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168. Presentation patterns and prognosis of 109 isolated venous injuries in 99 patients

Author

Kakkos, Stavros K, primary, Tsolakis, Ioannis A, additional, Markopoulos, George, additional, Maroulis, Ioannis, additional, Koletsis, Efstratios, additional, Fligou, Fotini, additional, Panagopoulos, Konstantinos, additional, Papadoulas, Spyros, additional, Lampropoulos, George, additional, Ntouvas, Ioannis, additional, Nikolakopoulos, Konstantinos M, additional, Papageorgopoulou, Chrysanthi P, additional, and Kouri, Anastasia, additional

Published
2019
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169. Effect of zooming on texture features of ultrasonic images

Author

Kyriacou Efthyvoulos, Nicolaides Andrew N, Kakkos Stavros K, Pattichis Constantinos S, and Geroulakos George

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Abstract Background Unstable carotid plaques on subjective, visual, assessment using B-mode ultrasound scanning appear as echolucent and heterogeneous. Although previous studies on computer assisted plaque characterisation have standardised B-mode images for brightness, improving the objective assessment of echolucency, little progress has been made towards standardisation of texture analysis methods, which assess plaque heterogeneity. The aim of the present study was to investigate the influence of image zooming during ultrasound scanning on textural features and to test whether or not resolution standardisation decreases the variability introduced. Methods Eighteen still B-mode images of carotid plaques were zoomed during carotid scanning (zoom factor 1.3) and both images were transferred to a PC and normalised. Using bilinear and bicubic interpolation, the original images were interpolated in a process of simulating off-line zoom using the same interpolation factor. With the aid of the colour-coded image, carotid plaques of the original, zoomed and two resampled images for each case were outlined and histogram, first order and second order statistics were subsequently calculated. Results Most second order statistics (21/25, 84%) were significantly (p < 0.05) sensitive to image zooming during scanning, in contrast to histogram and first order statistics (4/25, 16%, p < 0.001, Fisher's exact test). Median (interquartile range) change of those features sensitive to zooming was 18.14% (4.94–28.43). Image interpolation restored these changes, the bicubic interpolation being superior compared to bilinear interpolation (p = 0.036). Conclusion Texture analysis of ultrasonic plaques should be performed under standardised resolution settings; otherwise a resolution normalisation algorithm should be applied.

Published
2006
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171. Thromboprophylaxis; what is the future, for high risk surgical patients?

Author

Shelmerdine, Lauren, Nandhra, Sandip, Kakkos, Stavros K, Caprini, Joseph, and Stansby, Gerry

Subjects
THROMBOEMBOLISM prevention, VEINS, SERIAL publications, SURGERY, PATIENTS, COMPRESSION garments, ANTICOAGULANTS, TREATMENT effectiveness
Abstract

An editorial is presented on debate about the role of mechanical methods in the prevention of venous thromboembolism (VTE). Topics include applying one of the mechanical methods of VTE prophylaxis, anti-embolism, or graduated compression stockings (GCS); and pharmacological thromboprophylaxis being sufficient in moderate to high risk surgical patients in the prevention of VTE.

Published
2022
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173. Improved effectiveness of the repositionable GORE EXCLUDER AAA endoprosthesis featuring the C3 delivery system compared with the original GORE EXCLUDER AAA endoprosthesis for within the instructions for use treatment of aortoiliac aneurysms

Author

Tsolakis, Ioannis A., primary, Kakkos, Stavros K., additional, Papageorgopoulou, Chrysanthi P., additional, Zampakis, Peter, additional, Kalogeropoulou, Christina, additional, Papadoulas, Spyros, additional, Lampropoulos, George, additional, Nikolakopoulos, Konstantinos M., additional, Ntouvas, Ioannis, additional, and Kouri, Anastasia, additional

Published
2019
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178. Anaphylactic cardiovascular collapse and Kounis syndrome: systemic vasodilation or coronary vasoconstriction?

Author

Kounis, Nicholas G., primary, Cervellin, Gianfranco, additional, Koniari, Ioanna, additional, Bonfanti, Laura, additional, Dousdampanis, Periklis, additional, Charokopos, Nikolaos, additional, Assimakopoulos, Stelios F., additional, Kakkos, Stavros K., additional, Ntouvas, Ioannis G., additional, Soufras, George D., additional, and Tsolakis, Ioannis, additional

Published
2018
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180. Successful Resection of a Large Carotid Body Tumor Masquerading Complete Encasement of the Internal Carotid Artery on Preoperative Imaging

Author

Kakkos, Stavros K., primary, Zampakis, Peter, additional, Lampropoulos, George C., additional, Paridis, Leonidas, additional, Kaplanis, Charalampos, additional, Bantouna, Dimitra, additional, Nikolakopoulos, Konstantinos M., additional, Papageorgopoulou, Chrysanthi P., additional, Kalogeropoulou, Christina, additional, and Tsolakis, Ioannis A., additional

Published
2018
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182. Corrigendum to ‘Editor's Choice – European Society for Vascular Surgery (ESVS) 2020 Clinical Practice Guidelines on the Management of Vascular Graft and Endograft Infections’ [European Journal of Vascular & Endovascular Surgery 59/3 (2020) 339–384]

Author

Chakfé, Nabil, Diener, Holger, Lejay, Anne, Assadian, Ojan, Berard, Xavier, Caillon, Jocelyne, Fourneau, Inge, Glaudemans, Andor W.J.M., Koncar, Igor, Lindholt, Jes, Melissano, Germano, Saleem, Ben R., Senneville, Eric, Slart, Riemer H.J.A., Szeberin, Zoltan, Venermo, Maarit, Vermassen, Frank, Wyss, Thomas R., ESVS Guidelines Committee, de Borst, Gert J., Gonçalves, Frederico B., Kakkos, Stavros K., Kolh, Philippe, Tulamo, Riikka, de Ceniga, Melina V., Document Reviewers, von Allmen, Regula S., van den Berg, Jos C., Debus, E. Sebastian, Koelemay, Mark J.W., Linares-Palomino, Jose P., Moneta, Gregory L., Ricco, Jean-Baptiste, and Wanhainen, Anders

Published
2020
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183. A Review of Noninvasive Ultrasound Image Processing Methods in the Analysis of Carotid Plaque Morphology for the Assessment of Stroke Risk

Author

Kyriacou, Efthyvoulos C., Pattichis, Constantinos S., Pattichis, Marios S., Loizou, Christos P., Christodoulou, Chris C., Kakkos, Stavros K., Nicolaïdes, Andrew N., Pattichis, Constantinos S. [0000-0003-1271-8151], Christodoulou, Chris C. [0000-0001-9398-5256], Pattichis, Marios S. [0000-0002-1574-1827], Kyriacou, Efthyvoulos C. [0000-0002-4589-519X], and Loizou, Christos P. [0000-0003-1247-8573]

Subjects
Image analysis method, Image analysis, Segmentation, Image texture, Risk Factors, Medicine, Ultrasonics, Stroke, Ultrasonography, Image segmentation, Ultrasound, Textures, Despekle filtering, General Medicine, stroke, Computer Science Applications, Carotid Arteries, risk factor, Texture analysis, Future directions, Motion analysis, Feature extraction, Engineering and Technology, Radiology, Biotechnology, Visual classification, Risk analysis, medicine.medical_specialty, Medical Engineering, review, Feature extraction and classification, Image processing, Assessment of stroke, Plaque imaging, Standardized methods, 3D imaging, Humans, human, Carotid plaques, Electrical and Electronic Engineering, Carotid, carotid artery, business.industry, echography, medicine.disease, Ultrasound image processing, pathology, business, Ultrasound imaging, Clinical methods, Emerging trends
Abstract

Noninvasive ultrasound imaging of carotid plaques allows for the development of plaque-image analysis methods associated with the risk of stroke. This paper presents several plaque-image analysis methods that have been developed over the past years. The paper begins with a review of clinical methods for visual classification that have led to standardized methods for image acquisition, describes methods for image segmentation and denoizing, and provides an overview of the several texture-feature extraction and classification methods that have been applied. We provide a summary of emerging trends in 3-D imaging methods and plaque-motion analysis. Finally, we provide a discussion of the emerging trends and future directions in our concluding remarks. © 2006 IEEE. 14 4 1027 1038 Cited By :49

Published
2010
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184. Acute Effects of Graduated Elastic Compression Stockings in Patients with Symptomatic Varicose Veins: A Randomised Double Blind Placebo Controlled Trial

Author

Kakkos, Stavros K., primary, Timpilis, Marios, additional, Patrinos, Panayiotis, additional, Nikolakopoulos, Konstantinos M., additional, Papageorgopoulou, Chrysanthi P., additional, Kouri, Anastasia K., additional, Ntouvas, Ioannis, additional, Papadoulas, Spyros I., additional, Lampropoulos, George C., additional, and Tsolakis, Ioannis A., additional

Published
2018
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189. An Integrated System for Assessing Stroke Risk

Author

Kyriacou, Efthyvoulos C., Pattichis, Constantinos S., Karaolis, Minas A., Loizou, Christos P., Christodoulou, Christodoulos I., Pattichis, Marios S., Kakkos, Stavros K., Nicolaïdes, Andrew N., Pattichis, Constantinos S. [0000-0003-1271-8151], Pattichis, Marios S. [0000-0002-1574-1827], Kyriacou, Efthyvoulos C. [0000-0002-4589-519X], and Loizou, Christos P. [0000-0003-1247-8573]

Subjects
Risk analysis, atherosclerotic plaque, Noninvasive investigations, Pattern Recognition, Automated, cause of death, Image texture, Risk Factors, Reference Values, Clinical risk factors, Carotid Stenosis, Prospective Studies, Diagnosis, Computer-Assisted, ultrasound, Automatic Data Processing, article, General Medicine, Anatomy, Regional, stroke, Stroke, Carotid Sinus, risk factor, Data Interpretation, Statistical, Engineering and Technology, Medical Record Linkage, Radiology, medicine.symptom, Clinical risk factor, Algorithms, Carotid Artery, Internal, Natural history study, medicine.medical_specialty, Medical Engineering, Biomedical Engineering, Carotid plaque texture analysis, electrocardiogram, Asymptomatic, Stroke risk, statistical analysis, image analysis, Algorithm design and analysis, medicine, Humans, human, cardiovascular diseases, Texture feature, Electronic Data Processing, business.industry, Myocardium, high risk population, Decision Trees, Ιntegrated system, Image segmentation, Decision Support Systems, Clinical, medicine.disease, brain ischemia, Stenosis, Knowledge representation, Database Management Systems, carotid artery obstruction, entropy, business, intima
Abstract

The objective of this article is to present an integrated system for the assessment of risk of stroke based on two modules: 1) clinical risk factors and noninvasive investigations, and 2) carotid plaque texture analysis. The system supports the data collected from the Asymptomatic Carotid Stenosis and Risk of Stroke (ACSRS) natural history study that includes following data: 1) clinical, biochemical, and electrocardiographic risk factors associated with cardiovascular deaths, and 2) whether any independent risk factors can be used to identify a high-risk group for cardiovascular death. Furthermore, the carotid plaque texture analysis module supports the normalization, despeckling, segmentation, texture feature extraction, and classification of ultrasound plaque images.

Published
2007
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190. Classification of atherosclerotic carotid plaques using morphological analysis on ultrasound images

Author

Kyriacou, Efthyvoulos C., Pattichis, Marios S., Pattichis, Constantinos S., Mavrommatis, A., Christodoulou, Christodoulos I., Kakkos, Stavros K., Nicolaïdes, Andrew N., Pattichis, Constantinos S. [0000-0003-1271-8151], Pattichis, Marios S. [0000-0002-1574-1827], and Kyriacou, Efthyvoulos C. [0000-0002-4589-519X]

Subjects
Morphology, Artificial intelligence, Lipid cores, Morphological analyses, Svm classifiers, Computer science, Classification features, Grayscale, Asymptomatic, Image analysis, Morphological image analysis, Probabilistic neural networks, Probabilistic neural network, Isoechoic, Morphological models, Artificial Intelligence, medicine, Ultrasonics, Computer vision, Carotid plaques, Stroke, Support vector machines, Learning systems, Classifiers, Receiver operating characteristic, Ultrasonic imaging, business.industry, Ultrasound, Hypoechoic, Pattern recognition, medicine.disease, Probability distributions, Acoustic waves, Image enhancement, Morphological measurements, Morphological analysis, Ultrasound images, Classification results, L images, medicine.symptom, Lipid core, business, Neural networks, Scale morphologies
Abstract

The aim of this study was to investigate the usefulness of multilevel binary and gray scale morphological analysis in the assessment of atherosclerotic carotid plaques. Ultrasound images were recorded from 137 asymptomatic and 137 symptomatic plaques (Stroke, Transient Ischaemic Attack (TIA), Amaurosis Fugax (AF)). We carefully develop the clinical motivation behind our approach. We do this by relating the proposed L-images, M-images and H-images in terms of the clinically established hypoechoic, isoechoic and hyperechoic classification. Normalized pattern spectra were computed for both a structural, multilevel binary morphological model, and a direct gray scale morphology model. From the plots of the average pattern spectra, it is clear that we have significant differences between the symptomatic and asymptomatic spectra. Here, we note that the morphological measurements appear to be in agreement with the clinical assertion that symptomatic plaques tend to have large lipid cores while the asymptomatic plaques tend to have small lipid cores. The derived pattern spectra were used as classification features with two different classifiers, the Probabilistic Neural Network (PNN) and the Support Vector Machine (SVM). Both classifiers were used for classifying the pattern spectra into either a symptomatic or an asymptomatic class. The highest percentage of correct classifications score was 73.7% for multilevel binary morphological image analysis and 66.8% for gray scale morphological analysis. Both were achieved using the SVM classifier. Among all features, the L-image pattern spectra, that also measure the distributions of the lipid core components (and some non-lipid components) gave the best classification results. © 2007 Springer Science+Business Media, LLC. 30 1 3 23 Cited By :49

Published
2007
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191. Predictors of Operative Mortality of 928 Intact Aortoiliac Aneurysms

Author

Tsolakis, Ioannis A., Kakkos, Stavros K., Papageorgopoulou, Chrysanthi P., Papadoulas, Spyros, Lampropoulos, George, Fligou, Fotini, Nikolakopoulos, Konstantinos M., Ntouvas, Ioannis, and Kouri, Anastasia

Abstract

The aim of this study is to identify preoperative and intraoperative factors associated with in-hospital mortality of intact abdominal aortoiliac aneurysm repair.

Published
2021
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193. Editor's Choice – European Society for Vascular Surgery (ESVS) 2020 Clinical Practice Guidelines on the Management of Acute Limb Ischaemia.

Author

Björck, Martin, Earnshaw, Jonothan J., Acosta, Stefan, Bastos Gonçalves, Frederico, Cochennec, Frederic, Debus, E.S., Hinchliffe, Robert, Jongkind, Vincent, Koelemay, Mark J.W., Menyhei, Gabor, Svetlikov, Alexei V., Tshomba, Yamume, Van Den Berg, Jos C., ESVS Guidelines Committee, de Borst, Gert J., Chakfé, Nabil, Kakkos, Stavros K., Koncar, Igor, Lindholt, Jes S., and Tulamo, Riikka

Published
2020
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194. Asymptomatic internal carotid artery stenosis and cerebrovascular risk stratification

Author

Nicolaides, Andrew N, Kakkos, Stavros K., Kyriacou, Efthyvoulos, Griffin, Maura, Sabetai, Michael, Thomas, Dafydd J., Tegos, Thomas, Geroulakos, George, Labropoulos, Nicos, Dor, Caroline J., Morris, Tim P., Naylor, Ross, Abbott, Anne L., Adovasio, Roberto, Ziani, B., Alò, F. P., Cicilioni, C. G., Ambrosio, G., Andreev, A., Andreozzi, G. M., Verlato, F., Camporese, G., Arosio, E., Barkauskas, E., Barros D'Sa, A. A. B., Brannigan, P., Batchvarova, V., Dramov, A., Belardi, P., Novelli, Gp, Simoni, G., Bell, P., Biasi, G. M., Mingazzini, P., Bornstein, N. M., Bouchier Hayes, D., Fitzgerald, P., Cairols, M. A., Cao, P. G., Derango, P., Carboni, G. P., Geoffredo, C., Catalano, M., Chambers, B., Goetzmann, M., Dickinson, A., Clement, D., Bobelyn, M., Coccheri, S., Conti, E., Diamantopoulos, E., Andreadis, E. A., Dimakakos, P. B., Kotsis, T., Eikelboom, B., Entz, L., Ferrari Bardile, Null, Aloi, T., Salerno, M., Fernandes e. Fernandes, J., Pedro, L., Fitzgerald, D. E., O'Shaunnersy, Anne, Fletcher, J., Forconi, S., Cappeli, R., Bicchi, M., Arrigucci, S., Gallai, V., Cardaiolli, G., Geroulakos, G., Kakkos, S., Gomez Isaza, L. F., Gorgoyannis, G., Liasis, N., Graf, M., Guarini, P., Hardy, S., Harris, P., Aston, S., Iosa, G., Katsamouris, A., Giannoukas, A., Krzanowski, M., Ladurner, G., Leal Monedero, J., Lee, B. B., Liapis, C., Galanis, P., Liboni, W., Pavanelli, E., Mannarino, E., Vaudo, G., Mccollum, P., Levison, R., Micieli, G., Bosone, D., Middleton, L., Pantziaris, M., Tyllis, T., Minar, E., Willfort, A., Moggi, L., Nenci, G., Radicchia, S., Nicolaides, A., Thomas, D, Norgren, L., Ribbe, E., Novo, S., Tantillo, R., Olinic, D., Paaske, W., Pagnan, A., Pauletto, P., Pagliara, V., Pettina, G., Pratesi, C., Matticari, S., Polivka, J., Sevcik, P., Poredos, P., Blinc, A., Videcnik, V., Pujia, A., Raso, A., Rispoli, P., Conforti, M., Robinson, T., Dennis, M. S. J., Rosfors, S., Rudofsky, G., Schroeder, T., Gronholdt, M. L., Finocchi, C., Rodriguez, G., Spartera, C., Ventura, M., Scarpelli, P., Sprynger, M., Sadzot, B., Hottermans, C., Moonen, Null, Taylor, P. R., Tovar Pardo, A., Negreira, J., Vayssairat, M., Faintuch, J. M., Valaikiené, J., Walker, M. G., Wilkinson, A. R., Nicolaides, A, Kakkos, S, Kyriacou, E, Griffin, M, Sabetai, M, Thomas, D, Tegos, T, Geroulakos, G, Labropoulos, N, Dor, C, Morris, T, Naylor, R, Abbott, A, Adovasio, R, Ziani, B, Alò, F, Cicilioni, C, Ambrosio, G, Andreev, A, Andreozzi, G, Verlato, F, Camporese, G, Arosio, E, Barkauskas, E, Barros D'Sa, A, Brannigan, P, Batchvarova, V, Dramov, A, Belardi, P, Novelli, G, Simoni, G, Bell, P, Biasi, G, Mingazzini, P, Bornstein, N, Bouchier Hayes, D, Fitzgerald, P, Cairols, M, Cao, P, Derango, P, Carboni, G, Geoffredo, C, Catalano, M, Chambers, B, Goetzmann, M, Dickinson, A, Clement, D, Bobelyn, M, Coccheri, S, Conti, E, Diamantopoulos, E, Andreadis, E, Dimakakos, P, Kotsis, T, Eikelboom, B, Entz, L, Ferrari Bardileah, N, Aloi, T, Salerno, M, Fernandes, J, Pedro, L, Fitzgerald, D, O'Shaunnersy, A, Fletcher, J, Forconi, S, Cappeli, R, Bicchi, M, Arrigucci, S, Gallai, V, Cardaiolli, G, Gomez Isaza, L, Gorgoyannis, G, Liasis, N, Graf, M, Guarini, P, Hardy, S, Harris, P, Aston, S, Iosa, G, Katsamouris, A, Giannoukas, A, Krzanowski, M, Ladurner, G, Leal Monedero, J, Lee, B, Liapis, C, Galanis, P, Liboni, W, Pavanelli, E, Mannarino, E, Vaudo, G, Mccollum, P, Levison, R, Micieli, G, Bosone, D, Middleton, L, Pantziaris, M, Tyllis, T, Minar, E, Willfort, A, Moggi, L, Nenci, G, Radicchia, S, Norgren, L, Ribbe, E, Novo, S, Tantillo, R, Olinic, D, Paaske, W, Pagnan, A, Pauletto, P, Pagliara, V, Pettina, G, Pratesi, C, Matticari, S, Polivka, J, Sevcik, P, Poredos, P, Blinc, A, Videcnik, V, Pujia, A, Raso, A, Rispoli, P, Conforti, M, Robinson, T, Dennis, M, Rosfors, S, Rudofsky, G, Schroeder, T, Gronholdt, M, Finocchi, C, Rodriguez, G, Spartera, C, Ventura, M, Scarpelli, P, Sprynger, M, Sadzot, B, Hottermans, C, Moonenbp, N, Taylor, P, Tovar Pardo, A, Negreira, J, Vayssairat, M, Faintuch, J, Valaikiené, J, Walker, M, Wilkinson, A, Nicolaides, Andrew N, Kakkos, Stavros K., Kyriacou, Efthyvoulo, Griffin, Maura, Sabetai, Michael, Thomas, Dafydd J., Tegos, Thoma, Geroulakos, George, Labropoulos, Nico, Dor, Caroline J., Morris, Tim P., Naylor, Ro, Abbott, Anne L., Adovasio, Roberto, Ziani, B., Alò, F. P., Cicilioni, C. G., Ambrosio, G., Andreev, A., Andreozzi, G. M., Verlato, F., Camporese, G., Arosio, E., Barkauskas, E., Barros D'Sa, A. A. B., Brannigan, P., Batchvarova, V., Dramov, A., Belardi, P., Novelli, Gp, Simoni, G., Bell, P., Biasi, G. M., Mingazzini, P., Bornstein, N. M., Bouchier Hayes, D., Fitzgerald, P., Cairols, M. A., Cao, P. G., Derango, P., Carboni, G. P., Geoffredo, C., Catalano, M., Chambers, B., Goetzmann, M., Dickinson, A., Clement, D., Bobelyn, M., Coccheri, S., Conti, E., Diamantopoulos, E., Andreadis, E. A., Dimakakos, P. B., Kotsis, T., Eikelboom, B., Entz, L., Ferrari Bardile, Null, Aloi, T., Salerno, M., Fernandes e. Fernandes, J., Pedro, L., Fitzgerald, D. E., O'Shaunnersy, Anne, Fletcher, J., Forconi, S., Cappeli, R., Bicchi, M., Arrigucci, S., Gallai, V., Cardaiolli, G., Geroulakos, G., Kakkos, S., Gomez Isaza, L. F., Gorgoyannis, G., Liasis, N., Graf, M., Guarini, P., Hardy, S., Harris, P., Aston, S., Iosa, G., Katsamouris, A., Giannoukas, A., Krzanowski, M., Ladurner, G., Leal Monedero, J., Lee, B. B., Liapis, C., Galanis, P., Liboni, W., Pavanelli, E., Mannarino, E., Vaudo, G., Mccollum, P., Levison, R., Micieli, G., Bosone, D., Middleton, L., Pantziaris, M., Tyllis, T., Minar, E., Willfort, A., Moggi, L., Nenci, G., Radicchia, S., Nicolaides, A., Norgren, L., Ribbe, E., Novo, S., Tantillo, R., Olinic, D., Paaske, W., Pagnan, A., Pauletto, P., Pagliara, V., Pettina, G., Pratesi, C., Matticari, S., Polivka, J., Sevcik, P., Poredos, P., Blinc, A., Videcnik, V., Pujia, A., Raso, A., Rispoli, P., Conforti, M., Robinson, T., Dennis, M. S. J., Rosfors, S., Rudofsky, G., Schroeder, T., Gronholdt, M. L., Finocchi, C., Rodriguez, G., Spartera, C., Ventura, M., Scarpelli, P., Sprynger, M., Sadzot, B., Hottermans, C., Moonen, Null, Taylor, P. R., Tovar Pardo, A., Negreira, J., Vayssairat, M., Faintuch, J. M., Valaikiené, J., Walker, M. G., and Wilkinson, A. R.

Subjects
Male, Carotid Stenosi, carotid artery stenosis, Brain Ischemia, 80 and over, MED/22 - CHIRURGIA VASCOLARE, Carotid Stenosis, Cerebrovascular disease, cerebrovascular risk, Stroke, Ultrasonography, Aged, 80 and over, Middle Aged, cardiovascular system, Female, Radiology, Internal carotid artery, medicine.symptom, Cardiology and Cardiovascular Medicine, Carotid Artery, Internal, Adult, Aged, Amaurosis Fugax, Humans, ROC Curve, Risk Assessment, Surgery, Human, medicine.medical_specialty, Asymptomatic, Central nervous system disease, medicine.artery, medicine, Asymtomatic carotid stenosis, cardiovascular diseases, Risk factor, carotid surgery, Vascular disease, business.industry, Amaurosis fugax, medicine.disease, Internal, Stenosis, atherosclerosis, Carotid Artery, business
Abstract

Background: The purpose of this study was to determine the cerebrovascular risk stratification potential of baseline degree of stenosis, clinical features, and ultrasonic plaque characteristics in patients with asymptomatic internal carotid artery (ICA) stenosis. Methods: This was a prospective, multicenter, cohort study of patients undergoing medical intervention for vascular disease. Hazard ratios for ICA stenosis, clinical features, and plaque texture features associated with ipsilateral cerebrovascular or retinal ischemic (CORI) events were calculated using proportional hazards models. Results: A total of 1121 patients with 50% to 99% asymptomatic ICA stenosis in relation to the bulb (European Carotid Surgery Trial [ECST] method) were followed-up for 6 to 96 months (mean, 48). A total of 130 ipsilateral CORI events occurred. Severity of stenosis, age, systolic blood pressure, increased serum creatinine, smoking history of more than 10 pack-years, history of contralateral transient ischemic attacks (TIAs) or stroke, low grayscale median (GSM), increased plaque area, plaque types 1, 2, and 3, and the presence of discrete white areas (DWAs) without acoustic shadowing were associated with increased risk. Receiver operating characteristic (ROC) curves were constructed for predicted risk versus observed CORI events as a measure of model validity. The areas under the ROC curves for a model of stenosis alone, a model of stenosis combined with clinical features and a model of stenosis combined with clinical, and plaque features were 0.59 (95% confidence interval [CI] 0.54-0.64), 0.66 (0.62-0.72), and 0.82 (0.78-0.86), respectively. In the last model, stenosis, history of contralateral TIAs or stroke, GSM, plaque area, and DWAs were independent predictors of ipsilateral CORI events. Combinations of these could stratify patients into different levels of risk for ipsilateral CORI and stroke, with predicted risk close to observed risk. Of the 923 patients with

Published
2010
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198. Venous hemodynamic changes in lower limb venous disease : the UIP consensus according to scientific evidence

Author

Lee, Byung-Boong, Nicolaides, Andrew N., Myers, Kenneth, Meissner, Mark, Kalodiki, Evi, Allegra, Claudio, Antignani, Pier Luigi, Baekgaard, Niels, Beach, Kirk, Belcaro, Giovanni, Black, Stephen, Blomgren, Lena, Bouskela, Eliete, Cappelli, Massimo, Caprini, Joseph, Carpentier, Patrick, Cavezzi, Attilio, Chastanet, Sylvain, Christenson, Jan T., Christopoulos, Demetris, Clarke, Heather, Davies, Alun, De Maeseneer, Marianne, Eklof, Bo, Ermini, Stefano, Fernandez, Fidel, Franceschi, Claude, Gasparis, Antonios, Geroulakos, George, Gianesini, Sergio, Giannoukas, Athanasios, Gloviczki, Peter, Huang, Ying, Ibegbuna, Veronica, Kakkos, Stavros K., Kistner, Robert, Kolbel, Tilo, Kurstjens, Ralph L. M., Labropoulos, Nicos, Laredo, James, Lattimer, Christopher R., Lugli, Marzia, Lurie, Fedor, Maleti, Oscar, Markovic, Jovan, Mendoza, Erika, Monedero, Javier L., Moneta, Gregory, Moore, Hayley, Morrison, Nick, Mosti, Giovanni, Nelzen, Olle, Obermayer, Alfred, Ogawa, Tomohiro, Parsi, Kurosh, Partsch, Hugo, Passariello, Fausto, Perrin, Michel R., Pittaluga, Paul, Raju, Seshadri, Ricci, Stefano, Rosales, Antonio, Scuderi, Angelo, Slagsvold, Carl-Erik, Thurin, Anders, Urbanek, Tomasz, van Rij, Andre, Vasquez, Michael, Wittens, Cees H. A., Zamboni, Paolo, Zimmet, Steven, Ezpeleta, Santiago Zubicoa, Lee, Byung-Boong, Nicolaides, Andrew N., Myers, Kenneth, Meissner, Mark, Kalodiki, Evi, Allegra, Claudio, Antignani, Pier Luigi, Baekgaard, Niels, Beach, Kirk, Belcaro, Giovanni, Black, Stephen, Blomgren, Lena, Bouskela, Eliete, Cappelli, Massimo, Caprini, Joseph, Carpentier, Patrick, Cavezzi, Attilio, Chastanet, Sylvain, Christenson, Jan T., Christopoulos, Demetris, Clarke, Heather, Davies, Alun, De Maeseneer, Marianne, Eklof, Bo, Ermini, Stefano, Fernandez, Fidel, Franceschi, Claude, Gasparis, Antonios, Geroulakos, George, Gianesini, Sergio, Giannoukas, Athanasios, Gloviczki, Peter, Huang, Ying, Ibegbuna, Veronica, Kakkos, Stavros K., Kistner, Robert, Kolbel, Tilo, Kurstjens, Ralph L. M., Labropoulos, Nicos, Laredo, James, Lattimer, Christopher R., Lugli, Marzia, Lurie, Fedor, Maleti, Oscar, Markovic, Jovan, Mendoza, Erika, Monedero, Javier L., Moneta, Gregory, Moore, Hayley, Morrison, Nick, Mosti, Giovanni, Nelzen, Olle, Obermayer, Alfred, Ogawa, Tomohiro, Parsi, Kurosh, Partsch, Hugo, Passariello, Fausto, Perrin, Michel R., Pittaluga, Paul, Raju, Seshadri, Ricci, Stefano, Rosales, Antonio, Scuderi, Angelo, Slagsvold, Carl-Erik, Thurin, Anders, Urbanek, Tomasz, van Rij, Andre, Vasquez, Michael, Wittens, Cees H. A., Zamboni, Paolo, Zimmet, Steven, and Ezpeleta, Santiago Zubicoa

Abstract

There are excellent guidelines for clinicians to manage venous diseases but few reviews to assess their hemodynamic background. Hemodynamic concepts that evolved in the past have largely remained unchallenged in recent decades, perhaps due to their often complicated nature and in part due to emergence of new diagnostic techniques. Duplex ultrasound scanning and other imaging techniques which evolved in the latter part of the 20th century have dominated investigation. They have greatly improved our understanding of the anatomical patterns of venous reflux and obstruction. However, they do not provide the physiological basis for understanding the hemodynamics of flow, pressure, compliance and resistance. Hemodynamic investigations appear to provide a better correlation with post-treatment clinical outcome and quality of life than ultrasound findings. There is a far better prospect for understanding the complete picture of the patient's disability and response to management by combining ultrasound with hemodynamic studies. Accordingly, at the instigation of Dr Angelo Scuderi, the Union Internationale de Phlebologie (UIP) executive board commissioned a large number of experts to assess all aspects of management for venous disease by evidence-based principles. These included experts from various member societies including the European Venous Forum (EVF), American Venous Forum (AVF), American College of Phlebology (ACP) and Cardiovascular Disease Educational and Research Trust (CDERT). Their aim was to confirm or dispel long-held hemodynamic principles and to provide a comprehensive review of venous hemodynamic concepts underlying the pathophysiology of lower limb venous disorders, their usefulness for investigating patients and the relevant hemodynamic changes associated with various forms of treatment. Chapter 1 is devoted to basic hemodynamic concepts and normal venous physiology. Chapter 2 presents the mechanism and magnitude of hemodynamic changes in acute deep vein

Published
2016

199. Venous hemodynamic changes in lower limb venous disease:The UIP consensus according to scientific evidence

Author

Lee, Byung Boong, Nicolaides, Andrew N, Myers, Kenneth, Meissner, Mark, Kalodiki, Evi, Allegra, Claudio, Antignani, Pier Luigi, Bækgaard, Niels, Beach, Kirk, Belcaro, Giovanni, Black, Stephen, Blomgren, Lena, Bouskela, Eliete, Cappelli, Massimo, Caprini, Joseph, Carpentier, Patrick, Cavezzi, Attilio, Chastanet, Sylvain, Christenson, Jan T., Christopoulos, Demetris, Clarke, Heather, Davies, Alun H, De Maeseneer, Marianne, Eklof, Bo, Ermini, Stefano, Fernández, Fidel, Franceschi, Claude, Gasparis, Antonios, Geroulakos, George, Gianesini, Sergio, Giannoukas, Athanasios, Gloviczki, Peter, Huang, Ying-Ying, Ibegbuna, Veronica, Kakkos, Stavros K, Kistner, Robert, Kölbel, Tilo, Kurstjens, Ralph L M, Labropoulos, Nicos, Laredo, James, Imer, Christopher R Latt, Lugli, Marzia, Lurie, Fedor, Maleti, Oscar, Markovic, Jovan, Mendoza, Erika, Monedero, Javier L., Moneta, Gregory, Moore, Hayley R, Morrison, Nick, Mosti, Giovanni, Nelzén, Olle, Obermayer, Alfred, Ogawa, Tomohiro, Parsi, Kurosh, Sch, Hugo Part, Passariello, Fausto, Perrin, Michel R., Pittaluga, Paul, Raju, Seshadri, Ricci, Stefano, Rosales, Antonio, Scuderi, Angelo, Slagsvold, Carl Erik, Thurin, Anders, Urbanek, Tomasz, Rij, Andre Van, Vasquez, Michael, Wittens, Cees H A, Zamboni, Paolo, Zimmet, Steven, Ezpeleta, Santiago Zubicoa, Lee, Byung Boong, Nicolaides, Andrew N, Myers, Kenneth, Meissner, Mark, Kalodiki, Evi, Allegra, Claudio, Antignani, Pier Luigi, Bækgaard, Niels, Beach, Kirk, Belcaro, Giovanni, Black, Stephen, Blomgren, Lena, Bouskela, Eliete, Cappelli, Massimo, Caprini, Joseph, Carpentier, Patrick, Cavezzi, Attilio, Chastanet, Sylvain, Christenson, Jan T., Christopoulos, Demetris, Clarke, Heather, Davies, Alun H, De Maeseneer, Marianne, Eklof, Bo, Ermini, Stefano, Fernández, Fidel, Franceschi, Claude, Gasparis, Antonios, Geroulakos, George, Gianesini, Sergio, Giannoukas, Athanasios, Gloviczki, Peter, Huang, Ying-Ying, Ibegbuna, Veronica, Kakkos, Stavros K, Kistner, Robert, Kölbel, Tilo, Kurstjens, Ralph L M, Labropoulos, Nicos, Laredo, James, Imer, Christopher R Latt, Lugli, Marzia, Lurie, Fedor, Maleti, Oscar, Markovic, Jovan, Mendoza, Erika, Monedero, Javier L., Moneta, Gregory, Moore, Hayley R, Morrison, Nick, Mosti, Giovanni, Nelzén, Olle, Obermayer, Alfred, Ogawa, Tomohiro, Parsi, Kurosh, Sch, Hugo Part, Passariello, Fausto, Perrin, Michel R., Pittaluga, Paul, Raju, Seshadri, Ricci, Stefano, Rosales, Antonio, Scuderi, Angelo, Slagsvold, Carl Erik, Thurin, Anders, Urbanek, Tomasz, Rij, Andre Van, Vasquez, Michael, Wittens, Cees H A, Zamboni, Paolo, Zimmet, Steven, and Ezpeleta, Santiago Zubicoa

Abstract

There are excellent guidelines for clinicians to manage venous diseases but few reviews to assess their hemodynamic background. Hemodynamic concepts that evolved in the past have largely remained unchallenged in recent decades, perhaps due to their often complicated nature and in part due to emergence of new diagnostic techniques. Duplex ultrasound scanning and other imaging techniques which evolved in the latter part of the 20th century have dominated investigation. They have greatly improved our understanding of the anatomical patterns of venous reflux and obstruction. However, they do not provide the physiological basis for understanding the hemodynamics of flow, pressure, compliance and resistance. Hemodynamic investigations appear to provide a better correlation with post-treatment clinical outcome and quality of life than ultrasound findings. There is a far better prospect for understanding the complete picture of the patient's disability and response to management by combining ultrasound with hemodynamic studies. Accordingly, at the instigation of Dr Angelo Scuderi, the Union Internationale de Phlebologie (UIP) executive board commissioned a large number of experts to assess all aspects of management for venous disease by evidence-based principles. These included experts from various member societies including the European Venous Forum (EVF), American Venous Forum (AVF), American College of Phlebology (ACP) and Cardiovascular Disease Educational and Research Trust (CDERT). Their aim was to confirm or dispel long-held hemodynamic principles and to provide a comprehensive review of venous hemodynamic concepts underlying the pathophysiology of lower limb venous disorders, their usefulness for investigating patients and the relevant hemodynamic changes associated with various forms of treatment. Chapter 1 is devoted to basic hemodynamic concepts and normal venous physiology. Chapter 2 presents the mechanism and magnitude of hemodynamic changes in acute deep ve

Published
2016

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