62 results on '"Saratzis, A."'
Search Results
2. Acute Kidney Injury Following Revascularization in Patients With Chronic Limb-Threatening Ischemia and Non-Dialysis-Dependent Chronic Kidney Disease: Insights From the NSQIP Database at 30-Day Follow-Up
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Stavroulakis, Konstantinos, primary, Tsilimparis, Nikolaos, additional, Saratzis, Athanasios, additional, Rantner, Barbara, additional, Stana, Jan, additional, Dayama, Anand, additional, Davies, Mark G., additional, and Gouveia e Melo, Ryan, additional
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- 2023
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3. Long-Term Effects of Acute Kidney Injury Following Endovascular Femoropopliteal Intervention: Insights From a Multicenter Trial
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Katsogridakis, Emmanuel, primary, Saha, Prakash, additional, Diamantopoulos, Athanasios, additional, Saratzis, Nikolaos, additional, Davies, Robert, additional, Zayed, Hany, additional, Bown, Matthew J., additional, and Saratzis, Athanasios, additional
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- 2022
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4. A Systematic Review and Meta-Analysis of 12-Month Patency After Intervention for Iliofemoral Obstruction Using Dedicated or Non-Dedicated Venous Stents
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Rachael Morris, Jack Kingdon, Jemima Carter, Adam Gwozdz, Ghulam M Majeed, Krishan Lodhia, Prakash Saha, and Athanasios Saratzis
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medicine.medical_specialty ,medicine.medical_treatment ,MEDLINE ,Postthrombotic Syndrome ,Intervention (counseling) ,Back pain ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,Vein ,Vascular Patency ,Retrospective Studies ,business.industry ,Endovascular Procedures ,Stent ,medicine.disease ,Thrombosis ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,Meta-analysis ,Stents ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Major bleeding - Abstract
Background: Endovascular stenting of the deep venous system has been proposed as a method to treat patients with symptomatic iliofemoral outflow obstruction. The purpose of this systematic review and meta-analysis was to compare the effectiveness of this treatment at 1-year following the development of dedicated venous stents. Method and results: We searched MEDLINE and EMBASE for studies evaluating the effectiveness of venous stent placement. Data were extracted by disease pathogenesis: non-thrombotic iliac vein lesions (NIVL), acute thrombotic (DVT), or post-thrombotic syndrome (PTS). Main outcomes included technical success, stent patency at 1 year and symptom relief. A total of 49 studies reporting outcomes in 5154 patients (NIVL, 1431; DVT, 950; PTS, 2773) were included in the meta-analysis. Technical success rates were comparable among groups (97%-100%). There were no periprocedural deaths. Minor bleeding was reported in up to 5% of patients and major bleeding in 0.5% upon intervention. Transient back pain was noted in 55% of PTS patients following intervention. There was significant heterogeneity between studies reporting outcomes in PTS patients. Primary and cumulative patency at 1 year was: NIVL—96% and 100%; DVT—91% and 97%; PTS (stents above the ligament)—77% and 94%, and; PTS (stents across the ligament)—78% and 94%. There were insufficient data to compare patency outcomes of dedicated and nondedicated venous stents in patients with acute DVT. In NIVL and PTS patients, stent patency was comparable at 1 year. There was inconsistency in the use of validated tools for the measurement of symptoms before and after intervention. When reported, venous claudication, improved in 83% of PTS patients and 90% of NIVL patients, and ulcer healing occurred in 80% of PTS patients and 32% of NIVL patients. Conclusions: The first generation of dedicated venous stents perform comparably in terms of patency and clinical outcomes to non-dedicated technologies at 1 year for the treatment of patients with NIVL and PTS. However, significant heterogeneity exists between studies and standardized criteria are urgently needed to report outcomes in patients undergoing deep venous stenting.
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- 2021
5. Acute Kidney Injury Following Revascularization in Patients With Chronic Limb-Threatening Ischemia and Non-Dialysis-Dependent Chronic Kidney Disease: Insights From the NSQIP Database at 30-Day Follow-Up
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Konstantinos Stavroulakis, Nikolaos Tsilimparis, Athanasios Saratzis, Barbara Rantner, Jan Stana, Anand Dayama, Mark G. Davies, and Ryan Gouveia e Melo
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Radiology, Nuclear Medicine and imaging ,Surgery ,Cardiology and Cardiovascular Medicine - Abstract
Background: Patients with chronic limb-threatening ischemia (CLTI) and chronic kidney disease (CKD) are at risk of developing renal injury following revascularization. We aimed to compare the risk of adverse renal events following endovascular revascularization (ER) or open surgery (OS) in patients with CLTI and CKD. Methods: A retrospective analysis of the National Surgical Quality Improvement Program (NSQIP) databases (2011–2017) was performed including patients with CLTI and non-dialysis-dependent CKD, comparing ER to OS. The primary outcome was a composite of postprocedural kidney injury or failure within 30 days. Thirty-day mortality, major adverse cardiac and cerebrovascular events (MACCE), amputation, readmission or target lesion revascularization (TLR) were compared using multivariate logistic regression and propensity-score matched analysis. Results: A total of 5009 patients were included (ER: 2361; OS: 3409). The risk for the composite primary outcome was comparable between groups (odds ratio [OR]: 0.78, 95% confidence interval (CI): 0.53-1.17) as for kidney injury (n=54, OR: 0.97, 95% CI: 0.39-1.19) or failure (n=55, OR: 0.68, 95% CI: 0.39-1.19). In the adjusted regression, a significant benefit was observed with ER for the primary outcome (OR: 0.60, p=0.018) and renal failure (OR: 0.50, p=0.025), but not for renal injury (OR: 0.76, p=0.34). Lower rates of MACCE, TLR, and readmissions were observed after ER. Thirty-day mortality and major amputation rates did not differ. In the propensity score analysis, revascularization strategy was not associated with renal injury or failure. Conclusions: In this cohort, the incidence of renal events within 30 days of revascularization in CLTI was low and comparable between ER and OR. Clinical Impact In a cohort of 5009 patients with chronic limb-threatening ischemia and non-end-stage chronic kidney disease (CKD), postprocedural kidney injury or failure within 30 days was comparable between patients submitted to open or endovascular revascularization (ER). Lower rates of major adverse cardiac and cerebrovascular events, target lesion revascularization, and readmissions were observed after endovascular revascularization. Based on these findings, ER should not be avoided due to fear of worsening renal function in CKD patients with chronic limb-threatening ischemia. In fact, these patients benefit more from ER regarding cardiovascular outcomes with no increased risk of kidney injury.
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- 2023
6. Treatment of Aortoiliac Occlusive Disease With the Covered Endovascular Reconstruction of the Aortic Bifurcation (CERAB) Technique: Results of a UK Multicenter Study
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M Malina, Robert S.M. Davies, Cezar Sabbagh, Ansy Egun, Ramita Dey, Jennifer Nash, Murtaza Salem, Athanasios Saratzis, S. Abisi, Arindam Chaudhuri, Hany Zayed, Bella Huasen, Lorenzo Patrone, and Pui Fong Lau
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Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Aortic Diseases ,Aortoiliac occlusive disease ,Arterial Occlusive Diseases ,Revascularization ,Iliac Artery ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Vascular Patency ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Endovascular Procedures ,Aortic bifurcation ,Middle Aged ,medicine.disease ,United Kingdom ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,Multicenter study ,Female ,Stents ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Aortoiliac disease ,Claudication - Abstract
Objective This UK multicenter study aims to report early- and medium-term results following covered endovascular reconstruction of aortic bifurcation (CERAB) for the treatment of aortoiliac occlusive disease (AIOD) in patients with chronic limb threatening ischemia (CLTI) or intermittent claudication (IC). Materials and Methods Retrospective case analysis was performed of patients who underwent CERAB between November 1, 2012 and March 31, 2020 in 6 centers across the United Kingdom. Anatomical data, including degree of plaque calcification, were assessed using preoperative imaging. Outcome measures included mortality, perioperative complications, target lesion reintervention (TLR), and major limb amputation. Primary, assisted primary, and secondary patencies were calculated at set intervals. Results A total of 116 patients underwent CERAB over the study period for the following reasons [48% presenting with CLTI (Rutherford 4–6) and 52% with IC (Rutherford 1–3)]; 82% presented had Trans-Atlantic Inter-Society Consensus (TASC) D AIOD disease. Median age was 65 years (range 42–90 years); 76% of the cohort were male. Severely calcified aortic and iliac lesions were noted in 90% and 80% of patients, respectively. Over a median follow-up of 18 months (range 1–91 months), 2 (1.7%) patients were lost to follow up. In total 5, (4.3%) patients died and 2 (1.7%) had a major amputation. Endovascular TLR was required in 14 (12.1%) patients at last follow up. Surgical TLR was performed in 4 (3.4%) patients at last follow-up. Seven (6%) patients developed an aortic/iliac stent occlusion at last follow-up. The Kaplan-Meier (KM) freedom from TLR at 1 year was 94% and KM 1-year primary patency, assisted primary patency, and secondary patency were 88%, 94%, and 98% respectively. Subanalysis found the following features were associated with need for TLR; TASC D disease (OR = 2.45, 95% CI 1.44 to 3.71), severe aortic calcification (OR = 2.01, 95% CI 1.03 to 2.20), and presence of tissue loss at baseline (OR = 1.43, 95% CI 1.01 to 4.63). Conclusion Perioperative (
- Published
- 2021
7. Thirty-Day Results of the Novel CGuard-Covered Stent in Patients Undergoing Carotid Artery Stenting
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Dimitrios Karamanos, Kyriakos Stavridis, Nikolaos Saratzis, Panagiotis Kousidis, Manolis Abatzis-Papadopoulos, Nikolaos Melas, Konstantinos Tigkiropoulos, Dimitrios Mpismpos, Ioannis Lazaridis, and Ioakeim Papoutsis
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medicine.medical_specialty ,Tel aviv ,medicine.medical_treatment ,Carotid arteries ,THIRTY-DAY ,Humans ,Medicine ,Carotid Stenosis ,Radiology, Nuclear Medicine and imaging ,In patient ,Prospective Studies ,Israel ,Stroke ,Covered stent ,Embolic protection ,business.industry ,Stent ,medicine.disease ,Surgery ,Carotid Arteries ,Treatment Outcome ,Stents ,Cardiology and Cardiovascular Medicine ,business ,Carotid Artery, Internal - Abstract
Objective: The aim of this study was to provide early-term evaluation, safety, and efficacy of the novel CGuard (Inspire MD, Tel Aviv, Israel) micromesh self-expanding stent with embolic protection system (EPS) during carotid artery stenting (CAS) procedure. Materials and Methods: All patients who underwent CAS with CGuard carotid stent system from January 2018 to September 2020 in a tertiary center were prospectively evaluated. Primary endpoints included technical success and perioperative neurological events (0–48 hours). Secondary endpoint was the rate of neurologic, cardiac events, and death (major adverse event or MAE) at 30 days. Patency of CGuard, peak systolic velocity (PSV), and end diastolic velocity (EDV) were evaluated at 30 days with duplex ultrasound. Results: A total of 103 patients underwent CAS procedure. Forty patients were symptomatic, and 63 patients were asymptomatic with stenosis greater than 70%. Technical success was 100%. Local anesthesia was applied in 94 patients (93%). Embolic protection devices were used in 6 patients (5.8%). Access site complications were 1.9%. Mean internal carotid artery stenosis diameter reduced from 79.47% to 14.68%. Two patients had transient ischemic attack (1.9%) and 1 patient experienced a cerebral hyperperfusion syndrome (CHS) perioperatively. External carotid artery (ECA) occlusion occurred in 1.9%. Four patients experienced jaw claudication (3.8%) postoperatively. Mean time of operation was 41 minutes. Mean duration of hospitalization was 3.1 days. The 30-day rate of MAE was 0%. CGuard patency was 100%, mean internal carotid PSV was reduced from 251.57 to 77.29 cm/s, and mean internal carotid EDV was reduced from 154.62 to 24.63 cm/s at 30 days. Conclusion: Our study shows that CGuard stent with EPS is an effective and safe device for treatment of carotid artery stenosis with acceptable low perioperative neurologic events, even with low embolic protection device usage. Larger multicenter and randomized studies are necessary to confirm its long-term efficacy.
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- 2021
8. Long-Term Effects of Acute Kidney Injury Following Endovascular Femoropopliteal Intervention: Insights From a Multicenter Trial
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Emmanuel Katsogridakis, Prakash Saha, Athanasios Diamantopoulos, Nikolaos Saratzis, Robert Davies, Hany Zayed, Matthew J. Bown, and Athanasios Saratzis
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Radiology, Nuclear Medicine and imaging ,Surgery ,Cardiology and Cardiovascular Medicine - Abstract
Purpose: To examine the association between acute kidney injury (AKI) severity and duration with cardiovascular mortality, following endovascular treatment of femoropopliteal disease, and whether it is AKI in itself that confers an increased risk of cardiovascular mortality. Methods: A retrospective analysis of prospectively collected data obtained between 2014 and 2019 from 3 vascular centers. Renal function was followed up for a minimum of 90 days. Electronic records were queried to establish a cause of death, where applicable. Patients were excluded if unable to provide written informed consent or if presenting with acute limb ischemia. Primary outcomes were the hazard ratios for cardiovascular death (AKI patients vs no AKI; no AKI vs stage 1 AKI vs stage 3 AKI; and no AKI vs transient AKI vs established AKI). Propensity score–matched analysis was used to establish whether developing AKI, in patients with similar demographics and procedural characteristics, is associated with a higher risk of cardiovascular death. Results: Overall 239 patients developed AKI, and this was associated with an increased risk of cardiovascular mortality (hazard risk [HR]: 4.3, 95% confidence intervals [CIs]: 2.1–6.8, pairwise comparison p value=0.006]. This was dependent on the severity of the AKI stage (HR 5.4, 95% CI: 2.4–7.3, pairwise comparison p value=0.01) and duration (HR 4.2, 95% CI: 2.3–6.2, pairwise comparison p value=0.04). The propensity score–matched analysis showed that even when patients are matched for comorbidity and procedural characteristics, AKI confers an increased risk of mortality (p=0.04). Conclusions: Acute kidney injury is common after femoropopliteal endovascular therapy. It confers an increased risk of long-term cardiovascular mortality, which is still present when renal decline is transient, and highest for patients with established decline in renal function. Clinical Impact This is the first study in the setting of peripheral arterial disease to show that acute kidney injury has an adverse effect on cardiovascular mortality, in the long-term, that is dependent on its severity, and present even when the AKI is transient. We have also shown that this difference in cardiovascular mortality becomes more pronounced from the medium-term, and thus closer follow-up of these patients is required.
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- 2022
9. A Systematic Review and Meta-Analysis of 12-Month Patency After Intervention for Iliofemoral Obstruction Using Dedicated or Non-Dedicated Venous Stents
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Majeed, Ghulam M., primary, Lodhia, Krishan, additional, Carter, Jemima, additional, Kingdon, Jack, additional, Morris, Rachael I., additional, Gwozdz, Adam, additional, Saratzis, Athanasios, additional, and Saha, Prakash, additional
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- 2021
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10. Hybrid Repair of Distal Aortic Arch Dissection Aneurysm With Dissected Kommerell Diverticulum
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Konstantinos Tigkiropoulos, Panagiotis Kousidis, Ioannis Lazaridis, and Nikolaos Saratzis
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Aortic arch ,Kommerell diverticulum ,medicine.medical_specialty ,business.industry ,Treatment options ,Aberrant right subclavian artery ,General Medicine ,Dissection (medical) ,030204 cardiovascular system & hematology ,Stent grafting ,medicine.disease ,030218 nuclear medicine & medical imaging ,Surgery ,03 medical and health sciences ,surgical procedures, operative ,0302 clinical medicine ,Aneurysm ,medicine.artery ,cardiovascular system ,medicine ,cardiovascular diseases ,Common carotid artery ,Cardiology and Cardiovascular Medicine ,business - Abstract
Aberrant right subclavian artery (ARSA) with associated Kommerell diverticulum (KD) is a rare congenital aortic arch anomaly. Patients with KD have a high risk of rupture, dissection, compression of adjacent structures, as well as distal embolization symptoms. Several treatment options have been proposed (surgical, hybrid, endovascular), however, a consensus regarding optimal surgical management has not been established yet. We present a successful single-stage hybrid repair of distal aortic arch dissection aneurysm with dissecting KD and ARSA with debranching of innominate and left common carotid artery, bilateral carotid-subclavian bypass, and stent grafting.
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- 2020
11. Treatment of Aortoiliac Occlusive Disease With the Covered Endovascular Reconstruction of the Aortic Bifurcation (CERAB) Technique: Results of a UK Multicenter Study
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Saratzis, Athanasios, primary, Salem, Murtaza, additional, Sabbagh, Cezar, additional, Abisi, Said, additional, Huasen, Bella, additional, Egun, Ansy, additional, Nash, Jennifer, additional, Lau, Pui Fong, additional, Chaudhuri, Arindam, additional, Dey, Ramita, additional, Patrone, Lorenzo, additional, Malina, Martin, additional, Davies, Robert, additional, and Zayed, Hany, additional
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- 2021
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12. Thirty-Day Results of the Novel CGuard-Covered Stent in Patients Undergoing Carotid Artery Stenting
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Tigkiropoulos, Konstantinos, primary, Papoutsis, Ioakeim, additional, Abatzis-Papadopoulos, Manolis, additional, Kousidis, Panagiotis, additional, Mpismpos, Dimitrios, additional, Melas, Nikolaos, additional, Stavridis, Kyriakos, additional, Karamanos, Dimitrios, additional, Lazaridis, Ioannis, additional, and Saratzis, Nikolaos, additional
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- 2021
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13. The Effect of Malignancy on Outcomes Following Revascularization for Critical Limb Ischemia: A Case–Control Study
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Tom Calderbank, Arooj Syed, Robert S.M. Davies, Ahmed Karim, Mike Wall, and Athanasios Saratzis
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Male ,medicine.medical_specialty ,Duplex ultrasonography ,Time Factors ,Databases, Factual ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Revascularization ,Malignancy ,Amputation, Surgical ,Tertiary Care Centers ,03 medical and health sciences ,0302 clinical medicine ,Ischemia ,Risk Factors ,Interquartile range ,Cause of Death ,Neoplasms ,Internal medicine ,medicine ,Humans ,Vascular Patency ,Aged ,Retrospective Studies ,Aged, 80 and over ,Ultrasonography, Doppler, Duplex ,Vascular disease ,business.industry ,Case-control study ,General Medicine ,Critical limb ischemia ,Limb Salvage ,medicine.disease ,Treatment Outcome ,England ,Lower Extremity ,030220 oncology & carcinogenesis ,Concomitant ,Feasibility Studies ,Female ,Surgery ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Vascular Surgical Procedures - Abstract
Aim: Malignancy is common in patients presenting with critical lower limb ischemia (CLI). However, outcomes in patients with concomitant active malignancy and CLI have not been well defined in comparative prospective analyses. Using contemporary prospective data, we aimed to assess outcomes following revascularization in patients with CLI and active malignancy. Methods: A nested case–control study was performed using data from 2 tertiary referral centers for vascular disease. A total of 48 consecutive patients undergoing intervention for CLI who had a diagnosis of active malignancy were identified and matched to patients with CLI but no malignancy for age, sex, diabetes, and smoking. Patency rates and morbidity/mortality were assessed using duplex ultrasonography and regular clinical review. Results: A total of 48 consecutive patients (median age: 74.5 years; interquartile range: 68-80 years) with active malignancy and CLI were identified and case-matched (age, sex, diabetes, and smoking) to 48 patients undergoing intervention for CLI who had no malignancy. Major cardiovascular risk factors did not differ. All-cause mortality was 23% versus 12% ( P = .41) at 6 months and 54% versus 15% ( P < .001) at 12 months. None of the patients died due to complications relating directly to the lower limb intervention or within 30 days of the intervention. A total of 4 (8.3%) patients had required a major limb amputation at 6 months in both groups, compared with 5 (10.4%) patients with malignancy versus 4 (8.3%) patients without ( P = .73) at 12 months. Patency rates were similar at 12 months (73% vs 80%). Three patients had required reintervention in both groups (endovascular in all cases) at 12 months. Conclusion: Revascularization can be offered safely in selected patients with active malignancy; patency rates in those surviving to 1 year are similar to patients without malignancy.
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- 2018
14. Commentary: Understanding the Role of EndoAnchors in Infrarenal Endovascular Aneurysm Repair
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Bijan Modarai and Athanasios Saratzis
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medicine.medical_specialty ,Endoleak ,business.industry ,medicine.medical_treatment ,Endovascular Procedures ,Treatment outcome ,medicine.disease ,Endovascular aneurysm repair ,Blood Vessel Prosthesis ,Surgery ,In vitro model ,Blood Vessel Prosthesis Implantation ,Aortic aneurysm ,Treatment Outcome ,Blood vessel prosthesis ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine ,business ,Proximal neck ,Aortic Aneurysm, Abdominal - Published
- 2019
15. Revascularization Outcomes in Patients With Acute Limb Ischemia and Active Neoplastic Disease
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Argyriou, Angeliki, primary, Kafetzakis, Alexandros, additional, Saratzis, Athanasios, additional, Huasen, Bella, additional, Coscas, Raphaël, additional, Renard, Regis, additional, Bisdas, Theodosios, additional, Torsello, Giovanni, additional, Tsilimparis, Nikolaos, additional, Calderbank, Tom, additional, and Stavroulakis, Konstantinos, additional
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- 2020
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16. Reducing the risk of venous thromboembolism following superficial endovenous treatment: A UK and Republic of Ireland consensus study
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Dattani, Nikesh, primary, Shalhoub, Joseph, additional, Nandhra, Sandip, additional, Lane, Tristan, additional, Abu-Own, Abdulsalam, additional, Elbasty, Ahmed, additional, Jones, Aled, additional, Duncan, Andrew, additional, Garnham, Andrew, additional, Thapar, Ankur, additional, Murray, Anna, additional, Baig, Anzar, additional, Saratzis, Athanasios, additional, Sharif, Atif, additional, Huasen, Bella, additional, Dawkins, Claire, additional, Nesbitt, Craig, additional, Carradice, Daniel, additional, Morrow, Darren, additional, Bosanquet, David, additional, Kavanagh, Eamon, additional, Shaikh, Faisal, additional, Gosi, Gergely, additional, Ambler, Graeme, additional, Fulton, Gregory, additional, Singh, Gurdas, additional, Travers, Hannah, additional, Moore, Hayley, additional, Olivier, James, additional, Hitchman, Louise, additional, O’Donohoe, Martin, additional, Popplewell, Matthew, additional, Medani, Mekki, additional, Jenkins, Michael, additional, Goh, Mingzheng A, additional, Lyons, Oliver, additional, McBride, Olivia, additional, Moxey, Paul, additional, Stather, Philip, additional, Burns, Phillipa, additional, Forsythe, Rachel, additional, Sam, Rachel, additional, Brar, Ranjeet, additional, Brightwell, Robert, additional, Benson, Ruth, additional, Onida, Sarah, additional, Paravastu, Sharath, additional, Lambracos, Simon, additional, Vallabhaneni, Srinivasa R, additional, Walsh, Stewart, additional, Aktar, Tasleem, additional, Moloney, Tony, additional, Mzimba, Zola, additional, and Nyamekye, Isaac, additional
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- 2020
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17. Outcomes of Endovascular Aneurysm Repair Using the Anaconda Stent-Graft
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Tigkiropoulos, Konstantinos, primary, Stavridis, Kyriakos, additional, Lazaridis, Ioannis, additional, Bontinis, Evangelos, additional, Zournatzi, Ioulia, additional, Kolaki, Nikoletta, additional, Karamanos, Dimitrios, additional, and Saratzis, Nikolaos, additional
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- 2020
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18. Hybrid Repair of Distal Aortic Arch Dissection Aneurysm With Dissected Kommerell Diverticulum
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Tigkiropoulos, Konstantinos, primary, Kousidis, Panagiotis, additional, Lazaridis, Ioannis, additional, and Saratzis, Nikolaos, additional
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- 2020
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19. Commentary: Understanding the Role of EndoAnchors in Infrarenal Endovascular Aneurysm Repair
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Saratzis, Athanasios, primary and Modarai, Bijan, additional
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- 2019
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20. Rupture After Endovascular Abdominal Aortic Aneurysm Repair
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Pavlos Antoniadis, Triantafillos G. Giannakopoulos, John D. Kakisis, Vasilios Papavassiliou, Christos D. Liapis, Vasilios Saleptsis, Elias Kaperonis, Charalambos Tampakis, Dimitrios Kiskinis, Konstantinos Seretis, Sotirios Georgopoulos, Christos Klonaris, Vasilios Andrikopoulos, Anastasios Machairas, Nikolaos Saratzis, Athanasios D. Giannoukas, Konstantinos Dervisis, Constantine N. Antonopoulos, and Nikolaos Bessias
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Male ,medicine.medical_specialty ,Time Factors ,Databases, Factual ,Endoleak ,Aortic Rupture ,Prosthesis Design ,Aortic repair ,Aortography ,Blood Vessel Prosthesis Implantation ,Foreign-Body Migration ,Risk Factors ,Humans ,Medicine ,Hospital Mortality ,Aged ,Retrospective Studies ,Aged, 80 and over ,Surgical repair ,Greece ,business.industry ,Endovascular Procedures ,General Medicine ,medicine.disease ,Abdominal aortic aneurysm ,Blood Vessel Prosthesis ,Surgery ,Treatment Outcome ,Multicenter study ,Patient Compliance ,Female ,Stents ,Radiology ,Tomography, X-Ray Computed ,Cardiology and Cardiovascular Medicine ,business ,Aortic Aneurysm, Abdominal - Abstract
A total of 22 patients with ruptured abdominal aortic aneurysms (rAAAs) after previous endovascular aortic repair (EVAR; rAAAevar) were presented to 7 referral hospitals in Greece, between January 2006 and April 2012. Type Ia endoleak and endograft migration were identified in 72.7% and 50%, respectively. Compliance to follow-up protocol prior to rupture was 31.8%. In-hospital mortality was 36.4% (9.1% for those treated with secondary EVAR and 63.6% for those treated with open surgical repair, P = .02). An increase in the proportion of patients with rAAAevar among the total number of patients with rAAAs from 1.3% in 2007 to 18.2% in 2012 ( P for trend = .04) was recorded, corresponding to an annual increase of 2.8% (b = 2.84, P = .04). Rupture after EVAR seemed to be a clinical entity encountered with increasing frequency over the past years. Type I endoleak and endograft migration were most frequently observed, whereas compliance to follow-up was low.
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- 2014
21. Can Statins Suppress the Development of Abdominal Aortic Aneurysms? A Review of the Current Evidence
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George D. Kitas, Athanasios Saratzis, Nikolaos Saratzis, and Nikolaos Melas
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Simvastatin ,medicine.medical_specialty ,Atorvastatin ,Bioinformatics ,Risk Assessment ,Extracellular matrix ,Aortic aneurysm ,Aneurysm ,Downregulation and upregulation ,In vivo ,medicine ,Animals ,Humans ,Pyrroles ,cardiovascular diseases ,Inflammation ,business.industry ,Disease progression ,Cardiovascular Agents ,medicine.disease ,Matrix Metalloproteinases ,Abdominal aortic aneurysm ,Surgery ,Heptanoic Acids ,Models, Animal ,Disease Progression ,cardiovascular system ,Blood Vessels ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,Cardiology and Cardiovascular Medicine ,business ,Aortic Aneurysm, Abdominal ,medicine.drug - Abstract
Statins possess several pleiotropic effects and have been shown in vitro and in vivo to inhibit the expression of inflammatory mediators and downregulate molecules involved in extracellular matrix (ECM) degradation. Recent observational studies in humans suggest that statins may have a role in abdominal aortic aneurysm (AAA) prevention or may even inhibit aneurysm expansion. In this review, we summarize the effects of statins on the vessel wall of aneurysmal aortas and currently available data concerning their inhibitory effects on aneurysm progression.
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- 2009
22. The Effect of Malignancy on Outcomes Following Revascularization for Critical Limb Ischemia: A Case–Control Study
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Calderbank, Tom, primary, Karim, Ahmed, additional, Wall, Mike, additional, Syed, Arooj, additional, Davies, Robert S. M., additional, and Saratzis, Athanasios, additional
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- 2018
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23. Commentary: Late Rupture After Endovascular Aneurysm Repair
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Matthew J. Bown, Robert D. Sayers, and Athanasios Saratzis
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medicine.medical_specialty ,Heel ,Endoleak ,business.industry ,Aortic Rupture ,medicine.medical_treatment ,Endovascular Procedures ,medicine.disease ,Endovascular aneurysm repair ,Abdominal aortic aneurysm ,Surgery ,Blood Vessel Prosthesis Implantation ,medicine.anatomical_structure ,medicine ,Humans ,Open repair ,Radiology, Nuclear Medicine and imaging ,Radiology ,Cardiology and Cardiovascular Medicine ,Aortic rupture ,business ,Aortic Aneurysm, Abdominal - Published
- 2015
24. Active Proximal Sealing in the Endovascular Repair of Abdominal Aortic Aneurysms
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Melas, Nikolaos, primary, Stavridis, Kyriakos, additional, Saratzis, Athanasios, additional, Lazarides, John, additional, Gitas, Christos, additional, and Saratzis, Nikolaos, additional
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- 2015
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25. Commentary: Late Rupture After Endovascular Aneurysm Repair
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Saratzis, Athanasios, primary, Bown, Matthew J., additional, and Sayers, Robert D., additional
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- 2015
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26. Impact of Fenestrated Endovascular Abdominal Aortic Aneurysm Repair on Renal Function
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Saratzis, Athanasios N., primary, Bath, Michael F., additional, Harrison, Seamus C., additional, Sayers, Robert D., additional, and Bown, Matthew J., additional
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- 2015
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27. Endovascular Versus Surgical Revascularization for the Management of Chronic Mesenteric Ischemia
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Saedon, Mahmud, primary, Saratzis, Athanasios, additional, Karim, Ahmed, additional, and Goodyear, Steve, additional
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- 2015
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28. Rupture After Endovascular Abdominal Aortic Aneurysm Repair
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Antonopoulos, Constantine N., primary, Kakisis, John D., additional, Giannakopoulos, Triantafillos G., additional, Andrikopoulos, Vasilios, additional, Antoniadis, Pavlos, additional, Bessias, Nikolaos, additional, Dervisis, Konstantinos, additional, Georgopoulos, Sotirios, additional, Giannoukas, Athanasios, additional, Kaperonis, Elias, additional, Kiskinis, Dimitrios, additional, Klonaris, Christos, additional, Machairas, Anastasios, additional, Papavassiliou, Vasilios, additional, Saleptsis, Vasilios, additional, Saratzis, Nikolaos, additional, Seretis, Konstantinos, additional, Tampakis, Charalambos, additional, and Liapis, Christos D., additional
- Published
- 2014
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29. Anemia is Associated With Mortality Following Endovascular Repair of Abdominal Aortic Aneurysm
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Saratzis, Athanasios, primary, Melas, Nikolaos, additional, Hunter, James P., additional, Dixon, Hannah, additional, Nightingale, Peter, additional, Kiskinis, Dimitrios, additional, Saratzis, Nikolaos, additional, and Kitas, George D., additional
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- 2012
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30. Emergency Endovascular Treatment of Popliteal Aneurysms
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Saratzis, A., primary, Melas, N., additional, Dixon, H., additional, and Saratzis, N., additional
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- 2010
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31. Abdominal Aortic Aneurysm: A Review of the Genetic Basis
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Saratzis, Athanasios, primary, Abbas, Ahmed A., additional, Kiskinis, Dimitrios, additional, Melas, Nikolaos, additional, Saratzis, Nikolaos, additional, and Kitas, George D., additional
- Published
- 2010
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32. Can Statins Suppress the Development of Abdominal Aortic Aneurysms? A Review of the Current Evidence
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Saratzis, Athanasios, primary, Kitas, George D., additional, Saratzis, Nikolaos, additional, and Melas, Nikolaos, additional
- Published
- 2009
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33. Quantitative Evaluation of the Systemic Effects of Transposed Basilic Vein to Brachial Artery Arteriovenous Fistula: A Prospective Study
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Saratzis, N., primary, Saratzis, A., additional, Sarafidis, P.A., additional, Melas, N., additional, Ktenidis, K., additional, and Kiskinis, D., additional
- Published
- 2008
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34. 20.12 Catheter directed thrombolysis for acute thrombosis of the subclavian vein
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SARATZIS, N, primary
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- 1997
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35. 20.12 Catheter directed thrombolysis for acute thrombosis of the subclavian vein
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N Saratzis
- Subjects
medicine.medical_specialty ,business.industry ,Catheter directed thrombolysis ,medicine ,Radiology, Nuclear Medicine and imaging ,Surgery ,Acute thrombosis ,Cardiology and Cardiovascular Medicine ,business ,Subclavian vein - Published
- 1997
36. Shockwave Intravascular Lithotripsy Use in the Femoro-Popliteal Segment: Considerations From an Expert Pan-European Panel Regarding Best-Care Practice.
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Saratzis A, Jane Messeder S, and Thulasidasan N
- Abstract
Purpose: Produce expert recommendations regarding the optimal use of Shockwave intravascular lithotripsy (IVL) when treating femoro-popliteal steno-occlusive peripheral artery disease (PAD), guiding operators to use Shockwave IVL., Materials and Methods: A modified 3-step Delphi process was used to gain consensus surrounding preoperative/intraoperative/postoperative considerations when using Shockwave IVL for femoro-popliteal PAD. This included a structured survey, focus-group (with qualitative thematic analysis of views expressed), and final confirmatory round; participants were recruited across Europe including the United Kingdom/Switzerland., Results: Following a review to inform an online survey, 25 experts took part in a survey (5 European countries, 2023), followed by a focus-group (15 participants), 9 interviews, and final confirmatory round. A list of recommendations was prepared where at least moderate-level or high-level agreement was reached (≥70% participants agreeing). The recommendations relate to the optimal preoperative imaging, preoperative preparation(s), intraoperative imaging and use of adjuncts, as well as postoperative course, when using Shockwave IVL., Conclusion: A list of expert recommendations is provided guiding the optimal use of Shockwave IVL in femoro-popliteal PAD. This will help operators achieve better clinical outcomes., Clinical Impact: This pan-European panel of experts using intravascular lithotripsy in routine peripheral arterial disease endovascular practice has provided important insights into best care practices before, during, and after such procedures. Several recommendations have been produced based on a structured consensus process to guide clinicians globally. This will improve and standardise the use of this technology in the femoro-popliteal arterial segment., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: A.S received honoraria and lecture fees/consulting for Shockwave, Abbott, Cook; educational grant support from Cook; research funding from Shockwave, Abbott, Boston Scientific, and Angiodroid. N.T received honoraria and lecture fees/consulting for Shockwave, Philips, and Boston Scientific.
- Published
- 2024
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37. Long-Term Effects of Acute Kidney Injury Following Endovascular Femoropopliteal Intervention: Insights From a Multicenter Trial.
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Katsogridakis E, Saha P, Diamantopoulos A, Saratzis N, Davies R, Zayed H, Bown MJ, and Saratzis A
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- Humans, Male, Female, Time Factors, Aged, Retrospective Studies, Risk Factors, Treatment Outcome, Risk Assessment, Middle Aged, Aged, 80 and over, Severity of Illness Index, Acute Kidney Injury etiology, Acute Kidney Injury mortality, Endovascular Procedures adverse effects, Endovascular Procedures mortality, Peripheral Arterial Disease mortality, Peripheral Arterial Disease therapy, Peripheral Arterial Disease diagnostic imaging, Peripheral Arterial Disease physiopathology, Popliteal Artery diagnostic imaging, Popliteal Artery physiopathology, Popliteal Artery injuries, Femoral Artery diagnostic imaging, Femoral Artery physiopathology
- Abstract
Purpose: To examine the association between acute kidney injury (AKI) severity and duration with cardiovascular mortality, following endovascular treatment of femoropopliteal disease, and whether it is AKI in itself that confers an increased risk of cardiovascular mortality., Methods: A retrospective analysis of prospectively collected data obtained between 2014 and 2019 from 3 vascular centers. Renal function was followed up for a minimum of 90 days. Electronic records were queried to establish a cause of death, where applicable. Patients were excluded if unable to provide written informed consent or if presenting with acute limb ischemia. Primary outcomes were the hazard ratios for cardiovascular death (AKI patients vs no AKI; no AKI vs stage 1 AKI vs stage 3 AKI; and no AKI vs transient AKI vs established AKI). Propensity score-matched analysis was used to establish whether developing AKI, in patients with similar demographics and procedural characteristics, is associated with a higher risk of cardiovascular death., Results: Overall 239 patients developed AKI, and this was associated with an increased risk of cardiovascular mortality (hazard risk [HR]: 4.3, 95% confidence intervals [CIs]: 2.1-6.8, pairwise comparison p value=0.006]. This was dependent on the severity of the AKI stage (HR 5.4, 95% CI: 2.4-7.3, pairwise comparison p value=0.01) and duration (HR 4.2, 95% CI: 2.3-6.2, pairwise comparison p value=0.04). The propensity score-matched analysis showed that even when patients are matched for comorbidity and procedural characteristics, AKI confers an increased risk of mortality (p=0.04)., Conclusions: Acute kidney injury is common after femoropopliteal endovascular therapy. It confers an increased risk of long-term cardiovascular mortality, which is still present when renal decline is transient, and highest for patients with established decline in renal function., Clinical Impact: This is the first study in the setting of peripheral arterial disease to show that acute kidney injury has an adverse effect on cardiovascular mortality, in the long-term, that is dependent on its severity, and present even when the AKI is transient. We have also shown that this difference in cardiovascular mortality becomes more pronounced from the medium-term, and thus closer follow-up of these patients is required., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
- Published
- 2024
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38. The "Woundosome" Concept and Its Impact on Procedural Outcomes in Patients With Chronic Limb-Threatening Ischemia.
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Patrone L, Pasqui E, Conte MS, Farber A, Ferraresi R, Menard M, Mills JL, Rundback J, Schneider P, Ysa A, Abhishek K, Adams GL, Ahmad N, Ahmed I, Alexandrescu VA, Amor M, Alper D, Andrassy M, Attinger C, Baadh A, Barakat H, Biasi L, Bisdas T, Bhatti Z, Blessing E, Bonaca MP, Bonvini S, Bosiers M, Bradbury AW, Beasley R, Behrendt CA, Brodmann M, Cabral G, Cancellieri R, Casini A, Chandra V, Chisci E, Chohan O, Choke ETC, Chong PFS, Clerici G, Coscas R, Costantino M, Dalla Paola L, Dand S, Davies RSM, D'Oria M, Diamantopoulos A, Debus S, Deloose K, Del Giudice C, Donato G, Rubertis B, Paul De Vries J, Dias NV, Diaz-Sandoval L, Dick F, Donas K, Dua A, Fanelli F, Fazzini S, Foteh M, Gandini R, Gargiulo M, Garriboli L, Genovese EA, Gifford E, Goueffic Y, Goverde P, Chand Gupta P, Hinchliffe R, Holden A, Houlind KC, Howard DP, Huasen B, Isernia G, Katsanos K, Katzen B, Kolh P, Koncar I, Korosoglou G, Krishnan P, Kroencke T, Krokidis M, Kumarasamy A, Hayes P, Iida O, Alejandre Lafont E, Langhoff R, Lecis A, Lessne M, Lichaa H, Lichtenberg M, Lobato M, Lopes A, Loreni G, Lucatelli P, Madassery S, Maene L, Manzi M, Maresch M, Santhosh Mathews J, McCaslin J, Micari A, Michelagnoli S, Migliara B, Morgan R, Morelli L, Morosetti D, Mouawad N, Moxey P, Müller-Hülsbeck S, Mustapha J, Nakama T, Nasr B, N'dandu Z, Neville R, Noory E, Nordanstig J, Noronen K, Mariano Palena L, Parlani G, Patel AS, Patel P, Patel R, Patel S, Pena C, Perkov D, Portou M, Pratesi G, Rammos C, Reekers J, Riambau V, Roy T, Rosenfield K, Antonella Ruffino M, Saab F, Saratzis A, Sbarzaglia P, Schmidt A, Secemsky E, Siah M, Sillesen H, Simonte G, Sirvent M, Sommerset J, Steiner S, Sakr A, Scheinert D, Shishebor M, Spiliopoulos S, Spinelli A, Stravoulakis K, Taneva G, Teso D, Tessarek J, Theivacumar S, Thomas A, Thomas S, Thulasidasan N, Torsello G, Tripathi R, Troisi N, Tummala S, Tummala V, Twine C, Uberoi R, Ucci A, Valenti D, van den Berg J, van den Heuvel D, Van Herzeele I, Varcoe R, Vega de Ceniga M, Veith FJ, Venermo M, Vijaynagar B, Virdee S, Von Stempel C, Voûte MT, Khee Yeung K, Zeller T, Zayed H, and Montero Baker M
- Abstract
Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
- Published
- 2024
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39. A Systematic Review and Meta-Analysis of 12-Month Patency After Intervention for Iliofemoral Obstruction Using Dedicated or Non-Dedicated Venous Stents.
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Majeed GM, Lodhia K, Carter J, Kingdon J, Morris RI, Gwozdz A, Saratzis A, and Saha P
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- Humans, Retrospective Studies, Stents, Treatment Outcome, Vascular Patency, Endovascular Procedures adverse effects, Postthrombotic Syndrome diagnostic imaging, Postthrombotic Syndrome etiology, Postthrombotic Syndrome therapy
- Abstract
Background: Endovascular stenting of the deep venous system has been proposed as a method to treat patients with symptomatic iliofemoral outflow obstruction. The purpose of this systematic review and meta-analysis was to compare the effectiveness of this treatment at 1-year following the development of dedicated venous stents., Method and Results: We searched MEDLINE and EMBASE for studies evaluating the effectiveness of venous stent placement. Data were extracted by disease pathogenesis: non-thrombotic iliac vein lesions (NIVL), acute thrombotic (DVT), or post-thrombotic syndrome (PTS). Main outcomes included technical success, stent patency at 1 year and symptom relief. A total of 49 studies reporting outcomes in 5154 patients (NIVL, 1431; DVT, 950; PTS, 2773) were included in the meta-analysis. Technical success rates were comparable among groups (97%-100%). There were no periprocedural deaths. Minor bleeding was reported in up to 5% of patients and major bleeding in 0.5% upon intervention. Transient back pain was noted in 55% of PTS patients following intervention. There was significant heterogeneity between studies reporting outcomes in PTS patients. Primary and cumulative patency at 1 year was: NIVL-96% and 100%; DVT-91% and 97%; PTS (stents above the ligament)-77% and 94%, and; PTS (stents across the ligament)-78% and 94%. There were insufficient data to compare patency outcomes of dedicated and nondedicated venous stents in patients with acute DVT. In NIVL and PTS patients, stent patency was comparable at 1 year. There was inconsistency in the use of validated tools for the measurement of symptoms before and after intervention. When reported, venous claudication, improved in 83% of PTS patients and 90% of NIVL patients, and ulcer healing occurred in 80% of PTS patients and 32% of NIVL patients., Conclusions: The first generation of dedicated venous stents perform comparably in terms of patency and clinical outcomes to non-dedicated technologies at 1 year for the treatment of patients with NIVL and PTS. However, significant heterogeneity exists between studies and standardized criteria are urgently needed to report outcomes in patients undergoing deep venous stenting.
- Published
- 2022
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40. Revascularization Outcomes in Patients With Acute Limb Ischemia and Active Neoplastic Disease.
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Argyriou A, Kafetzakis A, Saratzis A, Huasen B, Coscas R, Renard R, Bisdas T, Torsello G, Tsilimparis N, Calderbank T, and Stavroulakis K
- Subjects
- Aged, Aged, 80 and over, Amputation, Surgical, Female, Humans, Ischemia surgery, Ischemia therapy, Limb Salvage, Male, Middle Aged, Peripheral Arterial Disease surgery, Peripheral Arterial Disease therapy, Retrospective Studies, Risk Factors, Time Factors, Treatment Outcome, Endovascular Procedures adverse effects, Neoplasms complications
- Abstract
Purpose: To report the outcomes of surgical (ST), endovascular (ET), and hybrid (HT) treatment in cancer patients with acute limb ischemia (ALI)., Materials and Methods: A multicenter retrospective registry collected 139 patients (mean age 72.3±12.4 years; 73 men) with ALI and active malignancy treated by ET (41, 29%), ST (70, 51%), or HT (28, 20%) in 7 European centers between July 2007 and February 2019. In 22 cases (16%) ALI was the first manifestation of the malignancy. Lung cancer was the most common diagnosis (38, 27%). The primary composite outcome was amputation-free survival (AFS). Overall survival, amputation-free time (AFT), and reintervention-free time (RFT) were also assessed. Cox regression analysis was applied to identify independent risk factors for the primary and secondary outcomes. Results are presented as the hazard ratio (HR) and 95% confidence intervals (CIs)., Results: ET was associated with improved 12-month AFS compared with both ST (HR 2.27, 95% CI 1.20 to 4.28, p=0.002) and HT (HR 2.14, 95% CI 1.09 to 4.18, p=0.008). ST (HR 2.50, 95% CI 1.19 to 5.53, p=0.003) and HT (HR 3.10, 95% CI 1.45 to 6.65, p<0.001) were related to an increased risk for mortality compared with ET. At 12 months, the AFT was similar between the 3 groups (ET vs ST: HR 1.52, 95% CI 0.51 to 4.53, p=0.45 and ET vs HT: HR 1.21, 95% CI 0.36 to 4.11, p=0.73). The 12-month RFT also did not differ significantly between the 3 treatment options (ET vs ST: HR 1.10, 95% CI 0.49 to 2.46, p=0.79 and ET vs HT: HR 0.51, 95% CI 0.22 to 1.17, p=0.19). ST and/or HT increased the risk for the major amputation and/or death (HR 1.76, 95% CI 1.05 to 2.05, p=0.03), while Rutherford class I ischemia (HR 0.12, 95% CI 0.02 to 0.90, p=0.04) and previous vascular interventions on the index limb (HR 0.55, 95% CI 0.32 to 0.97, p=0.04) showed a protective effect., Conclusion: In patients with ALI and active malignant disease, ET was associated with increased AFS and overall survival compared with both ST and HT, while the limb salvage and reintervention rates were comparable among the 3 groups.
- Published
- 2021
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41. A novel approach to minimize sealing defects: EndoAnchors reduce gutter size in an in vitro chimney graft model.
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Melas N, Perdikides T, Saratzis A, Lazaridis J, and Saratzis N
- Subjects
- Aortic Aneurysm, Abdominal surgery, Blood Vessel Prosthesis, Endovascular Procedures
- Published
- 2013
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42. Primary endoanchoring in the endovascular repair of abdominal aortic aneurysms with an unfavorable neck.
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Perdikides T, Melas N, Lagios K, Saratzis A, Siafakas A, Bountouris I, Kouris N, Avci M, Van den Heuvel DA, and de Vries JP
- Subjects
- Aged, Aged, 80 and over, Aortic Aneurysm, Abdominal diagnostic imaging, Aortography, Blood Vessel Prosthesis, Blood Vessel Prosthesis Implantation adverse effects, Blood Vessel Prosthesis Implantation instrumentation, Endoleak etiology, Equipment Design, Feasibility Studies, Female, Humans, Male, Middle Aged, Prospective Studies, Registries, Stents, Sutures, Time Factors, Treatment Outcome, Aortic Aneurysm, Abdominal surgery, Blood Vessel Prosthesis Implantation methods, Endovascular Procedures adverse effects, Endovascular Procedures instrumentation, Surgical Stapling adverse effects, Surgical Stapling instrumentation
- Abstract
Purpose: To investigate the feasibility and early results of endoanchoring (endostapling) using a new commercially available device as an adjunctive procedure during endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAAs) with an unfavorable proximal neck., Methods: Between June 2010 and May 2012, 13 consecutive patients (all men; median age 73 years, range 62-82) were prospectively enrolled in a 2-center registry to follow outcomes of adjunctive primary endoanchoring (Aptus HeliFX Aortic Securement System) of the proximal endograft to enhance proximal graft fixation and sealing during EVAR. Indications for proximal neck endoanchoring included at least one of the following: neck angulation 45° to 90°, length 8 to 15 mm, diameter 29 to 33 mm, conical neck configuration, or an irregularly shaped neck. The median AAA diameter was 56 mm (range 50-98). The Endurant stent-graft was implanted in 4 patients and the Zenith device in 9., Results: A median of 4 endoanchors were implanted per patient (range 3-10) in adjunctive procedures that required a median 12 minutes (range 7-20). Intraoperatively, 2 proximal type I endoleaks were present following endoanchor implantation (85% primary technical success); a cuff was deployed in 1 case, which successfully sealed the endoleak (92% assisted primary technical success). The second proximal type I endoleak was minute and sealed spontaneously within 30 days. No further major device-related complications occurred intraoperatively. In the 30-day perioperative period, the only procedure-related complications were 2 type II endoleaks, which required no intervention. Over a median follow-up of 7 months (range 2-17), no further complications occurred apart from an asymptomatic internal iliac artery occlusion and a non-lethal myocardial infarction at 9 months. The type II endoleaks spontaneously sealed. No endograft migration was noticed nor loss of endoanchor integrity. No deaths occurred throughout follow-up., Conclusion: Primary endoanchoring using the HeliFX aortic securement system is feasible, and early results were promising in this series.
- Published
- 2012
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43. Isolated common iliac artery aneurysms: a revised classification to assist endovascular repair.
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Melas N, Saratzis A, Dixon H, Saratzis N, Lazaridis J, Perdikides T, and Kiskinis D
- Subjects
- Decision Support Techniques, Humans, Iliac Aneurysm diagnostic imaging, Patient Selection, Radiography, Risk Assessment, Risk Factors, Blood Vessel Prosthesis Implantation adverse effects, Endovascular Procedures adverse effects, Iliac Aneurysm classification, Iliac Aneurysm surgery, Terminology as Topic
- Abstract
Isolated common iliac artery aneurysms (CIAAs) are relatively rare; they typically progress asymptomatically and are revealed incidentally, usually after they have acquired significant dimensions. Traditional open reconstruction is associated with high morbidity and mortality rates. Rupture is a common initial manifestation. Endovascular repair has been proposed as a minimally invasive alternative, associated with lower morbidity and mortality rates, even in patients at high surgical risk; some specialists have recently proposed endoluminal repair as the first-choice procedure in suitable anatomies. However, only a few sporadic attempts have been made to define the "suitable" anatomy for endovascular repair. This article proposes a classification of isolated CIAAs and provides endovascular specialists with a guide to deciding which type of repair is feasible and efficacious according to the anatomical configuration of the aneurysm.
- Published
- 2011
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44. Inferior vena cava stent-graft placement to treat endoleak associated with an aortocaval fistula.
- Author
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Melas N, Saratzis A, Saratzis N, Lazaridis I, and Kiskinis D
- Subjects
- Aged, Aortic Aneurysm, Abdominal diagnostic imaging, Aortic Diseases diagnostic imaging, Aortic Diseases etiology, Aortography methods, Blood Vessel Prosthesis Implantation adverse effects, Endoleak diagnostic imaging, Endoleak etiology, Endovascular Procedures adverse effects, Humans, Male, Reoperation, Time Factors, Tomography, X-Ray Computed, Treatment Outcome, Vascular Fistula diagnostic imaging, Vascular Fistula etiology, Vena Cava, Inferior diagnostic imaging, Aortic Aneurysm, Abdominal surgery, Aortic Diseases surgery, Blood Vessel Prosthesis, Blood Vessel Prosthesis Implantation instrumentation, Endoleak surgery, Endovascular Procedures instrumentation, Stents, Vascular Fistula surgery, Vena Cava, Inferior surgery
- Abstract
Purpose: To report a case in which a persistent high-flow type II endoleak after endovascular aneurysm repair (EVAR) of a leaking abdominal aortic aneurysm (AAA) complicated by an aortocaval fistula was repaired with a stent-graft in the inferior vena cava (IVC)., Case Report: A 76-year-old man underwent emergent EVAR with an aortomonoiliac device to exclude a leaking 9-cm AAA. The 30-day computed tomography (CT) scan showed 2-mm sac expansion and a type II endoleak arising from a lumbar artery; the outflow vessel was the inferior vena cava (IVC) via a fistula that was not depicted on the non-contrast preoperative CT or the intraoperative angiogram. No intervention was deemed necessary at the time. Six months after EVAR, the AAA had not expanded further, but the fistula between the sac and the IVC was larger in diameter. A tubular stent-graft was implanted in the IVC to seal the defect. No complications have been noted up to 36 months after the IVC stent-graft procedure., Conclusion: Aortocaval fistulae should be excluded in the case of persistent type II endoleaks after EVAR for ruptured AAAs. IVC endografting is a minimally invasive alternative to treat such a complication, with promising midterm results in this patient.
- Published
- 2011
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45. Abdominal aortic aneurysm: a review of the genetic basis.
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Saratzis A, Abbas AA, Kiskinis D, Melas N, Saratzis N, and Kitas GD
- Subjects
- HLA Antigens genetics, Humans, Interleukins genetics, Matrix Metalloproteinases genetics, Peptidyl-Dipeptidase A genetics, Tissue Inhibitor of Metalloproteinases genetics, Aortic Aneurysm, Abdominal genetics
- Abstract
Background: Abdominal aortic aneurysm (AAA) is a complex disease with a largely unknown pathophysiological background and a strong genetic component. Various studies have tried to link specific genetic variants with AAA., Methods: Systematic review of the literature (1947-2009)., Results: A total of 249 studies were identified, 89 of which were eventually deemed relevant to this review. Genetic variants (polymorphisms) in a wide variety of genes, most of which encode proteolytic enzymes and inflammatory molecules, have been associated with AAA development and progression., Conclusion: The genetic basis of AAA remains unknown, and most results from ''candidate-gene'' association studies are contradictory. Further analyses in appropriately powered studies in large, phenotypically well-characterized populations, including genome-wide association studies, are necessary to elucidate the exact genetic contribution to the pathophysiology of AAA.
- Published
- 2011
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46. Commentary: popliteal approach in the supine position after failed antegrade angioplasty for chronic superficial femoral artery occlusion.
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Saratzis A, Melas N, and Saratzis N
- Subjects
- Arterial Occlusive Diseases diagnosis, Arterial Occlusive Diseases etiology, Humans, Popliteal Artery, Supine Position, Angioplasty adverse effects, Angioplasty methods, Arterial Occlusive Diseases surgery, Blood Vessel Prosthesis Implantation, Femoral Artery, Stents
- Published
- 2010
- Full Text
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47. Can statins suppress the development of abdominal aortic aneurysms? A review of the current evidence.
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Saratzis A, Kitas GD, Saratzis N, and Melas N
- Subjects
- Animals, Aortic Aneurysm, Abdominal physiopathology, Atorvastatin, Blood Vessels drug effects, Blood Vessels physiopathology, Cardiovascular Agents pharmacology, Disease Progression, Heptanoic Acids pharmacology, Heptanoic Acids therapeutic use, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors pharmacology, Inflammation prevention & control, Matrix Metalloproteinases metabolism, Models, Animal, Pyrroles pharmacology, Pyrroles therapeutic use, Risk Assessment, Simvastatin pharmacology, Simvastatin therapeutic use, Aortic Aneurysm, Abdominal prevention & control, Cardiovascular Agents therapeutic use, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use
- Abstract
Statins possess several pleiotropic effects and have been shown in vitro and in vivo to inhibit the expression of inflammatory mediators and downregulate molecules involved in extracellular matrix (ECM) degradation. Recent observational studies in humans suggest that statins may have a role in abdominal aortic aneurysm (AAA) prevention or may even inhibit aneurysm expansion. In this review, we summarize the effects of statins on the vessel wall of aneurysmal aortas and currently available data concerning their inhibitory effects on aneurysm progression.
- Published
- 2010
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48. Aortoduodenal fistulas after endovascular stent-graft repair of abdominal aortic aneurysms: single-center experience and review of the literature.
- Author
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Saratzis N, Saratzis A, Melas N, Ktenidis K, and Kiskinis D
- Subjects
- Aged, Angiography, Aortic Diseases diagnostic imaging, Duodenal Diseases diagnostic imaging, Female, Humans, Intestinal Fistula diagnostic imaging, Male, Middle Aged, Prosthesis Failure, Tomography, X-Ray Computed, Vascular Fistula diagnostic imaging, Aortic Aneurysm, Abdominal therapy, Aortic Diseases etiology, Blood Vessel Prosthesis Implantation adverse effects, Duodenal Diseases etiology, Intestinal Fistula etiology, Stents adverse effects, Vascular Fistula etiology
- Abstract
Purpose: To report a single-center experience with aortoduodenal fistula (ADF) after successful endovascular aneurysm repair (EVAR) of an infrarenal abdominal aortic aneurysm (AAA)., Methods: Five patients (all men; mean age 68.4 years, range 60-75) developed an ADF between 18 days to 1 year after successful EVAR using 3 types of commercially available endografts: 1 bifurcated Anaconda, 1 unibody Powerlink, and 3 EndoFit stent-grafts in a tubular (n=1) or aortomonoiliac configuration (n=2). The internal iliac artery was not occluded in any of the cases., Results: Hematemesis and diffuse abdominal pain constituted the main symptoms leading to the diagnosis of ADF, which was confirmed on computed tomography. Infection was the etiology of the ADF in 3 patients; all underwent emergency surgical exploration, but 1 died in hospital; the other 2 have survived from 1 to 3 years after an emergency procedure. The other 2 ADFs developed in patients with large type I endoleaks; 1 patient died before surgery could be performed and the other one 18 hours after laparotomy. All stent-grafts were removed; none displayed any defects., Conclusion: ADF is a rare but dangerous complication of EVAR. The sequela may be primarily attributed to graft infection, as seen in this series. However, the exact pathogenesis of the pathology remains largely unknown. Prompt diagnosis and intervention are crucial to avoid a fatal outcome.
- Published
- 2008
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49. Midterm results of a modified technique for implanting tube grafts during endovascular abdominal aortic aneurysm repair.
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Saratzis N, Melas N, Saratzis A, Tsakiliotis S, Lazarides J, Ktenidis K, and Kiskinis D
- Subjects
- Adult, Aged, Aged, 80 and over, Angiography, Digital Subtraction, Aortic Aneurysm, Abdominal diagnostic imaging, Chi-Square Distribution, Female, Humans, Male, Middle Aged, Retrospective Studies, Statistics, Nonparametric, Tomography, X-Ray Computed, Treatment Outcome, Aortic Aneurysm, Abdominal therapy, Blood Vessel Prosthesis, Blood Vessel Prosthesis Implantation methods, Stents
- Abstract
Purpose: To retrospectively analyze the efficacy and midterm results of endovascular aneurysm repair (EVAR) with a tubular stent-graft using 2 different implantation techniques., Methods: Between November 2004 and September 2007, 53 patients (49 men; mean age 68.5+/-8.6 years, range 40-80) were treated with the EndoFit tube stent-graft. The majority (45, 85%) were treated using the trombone technique, in which 2 tubular aortoaortic endografts were deployed with 4 to 8 cm of overlap. This subgroup was compared to the 8 patients who received single tube grafts., Results: Technical and procedural success were 100%; perioperative mortality was 0%. Operative results were similar for patients treated with 1 graft versus those treated with the overlapping trombone technique. The overall device-related complication rate was significantly lower for patients treated with the trombone technique (11% versus 75%, p<0.001). Mean follow-up was 24 months (range 6-36). Endoleak type II occurred in 3 (5.7%) cases. Three (5.7%) patients died, 1 from an aortoduodenal fistula secondary to a proximal type I endoleak and 2 from acute myocardial infarction., Conclusion: The tubular EndoFit device appears both safe and effective in terms of midterm clinical outcome, especially when the trombone technique is utilized. It compares favorably with previously reported EVAR results.
- Published
- 2008
- Full Text
- View/download PDF
50. Anaconda aortic stent-graft: single-center experience of a new commercially available device for abdominal aortic aneurysms.
- Author
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Saratzis N, Melas N, Saratzis A, Lazarides J, Ktenidis K, Tsakiliotis S, and Kiskinis D
- Subjects
- Aged, Aged, 80 and over, Aortic Aneurysm, Abdominal mortality, Female, Humans, Male, Middle Aged, Postoperative Complications, Reoperation, Retrospective Studies, Statistics, Nonparametric, Survival Analysis, Treatment Outcome, Aortic Aneurysm, Abdominal surgery, Blood Vessel Prosthesis, Blood Vessel Prosthesis Implantation methods, Stents
- Abstract
Purpose: To report a retrospective evaluation of the efficacy and midterm clinical results of the Anaconda stent-graft in the endovascular repair of infrarenal abdominal aortic aneurysms., Methods: Fifty-one patients (48 men; mean age 71+/-8 years, range 62-89) were treated with the Anaconda stent-graft from January 2006 to September 2007. Six patients were considered at high risk for open repair (defined as ASA grade 3) and 10 had undergone previous laparotomy. The mean neck diameter and length were 26 mm (range 22-30) and 18.5 mm (range 14-35), respectively. Mean proximal neck angulation was 30 degrees (range 5-60). Severe iliac artery tortuosity (>60 degrees ) was seen in 20 (39%) patients; 3 (6%) had a proximal aneurysm neck angle >45 degrees., Results: The technical success rate was 100%; intraprocedurally, 7 (14%) stent-grafts were repositioned to address renal artery occlusion by the graft (n = 1) or type I endoleak. This maneuver resolved 6 of the 7 situations; a remaining endoleak required a proximal cuff to seal it. The procedural success rate (no major complication at 30 days) was 94%. The mean follow-up was 16 months (range 1-21). Five (10%) endoleaks (1 type I, 4 type II) and 1 (2%) graft migration occurred. The overall reintervention rate was 6%. Two (4%) patients died in late follow-up., Conclusion: The Anaconda stent-graft appears both safe and effective in terms of midterm clinical outcome and compares favorably with previously reported EVAR results. The ability to reposition the stent-graft is a particular advantage.
- Published
- 2008
- Full Text
- View/download PDF
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