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Galyfos G, Pikula M, Skalski A, Vagena S, Filis K, Sigala F. Using a novel three-dimensional holographic technology to perform open vascular surgery procedures. J Vasc Surg Cases Innov Tech 2024; 10:101440. [PMID: 38464890 PMCID: PMC10924202 DOI: 10.1016/j.jvscit.2024.101440] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 01/11/2024] [Indexed: 03/12/2024] Open
Abstract
Augmented reality technology has been introduced during recent years into everyday clinical practice. Several surgical specialties have begun using such technology for preoperative planning as well as intraoperatively. Regarding vascular surgery, a limited number of reports have described the benefits, mainly for endovascular procedures. We aim to present a novel three-dimensional holographic system we used to perform an open vascular procedure.
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Affiliation(s)
- George Galyfos
- Vascular Unit, First Propedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Marcel Pikula
- Vascular Unit, First Propedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Andrzej Skalski
- Vascular Unit, First Propedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Sylvia Vagena
- Vascular Unit, First Propedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Konstantinos Filis
- Vascular Unit, First Propedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Frangiska Sigala
- Vascular Unit, First Propedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
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Galyfos G, Charalampopoulos G, Chamzin A, Triantafillou A, Michalopoulou V, Intzes N, Kimpizi D, Zarmakoupis K, Sigala F, Filis K. Extra-anatomic bypass procedures for severe aortoiliac occlusive disease-A cohort study. Vascular 2024:17085381241236558. [PMID: 38407000 DOI: 10.1177/17085381241236558] [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] [Indexed: 02/27/2024]
Abstract
OBJECTIVES Extra-anatomic bypass (ExAB) grafting has been questioned due its inferior durability compared to anatomic bypass for aortoiliac occlusive disease (AIOD). This study aims to present early and late outcomes of patients treated with ExAB as well as to evaluate potential prognostic factors. METHODS This is a retrospective cohort study presenting a series of patients treated with ExAB for AIOD. All patients were treated between 2005 and 2022 within the Vascular Surgery Unit of a University Surgery Clinic. Both early (30-day) and late outcomes were evaluated. Univariate and multivariate analyses were conducted for potential predictors. Kaplan-Meier curve was produced for long-term patency. RESULTS A total of 41 patients were treated (85.3% males; mean age: 76.3 ± 4.2 years). Indication for treatment included severe claudication or critical limb ischemia (Rutherford stages III-VI). The following procedures were recorded: Femorofemoral bypass (FFB; n = 21) and axillofemoral bypass (AxFB; n = 20). All procedures were conducted using synthetic grafts with external rings. Early outcomes included no death, no myocardial infarction, no major bleeding, no graft infection, and no major amputation. Regarding late outcomes, 14.6% patients were lost after the first month. For the rest of patients (n = 35), five-year primary patency was 88.6%, primary-assisted patency was 94.3%, and secondary patency was also 94.3%. Limb salvage was 100% within follow-up. Endarterectomy at the distal anastomosis was the only independent predictor associated with worse patency in the long-term (OR = 5.356; 95% CI (1.012-185.562); p = .041). CONCLUSIONS FFB and AxFB is a safe and durable strategy for treating patients with severe AIOD where no other option is feasible. Regarding predictors, only endarterectomy at the distal anastomosis site was associated with an increased risk for graft failure.
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Affiliation(s)
- George Galyfos
- Vascular Surgery Unit, First Department of Propedeutic Surgery, Hippocration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Charalampopoulos
- Vascular Surgery Unit, First Department of Propedeutic Surgery, Hippocration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexandros Chamzin
- Vascular Surgery Unit, First Department of Propedeutic Surgery, Hippocration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexandra Triantafillou
- Vascular Surgery Unit, First Department of Propedeutic Surgery, Hippocration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Victoria Michalopoulou
- Vascular Surgery Unit, First Department of Propedeutic Surgery, Hippocration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Intzes
- Vascular Surgery Unit, First Department of Propedeutic Surgery, Hippocration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Despina Kimpizi
- Vascular Surgery Unit, First Department of Propedeutic Surgery, Hippocration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Zarmakoupis
- Vascular Surgery Unit, First Department of Propedeutic Surgery, Hippocration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Frangiska Sigala
- Vascular Surgery Unit, First Department of Propedeutic Surgery, Hippocration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Filis
- Vascular Surgery Unit, First Department of Propedeutic Surgery, Hippocration Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Galyfos G, Katsargyris A, Liakopoulos D, Filis K. Editorial: Minimally invasive vascular surgery. Front Surg 2024; 11:1362571. [PMID: 38288354 PMCID: PMC10822916 DOI: 10.3389/fsurg.2024.1362571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 01/02/2024] [Indexed: 01/31/2024] Open
Affiliation(s)
- George Galyfos
- Vascular Unit, First Propedeutic Department of Surgery, Hippocration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasios Katsargyris
- Second Department of Vascular Surgery, Laikon Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Konstantinos Filis
- Vascular Unit, First Propedeutic Department of Surgery, Hippocration Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Galyfos G, Chamzin A, Saliaris K, Theodorou P, Konstantinou K, Sigala F, Filis K. The effect of cilostazol on late outcomes after endovascular treatment for occlusive femoropopliteal disease. J Vasc Surg 2024:S0741-5214(24)00068-5. [PMID: 38215952 DOI: 10.1016/j.jvs.2024.01.010] [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: 11/17/2023] [Revised: 01/05/2024] [Accepted: 01/06/2024] [Indexed: 01/14/2024]
Abstract
OBJECTIVE Restenosis and late occlusion remain a significant problem for endovascular treatment of peripheral artery disease. This meta-analysis aims to evaluate the effect of cilostazol on late outcomes after endovascular repair of occlusive femoropopliteal disease. METHODS A systematic literature review was conducted conforming to established criteria to identify articles published up to September 2023 evaluating late outcomes after endovascular treatment for atherosclerotic femoropopliteal disease. Eligible studies should compare outcomes between patients treated with cilostazol and patients not treated with cilostazol. Both prospective and retrospective studies were eligible. Late outcomes included primary patency (PP), restenosis, target lesion revascularization (TLR), and major amputation during follow-up. RESULTS Overall, 10 clinical studies were identified for analysis including 4721 patients (1831 with cilostazol vs 2890 without cilostazol) that were treated for 5703 lesions (2235 with cilostazol vs 3468 without cilostazol). All studies were performed in Japan. Mean follow-up was 24.1 ± 12.5 months. Cilostazol was associated with a lower risk for restenosis (pooled odds ratio [OR], 0.503; 95% confidence interval [CI], 0.383-0.660; P < .0001). However, no association was found between cilostazol and TLR (pooled OR, 0.918; 95% CI, 0.300-2.812; P = .881) as well as major amputation (pooled OR, 1.512; 95% CI, 0.734-3.116; P = .263). Regarding primary patency, cilostazol was associated with a higher 12-month PP (OR, 3.047; 95% CI, 1.168-7.946; P = .023), and a higher 36-month PP (OR, 1.616; 95% CI, 1.412-1.850; P < .0001). No association was found between cilostazol and mortality during follow-up (pooled OR, .755; 95% CI, 0.293-1.946; P = .561). CONCLUSIONS Cilostazol seems to have a positive effect on 1- to 3-year PP and restenosis rates among patients treated endovascularly for atherosclerotic femoropopliteal disease. A positive effect on TLR and amputation risk was not verified in this review.
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Affiliation(s)
- George Galyfos
- Vascular Surgery Unit, First Department of Propedeutic Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece.
| | - Alexandros Chamzin
- Vascular Surgery Unit, First Department of Propedeutic Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Konstantinos Saliaris
- Vascular Surgery Unit, First Department of Propedeutic Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Panagiotis Theodorou
- Vascular Surgery Unit, First Department of Propedeutic Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Kyriaki Konstantinou
- Vascular Surgery Unit, First Department of Propedeutic Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Frangiska Sigala
- Vascular Surgery Unit, First Department of Propedeutic Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Konstantinos Filis
- Vascular Surgery Unit, First Department of Propedeutic Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
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Galyfos G, Chamzin A, Charalampopoulos G, Liasis N, Sigala F, Filis K. Direct oral anticoagulants for deep vein thrombosis among patients with hereditary thrombophilia-A cohort study. Phlebology 2023; 38:599-604. [PMID: 37647589 DOI: 10.1177/02683555231199004] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
OBJECTIVES to evaluate direct oral anticoagulants (DOACs) in patients with hereditary thrombophilia and deep venous thrombosis (DVT). METHODS This is a retrospective observational study. RESULTS In total, 45 patients were treated between 01/2012 and 12/2022 (mean follow-up: 1.5 +/- 0.3 years). The most frequent thrombophilias were heterozygous V Leiden (20%), heterozygous MTHFR C677T (37.8%), heterozygous MTHFR A1298C (24.4%), and hyperhomocysteinemia (26.7%). The patients received rivaroxaban (n = 19), apixaban (n = 15), and dabigatran (n = 11). Three cases presented symptoms' recurrence without evidence of thrombosis' recurrence (two under rivaroxaban and one under apixaban; p > .05). These patients improved under parenteral anticoagulation and were further treated with dabigatran. No other event or major bleeding occurred during the follow-up. The presence of more than two factors was associated with acute recurrence of symptoms (OR = 25.9; 95% CI [1.454-461.262]; p = .026). CONCLUSIONS DOACs seem to be safe and efficient for patients with hereditary thrombophilia and DVT. The presence of more than two thrombophilia factors is associated with a higher risk for symptom recurrence. Although statistically non-significant, symptoms' recurrence was also observed more frequently among patients under anti-Xa inhibitors than antithrombin inhibitors. This should be verified in larger comparative studies.
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Affiliation(s)
- George Galyfos
- First Department of Propedeutic Surgery, Vascular Surgery Unit, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Alexandros Chamzin
- First Department of Propedeutic Surgery, Vascular Surgery Unit, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Georgios Charalampopoulos
- First Department of Propedeutic Surgery, Vascular Surgery Unit, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Nikolaos Liasis
- First Department of Propedeutic Surgery, Vascular Surgery Unit, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Frangiska Sigala
- First Department of Propedeutic Surgery, Vascular Surgery Unit, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Konstantinos Filis
- First Department of Propedeutic Surgery, Vascular Surgery Unit, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
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Tsilimigras DI, Thanopoulou K, Salagianni M, Siasos G, Oikonomou E, Perrea DD, Nirakis N, Filis K, Tsioufis K, Tousoulis D, Sigala F. Rosuvastatin Attenuates Progression of Atherosclerosis and Reduces Serum IL6 and CCL2 Levels in Apolipoprotein-E-deficient Mice. In Vivo 2023; 37:994-1002. [PMID: 37103114 DOI: 10.21873/invivo.13173] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/28/2023] [Accepted: 03/29/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND/AIM Apolipoprotein E-deficient (Apoe-/-) mice develop atherosclerotic lesions that closely resemble metabolic syndrome in humans. We sought to investigate how rosuvastatin mitigates the atherosclerotic profile of Apoe-/- mice over time and its effects on certain inflammatory chemokines. MATERIALS AND METHODS Eighteen Apoe-/- mice were allocated into three groups of six mice each receiving: standard chow diet (SCD; control group); high-fat diet (HFD); and HFD and rosuvastatin at 5 mg/kg/d orally via gavage for 20 weeks. Analysis of aortic plaques and lipid deposition was conducted by means of en face Sudan IV staining and Oil Red O staining. Serum cholesterol, low-density lipoprotein, high-density lipoprotein, plasma glucose and triglyceride levels were determined at baseline and after 20 weeks of treatment. Serum interleukin 6 (IL6), C-C motif chemokine ligand 2 (CCL2) and tumor necrosis factor-α (TNFα) levels were measured by enzyme-linked immunosorbent assay at the time of euthanasia. RESULTS The lipidemic profile of Apoe-/- mice on HFD deteriorated over time. Apoe-/- mice on HFD developed atherosclerotic lesions over time. Sudan IV and Oil Red O-stained sections of the aorta revealed increased plaque formation and plaque lipid deposition in HFD-fed mice compared with SCD-fed mice and reduced plaque development in HFD-fed mice treated with rosuvastatin compared with mice not receiving statin treatment. Serum analysis revealed reduced metabolic parameters in HFD-fed mice on rosuvastatin compared with non-statin, HFD-fed mice. At the time of euthanasia, HFD-fed mice treated with rosuvastatin had significantly lower IL6 as well as CCL2 levels when compared with HFD-fed mice not receiving rosuvastatin. TNFα levels were comparable among all groups of mice, irrespective of treatment. IL6 and CCL2 positively correlated with the extent of atherosclerotic lesions and lipid deposition in atherosclerotic plaques. CONCLUSION Serum IL6 and CCL2 levels might potentially be used as clinical markers of progression of atherosclerosis during statin treatment for hypercholesterolemia.
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Affiliation(s)
- Diamantis I Tsilimigras
- Division of Vascular Surgery, First Propedeutic Department of Surgery, Hippokration Hospital, National and Kapodistrian University of Athens, Athens, Greece;
- N.S. Christeas Laboratory for Experimental Surgery and Surgical Research National and Kapodistrian University of Athens, Athens, Greece
| | - Kalliopi Thanopoulou
- Clinical, Experimental Surgery and Translational Research Center, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Maria Salagianni
- Clinical, Experimental Surgery and Translational Research Center, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Gerasimos Siasos
- First Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Evangelos Oikonomou
- First Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Despina D Perrea
- N.S. Christeas Laboratory for Experimental Surgery and Surgical Research National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Nirakis
- Division of Vascular Surgery, First Propedeutic Department of Surgery, Hippokration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Filis
- Division of Vascular Surgery, First Propedeutic Department of Surgery, Hippokration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Tsioufis
- First Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Dimitrios Tousoulis
- First Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Fragiska Sigala
- Division of Vascular Surgery, First Propedeutic Department of Surgery, Hippokration Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Galyfos G, Chamzin A, Intzes N, Matthaiou G, Spiliotopoulos S, Sotirakis D, Sigala F, Filis K. Acute limb ischemia. J Cardiovasc Surg (Torino) 2023:S0021-9509.22.12536-X. [PMID: 36762508 DOI: 10.23736/s0021-9509.22.12536-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Acute limb ischemia (ALI) is an emergency situation requiring rapid diagnosis and treatment. Although the traditional treating strategy for ALI includes open surgery, novel endovascular techniques have been introduced during the last decade. Additionally, many new cases of ALI have been reported due to infection by the SARS-CoV-2 virus. The aim of this study was to present an updated overview of characteristics, diagnosis, and current treating strategies of patients with ALI.
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Affiliation(s)
- George Galyfos
- Unit of Vascular Surgery, First Department of Propedeutic Surgery, Hippocration Hospital, National and Kapodistrian University of Athens, Athens, Greece -
| | - Alexandros Chamzin
- Unit of Vascular Surgery, First Department of Propedeutic Surgery, Hippocration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Intzes
- Unit of Vascular Surgery, First Department of Propedeutic Surgery, Hippocration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgia Matthaiou
- Unit of Vascular Surgery, First Department of Propedeutic Surgery, Hippocration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Spilios Spiliotopoulos
- Unit of Vascular Surgery, First Department of Propedeutic Surgery, Hippocration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimosthenis Sotirakis
- Unit of Vascular Surgery, First Department of Propedeutic Surgery, Hippocration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Frangeska Sigala
- Unit of Vascular Surgery, First Department of Propedeutic Surgery, Hippocration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Filis
- Unit of Vascular Surgery, First Department of Propedeutic Surgery, Hippocration Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Sigala E, Terentes-Printzios D, Baikoussis GN, Katsaros A, Koumallos N, Lozos V, Giakis N, Filis K, Tsioufis K, Vlachopoulos C. The long-term effect of surgical aortic valve replacement on arterial stiffness and wave reflections. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Assessing arterial properties in patients with aortic valve stenosis undergoing surgical aortic valve replacement (SAVR) is difficult, and the results to date have been inconclusive.
Purpose
We sought to investigate how SAVR affects vascular stiffness in the short and long term.
Methods
We included 69 patients (mean age 70.8±8.4 years, 62% men) with severe symptomatic aortic stenosis who underwent SAVR. Arterial stiffness was assessed using the carotid femoral pulse wave velocity (cfPWV) and brachial-ankle pulse wave velocity (baPWV). Measurements in patients with an ankle-brachial index (ABI) <0.9 were excluded from the analysis for baPWV measurments because a low ABI can affect the accuracy of baPWV. Augmentation index corrected for heart rate (Alx@75), central pressures and subendocardial viability ratio (SEVR) were assessed with arterial tonometry. Measurements were conducted at baseline, in the acute phase and 1 year after the operation.
Results
Immediately after SAVR there was an increase in cfPWV (8.04±1.3 m/s vs 8.54±1.6 m/s, p=0.02) that was sustained at 1 year (8.04±1.3 m/s vs 9.42±2.4 m/s, p≤0.001). Similarly, baPWV (n=55) increased in the acute phase (1633±429 cm/s vs 2014±606 cm/s, p<0.001) and persisted 1 year postoperatively (1633±429 cm/s vs 1867±408 cm/s, p<0.001). Post-SAVR we also observed a decrease in Alx@75 (31.02±10% vs 22.73±12%, p≤0.001) that was attenuated 1 year later (31.02±10% vs 26.65±8%, p≤0.001), and an increase in SEVR (136.1±30.4% vs 149.2±37.7%, p=0.01) which remained improved at 1 year (136.1±30.4% vs 147.5±30.4%, p=0.01).
Conclusions
After SAVR the arterial system shows an increase of stiffness in response to the acute relief of the obstruction, which is retained in the long term.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- E Sigala
- Hippokration General Hospital, 1st Department of Cardiology, Athens Medical School , Athens , Greece
| | - D Terentes-Printzios
- Hippokration General Hospital, 1st Department of Cardiology, Athens Medical School , Athens , Greece
| | - G N Baikoussis
- Hippokration General Hospital, Cardiac Surgery Department , Athens , Greece
| | - A Katsaros
- Hippokration General Hospital, Cardiac Surgery Department , Athens , Greece
| | - N Koumallos
- Hippokration General Hospital, Cardiac Surgery Department , Athens , Greece
| | - V Lozos
- Hippokration General Hospital, Cardiac Surgery Department , Athens , Greece
| | - N Giakis
- Hippokration General Hospital, Cardiac Surgery Department , Athens , Greece
| | - K Filis
- Hippokration General Hospital , Athens , Greece
| | - K Tsioufis
- Hippokration General Hospital, 1st Department of Cardiology, Athens Medical School , Athens , Greece
| | - C Vlachopoulos
- Hippokration General Hospital, 1st Department of Cardiology, Athens Medical School , Athens , Greece
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Tufford AR, Diou C, Lucassen DA, Ioakimidis I, O'Malley G, Alagialoglou L, Charmandari E, Doyle G, Filis K, Kassari P, Kechadi T, Kilintzis V, Kok E, Lekka I, Maglaveras N, Pagkalos I, Papapanagiotou V, Sarafis I, Shahid A, van ’t Veer P, Delopoulos A, Mars M. Toward Systems Models for Obesity Prevention: A Big Role for Big Data. Curr Dev Nutr 2022; 6:nzac123. [PMID: 36157849 PMCID: PMC9492244 DOI: 10.1093/cdn/nzac123] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 03/24/2022] [Accepted: 07/28/2022] [Indexed: 11/14/2022] Open
Abstract
The relation among the various causal factors of obesity is not well understood, and there remains a lack of viable data to advance integrated, systems models of its etiology. The collection of big data has begun to allow the exploration of causal associations between behavior, built environment, and obesity-relevant health outcomes. Here, the traditional epidemiologic and emerging big data approaches used in obesity research are compared, describing the research questions, needs, and outcomes of 3 broad research domains: eating behavior, social food environments, and the built environment. Taking tangible steps at the intersection of these domains, the recent European Union project "BigO: Big data against childhood obesity" used a mobile health tool to link objective measurements of health, physical activity, and the built environment. BigO provided learning on the limitations of big data, such as privacy concerns, study sampling, and the balancing of epidemiologic domain expertise with the required technical expertise. Adopting big data approaches will facilitate the exploitation of data concerning obesity-relevant behaviors of a greater variety, which are also processed at speed, facilitated by mobile-based data collection and monitoring systems, citizen science, and artificial intelligence. These approaches will allow the field to expand from causal inference to more complex, systems-level predictive models, stimulating ambitious and effective policy interventions.
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Affiliation(s)
- Adele R Tufford
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Christos Diou
- Department of Informatics and Telematics, Harokopio University of Athens, Athens, Greece
| | - Desiree A Lucassen
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Ioannis Ioakimidis
- Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden
| | - Grace O'Malley
- W82GO Child and Adolescent Weight Management Service, Children's Health Ireland at Temple Street, Dublin, Ireland
- Division of Population Health Sciences, School of Physiotherapy, Royal College of Surgeons in Ireland University for Medicine and Health Sciences, Dublin, Ireland
| | - Leonidas Alagialoglou
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evangelia Charmandari
- Division of Endocrinology, Metabolism, and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, “Aghia Sophia” Children's Hospital, Athens, Greece
- Division of Endocrinology and Metabolism, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Gerardine Doyle
- College of Business, University College Dublin, Dublin, Ireland
- Geary Institute for Public Policy, University College Dublin, Dublin, Ireland
| | | | - Penio Kassari
- Division of Endocrinology, Metabolism, and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, “Aghia Sophia” Children's Hospital, Athens, Greece
- Division of Endocrinology and Metabolism, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Tahar Kechadi
- CeADAR: Ireland's Centre for Applied AI, University College Dublin, Dublin 4, Ireland
| | - Vassilis Kilintzis
- Lab of Computing, Medical Informatics, and Biomedical Imaging Technologies, Department of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Esther Kok
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Irini Lekka
- Lab of Computing, Medical Informatics, and Biomedical Imaging Technologies, Department of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nicos Maglaveras
- Lab of Computing, Medical Informatics, and Biomedical Imaging Technologies, Department of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Pagkalos
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, Thessaloniki, Greece
| | - Vasileios Papapanagiotou
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Sarafis
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Arsalan Shahid
- CeADAR: Ireland's Centre for Applied AI, University College Dublin, Dublin 4, Ireland
| | - Pieter van ’t Veer
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Anastasios Delopoulos
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Monica Mars
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
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Galyfos G, Liakopoulos D, Sigala F, Filis K. New paradigms in minimally-invasive vascular surgery. Expert Rev Cardiovasc Ther 2022; 20:207-214. [PMID: 35341434 DOI: 10.1080/14779072.2022.2058492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Vascular surgery has been greatly evolved during the last decades and novel minimally invasive techniques have been introduced. Aim of this review is to briefly present all these advances and compare them with traditional repairs. AREAS COVERED The authors have extensively searched literature through the Pubmed and Embase databases. All articles published up to December 2021 referring to minimally invasive techniques used for treatment of peripheral artery disease, carotid disease, aortic aneurysms and venous disease were evaluated. Minimally invasive techniques under investigation included endovascular and hybrid techniques, robot-assisted and laparoscopic approaches. EXPERT OPINION Several minimally invasive techniques such as endovascular and hybrid approaches have been extensively used during the last two decades to treat vascular surgery patients offering them lower mortality and morbidity risks. Novel robot assisted techniques have shown promising results in preclinical studies although further clinical evaluation is needed.
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Galyfos G, Sianou A, Frountzas M, Vasilios K, Vouros D, Theodoropoulos C, Michalopoulou V, Sigala F, Filis K. Acute limb ischemia among patients with COVID-19 infection. J Vasc Surg 2022; 75:326-342. [PMID: 34390791 PMCID: PMC8358086 DOI: 10.1016/j.jvs.2021.07.222] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 07/27/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVE/BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been associated with thrombotic complications such as deep vein thrombosis or stroke. Recently, numerous cases of acute limb ischemia (ALI) have been reported although pooled data are lacking. METHODS We systematically searched PubMed, Embase, Scopus, and the Cochrane Library for studies published online up to January 2021 that reported cases with SARS-CoV-2 infection and ALI. Eligible studies should have reported early outcomes including mortality. Primary endpoints included also pooled amputation, clinical improvement, and reoperation rates. RESULTS In total, 34 studies (19 case reports and 15 case series/cohort studies) including a total of 540 patients (199 patients were eligible for analysis) were evaluated. All studies were published in 2020. Mean age of patients was 61.6 years (range, 39-84 years; data from 32 studies) and 78.4% of patients were of male gender (data from 32 studies). There was a low incidence of comorbidities: arterial hypertension, 49% (29 studies); diabetes mellitus, 29.6% (29 studies); dyslipidemia, 20.5% (27 studies); chronic obstructive pulmonary disease, 8.5% (26 studies); coronary disease, 8.3% (26 studies); and chronic renal disease, 7.6% (28 studies). Medical treatment was selected as first-line treatment for 41.8% of cases. Pooled mortality rate among 34 studies reached 31.4% (95% confidence interval [CI], 25.4%%-37.7%). Pooled amputation rate among 34 studies reached 23.2% (95% CI, 17.3%-29.7%). Pooled clinical improvement rate among 28 studies reached 66.6% (95% CI, 55.4%%-76.9%). Pooled reoperation rate among 29 studies reached 10.5% (95% CI, 5.7%%-16.7%). Medical treatment was associated with a higher death risk compared with any intervention (odds ratio, 4.04; 95% CI, 1.075-15.197; P = .045) although amputation risk was not different between the two strategies (odds ratio, 0.977; 95% CI, 0.070-13.600; P = .986) (data from 31 studies). CONCLUSIONS SARS-CoV-2 infection is associated with a high risk for thrombotic complications, including ALI. COVID-associated ALI presents in patients with a low incidence of comorbidities, and it is associated with a high mortality and amputation risk. Conservative treatment seems to have a higher mortality risk compared with any intervention, although amputation risk is similar.
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Affiliation(s)
- George Galyfos
- Vascular Surgery Unit, First Department of Propedeutic Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece.
| | - Argiri Sianou
- Department of Microbiology, National and Kapodistrian University of Athens, Areteion Hospital, Athens, Greece
| | - Maximos Frountzas
- Vascular Surgery Unit, First Department of Propedeutic Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Kotsarinis Vasilios
- Vascular Surgery Unit, First Department of Propedeutic Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Dimitrios Vouros
- Vascular Surgery Unit, First Department of Propedeutic Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Charis Theodoropoulos
- Vascular Surgery Unit, First Department of Propedeutic Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Victoria Michalopoulou
- Vascular Surgery Unit, First Department of Propedeutic Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Frangiska Sigala
- Vascular Surgery Unit, First Department of Propedeutic Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Konstantinos Filis
- Vascular Surgery Unit, First Department of Propedeutic Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
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Galyfos G, Tsoutsas I, Konstantopoulos T, Galanopoulos G, Sigala F, Filis K, Papavassiliou V. Early and Late Outcomes after Transcarotid Revascularisation for Internal Carotid Artery Stenosis: A Systematic Review and Meta-Analysis. J Vasc Surg 2021. [DOI: 10.1016/j.jvs.2021.04.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Galyfos G, Eleftheriou M, Theodoropoulos C, Vouros D, Georgiou K, Kimpizi D, Rentifis L, Sigala F, Filis K. Open versus endovascular repair for extracranial carotid aneurysms. J Vasc Surg 2021; 74:1017-1023.e5. [PMID: 33940071 DOI: 10.1016/j.jvs.2021.04.038] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 04/09/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Extracranial carotid artery aneurysms (ECCAs) are rare; however, they are associated with a high risk of stroke and mortality if untreated. In the present review, we compared the major outcomes between open and endovascular repair of ECCAs. METHODS We systematically searched PubMed, Embase, Scopus, and the Cochrane Library for clinical studies reported online up to September 2020 that had evaluated major outcomes after both open and endovascular repair of ECCAs. Eligible studies were required to have evaluated at least the 30-day mortality or stroke and/or transient ischemic attack rates. The quality of the studies was also evaluated. RESULTS Overall, seven studies (three high quality, two medium quality, and two low quality) with 374 patients and 383 ECCAs were eligible. All the studies had been reported from 2004 to 2020. In total, 220 open repairs were compared with 81 endovascular repairs. The open and endovascular treatments showed similar 30-day mortality rates (4% vs 0%; pooled odds ratio [OR], 2.67; 95% confidence interval [CI], 0.291-24.451) and stroke and transient ischemic attack rates (5.5% vs 1.2%; pooled OR, 1.42; 95% CI, 0.412-4.886). Open repair was associated in six studies with a greater incidence of cranial nerve injury compared with endovascular repair (14.5% vs 0%; OR, 3.98; 95% CI, 1.178-13.471). The hematoma or bleeding rate was also similar between the two methods in six studies (5.2% vs 0%; OR, 1.92; 95% CI, 0.518-7.094). CONCLUSIONS Open and endovascular repair of ECCAs is associated with similarly low early mortality and cerebrovascular event rates, although open repair showed a greater risk of cranial nerve injuries. An endovascular approach could be more appropriate when the aneurysm is located distally or requires extensive dissection. More studies are needed with standardized follow-up durations to evaluate late outcomes.
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Affiliation(s)
- George Galyfos
- Vascular Surgery Unit, First Department of Propedeutic Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece.
| | - Malvina Eleftheriou
- Vascular Surgery Unit, First Department of Propedeutic Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Charis Theodoropoulos
- Vascular Surgery Unit, First Department of Propedeutic Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Dimitris Vouros
- Vascular Surgery Unit, First Department of Propedeutic Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Konstantinos Georgiou
- Vascular Surgery Unit, First Department of Propedeutic Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Despina Kimpizi
- Vascular Surgery Unit, First Department of Propedeutic Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Loukas Rentifis
- Vascular Surgery Unit, First Department of Propedeutic Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Frangiska Sigala
- Vascular Surgery Unit, First Department of Propedeutic Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Konstantinos Filis
- Vascular Surgery Unit, First Department of Propedeutic Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
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14
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Tsilimigras DI, Bibli SI, Siasos G, Oikonomou E, Perrea DN, Filis K, Tousoulis D, Sigala F. Regulation of Long Non-Coding RNAs by Statins in Atherosclerosis. Biomolecules 2021; 11:biom11050623. [PMID: 33922114 PMCID: PMC8143454 DOI: 10.3390/biom11050623] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/12/2021] [Accepted: 04/20/2021] [Indexed: 01/04/2023] Open
Abstract
Despite increased public health awareness, atherosclerosis remains a leading cause of mortality worldwide. Significant variations in response to statin treatment have been noted among different populations suggesting that the efficacy of statins may be altered by both genetic and environmental factors. The existing literature suggests that certain long noncoding RNAs (lncRNAs) might be up- or downregulated among patients with atherosclerosis. LncRNA may act on multiple levels (cholesterol homeostasis, vascular inflammation, and plaque destabilization) and exert atheroprotective or atherogenic effects. To date, only a few studies have investigated the interplay between statins and lncRNAs known to be implicated in atherosclerosis. The current review characterizes the role of lncRNAs in atherosclerosis and summarizes the available evidence related to the effect of statins in regulating lncRNAs.
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Affiliation(s)
- Diamantis I. Tsilimigras
- First Propaedeutic Department of Surgery, Division of Vascular Surgery, Hippokration Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece; (K.F.); (F.S.)
- Correspondence: ; Tel.: +30-697-5683-212
| | - Sofia-Iris Bibli
- Centre for Molecular Medicine, Institute for Vascular Signalling, Goethe University, 60323 Frankfurt am Main, Germany;
| | - Gerasimos Siasos
- First Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens Medical School, 11527 Athens, Greece; (G.S.); (E.O.); (D.T.)
| | - Evangelos Oikonomou
- First Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens Medical School, 11527 Athens, Greece; (G.S.); (E.O.); (D.T.)
| | - Despina N. Perrea
- Laboratory for Experimental Surgery and Surgical Research “N.S. Christeas”, National and Kapodistrian University of Athens, 15772 Athens, Greece;
| | - Konstantinos Filis
- First Propaedeutic Department of Surgery, Division of Vascular Surgery, Hippokration Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece; (K.F.); (F.S.)
| | - Dimitrios Tousoulis
- First Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens Medical School, 11527 Athens, Greece; (G.S.); (E.O.); (D.T.)
| | - Fragiska Sigala
- First Propaedeutic Department of Surgery, Division of Vascular Surgery, Hippokration Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece; (K.F.); (F.S.)
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15
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Zarmakoupis C, Galyfos G, Tsoukalos G, Dalla P, Triantafyllou A, Zografos K, Sigala F, Filis K. Hybrid Repair of a Common Carotid Pseudoaneurysm and Concomitant Internal Carotid Stenosis With Retrograde Stenting and Carotid Endarterectomy. Vasc Endovascular Surg 2021; 55:627-630. [PMID: 33691546 DOI: 10.1177/1538574421992935] [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] [Indexed: 11/16/2022]
Abstract
This report aims to present a rare case of a common carotid artery (CCA) pseudoaneurysm with a concomitant internal carotid artery (ICA) stenosis that were treated with a hybrid technique. This strategy included the retrograde placement of a CCA covered stent under ICA clamping followed by standardized carotid endarterectomy. The technique will be discussed and compared with other possible treatments.
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Affiliation(s)
- Constantinos Zarmakoupis
- Vascular and Endovascular Surgery Department, Athens Euroclinic, Athens, Greece.,First Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - George Galyfos
- Vascular and Endovascular Surgery Department, Athens Euroclinic, Athens, Greece.,First Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Grigorios Tsoukalos
- Vascular and Endovascular Surgery Department, Athens Euroclinic, Athens, Greece
| | - Panagiota Dalla
- First Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Alexandra Triantafyllou
- First Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Konstantinos Zografos
- First Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Fragiska Sigala
- First Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Konstantinos Filis
- First Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
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16
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Dias SB, Diniz JA, Konstantinidis E, Savvidis T, Zilidou V, Bamidis PD, Grammatikopoulou A, Dimitropoulos K, Grammalidis N, Jaeger H, Stadtschnitzer M, Silva H, Telo G, Ioakeimidis I, Ntakakis G, Karayiannis F, Huchet E, Hoermann V, Filis K, Theodoropoulou E, Lyberopoulos G, Kyritsis K, Papadopoulos A, Depoulos A, Trivedi D, Chaudhuri RK, Klingelhoefer L, Reichmann H, Bostantzopoulou S, Katsarou Z, Iakovakis D, Hadjidimitriou S, Charisis V, Apostolidis G, Hadjileontiadis LJ. Assistive HCI-Serious Games Co-design Insights: The Case Study of i-PROGNOSIS Personalized Game Suite for Parkinson's Disease. Front Psychol 2021; 11:612835. [PMID: 33519632 PMCID: PMC7843389 DOI: 10.3389/fpsyg.2020.612835] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 12/22/2020] [Indexed: 11/13/2022] Open
Abstract
Human-Computer Interaction (HCI) and games set a new domain in understanding people's motivations in gaming, behavioral implications of game play, game adaptation to player preferences and needs for increased engaging experiences in the context of HCI serious games (HCI-SGs). When the latter relate with people's health status, they can become a part of their daily life as assistive health status monitoring/enhancement systems. Co-designing HCI-SGs can be seen as a combination of art and science that involves a meticulous collaborative process. The design elements in assistive HCI-SGs for Parkinson's Disease (PD) patients, in particular, are explored in the present work. Within this context, the Game-Based Learning (GBL) design framework is adopted here and its main game-design parameters are explored for the Exergames, Dietarygames, Emotional games, Handwriting games, and Voice games design, drawn from the PD-related i-PROGNOSIS Personalized Game Suite (PGS) (www.i-prognosis.eu) holistic approach. Two main data sources were involved in the study. In particular, the first one includes qualitative data from semi-structured interviews, involving 10 PD patients and four clinicians in the co-creation process of the game design, whereas the second one relates with data from an online questionnaire addressed by 104 participants spanning the whole related spectrum, i.e., PD patients, physicians, software/game developers. Linear regression analysis was employed to identify an adapted GBL framework with the most significant game-design parameters, which efficiently predict the transferability of the PGS beneficial effect to real-life, addressing functional PD symptoms. The findings of this work can assist HCI-SG designers for designing PD-related HCI-SGs, as the most significant game-design factors were identified, in terms of adding value to the role of HCI-SGs in increasing PD patients' quality of life, optimizing the interaction with personalized HCI-SGs and, hence, fostering a collaborative human-computer symbiosis.
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Affiliation(s)
- Sofia Balula Dias
- Faculdade de Motricidade Humana, Centro Interdisciplinar de Performance Humana, Universidade de Lisboa, Lisbon, Portugal
| | - José Alves Diniz
- Faculdade de Motricidade Humana, Centro Interdisciplinar de Performance Humana, Universidade de Lisboa, Lisbon, Portugal
| | | | - Theodore Savvidis
- Lab of Medical Physics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vicky Zilidou
- Lab of Medical Physics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Panagiotis D Bamidis
- Lab of Medical Physics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Athina Grammatikopoulou
- Centre for Research and Technology Hellas, Information Technologies Institute, Thessaloniki, Greece
| | - Kosmas Dimitropoulos
- Centre for Research and Technology Hellas, Information Technologies Institute, Thessaloniki, Greece
| | - Nikos Grammalidis
- Centre for Research and Technology Hellas, Information Technologies Institute, Thessaloniki, Greece
| | - Hagen Jaeger
- Fraunhofer Institute Intelligent Analysis and Information Systems, Sankt Augustin, Germany
| | - Michael Stadtschnitzer
- Fraunhofer Institute Intelligent Analysis and Information Systems, Sankt Augustin, Germany
| | - Hugo Silva
- PLUX, Wireless Biosignals, Lisbon, Portugal
| | | | | | | | | | | | | | | | | | | | - Konstantinos Kyritsis
- Multimedia Understanding Group, Information Processing Laboratory, Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexandros Papadopoulos
- Multimedia Understanding Group, Information Processing Laboratory, Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anastasios Depoulos
- Multimedia Understanding Group, Information Processing Laboratory, Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dhaval Trivedi
- International Parkinson Excellence Research Centre, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Ray K Chaudhuri
- International Parkinson Excellence Research Centre, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | | | - Heinz Reichmann
- Department of Neurology, Technical University Dresden, Dresden, Germany
| | | | - Zoe Katsarou
- Third Neurological Clinic, G. Papanikolaou Hospital, Thessaloniki, Greece
| | - Dimitrios Iakovakis
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stelios Hadjidimitriou
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasileios Charisis
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - George Apostolidis
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Leontios J Hadjileontiadis
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Department of Electrical Engineering and Computer Science/Biomedical Engineering, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
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Diou C, Sarafis I, Papapanagiotou V, Alagialoglou L, Lekka I, Filos D, Stefanopoulos L, Kilintzis V, Maramis C, Karavidopoulou Y, Maglaveras N, Ioakimidis I, Charmandari E, Kassari P, Tragomalou A, Mars M, Ngoc Nguyen TA, Kechadi T, O'Donnell S, Doyle G, Browne S, O'Malley G, Heimeier R, Riviou K, Koukoula E, Filis K, Hassapidou M, Pagkalos I, Ferri D, Perez I, Delopoulos A. BigO: A public health decision support system for measuring obesogenic behaviors of children in relation to their local environment. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020:5864-5867. [PMID: 33019308 DOI: 10.1109/embc44109.2020.9175361] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Obesity is a complex disease and its prevalence depends on multiple factors related to the local socioeconomic, cultural and urban context of individuals. Many obesity prevention strategies and policies, however, are horizontal measures that do not depend on context-specific evidence. In this paper we present an overview of BigO (http://bigoprogram.eu), a system designed to collect objective behavioral data from children and adolescent populations as well as their environment in order to support public health authorities in formulating effective, context-specific policies and interventions addressing childhood obesity. We present an overview of the data acquisition, indicator extraction, data exploration and analysis components of the BigO system, as well as an account of its preliminary pilot application in 33 schools and 2 clinics in four European countries, involving over 4,200 participants.
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18
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Sigala F, Galyfos G, Koniaris E, Barkolias C, Artsitas S, Zografos K, Filis K, Zografos G, Alexakis N. Epithelioid hemangioendothelioma of the retroperitoneum - a rare vascular tumor. VASA 2020; 50:312-316. [PMID: 32697157 DOI: 10.1024/0301-1526/a000898] [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] [Indexed: 11/19/2022]
Abstract
Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor, affecting the liver, the lungs and the bones most frequently. It has a heterogenous clinical presentation and there is no consensus on optimal treatment. This report aims to present a rare case of a retroperitoneal EHE and to discuss on proper management.
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Affiliation(s)
- Fragiska Sigala
- First Department of Propedeutic Surgery, National Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - George Galyfos
- First Department of Propedeutic Surgery, National Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Efthimios Koniaris
- First Department of Propedeutic Surgery, National Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Christos Barkolias
- First Department of Propedeutic Surgery, National Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Sotirios Artsitas
- First Department of Propedeutic Surgery, National Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Konstantinos Zografos
- First Department of Propedeutic Surgery, National Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Konstantinos Filis
- First Department of Propedeutic Surgery, National Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Georgios Zografos
- First Department of Propedeutic Surgery, National Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Nikolaos Alexakis
- First Department of Propedeutic Surgery, National Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
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19
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Dias SB, Grammatikopoulou A, Diniz JA, Dimitropoulos K, Grammalidis N, Zilidou V, Savvidis T, Konstantinidis E, Bamidis PD, Jaeger H, Stadtschnitzer M, Silva H, Telo G, Ioakeimidis I, Ntakakis G, Karayiannis F, Huchet E, Hoermann V, Filis K, Theodoropoulou E, Lyberopoulos G, Kyritsis K, Papadopoulos A, Delopoulos A, Trivedi D, Chaudhuri KR, Klingelhoefer L, Reichmann H, Bostantzopoulou S, Katsarou Z, Iakovakis D, Hadjidimitriou S, Charisis V, Apostolidis G, Hadjileontiadis LJ. Innovative Parkinson's Disease Patients' Motor Skills Assessment: The i-PROGNOSIS Paradigm. Front Comput Sci 2020. [DOI: 10.3389/fcomp.2020.00020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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20
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Filis K, Galyfos G, Sigala F, Karantzikos G, Vavouranakis M, Toutouzas K, Albanopoulos K, Zografos G. Vascular complications during transcatheter aortic valve implantation: The role of the vascular surgeon. Vascular 2020; 28:421-429. [DOI: 10.1177/1708538120902659] [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: 12/18/2022]
Abstract
Introduction This study compares the incidence of vascular complications and other major outcomes between patients undergoing transcatheter aortic valve implantation, with and without a standardized preoperative vascular surgeon consultation. Methods This retrospective study evaluated all patients scheduled for transcatheter aortic valve implantation during a five-year period at a Hellenic University Hospital. Two main periods were evaluated: Group A (early period (2014–2015), without a standardized preoperative vascular surgeon consultation) and Group B (late period (2016–2018), with a standardized preoperative vascular surgeon consultation). All vascular complications as well as other major outcomes (early death, stroke, myocardial infarction, and treatment) were recorded. Univariate and multivariate analyses were also conducted. Results Overall, 382 transcatheter aortic valve implantation procedures were conducted (Group A: n = 115; duration = 19 months; Group B: n = 267; duration = 41 months). Overall, 58 vascular complications were recorded (21 patients in Group A and 37 patients in Group B (18.3% versus 13.9%; P = 0.279)). However, vascular complications that necessitated a vascular surgeon’s interference were more frequent during the first period (13% versus 4.9%; P = 0.009). Among patients with a vascular complication, early mortality was higher during the first period (14.3% versus 0%; P = 0.034) although stroke and myocardial infarction rates were similar. Age >80 years (OR = 1.856 [1.134–3.452]; P = 0.03) and preoperative vascular surgeon consultation (OR = 0.345 [0.132–0.756]; P = 0.015) were the only independent predictors for vascular complications. Conclusions A standardized preoperative evaluation by a vascular surgeon may decrease the risk for vascular complications that necessitate a repair as well as early mortality among patients undergoing transcatheter aortic valve implantation procedures.
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Affiliation(s)
- Konstantinos Filis
- First Propedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - George Galyfos
- First Propedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Fragiska Sigala
- First Propedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Georgios Karantzikos
- First Propedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Manolis Vavouranakis
- First Cardiology Department, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Konstantinos Toutouzas
- First Cardiology Department, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Konstantinos Albanopoulos
- First Propedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
| | - Georgios Zografos
- First Propedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece
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Sigala E, Vlachopoulos C, Triantafyllou K, Katsaros A, Koumallos N, Lozos V, Baikoussis N, Kouerinis I, Giakis N, Michael D, Printzios DT, Filis K, Tousoulis D. P146 The Predictive Role of Arterial Stiffness in the Development of Acute Kidney Injury in Patients Undergoing Surgical Aortic Valve Replacement. Artery Res 2020. [DOI: 10.2991/artres.k.191224.166] [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: 11/01/2022] Open
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Bibli SI, Hu J, Leisegang MS, Wittig J, Zukunft S, Kapasakalidi A, Fisslthaler B, Tsilimigras D, Zografos G, Filis K, Brandes RP, Papapetropoulos A, Sigala F, Fleming I. Shear stress regulates cystathionine γ lyase expression to preserve endothelial redox balance and reduce membrane lipid peroxidation. Redox Biol 2019; 28:101379. [PMID: 31759247 PMCID: PMC6880097 DOI: 10.1016/j.redox.2019.101379] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 10/30/2019] [Accepted: 11/10/2019] [Indexed: 02/06/2023] Open
Abstract
Cystathionine γ lyase (CSE) is the major source of hydrogen sulfide-derived species (H2Sn) in endothelial cells and plays an important role in protecting against atherosclerosis. Here we investigated the molecular mechanisms underlying the regulation of CSE expression in endothelial cells by fluid shear stress/flow. Fluid shear stress decreased CSE expression in human and murine endothelial cells and was negatively correlated with the transcription factor Krüppel-like factor (KLF) 2. CSE was identified as a direct target of the KLF2-regulated microRNA, miR-27b and high expression of CSE in native human plaque-derived endothelial cells, was also inversely correlated with KLF2 and miR-27b levels. One consequence of decreased CSE expression was the loss of Prx6 sulfhydration (on Cys47), which resulted in Prx6 hyperoxidation, decamerization and inhibition, as well as a concomitant increase in endothelial cell reactive oxygen species and lipid membrane peroxidation. H2Sn supplementation in vitro was able to reverse the redox state of Prx6. Statin therapy, which is known to activate KLF2, also decreased CSE expression but increased CSE activity by preventing its phosphorylation on Ser377. As a result, the sulfhydration of Prx6 was partially restored in samples from plaque containing arteries from statin-treated donors. Taken together, the regulation of CSE expression by shear stress/disturbed flow is dependent on KLF2 and miR-27b. Moreover, in murine and human arteries CSE acts to maintain endothelial redox balance at least partly by targeting Prx6 to prevent its decamerization and inhibition of its peroxidase activity.
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Affiliation(s)
- Sofia-Iris Bibli
- Institute for Vascular Signalling, Centre for Molecular Medicine, Goethe University, Frankfurt am Main, Germany; German Center of Cardiovascular Research (DZHK), Partner site RheinMain, Frankfurt am Main, Germany
| | - Jiong Hu
- Institute for Vascular Signalling, Centre for Molecular Medicine, Goethe University, Frankfurt am Main, Germany; German Center of Cardiovascular Research (DZHK), Partner site RheinMain, Frankfurt am Main, Germany
| | - Matthias S Leisegang
- German Center of Cardiovascular Research (DZHK), Partner site RheinMain, Frankfurt am Main, Germany; Institute for Cardiovascular Physiology, Goethe University, Frankfurt am Main, Germany
| | - Janina Wittig
- Institute for Vascular Signalling, Centre for Molecular Medicine, Goethe University, Frankfurt am Main, Germany; German Center of Cardiovascular Research (DZHK), Partner site RheinMain, Frankfurt am Main, Germany
| | - Sven Zukunft
- Institute for Vascular Signalling, Centre for Molecular Medicine, Goethe University, Frankfurt am Main, Germany; German Center of Cardiovascular Research (DZHK), Partner site RheinMain, Frankfurt am Main, Germany
| | - Andrea Kapasakalidi
- Institute for Vascular Signalling, Centre for Molecular Medicine, Goethe University, Frankfurt am Main, Germany
| | - Beate Fisslthaler
- German Center of Cardiovascular Research (DZHK), Partner site RheinMain, Frankfurt am Main, Germany
| | - Diamantis Tsilimigras
- First Propedeutic Department of Surgery, Vascular Surgery Division, Hippokration Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Georgios Zografos
- First Propedeutic Department of Surgery, Vascular Surgery Division, Hippokration Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Konstantinos Filis
- First Propedeutic Department of Surgery, Vascular Surgery Division, Hippokration Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Ralf P Brandes
- German Center of Cardiovascular Research (DZHK), Partner site RheinMain, Frankfurt am Main, Germany; Institute for Cardiovascular Physiology, Goethe University, Frankfurt am Main, Germany
| | - Andreas Papapetropoulos
- Laboratory of Pharmacology, Faculty of Pharmacy, National and Kapodistrian University of Athens Medical School, Athens, Greece; Clinical, Experimental Surgery and Translational Research Center, Biomedical Research Foundation of the Academy of Athens, Soranou Ephessiou 4, Athens, 11527, Greece
| | - Fragiska Sigala
- First Propedeutic Department of Surgery, Vascular Surgery Division, Hippokration Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.
| | - Ingrid Fleming
- Institute for Vascular Signalling, Centre for Molecular Medicine, Goethe University, Frankfurt am Main, Germany; German Center of Cardiovascular Research (DZHK), Partner site RheinMain, Frankfurt am Main, Germany.
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Tsilimigras DI, Moris D, Karaolanis G, Kakkos SK, Filis K, Sigala F. Rivaroxaban versus Clopidogrel for Peripheral Artery Disease: A Clinico-Economic Approach of the COMPASS Trial. Curr Pharm Des 2019; 24:4516-4517. [PMID: 30621559 DOI: 10.2174/1381612825666190101100832] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 11/07/2018] [Revised: 12/18/2018] [Accepted: 12/26/2018] [Indexed: 11/22/2022]
Abstract
Peripheral artery disease (PAD) is the third most common manifestation of atherosclerosis after coronary artery (CAD) and cerebrovascular disease (CVD). People with PAD have plaque findings in other vascular territories as well and, thus, are at increased risk of major adverse cardiovascular or cerebrovascular events (MACCE), including myocardial infarction, and stroke. In that context, the COMPASS multicenter, randomized controlled trial showed that the risk of MACCE was significantly reduced by 24% in the rivaroxaban plus aspirin arm compared with aspirin alone (4.1% vs 5.4% respectively; HR: 0.76, 95% CI: 0.66 to 0.86). Interestingly, the rivaroxaban/aspirin arm also showed a reduction in cardiovascular death (HR: 0.78; 95% CI: 0.64-0.96]) and allcause mortality (HR: 0.82; 95% CI: 0.71-0.96) by 22% and 18%, respectively. Recently, the FDA approved the use of the dual pathway approach, rivaroxaban 2.5 mg twice daily plus aspirin 75-100mg once daily, to reduce the risk of major cardiovascular (CV) events, such as CV death, myocardial infarction and stroke, in people with CAD as well as PAD. In comparing rivaroxaban plus aspirin versus aspirin alone, a preliminary economic analysis showed that saving per patient was USD 462 for events and USD 220 for procedures with a total reduction of USD 682 per participant in the US with the combination group (rivaroxaban plus aspirin). The data from COMPASS trial suggest that low dose rivaroxaban plus aspirin may be a preferred treatment strategy in PAD patients in whom the bleeding risk is deemed to be favourable.
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Affiliation(s)
- Diamantis I Tsilimigras
- First Department of Propaedeutic Surgery, Vascular Unit, National and Kapodistrian University of Athens, Athens, Greece
| | - Demetrios Moris
- Department of Surgery, Duke University Medical Center, Duke University, Durham, NC, United States
| | - Georgios Karaolanis
- First Department of Surgery, Vascular Unit, Laiko University Hospital, Athens, Greece
| | - Stavros K Kakkos
- Departments of Vascular Surgery and Nephrology, University Hospital of Patras, Patras, Greece
| | - Konstantinos Filis
- First Department of Propaedeutic Surgery, Vascular Unit, National and Kapodistrian University of Athens, Athens, Greece
| | - Fragiska Sigala
- First Department of Propaedeutic Surgery, Vascular Unit, National and Kapodistrian University of Athens, Athens, Greece
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Filis K, Sigala F, Stamatina T, Georgia D, Zografos G, Galyfos G. Iatrogenic Vascular Injuries of the Abdomen and Pelvis: The Experience at a Hellenic University Hospital. Vasc Endovascular Surg 2019; 53:541-546. [DOI: 10.1177/1538574419858809] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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]
Abstract
Background: The aim of this study is to present the experience of a Vascular Division at a Hellenic University hospital concerning the management of iatrogenic vascular injuries (IVIs) of the abdomen or pelvis. Patients and Methods: This is a retrospective study evaluating all IVIs reported during a 10-year period in our institution. Only injuries warranting a vascular surgeon consultation were included in the study. Non-iatrogenic injuries were not included. Mortality and major complications within 30 days were evaluated. Results: Overall, 70 cases were recorded, with 41% being venous and 59% being arterial injuries. Iliac arteries (51%) were the most common location and rupture/lacerations (73%) were the most common type of injury. General surgery (61.5%) and cardiology (30%) procedures were the most frequently involved procedures. A 30-day mortality was 5.7%, with 30% of cases treated conservatively. Synthetic bypass grafting (odds ratio [OR] = 65.0; 95% confidence interval [CI], 4.022-1050.358; P = .003) and male gender (OR = 83.77; 95% CI, 4.040-1736.738; P = .004) were associated with death. Conclusions: Iatrogenic vascular injuries of the abdomen or pelvis are usually associated with general surgery and endovascular procedures. When vascular consultation is requested early, mortality could remain low. However, a selected number of stable patients with retroperitoneal or pelvic hematomas could be treated conservatively, yielding satisfying results.
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Affiliation(s)
- Konstantinos Filis
- First Propedeutic Department of Surgery, Hippocration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Fragiska Sigala
- First Propedeutic Department of Surgery, Hippocration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Triantafyllou Stamatina
- First Propedeutic Department of Surgery, Hippocration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Doulami Georgia
- First Propedeutic Department of Surgery, Hippocration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Zografos
- First Propedeutic Department of Surgery, Hippocration Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - George Galyfos
- First Propedeutic Department of Surgery, Hippocration Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Galyfos G, Sigala F, Filis K. Regarding "Outcomes after elective abdominal aortic aneurysm repair in obese versus nonobese patients". J Vasc Surg 2019; 69:2008. [PMID: 31159994 DOI: 10.1016/j.jvs.2018.12.053] [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] [Received: 11/22/2018] [Accepted: 12/02/2018] [Indexed: 11/30/2022]
Affiliation(s)
- George Galyfos
- First Department of Propedeutic Surgery, National and Kapodistrian University of Athens Medical School, Hippocration Hospital, Athens, Greece
| | - Fragiska Sigala
- First Department of Propedeutic Surgery, National and Kapodistrian University of Athens Medical School, Hippocration Hospital, Athens, Greece
| | - Konstantinos Filis
- First Department of Propedeutic Surgery, National and Kapodistrian University of Athens Medical School, Hippocration Hospital, Athens, Greece
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Galyfos G, Sigala F, Bazigos G, Filis K. Weekend effect among patients undergoing elective vascular surgery. J Vasc Surg 2019; 70:2038-2045. [PMID: 31147130 DOI: 10.1016/j.jvs.2019.03.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 12/06/2018] [Accepted: 03/07/2019] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Several studies have described a higher mortality among patients admitted or operated during the weekend for various diseases. However, pooled data on patients undergoing elective vascular surgery procedures are sparse. METHODS The PubMed, Embase, Scopus, and Cochrane Library databases were systematically searched to identify eligible studies. Studies comparing short-term mortality (≤30 days) between patients undergoing elective vascular surgery during the weekend and working days were included. When studies included patients undergoing mixed types of surgery, only the vascular surgery subgroups were evaluated. Urgent/emergency vascular procedures were excluded according to certain definitions provided by each study. Data were analyzed by using the StatsDirect Statistical software (Version 2.8.0, StatsDirect Ltd, Cambridge, UK). RESULTS Overall, four retrospective studies including 131,201 patients undergoing elective vascular surgery (on working days, n = 130,163; on the weekend, n = 1038) were evaluated. The pooled short-term mortality risk was higher among patients operated during the weekend compared with working days (odds ratio [OR], 2.41; 95% confidence interval [CI], 1.58-3.67; P = .0004). This weekend effect was more evident among patients undergoing abdominal aortic aneurysm repair and carotid surgery (OR, 3.62 [95% CI, 1.49-8.82; P = .0046] and OR, 3.48 [95% CI, 1.15-10.54; P = .027], respectively). In the United States, the weekend effect was more evident among patients undergoing aortic aneurysm repair (OR, 3.61; 95% CI, 1.99-6.53; P < .0001). However, data from Canada originated from one study on patients undergoing carotid and peripheral arterial surgery only. CONCLUSIONS Elective vascular surgery is associated with a higher short-term mortality risk when conducted over the weekend. Improvement of perioperative management during these days may be necessary to improve outcomes.
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Affiliation(s)
- George Galyfos
- First Department of Propaedeutic Surgery, National and Kapodistriakon University of Athens, Hippocration Hospital, Athens, Greece.
| | - Fragiska Sigala
- First Department of Propaedeutic Surgery, National and Kapodistriakon University of Athens, Hippocration Hospital, Athens, Greece
| | - Gerasimos Bazigos
- First Department of Propaedeutic Surgery, National and Kapodistriakon University of Athens, Hippocration Hospital, Athens, Greece
| | - Konstantinos Filis
- First Department of Propaedeutic Surgery, National and Kapodistriakon University of Athens, Hippocration Hospital, Athens, Greece
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Tsachiridi M, Galyfos G, Andreou A, Sianou A, Sigala F, Zografos G, Filis K. Autologous Platelet-Rich Plasma for Nonhealing Ulcers: A Comparative Study. Vasc Specialist Int 2019; 35:22-27. [PMID: 30993104 PMCID: PMC6453601 DOI: 10.5758/vsi.2019.35.1.22] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose The use of platelet-rich plasma (PRP) for the treatment of nonhealing ulcers is a relatively new technique. Although it seems to result in a satisfying level of healing and low complication rates, data regarding its effectiveness remain sparse. This study aims to evaluate the potential therapeutic effects of PRP on chronic nonhealing ulcers. Materials and Methods This was a prospectively designed study comparing outcomes between patients treated with PRP (Group A, n=15) and patients treated conventionally (Group B, n=12) for different types of nonhealing ulcers. In Group A, PRP was produced from the patients’ own peripheral blood samples and was applied on the ulcer once every week. In Group B, patients were treated conventionally, without applying PRP. The total treatment period was 5 weeks. Results Both groups were similar regarding age, sex, comorbidities, and time of treatment. In Group A, patients showed a nonsignificant reduction of 4.5 mm2 in ulcer area (P=0.190) and a reduction of more than 1 mm in depth (P=0.0006), while Group B showed an increase of 108±80.5 mm2 in ulcer area after 5 weeks (P=0.016). The healing rate (HR) in Group A was stable and positive throughout the treatment period, while HR in Group B was initially negative but became positive after the 3rd week. Conclusion PRP application once a week promotes the healing of chronic ulcers. It improves the ulcer’s depth and HR, although its effect on ulcer area seems to be nonsignificant. However, larger comparative series are still needed to confirm these findings.
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Affiliation(s)
- Maria Tsachiridi
- First Department of Propedeutic Surgery, Hippocration General Hospital, National Kapodistrian University of Athens, Athens, Greece.,Department of Upper Gastrointestinal Surgery, Northern General Hospital, Sheffield Teaching Hospitals NHS Trust, Sheffield, United Kingdom
| | - George Galyfos
- First Department of Propedeutic Surgery, Hippocration General Hospital, National Kapodistrian University of Athens, Athens, Greece
| | - Alexandros Andreou
- Department of General Surgery, York Hospital, York Teaching Hospital NHS Trust, York, United Kingdom
| | - Argiri Sianou
- Department of Microbiology, Areteion University Hospital, Athens, Greece
| | - Fragiska Sigala
- First Department of Propedeutic Surgery, Hippocration General Hospital, National Kapodistrian University of Athens, Athens, Greece
| | - George Zografos
- First Department of Propedeutic Surgery, Hippocration General Hospital, National Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Filis
- First Department of Propedeutic Surgery, Hippocration General Hospital, National Kapodistrian University of Athens, Athens, Greece
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Affiliation(s)
- George Galyfos
- First Department of Propedeutic Surgery, National and Kapodistrian University of Athens Medical School Hippocration Hospital, Athens, Greece
| | - Fragiska Sigala
- First Department of Propedeutic Surgery, National and Kapodistrian University of Athens Medical School Hippocration Hospital, Athens, Greece
| | - Konstantinos Filis
- First Department of Propedeutic Surgery, National and Kapodistrian University of Athens Medical School Hippocration Hospital, Athens, Greece
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Galyfos G, Sigala F, Filis K. Re: "Editor's Choice - Cerebral Hyperperfusion Syndrome after Carotid Artery Stenting: A Systematic Review and Meta-analysis". Eur J Vasc Endovasc Surg 2019; 57:892. [PMID: 30782502 DOI: 10.1016/j.ejvs.2018.11.022] [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] [Received: 11/13/2018] [Accepted: 11/23/2018] [Indexed: 10/27/2022]
Affiliation(s)
- George Galyfos
- First Department of Propedeutic Surgery, National and Kapodistrian University of Athens Medical School, Hippocration Hospital, Athens, Greece.
| | - Fragiska Sigala
- First Department of Propedeutic Surgery, National and Kapodistrian University of Athens Medical School, Hippocration Hospital, Athens, Greece
| | - Konstantinos Filis
- First Department of Propedeutic Surgery, National and Kapodistrian University of Athens Medical School, Hippocration Hospital, Athens, Greece
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Sigala F, Galyfos G, Stavridis K, Tigkiropoulos K, Lazaridis I, Karamanos D, Mpontinis V, Melas N, Zournatzi I, Filis K, Saratzis N. Prognostic Factors in Patients Treated with Drug-Coated Balloon Angioplasty for Symptomatic Peripheral Artery Disease. Vasc Specialist Int 2019; 34:94-102. [PMID: 30671418 PMCID: PMC6340698 DOI: 10.5758/vsi.2018.34.4.94] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 09/13/2018] [Accepted: 09/23/2018] [Indexed: 11/20/2022] Open
Abstract
Purpose Aim of this study is to report real-life experience on the treatment of peripheral artery disease (PAD) with a specific drug-coated balloon (DCB), and to evaluate potential prognostic factors for outcomes. Materials and Methods This is a retrospective study reporting outcomes in patients with PAD who were treated with the Lutonix DCB during a four-year period. Major outcomes included: all-cause mortality, amputation, clinical improvement, wound healing and target lesion revascularization (TLR). Mean follow-up was 24.2±2.3 months. Results Overall, 149 patients (mean age: 68.6±8.3 years; 113 males) were treated, either for intermittent claudication (IC) (n=86) or critical limb ischemia (CLI) (n=63). More than half the target lesions (n=206 in total) were located in the superficial femoral artery and 18.0% were below-the-knee lesions. CLI patients presented more frequently with infrapopliteal (P=0.002) or multilevel disease (P=0.0004). Overall, all-cause mortality during follow-up was 10.7%, amputation-free survival was 81.2% and TLR-free survival was 96.6%. CLI patients showed higher all-cause mortality (P=0.007) and total amputation (P=0.0001) rates as well as lower clinical improvement (P=0.0002), compared to IC patients. Coronary artery disease (CAD), gangrene and infrapopliteal disease were found to be predictors for death whereas CLI and gangrene were found to be predictors for amputation, during follow-up. Conclusion PAD treatment with Lutonix DCBs seems to be an efficient and safe endovascular strategy yielding promising results. However, CAD, gangrene, CLI and infrapopliteal lesions were found to be independent predictors for adverse outcomes. Larger series are needed to identify additional prognostic factors.
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Affiliation(s)
- Fragiska Sigala
- First Department of Surgery, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece.,First Department of Propaedeutic Surgery, Ethnikon and Kapodistriakon University of Athens, Hippocration Hospital, Athens, Greece
| | - George Galyfos
- First Department of Propaedeutic Surgery, Ethnikon and Kapodistriakon University of Athens, Hippocration Hospital, Athens, Greece
| | - Kyriakos Stavridis
- First Department of Surgery, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Konstantinos Tigkiropoulos
- First Department of Surgery, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Ioannis Lazaridis
- First Department of Surgery, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Dimitrios Karamanos
- First Department of Surgery, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Vangelis Mpontinis
- First Department of Surgery, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Nikolaos Melas
- First Department of Surgery, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Ioulia Zournatzi
- First Department of Surgery, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Konstantinos Filis
- First Department of Propaedeutic Surgery, Ethnikon and Kapodistriakon University of Athens, Hippocration Hospital, Athens, Greece
| | - Nikolaos Saratzis
- First Department of Surgery, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
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Triantafyllou T, Theodoropoulos C, Georgiou G, Kalles V, Chrysikos D, Filis K, Zografos G, Theodorou D. Long-term outcome of myotomy and fundoplication based on intraoperative real-time high-resolution manometry in achalasia patients. Ann Gastroenterol 2018; 32:46-51. [PMID: 30598591 PMCID: PMC6302195 DOI: 10.20524/aog.2018.0326] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 10/16/2018] [Indexed: 12/29/2022] Open
Abstract
Background Current treatment options for achalasia of the esophagus predominantly consist of endoscopic myotomy or laparoscopic myotomy combined with a partial fundoplication. The intraoperative use of conventional manometry has previously been proposed with various results. The aim of the present study was to introduce the use of high-resolution manometry (HRM) during surgical treatment for achalasia and to assess the long-term outcome of this technique. Methods We enrolled achalasia patients within the time period November 2013 to July 2016 who underwent HRM and evaluation of Eckardt scores (ES) before and after tailored laparoscopic myotomy and fundoplication with intraoperative recording using HRM. Results Twenty patients were classified as having achalasia type I (20%), type II (55%), or type III (25%). During surgery, 9 myotomies were extended and 13 fundoplications were modified according to HRM findings. Mean resting (16.1 vs. 41.9 mmHg) and residual (9 vs. 28.7 mmHg) pressures of the lower esophageal sphincter and ES (0.7 vs. 6.9) were significantly eliminated postoperatively over a mean follow-up time of 17.7 months. Conclusions The use of intraoperative HRM gives us the advantage of simultaneous real-time estimation of intraluminal pressures of the esophagus and the ability to identify the exact points that produce pressure during laparoscopy. Consequently, it may be the key to the tailoring of the Heller-Dor technique and improving the outcomes for achalasia patients.
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Affiliation(s)
- Tania Triantafyllou
- Department of Surgery, 1 Propaedeutic Surgical Clinic, Hippocration General Hospital of Athens, University of Athens (Tania Triantafyllou, Charalampos Theodoropoulos, Georgia Georgiou, Vasileios Kalles, Konstantinos Filis, Georgios Zografos, Dimitrios Theodorou)
| | - Charalampos Theodoropoulos
- Department of Surgery, 1 Propaedeutic Surgical Clinic, Hippocration General Hospital of Athens, University of Athens (Tania Triantafyllou, Charalampos Theodoropoulos, Georgia Georgiou, Vasileios Kalles, Konstantinos Filis, Georgios Zografos, Dimitrios Theodorou)
| | - Georgia Georgiou
- Department of Surgery, 1 Propaedeutic Surgical Clinic, Hippocration General Hospital of Athens, University of Athens (Tania Triantafyllou, Charalampos Theodoropoulos, Georgia Georgiou, Vasileios Kalles, Konstantinos Filis, Georgios Zografos, Dimitrios Theodorou)
| | - Vasileios Kalles
- Department of Surgery, 1 Propaedeutic Surgical Clinic, Hippocration General Hospital of Athens, University of Athens (Tania Triantafyllou, Charalampos Theodoropoulos, Georgia Georgiou, Vasileios Kalles, Konstantinos Filis, Georgios Zografos, Dimitrios Theodorou)
| | - Demosthenis Chrysikos
- General and Oncologic Hospital of Kifissia "Agii Anargiri" (Demosthenis Chrysikos), Athens, Greece
| | - Konstantinos Filis
- Department of Surgery, 1 Propaedeutic Surgical Clinic, Hippocration General Hospital of Athens, University of Athens (Tania Triantafyllou, Charalampos Theodoropoulos, Georgia Georgiou, Vasileios Kalles, Konstantinos Filis, Georgios Zografos, Dimitrios Theodorou)
| | - Georgios Zografos
- Department of Surgery, 1 Propaedeutic Surgical Clinic, Hippocration General Hospital of Athens, University of Athens (Tania Triantafyllou, Charalampos Theodoropoulos, Georgia Georgiou, Vasileios Kalles, Konstantinos Filis, Georgios Zografos, Dimitrios Theodorou)
| | - Dimitrios Theodorou
- Department of Surgery, 1 Propaedeutic Surgical Clinic, Hippocration General Hospital of Athens, University of Athens (Tania Triantafyllou, Charalampos Theodoropoulos, Georgia Georgiou, Vasileios Kalles, Konstantinos Filis, Georgios Zografos, Dimitrios Theodorou)
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Galyfos G, Sigala F, Filis K. Regarding "The effect of preoperative cognitive impairment and type of vascular surgery procedure on postoperative delirium with associated cost implications". J Vasc Surg 2018; 68:1615-1616. [PMID: 30360851 DOI: 10.1016/j.jvs.2018.07.032] [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] [Received: 06/25/2018] [Accepted: 07/02/2018] [Indexed: 11/26/2022]
Affiliation(s)
- George Galyfos
- First Department of Propaedeutic Surgery, University of Athens Medical School, Hippocration Hospital, Athens, Greece
| | - Fragiska Sigala
- First Department of Propaedeutic Surgery, University of Athens Medical School, Hippocration Hospital, Athens, Greece
| | - Konstantinos Filis
- First Department of Propaedeutic Surgery, University of Athens Medical School, Hippocration Hospital, Athens, Greece
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Galyfos G, Filis K. Letter by Galyfos and Filis Regarding Article, "Perioperative Myocardial Injury After Noncardiac Surgery: Incidence, Mortality, and Characterization". Circulation 2018; 138:1072-1073. [PMID: 30354539 DOI: 10.1161/circulationaha.117.033417] [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] [Indexed: 11/16/2022]
Affiliation(s)
- George Galyfos
- Vascular Division, First Department of Propaedeutic Surgery, Hippocration Hospital, Athens, Greece
| | - Konstantinos Filis
- Vascular Division, First Department of Propaedeutic Surgery, Hippocration Hospital, Athens, Greece
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Terentes-Printzios D, Koutagiar I, Vlachopoulos C, Skoumas I, Rigatou A, Miliou A, Skliros NP, Pantou S, Filis K, Tousoulis D. P626Relationship of PCSK9 levels with indices of vascular function and subclinical atherosclerosis in patients with familial dyslipidaemias. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p626] [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] [Indexed: 11/14/2022] Open
Affiliation(s)
- D Terentes-Printzios
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - I Koutagiar
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | | | - I Skoumas
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - A Rigatou
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - A Miliou
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - N P Skliros
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - S Pantou
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - K Filis
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
| | - D Tousoulis
- Hippokration Hospital, University of Athens, 1st Department of Cardiology, Athens, Greece
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Triantafyllou T, Theodoropoulos C, Mantides A, Chrysikos D, Smparounis S, Filis K, Zografos G, Theodorou D. Can the upper esophageal sphincter contractile integral help classify achalasia? Ann Gastroenterol 2018; 31:456-461. [PMID: 29991890 PMCID: PMC6033759 DOI: 10.20524/aog.2018.0270] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 04/02/2018] [Indexed: 11/17/2022] Open
Abstract
Background: The use of high-resolution manometry (HRM) in achalasia patients has revealed abnormal findings concerning upper esophageal sphincter (UES) function. The introduction of the UES contractile integral (UES-CI), as with the distal contractile integral (DCI), may complement the interpretation of the manometric study of achalasia subtypes, defined by the Chicago Classification v3.0. Methods: Patients were classified into achalasia subtypes based on HRM. UES length (cm), UES resting pressure (mmHg), and UES residual pressure (mmHg) were recorded. UES-CI (mmHg·sec·cm) was calculated in a manner similar to that used for the DCI measurement at rest (landmark CI), corrected for respiration, and its relation to achalasia subtypes was evaluated. Results: Twenty-four achalasia patients with mean age 55.29 years were included. Of these, 16.6% (n=4) were diagnosed with achalasia type I, 58.3% (n=14) with type II, and 25% (n=6) with type III. The landmark UES-CI, mean UES-CI, UES-CI corrected for respiration, and UES resting pressure were found to be significantly higher among patients with achalasia type II compared to the other types (1768.9 vs. 677.1, P=0.03; 1827.1 vs. 3555.1, P=0.036; 174.2 vs. 72.8, P=0.027; and 108.1 vs. 55.8, P=0.009, respectively). Conclusions: We introduce the CI index as a tool for the manometric evaluation of the UES in achalasia. UES resting pressure, landmark UES-CI and mean UES-CI were significantly higher in achalasia patients with panesophageal pressurization compared to types I and III. This finding may reflect a protective reaction against the risk of aspiration in this group, but further studying and clinical correlation is required.
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Affiliation(s)
- Tania Triantafyllou
- Foregut Surgery Department, 1st Propaedeutic Surgical Clinic, Hippocration General Hospital Athens (Tania Triantafyllou, Charalampos Theodoropoulos, Demosthenis Chrysikos, Spyridon Smparounis, Konstantinos Filis, Georgios Zografos, Dimitrios Theodorou)
| | - Charalampos Theodoropoulos
- Foregut Surgery Department, 1st Propaedeutic Surgical Clinic, Hippocration General Hospital Athens (Tania Triantafyllou, Charalampos Theodoropoulos, Demosthenis Chrysikos, Spyridon Smparounis, Konstantinos Filis, Georgios Zografos, Dimitrios Theodorou)
| | | | - Demosthenis Chrysikos
- Foregut Surgery Department, 1st Propaedeutic Surgical Clinic, Hippocration General Hospital Athens (Tania Triantafyllou, Charalampos Theodoropoulos, Demosthenis Chrysikos, Spyridon Smparounis, Konstantinos Filis, Georgios Zografos, Dimitrios Theodorou)
| | - Spyridon Smparounis
- Foregut Surgery Department, 1st Propaedeutic Surgical Clinic, Hippocration General Hospital Athens (Tania Triantafyllou, Charalampos Theodoropoulos, Demosthenis Chrysikos, Spyridon Smparounis, Konstantinos Filis, Georgios Zografos, Dimitrios Theodorou)
| | - Konstantinos Filis
- Foregut Surgery Department, 1st Propaedeutic Surgical Clinic, Hippocration General Hospital Athens (Tania Triantafyllou, Charalampos Theodoropoulos, Demosthenis Chrysikos, Spyridon Smparounis, Konstantinos Filis, Georgios Zografos, Dimitrios Theodorou)
| | - Georgios Zografos
- Foregut Surgery Department, 1st Propaedeutic Surgical Clinic, Hippocration General Hospital Athens (Tania Triantafyllou, Charalampos Theodoropoulos, Demosthenis Chrysikos, Spyridon Smparounis, Konstantinos Filis, Georgios Zografos, Dimitrios Theodorou)
| | - Dimitrios Theodorou
- Foregut Surgery Department, 1st Propaedeutic Surgical Clinic, Hippocration General Hospital Athens (Tania Triantafyllou, Charalampos Theodoropoulos, Demosthenis Chrysikos, Spyridon Smparounis, Konstantinos Filis, Georgios Zografos, Dimitrios Theodorou)
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Filis K, Tsioufis C, Sianou A, Triantafillou K, Sigala F, Galyfos G. Critical evaluation on proper antithrombotic treatment in different groups of patients undergoing vascular surgery. Hellenic J Cardiol 2018; 59:313-316. [PMID: 29723662 DOI: 10.1016/j.hjc.2018.04.006] [Citation(s) in RCA: 8] [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: 02/25/2018] [Revised: 04/21/2018] [Accepted: 04/24/2018] [Indexed: 12/14/2022] Open
Abstract
Antithrombotic treatment including anticoagulants and antiplatelets has evolved during the last decades, and several recommendations have been included in the latest guidelines regarding the proper management of patients undergoing vascular surgery. However, there are significant differences compared to older recommendations, and indications vary among patients with peripheral artery disease, carotid disease, and abdominal aortic aneurysm. In this mini review, we critically evaluate all these data to produce useful conclusions for everyday clinical practice.
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Affiliation(s)
- Konstantinos Filis
- First Department of Propedeutic Surgery, Hippocration Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Costas Tsioufis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Argyri Sianou
- Department of Microbiology, Areteion Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | | | - Fragiska Sigala
- First Department of Propedeutic Surgery, Hippocration Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - George Galyfos
- First Department of Propedeutic Surgery, Hippocration Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
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Galyfos G, Filis K. Regarding "Prediction of major cardiac events after vascular surgery". J Vasc Surg 2018; 67:1640. [PMID: 29685263 DOI: 10.1016/j.jvs.2018.01.024] [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] [Received: 01/06/2018] [Accepted: 01/22/2018] [Indexed: 11/28/2022]
Affiliation(s)
- George Galyfos
- Vascular Unit, First Department of Propedeutic Surgery, University of Athens Medical School, Ippokration Hospital, Athens, Greece
| | - Konstantinos Filis
- Vascular Unit, First Department of Propedeutic Surgery, University of Athens Medical School, Ippokration Hospital, Athens, Greece
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Tsioufis C, Andrikou I, Siasos G, Filis K, Tousoulis D. Anti-hypertensive treatment in peripheral artery disease. Curr Opin Pharmacol 2018; 39:35-42. [DOI: 10.1016/j.coph.2018.01.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 01/22/2018] [Accepted: 01/31/2018] [Indexed: 12/30/2022]
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Tigkiropoulos K, Sigala F, Tsilimigras DI, Moris D, Filis K, Melas N, Karamanos D, Kontogiannis C, Lazaridis I, Saratzis N. Endovascular Repair of Blunt Thoracic Aortic Trauma: Is Postimplant Hypertension an Incidental Finding? Ann Vasc Surg 2018. [PMID: 29524462 DOI: 10.1016/j.avsg.2018.01.100] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Blunt thoracic aortic injury (BTAI) is the second most common cause of death in trauma patients. Nowadays, thoracic endovascular aortic repair (TEVAR) has become the treatment of choice because of lower rates of mortality, paraplegia, and stroke. However, concerns have been raised whether graft implantation is related to the development of hypertension in the postoperative period. The aim of this study was to report short- and long-term outcomes of patients undergoing TEVAR for BTAIs at a tertiary hospital and to investigate postimplant hypertension. METHODS Between January 2005 and January 2016, 23 patients with blunt thoracic aortic trauma underwent TEVAR. Median age was 44 years (range, 18-73). Among them, 14 (60.9%) patients were diagnosed with aortic rupture, whereas 9 (39.1%) with pseudoaneurysm. Α single thoracic stent graft was deployed in 21 patients, and the rest 2 patients received 2 stent grafts. RESULTS Complete exclusion of the injury was feasible in all subjects (100% primary success). The left subclavian artery (SCA) was intentionally covered in 6 patients (26%). Intraoperative complications included one nonfatal stroke managed conservatively and one external iliac artery rupture treated with iliofemoral bypass. One patient (4.3%) died on the first postoperative day in the intensive care unit (ICU) because of hemorrhagic shock. The overall 30-day mortality and morbidity were 4.3% and 8.7%, respectively. New-onset postimplantation arterial hypertension was observed in 8 (34.8%) previously nonhypertensive patients. Younger age (P = 0.027) and SCA coverage (P = 0.01) were identified as potential risk factors for the development of postimplant hypertension, whereas the presence of concomitant injuries (P = 0.3) and intraoperative complications (P = 0.1) were not. After a median follow-up of 100 months (range, 18-120), 6 of them still remain on antihypertensive therapy, whereas the other 2 did not require permanent treatment. CONCLUSIONS TEVAR is a safe approach in the treatment of BTAI associated with low short- and long-term morbidity and mortality rates. Lower age and SCA coverage may contribute to the development of postimplant hypertension. Further larger cohort studies are warranted to elucidate the underlying mechanisms of postimplant hypertension.
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Affiliation(s)
- Konstantinos Tigkiropoulos
- 1st Department of Surgery, Aristotle University Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Fragiska Sigala
- 1st Department of Propaedeutic Surgery, Hippokration University Hospital, University of Athens Medical School, Athens, Greece
| | - Diamantis I Tsilimigras
- 1st Department of Propaedeutic Surgery, Hippokration University Hospital, University of Athens Medical School, Athens, Greece.
| | - Demetrios Moris
- Department of Surgery, Duke University Medical Center, Durham, NC, USA
| | - Konstantinos Filis
- 1st Department of Propaedeutic Surgery, Hippokration University Hospital, University of Athens Medical School, Athens, Greece
| | - Nikolaos Melas
- 1st Department of Surgery, Aristotle University Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Dimitrios Karamanos
- 1st Department of Surgery, Aristotle University Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Christos Kontogiannis
- 1st Department of Propaedeutic Surgery, Hippokration University Hospital, University of Athens Medical School, Athens, Greece
| | - Ioannis Lazaridis
- 1st Department of Surgery, Aristotle University Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Nikolaos Saratzis
- 1st Department of Surgery, Aristotle University Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
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Galyfos G, Filis K. Letter by Galyfos and Filis Regarding Article, "Effect of Obesity and Underweight Status on Perioperative Outcomes of Congenital Heart Operations in Children, Adolescents, and Young Adults: An Analysis of Data From the Society of Thoracic Surgeons Database". Circulation 2018; 137:757-758. [PMID: 29440204 DOI: 10.1161/circulationaha.117.031289] [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] [Indexed: 11/16/2022]
Affiliation(s)
- George Galyfos
- Vascular Division, First Department of Propaedeutic Surgery, Hippocration Hospital, Athens, Greece
| | - Konstantinos Filis
- Vascular Division, First Department of Propaedeutic Surgery, Hippocration Hospital, Athens, Greece
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Lagoudianakis E, Pappas A, Koronakis N, Tsekouras D, Dallianoudis J, Kontogianni P, Papanikolaou D, Chrysikos J, Karavitis G, Markogiannakis H, Filis K, Manouras A. Lymph Node Harvesting in Colorectal Carcinoma Specimens. Tumori 2018; 97:74-8. [DOI: 10.1177/030089161109700114] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Introduction Adequate lymph node evaluation is an important determinant of prognosis in patients with colorectal cancer. Current guidelines recommend evaluation of at least 12 lymph nodes; however, a significant number of patients fail to meet these criteria. Aim To investigate the factors that influence adequate recovery and evaluation of lymph nodes in colorectal cancer Methods We retrospectively analyzed 454 consecutive cases of colorectal cancer surgically treated from September 2000 to September 2006. Univariate and multivariate linear and logistic regression analysis was used to study the effect of various factors in lymph node recovery. Results The number of lymph nodes retrieved ranged from 0 to 62 with a median of 13 nodes. Overall, 189 (41.6%) patients had fewer than 12 nodes removed. Patient age, tumor stage, location and size were associated with lymph node retrieval. Multivariable regression revealed that the aforementioned variables, including gender and hospital type, explained 17% of the observed variance of the lymph node number. Conclusion Patient and tumor characteristics, although important, are only partly responsible for the variation of lymph node yield. Quality of surgical resection and/or the thoroughness of examination of the tissue by the pathologist might explain the wider proportion of this variance. Training in colorectal node evaluation could help to improve the quality of cancer care. Free full text available at www.tumorionline.it
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Affiliation(s)
- Emmanuel Lagoudianakis
- Second Department of Surgery, 417 NIMTS (Military Veterans' Fund Hospital), Athens, Greece
| | - Apostolos Pappas
- First Department of Propaedeutic Surgery, Hippokrateion Hospital, Athens Medical School, University of Athens, Athens, Greece
| | - Nikolaos Koronakis
- Second Department of Surgery, 417 NIMTS (Military Veterans' Fund Hospital), Athens, Greece
| | - Dimitrios Tsekouras
- First Department of Propaedeutic Surgery, Hippokrateion Hospital, Athens Medical School, University of Athens, Athens, Greece
| | - John Dallianoudis
- Second Department of Surgery, 417 NIMTS (Military Veterans' Fund Hospital), Athens, Greece
| | - Panagiota Kontogianni
- First Department of Propaedeutic Surgery, Hippokrateion Hospital, Athens Medical School, University of Athens, Athens, Greece
| | - Dimitrios Papanikolaou
- First Department of Propaedeutic Surgery, Hippokrateion Hospital, Athens Medical School, University of Athens, Athens, Greece
| | - John Chrysikos
- Second Department of Surgery, 417 NIMTS (Military Veterans' Fund Hospital), Athens, Greece
| | - George Karavitis
- Second Department of Surgery, 417 NIMTS (Military Veterans' Fund Hospital), Athens, Greece
| | - Haridimos Markogiannakis
- First Department of Propaedeutic Surgery, Hippokrateion Hospital, Athens Medical School, University of Athens, Athens, Greece
| | - Konstantinos Filis
- First Department of Propaedeutic Surgery, Hippokrateion Hospital, Athens Medical School, University of Athens, Athens, Greece
| | - Andreas Manouras
- First Department of Propaedeutic Surgery, Hippokrateion Hospital, Athens Medical School, University of Athens, Athens, Greece
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Sigala E, Terentes-Printzios D, Vlachopoulos C, Triantafillou K, Koumallos N, Katsaros A, Lozos V, Kouerinis I, Giakis N, Demosthenous M, Filis K, Tousoulis D. P152 THE EFFECT OF SURGICAL AORTIC VALVE REPLACEMENT ON AORTIC STIFFNESS AND THE PROGNOSTIC ROLE OF AORTIC STIFFNESS ON SURGICAL SUCCESS. Artery Res 2018. [DOI: 10.1016/j.artres.2018.10.205] [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: 10/27/2022] Open
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Galyfos G, Sigala F, Filis K. Transradial versus Transfemoral access in patients undergoing peripheral artery angioplasty/stenting: A meta-analysis. Cardiovasc Revasc Med 2017; 19:457-465. [PMID: 29126947 DOI: 10.1016/j.carrev.2017.09.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 08/13/2017] [Revised: 09/24/2017] [Accepted: 09/27/2017] [Indexed: 10/18/2022]
Abstract
Transradial (TR) access has been extensively compared to transfemoral (TF) access in patients undergoing percutaneous coronary interventions, with TR method showing a clear benefit over the latter. However, comparative data concerning peripheral artery endovascular interventions has been limited in the literature. Therefore, a systematic review was conducted in order to compare main outcomes between TR and TF access in patients undergoing peripheral artery angioplasty and/or stenting. Main outcomes included technical success, major/minor bleeding risk, access site complications, hospital stay, death, myocardial infarction, neurological events and other procedural parameters. TR and TF access methods seem to be associated with similar early outcomes in patients undergoing non-coronary endovascular angioplasty and/or stenting although paucity of data necessitates the conduction of better designed studies.
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Affiliation(s)
- George Galyfos
- First Department of Propaedeutic Surgery, University of Athens Medical School, Hippocration Hospital, Athens, Greece.
| | - Fragiska Sigala
- First Department of Propaedeutic Surgery, University of Athens Medical School, Hippocration Hospital, Athens, Greece
| | - Konstantinos Filis
- First Department of Propaedeutic Surgery, University of Athens Medical School, Hippocration Hospital, Athens, Greece
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Filis K, Zarmakoupis C, Karantzikos G, Sigala F, Bazigos G, Galyfos G. Late Sac Rupture due to a Type IV Endoleak after Previous Endovascular Aortic Aneurysm Repair: A Case Report. Front Surg 2017; 4:45. [PMID: 28848736 PMCID: PMC5554120 DOI: 10.3389/fsurg.2017.00045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 07/26/2017] [Indexed: 11/13/2022] Open
Abstract
Type IV endoleaks have been identified as endoleaks of low flow, and rupture risk has been estimated to be minimal in literature. Therefore, conservative treatment has been recommended in most cases. We are presenting a rare case of late rupture due to type IV endoleak that was treated with open repair applying a novel surgical technique.
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Affiliation(s)
- Konstantinos Filis
- First Department of Propaedeutic Surgery, University of Athens Medical School, Hippocration Hospital, Athens, Greece
| | - Constantinos Zarmakoupis
- First Department of Propaedeutic Surgery, University of Athens Medical School, Hippocration Hospital, Athens, Greece
| | - Georgios Karantzikos
- First Department of Propaedeutic Surgery, University of Athens Medical School, Hippocration Hospital, Athens, Greece
| | - Frangiska Sigala
- First Department of Propaedeutic Surgery, University of Athens Medical School, Hippocration Hospital, Athens, Greece
| | - Gerasimos Bazigos
- First Department of Propaedeutic Surgery, University of Athens Medical School, Hippocration Hospital, Athens, Greece
| | - George Galyfos
- First Department of Propaedeutic Surgery, University of Athens Medical School, Hippocration Hospital, Athens, Greece
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Galyfos G, Sianou A, Filis K. Cerebral hyperperfusion syndrome and intracranial hemorrhage after carotid endarterectomy or carotid stenting: A meta-analysis. J Neurol Sci 2017; 381:74-82. [PMID: 28991720 DOI: 10.1016/j.jns.2017.08.020] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 08/03/2017] [Accepted: 08/15/2017] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Cerebral hyperperfusion syndrome (CHS) and intracranial hemorrhage (ICH) after carotid revascularization have been associated with significant morbidity and mortality, although pooled data comparing these outcomes between open and endovascular treatment are lacking. Aim of this meta-analysis is to compare CHS and ICH risk between carotid endarterectomy (CEA) and carotid angioplasty with stenting (CAS). METHODS A systematic literature review was conducted conforming to established criteria, in order to identify eligible articles published prior to February 2017. Eligible studies compared CHS and/or ICH between patients undergoing CEA and CAS. Other outcomes evaluated in this review included stroke and death due to ICH. Outcome risks are presented as odds ratios (OR) and 95% confidence intervals (CI). RESULTS Overall, 6 studies (5 studies reporting on CHS and 4 studies reporting on ICH) included 236,537 procedures (218,144 CEA; 18,393 CAS) in total. CEA was associated with a higher risk for CHS compared to CAS (pooled OR=1.432 [95% CI=1.078-1901]; P=0.015), although this difference was generated mainly from older studies (prior to 2012). However, no difference was found regarding ICH risk between the two methods (pooled OR=0.544 [95% CI=0.111-2.658]; P=0.452). Regarding stroke incidence, no difference was found between the two methods as well, although this resulted mainly from studies with a higher volume of CAS procedures (pooled OR=0.964 [95% CI=0.741-1.252]; P=0.833). Finally, death rate was significantly higher among patients with ICH compared to patients without ICH (pooled OR=386.977 [95% CI=246.746-606.906]; P<0.0001). Pooled data were not adequate to calculate potential risk factors for CHS/ICH after CEA compared to CAS. CONCLUSIONS CEA seems to be associated with a higher risk for CHS compared to CAS, although this difference was generated mainly from older studies. However, there seems to be no difference regarding ICH risk between the two methods, with ICH being associated with a significantly higher risk for death.
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Affiliation(s)
- George Galyfos
- First Department of Propaedeutic Surgery, University of Athens Medical School, Hippocration Hospital, Athens, Greece.
| | - Argiri Sianou
- Department of Microbiology, University of Athens Medical School, Areteion Hospital, Athens, Greece
| | - Konstantinos Filis
- First Department of Propaedeutic Surgery, University of Athens Medical School, Hippocration Hospital, Athens, Greece
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Galyfos GC, Geropapas GE, Sianou A, Sigala F, Filis K. Risk factors for postoperative delirium in patients undergoing vascular surgery. J Vasc Surg 2017; 66:937-946. [PMID: 28583731 DOI: 10.1016/j.jvs.2017.03.439] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 03/22/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Postoperative delirium (PODE) remains a common complication after vascular surgery procedures although the exact pathogenesis remains unclear, mainly because of its multifactorial character. The aim of this systematic review was to evaluate pooled data on potential risk factors for PODE in patients undergoing vascular surgery procedures. METHODS A systematic literature review was conducted conforming to established criteria to identify eligible articles published from 1990 to 2016. Eligible studies evaluated potential risk factors for PODE after vascular surgery procedures, using both univariate and multivariate analysis. PODE was defined as a disturbance of consciousness with reduced ability to focus, sustain, or shift attention after vascular surgery procedures and was diagnosed in all studies using well-established criteria. Only risk factors reported in at least four studies were included in this review. Pooled results were calculated, and further multivariate regression analysis was conducted. RESULTS Overall, nine studies (published from 2003 to 2015) including 2388 patients in total were evaluated (457 with and 1931 without PODE). Patients with PODE were older (73.27 vs 69.87 years; P < .0001) and showed a higher male sex rate (78.1% vs 73.5%; P = .043). Open aortic surgery was the most frequent procedure in this analysis, followed by lower limb revascularization. Patients with PODE also showed higher rates of diabetes mellitus, hypertension, cardiac disease, and neurologic disease; lower hemoglobin level; larger duration of surgery; longer hospital and intensive care unit stay; and higher blood loss. Mean age (odds ratio [OR], 3.44; 95% confidence interval [CI], 2.933-4.034; P < .0001), hypertension (OR, 1.94; 95% CI, 1.469-2.554; P < .0001), cardiac disease (OR, 3.16; 95% CI, 2.324-4.284; P < .0001), open aortic surgery (OR, 1.74; 95% CI, 1.421-2.143; P < .0001), blood loss (OR, 1.01; 95% CI, 1.007-1.010; P < .0001), hospital stay (OR, 2.26; 95% CI, 1.953-2.614; P <. 0001), and intensive care unit stay (OR, 6.12; 95% CI, 4.699-7.957; P < .0001) were identified as the strongest risk predictors for PODE, followed by male sex, diabetes mellitus, neurologic disease, and history of smoking. However, body mass index, renal failure, preoperative hemoglobin level, and general anesthesia were not found to be risk factors for PODE in such patients. CONCLUSIONS This study has confirmed that PODE after vascular surgery procedures is a multifactorial disease, and several independent risk factors have been identified. However, pooled data regarding the effect of PODE on primary outcomes after vascular surgery procedures are still lacking. The results of this review could contribute to the designation of future prediction models and improve prevention of PODE in these patients.
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Affiliation(s)
- George C Galyfos
- First Department of Propaedeutic Surgery, University of Athens Medical School, Hippocration Hospital, Athens, Greece; Department of Vascular Surgery, "KAT" General Hospital, Athens, Greece.
| | | | - Argiri Sianou
- Department of Microbiology, University of Athens Medical School, Areteion Hospital, Athens, Greece
| | - Fragiska Sigala
- First Department of Propaedeutic Surgery, University of Athens Medical School, Hippocration Hospital, Athens, Greece
| | - Konstantinos Filis
- First Department of Propaedeutic Surgery, University of Athens Medical School, Hippocration Hospital, Athens, Greece
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Galyfos G, Sigala F, Filis K. Regarding "A short time interval between the neurologic index event and carotid endarterectomy is not a risk factor for carotid surgery". J Vasc Surg 2017; 65:1869. [PMID: 28527938 DOI: 10.1016/j.jvs.2016.12.135] [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] [Received: 11/20/2016] [Accepted: 12/06/2016] [Indexed: 10/19/2022]
Affiliation(s)
- George Galyfos
- Vascular Unit, First Department of Propedeutic Surgery, University of Athens Medical School, Ippokration Hospital, Athens, Greece
| | - Fragiska Sigala
- Vascular Unit, First Department of Propedeutic Surgery, University of Athens Medical School, Ippokration Hospital, Athens, Greece
| | - Konstantinos Filis
- Vascular Unit, First Department of Propedeutic Surgery, University of Athens Medical School, Ippokration Hospital, Athens, Greece
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Filis K, Galyfos G. Regarding "Outcomes for symptomatic abdominal aortic aneurysms in the American College of Surgeons National Surgical Quality Improvement Program". J Vasc Surg 2017; 65:1548-1549. [PMID: 28434603 DOI: 10.1016/j.jvs.2016.11.051] [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] [Received: 11/13/2016] [Accepted: 11/17/2016] [Indexed: 10/19/2022]
Affiliation(s)
- Konstantinos Filis
- Vascular Unit, First Department of Propedeutic Surgery, University of Athens Medical School, Ippokration Hospital, Athens, Greece
| | - George Galyfos
- Vascular Unit, First Department of Propedeutic Surgery, University of Athens Medical School, Ippokration Hospital, Athens, Greece
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Karanikola E, Karaolanis G, Galyfos G, Barbaressos E, Palla V, Filis K. Endovascular Management of Atherosclerotic Renal Artery Stenosis: Post-Cardiovascular Outcomes in Renal Atherosclerotic Lesions Era Winner or False Alarm? Vasc Specialist Int 2017; 33:1-15. [PMID: 28377906 PMCID: PMC5374954 DOI: 10.5758/vsi.2017.33.1.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 01/10/2017] [Accepted: 01/10/2017] [Indexed: 12/25/2022] Open
Abstract
Renal artery stenosis (RAS) is frequently associated with severe comorbidities such as reduced renal perfusion, hypertension, and end-stage renal failure. In approximately 90% of patients, renal artery atherosclerosis is the main cause for RAS, and it is associated with an increased risk for fatal and non-fatal cardiovascular and renal complications. Endovascular management of atherosclerotic RAS (ARAS) has been recently evaluated by several randomized controlled trials that failed to demonstrate benefit of stenting. Furthermore, the Cardiovascular Outcomes in Renal Atherosclerotic Lesions study did not demonstrate any benefit over the revascularization approach. In this review, we summarized the available data from retrospective, prospective and randomized trials on ARAS to provide clinicians with sufficient data in order to produce useful conclusions for everyday clinical practice.
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Affiliation(s)
- Evridiki Karanikola
- Division of Vascular Surgery, 1st Department of Propaedeutic Surgery, University of Athens Medical School, Hippocration General Hospital, Athens, Greece
| | - Georgios Karaolanis
- Vascular Surgery Unit, 1st Department of Surgery, University of Athens Medical School, Laikon General Hospital, Athens, Greece
| | - George Galyfos
- Division of Vascular Surgery, 1st Department of Propaedeutic Surgery, University of Athens Medical School, Hippocration General Hospital, Athens, Greece
| | - Emmanuel Barbaressos
- Division of Vascular Surgery, 1st Department of Propaedeutic Surgery, University of Athens Medical School, Hippocration General Hospital, Athens, Greece
| | - Viktoria Palla
- Vascular Surgery Unit, 1st Department of Surgery, University of Athens Medical School, Laikon General Hospital, Athens, Greece
| | - Konstantinos Filis
- Division of Vascular Surgery, 1st Department of Propaedeutic Surgery, University of Athens Medical School, Hippocration General Hospital, Athens, Greece
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Abstract
Statins belong to a specific group of drugs that have been described for their ability to control hyperlipidemia as well as for other pleiotropic effects such as improving vascular endothelial function, inhibition of oxidative stress pathways, and anti-inflammatory actions. Accumulating clinical evidence strongly suggests that statins also have a beneficial effect on perioperative morbidity and mortality. Therefore, this review aims to present all recent and pooled data on statin treatment in the perioperative setting as well as to highlight considerations regarding their indications and therapeutic application.
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Affiliation(s)
- George Galyfos
- Department of Propaedeutic Surgery, Division of Vascular Surgery, University of Athens Medical School, Hippocration Hospital, Athens, Greece
| | - Argyri Sianou
- Department of Microbiology, University of Athens Medical School, Areteion Hospital, Athens, Greece
| | - Konstantinos Filis
- Department of Propaedeutic Surgery, Division of Vascular Surgery, University of Athens Medical School, Hippocration Hospital, Athens, Greece
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