Publications by authors named "Geroulakos G"
Article Synopsis
- * The evaluation highlighted areas where the AI struggled, particularly in interpreting complex medical scenarios and demonstrated issues with context understanding, leading to errors in 27% of cases.
- * Although GPT-4 showed potential for clinical relevance, further scrutiny of its reasoning and accuracy is necessary before fully relying on it in a medical setting.
Objective: The aim of the study was to summarize epidemiologic data about aortobronchial fistulas and compare outcomes (mortality, recurrence, re-operation) of open, staged, and endovascular repair of aortobronchial fistula.
Methods: A systematic literature review was conducted to identify eligible studies published between January of 1999 and December of 2019. The Cochrane Library, PubMed and Scopus databases were used as search engines.
Article Synopsis
- - The study aimed to determine if umbilical cord blood platelet lysate (UCB-PL) gel improves healing rates for diabetic foot ulcers (DFU) compared to normal saline dressing.
- - In this trial, 110 patients were divided into two groups; one received UCB-PL gel every three days while the other received saline, with ulcer sizes assessed over six months.
- - Results showed UCB-PL gel led to a significantly greater reduction in ulcer size, with 97.6% of patients in the UCB-PL group seeing improvement compared to 73% in the saline group.
Objective: Late rupture after endovascular aortic aneurysm repair (EVAR) for an abdominal aortic aneurysm (AAA) is an increasing complication associated with a high mortality rate. This study aimed to analyse the causes and outcomes in patients with AAA rupture after EVAR.
Methods: A multi-institutional Greek study of late ruptures after EVAR between 2008 - 2022 was performed.
Article Synopsis
- Buerger's disease (BD) is a serious condition that requires early diagnosis for effective treatment, but there’s no universally accepted method for diagnosing it due to varied criteria used by different vascular centers.
- A recent Delphi Consensus Study highlighted the lack of consensus on BD diagnostic criteria, particularly beyond the requirement of a history of smoking, making it hard to compare patient outcomes globally.
- The VAS-European Independent Foundation has proposed that a definitive BD diagnosis should include a history of smoking, typical angiographic and histopathological features, and suggests using a combination of major and minor criteria for suspected diagnoses, with validation studies currently in progress.
Objective: Despite the publication of various national/international guidelines, several questions concerning the management of patients with asymptomatic (AsxCS) and symptomatic (SxCS) carotid stenosis remain unanswered. The aim of this international, multi-specialty, expert-based Delphi Consensus document was to address these issues to help clinicians make decisions when guidelines are unclear.
Methods: Fourteen controversial topics were identified.
The 2024 ESVS Guidelines on Lower Limb Peripheral Arterial Disease: A Step Forward.
Eur J Vasc Endovasc Surg
January 2024
Background: Compression ultrasonography of the leg is established for triaging proximal lower extremity deep vein thrombosis (DVT). AutoDVT, a machine-learning software, provides a tool for nonspecialists in acquiring compression sequences to be reviewed by an expert for patient triage. The purpose of this study was to test image acquisition and remote triaging in a clinical setting.
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- The study aimed to compare the outcomes of two treatment methods for abdominal aortic aneurysm (AAA) in younger patients: endovascular repair (EVAR) and open repair.
- A systematic review of 15 observational studies and 1 randomized controlled trial was conducted, involving nearly 49,000 young patients, with the risk of bias assessed through established frameworks.
- Results indicated that while EVAR had lower perioperative mortality and shorter hospital stays, overall and aneurysm-related mortality rates were not significantly different between the two methods, and complications were generally lower with EVAR as well.
Background: Coarctation of the aorta (CoA) is a congenital cardiovascular malformation involving narrowing of the thoracic aorta just distal to the left subclavian artery. The aim of our study was to evaluate the hemodynamic effects of endovascular treatment for CoA by using invasive aortic catheterization.
Methods: All patients with CoA who underwent treatment by aortic stent implantation between September 1, 2003, and February 1, 2019, at the "Onassis Cardiac Surgery Center," in Athens, Greece, were evaluated.
Background: To investigate outcomes of pre-emptive embolization of the aneurysm sac or aortic side branches in endovascular aneurysm repair (EVAR).
Methods: The review was reported as per Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 with a preregistered protocol. Bibliographic sources (MEDLINE, Embase, and CENTRAL) were searched using subject headings and free text terms.
Background: Evidence suggests thoracic stent grafts increase the aortic stiffness postimplantation. Our objective was to examine the effect of thoracic aortic stenting on heart function, as demonstrated with echocardiography.
Methods: We considered nonrandomized studies examining echocardiographic parameters (left ventricle ejection fraction (LVEF), left ventricle end-diastolic (LVED) and end-systolic diameter (LVESD), posterior wall thickness (LVPWT), interventricular septal thickness (IVST), mass, and mass index) pre and poststent graft implantation in patients with thoracic aortic diseases (aneurysm, dissection, and blunt injury).
Article Synopsis
- Current guidelines advise against screening for asymptomatic carotid artery stenosis (AsxCS) due to the risk of unnecessary interventions, unlike the strong recommendation for abdominal aortic aneurysm screening.
- A literature analysis reveals that patients with AsxCS are at a high risk for future cardiovascular issues, yet universal screening is not advisable.
- Selective screening for high-risk individuals could be beneficial, focusing on risk factor management and medical therapy to prevent future cardiovascular events rather than identifying candidates for surgery.
Congenital abnormalities of the Inferior Vena Cava (IVC) should be suspected in cases of Deep Venous Thrombosis (DVT), especially in young patients, with no other risk factors and apparent causes. Currently, there is no guidance regarding the management of such patients. We report a case of Iliofemoral vein thrombosis in a young patient with congenital absence of the IVC that was successfully treated with catheter-directed thrombolysis (CDT) and perform a systematic review of the literature to identify evidence about the epidemiology, clinical presentation, management, and prognosis of this rare cause of DVT.
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- International guidelines recommend using statins, alone or with other medications, to lower LDL cholesterol in patients with asymptomatic or symptomatic carotid stenosis, as it significantly reduces risks of stroke and cardiovascular events.
- The overview evaluates the effectiveness of various lipid-lowering agents, emphasizing that statins and PCSK9 inhibitors offer substantial benefits like stabilizing carotid plaques and lowering stroke rates, while non-statin options like ezetimibe and fibrates also help but to a lesser extent.
- Despite potential side effects, the advantages of lowering LDL cholesterol for these patients outweigh the risks, leading to a recommendation for high-dose statin therapy for all individuals, regardless of their baseline LDL levels.
Despite the publication of several national/international guidelines, the optimal management of patients with asymptomatic carotid stenosis (AsxCS) remains controversial. This article compares 3 recently released guidelines (the 2020 German-Austrian, the 2021 European Stroke Organization [ESO], and the 2021 Society for Vascular Surgery [SVS] guidelines) vs the 2017 European Society for Vascular Surgery (ESVS) guidelines regarding the optimal management of AsxCS patients.The 2017 ESVS guidelines defined specific imaging/clinical parameters that may identify patient subgroups at high future stroke risk and recommended that carotid endarterectomy (CEA) should or carotid artery stenting (CAS) may be considered for these individuals.
View Article and Find Full Text PDFBackground: It is generally assumed by practitioners and guideline authors that combined modalities (methods of treatment) are more effective than single modalities in preventing venous thromboembolism (VTE), defined as deep vein thrombosis (DVT) or pulmonary embolism (PE), or both. This is the second update of the review first published in 2008.
Objectives: The aim of this review was to assess the efficacy of combined intermittent pneumatic leg compression (IPC) and pharmacological prophylaxis compared to single modalities in preventing VTE.
The recommendations of international guidelines for the management of asymptomatic carotid stenosis (ACS) often vary considerably and extend from a conservative approach with risk factor modification and best medical treatment (BMT) alone, to a more aggressive approach with a carotid intervention plus BMT. The aim of the current multispecialty position statement was to reconcile the conflicting views on the topic. A literature review was performed with a focus on data from recent studies.
View Article and Find Full Text PDFObjectives: The recommendations of international guidelines for the management of asymptomatic carotid stenosis (ACS) often vary considerably and extend from a conservative approach with risk factor modification and best medical treatment (BMT) alone, to a more aggressive approach with a carotid intervention plus BMT. The aim of the current multispecialty position statement is to reconcile the conflicting views on the topic.
Materials And Methods: A literature review was performed with a focus on data from recent studies.
Objective: The aim of the study was to summarize epidemiologic data about aortobronchial fistulae and compare outcomes (mortality, recurrence, reoperation) of open, staged, and endovascular repair of aortobronchial fistula.
Methods: A systematic literature review was conducted to identify eligible studies published between January 1999 and December 2019. The Cochrane Library, PubMed, and Scopus databases were used as search engines.
Renal artery aneurysm (RAA) concomitant with a renal arteriovenous fistula (RAVF) has been infrequently reported in the literature. We report a case of a 42-year-old man suffering from a giant RAA combined with a congenital high-flow RAVF. The contrast-enhanced CTA showed a 12.
View Article and Find Full Text PDFIntroduction: Aortic graft infection remains a considerable clinical challenge, and it is unclear which variables are associated with adverse outcomes among patients undergoing partial resection.
Methods: A retrospective, multi-institutional study of patients who underwent partial resection of infected aortic grafts from 2002 to 2014 was performed using a standard database. Baseline demographics, comorbidities, operative, and postoperative variables were recorded.
Objective: We evaluated the safety and efficacy of multilayer flow modulator (MFM) stents (Cardiatis, Isnes, Belgium) for the treatment of complex aortic lesions.
Methods: A systematic electronic research was conducted for studies reported from December 2008 to May 2020. Data extracted from 15 eligible case series (CS) were appropriately pooled and analyzed in a meta-analysis.