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Luca Luzzani

Bio: Luca Luzzani is an academic researcher. The author has contributed to research in topics: Aneurysm & Revascularization. The author has an hindex of 10, co-authored 24 publications receiving 450 citations.

Papers
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Journal ArticleDOI
TL;DR: Successful revascularization was lower than expected which the authors hypothesize is due to a virus-related hypercoagulable state and the use of prolonged systemic heparin may improve surgical treatment efficacy as well as improve limb salvage and overall mortality.

351 citations

Journal Article
TL;DR: It is concluded that elective repair is indicated in all patients with popliteal aneurysm > or = 2 cm to avoid a critical ischemia with poorer results in terms of CP and LS.
Abstract: Objectives A retrospective study to evaluate the treatment, long term follow-up and factors affecting revascularization results particularly in regard to clinical presentation and prosthetic materials used after 20 years of experience. Materials and methods Between 1974 and September 1995 there were 67 popliteal aneurysms in 58 patients. Three patients underwent a primary amputation because of irreversible ischaemia and 3 patients a surgical sympathectomy. Operative repair was performed in 61 cases: as an emergency in 9 (14.7%) limbs and as an elective procedure in 52 (85.3%) limbs. Graft replacement was performed employing polytetrafluoroethylene (PTFE) grafts in 34 (55.7%) cases 13 of which with Ringed PTFE, autogenous saphenous vein in 10 (16.4%) cases and Dacron in 17 (27.9%). Results The cumulative primary patency (CP) and limb salvage rate (LS) at 10 years were 75.1% and 83.3% respectively. We divided the patients into two groups: asymptomatic (Group I) and symptomatic with limb threatening ischemia (Group II). At 10 years the CP in Group I and II were 78.2% vs 67.2% respectively (p Conclusions We conclude that elective repair is indicated in all patients with popliteal aneurysm > or = 2 cm to avoid a critical ischemia with poorer results in terms of CP and LS. In the last 3 years our technique of choice is the exclusion of the aneurysm with a short PTFE bypass with good long-term of CP and LS rates.

56 citations

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TL;DR: The argument that standard CEA performed with routine shunting as brain protection leads to excellent early and long-term results support the argument that basic shunting is a safe and reliable method of cerebral protection.

46 citations

Journal ArticleDOI
TL;DR: The histopathologic study showed a non-specific aneurysm without specific alterations, excluding atherosclerotic or micotic nature, in a 63-year-old healthy non-smoking woman with no history of trauma.
Abstract: Aneurysms of the radial artery are uncommon; most of the recorded cases occurred after trauma. We report a case of true aneurysm of radial artery in the anatomical snuff box in a 63-year-old healthy non-smoking woman with no history of trauma. The Duplex scan and the MRA confirmed the presence of the aneurysm of the distal radial artery, approximately 1.1 by 1.0cm. We checked the patency of the palmar collateral circle by a preoperative and intraoperative Allen's test with a hand held Doppler. We ligated the radial artery and excised the aneurysm. The histopathologic study showed a non-specific aneurysm without specific alterations, excluding atherosclerotic or micotic nature.

18 citations

Journal ArticleDOI
TL;DR: Three consecutive cases of true aneurysms of the pancreaticoduodenal artery associated with celiac axis occlusion are presented with different options of surgical treatment.

16 citations


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Journal ArticleDOI
TL;DR: The interaction between the viral spike protein and angiotensin-converting enzyme 2, which triggers entry of the virus into host cells, is likely to be involved in the cardiovascular manifestations of COVID-19.
Abstract: Coronavirus disease 2019 (COVID-19), caused by a strain of coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic that has affected the lives of billions of individuals. Extensive studies have revealed that SARS-CoV-2 shares many biological features with SARS-CoV, the zoonotic virus that caused the 2002 outbreak of severe acute respiratory syndrome, including the system of cell entry, which is triggered by binding of the viral spike protein to angiotensin-converting enzyme 2. Clinical studies have also reported an association between COVID-19 and cardiovascular disease. Pre-existing cardiovascular disease seems to be linked with worse outcomes and increased risk of death in patients with COVID-19, whereas COVID-19 itself can also induce myocardial injury, arrhythmia, acute coronary syndrome and venous thromboembolism. Potential drug-disease interactions affecting patients with COVID-19 and comorbid cardiovascular diseases are also becoming a serious concern. In this Review, we summarize the current understanding of COVID-19 from basic mechanisms to clinical perspectives, focusing on the interaction between COVID-19 and the cardiovascular system. By combining our knowledge of the biological features of the virus with clinical findings, we can improve our understanding of the potential mechanisms underlying COVID-19, paving the way towards the development of preventative and therapeutic solutions.

927 citations

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TL;DR: The case-fatality rate of recurrent VTE decreases after completion of the initial period of anticoagulation and major bleeding events are similar during theInitial period of VTE treatment, suggesting that clinicians have a surrogate measure of mortality to balance the risks and benefits of antICOagulant therapy in patients with VTE.
Abstract: Physicians must consider case-fatality rates for recurrent venous thromboembolism (VTE) and major bleeding when weighing the benefits and harms of new anticoagulant strategies for VTE. This systema...

410 citations

Journal ArticleDOI
TL;DR: The latest evidence indicating that platelet and endothelial dysfunction are essential components of CO VID-19 pathology is summarized, the potential mechanisms underlying the contribution of cardiovascular risk factors to the most severe outcomes in COVID-19 are described and the roles of coagulopathy, thrombocytopathy and endotheliopathy are highlighted.
Abstract: The core pathology of coronavirus disease 2019 (COVID-19) is infection of airway cells by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that results in excessive inflammation and respiratory disease, with cytokine storm and acute respiratory distress syndrome implicated in the most severe cases. Thrombotic complications are a major cause of morbidity and mortality in patients with COVID-19. Patients with pre-existing cardiovascular disease and/or traditional cardiovascular risk factors, including obesity, diabetes mellitus, hypertension and advanced age, are at the highest risk of death from COVID-19. In this Review, we summarize new lines of evidence that point to both platelet and endothelial dysfunction as essential components of COVID-19 pathology and describe the mechanisms that might account for the contribution of cardiovascular risk factors to the most severe outcomes in COVID-19. We highlight the distinct contributions of coagulopathy, thrombocytopathy and endotheliopathy to the pathogenesis of COVID-19 and discuss potential therapeutic strategies in the management of patients with COVD-19. Harnessing the expertise of the biomedical and clinical communities is imperative to expand the available therapeutics beyond anticoagulants and to target both thrombocytopathy and endotheliopathy. Only with such collaborative efforts can we better prepare for further waves and for future coronavirus-related pandemics.

267 citations

Journal ArticleDOI
TL;DR: Novel dosing approaches are described for commonly used antithrombotic agents (especially heparin-based regimens) and the potential use of less widely used antithsombotic drugs in the absence of confirmed thrombosis.
Abstract: Coronavirus disease 2019 (COVID-19), currently a worldwide pandemic, is a viral illness caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The suspected contribution of thrombotic events to morbidity and mortality in COVID-19 patients has prompted a search for novel potential options for preventing COVID-19-associated thrombotic disease. In this article by the Global COVID-19 Thrombosis Collaborative Group, we describe novel dosing approaches for commonly used antithrombotic agents (especially heparin-based regimens) and the potential use of less widely used antithrombotic drugs in the absence of confirmed thrombosis. Although these therapies may have direct antithrombotic effects, other mechanisms of action, including anti-inflammatory or antiviral effects, have been postulated. Based on survey results from this group of authors, we suggest research priorities for specific agents and subgroups of patients with COVID-19. Further, we review other agents, including immunomodulators, that may have antithrombotic properties. It is our hope that the present document will encourage and stimulate future prospective studies and randomized trials to study the safety, efficacy, and optimal use of these agents for prevention or management of thrombosis in COVID-19.

191 citations

Journal ArticleDOI
TL;DR: In this article, the authors examined prescription drug and health-care use after SARS-CoV-2 infection not requiring hospital admission and found that SARS co-v2-positive individuals were not at an increased risk of initiating new drugs.
Abstract: Summary Background Individuals admitted to hospital for COVID-19 might have persisting symptoms (so-called long COVID) and delayed complications after discharge. However, little is known regarding the risk for those not admitted to hospital. We therefore examined prescription drug and health-care use after SARS-CoV-2 infection not requiring hospital admission. Methods This was a population-based cohort study using the Danish prescription, patient, and health insurance registries. All individuals with a positive or negative RT-PCR test for SARS-CoV-2 in Denmark between Feb 27 and May 31, 2020, were eligible for inclusion. Outcomes of interest were delayed acute complications, chronic disease, hospital visits due to persisting symptoms, and prescription drug use. We used data from non-hospitalised SARS-CoV-2-positive and matched SARS-CoV-2-negative individuals from 2 weeks to 6 months after a SARS-CoV-2 test to obtain propensity score-weighted risk differences (RDs) and risk ratios (RRs) for initiation of 14 drug groups and 27 hospital diagnoses indicative of potential post-acute effects. We also calculated prior event rate ratio-adjusted rate ratios of overall health-care use. This study is registered in the EU Electronic Register of Post-Authorisation Studies (EUPAS37658). Findings 10 498 eligible individuals tested positive for SARS-CoV-2 in Denmark from Feb 27 to May 31, 2020, of whom 8983 (85·6%) were alive and not admitted to hospital 2 weeks after their positive test. The matched SARS-CoV-2-negative reference population not admitted to hospital consisted of 80 894 individuals. Compared with SARS-CoV-2-negative individuals, SARS-CoV-2-positive individuals were not at an increased risk of initiating new drugs (RD Interpretation The absolute risk of severe post-acute complications after SARS-CoV-2 infection not requiring hospital admission is low. However, increases in visits to general practitioners and outpatient hospital visits could indicate COVID-19 sequelae. Funding None.

175 citations