Versatility, clinical outcomes and mammographic follow-up of Chest Wall Perforator Flaps (CWPF): A single-centre experience

2020 ◽  
Vol 138 ◽  
pp. S37-S38
Author(s):  
T. Seddon ◽  
D. Dragoumis ◽  
M. Al-Attar ◽  
K. Valassiadou
EP Europace ◽  
2017 ◽  
Vol 19 (suppl_3) ◽  
pp. iii206-iii208
Author(s):  
F. Zanon ◽  
L. Marcantoni ◽  
G. Pastore ◽  
D. Lanza ◽  
L. Conte ◽  
...  

Author(s):  
E. Sala ◽  
G. Carosi ◽  
G. Del Sindaco ◽  
R. Mungari ◽  
A. Cremaschi ◽  
...  

Abstract Purpose A long-lasting remission of acromegaly after somatostatin analogues (SAs) withdrawal has been described in some series. Our aim was to update the disease evolution after SAs withdrawal in a cohort of acromegalic patients. Methods We retrospectively evaluated 21 acromegalic patients previously included in a multicentre study (Ronchi et al. 2008), updating data at the last follow-up. We added further 8 patients selected for SAs withdrawal between 2008–2018. Pituitary irradiation represented an exclusion criterion. The withdrawal was suggested after at least 9 months of clinical and hormonal disease control. Clinical and biochemical data prior and after SAs withdrawal were analysed. Results In the whole cohort (29 patients) mean age was 50 ± 14.9 years and 72.4% were females. In 69% pituitary surgery was previously performed. Overall, the median time of treatment before SAs withdrawal was 53 months (IQR = 24–84). At the last follow up in 2019, 23/29 patients (79.3%) had a disease relapse after a median time of 6 months (interquartile range or IQR = 3–12) from the drug suspension, while 6/29 (20.7%) were still on remission after 120 months (IQR = 66–150). IGF-1 levels were significantly lower before withdrawal in patients with persistent remission compared to relapsing ones (IGF-1 SDS: -1.5 ± 0.6 vs -0.11 ± 1, p = 0.01). We did not observe any other difference between patients with and without relapse, including SAs formulation, dosage and treatment duration. Conclusion A successful withdrawal of SAs is possible in a subset of well-controlled acromegalic patients and it challenges the concept that medical therapy is a lifelong requirement.


Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Boris Schmidt ◽  
KR Julian Chun ◽  
Buelent Koektuerk ◽  
Feifan Ouyang ◽  
Karl-Heinz Kuck

Background: Radiofrequency current ablation (RFA) of ventricular tachycardia (VT) focuses on endocardial (endo) substrates. However, if endo RFA fails, an epi approach is a potential treatment option. We report a single centre experience of epi VT ablation. Patients and Methods: Between 06/2005 and 02/2008 42 pts (14 female, mean age 49 ± 18 years) underwent electroanatomical endo and epi mapping and ablation for intractable VT, syncope or VT storm with multiple ICD discharges. Pts with normal heart (n=7), ischemic cardiomyopathy (ICM; n=8), NICM (n=11), ARVD (n=8), LV-aneurysm (n=7) or sarcoidosis (n=1) were studied. Mean LV ejection fraction was 45±12%. 20/42 had had at least 1 previous ablation attempt for VT (range 1– 4 ablations). Acute success was defined as non-inducibility of the previously inducible VT. Chronic success was defined as recurrence of any VT. Results: Acute procedural success rate was 79% (30/38). In 4 pts VTs were not inducible during EPS. In 28/42 pts endo mapping revealed no pathologic potentials. In 23/38 pts and 7/38 the succesful RFC ablation site was epi and endo, respectively. In 9/38 pts endo ablation failed and VT could only be ablated from epi. Further 7/38 pts needed both endo and epi ablation. In In 4/8 failed ablations epi RFC ablation was impossible due to failed access to target site (adhesions; n=2), close vicinity of a coronary artery (n=1) or the phrenic nerve (n=1). Procedure duration was 263±97 min. Unfortunately, 1 pt died due to perforation of RV and 1 pt had severe hepatic bleeding after epi puncture. One pt died in cardiogenic shock 1 d after the procedure. In 2 pts a sterile pericarditis occurred which resolved without any further intervention. After a median follow-up of 293 days (1–929 days) 53% of pts were alive and free from any VT. Conclusion: In pts with failed endo RFC ablation for VT due to different etiologies epi RFC ablation was acutely successful in 61% of pts with a moderate chronic success rate. However, major complications occured in approximately 5% of pts. Epi mapping should be considered if endo pathologic potentials are absent or if endo ablation failed.


2017 ◽  
Vol 12 (1) ◽  
pp. 11-19 ◽  
Author(s):  
Neeraj Ramesh Mahboobani ◽  
Wing Ho Chong ◽  
Samuel Siu Kei Lam ◽  
Jimmy Chi Wai Siu ◽  
Chong Boon Tan ◽  
...  

2018 ◽  
Vol 25 (1) ◽  
pp. 50 ◽  
Author(s):  
M. Kunkiel ◽  
M. Maczkiewicz ◽  
A. Jagiello-Gruszfeld ◽  
Z. Nowecki

Angiosarcomas of the breast are rare parenchymal malignancies of the chest wall. Surgery is the main treatment modality with chemotherapy and radiotherapy used in case of recurrence. With generally unfavourable prognosis and lack of clear treatment guidelines due to its rarity and scarcity of available data, angiosarcoma of the breast is a challenging clinical situation for both oncologist and patient. We present here the results of a series of 11 consecutive primary angiosarcoma cases treated at our institute between 2000 and 2015.


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