Kipras Mikelis

Vilnius University

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Edgaras Smolskas

King's College Hospital NHS Foundation Trust

Algirdas Tamošiūnas

Vilnius University

Gintautas Brimas

Vilnius University

AŠ

Audrius Širvinskas

Vilnius University

Givi Lengvenis

Vilnius University

Marius Kurminas

Vilnius University

Donatas Jocius

Vilnius University

Skirmante Jokubauskiene

Vilnius University

Kęstutis Strupas

Vilnius University

Donatas Vajauskas

Lithuanian University of Health Sciences

Cooperative Institutions

Vilnius University

Vilnius University Hospital Santariskiu Klinikos

Lietuvos Bioetikos Komitetas

National Cancer Institute

Klaipėda University

Institute of Nephro Urology

Lithuanian University of Health Sciences

Ministry of Culture

Institute of Biomedical Science

Institute of Clinical Research

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Transanal endoscopic microsurgery for rectal adenomas: single center experience

Videosurgery and Other Miniinvasive Techniques (2015)

Narimantas Evaldas Samalavičius Edgaras Smolskas Kipras Mikelis Robertas Samalavičius

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Samalavicius N, Smolskas E, Mikelis K, Samalavicius R. Transanal endoscopic microsurgery for rectal adenomas: single center experience. Videosurgery and Other Miniinvasive Techniques. 2016;11(1):26-30. doi:10.5114/wiitm.2015.56408. APA Samalavicius, N., Smolskas, E., Mikelis, K., & Samalavicius, R. (2016). Transanal endoscopic microsurgery for rectal adenomas: single center experience. Videosurgery and Other Miniinvasive Techniques, 11(1), 26-30. https://doi.org/10.5114/wiitm.2015.56408 Chicago Samalavicius, Narimantas Evaldas, Edgaras Smolskas, Kipras Mikelis, and Robertas Samalavicius. 2016. "Transanal endoscopic microsurgery for rectal adenomas: single center experience". Videosurgery and Other Miniinvasive Techniques 11 (1): 26-30. doi:10.5114/wiitm.2015.56408. Harvard Samalavicius, N., Smolskas, E., Mikelis, K., and Samalavicius, R. (2016). Transanal endoscopic microsurgery for rectal adenomas: single center experience. Videosurgery and Other Miniinvasive Techniques, 11(1), pp.26-30. https://doi.org/10.5114/wiitm.2015.56408 MLA Samalavicius, Narimantas Evaldas et al. "Transanal endoscopic microsurgery for rectal adenomas: single center experience." Videosurgery and Other Miniinvasive Techniques, vol. 11, no. 1, 2016, pp. 26-30. doi:10.5114/wiitm.2015.56408. Vancouver Samalavicius N, Smolskas E, Mikelis K, Samalavicius R. Transanal endoscopic microsurgery for rectal adenomas: single center experience. Videosurgery and Other Miniinvasive Techniques. 2016;11(1):26-30. doi:10.5114/wiitm.2015.56408.

Demographics

Single Center

10.5114/wiitm.2015.56408

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Transcatheter arterial embolization for upper gastrointestinal tract bleeding.

Videosurgery and Other Miniinvasive Techniques (2017)

Audrius Širvinskas Edgaras Smolskas Kipras Mikelis Vilma Brimienė Gintautas Brimas

Transcatheter arterial embolization is a possible treatment for patients with recurrent bleeding from the upper gastrointestinal tract after failed endoscopic management and is also an alternative to surgical treatment.To analyze the outcomes of transcatheter arterial embolization and identify the clinical and technical factors that influenced the rates of morbidity and mortality.A retrospective analysis was carried out, based on the data of 36 patients who underwent transcatheter arterial embolization for acute nonvariceal upper gastrointestinal bleeding in 2013 to 2015 in our center. An analysis was performed between early rebleeding rates, mortality and the following factors: patient sex, age, number of units of packed red blood cells and packed plasma administered to the patients, length of hospital stay, therapeutic or prophylactic embolization.The technical success rate of the embolization procedure was 100%. There were 15 (41.70%) therapeutic embolizations and 21 (58.3%) prophylactic embolizations. There was a 77.8% clinical success rate. Following embolization, 10 (27.80%) patients had repeated bleeding and 9 (25.0%) patients died. Significant associations were found between rebleeding and prophylactic embolization (OR = 10.53; p = 0.04) and between mortality and prophylactic embolization (OR = 10.53; p = 0.04) and units of packed red blood cells (OR = 1.25; p < 0.01).In our experience, transcatheter arterial embolization is a safe treatment method for acute nonvariceal upper gastrointestinal bleeding and a possible alternative to surgery for high-risk patients.

Arterial Embolization

Upper Gastrointestinal Bleeding

10.5114/wiitm.2017.72319

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Assessing Liver Fibrosis Using 2D-SWE Liver Ultrasound Elastography and Dynamic Liver Scintigraphy with 99mTc-mebrofenin: A Comparative Prospective Single-Center Study

Medicina (2023)

Donatas Jocius Donatas Vajauskas Artūras Samuilis Kipras Mikelis Skirmante Jokubauskiene

Background and Objectives: Many quantitative imaging modalities are available that quantify chronic liver disease, although only a few of them are included in clinical guidelines. Many more imaging options are still competing to find their place in the area of diagnosing chronic liver disease. We report our first prospective single-center study evaluating different imaging modalities that stratify viral hepatitis-associated liver fibrosis in a treatment-naïve patient group. Materials and Methods: The aim of our study is to compare and to combine already employed 2D shear wave elastography (2D-SWE) with dynamic liver scintigraphy with 99mTc-mebrofenin in chronic viral hepatitis patients for the staging of liver fibrosis. Results: Seventy-two patients were enrolled in the study. We found that both 2D-SWE ultrasound imaging, with dynamic liver scintigraphy with 99mTc-mebrofenin are able to stratify CLD patients into different liver fibrosis categories based on histological examination findings. We did not find any statistically significant difference between these imaging options, which means that dynamic liver scintigraphy with 99mTc-mebrofenin is not an inferior imaging technique. A combination of these imaging modalities showed increased accuracy in the non-invasive staging of liver cirrhosis. Conclusions: Our study presents that 2D-SWE and dynamic liver scintigraphy with 99mTc-mebrofenin could be used for staging liver fibrosis, both in singular application and in a combined way, adding a potential supplementary value that represents different aspects of liver fibrosis in CLD.

Chronic liver disease

Liver disease

10.3390/medicina59030479

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Quantitative Assessment of Liver Impairment in Chronic Viral Hepatitis with [99mTc]Tc-Mebrofenin: A Noninvasive Attempt to Stage Viral Hepatitis-Associated Liver Fibrosis

Medicina (2022)

Donatas Jocius Donatas Vajauskas Kipras Mikelis Skirmante Jokubauskiene Jolita Jakutiene

Background and objectives-Chronic viral hepatitis B and C infections are one of the leading causes of chronic liver impairment, resulting in liver fibrosis and liver cirrhosis. An early diagnosis with accurate liver fibrosis staging leads to a proper diagnosis, thus tailoring correct treatment. Both invasive and noninvasive techniques are used in the diagnosis and staging of chronic liver impairment. Those techniques include liver biopsy, multiple serological markers (as either single tests or combined panels), and imaging examinations, such as ultrasound or magnetic resonance elastography. Nuclear medicine probes may also be employed in staging liver fibrosis, although the literature scarcely reports this. The purpose of our study was to investigate whether a dynamic liver scintigraphy with [99mTc]Tc-mebrofenin has any value in staging or grading chronic liver damage. Materials and Methods-We prospectively enrolled patients with chronic viral hepatitis B and C infection referred for liver biopsy. All patient underwent dynamic liver scintigraphy with 99mTc-mebrofenin prior to liver biopsy. Dynamic liver scintigraphy was performed immediately after intravenous tracer injection for 30 min scanning time. Multiple scintigraphy parameters were calculated (whole liver lobe and focal area time to peak (TTP), 30 min to peak ratio (30/peak), whole lobe and focal area slope index in 350 s (slope_350). Liver biopsy took place shortly after imaging. Results-We found that many dynamic scintigraphic parameters are positively or negatively associated with different stages of liver fibrosis. The main parameters that showed most value are the ratio between 30 min and the peak of the dynamic curve (30/peak_dex (ratio)), and liver clearance corrected for body surface area and liver area (LCL_m2_dm2 (%/min/m2/dm2)). Conclusions-Our present study proves that conducting dynamic liver scintigraphies with [99mTc]Tc-mebrofenin has potential value in staging liver fibrosis. The benefits of this method, including whole liver imaging and direct imaging of the liver function, provide an advantage over presently used quantitative imaging modalities.

Viral Hepatitis

Liver damage

10.3390/medicina58101333

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Transkateterinė arterinė embolizacija gydant skrandžio ir dvylikapirštės žarnos opas

DOAJ (DOAJ: Directory of Open Access Journals) (2016)

Audrius Širvinskas Edgaras Smolskas Kipras Mikelis Gintautas Brimas

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Use of Double-Layer Carotid Stents is Associated with Improved Patient Survival and Lower Neurological Complications: A Single-Center Retrospective Observational Study

Journal of Clinical Medicine (2025)

Kipras Mikelis Marius Kurminas Givi Lengvenis Radvilas Jančiauskas Nerijus Misonis

Background/Objectives: Dual-layer stents (DLS) with micromesh technology may offer better protection from plaque protrusion compared to single-layer stents (SLS), but little data are available. The aim of this study is to compare clinical outcomes of elective carotid artery stenting for asymptomatic and symptomatic patients treated for primary CAS with DLS or SLS in a high-volume center. Methods: This study is a single-center retrospective cohort study and included patients who underwent elective CAS between December 2006 and September 2023. The final analysis included patient baseline characteristics, postoperative complications and patient outcomes. Results: A total of 573 patients underwent elective carotid artery stenting in the study period. Most of the 573 patients undergoing CAS were male (62.5%), and the median age of patients at the time of CAS was 70 years. Of the 573 eligible patients, 43.5% (n = 249) were asymptomatic and 56.4% (n = 323) were symptomatic. Analyzing neurological complications, it was found that the only factor that had a statistically significant effect was the type of stent used. Patients who had a carotid stenting procedure using a single-layer carotid stent had statistically significantly more periprocedural neurological complications (8.3% (n = 35)) than the double-mesh stent group (2% (n = 3)), mostly due to more transient ischemic attacks in the single-layer stent group (4% (n = 17)) compared to the double-mesh group (0.7% (n = 1)). Conclusions: The use of carotid double-layer stents is associated with a low rate of periprocedural and postprocedural events.

Single Center

Carotid stenting

10.3390/jcm14030888

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Association between Left Atrial Appendage Morphology and Clot Histology in Patients with Embolic Ischemic Stroke: An Exploratory Study

Journal of Clinical Medicine (2024)

Givi Lengvenis Julius Drachneris Edvardas Žurauskas Aleksandra Ekkert Andrius Berūkštis

Background: Acute embolic ischemic stroke poses a significant healthcare challenge. Histological clot features’ variability among patients with acute ischemic stroke treated by mechanical thrombectomy has potential implications for determining treatment and etiology. This study investigated the clot histological feature differences among patients who experienced cardioembolic stroke and embolic stroke of undetermined source with different left atrial appendage (LAA) morphologies. Methods: We conducted a prospective observational study involving 79 patients with acute embolic ischemic stroke undergoing mechanical thrombectomy. Computed tomography angiography images were used to classify LAA morphologies. An artificial intelligence algorithm assessed the clot fibrin and red blood cell contents. Results: Patients with chicken-wing LAA morphology exhibited lower mean clot fibrin proportions than did those with non-chicken-wing morphology (p < 0.001). Linear regression analysis showed that chicken-wing LAA was significantly associated with a lower clot fibrin proportion (estimate, −0.177; 95% CI [−0.259, −0.096]; p < 0.001). The successful recanalization rate and first-pass effect between the groups did not differ significantly. Conclusions: The chicken-wing LAA morphological type is associated with lower clot fibrin contents, suggesting potentially different embolism mechanisms or diverse embolic sources, compared with the non-chicken-wing LAA types. Further studies are required to investigate this association.

Stroke

Embolus

Etiology

10.3390/jcm13061734

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Transkateterinė arterinė embolizacija gydant skrandžio ir dvylikapirštės žarnos opas

Lietuvos chirurgija (2016)

Audrius Širvinskas Edgaras Smolskas Kipras Mikelis Gintautas Brimas

ĮvadasTranskateterinė arterinė embolizacija yra chirurginio gydymo alternatyva. Ji taikoma esant pakartotiniam kraujavimui iš skrandžio ar dvylikapirštės žarnos opos po nepavykusio kraujo stabdymo endoskopijos metu. Mes nagrinėjometranskateterinės embolizacijos efektyvumą, gydymo baigtis ir rodiklius, galinčius turėti įtakos sergamumui bei mirtingumui.MetodaiAtlikome retrospektyviąją analizę, į kurią įtraukėme 20 pacientų, kuriems nuo 2012 m. iki 2015 m. Respublikinėje Vilniaus universitetinėje ligoninėje buvo atlikta transkateterinė arterinė embolizacija dėl ūminio kraujavimo iš viršutinės virškinamojo trakto dalies. Ieškojome ryšio tarp pakartotinio kraujavimo bei mirštamumo ir pacientų lyties, amžiaus, perpiltų kraujokomponentų vienetų, hospitalizacijos trukmės, laiko iki embolizacijos, atliktos embolizacijos rūšies (profilaktinė ar terapinė).RezultataiEmbolizacijos techninis efektyvumas buvo 100 %. Keturiolikai pacientų (70 %) buvo atlikta profilaktinė ir 6 (30 %) – terapinė embolizacija. Trims (15 %) pacientams po embolizacijos pasikartojo kraujavimas. Penki (25 %) pacientai mirė. Pacientams, kurie vėliau mirė, buvo perpilta statistiškai reikšmingai daugiau kraujo komponentų vienetų (šviežiai šaldytos plazmos p=0,04;eritrocitų masės p=0,01), jų hospitalizacija buvo ilgesnė (p=0,05). Statistiškai reikšmingų veiksnių, galinčių turėti įtakos pakartotinio kraujavimo dažniui, neradome.IšvadosTranskateterinė arterinė embolizacija yra tinkamas metodas po endoskopinio gydymo pasikartojusiam kraujavimui iš skrandžio ar dvylikapirštės žarnos opų gydyti. Nors šis būdas pasižymi dideliu techniniu ir klinikiniu efektyvumu ir mažu komplikacijų dažniu, tačiau reikalingi tolesni atsitiktinių imčių tyrimai šio gydymo būdo tinkamumui pagrįsti.

10.15388/lietchirur.2016.4.10277

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