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P B Dimakakos

Publications and source records attributed to P B Dimakakos.

At least 19 recordsLinked to original sources
PubMed2000

Comparative results of staged and simultaneous bilateral carotid endarterectomy: a clinical study and surgical treatment.

OBJECTIVE: Bilateral carotid stenoses are actually managed by staged endarterectomy. The present study compares the results of the above surgical procedure with simultaneous bilateral carotid endarterectomy. METHODS: Sixty-four carotid endarterectomies were carried out on two groups of thirty-two patients with bilateral carotid stenoses. Fifteen patients (group A) were subjected to staged and 17 patients (group B) who were subjected to simultaneous bilateral carotid endarterectomies. RESULTS: The mortality rate was zero in both groups; no statistically significant difference was found concerning complications related to the heart, neurological deficit and postoperative hypertension. CONCLUSIONS: Simultaneous carotid endarterectomy is a challenging and technically demanding operation but with limited indications in strictly selected patients. The development of methods of more effective monitoring and protection of the cerebral cells might broaden the indications of such a surgical tactic in the future. Staged carotid endarterectomy, however, remains the method of choice for the management of bilateral carotid occlusive disease.

Adult↗
PubMed2000

Effect of balloon angioplasty and stenting following clips vs suture arterial stenosis: an experimental study.

BACKGROUND: Comparative evaluation of balloon angioplasty following intravascular stenting after experimental stenoses caused by arterial reconstruction with vascular clips and conventional sutures. MATERIALS AND METHODS: A total of 24 arteriotomies were carried out at the carotid and common iliac arteries of pigs following a 10 mm longitudinal arteriotomy and provocation of stenosis. Twelve of the arteries were reconstructed with vascular clips and 12 with conventional suture. Ultrasonography revealed stenosis fluctuating from 60-95% (PSV: 1.8-3.5 m/sec EDV: 1.3-1.47 m/sec PSV ratio > 3.5). After 8 weeks, following digital subtraction angiography, which revealed > 50% stenosis in all of the cases, balloon angioplasty followed by placement of intravascular stent was carried out. RESULTS: All the angioplasties remained angiographically and macroscopically patent two months after without thrombus formation. Rupture during dilatation occurred in one of the sutured cases. Histologically no degenerative changes, necrosis or remarkable intimal thickness were observed in either method. Focal inflammatory reaction was seen in 2 sutured and in 1 clipped cases while intimal ulceration was observed in 2 sutured cases. All cases with clips presented an intact endothelial surface. CONCLUSION: Early experimental results suggested that arterial stenosis provoked by clipped reconstruction could be managed successfully by balloon angioplasty followed by placement of intravascular stent.

Angioplasty, Balloon↗
PubMed2000

E. Kondoleon: the man behind the procedure.

UNLABELLED: Historical events and their in-depth analysis have much to teach us about medicine today. Moreover, the lives of those who have made their mark in medical history can be a source of inspiration to future generations of medical scientists. A case in point is the career of E. Kondoleon, originator of the surgical procedure that bears his name. METHODS: Retrieval in the archives of the "Areteion" and "Hippocration" hospitals, where E. Kondoleon had worked and passed away, together with information obtained from the Chair of History of Medicine of the University of Athens, as well as information taken from the Hellenic Surgical Society relative to his life and the motives which led him to the Kondoleon surgical procedure namely: Wide excision of the fascia and concomitant partial excision of the hypertrophic tissue in the treatment of lymphoedema. RESULTS: The Kondoleon operative procedure was not a simple applicable idea of a surgical technique but the result of a long-term systematical study of the anatomy and pathophysiology of the lymphovascular system as well as the continuation of their experimental application. Thus in the beginning of our century, Kondoleon took the lead of carrying out his own technique on the human which for more than 50 years was the object of discussion and application in the treatment of lymphoedema. CONCLUSIONS: Although "the microworld" of the electronic microscope and the conventional microscope of surgery have illuminated many sections of pathophysiology and has led to newer evolutionary tactics (vascular anastomoses, transplantation of lymph-vessels) in the management of lymphoedema, the Kondoleon operative procedure has given the necessary stimuli for these developments. As with other prominent, celebrated men in the history of investigation, Kondoleon had a dramatic end.

Education, Medical↗
PubMed2000

Therapeutic tactics and late results in predominant truncal congenital malformation.

BACKGROUND: Congenital vascular malformations are rare vascular lesions of unknown etiology, non-degenerative or of inflammatory nature, which begin during embryological development; they are characterized by anomalies of the vascular system, apparently due to hemodynamic and metabolic disturbances. METHODS: Our diagnostic and therapeutic management in addition to the late results in 60, mainly truncal cases, out of 265 congenital vascular malformations, are analyzed in the present study. In a 20-year period 25,000 vascular examinations were carried out, among which 265 (1.06%) congenital vascular malformations (CVMs) were discovered, that is 77% (205/265) extra-truncal venous angiomata and 22.7% (60/265) truncal diffuse or localized types. The distribution of the above types was: 22 (36.6%) arteriovenous, 30 (50%) venous and 8 (13.4%) lymphatic. RESULTS: Surgery was carried out in 48.3% (29/60) of the truncal types of which 37.9% of the cases, on average, recurred 8 years later. Of the 22 arteriovenous malformations 20 patients were operated on (90%), of whom 35% (7/20) had a recurrence; of the 30 venous defects 30% (9/30) were operated on and 44.5% (4/9) of these had a recurrence. The recurrence rate rose to 50% (5/10) in cases of operative therapy of arteriovenous defects and to 20% (2/10) with combined surgical and non surgical methods. The recurrence incidence of venous defects with surgical treatment and sclerotherapy was 54.1% (6/11). CONCLUSIONS: Timely diagnosis, microsurgical techniques and highly specialized surgical and interventional experience are expected to improve these results significantly.

Abnormalities, Multiple↗
PubMed1999

Management of inflammatory abdominal aneurysms--immediate and late results.

INTRODUCTION: Despite progress in the technical approach to aneurysms, inflammatory aortic aneurysms (IAA) in particular present the surgical team with a unique challenge. This retrospective study investigates immediate and late results after surgical treatment of IAA. PATIENTS AND METHOD: Fifteen cases of IAA among 520 aneurysmectomies of the abdominal aorta were operated during the period 1986-1995. All the patients were males of a mean age of 66 years. Diagnosis was established on preoperative CT-Scan, gross appearance at surgery and histologically. CT scanning could detect the IAA in 13 of 15 cases. In 2 cases MRI was diagnostic. Surgical treatment using the inlay method, constitutes the method of choice due to restricted dissection, as it reduces the possibility of iatrogenic injuries. RESULTS: None of the patients died during the first 30 postoperative days. One patient died at the age of 78, 40 days after the operative procedure, due to a cerebral episode. Four to 120 months later 3 patients had also died from cause unrelated to the operation and one more patient was lost on follow-up. The remaining 10 patients were free of symptoms without any progression of the fibrotic process in the CT scanning. We observed a total regression in 7 and partial regression in 3 patients without detecting any inflammatory findings or renal failure. CONCLUSION: IAA's are rare. CT and/or MRI establish the diagnosis preoperatively and contribute to the surgical program with immediate and late results equal to those found in arteriosclerotic aneurysms of the abdominal aorta.

Aged↗
PubMed1999

Aortic aneurysms.

Explore the source record for details and available documents.

Aortic Aneurysm, Abdominal↗
PubMed1999

The physician B. Adamantiades and his contribution to the disease Adamantiades-Behçet.

Adamantiades-Behçet disease is a multifocal entity which was first described by Hippocrates 500 years BC. The disease is characterised by relapsing oral aphthae, genital ulcers and iritis, while 24-40% of cases present with arterial or venous thromboses, arterial aneurysms or varices. In rare cases, due to invasion of different systems, the clinical picture varies, making timely diagnosis difficult. The disease is common all over the world but is more frequent in Japan, Korea, China and the Middle East. The first description in contemporary times was made by the Greek ophthalmologist Benedict Adamantiades in 1931, and the disease was described for the second time, independently, by the Turkish dermatologist Hulusi Behçet in 1937.

Behcet Syndrome↗
PubMed1999

Carotid endarterectomy without protective measures in patients with occluded and non occluded contralateral carotid artery.

BACKGROUND: Comparison of carotid endarterectomy in patients with and without occluded contralateral carotid artery. METHODS DESIGN: evaluation of results without using shunt or patch. SETTING: < > Hospital, Medical School, University of Athens. SUBJECTS: 235 patients, divided into group I of 40 patients with and group II of 195 patients without occluded contralateral carotid artery. INTERVENTION: carotid endarterectomy under general anesthesia. MAIN OUTCOME MEASURES: heparin administration, stable hemodynamic status during clamping, short duration monitoring postoperatively. RESULTS: Postoperative morbidity of both groups was 2.5% (6/235) and mortality 1.7% (4/235). Group I: mortality rate was 2.5% (1/40) major and minor stroke each 2.5% (1/40) and group I: 1.5% (3/195) and 1% (2/195) respectively (NS). Four to 108 months later, 30% (12/40) of group I and 21% (41/195) of group II died. CONCLUSIONS: Endarterectomy of the carotid artery under general anesthesia without use of shunt and patch in patients with or without occlusion of the contralateral carotid artery presented the same comparative results. Candidates for carotid endarterectomy should be screened systematically for coronary disease preoperatively and annual stress testing postoperatively, tactics which may improve early and late mortality rate after carotid surgery.

Aged↗