Research Interests:
Poster: "ECR 2012 / C-1571 / Percutaneous vertebroplasty for the treatment of painful vertebral lesions in patients with multiple myeloma: clinical experience and results" by: "D. K. Filippiadis, M. Tsitskari, N.... more
Poster: "ECR 2012 / C-1571 / Percutaneous vertebroplasty for the treatment of painful vertebral lesions in patients with multiple myeloma: clinical experience and results" by: "D. K. Filippiadis, M. Tsitskari, N. Oikonomopoulos, A. Mazioti, E. Brountzos, N. L. Kelekis, A. D. Kelekis; Athens/GR"
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Poster: "ECR 2012 / C-2113 / Image guided percutaneous ablation of hepatic lesions: educational review and technical tips for successful outcome" by: "D. K. Filippiadis, A. Mazioti, E. Alexopoulou, S. Argentos, N.... more
Poster: "ECR 2012 / C-2113 / Image guided percutaneous ablation of hepatic lesions: educational review and technical tips for successful outcome" by: "D. K. Filippiadis, A. Mazioti, E. Alexopoulou, S. Argentos, N. Oikonomopoulos, A. D. Kelekis, N. L. Kelekis; Athens/GR"
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Poster: "ECR 2015 / C-1461 / Imaging of low back pain: Anatomy, imaging modalities, pathology and percutaneous treatments" by: "D. K. Filippiadis1, A. Mazioti2, E. Alexopoulou1, K. Malagari3, E. Brountzos4, N. L. Kelekis1,... more
Poster: "ECR 2015 / C-1461 / Imaging of low back pain: Anatomy, imaging modalities, pathology and percutaneous treatments" by: "D. K. Filippiadis1, A. Mazioti2, E. Alexopoulou1, K. Malagari3, E. Brountzos4, N. L. Kelekis1, A. D. Kelekis1; 1Athens/GR, 2Pefki - Athens/GR, 3Papagou/GR, 4Haidari/GR"
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Poster: "ESSR 2013 / P-0091 / Trans-foraminal infiltration in the cervical spine through the ipsilateral facet joint: clinical experience and results" by: "D. K. Filippiadis, A. Mazioti, A. O. Maratsos, X. Tsobanlioti, E.... more
Poster: "ESSR 2013 / P-0091 / Trans-foraminal infiltration in the cervical spine through the ipsilateral facet joint: clinical experience and results" by: "D. K. Filippiadis, A. Mazioti, A. O. Maratsos, X. Tsobanlioti, E. Brountzos, N. L. Kelekis, A. D. Kelekis; Athens/GR"
Research Interests:
Radiofrequency is the most widely used, studied, and evaluated energy form in the field of tumor ablation. In addition to tumor destruction nowadays, radiofrequency energy is also used in neurolysis for pain management. Radiofrequency... more
Radiofrequency is the most widely used, studied, and evaluated energy form in the field of tumor ablation. In addition to tumor destruction nowadays, radiofrequency energy is also used in neurolysis for pain management. Radiofrequency energy is characterized by a frequency between 3 Hz and 300 GHz. In clinical applications radiofrequency energy is applied as a continuous sinusoidal waveform at a frequency between 400 and 500 kHz. The produced heat is primarily generated in the tissue around the electrode’s active tip and is conducted both inward (to the cannula lumen) and outward (creating concentric tissue lesions of lower temperature as the distance increases). Clinical indications for application of radiofrequency energy include cutting and cauterization in surgical operations, treatment of chronic venous insufficiency, renal denervation, cardiac arrhythmias and Barrett’s esophagus, neoplasm destruction (for both benign and malignant cases), and neurolysis for pain management. Radiofrequency ablation in the spine, due to the unique anatomy, requires a reproducible, successful, and safe procedure.
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Research Interests:
To evaluate the outcome of transjugular intrahepatic portosystemic shunt (TIPS) in patients with Budd-Chiari syndrome (BCS). Fourteen patients (11 female, mean age 45.8 years), with symptomatic BCS refractory to conventional therapy, were... more
To evaluate the outcome of transjugular intrahepatic portosystemic shunt (TIPS) in patients with Budd-Chiari syndrome (BCS). Fourteen patients (11 female, mean age 45.8 years), with symptomatic BCS refractory to conventional therapy, were treated with TIPS placement in our department within a period of 9 years. Stent grafts were primarily used in 12 patients. Mean follow-up time was 38.1 ± 36.1 months (range 7-114). Model for end-stage liver disease (MELD) score, BCS Rotterdam index, and Child-Pugh score were calculated for all patients. In addition, the recently suggested BCS-TIPS prognostic index score (BSC-TIPS PI) was applied. BCS-TIPS PI score was ≤7 in all patients. Most of our patients (12 of 14) had good or intermediate prognosis according to MELD, Rotterdam and Child-Pugh scores. Technical success was achieved in all 14 patients and was accompanied by complete resolution of the symptoms. In 3 patients, the procedure was complicated by hemoperitoneum, which was successfully treated in two patients with coils or stent-graft placement, whereas 1 patient was managed in the operating room. Thirteen patients are symptom and orthotopic liver transplantation-free. Primary patency was 92.8, 84.7, and 58.7 % at 6, 12, and 24 months, respectively. Secondary patency was 100, 100 and 84.6 % at 6, 12, and 24 months respectively. In symptomatic BCS patients with moderate prognosis according to MELD, Child-Pugh, and BCS Rotterdam scores, as well as BCS-TIPS PI score ≤7, TIPS has high clinical success, low morbidity, and no mortality, and it offers durable mid-term resolution of the symptoms and OLT-free survival.
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Poster: "ECR 2012 / C-1569 / Percutaneous minimally invasive techniques for the treatment of symptomatic vertebral hemangiomas: clinical experience and results" by: "D. K. Filippiadis, A. Pantos, O. Papakonstantinou, A.... more
Poster: "ECR 2012 / C-1569 / Percutaneous minimally invasive techniques for the treatment of symptomatic vertebral hemangiomas: clinical experience and results" by: "D. K. Filippiadis, A. Pantos, O. Papakonstantinou, A. Malagari, E. Brountzos, N. L. Kelekis, A. D. Kelekis; Athens/GR"
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Research Interests: Low back pain and Disease
Poster: "ESSR 2015 / P-0077 / Biopsy in the spine: from A to Z" by: "D. K. Filippiadis1, A. Mazioti2, G. Velonakis3, E. Alexopoulou3, E. Brountzos4, N. L. Kelekis3, A. D. Kelekis3; 1Marousi - Athens/GR, 2PEFKI - ATHENS/GR,... more
Poster: "ESSR 2015 / P-0077 / Biopsy in the spine: from A to Z" by: "D. K. Filippiadis1, A. Mazioti2, G. Velonakis3, E. Alexopoulou3, E. Brountzos4, N. L. Kelekis3, A. D. Kelekis3; 1Marousi - Athens/GR, 2PEFKI - ATHENS/GR, 3ATHENS/GR, 4Haidari/GR"
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Poster: "ECR 2011 / C-1381 / Spine infiltrations: a pictorial review" by: "D. K. Filippiadis1, A. D. Kelekis2, A. Mazioti1, E. Alexopoulou3, E. Brountzos4, N. L. Kelekis2; 1MAROUSI - ATHENS/GR, 2Athens/GR, 3CHOLARGOS/GR,... more
Poster: "ECR 2011 / C-1381 / Spine infiltrations: a pictorial review" by: "D. K. Filippiadis1, A. D. Kelekis2, A. Mazioti1, E. Alexopoulou3, E. Brountzos4, N. L. Kelekis2; 1MAROUSI - ATHENS/GR, 2Athens/GR, 3CHOLARGOS/GR, 4Haidari/GR"
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Poster: "ECR 2013 / C-1481 / Percutaneous vertebral augmentation with a medium viscosity cement that allows twenty minutes of injection time: clinical experience and results" by: "D. K. Filippiadis, O. Papakonstantinou, A.... more
Poster: "ECR 2013 / C-1481 / Percutaneous vertebral augmentation with a medium viscosity cement that allows twenty minutes of injection time: clinical experience and results" by: "D. K. Filippiadis, O. Papakonstantinou, A. O. Maratsos, A. Mazioti, E. Alexopoulou, N. L. Kelekis, A. D. Kelekis; Athens/GR"
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Poster: "ECR 2011 / B-503 / Vertebroplasty and baropodometry: a comparison of load distribution among normal population and patients with vertebral fractures treated with vertebroplasty" by: "D. K. Filippiadis, G.... more
Poster: "ECR 2011 / B-503 / Vertebroplasty and baropodometry: a comparison of load distribution among normal population and patients with vertebral fractures treated with vertebroplasty" by: "D. K. Filippiadis, G. Velonakis, A. Mazioti, E. Brountzos, N. L. Kelekis, A. D. Kelekis; Athens/GR"
Research Interests: Medicine and Population
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Piriformis syndrome (PS), first described by Yeoman in 1928, is a general term referring to low back pain, sciatica, and instability. PS has a 6% incidence rate worldwide. In this study, we aim to retrospectively evaluate the... more
Piriformis syndrome (PS), first described by Yeoman in 1928, is a general term referring to low back pain, sciatica, and instability. PS has a 6% incidence rate worldwide. In this study, we aim to retrospectively evaluate the effectiveness of computed tomography (CT)-guided percutaneous infiltration in a series of consecutive PS patients who have symptoms that are refractory to conservative therapies. An institutional database search identified 20 such consecutive patients who underwent infiltration with a mixture of long-acting corticosteroid and local anesthetic. Preoperational evaluation included physical examination and magnetic resonance imaging. The correct position of the 22-gauge spinal needle was verified with CT scan after contrast medium injection. Pain measured before the procedure and at 1 wk and 1, 6, and 12 mo after the procedure was compared by means of a numeric visual scale (NVS) questionnaire. The mean pain score before CT-guided percutaneous infiltration was 8.95 ± 1.432 NVS units. This score was reduced to a mean value of 0.85 ± 0.933 units at 1 wk, 0.90 ± 0.852 at 1 mo, 1.10 ± 1.165 at 6 mo, and 1.20 ± 1.399 at 12 mo follow-up (p < 0.001). Two patients of 20 (10%) underwent a second infiltration that was performed at 7 and 10 d after the first, respectively. No complications were observed. CT-guided infiltration seems to be a feasible, efficacious, and safe approach for pain reduction and mobility improvement in patients with symptomatic PS.
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Percutaneous radiofrequency thermal ablation (RFA) has been used to treat primary and secondary liver tumors under ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI) guidance for the past decade [Park et al., Radiol... more
Percutaneous radiofrequency thermal ablation (RFA) has been used to treat primary and secondary liver tumors under ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI) guidance for the past decade [Park et al., Radiol Clin North Am 38:545–561, 2000; Siperstein and Gotomirski, Cancer J 6:S293–S301, 2000; Kelekis et al., Eur Radiol 13:1100–1105, 2003]. RFA is a low-cost, minimally invasive treatment that has recently attracted attention for treating tumors in different solid organs with promising results [Dupuy and Goldberg, J Vasc Interv Radiol 12:1135–1148, 2001; Friedman et al., Cardiovasc Intervent Radiol 27:427–434, 2004]. It can be provided with minimal hospitalization, and experienced practitioners have reported low complication rates [Dupuy and Goldberg, J Vasc Interv Radiol 12:1135–1148, 2001; Livraghi et al., Radiology 226:441–451, 2003]. Patients with lung malignancies (primary lung cancer or pulmonary metastases), who cannot be operated, might be candidates for RFA treatment. It can also be used in association with other treatments (i.e., chemotherapy, radiotherapy) for better disease control. Combination of the above with RFA may help reduce morbidity and mortality. Many ways to apply energy to the tumor exist (monopolar and bipolar RFA, microwave, laser, brachytherapy). In this review we will focus on expandable monopolar systems, which despite their deficiencies are the most popular in the interventional radiology sector.
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Research Interests: Gastroenterology, Cardiovascular, Greece, Humans, Internal Medicine, and 15 moreFemale, Male, Hepatocellular Carcinoma, Liver Function, Aged, Doxorubicin, Adverse Event, Liver Failure, Liver function tests, Gastrointestinal bleeding, Adverse effect, Liver neoplasms, Cardiovascular medicine and haematology, Liver Enzyme, and Chemoembolization therapeutic
Vertebral augmentation has been used to treat painful vertebral compression fractures and metastatic lesions in millions of patients around the world. An international group of subject matter experts have considered the evidence,... more
Vertebral augmentation has been used to treat painful vertebral compression fractures and metastatic lesions in millions of patients around the world. An international group of subject matter experts have considered the evidence, including but not limited to mortality. These considerations led them to ask whether it is appropriate to allow the subjective measure of pain to so dominate the clinical decision of whether to proceed with augmentation. The discussions that ensued are related below.
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To report our preliminary results upon feasibility, efficacy and safety of percutaneous splanchnic nerves cryoneurolysis for the treatment of abdominal pain refractory to conservative medication in patients with pancreatic cancer... more
To report our preliminary results upon feasibility, efficacy and safety of percutaneous splanchnic nerves cryoneurolysis for the treatment of abdominal pain refractory to conservative medication in patients with pancreatic cancer Institutional database research (retrospective review of prospectively collected data from April 2019 till August 2020) identified 5 patients with pancreatic cancer and pain refractory to conservative medication who underwent percutaneous cryoneurolysis of splanchnic nerves. In all patients, percutaneous cryoneurolysis was performed with posterolateral paravertebral approach using a 17 Gauge cryoprobe under computed tomography guidance and local anesthesia. Self-reported pain scores were assessed before and at the last follow-up using a pain inventory with visual analog scale (VAS) units. Mean patient age was 63.81 years (male–female: 3–2). Mean pain score prior to cryoanalgesia of splanchnic nerves was 9.4 VAS units. This score was reduced to a mean value of 2.6, 2.6 and 3 VAS units at 1, 3 and 6 months of follow-up, respectively. All patients reported significantly reduced analgesic usage. No complication was reported according to the CIRSE classification system. The mean procedure time was 44.4 min (range 39–50 min), including local anesthesia, cryoprobe(s) placement, ablation and post-procedural CT evaluation. Percutaneous cryoanalgesia of the splanchnic nerves is a minimally invasive, safe and effective procedure for pancreatic cancer pain relief. A larger, randomized trial is justified to substantiate these findings.
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Poster: "ESSR 2017 / P-0301 / Skeletal involvement in Langerhans cell histiocytosis: Imaging appearances." by: "O. Papakonstantinou1, D. K. Filippiadis1, V. Bizimi1, C. Chrona2, C. Konstantos1, N. L. Kelekis1, A. D.... more
Poster: "ESSR 2017 / P-0301 / Skeletal involvement in Langerhans cell histiocytosis: Imaging appearances." by: "O. Papakonstantinou1, D. K. Filippiadis1, V. Bizimi1, C. Chrona2, C. Konstantos1, N. L. Kelekis1, A. D. Kelekis1; 1Athens/GR, 2Athens /GR"
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Poster: "ECR 2015 / C-1824 / Osteochondral lesions of the talus: a review of MR imaging findings." by: "V. Papalouka1, V. Bizimi1, D. K. Filippiadis1, N. S. Sideri2, I. Misichroni1, A. D. Kelekis1, O. Papakonstantinou1;... more
Poster: "ECR 2015 / C-1824 / Osteochondral lesions of the talus: a review of MR imaging findings." by: "V. Papalouka1, V. Bizimi1, D. K. Filippiadis1, N. S. Sideri2, I. Misichroni1, A. D. Kelekis1, O. Papakonstantinou1; 1Athens/GR, 2Athens /GR"
Research Interests: Engineering and Medicine
PURPOSE To assess safety and efficacy of CT-guided radio frequency ablation (RFA) and Magnetic Resonance guided Focused Ultrasounds (MRgFUS) in the treatment of osteoid osteoma with a long-term follow-up study (mean follow-up time longer... more
PURPOSE To assess safety and efficacy of CT-guided radio frequency ablation (RFA) and Magnetic Resonance guided Focused Ultrasounds (MRgFUS) in the treatment of osteoid osteoma with a long-term follow-up study (mean follow-up time longer than 2 years). MATERIALS AND METHODS Database research was carried out in two different centres with experience in musculoskeletal interventions. Both centres, one performing RFA, the other MRgFUS, identified 116 patients, who were submitted to either RFA or MRgFUS for the treatment of symptomatic osteoid osteoma and retrospectively evaluated data regarding pain scores (using a visual analogue scale). Complications were recorded according to the CIRSE classification system. Propensity score matching for multiple variables was performed. Pre- and post-therapy pain scores were compared. RESULTS Out of the 116 patients treated, 61 underwent RFA and 55 MRgFUS. The mean values of pre-treatment pain in the two groups were 9.1±0.88 (RFA) and 8.7±0.73 (MRgFUS) VAS units. Post- treatment statistically significant (p<0.00001) overall reduction in pain symptomatology was recorded. No statistically significant difference was observed between the post-treatment mean values of both groups (p=0.256). Four cases of relapse (1 RFA; 3 MRgFUS) and one complication (RFA) were observed. The analysis from propensity score matching that identified a matched cohort of 48 patients showed similar results. CONCLUSIONS Both techniques for the treatment of osteoid osteoma seem to ensure a similar pain relief. The presence of thick cortical bone over the nidus can of reduce the effectiveness of MRgFUS.
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To date, conservative management including physical and/or systemic pharmacologic therapy is considered as the first line approach for the management of neuropathic pain syndromes. In the era of an opioid overdose crisis with an increased... more
To date, conservative management including physical and/or systemic pharmacologic therapy is considered as the first line approach for the management of neuropathic pain syndromes. In the era of an opioid overdose crisis with an increased concern upon the risks and harms arising from the misuse of medicines for pain management, percutaneous minimally invasive techniques such as nerve infiltrations as well as neurolysis or neuromodulation techniques can be proposed to control pain and improve life quality. Computed tomography can serve as an ideal guiding technique due to its specific characteristics including precise anatomic delineation, high spatial resolution and good tissue contrast. The purpose of this review is to make the reader familiar with the most common indications for minimally invasive imaging-guided techniques in patients with neuralgia and provide current evidence regarding technical considerations.
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The present review aims at providing an assessment of the clinical significance of Biphosphonates (BPs) in the treatment of patients with cancer. A systematic literature review was performed based on database search in PubMed/Medline and... more
The present review aims at providing an assessment of the clinical significance of Biphosphonates (BPs) in the treatment of patients with cancer. A systematic literature review was performed based on database search in PubMed/Medline and included articles up to August 2013. BPs can reduce, delay, and prevent complications related to bone metastases. They improve mobility, functionality, pain, and quality of life. They limit survival of any inactive cancer cells in the microenvironment of the bone marrow, contributing to their death from anti-neoplastic treatments. Moreover, they limit and delay bone morbidity due to osteoporosis related to hormonotherapy in breast and prostate cancer. Finally, benefits can be derived from the combination of BPs with radiotherapy in bone density, recalcification, opioid use, and patient's quality of life and performance status. The contribution of BPs in the course of certain neoplasms is preventive and synergistic to other treatments.
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Background: Trigeminal neuralgia (TN) is associated with multiple mechanisms involving peripheral and central nervous system pathologies. Among percutaneous treatments offered, radiofrequency thermocoagulation (RFT) is associated with... more
Background: Trigeminal neuralgia (TN) is associated with multiple mechanisms involving peripheral and central nervous system pathologies. Among percutaneous treatments offered, radiofrequency thermocoagulation (RFT) is associated with longer duration of pain relief. Mostly due to anatomic variation, cannulation of the foramen ovale using the Hartel approach has a failure rate of 5.17%. Objectives: To report safety and efficacy of continuous RFT with an alternative to Hartel anterior approach under computed tomography (CT) guidance in patients with classic TN. Study Design: Retrospective institutional database review; bicentral study. Setting: Although this was a retrospective database research, institutional review board approval was obtained. Methods: Institutional database review identified 10 patients (men 8, women 2) who underwent CT-guided RFT of the Gasserian ganglion. Preoperational evaluation included physical examination and magnetic resonance imaging. Under anesthesiology ...
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Purpose. To retrospectively evaluate the effectiveness of intra-articular application of Sluijter-Teixera Poisson pulsed radiofrequency (STP PRF) in knee osteoarthritis symptomatic patients with chronic pain refractory to conservative... more
Purpose. To retrospectively evaluate the effectiveness of intra-articular application of Sluijter-Teixera Poisson pulsed radiofrequency (STP PRF) in knee osteoarthritis symptomatic patients with chronic pain refractory to conservative therapies. Materials and Methods. Institutional database research of two centers identified 39 cases of knee osteoarthritis patients treated with intra-articular STP PRF. Pain prior and one-week and one-, three-, six-, and twelve-month post-STP PRF was compared by means of a numeric visual scale (NVS) questionnaire. Cardiovascular and Interventional Radiological Society of Europe (CIRSE) classification system was used for complications reporting. Mean patient age was 71.59 ± 11.99 years, mean body mass index was 30.23 ± 4.69, and male/female ratio was 9/30. Results. Mean baseline pain score was 8.31 ± 1.70 NVS units. This was reduced to a mean value of 0.90 ± 1.50 NVS units one-week post-RF, 1.08 ± 1.53 at one month, 1.54 ± 1.88 at three months, 2.33 ±...
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The purpose of this study was to retrospectively compare efficacy and safety between intradiscal injection of a gelified ethanol product and tubular discectomy in the treatment of intervertebral disk herniation. A bi-central institutional... more
The purpose of this study was to retrospectively compare efficacy and safety between intradiscal injection of a gelified ethanol product and tubular discectomy in the treatment of intervertebral disk herniation. A bi-central institutional database research identified forty (40) patients suffering from symptomatic contained disc herniation. Nucleolysis Group included 20 patients [mean 50.05 ± 9.27 years-of-age (male/female 14/6–70/30%)] and Surgery Group included 20 patients [mean 48.45 ± 14.53 years-of-age, (male/female 12/8–60/40%)]. Primary outcome was overall 12-month improvement over baseline in leg pain (NVS units). Procedural technical outcomes were recorded, and adverse events were evaluated at all follow-up intervals. CIRSE classification system was used for complications’ reporting. Mean pre-operative pain score in Nucleolysis Group was 7.95 ± 0.94 reduced to 1.25 ± 1.11 at month 1 and 0.45 ± 0.75 NVS units at year 1. Mean pre-operative pain score in Surgery Group was 7.65 ...
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Research Interests: Cardiology, Radiology, Computed Tomography, Medicine, Lung Cancer, and 15 moreComplication, Humans, Pneumonia, Male, Anesthesia, Radiofrequency Ablation, Clinical Sciences, Aged, Radiofrequency, Catheter ablation, Pneumothorax, X ray Computed Tomography, Exacerbation, Cardiovascular medicine and haematology, and lung neoplasms
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Poster: "ESSR 2013 / P-0131 / Bone tumors mimicking skeletal infections: Spectrum of imaging findings and traps." by: "O. Papakonstantinou1, D. K. Filippiadis2, G. Velonakis1, G. OIKONOMOULAS1, V. Bizimi1, A. Mazioti1, A.... more
Poster: "ESSR 2013 / P-0131 / Bone tumors mimicking skeletal infections: Spectrum of imaging findings and traps." by: "O. Papakonstantinou1, D. K. Filippiadis2, G. Velonakis1, G. OIKONOMOULAS1, V. Bizimi1, A. Mazioti1, A. D. Kelekis1; 1Athens/GR, 2MAROUSI - ATHENS/GR"
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Poster: "ESSR 2015 / P-0076 / Spectrum of imaging features of SAPHO/ CRMO syndrome" by: "A. Kalpaxi1, V. Bizimi1, E. Skoufa1, I. Misichroni1, N. S. Sideri2, D. K. Filippiadis3, A. D. Kelekis1, C. Kontopoulou1, N. L.... more
Poster: "ESSR 2015 / P-0076 / Spectrum of imaging features of SAPHO/ CRMO syndrome" by: "A. Kalpaxi1, V. Bizimi1, E. Skoufa1, I. Misichroni1, N. S. Sideri2, D. K. Filippiadis3, A. D. Kelekis1, C. Kontopoulou1, N. L. Kelekis1, O. Papakonstantinou1; 1ATHENS/GR, 2Chaidari/GR, 3Marousi - Athens/GR"
Poster: "ECR 2012 / C-2358 / Percutaneous disc decompression using nucleoplasty in patients with discogenic low back pain" by: "P. Nikolopoulos, P. Maniatis, A. P. Giannila, A. D. Kelekis, J. Papailiou, C. Triantopoulou;... more
Poster: "ECR 2012 / C-2358 / Percutaneous disc decompression using nucleoplasty in patients with discogenic low back pain" by: "P. Nikolopoulos, P. Maniatis, A. P. Giannila, A. D. Kelekis, J. Papailiou, C. Triantopoulou; Athens/GR"
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Poster: "ECR 2013 / C-1248 / Percutaneous tumour ablation with computed tomography-guided microwave ablation using a high energy delivering system" by: "V. Papalouka, D. K. Filippiadis, A. O. Maratsos, M. Mademli, A.... more
Poster: "ECR 2013 / C-1248 / Percutaneous tumour ablation with computed tomography-guided microwave ablation using a high energy delivering system" by: "V. Papalouka, D. K. Filippiadis, A. O. Maratsos, M. Mademli, A. Mazioti, A. D. Kelekis, N. L. Kelekis; Athens/GR"
Research Interests:
Low back pain with or without radicular leg pain is an extremely common health condition significantly impacting patient's activities and quality of life. When conservative management fails, epidural injections providing only... more
Low back pain with or without radicular leg pain is an extremely common health condition significantly impacting patient's activities and quality of life. When conservative management fails, epidural injections providing only temporary relief, are frequently utilized. Intradiscal oxygen-ozone may offer an alternative to epidural injections and further reduce the need for microdiscectomy. To compare the non-inferiority treatment status and clinical outcomes of intradiscal oxygen-ozone with microdiscectomy in patients with refractory radicular leg pain due to single-level contained lumbar disc herniations. Multicenter pilot prospective non-inferiority blocked randomized control trial conducted in three European hospital spine centers. Forty-nine patients (mean 40 years of age, 17 females/32 males) with a single-level contained lumbar disc herniation, radicular leg pain for more than six weeks, and resistant to medical management were randomized, 25 to intradiscal oxygen-ozone and 24 to microdiscectomy. 88% (43/49) received their assigned treatment and constituted the AS-Treated (AT) population. Primary outcome was overall 6-month improvement over baseline in leg pain. Other validated clinical outcomes, including back numerical rating pain scores (NRS), Roland Morris Disability Index (RMDI) and EQ-5D, were collected at baseline, 1 week, 1-, 3- and 6-months. Procedural technical outcomes were recorded and adverse events were evaluated at all follow-up intervals. Oxygen-ozone treatment performed as outpatient day surgeries, included a one-time intradiscal injection delivered at a concentration of 35 ± 3 μg/cc of oxygen-ozone by a calibrated delivery system. Discectomies performed as open microdiscectomy inpatient surgeries, were without spinal instrumentation and not as subtotal microdiscectomies. Primary analyses with a non-inferiority margin of -1.94 point difference in 6-month cumulative weighted mean leg pain NRS scores were conducted using As-Treated (AT) and Intent-to-Treat (ITT) populations. In post hoc analyses, differences between treatment groups in improvement over baseline were compared at each follow-up visit, using baseline leg pain as a covariate. In the primary analysis, the overall 6-month difference between treatment groups in leg pain improvement using the AT population was -0.31 (SE, 0.84) points in favor of microdiscectomy and using the ITT population, the difference was 0.32 (SE, 0.88) points in favor of oxygen-ozone. The difference between oxygen-ozone and microdiscectomy did not exceed the non-inferiority 95% confidence lower limit of treatment difference in either the AT (95% lower limit, -1.72) or ITT (95% lower limit, -1.13) populations. Both treatments resulted in rapid and statistically significant improvements over baseline in leg pain, back pain, RMDI, and EQ-5D that persisted in follow-up. Between group differences were not significant for any outcomes. During 6-month follow-up, 71% (17/24) of patients receiving oxygen-ozone, avoided microdiscectomy. The mean procedure time for oxygen-ozone was significantly faster than microdiscectomy by 58 minutes (P < 0.0010) and the mean discharge time from procedure was significantly shorter for the oxygen-ozone procedure (4.3 ± 2.9 hours versus 44.2 ± 29.9 hours, P < 0.001). No major adverse events occurred in either treatment group. Intradiscal oxygen-ozone chemonucleolysis for single-level lumbar disc herniations unresponsive to medical management, met the non-inferiority criteria to microdiscectomy on 6-month mean leg pain improvement. Both treatment groups achieved similar rapid significant clinical improvements that persisted and overall, 71% undergoing intradiscal oxygen-ozone were able to avoid surgery.
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We present a study comparing etidronate or indomethacin for the prevention of heterotopic ossification after total hip arthroplasty in patients with hypertrophic osteoarthritis. 52 patients were divided in two groups. Group A (26... more
We present a study comparing etidronate or indomethacin for the prevention of heterotopic ossification after total hip arthroplasty in patients with hypertrophic osteoarthritis. 52 patients were divided in two groups. Group A (26 patients) received etidronate (20 mg/kg/day for 12 weeks) and Group B (26 patients) indomethacin 75 mg/day for 2 weeks. Mean follow up was 36 months (range, 18 to 50 months). The incidence of side effects was 15.4% in group A and 30.8% in group B (p=0.324). At 6 months there was no statistically significant difference in terms of clinical (p=0.532) and radiographic evaluation between the two groups (p=0.303). However, the cost of etidronate which may be as much as six times more expensive than that of indomethacin could not justify its routine prophylactic use.
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BACKROUND-AIMS: To determine long term outcomes, regarding recurrence and survival, in patients with HCC that achieved complete response after initial treatment with drug eluting beads (DEB) using DC Bead loaded with doxorubicin... more
BACKROUND-AIMS: To determine long term outcomes, regarding recurrence and survival, in patients with HCC that achieved complete response after initial treatment with drug eluting beads (DEB) using DC Bead loaded with doxorubicin (DEB-DOX). Forty-five patients with HCC, not suitable for curative treatments that exhibited complete response (EASL criteria) to initial DEB-DOX treatment were retrospectively analyzed after a median follow up period of 63 months. Child-Pugh class was A/B (62.2/37.8%) and mean lesion diameter 5.36 ± 1.1 cm. Lesion morphology was one dominant ≤5cm (53.3%), one dominant >5cm (31.1%) and multifocal (15.6%). At 5 years, overall survival was 62.2% and recurrence-free survival 8.9%. All deaths that occurred were related to tumor progression (31.1%) or complications of underlying liver disease (28.9%). Median time of initial recurrence from baseline treatment was 18 months (range 8-52). When recurrence occurred, a mean time interval between additional DEB-DOX p...