Papers by Miltiadis Matsagkas
World Journal of Orthopedics
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European Journal of Clinical Investigation, 2020
IntroductionAsymptomatic carotid artery stenosis (ACAS) may cause future stroke and therefore pat... more IntroductionAsymptomatic carotid artery stenosis (ACAS) may cause future stroke and therefore patients with ACAS require best medical treatment. Patients at high risk for stroke may opt for additional revascularization (either surgery or stenting) but the future stroke risk should outweigh the risk for peri/post‐operative stroke/death. Current risk stratification for patients with ACAS is largely based on outdated randomized‐controlled trials that lack the integration of improved medical therapies and risk factor control. Furthermore, recent circulating and imaging biomarkers for stroke have never been included in a risk stratification model. The TAXINOMISIS Project aims to develop a new risk stratification model for cerebrovascular complications in patients with ACAS and this will be tested through a prospective observational multicentre clinical trial performed in six major European vascular surgery centres.Methods and analysisThe risk stratification model will compromise clinical...
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Journal of Vascular Surgery, 2004
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The American Journal of Surgery, 1993
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European Journal of Vascular and Endovascular Surgery, Nov 1, 2022
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Journal of Endovascular Therapy, Dec 1, 2002
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European Journal of Vascular and Endovascular Surgery, Mar 1, 2003
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Journal of Endovascular Therapy, 2019
Purpose: To compare different anatomical characteristics between intact and ruptured large abdomi... more Purpose: To compare different anatomical characteristics between intact and ruptured large abdominal aortic aneurysms (rAAA >80 mm) with the goal of refining the process of estimating rupture risk. Materials and Methods: A retrospective study involving 62 male patients with large (>80 mm) aneurysms matched for age and smoking produced a 31-patient elective group with a mean maximum aneurysm diameter of 92±9.7 mm and a 31-patient rAAA group (mean maximum aneurysm diameter 95.7±12 mm). Preoperative computed tomography angiography scans were analyzed with a dedicated workstation, and anatomical characteristics of the aortic neck, iliac arteries, and aneurysm were compared in multivariable regression analyses; the outcomes are given as the odds ratio (OR) with 95% confidence interval (CI). The prognostic utility of several characteristics as predictors of rupture occurrence was examined with receiver operating characteristic (ROC) curves. Results: Anatomical characteristics differ...
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The International Journal of Lower Extremity Wounds, Sep 1, 2013
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Thrombosis and Haemostasis, May 5, 2023
Background Coronavirus disease 2019 (COVID-19) is associated with venous and arterial thromboembo... more Background Coronavirus disease 2019 (COVID-19) is associated with venous and arterial thromboembolism (VTE and ATE) and all-cause mortality (ACM) in hospitalized patients. High-quality data are needed on postdischarge outcomes in patients with cardiovascular disease. Objectives To analyze outcomes and identify risk factors for ATE, VTE, and ACM in a high-risk subgroup of hospitalized COVID-19 patients with baseline cardiovascular disease. Methods We investigated postdischarge rates and associated risk factors of ATE, VTE, and ACM in 608 hospitalized COVID-19 patients with coronary artery disease, carotid artery stenosis (CAS), peripheral arterial disease (PAD), or ischemic stroke. Results Through 90 days postdischarge, outcome rates were: ATE 27.3% (10.2% myocardial infarction, 10.1% ischemic stroke, 13.2% systemic embolism, 12.7% major adverse limb event); VTE 6.9% (4.1% deep vein thrombosis, 3.6% pulmonary embolism); composite of ATE, VTE, or ACM 35.2% (214/608). Multivariate analysis showed significant association between this composite endpoint and age >75 years (odds ratio [OR]: 1.90, 95% confidence interval [CI]: 1.22–2.94, p = 0.004), PAD (OR: 3.23, 95% CI: 1.80–5.81, p ≤ 0.0001), CAS (OR: 1.74, 95% CI: 1.11–2.75, p = 0.017), congestive heart failure (CHF) (OR: 1.84, 95% CI: 1.02–3.35, p = 0.044), previous VTE (OR: 3.08, 95% CI: 1.75–5.42, p < 0.0001), and intensive care unit (ICU) admission (OR: 2.93, 95% CI: 1.81–4.75, p < 0.0001). Conclusion COVID-19 inpatients with cardiovascular disease experience high rates of ATE, VTE, or ACM through 90 days postdischarge. Age >75 years, PAD, CAS, CHF, previous VTE, and ICU admission are independent risk factors.
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Current Oncology, Jun 4, 2023
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Journal of Vascular Surgery, Jul 1, 2023
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Journal of Endovascular Therapy, Dec 7, 2021
Background: Ascending aorta and aortic arch diseases have an increasing interest among cardiovasc... more Background: Ascending aorta and aortic arch diseases have an increasing interest among cardiovascular specialists regarding diagnosis and management. Innovations in endovascular surgery and evolution of open surgery have extended the indications for treatment in patients previously considered unfit for surgery. The aim of this systematic review of the literature was to present and analyze current cardiovascular guidelines for overlap and differences in their recommendations regarding ascending aorta and aortic arch diseases and the assessment of evidence. Methods: The English medical literature was searched using the MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials databases from January 2009 to December 2020. Recommendations on selected topics were analyzed, including issues from definitions and diagnosis (imaging and biomarkers) and indications for treatment to management, including surgical techniques, of the most important ascending aorta and aortic arch diseases. Results: The initial search identified 2414 articles. After exclusion of duplicate or inappropriate articles, the final analysis included 5 articles from multidisciplinary, cardiovascular societies published between 2010 and 2019. The definition of non-A-non-B aortic dissection is lacking from most of the guidelines. There is a disagreement regarding the class of recommendation and level of evidence for the diameter of ascending aorta as an indication. The indication for treatment of aortic disease may be individualized in specific cases while the growth rate may also affect the decision making. The role of endovascular techniques has not been established in current guidelines except by 1 society. Supportive evidence level in the management of aortic arch diseases remains limited. Conclusion: In current recommendations of cardiovascular societies, the ascending aorta and aortic arch remain a domain of open surgery despite the introduction of endovascular techniques. Recommendations of the included societies are mostly based on expert opinion, and the role of endovascular techniques has been highlighted only from 1 society. The chronological heterogeneity apparent among guidelines and the inconsistency in evidence level should be also acknowledged. More data are needed to develop more solid recommendations for the ascending aorta and aortic arch diseases.
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European Journal of Vascular and Endovascular Surgery, Nov 1, 2022
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Vascular, Nov 17, 2022
ObjectivesCOVID-19 associated arterial thrombosis has been attributed to multiple inflammation an... more ObjectivesCOVID-19 associated arterial thrombosis has been attributed to multiple inflammation and coagulation mechanisms. The aim of this study was to report the experience of a tertiary center on COVID-19 patients managed for acute peripheral arterial thrombosis.MethodsA single-center case series was conducted, including retrospectively collected data from all COVID-19 patients presenting arterial thrombosis, from March 2020 to February 2022. Intensive care unit (ICU) and non-ICU cases were included. The primary outcomes were mortality, successful revascularization, and amputation at 30 days.ResultsTwenty patients presented peripheral arterial thrombosis (90% males, mean age 65 years (16–82 years)). Eighteen were diagnosed with the Delta variant and none was previously vaccinated. All cases presented acute lower limb ischemia; in 20% with bilateral involvement. Nine patients were hospitalized in the ward while 11 in the ICU. From the non-ICU cases, five presented Rutherford IIb and four cases, Rutherford’s IIa ischemia. Six cases underwent revascularization (67%). Two of them were finally amputated (33%) and two died during hospitalization (33%). Two revascularizations were considered successful (33%). The ICU group presented mainly with Rutherford’s III ischemia (54.5%). The mortality in the ICU cohort was 72.7%. Only one patient underwent successful revascularization and two were amputated in this subgroup. Early mortality was 50% for the total cohort while the type of management was not related to mortality.ConclusionsCovid-19 related arterial thrombosis in non-vaccinated population is associated with 50% early mortality; increased up to 72% in the ICU patients. The amputation rate was 20% while only 40% of the revascularizations were considered successful.
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European Journal of Vascular and Endovascular Surgery, Aug 1, 2020
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Annals of Vascular Surgery, Nov 1, 2019
INTRODUCTION Remodeling of supra-renal aorta after endovascular aortic aneurysm repair (EVAR) in ... more INTRODUCTION Remodeling of supra-renal aorta after endovascular aortic aneurysm repair (EVAR) in relation to different endograft design has not been thoroughly investigated. The aim of this study was to assess the anatomical configuration of the supra-renal aorta after using endografts with different proximal fixation during the first post-EVAR year. METHODS A retrospective study including EVAR patients using 3 types of endografts with different proximal fixation system according to Instructions for Use was undertaken (50: Ovation Endologix, CA, USA; 25: Endurant IIs, Medtronic, Calif, USA; 25: Excluder C3, W.L. Gore & Associates, AZ, USA). Co-morbidities were recorded. Anatomic variables of the supra-aortic anatomy, abdominal aortic aneurysm (AAA) maximum diameter, and neck angulation, were analyzed. Computed tomography angiography (CTA) was obtained pre-operatively at 1 and 12 months post-EVAR, while a duplex scan was undertaken at 6 months. RESULTS Co-morbidities were not different across the 3 groups. Presence and amount of neck calcification (P=0.139) and thrombus (P=0.116) was similar among groups. Maximum aortic diameter showed significant reduction from pre-operative measurements to 12-month post-operative ones, for all groups. (Ovation: 56.5mm to 53mm; P<0.001, Endurant: 57mm to 51mm; P<0.001, Excluder: 55mm to 50mm; P<0.001). Supra-renal angulation was decreased significantly in the Ovation (P<0.001) and Excluder group (P=0.05), while the infra-renal angulation was decreased in all groups. Among endografts, the decrease of AAA maximum diameter was similar (P=0.99), while the supra-renal aortic diameter was significantly increased in Ovation patients in comparison to the other two endografts at the level of 5mm (P=0.02) and 25mm (P=0.01). Supra-renal angulation reduction was similar (P=0.7), while infra-renal angulation was significantly more decreased in Ovation endograft than the other two systems (P<0.001). CONCLUSION Proximal endograft configuration appears to have different impact on supra-aortic anatomy. Longer follow up is needed to clarify future remodeling and clinical impact of these observations.
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Journal of Endovascular Therapy
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Oncology Letters
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Case report
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Papers by Miltiadis Matsagkas