Rytis Stasys Kaupas

Kaunas University of Technology, Caunas, Kauno Apskritis, Lithuania

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Publications (7)5.67 Total impact

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    ABSTRACT: The rate of endovascular interventions for iliac occlusive lesions is continuously growing. The evolution of the technology supporting these therapeutic measures improves the results of these interventions. We performed a review of the literature to report and appreciate short- and long-term results of endovascular stenting of iliac artery occlusive lesions. The Medline database was searched to identify all the studies reporting iliac artery stenting for aortoiliac occlusive disease (Trans Atlantic Inter-Society Consensus [TASC] type A, B, C, and D) from January 2006 to July 2012. The outcomes were technical success, long-term primary and secondary patency rates, early mortality, and complications. Technical success was achieved in 91% to 99% of patients as reported in all the analyzed articles. Early mortality was described in 5 studies and ranged from 0.7% to 3.6%. The most common complications were access site hematomas, distal embolization, pseudoaneurysms, and iliac artery ruptures. The complications were most often treated conservatively or using percutaneous techniques. The 5-year primary and secondary patency rates ranged from 63% to 88% and 86% to 93%, respectively; and the 10-year primary patency rates ranged from 68% to 83%. In this article, combined percutaneous endovascular iliac stenting and infrainguinal surgical reconstructions and new techniques in the treatment of iliac stent restenosis are discussed. Iliac stenting is a feasible, safe, and effective method for the treatment of iliac occlusive disease. Initial technical and clinical success rates are high; early mortality and complication rates are low. Long-term patency is comparable with that after bypass surgery.
    Medicina (Kaunas, Lithuania) 01/2012; 48(12):653-9. · 0.55 Impact Factor
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    ABSTRACT: OBJECTIVE: Based on recent literature data, subintimal arterial angioplasty, its indications and contraindications, methods and techniques, treatment results, and perspectives are introduced in this article. During the last two decades, with increasing human lifespan, more and more frequently a combination of progressive chronic lower limb ischemia, which is caused by occlusive disease, and severe condition occurs. In such cases, patients cannot be operated on. In Europe and the United States of America, patients undergo subintimal angioplasty. It is a minimally invasive technique for the treatment of lower limb occlusive disease, when without tissue incision, under local anesthesia, blood flow through damaged artery is normalized. Thus, the occlusion is removed without surgery, patient's quality of life is improved, and survival is increased.
    Medicina (Kaunas, Lithuania) 02/2009; 45(4):327-39. · 0.55 Impact Factor
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    ABSTRACT: To report results of subintimal angioplasty (SA) of superficial femoral artery occlusions and to compare these results with percutaneous transluminal angioplasty (PTA) of similar lesions. Prospective study. In the period from June 2002 to August 2006, 73 SA procedures were performed in 71 patients and 75 PTA procedures were performed in 75 patients. All cases treated with SA or PTA for superficial femoral artery occlusions were prospectively registered and reviewed. Assessments of comorbidities, indication for procedure, run-off, occlusion length, calcification of the artery and graft patency were recorded. The technical success rate of SA was 87.7% versus 81.3% for PTA. Primary patency rates in the SA group at 1, 6, 12, 24 months were respectively 84.9+/-4.2, 71.2+/-5.1, 68.5+/-5.3 and 65.8+/-5.2%; in the PTA group - 81.3+/-4.4, 45.3+/-5.7, 42.7+/-5.6 and 38.7+/-5.5% respectively. At the same time-points primary assisted patency rates were in SA group 84.9+/-4.2, 83.6+/-4.2, 71.2+/-5.2 and 68.5+/-5.3%; and in the PTA group 81.3+/-4.4, 62.5+/-5.5, 44+/-5.6 and 42.7+/-5.6%. Calcification was associated with SA failure. There were no amputations in the follow up of either SA or PTA procedures. Results from subintimal angioplasty of superficial femoral artery occlusions was superior to the results of PTA.
    European journal of vascular and endovascular surgery: the official journal of the European Society for Vascular Surgery 08/2008; 36(1):101-6. · 2.92 Impact Factor
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    ABSTRACT: Malignant biliary obstruction may be caused by cholangiocarcinoma and other nonbiliary carcinomas. At the time of diagnosis, 90% of patients with malignant obstructive jaundice may benefit from palliative treatment only. The objective of palliation is to relieve jaundice-related symptoms, prevent cholangitis, prolong survival, and improve quality of life. Percutaneous transhepatic biliary stenting is a well-established procedure used in patients with malignant obstruction of intra- and extrahepatic bile ducts. Twelve patients (9 women, 3 men; mean age, 68 years; range, 44-88 years) with inoperable malignant biliary obstruction were selected for percutaneous transhepatic biliary stenting with metallic stents in the period from January to December 2007. Technical and clinical success rate in this patient series was 83% and 80%, respectively. Minor and major complications occurred in 17% and 8% of cases, respectively, which is in the range reported by the others. This is our first experience of percutaneous transhepatic biliary stenting at the Hospital of Kaunas University of Medicine and, to our knowledge, the first reported patient series in Lithuania. These first results encourage expanding effective palliation by the employment of the percutaneous transhepatic biliary stenting in patients with nonresectable malignant biliary obstruction or in case of a recurrent disease after curative surgery. The cost effectiveness of percutaneous transhepatic biliary stenting against percutaneous transhepatic biliary drainage has yet to be evaluated in a prospective manner. However, immediate clinical benefits and positive short-term outcomes are unequivocal.
    Medicina (Kaunas, Lithuania) 02/2008; 44(12):969-76. · 0.55 Impact Factor
  • Nerijus Aleksynas, Rytis Stasys Kaupas
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    ABSTRACT: To assess prospectively the first experience of subintimal angioplasty of superficial femoral artery occlusions. Within a period of 36 months, 45 patients with 45 chronic occlusions in superficial femoral artery were treated at Kaunas University of Medicine Hospital. The technical success rate was 84.4%, and four failures were treated by conventional surgery. The following complications occurred: one hematoma at the arterial puncture site, one artery spasm, and two distal embolizations. The mean length of occlusions was 14.2+/-1.4 cm. The mean ankle-brachial index improved from 0.41+/-0.15 to 0.81+/-0.04 after successful subintimal angioplasty (P<0.001). Primary assisted patency rates were 94.7%, 92.1%, 84.2%, 81.6%, and 81.6% at 1, 3, 6, 12, and 24 months, respectively. The limb salvage rates were 100% and 97.8% at 1-3 and 6-12-24 months, respectively. There were no treatment-related amputations. Subintimal angioplasty of occluded superficial femoral artery is a safe and minimally invasive procedure with a high initial technical success rate, low complication rate, and good early results, and in case of failure, subsequent surgery can be performed.
    Medicina (Kaunas, Lithuania) 02/2007; 43(6):447-54. · 0.55 Impact Factor
  • Nerijus Aleksynas, Rytis Stasys Kaupas
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    ABSTRACT: To evaluate prospectively the impact of various factors on subintimal angioplasty of superficial femoral artery. Within a period of 36 months, 44 patients with 45 chronic occlusions in superficial femoral artery were examined. The influence of sex, age, hypertension, diabetes mellitus, smoking, chronic ischemia stage, occlusion length and calcification, flush occlusion of the superficial femoral artery, ischemic cardiac disease, postprocedural medical treatment was evaluated. Arterial calcification had a significant impact on technical success of subintimal angioplasty (p=0.03). Sex, age, smoking, flush occlusion of the superficial femoral artery, and cardiac disease influenced technical and hemodynamic success (p=0.086-0.295). Hypertension, diabetes mellitus, chronic ischemia stage, occlusion length, and postprocedural medical treatment did not significantly influence technical and hemodynamic success (p>0.05). Arterial calcification had a significant impact on technical success of subintimal angioplasty. Sex, age, smoking, flush occlusion of the superficial femoral artery, and ischemic cardiac disease influenced technical and hemodynamic success. Hypertension, diabetes mellitus, chronic ischemia stage, occlusion length, and postprocedural medical treatment had no statistically significant impact on technical and hemodynamic success.
    Medicina (Kaunas, Lithuania) 02/2007; 43(1):43-50. · 0.55 Impact Factor
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    Nerijus Aleksynas, Rytis Stasys Kaupas
    01/2007;