Giovanni Torsello

Prof.
  • Function: Director
  • Speciality: Vascular Surgery
  • Country: DE
  • Working place: St. Franziskus Hospital, Muenster, DE

Activities

Comment on Jan 22, 2019

Gladiol Zenunaj commented on presentation VRTD 2: Association between PTX-coated devices and overall mortality.

»Greetings, thanks for sharing your research. The authors are reporting that mortality paclitaxel- related is dependent on the dose loaded on the device. Do the authors think that mortality paclitaxel-related after 1 year could depend whether on the paclitaxel load transferred to vessel wall or the load lost in the bloodstream during the delivering of the device. If this could be related to the load of paclitaxel lost during the delivering it shuld urge the developement of better drug bonding to the device.«
Comment on Jan 14, 2019

Gladiol Zenunaj replied to your comment on presentation VRTD 2: Association between PTX-coated devices and overall mortality.

»Very interesting paper. However, if their findings are confirmed in other studies, I think it might have any impact on the PTX-devices use rather than reducing the number of endovascular procedures. Nowadays, the increasing age, number of comorbidities of patients we have to deal with, make an open approach unthinkable.«
Comment on Jan 14, 2019

Konstantinos Katsanos commented on presentation VRTD 2: Association between PTX-coated devices and overall mortality.

»RCTs were included only in the meta-analysis. The paclitaxel arms and the control arms had similar-comparable baseline demographics without any significant differences (please refer to Appendix of the paper in JAHA). Not all studies had the same periods of follow-up time. Hence, the different number of studies for each time point. Our raw data is available 'open access' in the paper for any body to double-check. Independent reviews are of course more than welcome.«
Comment on Jan 13, 2019

Giovanni Torsello commented on presentation VRTD 2: Association between PTX-coated devices and overall mortality.

»I am not a statistician. But the statement "the two group are identical" is wrong. The groups may be comparable. Randomization was for sure not done for life expectancy, but for lesion characteristics. We need the opinion of a statistician. The study was not accepted for publication in "high ranked" Journals. Why? Additionally, the comparison of many studies at the beginning and of a few studies at 2 and 5 years looks "strange" in my opinion. The studies were externally controlled by Independent committees. What is the reason why they did not find safety issues? It is a pity that these points were not addressed during the round table.«
Technical note

SMA occlusion: when open, when endo and how?

This presentation includes important clinical and anatomic issues, which play a relevant role in the decision making between open surgical and endovascular treatment of the SMA occlusion. Which technique is appropriate for open surgical revascularization? Which material should be used as bypass or patch? When should you go for an endovascular-first approach? Which kind of stents? Do we have evidence? All these questions are answered in this presentation.

Giovanni Torsello
June 16, 2018 No Comments
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Comment on Jun 05, 2018

Giovanni Torsello commented on presentation Carotid artery endarterectomy with patchplasty: step by step procedure.

»Thank you, Dr. Dr. Georgakarakos for your comment. I have no personal experience with bovine pericardium but a long positive experience with Dacron patch. Therefore I have not changed my strategy. Until 1997 I have used autologous vein as patch material. However, by Duplex US I found increased dilatation of the treated segment sometimes also with parietal thrombus load. This is the reason why I switched to alloplastic material. For elongated ICA our preferred technique is the eversion. For the next weeks we are preparing a video. In case you have alternatives please feel free to show your own experience. Warm regards G.Torsello«
Review of the literature

Chimney Reconstructions for Juxtarenal Aneurysms: Indications, Optimal Technique and Outcome Data

In this presentation, you will find important information about the chimney technique (chEVAR) for the treatment of juxtarenal or pararenal aortic aneurysms.

Giovanni Torsello
May 22, 2018 No Comments
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Poll 06/01/2020 – 31/01/2020

VASCUPEDIA@LINC – ENDOLEAKS-CASE-BASED SOLUTIONS

The topic of this month is called ENDOLEAKS-CASE-BASED SOLUTIONS and aims to provide more information to the discussants of the session about endoleaks that will take place on Thursday, January 30, 2020 in Leipzig, during the LINC symposium. Take the opportunity to answer the questions and to inform the experts about your current practice for the treatment of all type of endoleaks.

Your participation will provide unique data for an interesting discussion and your answers will challenge the experts during the session.

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Poll 04/10/2019 – 31/10/2019

Choice of antiplatelet therapy around complex revascularisation

A 79-year-old diabetic male patient with no history of coronary disease is referred to you to undergo angioplasty for tissue loss on the tips of the hallux and second toe. He is taking Aspirin 75mg. From preoperative imaging he needs a 20cm SFA occlusion stopping before the adductor hiatus recanalizing as well as multilevel tibial disease which appears to be a combination of short occlusions and stenoses. The dorsal pedal is seen in the foot and is in continuity with the arch. The PT artery appears occluded through it’s whole length.

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Poll 05/09/2019 – 30/09/2019

Online education in vascular medicine

Shape your learning experience on Vascupedia

 

Dear colleagues, our mission is to help physicians worldwide to bring their interventions to perfection. Our hope is to indirectly contribute to safety and well-being of patients with vascular diseases.

Over a year ago, we started Vascupedia as a unique online project that we believe fulfills the need for free education in the challenging field of Vascular Medicine. Now it’s time to ask you to help us to become better for you! Are we offering the right information in the right way at the right level? Is there anything missing to support you in your quest to grow your knowledge to treat your patients in the best possible way? Please complete this short survey to make sure we will work on improving the platform to serve YOUR educational needs!

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Poll 01/05/2019 – 31/05/2019

The radiation exposure

Since January 2018, employers in the U.K and Europe have had to comply with their duties under the Ionising Radiations Regulations 2017, IRR17. Previous to this most health trusts working with ionising radiation followed IRR99.

The main changes since the last edition (IRR99) that affect the operator:

  • The dose limit for exposure to the lens of the eye has been reduced from 150 mSv to 20 mSv in a year. This is usually assessed using forehead monitoring bands.

It is the duty of the operator to control methods for restricting exposure to ionising radiation by use of distance and shielding etc.

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Poll 01/03/2019 – 31/03/2019

The chronic mesenteric ischemia

Patient’s characteristics

 

Gender: Female

Age: 69 years old

Comorbidity: Arterial hypertension, Dyslipidemia, coronary heart disease (DES deployment 2 years ago)

Symptoms:  Postprandial pain

Previous abdominal operations: None

DUS: Occlusion of the superior mesenteric artery

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Poll 02/02/2019 – 28/02/2019

The acute limb ischemia

Patient’s characteristics

Gender: Female

Age: 65 years old

Comorbidity: Arterial hypertension, Dyslipidemia

Symptoms:  Acute onset of claudication (<2 weeks), Rutherford class 3 of the left limb

Previous operations: None

ABI: 0.5

DUS: Occlusion of the left popliteal artery

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Poll 01/11/2018 – 30/11/2018

Ilio-femoral deep vein thrombosis

45 years old female patient presenting with painful swelling of the right limb during the last 24 hours. Wells score on admission was 4 points. The duplex ultrasound scanning revealed a femoropopliteal and iliac deep vein thrombosis. No other risk factors were present. No previous operations. No thrombophilia documented.

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Poll 01/10/2018 – 31/10/2018

Critical limb-threatening ischemia – CLI Global Society

Patient’s characteristics

 

Gender: Male

Age: 79 years old

Comorbidity: Arterial hypertension, hypercholesterinemia, chronic kidney disease (GFR: 53 ml/min/1,73m²), NYHA II, Coronary artery disease, previous CABG

Symptoms:  Toe ulceration of the left limb

Previous operations: None

ABI: incompressible, Toe pressure: 32 mmHg

Vascular Imaging – Duplex ultrasound: Isolated tibial vessel disease

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Poll 13/04/2018 – 30/06/2018

Topic: Asymptomatic juxta- and pararenal aortic aneurysms

Patient’s characteristics

Gender: Female
Age: 75 years old
Comorbidity: Arterial hypertension, hypercholesterinemia, previous aortocoronary bypass grafting, previous myocardial infarction, previous smoker, peripheral arterial disease, atrial fibrillation
Symptoms: None
Previous operations: None

 

Aneurysm characteristics:

Max. aneurysm diameter: 54 mm

Length of proximal infrarenal neck: 0 mm

Distance between SMA and LRA: 20 mm

Diameter of renal arteries: RRA: 5,3 mm, LRA: 6 mm

Suprarenal angulation: 60°

Diameter of distal neck: 30 mm

Minimum diameter of common iliac arteries: R: 11 mm, L:9 mm

Maximum diameter of common iliac arteries: R: 11 mm, L: 14 mm

Minimum diameter of external iliac arteries: R: 7 mm, L: 6,2 mm

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