi-vessel diseases, and connecting different specialists in a multidisciplinary effort. Vascular medicine practise varies across European countries. While it is a firmly accepted medical speciality in many European countries it is not formally recognized by the European Union limiting adoption in the other countries. The lack of vascular physicians likely accounts for inequality of care of vascular patients as compared for example to patients with heart disease and might contribute to adverse outcomes and healthcare costs associated with vascular diseases. To move forward in the struggle to provide efficient care for multimorbid poly-vascular patients, it is essential to establish vascular medicine programs in Europe and worldwide. Important steps to achieve this goal include improving public awareness of vascular diseases, attain formal recognition by the EU of angiology/vascular medicine as a medical specialty, creating specialized treatment guidelines, and to harmonize vascular care in Europe.
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  • Palagi, Stefano, et al. (författare)
  • Propulsion of swimming microrobots inspired by metachronal waves in ciliates: from biology to material specifications
  • 2013
  • Ingår i: Bioinspiration & Biomimetics. - : Institute of Physics: Hybrid Open Access. - 1748-3182 .- 1748-3190. ; 8:4, s. 046004-
  • Tidskriftsartikel (refereegranskat)abstract
    • The quest for swimming microrobots originates from possible applications in medicine, especially involving navigation in bodily fluids. Swimming microorganisms have become a source of inspiration because their propulsion mechanisms are effective in the low-Reynolds number regime. In this study, we address a propulsion mechanism inspired by metachronal waves, i.e. the spontaneous coordination of cilia leading to the fast swimming of ciliates. We analyse the biological mechanism (referring to its particular embodiment in Paramecium caudatum), and we investigate the contribution of its main features to the swimming performance, through a three-dimensional finite-elements model, in order to develop a simplified, yet effective artificial design. We propose a bioinspired propulsion mechanism for a swimming microrobot based on a continuous cylindrical electroactive surface exhibiting perpendicular wave deformations travelling longitudinally along its main axis. The simplified propulsion mechanism is conceived specifically for microrobots that embed a micro-actuation system capable of executing the bioinspired propulsion (self-propelled microrobots). Among the available electroactive polymers, we select polypyrrole as the possible actuation material and we assess it for this particular embodiment. The results are used to appoint target performance specifications for the development of improved or new electroactive materials to attain metachronal-waves-like propulsion.
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  • Venermo, Maarit, et al. (författare)
  • Editor's Choice - Follow-up of Patients After Revascularisation for Peripheral Arterial Diseases : A Consensus Document From the European Society of Cardiology Working Group on Aorta and Peripheral Vascular Diseases and the European Society for Vascular Surgery
  • 2019
  • Ingår i: European Journal of Vascular and Endovascular Surgery. - 1078-5884 .- 1532-2165. ; 58:5, s. 641-653
  • Tidskriftsartikel (refereegranskat)abstract
    • Peripheral arterial diseases comprise different clinical presentations, from cerebrovascular disease down to lower extremity artery disease, from subclinical to disabling symptoms and events. According to clinical presentation, the patient's general condition, anatomical location and extension of lesions, revascularisation may be needed in addition to best medical treatment. The 2017 European Society of Cardiology guidelines in collaboration with the European Society for Vascular Surgery have addressed the indications for revascularisation. While most cases are amenable to either endovascular or surgical revascularisation, maintaining long-term patency is often challenging. Early and late procedural complications, but also local and remote recurrences frequently lead to revascularisation failure. The rationale for surveillance is to propose the accurate implementation of preventive strategies to avoid other cardiovascular events and disease progression and avoid recurrence of symptoms and the need for redo revascularisation. Combined with vascular history and physical examination, duplex ultrasound scanning is the pivotal imaging technique for identifying revascularisation failures. Other non-invasive examinations (ankle and toe brachial index, computed tomography scan, magnetic resonance imaging) at regular intervals can optimise surveillance in specific settings. Currently, optimal revascularisation surveillance programmes are not well defined and systematic reviews addressing long-term results after revascularisation are lacking. We have systematically reviewed the literature addressing follow-up after revascularisation and we propose this consensus document as a complement to the recent guidelines for optimal surveillance of revascularised patients beyond the perioperative period.
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  • Venermo, Maarit, et al. (författare)
  • Follow-up of patients after revascularisation for peripheral arterial diseases : a consensus document from the European Society of Cardiology Working Group on Aorta and Peripheral Vascular Diseases and the European Society for Vascular Surgery
  • 2019
  • Ingår i: European Journal of Preventive Cardiology. - 2047-4873 .- 2047-4881. ; 26:18, s. 1971-1984
  • Tidskriftsartikel (refereegranskat)abstract
    • Peripheral arterial diseases comprise different clinical presentations, from cerebrovascular disease down to lower extremity artery disease, from subclinical to disabling symptoms and events. According to clinical presentation, the patient's general condition, anatomical location and extension of lesions, revascularisation may be needed in addition to best medical treatment. The 2017 European Society of Cardiology guidelines in collaboration with the European Society for Vascular Surgery have addressed the indications for revascularisation. While most cases are amenable to either endovascular or surgical revascularisation, maintaining long-term patency is often challenging. Early and late procedural complications, but also local and remote recurrences frequently lead to revascularisation failure. The rationale for surveillance is to propose the accurate implementation of preventive strategies to avoid other cardiovascular events and disease progression and avoid recurrence of symptoms and the need for redo revascularisation. Combined with vascular history and physical examination, duplex ultrasound scanning is the pivotal imaging technique for identifying revascularisation failures. Other non-invasive examinations (ankle and toe brachial index, computed tomography scan, magnetic resonance imaging) at regular intervals can optimise surveillance in specific settings. Currently, optimal revascularisation surveillance programmes are not well defined and systematic reviews addressing long-term results after revascularisation are lacking. We have systematically reviewed the literature addressing follow-up after revascularisation and we propose this consensus document as a complement to the recent guidelines for optimal surveillance of revascularised patients beyond the perioperative period.
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