Browsing by Author "Savlovskis, Janis"

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    Endovascular thrombectomy in anterior circulation stroke and clinical value of bridging with intravenous thrombolysis
    (2019) Balodis, Arturs; Radziņa, Maija; Miglāne, Evija; Rudd, Anthony; Millers, Andrejs; Savlovskis, Janis; Kupčs, Kārlis; Department of Radiology
    Background Bridging treatment with intravenous thrombolysis (IVT) before endovascular thrombectomy (EVT) in acute ischemic stroke is applied under the assumption of benefits for patients with large vessel occlusion (LVO). However, the benefit of this additional step has not yet been proven. Purpose To compare procedural parameters (procedural time, number of attempts), complications, and clinical outcome in patients receiving EVT vs. patients with bridging treatment. Material and Methods In this prospective study all patients had acute anterior cerebral circulation occlusion and were treated with EVT. All patients were selected for treatment based on clinical criteria, multimodal computed tomography (CT) imaging. Eighty-four patients were treated with bridging IVT followed by EVT; 62 patients were treated with EVT only. Results Bridging therapy did not influence endovascular procedure time (P = 0.71) or number of attempts needed (P = 0.63). Bleeding from any site was more common in the bridging group (27, 32%) vs. the EVT group (12, 19%) (P = 0.09). Functional independence modified Rankin Scale after 90 days was slightly higher in the bridging group (44%) vs. the EVT group (42%) (P = 0.14). Mortality did not differ significantly at 90 days: 17% in the bridging group vs. 21% in EVT alone (P = 0.57). Both treatment methods showed high recanalization rates: 94% in the bridging group and 89% for EVT alone. Conclusion Bridging treatment in LVO did not show benefits or elevated risks of complications in comparison to EVT only. The bridging group did not show significantly better neurological outcome or significant impact on procedural parameters vs. EVT alone
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    Multidisciplinary approach to treat ruptured abdominal aortic aneurysm into the vena cava
    (2020-12) Lacis, Aigars; Savlovskis, Janis; Kisis, Kaspars; Zellans, Edgars; Zarins, Christopher K.; Krievins, Dainis; Rīga Stradiņš University
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    Three-Year Patency Results following Endovascular Transvenous Femoropopliteal Bypass
    (2023-02-25) Rumba, Roberts; Krievins, Dainis; Savlovskis, Janis; Ezite, Natalija; Lacis, Aigars; Petrosina, Eva; Mouttet, Ludovic; Gardovskis, Janis; Zarins, Christopher K.; Rīga Stradiņš University; Statistics Unit
    Background and Objectives: Peripheral artery disease is one of the most common vascular pathologies. There is an ongoing debate among specialists on whether open or endovascular revascularization is preferred in cases of complex superficial femoral artery (SFA) lesions. The purpose of this study was to assess patency results of a relatively new transvenous endovascular bypass device. This could add to existing evidence and aid in comparison between open and endovascular bypass. Materials and Methods: Patients with complex TASC-C and D SFA lesions who had indications for revascularization were identified. Prospective analysis of stent graft patency from 54 transvenous femoropopliteal bypass procedures was performed. Patency was assessed by Duplex ultrasound every six months. Kaplan–Meier analysis was performed to assess primary, primary-assisted, and secondary patency of transvenous bypass. Results: Following endovascular transvenous femoropopliteal bypass, 3-year graft primary, primary-assisted, and secondary patency was 43.8%, 66.3%, and 73.9%, respectively. Conclusions: Transvenous endovascular femoropopliteal bypass is a viable option for selected patients who lack adequate saphenous vein or have comorbidities that increase the risk of open femoropopliteal bypass. Strict post-operative follow-up is necessary to improve patency rates.