Nefrologia Interventistica: una disciplina in evoluzione. L'esperienza di due centri italiani a confronto

We describe the multidisciplinary work of nephrological realities belonging to two different Regional Health Systems, Lombardia and Lazio. The interventional nephrologist is a specialist in nephrology with ultra-specialist know-how for vascular access for dialysis. He is the coordinator of a team of vascular accesses and applies a team work with the other interventional nephrologists, with the vascular surgeon and the interventional radiologist, with whom he decides the diagnostic-therapeutic procedure to perform the best possible vascular access for that individual patient

Surgical conversion for intragraft thrombosis following endovascular repair of traumatic aortic injury

We report the case of a 32-year-old man with severe polytrauma, submitted to urgent endovascular exclusion of a posttraumatic thoracic aortic pseudoaneurysm. Two years later, computed tomography scan showed asymptomatic mural atherothrombosis of the aortic stent graft in its middle-distal portion, and the patient was placed on oral anticoagulants. As subsequent computed tomography scan showed progression of the thrombosis, the patient underwent surgical conversion, with stent graft explantation and in situ aortic replacement. Gross examination revealed mural organized thrombosis and a significant infolding of the distal end of the stent graft