Publications by authors named "Nikolaos-Achilleas Arkoudis"

A 60-year-old male patient with a previously unremarkable medical history presented with unilateral eyelid ptosis and binocular diplopia in the past year. Clinical and laboratory workup confirmed the diagnosis of ocular myasthenia gravis. In addition, further workup with orbital MRI performed due to exophthalmos and unilateral ophthalmoplegia demonstrated findings compatible with thyroid eye disease, which were further verified by antibody testing.

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Article Synopsis
  • Autoimmune GFAP astrocytopathy is a neurological disorder characterized by antibodies attacking GFAP, leading to symptoms like headaches, visual issues, and psychiatric disturbances, often manifesting as meningoencephalitis.
  • The condition may be triggered by neoplasms or viral infections, and about 20-30% of patients experience relapses after initial treatment, which responds favorably to steroids.
  • The review includes two case studies, explores the role of anti-GFAP antibodies, and discusses clinical features, imaging findings, and treatment strategies for this emerging disorder.
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Effective communication and collaboration among healthcare professionals are crucial for delivering high-quality patient care. Interdepartmental miscommunication poses a significant challenge to healthcare systems, potentially undermining the quality of healthcare services provided. In the same manner, communication barriers between referring physicians and radiologists can specifically affect radiology services and patient outcomes.

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Transarterial chemoembolization (TACE) has revolutionized the treatment landscape for malignant liver disease, offering localized therapy with reduced systemic toxicity. This manuscript delves into the use of degradable microspheres (DMS) in TACE, exploring its potential advantages and clinical applications. DMS-TACE emerges as a promising strategy, offering temporary vessel occlusion and optimized drug delivery.

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Image-guided percutaneous cholecystostomy (IGPC) is a widely recognized and regularly employed procedure in numerous institutions, serving as an indispensable cornerstone in the management of patients with acute cholecystitis. The most up-to-date literature has found that the transperitoneal route is at least as safe as the transhepatic route and that both the trocar and Seldinger techniques are equally safe and effective. The above novel insights may offer reassurance and alleviate concerns among operators performing IGPC by dispelling the fixation on previously established beliefs and thus providing flexibility, which lightens the load on the operator.

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Purpose: The goal of this preclinical study is to assess the functionality, technical feasibility, and safety of a new vascular robotic LIBERTY 3 System, in the microcatheterization of vascular targets using a range of guidewires and microcatheters.

Material And Methods: An anesthetized pig served as an arterial model for the robotic device (LIBERTY3; Microbot Medical Ltd, Yoqneam, IL). The primary efficacy endpoint was the evaluation of its capability to selectively catheterize predetermined distal arterial branches in the liver, kidneys, and mesenteric arteries (technical success), under fluoroscopy guidance.

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An endovascular approach is often considered the first line treatment option for lower limb chronic limb-threatening ischemia (CLTI), which is defined by the presence of ischemic rest pain and severe tissue loss, such as ulcers or gangrene. Although the technical success rate of endovascular revascularization is high, in specific patients with advanced infrapopliteal disease and the absence of run-off tibial vessels, the so-called 'desert foot', the chance of successful endovascular revascularization is minimal. In order to avoid primary amputation, several treatment options are currently being investigated, including gene therapy and deep venous arterialization.

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Posterior dislocation is a rather rare injury, often misdiagnosed. The current report offers valuable insights regarding the anatomical background of this clinical entity and emphasizes the 'light-bulb sign,' which can be observed in anterior-posterior shoulder X-rays when there is a posterior dislocation. It is crucial for healthcare professionals, including emergency department physicians, radiologists, general practitioners, orthopedic surgeons, and other relevant medical experts, to be well-acquainted with this sign and maintain a heightened awareness when encountering such cases.

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Acute cholecystitis (AC) is a critical condition requiring immediate medical attention and treatment and is one of the most frequently encountered acute abdomen emergencies in surgical practice, requiring hospitalization. Laparoscopic cholecystectomy is considered the favored treatment for patients with AC who are fit for surgery. However, in high-risk patients considered poor surgical candidates, percutaneous cholecystostomy (PC) has been suggested and employed as a safe and reliable alternative option.

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Objectives: The purpose of this study is to investigate the safety and effectiveness of the US-guided bedside trocar vs. the Seldinger technique for percutaneous cholecystostomy (PC) procedures.

Methods: This is a prospective single-center, randomized, controlled trial (RCT) comparing the trocar (group T; 50 patients [27 men]; mean [± SD] age, 74.

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Introduction: Septic arthritis usually affects native joints and represents an invasion of the joint space by a wide variety of microorganisms, most commonly bacteria, such as Staphylococci, Streptococci, and Gram-negative rods. An extremely rare case of septic knee arthritis caused by Pantoea agglomerans in a 67-year-old male is presented.

Case Report: The patient was initially treated with arthroscopic debridement, but due to persistent symptomatology open surgical debridement 3 days after initial surgery was also performed.

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Extrahepatic metastases of hepatocellular carcinoma (HCC) are associated with poor prognosis, while such lesions in skeletal muscles are extremely rare. A unique case of skeletal metastasis in the soleus muscle in a 76-year-old male patient with HCC is reported. The patient presented with a painful palpable mass in his left calf.

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Direct percutaneous embolization, has been deliberately employed before on various occasions. However, to our knowledge, there is no report in the literature, of its use in order to achieve urgent hemostasis after iatrogenic erroneous arterial puncture. A 75-year-old female patient underwent a CT-guided biopsy of a pancreatic body necrotic mass encasing the patent splenic artery and thrombosed splenic vein.

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To report a rare event of a retrograde flow of cement leakage during balloon kyphoplasty and discuss the possible mechanism. We present a 55-year-old male patient, who underwent a 4-level balloon kyphoplasty for Langerhans histiocytosis that had spread to the spine. With the patient prone under general anesthesia, intrathoracic pressure was raised as a precaution measure to prevent cement embolic complications as a protocol reported elsewhere.

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Osteoporotic vertebral fractures (OVFs) are considered benign and heal after 8-12 weeks. Nevertheless, up to one third of these patients will have persistent back pain, which may be complicated with neurologic deficit or paraplegia A unique unusual case of delayed onset of neurological complication of an osteoporotic vertebral fracture (OVF) in an elderly patient is reported. The patient presented with paraparesis due to isolated substantial atrophy of the psoas muscle 12 months after the initial fracture.

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