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2. Editor's Choice – Vascular Registries Contributing to VASCUNET Collaborative Abdominal Aortic Aneurysm Outcome Projects: A Scoping Review

Author

Altreuther, Martin, Beiles, Barry, Cassar, Kevin, Coelho, Andreia, Cromwell, David, Fitridge, Rob, Grima, Matthew Joe, Khashram, Manar, Koncar, Igor, Lareyre, Fabien, Lattmann, Thomas, Laxdal, Elín, Lazaris, Andreas M., Moulakakis, Konstantinos G., Setacci, Carlo, Slobodan, Tanaskovic, Szeberin, Zoltán, Venermo, Maarit, Waton, Sam, Pouncey, Anna L., Meuli, Lorenz, Lopez-Espada, Cristina, Budtz-Lilly, Jacob, Boyle, Jonathan R., Behrendt, Christian-Alexander, Mani, Kevin, and Pherwani, Arun D.

Published
2024
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3. A Greek Multicentre Study Assessing the Outcome of Late Rupture After Endovascular Abdominal Aortic Aneurysm Repair

Author

Tasopoulou, Kalliopi-Maria, Triantafyllou, Nikolaos, Papadoulas, Spyros I., Tsimpoukis, Andreas L., Stagkoglou, Christos, Seretis, Konstantinos, Papas, Theophanis T., Tsiantoula, Paraskevi, Kakisis, John D., Sfyroeras, George, Maltezos, Chrysostomos, Kopadis, George, Chatzigakis, Petros K., Katsargyris, Athanasios, Hasemaki, Natasha, Bountouris, Ioannis, Theocharopoulos, Georgios, Moulakakis, Konstantinos G., Lazaris, Andreas M., Georgiadis, George S., Kakkos, Stavros, Papavasileiou, Vasileios G., Antonopoulos, Constantine N., Papapetrou, Anastasios, Katsikas, Vasilios, Klonaris, Chris, and Geroulakos, George

Published
2024
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4. Editor's Choice – The VASCUNExplanT Project: An International Study Assessing Open Surgical Conversion of Failed Non-Infected Endovascular Aortic Aneurysm Repair

Author

Linares-Palomino, Jose, Bastos Goncalves, Frederico, Beiles, Barry, Grima, Matthew Joe, Koncar, Igor, Laxdal, Elin, Lazaris, Andreas M., Moulakakis, Konstantinos G., Rother, Ulrich, Setacci, Carlo, Szeberin, Zoltán, Venermo, Maarit, Zlatonovic, Petar, Daryapeyman, Alireza, Wanhainen, Anders, Tachtaras, Evangelos, Attigah, Nicolas, Becker, Daniel, Mujagic, Edin, Meuli, Lorenz, Dick, Florian, Olivera Pinto, Jose Pedro, Usai, Marco Virgilio, Nordanstig, Joakin, Langenskiold, Marcus, Lyons, Oliver, Lim, Eric T.A., Taumoepeau, Lupe, Haran, Cheyaanthan, Hill, Andrew, Dean, Anastasia, Chakfe, Nabil, Kuntz, Salomé, Lejay, Anne, Lepide, Sandro, Antonello, Michele, Piazza, Michele, Schiro, Andrew, Carreira Garcia, Rita, Lopez Espada, Cristina, Behrendt, Christian-Alexander, Mani, Kevin, D’Oria, Mario, Lattman, Thomas, Khashram, Manar, Altreuther, Martin, Cohnert, Tina U., Pherwani, Arun, and Budtz-Lilly, Jacob

Published
2023
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5. Career barriers for women in surgery

Author

Schizas, Dimitrios, Papapanou, Michail, Routsi, Eleni, Mastoraki, Aikaterini, Lidoriki, Irene, Zavras, Nikolaos, Avgerinos, Dimitrios V., Lazaris, Andreas M., and Tsaroucha, Alexandra

Published
2022
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6. Documenting the Recovery of Vascular Services in European Centres Following the Initial COVID-19 Pandemic Peak: Results from a Multicentre Collaborative Study

Author

Ruffino, Maria Antonella, Chan, Sharon, Coughlin, Patrick, Awopetu, Ayoola, Stather, Philip, Lane, Tristan, Theodosiou, Dimitrios, Ahmed, Mohamed Abozeid, Vasudevan, Thodur, Ibrahim, Mohammed, Al Maadany, Faraj, Eljareh, Mohamed, Alkhafeefi, Fatimah Saad, Coscas, Raphael, Ünal, Ertekin Utku, Pulli, Raffaele, Zacà, Sergio, Angiletta, Domenico, Kotsis, Thomas, Moawad, Magdy, Tozzi, Matteo, Patelis, Nikolaos, Lazaris, Andreas M., Chuen, Jason, Croo, Alexander, Tsolaki, Elpiniki, Zenunaj, Gladiol, Kamal, Dhafer, Tolba, Mahmoud MH., Maresch, Martin, Khetarpaul, Vipul, Mills, Joseph, Gangwani, Gaurav, Elahwal, Mohamed, Khalil, Rana, Azab, Mohammed A., Mahomed, Anver, Whiston, Richard, Contractor, Ummul, Esposito, Davide, Pratesi, Carlo, Giacomelli, Elena, Troncoso, Martín Veras, Elkouri, Stephane, Johansson, Flavia Gentile, Dodos, Ilias, Benezit, Marie, Vidoedo, José, Rocha-Neves, João, Pereira-Neves, António Henrique, Dias-Neto, Marina Felicidade, Campos Jácome, Ana Filipa, Loureiro, Luis, Silva, Ivone, Garza-Herrera, Rodrigo, Canata, Victor, Bezard, Charlotte, Bowser, Kathryn, Tobar, Jorge Felipe, Vera, Carlos Gomez, Parra, Carolina Salinas, Lopez, Eugenia, Serra, Yvis Gadelha, Varela, Juan, Rubio, Vanessa, Victoria, Gerardo, Johnson, Adam, O’Banion, Leigh Ann, Makar, Ragai, Tantawy, Tamer Ghatwary, Storck, Martin, Jongkind, Vincent, falah, Orwa, McBride, Olivia, Isik, Arda, Papaioannou, Athanasios, Ocke Reis, Paulo Eduardo, Bracale, Umberto Marcello, Atkins, Ellie, Tinelli, Giovanni, Scott, Emma, Wales, Lucy, Sivaharan, Ashwin, Priona, Georgia, Nesbitt, Craig, Grainger, Tabitha, Shelmerdine, Lauren, Chong, Patrick, Bajwa, Adnan, Arwynck, Luke, Hadjievangelou, Nancy, Elbasty, Ahmed, Rubio, Oscar, Ricardo, Michael, Ulloa, Jorge H., Tarazona, Marcos, Pabon, Manuel, Pitoulias, Georgios, Corless, Kevin, Ioannidis, Orestis, Friedrich, Oliver, Van Herzeele, Isabelle, Vijaynagar, Badri, Cohnert, Tina, Bell, Rachel, Moore, Hayley, Saha, Prakash, Gifford, Edward, Laine, Matti, Barkat, Adel, Karkos, Christos, Binti Safri, Lenny Suryani, Buitron, Gabriel, Del Castillo, Javier, Carrera, Paul, Salinas, Nilson, Biagioni, Rodrigo Bruno, Benites, Sergio, Mafla, César Andrés, Pian, Putera Mas, Albino, Pereira, Serrano, Ernesto, Marin, Andres, González, Marco, Foreroga, Marsha, Russo, Alejandro, Reyes, Andrés, Guglielmone, Daniel, Grillo, Lorena, Flumignan, Ronald, Palones, Francisco Gomez, Silveira, Pierre Galvagni, Ramely, Rosnelifaizur Bin, Edeiken, Sara, Chetter, Ian, Green, Lucy, Sudarsanam, Abhilash, Lyons, Oliver, Lemmon, Gary, Neville, Richard, Castelli, Mariano, Hinojosa, Carlos A., Carvajal, Rubén Rodríguez, Rivera, Aksim, Wong, Peng, Drudi, Laura, Perkins, Jeremy, Sieunarine, Kishore, Attia, Doaa, Atef, Mahmoud, Eftychios, Lostoridis, Weaver, Fred, Ren, Leong Chuo, Alomari, Mohannad, Jamjoom, Reda, Aljarrah, Qusai, Abbas, Ayman, Alomran, Faris, Kumar, Ambrish, Altoijri, Abdulmajeed, ElSanhoury, Kareem T., Alhumaid, Ahmed, Fekry, Tamer, Sekhar, Raghuram, Theodoridis, Panagiotis, Panagiotis, Theodoridis, Roditis, Konstantinos, Tsiantoula, Paraskevi, Antoniou, Afroditi, Soler, Raphael, Hasemaki, Natasha, Baili, Efstratia, Mpaili, Eustratia, Huasen, Bella, Wallace, Tom, Duncan, Andrew, Metcalfe, Matthew, Mannoia, Kristyn, Bechara, Carlos F., Tsilimparis, Nikolaos, Aranson, Nathan, Riding, David, Palena, Mariano, McDonnell, Ciarán, Mouawad, Nicolas J., Banegas, Shonda, Rossi, Peter, Oshodi, Taohid, Diaz, Rodney, Afifi, Rana, Dindyal, Shiva, Thapar, Ankur, Kordzadeh, Ali, Pullas, Gonzalo, Lin, Stephanie, Davies, Chris, Darvall, Katy, Kodama, Akio, Gooneratne, Thushan, Gunawansa, Nalaka, Munoz, Alberto, Jie, Ng Jun, Bradley, Nicholas, Al-Jundi, Wissam, Meyer, Felicity, Lee, Cheong, Malina, Martin, Renton, Sophie, Lui, Dennis, Batchelder, Andrew, Oszkinis, Grzegorz, Freyrie, Antonio, Giordano, Jacopo, Saratzis, Nikolaos, Tigkiropoulos, Konstantinos, Kyriakos, Stavridis, Popov, Guriy, Cheema, Muhammad Usman, Lapolla, Pierfrancesco, Ling Patricia, Yih Chun, Ennab, Raed, Ullery, Brant W., Pasenidou, Ketino, Tam, Jacky, Sidel, Gabriel, Jayaprakash, Vivek Vardhan, Bennett, Lisa, Hardy, Simon, Davies, Emma, Baker, Sara, Wijesinghe, Lasantha, Tam, Adam, McCune, Ken, Chana, Manik, Lowe, Chris, Goh, Aaron, Powezka, Katarzyna, Kyrou, Ioanna, Altaf, Nishath, Harkin, Denis, Travers, Hannah, Cragg, James, sharif, Atif, Akhtar, Tasleem, Chávez, José Antonio, Ordonez, Claudia, Mazzurco, Martin, Choke, Edward, Asghar, Imran, Summerour, Virginia, Dunlop, Paul, Morley, Rachel, Hardy, Thomas, Bevis, Paul, Cuff, Robert, Stavroulakis, Konstantinos, Beropoulis, Efthymios, Argyriou, Angeliki, Loftus, Ian, Azhar, Bilal, Sheth, Sharvil, Usai, Marco Virgilio, Choudhry, Asad, Nicole, Kira, Boyle, Emily, Joyce, Doireann, Abdelaty Hassan, Mohammed Hassan, Saltiel, Alberto, Frahm-Jensen, Gert, Antoniou, George, Elhadi, Muhammed, Kimyaghalam, Ali, Malgor, Rafael, O'Banion, Leigh Ann, Telve, Diego, Isaak, Andrej, Schmidli, Jürg, McKevitt, Kevin, Siddiqui, Tam, Asciutto, Giuseppe, Floros, Nikolaos, Papadopoulos, George, Kafetzakis, Alexandros, Koutsias, Stylianos G., Nana, Petroula, Giannoukas, Athanasios, Kakkos, Stavros, Moulakakis, Konstantinos G., Shafique, Natasha, Jawien, Arkadiusz, Popplewell, Matthew, Imray, Chris, Abayasekara, Kumar, Rowlands, Timothy, Kuhan, Ganesh, Rajagopalan, Sriram, Jaipersad, Anthony, Sadia, Uzma, Kobe, Isaac, Mittapalli, Devender, Enemosah, Ibrahim, Behrendt, Christian-Alexander, Beck, Adam, Almudhafer, Muayyad, Ancetti, Stefano, Jacobs, Donald, Jayakumar, Priya, Malekpour, Fatemeh, Shalhub, Sherene, Keldiyorov, Boboyor, Simon, Meryl, Khashram, Manar, Rich, Nicole, Shepherd, Amanda, Meecham, Lewis, Doherty, Daniel, and Benson, Ruth A.

Published
2022
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9. A Greek Multicentre Study Assessing the Outcome of Late Rupture After Endovascular Abdominal Aortic Aneurysm Repair.

Author

Moulakakis, Konstantinos G., Lazaris, Andreas M., Georgiadis, George S., Kakkos, Stavros, Papavasileiou, Vasileios G., Antonopoulos, Constantine N., Papapetrou, Anastasios, Katsikas, Vasilios, Klonaris, Chris, and Geroulakos, George

Abstract

Late rupture after endovascular aortic aneurysm repair (EVAR) for an abdominal aortic aneurysm (AAA) is an increasing complication associated with a high mortality rate. This study aimed to analyse the causes and outcomes in patients with AAA rupture after EVAR. A multi-institutional Greek study of late ruptures after EVAR between 2008 – 2022 was performed. Primary outcomes were intra-operative and in hospital death. A total of 70 patients presented with late rupture after EVAR (proportion of ruptured EVARs among all EVARs, 0.6%; 69 males; mean age 77.2 ± 6.7 years). The mean time interval between EVAR and late rupture was 72.3 months (range 6 – 180 months). In all cases the cause of rupture was the presence of an endoleak (type I, 73%) with sac enlargement. Moreover, 34% of subjects with rupture after EVAR had been lost to follow up and 32% underwent a secondary intervention. Additionally, 57 patients (81%) were treated by conversion to open surgical repair (COSR) and the remainder by endovascular correction of endoleak (ECE). Eleven intra-operative deaths (16%) were recorded. The overall in hospital mortality rate was 41% (23% ECE vs. 46% COSR; p =.21). Of the patients who presented as initially haemodynamically stable, 23% died during hospitalisation, while the respective mortality rate for patients who presented as unstable was 78% (odds ratio [OR] 11.8, 95% confidence interval [CI] 3.6 – 39.1; p <.001). Multivariable logistic regression analysis revealed that severity of haemodynamic shock was the most significant risk factor for intra-operative (OR 7.15, 95% CI 1.58 – 32.40; p =.010) and in hospital death (OR 9.53, 95% CI 2.79 – 32.58; p <.001). These data underline the devastating prognosis of late rupture after EVAR. Haemodynamic status at presentation was an important predictive factor for death both in the ECE and COSR groups. Rigorous follow up and prompt evaluation of an unstable patient in case of rupture after EVAR is recommended. [ABSTRACT FROM AUTHOR]

Published
2024
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22. Precision Medicine in Aortic Anastomosis: A Numerical and Experimental Study of a Novel Double-Sided Needle

Author

Manolesou, Danae G. Korompili, Georgia Davazoglou, Dimitris and Lazaris, Andreas M. Schizas, Dimitrios Sanoudou, Despina and Liakakos, Theodore Tsioufis, Constantinos Papaioannou, Theodore G.

Abstract

Background: Hand-sewn anastomosis is a crucial part of aortic reconstruction surgery and significantly affects its outcome. The present study presents a novel, bidirectional surgical needle aimed to improve aortic anastomosis in terms of speed and ease of use. Our objective was to assess the efficacy of the new design in comparison with the conventional needle. Methods: A series of simulations were conducted with COMSOL software in order to perform a fatigue comparative analysis between the new and the conventional needle design. Ease of penetration into a piece of polydimethylsiloxane was evaluated. Lastly, the prototype was tested under in-vitro conditions in comparison with the conventional needle. Results: Based on fatigue analysis, the new needle design improves durability, provided the two tips are equally used. The polytetrafluoroethylene coating improves penetration into the tissue by 7% to 17%, while electropolishing improves penetration up to 19%. When using the novel needle design, the average anastomotic task completion time was significantly reduced by 22% and the overall distance of hand movements was significantly reduced by 20%. Conclusions: The proposed design exhibited a shorter anastomotic time and seems promising in relation to ease of use and simplicity of the anastomotic technique it introduces.

Published
2021

24. Laparoscopic Management of Concomitant Sigmoid Colon Cancer and Type 2 Endoleak Following Endovascular Aneurysm Repair.

Author

Bakopoulos, Anargyros, Koliakos, Nikolaos, Papaconstantinou, Dimitrios, Bistarakis, Dimitrios, Zymvragoudakis, Vassilios, Schizas, Dimitrios, Pikoulis, Emmanouil, and Lazaris, Andreas M.

Subjects
AORTIC aneurysm diagnosis, AORTIC aneurysm treatment, ENDOVASCULAR aneurysm repair, COLON tumors, BLOOD vessels, POSTOPERATIVE care, COLORECTAL cancer, LAPAROSCOPY, COMPUTED tomography
Abstract

The co-occurrence of abdominal aortic aneurysm (AAA) and colorectal malignancy creates a significant surgical dilemma over which entity should be addressed first. A 73-year-old male was referred to our hospital due to a painful pulsatile abdominal mass. Computed tomographic angiography revealed an infrarenal aortic aneurysm measuring 5.8 cm in diameter and incidentally, a synchronous mass lesion in the sigmoid colon. The patient underwent an emergency EVAR using a Gore Excluder endograft. Postoperative CT staging for colon cancer revealed a type 2 endoleak on the grounds of a patent wide inferior mesenteric artery. The patient underwent a standard laparoscopic left colectomy with high ligation of the inferior mesenteric artery in order to simultaneously address the ongoing type 2 endoleak. Follow-up examinations with computed tomographic angiography were performed confirming the resolution of the endoleak. Synchronous laparoscopic sigmoidectomy and high ligation of inferior mesenteric artery for type 2 endoleak treatment appears to be applicable with hopeful results. [ABSTRACT FROM AUTHOR]

Published
2022
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33. Extracranial Internal Carotid Artery Aneurysm in a Patient with Marfan Syndrome

Author

Sfyroeras, George S. Nikolopoulou, Eleni Aliki Moulakakis, Konstantinos G. Lazaris, Andreas M. Kakisis, John D. and Geroulakos, George

Subjects
cardiovascular system, cardiovascular diseases
Abstract

Extracranial internal carotid artery (ICA) aneurysms are rare and most of them are considered of atherosclerotic etiology. Marfan syndrome (MS) is a systemic connective tissue disorder caused by mutation in the extracellular matrix protein fibrillin 1. Clinical manifestations of the MS include aortic aneurysms, dislocation of the ocular lens, and long bone overgrowth. The presence of extracranial ICA aneurysm in patients with MS is very rare. We report a 62-year-old female patient with MS presented with an extracranial ICA aneurysm. She was treated with aneurysmectomy and end-to-end anastomosis, with good outcomes. Only 10 cases of patients with MS and extracranial ICA aneurysm have been described in the literature. Clinical presentation, treatment, and outcome of these patients are reviewed and discussed.

Published
2019

34. Paraneoplastic digital ischemia in clear-cell renal-cell carcinoma: Report of a case and review of the literature

Author

Kampoli, Katerina Gardeli, Dimitra Mouktaroudi, Maria and Fanouriakis, Antonis Lazaris, Andreas M. Koumarianou, Anna

Abstract

Digital ischemia has been rarely associated, as a paraneoplastic syndrome, with renal cancer. Since it can severely compromise the patients' quality of life, early recognition is important, in order to optimally address it with currently available treatment options, such as tyrosine inhibitors. Digital ischemia may occur in the general population and it can be the result of other non-cancerous diseases; accordingly, a thorough and aggressive work-up is mandatory, together with appropriate therapeutic steps such as tyrosine kinase inhibitors, vasodilators, and antiaggregants. Herein, we report a 78-year-old male patient with a history of clear-cell renal-cell cancer, who presented in the emergency department with critical ischemia in the upper limbs.

Published
2019

36. European College of Phlebology guideline for truncal ablation.

Author

Kürşat Bozkurt, A, Lawaetz, Martin, Danielsson, Gudmundur, Lazaris, Andreas M, Pavlovic, Milos, Olariu, Sorin, and Rasmussen, Lars

Subjects
ADHESIVES, ENDOVASCULAR surgery, CATHETER ablation, CONSENSUS (Social sciences), SCLEROTHERAPY, MEDICAL lasers, MEDICAL protocols, SAPHENOUS vein, VENOUS insufficiency
Abstract

Background: The purpose of the guideline was to achieve consensus in the care and treatment of patients with chronic venous disease, based on current evidence. Method: A systematic literature search was performed in PubMed, Embase, Cinahl, and the Cochrane library up until 1 February 2019. Additional relevant literature were added through checking of references. Level of evidence was graded through the GRADE scale and recommendations were concluded. Results: For the treatment of great and small saphenous vein reflux, endovenous ablation with laser or radiofrequency was recommended in preference to surgery or foam sclerotherapy. If tributaries are to be treated it should be done in the same procedure. Treatment with mecanicochemical ablation and glue can be used but we still need long term follow up results. Conclusion: For the treatment of truncal varicosities, endovenous ablation with laser or radiofrequency combined with phlebectomies is recommended before surgery or foam. [ABSTRACT FROM AUTHOR]

Published
2020
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38. Comparison of Fluid Dynamics Variations Between Chimney and Fenestrated Endografts for Pararenal Aneurysms Repair: A Patient Specific Computational Study as Motivation for Clinical Decision-Making.

Author

Moulakakis, Konstantinos G., Kakisis, John, Gonidaki, Eleni, Lazaris, Andreas M., Tsangaris, Sokrates, Geroulakos, George, and Manopoulos, Christos

Subjects
BLOOD circulation, ABDOMINAL aortic aneurysms, BLOOD flow measurement, BLOOD vessel prosthesis, COMPARATIVE studies, COMPUTED tomography, HEMODYNAMICS, PERFUSION, RENAL artery, TRANSPLANTATION of organs, tissues, etc., DECISION making in clinical medicine, BIOINFORMATICS, THREE-dimensional imaging, PHYSIOLOGIC strain, TREATMENT effectiveness, PATIENT-centered care, DATA analysis software, DESCRIPTIVE statistics, PHYSIOLOGY
Abstract

Background-Aim: Limited data exist concerning the fluid dynamic changes induced by endovascular aortic repair with fenestrated and chimney graft modalities in pararenal aneurysms. We aimed to investigate and compare the wall shear stress (WSS) and flow dynamics for the branch vessels before and after endovascular aortic repair with fenestrated and chimney techniques. Methods: Modeling was done for patient specific pararenal aortic aneurysms employing fenestrated and chimney grafts (Materialise Mimics 10.0) before and after the endovascular procedure, using computed tomography scans of patients. Surface and spatial grids were created using the ANSYS CFD meshing software 2019 R2. Assessment of blood flow, streamlines, and WSS before and after aneurysm repair was performed. Results: The endovascular repair with chimney grafts leaded to a 43% to 53% reduction in perfusion in renal arteries. In fenestrated reconstruction, we observed a 15% reduced perfusion in both renal arteries. In both cases, we observed a decrease in the recirculation phenomena of the aorta after endovascular repair. Concerning the grafts of the renal arteries, we observed in both the transverse and longitudinal axes low WSS regions with simultaneous recirculation of the flow 1 cm distal to the ostium sites in both aortic graft models. High WSS regions appeared in the sites of ostium. Conclusions: We observed reduced renal perfusion in chimney grafts compared to fenestrated grafts, probably caused by the long and kinked characteristics of these devices. [ABSTRACT FROM AUTHOR]

Published
2019
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39. Paraneoplastic digital ischemia in clear-cell renal-cell carcinoma: Report of a case and review of the literature.

Author

Kampoli, Katerina, Gardeli, Dimitra, Mouktaroudi, Maria, Fanouriakis, Antonis, Lazaris, Andreas M, and Koumarianou, Anna

Subjects
ISCHEMIA, LITERATURE reviews, RENAL cancer, PARANEOPLASTIC syndromes, PROTEIN-tyrosine kinases, ARM
Abstract

Digital ischemia has been rarely associated, as a paraneoplastic syndrome, with renal cancer. Since it can severely compromise the patients' quality of life, early recognition is important, in order to optimally address it with currently available treatment options, such as tyrosine inhibitors. Digital ischemia may occur in the general population and it can be the result of other non-cancerous diseases; accordingly, a thorough and aggressive work-up is mandatory, together with appropriate therapeutic steps such as tyrosine kinase inhibitors, vasodilators, and antiaggregants. Herein, we report a 78-year-old male patient with a history of clear-cell renal-cell cancer, who presented in the emergency department with critical ischemia in the upper limbs. [ABSTRACT FROM AUTHOR]

Published
2019
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40. Advances in assessment and management of carotid body tumors

Author

Avgerinos, Efthimios D. Moulakakis, Konstantinos Brountzos, Elias Giannakopoulos, Triantafillos G. Lazaris, Andreas M. and Koumarianou, Anna Geronikola-Trapali, Xenia Ptohis, Nikolas and Papapetrou, Anastasios Liapis, Christos D.

Abstract

Evolving technology has the potential to alter the overall management of carotid body tumors (CBTs). We review our 35-year experience emphasizing on novel modalities available in the evaluation and treatment of CBTs. Medical records of 27 CBT patients between 1975 and 2009 were retrospectively reviewed. The study cohort has been arbitrarily divided into two groups: the early years’ group A (18 patients, 1975-1998) and the later years’ group B (9 patients, 1999-2009). The most common presenting symptom was a painless lateral neck mass (89%). Octreotide scintigraphy and genetic testing were routinely used for group B. In two cases, octreotide scintigraphy was coupled with intraoperative radiolocalization of the lesion. Preoperative embolization was performed in four CBTs. Among group B patients, five were pretreated via a covered stent placement in the external carotid artery (ECA). Twenty-three patients (24 CBTs) were eventually operated upon. One cardiovascular death, one permanent vocal cord paralysis and six transient cranial nerve injuries account for a 4.4% 30-day mortality and a 30.4% morbidity with no significant differences among groups. In conclusion, appropriate use of new techniques in CBT management has improved diagnostic accuracy and early detection without clearly affecting overall outcome in our study cohort.

Published
2011

43. Peripheral Arterial Embolization of Cement during Revision Spine Surgery

Author

Soultanis, Konstantinos Kakisis, John D. Pyrovolou, Nikolaos and Lazaris, Andreas M. Vasdekis, Spyros Soukakos, Panagiotis

Subjects
musculoskeletal diseases, technology, industry, and agriculture
Abstract

Cement embolism of the pulmonary arteries is a well-known complication of percutaneous vertebroplasty as well as orthopedic procedures involving instrumentation of the medullary canal. A few cases of paradoxical cement embolism have also been described. Herein, we report a case of cortical bone void filler embolism to the infragenicular arteries during revision spine surgery. The cement had entered the aorta via the left L3 lumbar artery. To the best of our knowledge, this is the first report of embolism due to direct arterial migration of cement during an orthopedic procedure.

Published
2009

44. Common femoral artery injury secondary to tennis ball strike

Author

Vasdekis, Spyros N. Kakisis, John D. Lazaris, Andreas M. and Panayiotides, John G. Angeli, Aikaterini A. Karkaletsis, Konstantinos G.

Subjects
human activities
Abstract

Tennis is a popular, safe sport that exposes amateur or professional players to minimal risk of injury. Most of this risk is related to musculoskeletal injuries, and vascular trauma is extremely rare. We present a case of a 68-year-old man in whom intermittent claudication developed after his right groin was struck by a tennis ball. The patient sought medical evaluation 2 months after the accident, and a subtotal occlusion of his right common femoral artery was disclosed by angiography and treated by endarterectomy.

Published
2006

45. Effect of diabetes mellitus on the clinical outcome of lower limb arterial bypass surgery: A propensity score analysis.

Author

Lazaris, Andreas M., Kontopantelis, Evangelos, Antonopoulos, Konstantinos, Mantas, Georgios, Kouvelos, Georgios, Moulakakis, Konstantinos, Matsagkas, Miltiadis I., Vasdekis, Spyros N., and Geroulakos, George

Subjects
AMPUTATION, CARDIOVASCULAR surgery, COMPARATIVE studies, DATABASES, DIABETIC angiopathies, LEG, LIMB salvage, VASCULAR resistance, RESEARCH methodology, MEDICAL cooperation, PERIPHERAL vascular diseases, PROBABILITY theory, PROGNOSIS, RESEARCH, RESEARCH funding, RISK assessment, TIME, LOGISTIC regression analysis, EVALUATION research, TREATMENT effectiveness, KAPLAN-Meier estimator
Abstract

Objectives Diabetic patients who undergo lower limb arterial bypass surgery are considered to have a worse clinical outcome compared to non-diabetics. The aim of the study was to test this hypothesis after applying propensity score matching analysis. Patients and methods A total of 113 consecutive lower limb bypass procedures (55 diabetic and 58 non-diabetic) were evaluated regarding their clinical outcome. Endpoints of the study included amputation-free survival, limb salvage, patency and patients' survival up to 36 months post-procedure. After propensity score matching analysis, two new groups, diabetic and non-diabetic, of 31 limbs in each one were created, both equivalent regarding all baseline characteristics. Results Between the propensity score matching groups, the amputation-free survival was 68.8% in the non-diabetic and 37.7% in the diabetic group at 36 months ( p = 0.004). Similarly, the survival was 88.6% and 57.6%, respectively, in the two groups at the same time point ( p = 0.01). On the contrary, no difference was found in patency (58.3% vs. 56%) and in limb salvage rate (74.1% vs. 60.8%). Conclusions Lower limbs arterial bypass surgery has similar results regarding patency and limb salvage rate in diabetic and non-diabetic patients. On the contrary, mortality is worse in diabetic patients, this affecting negatively their amputation-free survival. [ABSTRACT FROM AUTHOR]

Published
2017
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46. A systematic review of the surgical management of secondary aortoduodenal fistula.

Author

Koliakos, Nikolaos, Papakonstantinou, Dimitrios, Tzortzis, Andrianos-Serafeim, Antonopoulos, Constantine N., Stavratis, Fotios-Christos, Bakopoulos, Anargyros, Schizas, Dimitrios, and Lazaris, Andreas M.

Abstract

Secondary aortoduodenal fistulae (SADF) are uncommon but life-threatening conditions that occur as complications of aortic reconstructive surgery. Data on the mortality and morbidity of procedures associated with SADF remain scarce. Comprehensive literature search was conducted on the MedLine, Scopus, Embase, and Web of Knowledge databases for cases of SADF. Data regarding patient demographics, fistula anatomy and treatment interventions performed were extracted for further analysis. The study pool consisted of 127 case reports, 28 case series and 1 retrospective study published between 1973 and 2021. A total of 189 patients were operated for SADF. Among the 189 patients, 141 patients (74.6%) had aortic graft excision, 26 (13.8%) aortic primary repair, and 22 (11.6%) EVAR. Although patients undergoing EVAR were older with higher Charlson Comorbidity Index, compared with patients who had graft excision and primary aortic repair these differences were not statistically significant (P =.12 and P =.22, respectively). Primary bowel repair was performed in 145 patients (76.7%), duodenectomy in 25 (13.2%), and no bowel repair in 19 (10.1%). Additional omentoplasty was performed in 65 patients (34.6%). Mortality was comparable with respect to the type of aortic and bowel repair, with no statistically significant differences recorded (P =.54 and P =.77, respectively). Omentoplasty significantly decreased the risk of death (odds ratio, 0.4; 95% confidence interval, 0.2-0.8, P =.01). Optimal operative management should address both the aortic and duodenal defects and be complemented with appropriate reconstructive procedures. Endovascular aortic approaches seem feasible in carefully select patients in whom duodenal repair may be omitted. [ABSTRACT FROM AUTHOR]

Published
2023
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47. Remote Ischemic Preconditioning May Attenuate Renal Ischemia-Reperfusion Injury in a Porcine Model of Supraceliac Aortic Cross-Clamping.

Author

athanasiadis, Dimitris, Kapelouzou, alkistis, Martikos, Georgios, Katsimpoulas, Michael, Schizas, Dimitrios, Vasdekis, Spyros N., Kostakis, alkiviadis, Liakakos, Theodore D., and Lazaris, andreas M.

Subjects
ISCHEMIA, REPERFUSION, LIPOCALINS, CREATININE, MALONDIALDEHYDE
Abstract

Aim: The effect of remote ischemic preconditioning (RIPC) in decreasing renal ischemia-reperfusion injury (IRI) during a suprarenal aortic cross-clamping was examined in a swine model. Materials and Methods: Four groups of pigs were examined: (a) ischemia-reperfusion (IR) group, renal IRI produced by 30 min of supraceliac aortic cross-clamping; (b) RIPC I group, the same renal IRI following RIPC by brief occlusion of the infrarenal aorta (15 min ischemia and 15 min reperfusion); (c) RIPC II group, the same renal IRI following RIPC by brief occlusion of the infrarenal aorta (3 cycles of 5 min ischemia and 5 min reperfusion); (d) sham group. Renal function was assessed before and after IRI by examining creatinine, neutrophil gelatinase-associated lipocalin (NGAL), TNF-α, malondialdehyde (MDA), cystatin C and C-reactive protein (CRP) from renal vein blood samples at specific time intervals. Results: Both RIPC groups presented significantly less impaired results compared to the IR group when considering MDA, cystatin C, CRP and creatinine. Between the two RIPC groups, RIPC II presented a better response with regard to CRP, NGAL, TNF-α, MDA and cystatin C. Conclusions: Remote IR protocols and mainly repetitive short periods of cycles of IR ameliorate the biochemical kidney effects of IRI in a model of suprarenal aortic aneurysm repair. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Published
2016
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49. Advances in assessment and management of carotid body tumors.

Author

Avgerinos, Efthimios D., Moulakakis, Konstantinos, Brountzos, Elias, Giannakopoulos, Triantafillos G., Lazaris, Andreas M., Koumarianou, Anna, Geronikola-Trapali, Xenia, Ptohis, Nikolas, Papapetrou, Anastasios, and Liapis, Christos D.

Abstract

Evolving technology has the potential to alter the overall management of carotid body tumors (CBTs). We review our 35-year experience emphasizing on novel modalities available in the evaluation and treatment of CBTs. Medical records of 27 CBT patients between 1975 and 2009 were retrospectively reviewed. The study cohort has been arbitrarily divided into two groups: the early years' group A (18 patients, 1975?1998) and the later years' group B (9 patients, 1999?2009). The most common presenting symptom was a painless lateral neck mass (89%). Octreotide scintigraphy and genetic testing were routinely used for group B. In two cases, octreotide scintigraphy was coupled with intraoperative radiolocalization of the lesion. Preoperative embolization was performed in four CBTs. Among group B patients, five were pretreated via a covered stent placement in the external carotid artery (ECA). Twenty- three patients (24 CBTs) were eventually operated upon. One cardiovascular death, one permanent vocal cord paralysis and six transient cranial nerve injuries account for a 4.4% 30-day mortality and a 30.4% morbidity with no significant differences among groups. In conclusion, appropriate use of new techniques in CBT management has improved diagnostic accuracy and early detection without clearly affecting overall outcome in our study cohort. [ABSTRACT FROM AUTHOR]

Published
2011
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