Athanasios Lioupis

Aristotle University of Thessaloniki, Saloníki, Central Macedonia, Greece

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Publications (9)17.44 Total impact

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    ABSTRACT: To present an unusual case of blunt aortic injury in a 30-year-old male patient with an aberrant right subclavian artery. Driven by the complicated and challenging nature of the case, we decided to treat the patient by a combined approach-right subclavian artery transposition and endograft implantation at the isthmus level. During the 24-month follow-up (clinical examination, angiogram, computed tomographic scan), we registered no complaints; normal perfusion of the right arm; and adequate sealing of the aortic tear. We believe that the hybrid management of such trauma is a feasible, effective, and less-invasive option.
    Annals of Vascular Surgery 01/2012; 26(3):421.e1-5. · 0.99 Impact Factor
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    ABSTRACT: We are presenting a case of giant internal carotid artery aneurysm (ICAA) managed by a new exposure technique. Following double mandibular osteotomy, the exposure of the entire aneurysm was achieved by mandible mobilization. The aneurysm repair was performed by resection and graft interposition. Mandible bone reconstruction was succeeded via mini plate osteosynthesis. No adverse events were noticed during the 24-month follow-up period. The surgical ICAA management is necessary to prevent severe complications. In cases of aneurysm extension to the skull base, double mandibular osteotomy is a safe technique that facilitates aneurysm exposure and control.
    Journal of vascular surgery: official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter 03/2011; 54(2):522-5. · 3.52 Impact Factor
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    ABSTRACT: Traumatic rupture of the thoracic aorta secondary to blunt chest trauma is a life-threatening emergency and a common cause of death, usually following violent collisions. The objective of this retrospective report was to evaluate the efficacy of endovascular treatment of thoracic aortic disruptions with a single commercially available stent-graft. Nine men (mean age 29.5 years) were admitted to our institution between January 2003 and January 2006 due to blunt aortic trauma following violent motor vehicle collisions. Plain chest radiography, spiral computed tomography, aortography, and transesophageal echocardiography were used for diagnostic purposes in all cases. All patients were diagnosed with contained extramural thoracic aortic hematomas, secondary to aortic disruption. One patient was also diagnosed with a traumatic thoracic aortic dissection, secondary to blunt trauma. All subjects were poor surgical candidates, due to major injuries such as multiple bone fractures, abdominal hematomas, and pulmonary contusions. All repairs were performed using the EndoFit (LeMaitre Vascular) stent-graft. Complete exclusion of the traumatic aortic disruption and pseudoaneurysm was achieved and verified at intraoperative arteriography and on CT scans, within 10 days of the repair in all patients. In 1 case the deployment of a second cuff was necessary due to a secondary endoleak. In 2 cases the left subclavian artery was occluded to achieve adequate graft fixation. No procedure-related deaths have occurred and no cardiac or peripheral vascular complications were observed within the 12 months (range 8-16 months) follow-up. This is the first time the EndoFit graft has been utilized in the treatment of thoracic aortic disruptions secondary to chest trauma. The repair of such pathologies is technically feasible and early follow-up results are promising.
    CardioVascular and Interventional Radiology 06/2007; 30(3):370-5. · 2.14 Impact Factor
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    ABSTRACT: To evaluate the efficacy of carotid artery stent placement with embolic protection. During a 2-year period (May 2003 to April 2005), 232 patients underwent carotid artery stent placement with the Acculink RX stent-graft and an embolic protection device. There were 150 men (mean age,70 years; age range, 58-85 years) and 82 women (mean age, 76 years; age range, 56-82 years). One hundred sixty-five patients were symptomatic and 67 were asymptomatic. All patients were at high risk for carotid endarterectomy. The procedure was technically successful in 231 patients. The procedure was stopped in one patient due to asystole. In three patients, a cervical approach was necessary owing to aortic arch anatomy. During the procedure,11 patients (4.74%) experienced bradycardia and two developed a major stroke (0.86%). The mean follow-up was 30 months (range, 12-36 months). Four patients died. No stent occlusion was observed. During the late follow-up period(>30 days), two patients (0.86%) had minor strokes, three (1.29%) had nonfatal transient ischemic attacks, and seven(3.01%) had myocardial infarctions. Carotid artery stent placement with cerebral protection by using the specific devices compares favorably to previously reported surgical results.
    Journal of vascular and interventional radiology: JVIR 04/2007; 18(3):337-42. · 1.81 Impact Factor
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    ABSTRACT: To evaluate the mid-term feasibility, efficacy, and durability of descending thoracic aortic aneurysm (DTAA) exclusion using the EndoFit device (LeMaitre Vascular). Twenty-three (23) men (mean age 66 years) with a DTAA were admitted to our department for endovascular repair (21 were ASA III+ and 2 refused open repair) from January 2003 to July 2005. Complete aneurysm exclusion was feasible in all subjects (100% technical success). The median follow-up was 18 months (range 8-40 months). A single stent-graft was used in 6 cases. The deployment of a second stent-graft was required in the remaining 17 patients. All endografts were attached proximally, beyond the left subclavian artery, leaving the aortic arch branches intact. No procedure-related deaths have occurred. A distal type I endoleak was detected in 2 cases on the 1 month follow-up CT scan, and was repaired with reintervention and deployment of an extension graft. A nonfatal acute myocardial infarction occurred in 1 patient in the sixth postoperative month. Graft migration, graft infection, paraplegia, cerebral or distal embolization, renal impairment or any other major complications were not observed. The treatment of DTAAs using the EndoFit stent-graft is technically feasible. Mid-term results in this series are promising.
    CardioVascular and Interventional Radiology 01/2007; 30(2):177-81. · 2.14 Impact Factor
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    ABSTRACT: To evaluate the feasibility and efficacy of repairing isolated iliac artery aneurysms with short proximal necks (<10 mm) by implanting the EndoFit stent-graft. Seven patients (6 men; median age 73 years, range 70-78) were diagnosed with an isolated common iliac artery (CIA) aneurysm that featured a short proximal landing zone, complicating endovascular treatment. The median aneurysm diameter was 4.4 cm (range 3.5-7.0), and the median proximal neck length was 7 mm (range 5-9).The aneurysms were treated using the EndoFit stent-graft, which can be deployed in a short proximal landing zone. The modified technique involves the deployment of the graft directly above the aneurysm sac without obstructing the contralateral iliac axis, thus affixing the bare proximal stent in the terminal aorta. Follow-up was performed by clinical evaluation and computed tomography at 1, 6, and 12 months postoperatively. The EndoFit stent-graft was successfully deployed in all cases, with complete aneurysm exclusion. In 1 case, the deployment of a second cuff was necessary to secure complete aneurysm exclusion. The median follow-up was 18 months, during which no deaths occurred, and no endoleak or stent-graft migration was observed. Endograft thrombosis occurred in 1 case due to graft angulation caused by external iliac artery stenosis and kinking. None of the aneurysms has ruptured, and there have been no serious complications. Direct endoluminal repair of isolated CIA aneurysms with short proximal necks is feasible using this technique. Efficacy and long-term results are to be confirmed by larger scale series over a long time period.
    Journal of Endovascular Therapy 11/2006; 13(5):667-71. · 2.70 Impact Factor
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    ABSTRACT: The aim of this study is to investigate the safety and efficacy of abdominal aortic aneurysm (AAA) repair with modular bifurcated Talent stent-graft. Between September 2001 and September 2005, 85 patients with infrarenal AAA underwent treatment with Talent stent-graft. There were 83 men and 2 women with a median age of 69.3 years. Anatomy of the abdominal aorta and the iliac arteries was investigated with high resolution contrast CT together with digital subtraction angiography. The majority of patients had comorbid illnesses like arterial hypertension (60%), CAD (38%) and previous CABG (26%). Duration of follow-up period ranged from 1 to 48 months (median 18 months). Repair was performed with transrenal fixation of the bifurcated Talent stent-graft under regional anesthesia in 80% of all cases. Technical success rate was 97.6%. Aneurysm related mortality was 2.4% due to aneurysm rupture in the postoperative period. Overall mortality rate was 9.4%. Morbidity rate was 16.5%. Immediate conversion to open repair was necessary in 1 patient (1.2%). Endoleak rate was 4.8% at 1 month follow-up period. Secondary intervention was required in 1.2% of patients. Iliac limb occlusion was detected in 1 patient (1.2%). Talent stent-graft exhibits a high degree of technical success in AAA repair in patients with comorbid conditions with a low perioperative morbidity and mortality rate.
    International angiology: a journal of the International Union of Angiology 07/2006; 25(2):197-203. · 1.46 Impact Factor
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    ABSTRACT: Atherosclerotic lesions of the thoracic aorta and particularly mobile mural thrombi constitute a rare but important source of cerebral and peripheral emboli. Conventional treatment of such pathologies includes systematic anticoagulation therapy and surgical thromboendarterectomy, with potential segmental replacement of the thoracic aorta using synthetic grafts. We report the successful covering of a mobile thoracic aortic thrombus using a commercially available endograft (Endofit) in a patient presented with multiple peripheral emboli. The endovascular treatment of such lesions constitutes a new alternative treatment particularly effective and safe that decreases considerably both operational time and surgical risk.
    European Journal of Vascular and Endovascular Surgery - EUR J VASC ENDOVASC SURG. 01/2006; 31(5):564-564.
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    ABSTRACT: To evaluate the feasibility and efficacy of a specific aortomonoiliac endograft and the durability of the femorofemoral bypass for treatment of abdominal aortic aneurysm (AAA). From 2002 to 2004, 39 high-risk (ASA III/IV) patients (36 men; median age 74 years, range 63-84) with AAA (n = 33) or AAA and common iliac artery aneurysm (n = 6) were treated with an EndoFit aortomonoiliac endograft and femorofemoral crossover bypass. The contralateral iliac axis was obstructed with an endoluminal occluder. Patients were followed with contrast-enhanced computed tomography at 1, 6, 12, and 24 months. EndoFit AMI stent-grafts were implanted successfully in all patients. Perioperative mortality was zero. Endoleak occurred in 3 (7.7%) cases. A proximal type I endoleak was identified at 1 month and was treated with a proximal cuff. Two type II endoleaks are under surveillance because the aneurysm sac shows no enlargement. Thrombosis of the femorofemoral graft occurred in 1 case during the immediate postoperative period due to insufficient inflow from a residual stenosis of the endograft (primary patency 97.5%). The deficit was treated successfully (secondary patency 100%). Two (5.1%) tunnel hematomas were treated conventionally. Median follow-up was 14 months (range 6-30). All patients are alive. None of the aneurysms has ruptured or been converted to an open procedure. Graft migration, serious infection, paraplegia, distal embolization, or any other serious complication has not been observed. In high surgical risk patients with complex iliac anatomy, aortomonoiliac endograft with femorofemoral crossover bypass is feasible and efficacious. Moreover, the midterm patency of the extra-anatomic bypass appears quite satisfactory.
    Journal of Endovascular Therapy 07/2005; 12(3):280-7. · 2.70 Impact Factor