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  1. Article ; Online: One-year duplex ultrasound-assessed closure outcomes of percutaneous endovenous microwave ablation for the treatment of varicose veins of the lower limbs.

    Karnabatidis, Dimitris / Papageorgiou, Christos / Kitrou, Panagiotis / Spiliopoulos, Stavros

    Vascular

    2022  Volume 31, Issue 5, Page(s) 1011–1016

    Abstract: Purpose: This study aims to investigate the safety and efficacy of a new device using microwave technology for the endovenous ablation of the great saphenous vein (GSV) causing symptomatic lower limb varicose veins (LLVV).: Materials and methods: ... ...

    Abstract Purpose: This study aims to investigate the safety and efficacy of a new device using microwave technology for the endovenous ablation of the great saphenous vein (GSV) causing symptomatic lower limb varicose veins (LLVV).
    Materials and methods: This prospective, single-arm, single-center, cohort study investigated the safety and effectiveness of endovenous microwave ablation for the treatment of symptomatic LLVV. Enrollment period was set between January and December 2020. Primary safety endpoint was the occurrence of procedure-related complications and primary efficacy endpoint was anatomical success defined as the duplex ultrasound (DUS)-proven GSV occlusion at 1 year follow-up. Secondary endpoints included 1-year clinical success (CEAP classification improvement), repeat procedures rate due to GSV recanalization, and pain assessment at 24 h post treatment.
    Results: In total, 50 patients (42 female; mean age: 62 ± 12 years) with 64 limbs were treated. No procedure-related complications were noted. Technical success was 95.3% (61/64 GSVs), as three cases of GSV recanalization were detected. Clinical success was 100%, as in all cases symptoms improvement by at least one grade according to CEAP classification, was achieved. Mean CEAP grade significantly improved from 3.3 ± 0.72 (median: 3) at baseline to 1.8 ± 0.85 (median: 2) at 1-year (
    Conclusions: Endovenous microwave ablation was safe and effective for the treatment of varicose veins, achieving high 1-year GSV occlusion rates.
    MeSH term(s) Humans ; Female ; Middle Aged ; Aged ; Cohort Studies ; Prospective Studies ; Microwaves/adverse effects ; Treatment Outcome ; Varicose Veins/diagnostic imaging ; Varicose Veins/surgery ; Lower Extremity ; Saphenous Vein/diagnostic imaging ; Saphenous Vein/surgery ; Laser Therapy/adverse effects ; Venous Insufficiency/diagnostic imaging ; Venous Insufficiency/surgery ; Venous Insufficiency/etiology
    Language English
    Publishing date 2022-05-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 2137151-9
    ISSN 1708-539X ; 1708-5381
    ISSN (online) 1708-539X
    ISSN 1708-5381
    DOI 10.1177/17085381221099115
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    Zs.A 4277: Show issues Location:
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  2. Article ; Online: Health-related quality of life in patients with solid tumors receiving implantable venous access ports for chemotherapy: A prospective randomized controlled trial.

    Chrisanthopoulou, Panagiota / Iconomou, Gregoris / Assimakopoulos, Konstantinos / Vlachopoulos, George / Makatsoris, Thomas / Koutras, Angelos / Karnabatidis, Dimitris / Katsanos, Konstantinos

    European journal of oncology nursing : the official journal of European Oncology Nursing Society

    2023  Volume 67, Page(s) 102445

    Abstract: Purpose: Implantable venous access ports are widely used in patients receiving chemotherapy, but there is still scarce evidence about any patient-reported outcome measures. This prospective randomized controlled trial examined the impact on patients' ... ...

    Abstract Purpose: Implantable venous access ports are widely used in patients receiving chemotherapy, but there is still scarce evidence about any patient-reported outcome measures. This prospective randomized controlled trial examined the impact on patients' quality-of-life following the placement of an implantable port device for long-term chemotherapy treatment.
    Method: A total of 120 chemotherapy naïve adult outpatients scheduled to receive chemotherapy (duration ≥12 weeks) for solid tissue tumors in a single academic oncology unit were randomly allocated (n = 60 in each arm) between radiologically guided insertion of an implantable venous access port (PORT arm) or standard repeated peripheral venous access (Control arm). Health-related quality-of-life scores (HRQoL) were assessed with the EQ-5D-5L and the oncology-specific EORTC QLQ-C30 (version 3.0) questionnaires at baseline, 3- and 6-months post randomization. Non-parametric tests were applied and differences between medians (Δ) are reported because of skewed-left HRQoL data.
    Results: Baseline clinical and demographic characteristics were well balanced between the two groups. There were no complications during insertion and no infection or device failure in the PORT subjects through the 6-month follow-up. The functional and symptom scales of the EORTC QLQ-C30 questionnaire were similar between both study arms at all time intervals. The EORTC QLQ-C30 global health status was significantly improved in the PORT subjects both at 3 months (Δ: 8.3 out of 100; P = 0.04) and 6 months follow-up (Δ: 16.7 out of 100; P = 0.003). Changes in EQ-5D-5L scores were significantly improved at 6 months in the PORT arm compared to control (Δ: 0.074 out of 1; P = 0.01).
    Conclusions: Implantable venous access ports may confer significantly improved patient-reported quality-of-life benefits in patients receiving chemotherapy for solid tissue tumors.
    MeSH term(s) Adult ; Humans ; Catheterization, Central Venous/adverse effects ; Quality of Life ; Prospective Studies ; Neoplasms/drug therapy ; Central Venous Catheters
    Language English
    Publishing date 2023-10-09
    Publishing country Scotland
    Document type Randomized Controlled Trial ; Journal Article
    ZDB-ID 2017117-1
    ISSN 1532-2122 ; 1462-3889
    ISSN (online) 1532-2122
    ISSN 1462-3889
    DOI 10.1016/j.ejon.2023.102445
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  3. Article ; Online: Management of Central Venous Stenoses and Occlusions.

    Kitrou, Panagiotis / Katsanos, Konstantinos / Karnabatidis, Dimitrios

    Cardiovascular and interventional radiology

    2023  Volume 46, Issue 9, Page(s) 1182–1191

    Abstract: Symptomatic central venous stenosis and occlusion remains the gordian knot of vascular access. Advances in techniques, like sharp recanalization, allowed for improved success rates in crossing these difficult lesions. There is also increasing evidence of ...

    Abstract Symptomatic central venous stenosis and occlusion remains the gordian knot of vascular access. Advances in techniques, like sharp recanalization, allowed for improved success rates in crossing these difficult lesions. There is also increasing evidence of new devices in treating central venous stenosis and, at the same time, improving the time needed between interventions. High-pressure balloons, paclitaxel-coated balloons, bare metal stents and covered stents have been tested with an aim to offer additional treatment options, although obstacles still exist. In the current review, authors describe relevant techniques and options, provide the evidence and evaluate the actual implementation of these devices in this demanding field.
    MeSH term(s) Humans ; Constriction, Pathologic/therapy ; Treatment Outcome ; Vascular Diseases ; Veins ; Stents ; Renal Dialysis ; Vascular Patency ; Angioplasty, Balloon ; Arteriovenous Shunt, Surgical
    Language English
    Publishing date 2023-07-17
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 603082-8
    ISSN 1432-086X ; 0342-7196 ; 0174-1551
    ISSN (online) 1432-086X
    ISSN 0342-7196 ; 0174-1551
    DOI 10.1007/s00270-023-03461-7
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    Zs.A 1378: Show issues Location:
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  4. Article ; Online: 2D perfusion DSA with an open-source, semi-automated, color-coded software for the quantification of foot perfusion following infrapopliteal angioplasty: a feasibility study.

    Kagadis, George C / Tsantis, Stavros / Gatos, Ilias / Spiliopoulos, Stavros / Katsanos, Konstantinos / Karnabatidis, Dimitris

    European radiology experimental

    2020  Volume 4, Issue 1, Page(s) 47

    Abstract: Background: Foot perfusion has been recently implemented as a new tool for optimizing outcomes of peripheral endovascular procedures. A custom-made, two-dimensional perfusion digital subtraction angiography (PDSA) algorithm has been implemented to ... ...

    Abstract Background: Foot perfusion has been recently implemented as a new tool for optimizing outcomes of peripheral endovascular procedures. A custom-made, two-dimensional perfusion digital subtraction angiography (PDSA) algorithm has been implemented to quantify outcomes of endovascular treatment of critical limb ischemia (CLI), assist intra-procedural decision-making, and enhance clinical outcomes.
    Methods: The study was approved by the Hospital's Ethics Committee. This prospective, single-center study included seven consecutive patients scheduled to undergo infrapopliteal endovascular treatment of CLI. Perfusion blood volume (PBV), mean transit time (MTT), and perfusion blood flow (PBF) maps were extracted by analyzing time-intensity curves and signal intensity on the perfused vessel mask. Mean values calculated from user-specified regions of interest (ROIs) on perfusion maps were employed to evaluate pre- and post-endovascular treatment condition. Measurements were performed immediately after final PDSA.
    Results: In total, five patients (aged 54 ± 16 years, mean ± standard deviation) were analyzed, as two patients were excluded due to significant motion artifacts. Post-procedural MTT presented a mean decrease of 19.1% for all patients and increased only in 1 of 5 patients, demonstrating in 4/5 patients an increase in tissue perfusion after revascularization. Overall mean PBF and PBV values were also analogously increased following revascularization (446% and 69.5% mean, respectively) and in the majority of selected ROIs (13/15 and 12/15 ROIs, respectively).
    Conclusions: Quantification of infrapopliteal angioplasty outcomes using this newly proposed, custom-made, intra-procedural PDSA algorithm was performed using PBV, MTT, and PBF maps. Further studies are required to determine its role in peripheral endovascular procedures ( ClinicalTrials.gov Identifier: NCT04356092).
    MeSH term(s) Algorithms ; Angiography, Digital Subtraction ; Blood Flow Velocity ; Endovascular Procedures/methods ; Feasibility Studies ; Female ; Foot/blood supply ; Humans ; Ischemia/diagnostic imaging ; Ischemia/surgery ; Male ; Middle Aged ; Peripheral Arterial Disease/diagnostic imaging ; Peripheral Arterial Disease/surgery ; Prospective Studies ; Radiographic Image Interpretation, Computer-Assisted ; Software
    Language English
    Publishing date 2020-09-02
    Publishing country England
    Document type Journal Article
    ISSN 2509-9280
    ISSN (online) 2509-9280
    DOI 10.1186/s41747-020-00176-z
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  5. Article ; Online: Debulking Atherectomy in the Peripheral Arteries: Is There a Role and What is the Evidence?

    Katsanos, Konstantinos / Spiliopoulos, Stavros / Reppas, Lazaros / Karnabatidis, Dimitris

    Cardiovascular and interventional radiology

    2017  Volume 40, Issue 7, Page(s) 964–977

    Abstract: Traditional percutaneous balloon angioplasty and stent placement is based on mechanical plaque disruption and displacement within the arterial wall. On the contrary, transcatheter atherectomy achieves atherosclerotic plaque clearance by means of ... ...

    Abstract Traditional percutaneous balloon angioplasty and stent placement is based on mechanical plaque disruption and displacement within the arterial wall. On the contrary, transcatheter atherectomy achieves atherosclerotic plaque clearance by means of directional plaque excision or rotational plaque removal or laser plaque ablation. Debulking atherectomy may allow for a more uniform angioplasty result at lower pressures with consequently less vessel barotrauma and improved luminal gain, thereby decreasing the risk of plaque recoil and dissection that may require permanent metal stenting. It has been also argued that atherectomy may disrupt the calcium barrier and optimize drug transfer and delivery in case of drug-coated balloon applications. The authors discuss the various types of atherectomy devices available in clinical practice to date and critically appraise their mode of action as well as relevant published data in each case. Overall, amassed randomized and observational evidence indicates that percutaneous atherectomy of the femoropopliteal and infrapopliteal arteries may achieve high technical success rates and seems to lessen the frequency of bailout stenting, however, at the expense of increased risk of peri-procedural distal embolization. Long-term clinical outcomes reported to date do not support the superiority of percutaneous atherectomy over traditional balloon angioplasty and stent placement in terms of vessel patency or limb salvage. The combination of debulking atherectomy and drug-coated balloons has shown promise in early studies, especially in the treatment of more complex lesions. Unanswered questions and future perspectives of this continuously evolving endovascular technology as part of a broader treatment algorithm are discussed.
    Language English
    Publishing date 2017-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 603082-8
    ISSN 1432-086X ; 0342-7196 ; 0174-1551
    ISSN (online) 1432-086X
    ISSN 0342-7196 ; 0174-1551
    DOI 10.1007/s00270-017-1649-6
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  6. Article ; Online: Response to "Re Risk of Major Amputation Following Application of Paclitaxel Coated Balloons in the Lower Limb Arteries: a Systematic Review and Meta-Analysis of Randomised Controlled Trials".

    Katsanos, Konstantinos / Spiliopoulos, Stavros / Karnabatidis, Dimitrios

    European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery

    2022  Volume 63, Issue 4, Page(s) 661–662

    Language English
    Publishing date 2022-02-02
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 1225869-6
    ISSN 1532-2165 ; 1078-5884
    ISSN (online) 1532-2165
    ISSN 1078-5884
    DOI 10.1016/j.ejvs.2022.01.016
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  7. Article ; Online: Can we improve dialysis arteriovenous graft survival?

    Karnabatidis, Dimitrios

    American journal of nephrology

    2015  Volume 41, Issue 4-5, Page(s) 418–419

    MeSH term(s) Arteriovenous Shunt, Surgical ; Blood Vessel Prosthesis ; Female ; Graft Occlusion, Vascular/diagnostic imaging ; Humans ; Kidney Failure, Chronic/therapy ; Male ; Neointima/diagnostic imaging ; Ultrasonography ; Vascular Calcification/diagnostic imaging
    Language English
    Publishing date 2015
    Publishing country Switzerland
    Document type Editorial ; Comment
    ZDB-ID 604540-6
    ISSN 1421-9670 ; 0250-8095
    ISSN (online) 1421-9670
    ISSN 0250-8095
    DOI 10.1159/000437153
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  8. Article ; Online: Cutting balloons, covered stents and paclitaxel-coated balloons for the treatment of dysfunctional dialysis access.

    Kitrou, Panagiotis / Spiliopoulos, Stavros / Karnabatidis, Dimitris / Katsanos, Konstantinos

    Expert review of medical devices

    2016  Volume 13, Issue 12, Page(s) 1119–1126

    Abstract: Introduction: Percutaneous transcatheter balloon angioplasty has evolved to the current mainstay treatment for salvage of dysfunctional dialysis access. Nonetheless, it is frequently associated with recurrent vessel restenosis and the need for multiple ... ...

    Abstract Introduction: Percutaneous transcatheter balloon angioplasty has evolved to the current mainstay treatment for salvage of dysfunctional dialysis access. Nonetheless, it is frequently associated with recurrent vessel restenosis and the need for multiple repeat treatments in order to maintain hemodynamic patency. Cutting-balloons, covered stents or stent-grafts, and paclitaxel-coated balloons have been extensively tested and investigated with the aim to improve immediate anatomical and long-term clinical results. Areas covered: In the present overview, we discuss the background and appraise relevant medical literature on the aforementioned technologies and provide a more in-depth synthesis of the results of different clinical studies for each device category. We will also discuss the limitations in the mode of action of each group of devices and envision what the future holds for the challenging field of dialysis access interventions. Expert commentary: We propose a good practice algorithm for the treatment of thrombosed or dysfunctional dialysis access.
    MeSH term(s) Angioplasty, Balloon ; Clinical Trials as Topic ; Coated Materials, Biocompatible/pharmacology ; Humans ; Paclitaxel/pharmacology ; Renal Dialysis ; Stents
    Chemical Substances Coated Materials, Biocompatible ; Paclitaxel (P88XT4IS4D)
    Language English
    Publishing date 2016-12
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2250857-0
    ISSN 1745-2422 ; 1743-4440
    ISSN (online) 1745-2422
    ISSN 1743-4440
    DOI 10.1080/17434440.2016.1254548
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    Zs.A 6424: Show issues Location:
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  9. Article ; Online: 2D perfusion DSA with an open-source, semi-automated, color-coded software for the quantification of foot perfusion following infrapopliteal angioplasty

    George C. Kagadis / Stavros Tsantis / Ilias Gatos / Stavros Spiliopoulos / Konstantinos Katsanos / Dimitris Karnabatidis

    European Radiology Experimental, Vol 4, Iss 1, Pp 1-

    a feasibility study

    2020  Volume 12

    Abstract: Abstract Background Foot perfusion has been recently implemented as a new tool for optimizing outcomes of peripheral endovascular procedures. A custom-made, two-dimensional perfusion digital subtraction angiography (PDSA) algorithm has been implemented ... ...

    Abstract Abstract Background Foot perfusion has been recently implemented as a new tool for optimizing outcomes of peripheral endovascular procedures. A custom-made, two-dimensional perfusion digital subtraction angiography (PDSA) algorithm has been implemented to quantify outcomes of endovascular treatment of critical limb ischemia (CLI), assist intra-procedural decision-making, and enhance clinical outcomes. Methods The study was approved by the Hospital’s Ethics Committee. This prospective, single-center study included seven consecutive patients scheduled to undergo infrapopliteal endovascular treatment of CLI. Perfusion blood volume (PBV), mean transit time (MTT), and perfusion blood flow (PBF) maps were extracted by analyzing time-intensity curves and signal intensity on the perfused vessel mask. Mean values calculated from user-specified regions of interest (ROIs) on perfusion maps were employed to evaluate pre- and post-endovascular treatment condition. Measurements were performed immediately after final PDSA. Results In total, five patients (aged 54 ± 16 years, mean ± standard deviation) were analyzed, as two patients were excluded due to significant motion artifacts. Post-procedural MTT presented a mean decrease of 19.1% for all patients and increased only in 1 of 5 patients, demonstrating in 4/5 patients an increase in tissue perfusion after revascularization. Overall mean PBF and PBV values were also analogously increased following revascularization (446% and 69.5% mean, respectively) and in the majority of selected ROIs (13/15 and 12/15 ROIs, respectively). Conclusions Quantification of infrapopliteal angioplasty outcomes using this newly proposed, custom-made, intra-procedural PDSA algorithm was performed using PBV, MTT, and PBF maps. Further studies are required to determine its role in peripheral endovascular procedures ( ClinicalTrials.gov Identifier: NCT04356092).
    Keywords Angiography (digital subtraction) ; Endovascular procedures ; Foot ; Perfusion ; Peripheral arterial disease ; Medical physics. Medical radiology. Nuclear medicine ; R895-920
    Subject code 610
    Language English
    Publishing date 2020-09-01T00:00:00Z
    Publisher SpringerOpen
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: Starclose SE® hemostasis after 6F direct antegrade superficial femoral artery access distal to the femoral head for peripheral endovascular procedures in obese patients.

    Spiliopoulos, Stavros / Kitrou, Panagiotis / Christeas, Nikolaos / Karnabatidis, Dimitris

    Diagnostic and interventional radiology (Ankara, Turkey)

    2016  Volume 22, Issue 6, Page(s) 542–547

    Abstract: Purpose: Direct superficial femoral artery (SFA) antegrade puncture is a valid alternative to common femoral artery (CFA) access for peripheral vascular interventions. Data investigating vascular closure device (VCD) hemostasis of distant SFA 6F access ... ...

    Abstract Purpose: Direct superficial femoral artery (SFA) antegrade puncture is a valid alternative to common femoral artery (CFA) access for peripheral vascular interventions. Data investigating vascular closure device (VCD) hemostasis of distant SFA 6F access are limited. We aimed to investigate the safety and effectiveness of the Starclose SE® VCD for hemostasis, following direct 6F antegrade SFA access distal to the femoral head.
    Methods: This prospective, single-center study included patients who were not suitable for CFA puncture and were scheduled to undergo peripheral endovascular interventions using direct antegrade SFA 6F access, at least 2 cm below the inferior edge of femoral head. Hemostasis was obtained with the Starclose SE® VCD (Abbott Laboratories). Primary endpoints were successful hemostasis rate and periprocedural (30-day) major complication rate. Secondary endpoint was the rate of minor complications. Clinical and Doppler ultrasound follow-up was performed at discharge and at one month.
    Results: Between September 2014 and August 2015, a total of 30 patients (21 male; 70.0%) with a mean body mass index of 41.2 kg/m2 were enrolled. Mean age was 72±9 years (range, 67-88 years). Most patients suffered from critical limb ischemia (87.1%) and diabetes (61.3%). Calcifications were present in eight cases (26.6%). Reason for direct SFA puncture was obesity (100%). Successful hemostasis was achieved in 100% of the cases. No major complications were noted after one-month follow-up. Minor complications included two <5 cm hematomas (6.6%) not necessitating treatment.
    Conclusion: In this prospective study, Starclose SE® VCD was safe and effective for hemostasis of antegrade direct SFA puncture. Uncomplicated hemostasis was achieved even in cases of puncturing 2 to 7 cm below the inferior edge of the femoral head.
    MeSH term(s) Aged ; Aged, 80 and over ; Endovascular Procedures/instrumentation ; Female ; Femoral Artery/diagnostic imaging ; Femoral Artery/surgery ; Hemostasis ; Humans ; Male ; Obesity/complications ; Prospective Studies ; Treatment Outcome ; Ultrasonography, Doppler, Duplex ; Ultrasonography, Interventional ; Vascular Closure Devices
    Language English
    Publishing date 2016-11
    Publishing country Turkey
    Document type Journal Article
    ZDB-ID 2184145-7
    ISSN 1305-3612 ; 1305-3825
    ISSN (online) 1305-3612
    ISSN 1305-3825
    DOI 10.5152/dir.2016.15614
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