Safety and efficacy of vacuum assisted thrombo-aspiration in patients with acute lower limb ischaemia: The INDIAN Trial

Objective: The aim was to evaluate the short term safety and effectiveness of the Penumbra/Indigo aspiration thrombectomy Systems (Penumbra Inc.) in patients with acute lower limb ischaemia. (ALLI). Recently, endovascular vacuum assisted thrombectomy devices, similar to those used in the management of acute ischaemic stroke, have become available for peripheral arteries, but data are still scarce.Methods: To assess vessel patency, a modified Thrombolysis in Myocardial Infarction (TIMI) classification, called TIPI (Thrombo-aspiration In Peripheral Ischaemia), is proposed. The TIPI flow is assessed at presentation, immediately after treatment with the study device, and after all adjuvant procedures. The primary outcome is the technical success of the thrombo-aspiration with the investigative system, defined as near complete or complete revascularisation TIPI 2 - 3. Safety and clinical success rate were collected at one month.Results: One hundred and fifty patients were enrolled. The mean age was 72.4 years and 73.3% were male. Rutherford grade on enrolment was I in 16%, IIa in 40.7%, and IIb in 43.3% with a mean ankle brachial index of 0.19. Primary technical success (TIPI 2 - 3 flow) was achieved in 88.7% of patients. Adjunctive procedures included angioplasty/stenting of chronic atherosclerotic lesions (n = 39), thrombolysis (n = 31), covered stenting (n = 15), and supplementary Fogarty embolectomy (n = 6). After all interventions, assisted primary technical success was 95.3% (TIPI 2 - 3 in 143/150). No systemic bleeding complications or device related serious adverse events were reported. At one month follow up, one death, and one below the knee amputation were recorded. Primary patency was 92% (138/150), and the re-intervention rate was 7.33%, resulting in an assisted primary and secondary patency of 94% and 99.33%, respectively.Conclusion: Results from the INDIAN registry reveal that mechanical thrombectomy using the Indigo system is safe and effective for revascularisation of ALLI as a primary therapy

The great Millennials’ trouble: leading or confused green generation? An Italian insight

3sinonenoneMichelle Bonera; Anna Paola Codini; Giulia MinieroBonera, Michelle; Codini, Anna Paola; Miniero, Giuli

Complete Recovery of an Iatrogenic Venous Gaseous Embolism (VGE) Clinical Presentation Thanks to a Timely Hyperbaric Oxygen Therapy (HBOT) Treatment

Gas embolism is a potentially fatal occurrence in which bubbles are introduced into the arterial/venous circulation. A multifocal ischemia could be the life-threatening scenario of that and occurring after diving-related activities, or pulmonary barotrauma, or even iatrogenic procedure capable to cause an accidental introduction of gas into the vasculature. The case here reported concerns the good outcome of one of these rare occurrences thanks to a prompt diagnosis and proper management of the ongoing gaseous lesion. Unfortunately, it remains ethically and technically complex to consider feasible Randomized Clinical Trials (RCTs) in hyperbaric medicine in general, and even more so in this type of eventuality. We are happy to share this further favorable result as we believe it is just thanks to growing documented clinical evidence that now anyone, if ever had to be suffering from gas embolism, in presence of a RCT would widely prefer to be included in the arm that can take advantage of oxygen hyperbaric (HBO) therapy

Stimolare le scelte di consumo green

The present study contributes to the debate about how to convince consumers to engage into green consumption. It aims to investigate the role that a particular individual difference, the regulatory focus, assumes in green consumer behavior. The regulatory focus is the strategic orientation individuals use to pursue their goals. In particular we want to evaluate if and how the individuals regulatory focus may be a stimulating factor for the adoption of green behavior. One experimental study was conducted aimed at measuring the effect of regulatory focus in green and not green consumption. The study empirically verifies which of the two orientations (promotion/prevention) takes discriminant value in the decision to purchase a green product and, more generally, the comparative analysis of the two conditions confirmed that this effect can be considered to be more noticeable when buying green instead than not green products. Thus, managers and advertisers that want to persuade consumers to engage into green consumption should make sure to take into consideration the regulatory focus boosting effect

Tourism experience and destination image: the case of Garda Lake

In the last years, the study of image has become one of the most popular topics in tourism research, mainly because of its impact on potential travellers’ destination selection, evaluation and purchase intentions. Basing on the idea that actual visit of a destination affects and modifies the destination image, this study investigates how the image of Garda Lake is perceived among international and Italian tourists. In particular, in this paper we report the first results of a content analysis focusing on how tourists’ experiences on Garda Lake are portrayed and expressed in travel consumer review websites. The analysis reported in the paper tried to identify if tourists are more willing to describe the tourism offer of Garda Lake or the feelings evoked during their visit. The content analysis we carried out on 1.109 Italian and international posts collected from Tripadvisor and Travelpod confirms that people use travel consumer review sites to describe many aspects of their trip, ranging from visiting attractions and enjoying the culture to the use of tourism-related facilities. Hence, they cannot reflect experiences except operationally, as they lack the “experience essence”(Volo, 2009). Some important differences among Italian and foreign tourists emerge too