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Article ; Online: Bilateral watershed infarcts due to hypoperfusion in the context of drug abuse: case report.

Redmond, Aine / Archontakis-Barakakis, Paraschos / Chlorogiannis, David-Dimitris / Ntaios, George / Mavridis, Theodorοs

The International journal of neuroscience

2024 , Page(s) 1–5

Abstract: Background: Watershed infarcts (WIs) are a distinct type of stroke with a varying clinical presentation that affects the border areas between the territories of two cerebral arteries and are typically associated with hemodynamic impairment and internal ... ...

Abstract	Background: Watershed infarcts (WIs) are a distinct type of stroke with a varying clinical presentation that affects the border areas between the territories of two cerebral arteries and are typically associated with hemodynamic impairment and internal carotid artery stenosis. However, there is a paucity of data concerning its association with the history of recreational substance and drug abuse. Methods/case report: This case report presents a unique instance of bilateral internal watershed infarcts in a 23-year-old male with a history of polysubstance abuse, including methadone and cocaine. The patient's presentation included confusion, lower limb weakness, and systemic complications such as acute liver injury and myonecrosis, underlying the complexity of the clinical scenario. Results: The investigation revealed no evidence of arterial stenosis or thrombosis, leading to the conclusion that the infarctions were likely precipitated by a total loss of consciousness due to substance abuse-related cerebral hypoperfusion and vasoconstriction. Methadone and cocaine, both implicated in vasoconstriction, lowering the seizure threshold and contributing to QTc prolongation, thus leading to loss of consciousness, were identified as potential triggers for the episode. Conclusions: In the young adult population, it is important to consider drug abuse as an etiological trigger for watershed infarcts, whereas the multi-system involvement and atypical presentation highlight the need for a comprehensive approach.
Language	English
Publishing date	2024-04-01
Publishing country	England
Document type	Journal Article
ZDB-ID	3061-2
ISSN	1563-5279 ; 1543-5245 ; 0020-7454
ISSN (online)	1563-5279 ; 1543-5245
ISSN	0020-7454
DOI	10.1080/00207454.2024.2333480
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Article ; Online: Evolving frontiers: endovascular strategies for the treatment of delayed cerebral ischemia.

Chlorogiannis, David-Dimitris / Aloizou, Athina-Maria / Mavridis, Theodoros / Sänger, Jonathan Andreas / Chlorogiannis, Anargyros / Madouros, Nikolaos / Papanagiotou, Panagiotis

Reviews in the neurosciences

2024

Abstract: Cerebral vasospasm and delayed cerebral ischemia represent a very challenging aspect of cerebrovascular pathophysiology, most commonly subarachnoid hemorrhage, with significantly high mortality if left untreated. Considerable advances have been made in ... ...

Abstract	Cerebral vasospasm and delayed cerebral ischemia represent a very challenging aspect of cerebrovascular pathophysiology, most commonly subarachnoid hemorrhage, with significantly high mortality if left untreated. Considerable advances have been made in medical treatment and prompt diagnosis, while newer endovascular modalities have recently been proposed for cases of resistant cerebral vasospasm. However, there is still paucity of data regarding which and whether a single endovascular technique is non inferior to the pharmacological standard of care. In this review, we aim to summarize the current funds of knowledge concerning cerebral vasospasm and the emerging role of the endovascular techniques for its treatment.
Language	English
Publishing date	2024-01-25
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	639035-3
ISSN	2191-0200 ; 0334-1763
ISSN (online)	2191-0200
ISSN	0334-1763
DOI	10.1515/revneuro-2023-0148
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Article: Argatroban as an Add-On to rtPA in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis.

Chlorogiannis, David-Dimitris / Mavridis, Theodoros / Adamou, Anastasia / Kyriakoulis, Ioannis / Stamatiou, Iliana / Botou, Polyxeni / Chen, Hui-Sheng / Ntaios, George

Journal of clinical medicine

2024 Volume 13, Issue 2

Abstract: Current treatment options for acute ischemic stroke, including intravenous thrombolysis (IVT) and mechanical thrombectomy, have undoubtedly revolutionized stroke care. The need for additional treatment options has brought into the light direct thrombin ... ...

Abstract	Current treatment options for acute ischemic stroke, including intravenous thrombolysis (IVT) and mechanical thrombectomy, have undoubtedly revolutionized stroke care. The need for additional treatment options has brought into the light direct thrombin inhibitors (DTIs) and, specifically, argatroban as a promising candidate. However, there is uncertainty regarding the safety of adding argatroban to IVT, mainly due to the increased hemorrhagic risk. In this study, we performed a systematic review and meta-analysis examining the safety and efficacy of argatroban as an add-on treatment for IVT. The following databases were searched from inception until the 14th of May 2023: Pubmed/MEDLINE, ClinicalTrials.gov, the EU Clinical Trials Register, EMBASE/Scopus, and the Cochrane Library. Only randomized clinical trials (RCTs) enrolling patients with acute ischemic stroke who underwent IVT evaluating the add-on use of any DTIs were selected for the systematic review and further meta-analysis. The PRISMA guidelines were followed at all stages. Four studies with argatroban were included in the final analysis. Analysis of risk ratio and relative risk shows that the add-on therapy with argatroban seems to be effective and favors a good clinical outcome (mRS 0-2) at 90 days, similar to that of alteplase. All studies showed a low pooled incidence of symptomatic intracerebral hemorrhage (5%), parenchymal hematoma (3%), and other major bleeding (1%). Argatroban as an add-on treatment to IVT seems not to be associated with excessive bleeding risk; however, its efficacy remains unproven. According to this synopsis of the currently available evidence, it is premature to use argatroban as an add-on to IVT treatment outside the current clinical trial setting.
Language	English
Publishing date	2024-01-18
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm13020563
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Article: Imaging Considerations before and after Liver-Directed Locoregional Treatments for Metastatic Colorectal Cancer.

Chlorogiannis, David-Dimitris / Moussa, Amgad M / Zhao, Ken / Alexander, Erica S / Sofocleous, Constantinos T / Sotirchos, Vlasios S

Diagnostics (Basel, Switzerland)

2024 Volume 14, Issue 7

Abstract: Colorectal cancer is a leading cause of cancer-related death. Liver metastases will develop in over one-third of patients with colorectal cancer and are a major cause of morbidity and mortality. Even though surgical resection has been considered the ... ...

Abstract	Colorectal cancer is a leading cause of cancer-related death. Liver metastases will develop in over one-third of patients with colorectal cancer and are a major cause of morbidity and mortality. Even though surgical resection has been considered the mainstay of treatment, only approximately 20% of the patients are surgical candidates. Liver-directed locoregional therapies such as thermal ablation, Yttrium-90 transarterial radioembolization, and stereotactic body radiation therapy are pivotal in managing colorectal liver metastatic disease. Comprehensive pre- and post-intervention imaging, encompassing both anatomic and metabolic assessments, is invaluable for precise treatment planning, staging, treatment response assessment, and the prompt identification of local or distant tumor progression. This review outlines the value of imaging for colorectal liver metastatic disease and offers insights into imaging follow-up after locoregional liver-directed therapy.
Language	English
Publishing date	2024-04-05
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics14070772
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Article ; Online: Exploring the latest findings on endovascular treatments for giant aneurysms: a review.

Chlorogiannis, David-Dimitris / Aloizou, Athina-Maria / Chlorogiannis, Anargyros / Kosta, Nefeli / Sänger, Jonathan Andreas / Chatziioannou, Achilles / Papanagiotou, Panagiotis

Reviews in the neurosciences

2024

Abstract: Giant intracranial aneurysms represent a very challenging aspect of aneurysmal pathophysiology with very high mortality and morbidity if left untreated. Their variety in clinical presentation (subarachnoid hemorrhage, cranial nerve palsy, etc.) and ... ...

Abstract	Giant intracranial aneurysms represent a very challenging aspect of aneurysmal pathophysiology with very high mortality and morbidity if left untreated. Their variety in clinical presentation (subarachnoid hemorrhage, cranial nerve palsy, etc.) and pathological and imaging properties (location, anatomy, presence of collateral circulation) pose serious questions regarding the best treatment option. Admirable advances have been achieved in surgical techniques, while endovascular modalities with flow diversion techniques have become widely used. However, there is still lack of data regarding whether a single endovascular technique can be the universal treatment for such cases. In this review, we aim to summarize the current funds of knowledge concerning giant intracranial aneurysms and the role of endovascular management in their treatment.
Language	English
Publishing date	2024-01-01
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	639035-3
ISSN	2191-0200 ; 0334-1763
ISSN (online)	2191-0200
ISSN	0334-1763
DOI	10.1515/revneuro-2023-0082
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Article ; Online: Sodium-glucose cotransporter-2 inhibitors in heart failure patients across the range of body mass index: a systematic review and meta-analysis of randomized controlled trials.

Adamou, Anastasia / Chlorogiannis, David Dimitris / Kyriakoulis, Ioannis G / Stamatiou, Iliana / Koukousaki, Despoina / Kardoutsos, Ioannis / Sagris, Dimitrios / Doehner, Wolfram / Ntaios, George

Internal and emergency medicine

2024 Volume 19, Issue 2, Page(s) 565–573

Abstract: Sodium-glucose cotransporter-2 (SGLT2) inhibitors improve outcomes in patients with heart failure, with or without diabetes. We sought to assess whether there is an interaction of these effects with body mass index (BMI). A systematic review of the ... ...

Abstract	Sodium-glucose cotransporter-2 (SGLT2) inhibitors improve outcomes in patients with heart failure, with or without diabetes. We sought to assess whether there is an interaction of these effects with body mass index (BMI). A systematic review of the MEDLINE and Scopus databases (last search: November 15th, 2022) was performed according to the PRISMA statement. Studies eligible for this review were randomized control trials (RCTs) with patients with chronic heart failure with either preserved or reduced ejection fraction randomly assigned to SGLT2 inhibitors or placebo. Data were extracted independently by two reviewers. BMI was classified according to the WHO classification into under/normal weight (BMI: < 25 kg/m
MeSH term(s)	Female ; Humans ; Male ; Sodium-Glucose Transporter 2 Inhibitors/pharmacology ; Sodium-Glucose Transporter 2 Inhibitors/therapeutic use ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/drug therapy ; Body Mass Index ; Randomized Controlled Trials as Topic ; Heart Failure/drug therapy ; Heart Failure/complications ; Ventricular Dysfunction, Left/complications ; Sodium ; Obesity/complications ; Obesity/drug therapy ; Glucose
Chemical Substances	Sodium-Glucose Transporter 2 Inhibitors ; Sodium (9NEZ333N27) ; Glucose (IY9XDZ35W2)
Language	English
Publishing date	2024-02-14
Publishing country	Italy
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Review
ZDB-ID	2454173-4
ISSN	1970-9366 ; 1828-0447
ISSN (online)	1970-9366
ISSN	1828-0447
DOI	10.1007/s11739-024-03532-8
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Article ; Online: Percutaneous Microwave Ablation Versus Robot-Assisted Partial Nephrectomy for Stage I Renal Cell Carcinoma: A Propensity-Matched Cohort Study Focusing Upon Long-Term Follow-Up of Oncologic Outcomes.

Chlorogiannis, David-Dimitris / Kratiras, Zisis / Efthymiou, Evgenia / Moulavasilis, Napoleon / Kelekis, Nikolaos / Chrisofos, Michail / Stravodimos, Konstandinos / Filippiadis, Dimitris K

Cardiovascular and interventional radiology

2024 Volume 47, Issue 5, Page(s) 573–582

Abstract: Purpose: To retrospectively compare long-term oncologic outcomes of percutaneous computed tomography-guided microwave ablation (MWA) and robot-assisted partial nephrectomy (RAPN) for the treatment of stage 1 (T1a and T1b) renal cell carcinoma (RCC) ... ...

Abstract	Purpose: To retrospectively compare long-term oncologic outcomes of percutaneous computed tomography-guided microwave ablation (MWA) and robot-assisted partial nephrectomy (RAPN) for the treatment of stage 1 (T1a and T1b) renal cell carcinoma (RCC) patients. Materials and methods: Institutional database research identified all T1 RCC patients who underwent either MWA or RAPN. Models were adjusted with propensity score matching. Kaplan-Meier log-rank test analyses and Cox proportional hazard regression models were used to compare the oncologic outcomes. Patient and tumor characteristics, technical success as well as oncologic outcomes were evaluated and compared between the 2 groups. Results: After propensity score matching, a total of 71 patients underwent percutaneous MWA (mean age 70 ± 10 years) and 71 underwent RAPN (mean age 60 ± 9 years). At 8-year follow-up, the estimated survival rates for MWA cohort were 98% (95% confidence interval [CI] 95-100%) for overall survival, 97% (95% CI 93-100%) for recurrence-free survival, and 97% (95% CI 93-100%) for metastasis-free survival. The matched cohort that underwent RAPN exhibited survival rates of 100% (95% CI 100-100%) for overall survival, 98% (95% CI 94-100%) for recurrence-free survival, and 98% (95% CI 94-100%) for metastasis-free survival. After performing log-rank testing, these rates were not significantly different (p values of 0.44, 0.67, and 0.67, respectively). Conclusion: The results of the present study suggest that both MWA and RAPN are equally effective in terms of oncologic outcome for the treatment of T1 RCC.
MeSH term(s)	Humans ; Carcinoma, Renal Cell/surgery ; Carcinoma, Renal Cell/pathology ; Carcinoma, Renal Cell/diagnostic imaging ; Kidney Neoplasms/surgery ; Kidney Neoplasms/pathology ; Kidney Neoplasms/diagnostic imaging ; Male ; Female ; Nephrectomy/methods ; Microwaves/therapeutic use ; Aged ; Middle Aged ; Robotic Surgical Procedures/methods ; Retrospective Studies ; Propensity Score ; Follow-Up Studies ; Treatment Outcome ; Neoplasm Staging ; Tomography, X-Ray Computed ; Radiography, Interventional/methods ; Survival Rate
Language	English
Publishing date	2024-04-01
Publishing country	United States
Document type	Journal Article ; Comparative Study
ZDB-ID	603082-8
ISSN	1432-086X ; 0342-7196 ; 0174-1551
ISSN (online)	1432-086X
ISSN	0342-7196 ; 0174-1551
DOI	10.1007/s00270-024-03695-z
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Article: Updated Clinical Evidence on the Role of Adipokines and Breast Cancer: A Review.

Verras, Georgios-Ioannis / Tchabashvili, Levan / Chlorogiannis, David-Dimitris / Mulita, Francesk / Argentou, Maria-Ioanna

Cancers

2023 Volume 15, Issue 5

Abstract: With the recent leaps in medicine, the landscape of our knowledge regarding adipose tissue has changed dramatically: it is now widely regarded as a fully functional endocrine organ. In addition, evidence from observational studies has linked the ... ...

Abstract	With the recent leaps in medicine, the landscape of our knowledge regarding adipose tissue has changed dramatically: it is now widely regarded as a fully functional endocrine organ. In addition, evidence from observational studies has linked the pathogenesis of diseases like breast cancer with adipose tissue and mainly with the adipokines that are secreted in its microenvironment, with the catalog continuously expanding. Examples include leptin, visfatin, resistin, osteopontin, and more. This review aims to encapsulate the current clinical evidence concerning major adipokines and their link with breast cancer oncogenesis. Overall, there have been numerous meta-analyses that contribute to the current clinical evidence, however more targeted larger-scale clinical studies are still expected to solidify their clinical utility in BC prognosis and reliability as follow-up markers.
Language	English
Publishing date	2023-03-03
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers15051572
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Article: Inflammation, anti-inflammatory agents, and the role of colchicine in carotid artery stenosis.

Chlorogiannis, David-Dimitris / Pargaonkar, Sumant / Papanagiotou, Panagiotis / Bakogiannis, Nikolaos C / Bakoyiannis, Christos / Kokkinidis, Damianos G

VASA. Zeitschrift fur Gefasskrankheiten

2023 Volume 53, Issue 1, Page(s) 4–12

Abstract: Cardiovascular disease is a major cause of morbidity and mortality worldwide. In the last few years, the role of inflammation and inflammatory modulatory medications is investigated for the optimal treatment of coronary artery disease. It can be ... ...

Abstract	Cardiovascular disease is a major cause of morbidity and mortality worldwide. In the last few years, the role of inflammation and inflammatory modulatory medications is investigated for the optimal treatment of coronary artery disease. It can be hypothesized that since inflammation is also involved in carotid artery stenosis development and progression, the same class of medication could be useful. Our objective with this review is to present the available evidence, published studies and promising ongoing trials on the role of anti-inflammatory medications - with a special emphasis on the most commonly used drug of this class: colchicine - in patients with carotid artery stenosis.
MeSH term(s)	Humans ; Colchicine/adverse effects ; Carotid Stenosis/complications ; Carotid Stenosis/diagnostic imaging ; Carotid Stenosis/drug therapy ; Anti-Inflammatory Agents/adverse effects ; Inflammation/drug therapy ; Coronary Artery Disease
Chemical Substances	Colchicine (SML2Y3J35T) ; Anti-Inflammatory Agents
Language	English
Publishing date	2023-12-11
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	120977-2
ISSN	1664-2872 ; 0301-1526
ISSN (online)	1664-2872
ISSN	0301-1526
DOI	10.1024/0301-1526/a001104
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Article ; Online: Pre-operative ultrasound mapping before arteriovenous fistula formation: an updated systematic review and meta-analysis.

Chlorogiannis, David-Dimitris / Bousi, Stelios-Elion / Zachiotis, Marinos / Chlorogiannis, Anargyros / Kyriakoulis, Ioannis / Bellos, Ioannis

Journal of nephrology

2023 Volume 37, Issue 2, Page(s) 281–292

Abstract: Background: Arteriovenous fistula represents the preferred vascular access for patients with kidney failure requiring hemodialysis. Surgeons have traditionally used physical examination to identify the most suitable vessels. This meta-analysis aims to ... ...

Abstract	Background: Arteriovenous fistula represents the preferred vascular access for patients with kidney failure requiring hemodialysis. Surgeons have traditionally used physical examination to identify the most suitable vessels. This meta-analysis aims to evaluate whether ultrasound mapping should be routinely performed before arteriovenous fistula creation. Methods: Medline, Scopus, Web of Science and CENTRAL were systematically searched from inception to November 1, 2022. Randomized controlled trials and cohort studies comparing routine ultrasound mapping to physical examination in terms of arteriovenous fistula patency were included. Meta-analysis was performed by fitting random-effects models. The study protocol has been prospectively registered in PROSPERO (CRD42023402390). Results: Overall, 18 studies were included, comprising 3655 participants. Routine pre-operative ultrasound mapping was associated with significantly lower rates of primary arteriovenous fistula failure (Risk Ratio-RR: 0.56, 95% confidence intervals-CI: 0.37-0.84, low certainty). A significant outcome was observed by separately pooling randomized controlled trials (RR: 0.37, 95% CI: 0.25-0.54). Routine ultrasound mapping was also associated with significantly higher rates of 1-year primary arteriovenous fistula patency (RR: 1.33, 95% CI: 1.19-1.47, moderate certainty). This effect remained significant in the analysis of randomized controlled trials (RR: 1.26, 95% CI: 1.02-1.56). Conclusions: Implementing routine pre-operative ultrasound mapping of vessels is associated with significantly better outcomes in terms of early arteriovenous fistula failure and primary patency rates at 12 months. Further research should confirm the long-term benefits of routine ultrasound examination and evaluate its cost-effectiveness in different populations.
MeSH term(s)	Humans ; Arteriovenous Shunt, Surgical/adverse effects ; Renal Dialysis ; Ultrasonography ; Vascular Patency ; Preoperative Care/methods ; Kidney Failure, Chronic/therapy
Language	English
Publishing date	2023-12-22
Publishing country	Italy
Document type	Journal Article ; Systematic Review ; Meta-Analysis ; Review
ZDB-ID	1093991-x
ISSN	1724-6059 ; 1120-3625 ; 1121-8428
ISSN (online)	1724-6059
ISSN	1120-3625 ; 1121-8428
DOI	10.1007/s40620-023-01814-6
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