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Murphy K, Kelekis A, Bonaldi G, Cianfoni A, Filippiadis D, Bernucci C, Hooper D, Benhabib H, Buric J. Abstract No. 2 ▪ ABSTRACT OF THE YEAR Intradiscal oxygen-ozone chemonucleolysis versus microdiscectomy for lumbar disc herniation radiculopathy: a non-inferiority randomized control trial. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Filippiadis D, Velonakis G, Charalampopoulos G, Masala S, Kelekis A, Kelekis N. Percutaneous Microwave Ablation for the Management of Hepatocellular Carcinoma in Transfusion-Dependent Beta-Thalassemia Patients. Cardiovasc Intervent Radiol 2022; 45:709-711. [PMID: 35166888 DOI: 10.1007/s00270-022-03084-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 01/30/2022] [Indexed: 11/02/2022]
Affiliation(s)
- D Filippiadis
- 2nd Department of Radiology, Medical School, University General Hospital "ATTIKON", National and Kapodistrian University of Athens, 1 Rimini Str, Haidari, 12462, Athens, Greece.
| | - G Velonakis
- 2nd Department of Radiology, Medical School, University General Hospital "ATTIKON", National and Kapodistrian University of Athens, 1 Rimini Str, Haidari, 12462, Athens, Greece
| | - G Charalampopoulos
- 2nd Department of Radiology, Medical School, University General Hospital "ATTIKON", National and Kapodistrian University of Athens, 1 Rimini Str, Haidari, 12462, Athens, Greece
| | - S Masala
- Department of Diagnostic Imaging and Interventional Radiology, University of Rome Tor Vergata, Viale Oxford, 31-00133, Roma, Italy
| | - A Kelekis
- 2nd Department of Radiology, Medical School, University General Hospital "ATTIKON", National and Kapodistrian University of Athens, 1 Rimini Str, Haidari, 12462, Athens, Greece
| | - N Kelekis
- 2nd Department of Radiology, Medical School, University General Hospital "ATTIKON", National and Kapodistrian University of Athens, 1 Rimini Str, Haidari, 12462, Athens, Greece
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Filippiadis D, Mavrogenis A, Spiliopoulos S, Palialexis K, Brountzos E, Kelekis A. Percutaneous computed tomography-guided radiofrequency ablation of a spinal osteoid osteoma abutting the dura: a case report and review of the literature. Eur J Orthop Surg Traumatol 2021; 31:1625-1630. [PMID: 33709268 DOI: 10.1007/s00590-021-02922-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 02/25/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE Osteoid osteomas in the spine constitute a challenging group for both surgical and percutaneous approaches. Purpose of the present study is to report a case report of a spinal osteoid osteoma in a challenging spinal location and review literature for safety and efficacy of the technique. METHODS We report a case of spinal osteoid osteoma extending in the epidural space and abutting the dura in a pediatric patient treated by percutaneous computed tomography-guided radiofrequency ablation. This is not a systematic review of the literature. A number of separate literature searches were performed. Non-English studies and case reports were excluded from the study. All references of the obtained articles were also evaluated for any additional information. RESULTS Although all prophylactic measures were taken (hydrodissection, thermocouples and neurophysiologic monitoring) and the procedure was uneventful, patient within three hours, was unable to raise or bend the unilateral lower extremity below the knee. Pain reduction was significant from the first morning post-ablation and during the follow-up period of 18 months. MR scan was within normal limits. Dexamethasone was iv injected for 24 h and prescribed per os for 7 days. At follow-up 1 week later mobility of the lower extremity had returned to normal. CONCLUSION As far as spine ablation is concerned, all prophylactic measures should be taken; neurophysiologic monitoring seems to be more sensitive than temperature measurement. Intravenous and per os corticosteroids are extremely useful in case of nerve damage.
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Affiliation(s)
- D Filippiadis
- 2nd Department of Radiology, Medical School, University General Hospital "ATTIKON", National and Kapodistrian University of Athens, 1 Rimini str, 12462, Haidari/Athens, Greece.
| | - A Mavrogenis
- A Orthopedic Clinic, University General Hospital "ATTIKON", Athens, Greece
| | - S Spiliopoulos
- 2nd Department of Radiology, Medical School, University General Hospital "ATTIKON", National and Kapodistrian University of Athens, 1 Rimini str, 12462, Haidari/Athens, Greece
| | - K Palialexis
- 2nd Department of Radiology, Medical School, University General Hospital "ATTIKON", National and Kapodistrian University of Athens, 1 Rimini str, 12462, Haidari/Athens, Greece
| | - E Brountzos
- 2nd Department of Radiology, Medical School, University General Hospital "ATTIKON", National and Kapodistrian University of Athens, 1 Rimini str, 12462, Haidari/Athens, Greece
| | - A Kelekis
- 2nd Department of Radiology, Medical School, University General Hospital "ATTIKON", National and Kapodistrian University of Athens, 1 Rimini str, 12462, Haidari/Athens, Greece
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Filippiadis D, Ptohis N, Efthymiou E, Kelekis A. A Technical Report on the Performance of Percutaneous Cryoneurolysis of Splanchnic Nerves for the Treatment of Refractory Abdominal Pain in Patients with Pancreatic Cancer: Initial Experience. Cardiovasc Intervent Radiol 2021; 44:789-794. [PMID: 33409546 DOI: 10.1007/s00270-020-02756-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 12/23/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE To report our preliminary results upon feasibility, efficacy and safety of percutaneous splanchnic nerves cryoneurolysis for the treatment of abdominal pain refractory to conservative medication in patients with pancreatic cancer MATERIALS METHODS: Institutional database research (retrospective review of prospectively collected data from April 2019 till August 2020) identified 5 patients with pancreatic cancer and pain refractory to conservative medication who underwent percutaneous cryoneurolysis of splanchnic nerves. In all patients, percutaneous cryoneurolysis was performed with posterolateral paravertebral approach using a 17 Gauge cryoprobe under computed tomography guidance and local anesthesia. Self-reported pain scores were assessed before and at the last follow-up using a pain inventory with visual analog scale (VAS) units. RESULTS Mean patient age was 63.81 years (male-female: 3-2). Mean pain score prior to cryoanalgesia of splanchnic nerves was 9.4 VAS units. This score was reduced to a mean value of 2.6, 2.6 and 3 VAS units at 1, 3 and 6 months of follow-up, respectively. All patients reported significantly reduced analgesic usage. No complication was reported according to the CIRSE classification system. The mean procedure time was 44.4 min (range 39-50 min), including local anesthesia, cryoprobe(s) placement, ablation and post-procedural CT evaluation. CONCLUSION Percutaneous cryoanalgesia of the splanchnic nerves is a minimally invasive, safe and effective procedure for pancreatic cancer pain relief. A larger, randomized trial is justified to substantiate these findings.
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Affiliation(s)
- D Filippiadis
- 2nd Department of Radiology Dpt, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, 1 Rimini str, 12,462, Haidari/Athens, Greece.
| | - N Ptohis
- Department of Interventional Radiology, General Hospital of Athens "G. Gennimatas", 154 Mesogion Av., 11,527, Athens, Greece
| | - E Efthymiou
- 2nd Department of Radiology Dpt, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, 1 Rimini str, 12,462, Haidari/Athens, Greece
| | - A Kelekis
- 2nd Department of Radiology Dpt, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, 1 Rimini str, 12,462, Haidari/Athens, Greece
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Filippiadis D, Gkizas C, Velonakis G, Flevas DA, Kokkalis ZT, Mavrogenis AF, Mazioti A, Brountzos E, Kelekis N, Kelekis A. Computed Tomography-Guided Percutaneous Infiltrations for Piriformis Syndrome: A Single-Center Retrospective Study. J Long Term Eff Med Implants 2021; 30:113-118. [PMID: 33426849 DOI: 10.1615/jlongtermeffmedimplants.2020035543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Piriformis syndrome (PS), first described by Yeoman in 1928, is a general term referring to low back pain, sciatica, and instability. PS has a 6% incidence rate worldwide. In this study, we aim to retrospectively evaluate the effectiveness of computed tomography (CT)-guided percutaneous infiltration in a series of consecutive PS patients who have symptoms that are refractory to conservative therapies. An institutional database search identified 20 such consecutive patients who underwent infiltration with a mixture of long-acting corticosteroid and local anesthetic. Preoperational evaluation included physical examination and magnetic resonance imaging. The correct position of the 22-gauge spinal needle was verified with CT scan after contrast medium injection. Pain measured before the procedure and at 1 wk and 1, 6, and 12 mo after the procedure was compared by means of a numeric visual scale (NVS) questionnaire. The mean pain score before CT-guided percutaneous infiltration was 8.95 ± 1.432 NVS units. This score was reduced to a mean value of 0.85 ± 0.933 units at 1 wk, 0.90 ± 0.852 at 1 mo, 1.10 ± 1.165 at 6 mo, and 1.20 ± 1.399 at 12 mo follow-up (p < 0.001). Two patients of 20 (10%) underwent a second infiltration that was performed at 7 and 10 d after the first, respectively. No complications were observed. CT-guided infiltration seems to be a feasible, efficacious, and safe approach for pain reduction and mobility improvement in patients with symptomatic PS.
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Affiliation(s)
- D Filippiadis
- Second Radiology Department, Medical School, National and Kapodistrian University of Athens, University General Hospital "ATTIKON", Athens, Greece
| | - C Gkizas
- Second Radiology Department, Medical School, National and Kapodistrian University of Athens, University General Hospital "ATTIKON", Athens, Greece
| | - G Velonakis
- Second Radiology Department, Medical School, National and Kapodistrian University of Athens, University General Hospital "ATTIKON", Athens, Greece
| | - Dimitrios A Flevas
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens Greece
| | - Z T Kokkalis
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, University General Hospital "ATTIKON", Athens, Greece
| | - Andreas F Mavrogenis
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece
| | - A Mazioti
- Second Radiology Department, Medical School, National and Kapodistrian University of Athens, University General Hospital "ATTIKON", Athens, Greece
| | - E Brountzos
- Second Radiology Department, Medical School, National and Kapodistrian University of Athens, University General Hospital "ATTIKON", Athens, Greece
| | - N Kelekis
- Second Radiology Department, Medical School, National and Kapodistrian University of Athens, University General Hospital "ATTIKON", Athens, Greece
| | - A Kelekis
- Second Radiology Department, Medical School, National and Kapodistrian University of Athens, University General Hospital "ATTIKON", Athens, Greece
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Filippiadis D, Efthymiou E, Tsochatzis A, Kelekis A, Prologo JD. Percutaneous cryoanalgesia for pain palliation: Current status and future trends. Diagn Interv Imaging 2020; 102:273-278. [PMID: 33281081 DOI: 10.1016/j.diii.2020.11.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/16/2020] [Accepted: 11/17/2020] [Indexed: 12/11/2022]
Abstract
Cryoanalgesia, otherwise termed cryoneurolysis, refers to application of extreme cold upon peripheral nerves for palliation of pain associated to nerve lesions or biomechanical syndromes of neoplastic and non-neoplastic substrate. Application of cryoanalgesia initiates a cascade of pathophysiologic events interrupting nerve conduction of painful stimuli without irreversible nerve damage. Cryoanalgesia is considered a safe procedure with minimal risk of complications when performed with percutaneous approaches under imaging guidance. In the era of an opioid overdose crisis, cryoanalgesia can be proposed as an alternative aiming at controlling pain and improving life quality. Imaging guidance has substituted open surgical and nerve stimulation approaches in nerve identification, significantly contributing to the minimally invasive character of percutaneous approaches. Ultrasound or computed tomography can serve as low cost, ideal guiding techniques due to their abilities for precise anatomic delineation, high spatial resolution and good tissue contrast. The purpose of this review is to become familiar with the most common imaging guided percutaneous cryoanalgesia indications, to learn about different technical considerations during performance providing the current evidence. Controversies concerning products will be addressed.
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Affiliation(s)
- Dimitrios Filippiadis
- Second Radiology Department, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, Athens, Greece.
| | - E Efthymiou
- Second Radiology Department, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - A Tsochatzis
- Second Radiology Department, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - A Kelekis
- Second Radiology Department, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - J D Prologo
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364, Clifton road NE, 30322 Atlanta, GA, USA
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Psarras M, Ploussi A, Carinou E, Brountzos E, Spiliopoulos SC, Palialexis K, Kelekis A, Filippiadis D, Seimenis I, Efstathopoulos EP. RADIATION DOSES TO THE EYE LENS AND FOREHEAD OF INTERVENTIONAL RADIOLOGISTS: HOW HIGH AND ON WHAT GROUNDS? Radiat Prot Dosimetry 2020; 190:150-157. [PMID: 32626896 DOI: 10.1093/rpd/ncaa097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 05/05/2020] [Accepted: 06/10/2020] [Indexed: 02/05/2023]
Abstract
The aim of the study was to measure and evaluate the radiation dose to the eye lens and forehead of interventional radiologists (IRs). The study included 96 procedures (lower-limb percutaneous transluminal angioplasties, embolisations/chemoembolisations and vertebroplasties) performed by 6 IRs. A set of seven thermoluminescence dosemeters was allocated to each physician. The highest dose per procedure was found for the left eye lens of the primary operator in vertebroplasties (1576 μSv). Left and right eye doses were linearly correlated to left and right forehead doses, respectively. A workload-based estimation of the annual dose to participating IRs revealed that the occupational dose limit for the eye lens can be easily exceeded. The left eye dose of ΙRs must be routinely monitored on a personalised basis. Τhe left eye dose measurement provides a reliable assessment of the ipsilateral forehead dose, along with valid estimations for the right eye and right forehead doses.
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Affiliation(s)
- M Psarras
- 2nd Department of Radiology, Medical Physics Unit, National and Kapodistrian University of Athens, Attikon University Hospital, 12462, Athens, Greece
| | - A Ploussi
- 2nd Department of Radiology, Medical Physics Unit, National and Kapodistrian University of Athens, Attikon University Hospital, 12462, Athens, Greece
| | - E Carinou
- Greek Atomic Energy Commission (GAEC), 15310, Agia Paraskevi, Attiki, Greece
| | - E Brountzos
- 2nd Department of Radiology, Interventional Radiology Unit, National and Kapodistrian University of Athens, Attikon University Hospital, 12462, Athens, Greece
| | - S C Spiliopoulos
- 2nd Department of Radiology, Interventional Radiology Unit, National and Kapodistrian University of Athens, Attikon University Hospital, 12462, Athens, Greece
| | - K Palialexis
- 2nd Department of Radiology, Interventional Radiology Unit, National and Kapodistrian University of Athens, Attikon University Hospital, 12462, Athens, Greece
| | - A Kelekis
- 2nd Department of Radiology, Interventional Radiology Unit, National and Kapodistrian University of Athens, Attikon University Hospital, 12462, Athens, Greece
| | - D Filippiadis
- 2nd Department of Radiology, Interventional Radiology Unit, National and Kapodistrian University of Athens, Attikon University Hospital, 12462, Athens, Greece
| | - I Seimenis
- Medical Physics Laboratory, Medical School, National and Kapodistrian University of Athens, Athens, 115 27, Greece
| | - E P Efstathopoulos
- 2nd Department of Radiology, Medical Physics Unit, National and Kapodistrian University of Athens, Attikon University Hospital, 12462, Athens, Greece
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Zeiger OM, Mazioti A, Prountzos S, Filippiadis D, Brountzos E, Kelekis NL, Kelekis A. CT-Guided Radiofrequency Ablation of Osteoid Osteoma in a Pediatric Population: A Single Center’s Experience. Semin Musculoskelet Radiol 2020. [DOI: 10.1055/s-0040-1722504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Filippiadis D, Bolotis D, Mazioti A, Tsitskari M, Charalampopoulos G, Vrachliotis T, Kelekis N, Kelekis A. Percutaneous imaging-guided techniques for the treatment of benign neuropathic pain. Diagn Interv Imaging 2020; 102:11-18. [PMID: 32439315 DOI: 10.1016/j.diii.2020.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 04/22/2020] [Accepted: 05/02/2020] [Indexed: 11/17/2022]
Abstract
To date, conservative management including physical and/or systemic pharmacologic therapy is considered as the first line approach for the management of neuropathic pain syndromes. In the era of an opioid overdose crisis with an increased concern upon the risks and harms arising from the misuse of medicines for pain management, percutaneous minimally invasive techniques such as nerve infiltrations as well as neurolysis or neuromodulation techniques can be proposed to control pain and improve life quality. Computed tomography can serve as an ideal guiding technique due to its specific characteristics including precise anatomic delineation, high spatial resolution and good tissue contrast. The purpose of this review is to make the reader familiar with the most common indications for minimally invasive imaging-guided techniques in patients with neuralgia and provide current evidence regarding technical considerations.
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Affiliation(s)
- D Filippiadis
- 2nd Department of Radiology, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, 1 Rimini street, 12462 Haidari, Athens, Greece.
| | - D Bolotis
- Department of Radiology, Karolinska University Hospital, 14186 Stockholm, Sweden
| | - A Mazioti
- 2nd Department of Radiology, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, 1 Rimini street, 12462 Haidari, Athens, Greece
| | - M Tsitskari
- Department of Radiology, Apollonio Private Hospital, 20 Lefkotheou street, 2054 Strovolos, Nicosia, Cyprus
| | - G Charalampopoulos
- 2nd Department of Radiology, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, 1 Rimini street, 12462 Haidari, Athens, Greece
| | - T Vrachliotis
- Department of Radiology, Henry Dunant Hospital Center, 107 Mesogion Avenue 11525 Athens, Greece
| | - N Kelekis
- 2nd Department of Radiology, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, 1 Rimini street, 12462 Haidari, Athens, Greece
| | - A Kelekis
- 2nd Department of Radiology, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, 1 Rimini street, 12462 Haidari, Athens, Greece
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Malagari K, Moschouris H, Kiakidis T, Harward S, Kelekis A, Vrakas S, Koundouras D, Filipiadis D, Glantzounis G, Emmanouil E, Chatziioannou A, Vergadis V, Elefsiniotis I, Koskinas J, Dourakis S, Kelekis N. Five-Years Outcome Analysis of 142 Consecutive Hepatocellular Carcinoma Patients Treated with Doxorubicin Eluting Microspheres 30-60 μm: Results from a Single-Centre Prospective Phase II Trial. Cardiovasc Intervent Radiol 2019; 42:1551-1562. [PMID: 31321482 DOI: 10.1007/s00270-019-02260-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 06/03/2019] [Indexed: 12/19/2022]
Abstract
PURPOSE To assess prospectively long-term results of doxorubicin-loaded HepaSphere 30-60 μm in consecutive patients with hepatocellular carcinoma (HCC) not amenable to curative treatments. PATIENTS AND METHODS Single-center study from June 2011 to December 2015 in 151 patients treated with 75 mg of doxorubicin per HepaSphere vial. Baseline: Barcelona Clinic Liver Cancer BCLC A/B was 49.3%/50.7%, and median diameter 6.1 cm (mean 6.7 ± 2.0). Liver function, local response (mRECIST), liver time to progression (LTTP), progression-free survival (PFS), overall survival (OS) and adverse events (AEs) were recorded. RESULTS Final analysis included 142 patients with median follow-up of 46.8 months (range 4-72) without grade 4/5 AEs, and 30-day mortality was 0%. Mean number of scheduled treatments was 2.6 (range 1-3) and on demand 3 (range 1-8). Complete response for single tumor ≤ 5 cm was 75.0% and 66.7% for Child A and Child B, while for > 5 cm was 28.6% and 11.8%, respectively. OS was 31.0 months (mean 33.3 ± 15.2; range 8-69), notably for BCLC A 41 months (mean 41.1 ± 15.3; range 13-69) and for BCLC B 26.0 (mean 26.0 ± 10.5; range 8-51). OS at 1, 3 and 5 years: 95.8%, 75.7% and 21.4% for BCLC A, and 94.4%, 36.1% and 2.7% for BCLC B. Median LTTP for BCLC A was 11 months (mean 11.9 ± 4.7; range 3-24) and 7.5 for BCLC B (mean 7.9 ± 2.9). Local response was significant for OS and LTTP (p < 0.0001), while size and lesion number affected LPFS and OS (p < 0.001). CONCLUSIONS HepaSphere 30-60 μm loaded with doxorubicin provides a safe and effective treatment option for patients with HCC.
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Affiliation(s)
- K Malagari
- 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, 19 Monis Kyccou, 15669, Papagou, Athens, Greece. .,Attikon Hospital, Chaidari, Greece. .,Evgenidion Hospital, Athens, Greece.
| | - H Moschouris
- Radiology Department of Tzanion General Hospital, Athens, Greece
| | - Th Kiakidis
- 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, 19 Monis Kyccou, 15669, Papagou, Athens, Greece.,Evgenidion Hospital, Athens, Greece
| | - S Harward
- University of Massachusets Medical School, Worcester, MA, USA
| | - A Kelekis
- 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, 19 Monis Kyccou, 15669, Papagou, Athens, Greece.,Attikon Hospital, Chaidari, Greece.,Evgenidion Hospital, Athens, Greece
| | - S Vrakas
- Tzanion Hospital, Athens, Greece
| | - D Koundouras
- 2nd Clinic of Medicine and Hepatology Medical School, National and Kapodistrian University of Athens, Athens, Greece.,2nd Clinic of Internal Medicine University of Athens Hippokration Hospital, Athens, Greece
| | - D Filipiadis
- 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, 19 Monis Kyccou, 15669, Papagou, Athens, Greece.,Attikon Hospital, Chaidari, Greece
| | - G Glantzounis
- Department of Surgery, University Hospital of Ioannina (UOI), Ioannina, Greece
| | - E Emmanouil
- 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, 19 Monis Kyccou, 15669, Papagou, Athens, Greece.,Evgenidion Hospital, Athens, Greece
| | - A Chatziioannou
- Evgenidion Hospital, Athens, Greece.,1st Department of Radiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - V Vergadis
- Radiology Department of Laikon University Hospital, Athens, Greece
| | - I Elefsiniotis
- Department of Internal Medicine and Hepatology Unit, Agioi Anargyroi General and Oncology Hospital of Kifissia Hospital Timiou Stavrou and Noufaron, Kalyftaki, Athens, Greece
| | - J Koskinas
- 2nd Clinic of Medicine and Hepatology Medical School, National and Kapodistrian University of Athens, Athens, Greece.,2nd Clinic of Internal Medicine University of Athens Hippokration Hospital, Athens, Greece
| | - S Dourakis
- 2nd Clinic of Medicine and Hepatology Medical School, National and Kapodistrian University of Athens, Athens, Greece.,2nd Clinic of Internal Medicine University of Athens Hippokration Hospital, Athens, Greece
| | - N Kelekis
- 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, 19 Monis Kyccou, 15669, Papagou, Athens, Greece.,Attikon Hospital, Chaidari, Greece.,Evgenidion Hospital, Athens, Greece
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Filippiadis D, Charalampopoulos G, Mazioti A, Alexopoulou E, Vrachliotis T, Brountzos E, Kelekis N, Kelekis A. Interventional radiology techniques for pain reduction and mobility improvement in patients with knee osteoarthritis. Diagn Interv Imaging 2019; 100:391-400. [PMID: 30935863 DOI: 10.1016/j.diii.2019.02.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 02/10/2019] [Accepted: 02/17/2019] [Indexed: 02/06/2023]
Abstract
Osteoarthritis of the knee is the most common cause of chronic knee pain being more prevalent in middle-aged and elderly patients. Symptomatic patients complain of pain and mobility impairment. Therapeutic armamentarium includes physical therapy, oral pharmacologic therapy, intra-articular injections, nerve ablation or modulation, trans-catheter arterial embolization, minimally invasive arthroscopic treatment and partial or total knee arthroplasty. Interventional radiology therapies for knee osteoarthritis include intra-articular injections, neurotomy and neuromodulation techniques as well as transcatheter intra-arterial therapies. These therapies aim to control pain and inflammation, improve mobility and function whilst the novel cell-based therapies have the potential for bone and cartilage regenerative repair facilitating the delay to surgery. The purpose of this review is to illustrate the technical aspects, the indications and the methodology of local therapies for knee osteoarthritis performed by interventional radiologists and provide current evidence.
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Affiliation(s)
- D Filippiadis
- 2(nd) Department of Radiology, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, Athens, Greece.
| | - G Charalampopoulos
- 2(nd) Department of Radiology, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - A Mazioti
- 2(nd) Department of Radiology, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - E Alexopoulou
- 2(nd) Department of Radiology, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - T Vrachliotis
- 2(nd) Department of Radiology, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - E Brountzos
- 2(nd) Department of Radiology, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - N Kelekis
- 2(nd) Department of Radiology, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - A Kelekis
- 2(nd) Department of Radiology, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Filippiadis D, Velonakis G, Mazioti A, Konstantos C, Brountzos E, Kelekis N, Kelekis A. Intra-articular application of pulsed radiofrequency combined with viscosupplementation for improvement of knee osteoarthritis symptoms: a single centre prospective study. Int J Hyperthermia 2018; 34:1265-1269. [DOI: 10.1080/02656736.2017.1409910] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- D. Filippiadis
- 2nd Radiology Department, University General Hospital “ATTIKON”, Athens, Greece
| | - G. Velonakis
- 2nd Radiology Department, University General Hospital “ATTIKON”, Athens, Greece
| | - A. Mazioti
- 2nd Radiology Department, University General Hospital “ATTIKON”, Athens, Greece
| | - C. Konstantos
- 2nd Radiology Department, University General Hospital “ATTIKON”, Athens, Greece
| | - E. Brountzos
- 2nd Radiology Department, University General Hospital “ATTIKON”, Athens, Greece
| | - N. Kelekis
- 2nd Radiology Department, University General Hospital “ATTIKON”, Athens, Greece
| | - A. Kelekis
- 2nd Radiology Department, University General Hospital “ATTIKON”, Athens, Greece
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13
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Filippiadis DK, Gkizas C, Chrysofos M, Siatelis A, Velonakis G, Alexopoulou E, Kelekis A, Brountzos E, Kelekis N. Percutaneous microwave ablation of renal cell carcinoma using a high power microwave system: focus upon safety and efficacy. Int J Hyperthermia 2017; 34:1077-1081. [DOI: 10.1080/02656736.2017.1408147] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Affiliation(s)
- D. K. Filippiadis
- 2nd Radiology Department, University General Hospital “ATTIKON”, Athens, Greece
| | - C. Gkizas
- 2nd Radiology Department, University General Hospital “ATTIKON”, Athens, Greece
| | - M. Chrysofos
- Urology Clinic, University General Hospital “ATTIKON”, Athens, Greece
| | - A. Siatelis
- Urology Clinic, University General Hospital “ATTIKON”, Athens, Greece
| | - G. Velonakis
- 2nd Radiology Department, University General Hospital “ATTIKON”, Athens, Greece
| | - E. Alexopoulou
- 2nd Radiology Department, University General Hospital “ATTIKON”, Athens, Greece
| | - A. Kelekis
- 2nd Radiology Department, University General Hospital “ATTIKON”, Athens, Greece
| | - E. Brountzos
- 2nd Radiology Department, University General Hospital “ATTIKON”, Athens, Greece
| | - N. Kelekis
- 2nd Radiology Department, University General Hospital “ATTIKON”, Athens, Greece
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Filippiadis DK, Velonakis G, Kostantos C, Kouloulias V, Brountzos E, Kelekis N, Kelekis A. Computed tomography-guided radiofrequency ablation of intra-articular osteoid osteoma: a single centre’s experience. Int J Hyperthermia 2017; 33:670-674. [DOI: 10.1080/02656736.2017.1294711] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- D. K. Filippiadis
- 2nd Radiology Department, University General Hospital “ATTIKON”, Athens, Greece
| | - G. Velonakis
- 2nd Radiology Department, University General Hospital “ATTIKON”, Athens, Greece
| | - C. Kostantos
- 2nd Radiology Department, University General Hospital “ATTIKON”, Athens, Greece
| | - V. Kouloulias
- 2nd Radiology Department, University General Hospital “ATTIKON”, Athens, Greece
| | - E. Brountzos
- 2nd Radiology Department, University General Hospital “ATTIKON”, Athens, Greece
| | - N. Kelekis
- 2nd Radiology Department, University General Hospital “ATTIKON”, Athens, Greece
| | - A. Kelekis
- 2nd Radiology Department, University General Hospital “ATTIKON”, Athens, Greece
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15
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Filippiadis D, Mazioti A, Tsitskari M, Malagari K, Kelekis N, Kelekis A. Percutaneous, computed tomography guided neurolysis with continuous or pulsed radiofrequency as palliative therapy for pain reduction in oncologic patients. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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16
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Kelekis A, Filippiadis D, Velonakis G, Tsitskari M, Malagari K, Kelekis N. CT-guided radiofrequency ablation of intra-articular osteoid osteoma:clinical experience and results. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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17
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Kelekis A, Filippiadis D, Anselmetti G, Brountzos E, Mavrogenis A, Papagelopoulos P, Kelekis N, Martin JB. Percutaneous Augmented Peripheral Osteoplasty in Long Bones of Oncologic Patients for Pain Reduction and Prevention of Impeding Pathologic Fracture: The Rebar Concept. Cardiovasc Intervent Radiol 2015; 39:90-6. [PMID: 26048014 DOI: 10.1007/s00270-015-1138-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Accepted: 05/01/2015] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate clinical efficacy/safety of augmented peripheral osteoplasty in oncologic patients with long-term follow-up. MATERIALS AND METHODS Percutaneous augmented peripheral osteoplasty was performed in 12 patients suffering from symptomatic lesions of long bones. Under extensive local sterility measures, anesthesiology care, and fluoroscopic guidance, direct access to lesion was obtained and coaxially a metallic mesh consisting of 25-50 medical grade stainless steel micro-needles (22 G, 2-6 cm length) was inserted. PMMA for vertebroplasty was finally injected under fluoroscopic control. CT assessed implant position 24-h post-treatment. RESULTS Clinical evaluation included immediate and delayed follow-up studies of patient's general condition, NVS pain score, and neurological status. Imaging assessed implant's long-term stability. Mean follow-up was 16.17 ± 10.93 months (range 2-36 months). Comparing patients' scores prior (8.33 ± 1.67 NVS units) and post (1.42 ± 1.62 NVS units) augmented peripheral osteoplasty, there was a mean decrease of 6.92 ± 1.51 NVS units. Overall mobility improved in 12/12 patients. No complication was observed. CONCLUSION Percutaneous augmented peripheral osteoplasty (rebar concept) for symptomatic malignant lesions in long bones seems to be a possible new technique for bone stabilization. This combination seems to provide necessary stability against shearing forces applied in long bones during weight bearing.
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Affiliation(s)
- A Kelekis
- 2nd Radiology Department, University General Hospital "ATTIKON", 1 Rimini Str, 12462, Athens, Greece.
| | - D Filippiadis
- 2nd Radiology Department, University General Hospital "ATTIKON", 1 Rimini Str, 12462, Athens, Greece.
| | - G Anselmetti
- GVM Care and Research Maria Pia Hospital, Strada Comunale di Mongreno 180, 10132, Turin, Italy.
| | - E Brountzos
- 2nd Radiology Department, University General Hospital "ATTIKON", 1 Rimini Str, 12462, Athens, Greece.
| | - A Mavrogenis
- A Orthopedic Clinic, University General Hospital "ATTIKON", Athens, Greece.
| | - P Papagelopoulos
- A Orthopedic Clinic, University General Hospital "ATTIKON", Athens, Greece.
| | - N Kelekis
- 2nd Radiology Department, University General Hospital "ATTIKON", 1 Rimini Str, 12462, Athens, Greece.
| | - J-B Martin
- Centre Imaginerie Rive Droite & Gauche, Geneva, Switzerland.
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Kelekis A, Filippiadis D, Velonakis G, Malagari A, Alexopoulou E, Brountzos E, Kelekis N. Percutaneous augmented osteoplasty for the treatment of symptomatic fractures in peripheral long bones. J Vasc Interv Radiol 2014. [DOI: 10.1016/j.jvir.2014.02.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Kelekis A, Filippiadis DK. Percutaneous treatment of cervical and lumbar herniated disc. Eur J Radiol 2014; 84:771-6. [PMID: 24673977 DOI: 10.1016/j.ejrad.2014.02.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 02/17/2014] [Accepted: 02/20/2014] [Indexed: 12/27/2022]
Abstract
Therapeutic armamentarium for symptomatic intervertebral disc herniation includes conservative therapy, epidural infiltrations (interlaminar or trans-foraminal), percutaneous therapeutic techniques and surgical options. Percutaneous, therapeutic techniques are imaging-guided, minimally invasive treatments for intervertebral disc herniation which can be performed as outpatient procedures. They can be classified in 4 main categories: mechanical, thermal, chemical decompression and biomaterials implantation. Strict sterility measures are a prerequisite and should include extensive local sterility and antibiotic prophylaxis. Indications include the presence of a symptomatic, small to medium sized contained intervertebral disc herniation non-responding to a 4-6 weeks course of conservative therapy. Contraindications include sequestration, infection, segmental instability (spondylolisthesis), uncorrected coagulopathy or a patient unwilling to provide informed consent. Decompression techniques are feasible and reproducible, efficient (75-94% success rate) and safe (>0.5% mean complications rate) therapies for the treatment of symptomatic intervertebral disc herniation. Percutaneous, imaging guided, intervertebral disc therapeutic techniques can be proposed either as an initial treatment or as an attractive alternative prior to surgery for the therapy of symptomatic herniation in both cervical and lumbar spine. This article will describe the mechanism of action for different therapeutic techniques applied to intervertebral discs of cervical and lumbar spine, summarize the data concerning safety and effectiveness of these treatments, and provide a rational approach for the therapy of symptomatic intervertebral disc herniation in cervical and lumbar spine.
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Affiliation(s)
- A Kelekis
- University of Athens, 2nd Radiology Dpt, University General Hospital "ATTIKON", 1 Rimini str , 12462 Haidari/Athens, Greece.
| | - D K Filippiadis
- University of Athens, 2nd Radiology Dpt, University General Hospital "ATTIKON", 1 Rimini str , 12462 Haidari/Athens, Greece.
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Kelekis A, Filippiadis D, Velonakis G, Mazioti A, Malagari A, Brountzos E, Kelekis N. Vertebral augmentation with biocompatible polymer (KIVA implant) in AO-Magerl A2 and A3 (split or incomplete burst) Fractures: Clinical experience and preliminary results. J Vasc Interv Radiol 2013. [DOI: 10.1016/j.jvir.2013.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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21
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Kelekis A, Mailli L, Filippiadis D, Mazioti A, Brountzos E, Kelekis N. Abstract No. 185: Clinical outcome and safety of multilevel vertebroplasty: clinical experience and results. J Vasc Interv Radiol 2012. [DOI: 10.1016/j.jvir.2011.12.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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22
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Kelekis A, Filippiadis D, Vergadis C, Tsitskari M, Brountzos E, Kelekis N. Abstract No. 187: Percutaneous vertebroplasty and baropodometry: comparative prospective study of load distribution variation between osteoporotic patients and normal population. J Vasc Interv Radiol 2012. [DOI: 10.1016/j.jvir.2011.12.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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23
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Filippiadis DK, Mazioti A, Papakonstantinou O, Brountzos E, Gouliamos A, Kelekis N, Kelekis A. Quantitative Discomanometry: Correlation of Intradiscal Pressure Values to Pain Reduction in Patients With Intervertebral Disc Herniation Treated With Percutaneous, Minimally Invasive, Image-Guided Techniques. Cardiovasc Intervent Radiol 2011; 35:1145-53. [DOI: 10.1007/s00270-011-0255-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2010] [Accepted: 07/22/2011] [Indexed: 11/30/2022]
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Lazoura O, Vlychou M, Vassiou K, Kelekis A, Kanavou T, Thriskos P, Fezoulidis I. 128-Detector-Row Computed Tomography coronary angiography assessing differences in morphology and distribution of atherosclerotic plaques between patients with and without pre-test probability of significant coronary artery disease. Eur J Radiol 2011; 77:123-30. [DOI: 10.1016/j.ejrad.2009.07.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2009] [Revised: 06/30/2009] [Accepted: 07/17/2009] [Indexed: 10/20/2022]
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Vasileiadis GI, Sakellariou VI, Kelekis A, Galanos A, Soucacos PN, Papagelopoulos PJ, Babis GC. Prevention of heterotopic ossification in cases of hypertrophic osteoarthritis submitted to total hip arthroplasty. Etidronate or Indomethacin? J Musculoskelet Neuronal Interact 2010; 10:159-165. [PMID: 20516633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
We present a study comparing etidronate or indomethacin for the prevention of heterotopic ossification after total hip arthroplasty in patients with hypertrophic osteoarthritis. 52 patients were divided in two groups. Group A (26 patients) received etidronate (20 mg/kg/day for 12 weeks) and Group B (26 patients) indomethacin 75 mg/day for 2 weeks. Mean follow up was 36 months (range, 18 to 50 months). The incidence of side effects was 15.4% in group A and 30.8% in group B (p=0.324). At 6 months there was no statistically significant difference in terms of clinical (p=0.532) and radiographic evaluation between the two groups (p=0.303). However, the cost of etidronate which may be as much as six times more expensive than that of indomethacin could not justify its routine prophylactic use.
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Affiliation(s)
- G I Vasileiadis
- 1st Orthopaedic Department, University of Athens, ATTIKON University General Hospital, Athens, Greece
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Filippiadis D, Ptohis N, Brountzos E, Kelekis N, Kelekis A. Abstract No. 252 EE: Percutaneous intervertebral disc decompression and ablative techniques: A pictorial review. J Vasc Interv Radiol 2010. [DOI: 10.1016/j.jvir.2009.12.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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27
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Mystakidou K, Kouloulias V, Nikolaou V, Tsilika E, Lymperopoulou G, Balafouta M, Kouvaris I, Kelekis A, Gouliamos A. A comparative study of prophylactic antiemetic treatment in cancer patients receiving radiotherapy. J BUON 2010; 15:29-35. [PMID: 20414924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
PURPOSE Gastrointestinal side effects can often complicate radiotherapy (RT) in cancer patients. This work presents results of a retrospective open label study aiming to evaluate the optimum prophylactic treatment for nausea and vomiting in patients receiving fractionated radical or palliative RT. METHODS 576 cancer patients were allocated in 5 treatment groups: 120 patients received tropisetron, 129 tropisetron plus dexamethasone, 101 metochlopramide, 119 dexamethasone, and 107 received metochlopramide plus dexamethasone. To determine the optimum antiemetic prophylactic treatment, nausea and vomiting were evaluated at baseline, 24 and 72 h after the initiation of RT, and at the end of every week during RT. Adverse effects, Eastern Cooperative Oncology Group (ECOG) performance status (PS), and the intensity of nausea and vomiting were recorded. RESULTS Statistically significant differences in incidence and intensity of nausea and vomiting were found among the 5 antiemetic treatment groups from the 1st till the 5th week of the RT. Tropisetron + dexamethasone group had significantly reduced odds for nausea and vomiting, and significantly less severe nausea and vomiting than any other treatment group. Factors significantly associated with increased ECOG PS were palliative RT, dose fraction >3Gy, field size >200 cm(2), and treatment with metochlopramide, metochlopramide+dexamethasone and dexamethasone. CONCLUSION Patients receiving prophylactic antiemetic treatment with tropisetron+dexamethasone completed RT with lower intensity of nausea and vomiting and lower ECOG PS scores compared to groups that received other antiemetic treatments.
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Affiliation(s)
- K Mystakidou
- Department of Radiology, Areteion Hospital, School of Medicine, University of Athens, Athens, Greece.
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Miliaras D, Meditskou S, Kelekis A, Papachristos I. Human Pulmonary Dirofilariasis: One More Case in Greece Suggests That Dirofilaria is a Rather Common Cause of Coin Lesions in the Lungs in Endemic Areas of Europe. Int J Immunopathol Pharmacol 2010; 23:345-8. [DOI: 10.1177/039463201002300133] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Herein we describe a case of a 52 year-old male from Greece who presented with a coin lesion in the right lung, which proved to be an infection from Dirofilaria immitis. A careful review of the literature shows that, contrary to the common perception, humans may be frequently infected by Dirofilaria species. For this reason the authors suggest that in every case which presents with a coin lesion in the lung in endemic areas, dirofilariasis should always be considered, and excluded before any other intervention is decided.
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Affiliation(s)
- D. Miliaras
- Laboratory of Histology and Embryology, Medical School, Aristotle University, Thessaloniki
- Department of Pathology, Euromedica General Hospital, Thessaloniki, Greece
| | - S. Meditskou
- Laboratory of Histology and Embryology, Medical School, Aristotle University, Thessaloniki
- Department of Pathology, Euromedica General Hospital, Thessaloniki, Greece
| | - A. Kelekis
- Department of Radiology, Euromedica General Hospital, Thessaloniki, Greece
| | - I. Papachristos
- Department of Thoracic Surgery, Euromedica General Hospital, Thessaloniki, Greece
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Kelekis A. Disc Herniation: Diagnostic Procedures. Neuroradiol J 2009. [DOI: 10.1177/19714009090220s123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- A. Kelekis
- 2nd Department of radiology, University of Athens, Attikon University Hospital; Athene, Greece
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Tzoufi M, Kitsou M, Matsota P, Matiatou S, Kelekis A, Gouliamos A, Stolis S, Kostopanagiotou G. 432. General Versus Epidural Anesthesia in Elderly Patients With Osteoporotic Vertebral Fractures Requiring Percutaneous Vertebroplasty. Reg Anesth Pain Med 2008. [DOI: 10.1136/rapm-00115550-200809001-00468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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31
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Tzoufi M, Kitsou M, Kelekis A, Gouliamos A, Pantazi A, Sidiropoulou T, Kanelopoulos I, Kostopanagiotou G. 468. Efficacy and Safety of 0.55% Versus 0.35% Epidural Ropivacaine Combined With Fentanyl During Lumbar Percutaneous Vertebroplasty. Reg Anesth Pain Med 2008. [DOI: 10.1136/rapm-00115550-200809001-00481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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32
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Malagari K, Alexopoulou E, Dourakis S, Kelekis A, Hatzimichail K, Sissopoulos A, Delis S, Letsou D, Kelekis D. Transarterial embolization of giant liver hemangiomas associated with Kasabach-Merritt syndrome: a case report. Acta Radiol 2007; 48:608-12. [PMID: 17611866 DOI: 10.1080/02841850701326917] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Of 22 patients with symptomatic giant liver hemangiomas referred for embolization, two females (52 and 74 years) had Kasabach-Merritt syndrome (KMS). Hematocrit values were observed to be 33% and 29%, platelets 4000 and 5400/mm(3), and fibrinogen 98 and 77 mg/dl, respectively. Lesion diameters were 7 and 14 cm, respectively. Hepatic angiography revealed excessive vascular lakes typical of cavernous hemangiomas. Microspheres of 40-300 microm were superselectively injected under fluoroscopic guidance until cessation of flow. Coil packing of the feeding hepatic artery was additionally used in one patient. The procedure was uneventful in both. Partial restoration of platelet count was observed immediately; fibrinogen levels and platelets were restored completely in one patient and partially in the other, without remissions at 2-year follow-up.
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Affiliation(s)
- K Malagari
- Second Department of Radiology, Medical School, University of Athens, Greece.
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Abstract
We present a case of traumatic vertical atlantoaxial dislocation of 16 millimetres with a fatal outcome. We hypothesize that this extremely rare traumatic vertical atlantoaxial dislocation results from insufficiency of the C1/C2 facet capsules after rupture of the tectorial membrane and the alar ligaments.
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Affiliation(s)
- M Payer
- Department of Neurosurgery, University Hospital of Geneva, Switzerland.
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Lövblad KO, Wetzel SG, Somon T, Wilhelm K, Mehdizade A, Kelekis A, El-Koussy M, El-Tatawy S, Bishof M, Schroth G, Perrig S, Lazeyras F, Sztajzel R, Terrier F, Rüfenacht D, Delavelle J. Diffusion-weighted MRI in cortical ischaemia. Neuroradiology 2004; 46:175-82. [PMID: 14749911 DOI: 10.1007/s00234-003-1133-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2003] [Accepted: 08/23/2003] [Indexed: 11/30/2022]
Abstract
We carried out MRI on 16 male and three female comatose patients, aged 2 days to 79 years, with suspected cortical ischaemia referred from our intensive care units. Using a head coil, and following standard imaging, including coronal fluid-attenuated inversion-recovery images, we performed diffusion-weighted imaging (DWI) using a whole-brain multislice single-shot echo-planar sequence with b 0 and 1000 s/mm2: 5-mm slices covering the whole brain, TR 7000 TE 106 ms, 128 x 128 pixels, field of view 250 mm, one excitation. Maps of apparent diffusion coefficients (ADC) were generated automatically. DWI showed cortical, basal ganglia and watershed-area high signal in all cases, associated with a decrease in ADC to 60- 80% of normal. DWI showed lesions not seen (40%) or underestimated (40%) on conventional T2-weighted imaging. Within 24 h of the onset of symptoms, DWI showed changes not readily detectable on T2-weighted images. The cortical high signal on DWI and the ADC changes, suggesting severe ischaemia rather than oedema, was found in areas known to be affected by cortical laminar necrosis. Extension to the brain stem and white matter was associated with a higher likelihood of death.
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Affiliation(s)
- K O Lövblad
- Unité de Neuroradiologie, Service de Radiodiagnostic, DRRI, Hôpital Cantonal Un iversitaire de Genève, 24 rue Micheli-du-Crest, 1211 Geneva 14, Switzerland.
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Malagari K, Brountzos E, Gougoulakis A, Kelekis A, Drakopoulos S, Sehas M, Kelekis DA. Endovascular repair of abdominal aortic aneurysm in renal transplantation. Urol Int 2003; 70:51-4. [PMID: 12566816 DOI: 10.1159/000067701] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2001] [Accepted: 03/05/2002] [Indexed: 11/19/2022]
Abstract
Successful endovascular correction of a 12-cm abdominal aortic aneurysm (AAA) is described in a 76-year-old man with a functional pelvic renal transplant and 18-month follow-up. Endovascular treatment is a safe alternative to surgery for AAA correction in the elderly post-transplantation patient since it does not require flow interruption during the procedure.
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Affiliation(s)
- K Malagari
- 2nd Department of Radiology, National and Kapodistrian University of Athens, Athens, Greece
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Mehdizade A, Somon T, Wetzel S, Kelekis A, Martin JB, Scheidegger JR, Sztajzel R, Lovblad KO, Ruefenacht DA, Delavelle J. Diffusion weighted MR imaging on a low-field open magnet. Comparison with findings at 1.5T in 18 patients with cerebral ischemia. J Neuroradiol 2003; 30:25-30. [PMID: 12624588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Diffusion-weighted MR imaging (DWI) is particularly sensitive for the detection of acute stoke. Until recently, DWI was performed with EPI technology. We compared 18 patients with clinical suspicion of acute stroke on a standard 1.5T unit and an open low-field MR scanner. Eighteen patients with 20 lesions of acute stroke were studied retrospectively with DWI and ADC mapping on both systems. The technique used was a rotating fast-spin echo T2 at low-field and an EPI sequence at 1.5T. Both examinations were performed within 24 hours and analyzed by two neuroradiologists. We obtained the same results on DWI sequences on both systems, regarding high intensity lesions on DWI. Interpretation of the ADC maps proved to be difficult on low-field MR near the lateral ventricles (3/18). We experienced the same difficulty of interpretation at low and high field in the cerebellum, in the temporal fossa and in cortex situated near bone, due to susceptibility artifacts. Chronic lesions were better visualized at low than at high field. In our opinion, DWI on a low-field open MR scanner is a good technique to evaluate subacute stroke and was as reliable as when performed on a 1.5T MR system.
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Affiliation(s)
- A Mehdizade
- (1) Division of Neuroradiology, University Hospital, Geneva, Switzerland
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Brountzos EN, Malagari K, Gougoulakis A, Argentos S, Alexopoulou E, Kelekis A, Kelekis DA. Common femoral artery anastomotic pseudoaneurysm: endovascular treatment with hemobahn stent-grafts. J Vasc Interv Radiol 2000; 11:1179-83. [PMID: 11041475 DOI: 10.1016/s1051-0443(07)61360-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- E N Brountzos
- Second Department of Radiology, Eugenidion Hospital, Medical School, Athens University, Greece.
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