Bu çalışmada karotis arter darlığında izlediğimiz tedavi yöntemlerimiz ve tedavi sonrası tekrarla... more Bu çalışmada karotis arter darlığında izlediğimiz tedavi yöntemlerimiz ve tedavi sonrası tekrarlayan darlıklardaki yaklaşımlarımız sunuldu. Hastalar ve Yöntemler: Ocak 2003-Haziran 2017 tarihleri arasında karotis arter darlığı nedeni ile müdahale edilen 557 hasta (304 erkek, 253 kadın; ort. yaş 68.2 yıl; dağılım, 54-82 yıl) retrospektif olarak değerlendirildi. Toplam 392 hastaya karotis arter endarterektomisi (KAE) yapılırken, 165 hastaya karotis arter stentleme (KAS) uygulandı. Toplam 392 hastanın 34'üne (%8.6) eversiyon, 188'ine (%47.2) yama ile kapatma ve 170'ine (%43.3) primer kapatma yapıldı. Karotis arter stentleme yapılan 165 hastanın 114'üne (%69) wallstent ve 51'ine (%31) nitinol stent uygulandı. Her iki grupta tekrarlayan karotis arter darlıkları (KAR) ve tedavi yöntemlerinin riskleri incelendi. Bulgular: Toplam 29 hastada (%5.2) KAR saptandı. Bu hastaların sekizi (%4.84) KAS grubundan iken, 21'i (%5.35) KAE grubunda idi. Primer kapatma yapılan hastalarda tekrar müdahale ihtiyacı %9.4 oranında (n=16) iken, bu oran eversiyon yapılan hastalarda %5.88 (n=2) idi. Yama ile kapatılan hasta grubunda tekrar müdahale ihtiyacı ise %1.59 (n=3) idi. Tekrarlayan karotis arter darlığı gelişen 26 hastaya endovasküler girişim yapılırken, iki hastaya tekrar cerrahi girişim yapıldı. Cerrahi girişim yapılan hasta grubunda mortalite izlenmedi. İki hastada da yalnızca sinir hasarı görüldü. Tekrarlayan karotis arter darlığı nedeni ile endovasküler girişim yapılan hasta grubunda da mortalite izlenmedi; ancak bir hastada majör inme gelişti. Sonuç: Karotis arter darlıklarında altın standart tedavi yöntemi KAE'dir. Komorbidite ve mortalitesi yüksek olan hastalar ve KAR'de endovasküler tedavi yöntemleri KAE'ye iyi bir alternatiftir.
Canadian respiratory journal : journal of the Canadian Thoracic Society, 2006
To evaluate the role of preserved pleural integrity in postoperative pain and respiratory functio... more To evaluate the role of preserved pleural integrity in postoperative pain and respiratory functional status in patients undergoing coronary revascularization. Two hundred forty patients undergoing on-pump coronary artery bypass grafting between March 2004 and February 2005 were included in the present study. The patients were prospectively randomized and divided into either an opened pleura (OP) group (n=120, patients with an OP) or a closed pleura (CP) group (n=120, patients whose pleural integrity was preserved). Preoperative patient characteristics were similar. Postoperative respiratory functions were compared between the groups by chest x-rays, respiratory functional tests and arterial blood gas analyses. Postoperative pain was compared by using a multidimensional pain score. All the tests were examined by the same blinded clinician. The mean age of the patients was 60.4+/-8.8 years. Postoperative bleeding and the duration of hospital stay were markedly higher in the OP group t...
Renal dysfunction is associated with markedly increased risk for both mortality and morbidity in ... more Renal dysfunction is associated with markedly increased risk for both mortality and morbidity in patients undergoing coronary artery bypass surgery (CABG), especially in elderly patients. In the current study, we aimed to determine the impact of prophylactic preoperative hemodialysis on operative outcome in patients with mild renal dysfunction. Between March 2002 and May 2005 a total of 64 patients, all of whom were more than 70 years of age and with preoperative creatinine levels greater than 2 mg/ dL, underwent primary elective on pump coronary artery bypass surgery. The mean age was 76.3 ± 6.4 (range 70-83). The patients were prospectively allocated into two groups. Group A was the dialysis group (31 patients) and preoperative prophylactic hemodialysis was carried out in all patients. Group B (33 patients) was taken as a control group without preoperative hemodialysis. During the present study, 10 patients died (15.6%) in the hospital. In the postoperative period mean levels of creatinine were found to be decreased in dialysis group. (2.3 ± 0.8 mg/dL vs. 3.4 ± 0.2 mg/, P = 0.037). The incidence of overall morbidity (such as acute renal failure, need of postoperative dialysis, low cardiac output and multiple organ failure) were also found to be decreased in dialysis group. We conclude from the present study that preoperative renal dysfunction and advanced age increase the risk of mortality and morbidity after on-pump coronary artery bypass surgery. We believe that perioperative prophylactic hemodialysis is an easy and effective method and it decreases both operative mortality and morbidity in elderly patients with renal dysfunction.
To evaluate the impact of interpleural analgesia (IP) on postthoracotomy pain and respiratory fun... more To evaluate the impact of interpleural analgesia (IP) on postthoracotomy pain and respiratory function as an alternative to thoracic epidural analgesia (TEA). Prospective, randomized study. Tertiary-care military hospital. Sixty young patients scheduled for elective thoracic surgery (correction of aorta coarctation and patent ductus arteriosus). Patients were randomized into two groups to receive either IP or TEA for postthoracotomy pain management. Patients in the IP group (n = 30) had a catheter inserted between the parietal and visceral pleura by a surgeon, and 0.2% ropivacaine was given through this catheter. In the TEA group, ropivacaine was administered through a thoracic epidural catheter. The impact of both methods on pain control, respiratory function, and pulmonary complications was analyzed and compared. The frequency of atelectasis and pleural effusion was also significantly high in the IP group (P < 0.01). Respiratory function and postoperative pain scores were better in the TEA group (P < 0.01). Arterial blood gas analysis on the fifth postoperative day was significantly better in the TEA group. Thoracic epidural analgesia has more beneficial effects on respiratory function and postoperative pain after thoracotomy than does IP.
Cerebral swelling after cardiopulmonary bypass might trigger a critical cerebral consequence resu... more Cerebral swelling after cardiopulmonary bypass might trigger a critical cerebral consequence resulting from intracranial spaceoccupying lesion. We experienced a 75-year-old woman who suffered from a delayed left hemiplegia after mitral valve replacement. Urgent diagnostic imaging revealed the presence of a brain tumor with perifocal cerebral edema. Fluid shifts occurring within a few days after the cardiopulmonary bypass, manifesting the focal cerebral edema, played a key role in this unique clinical course.
The International Journal of Cardiovascular Imaging, 2006
Objective Aneurysms of the thoracic aorta are still potentially life-threatening situations. The ... more Objective Aneurysms of the thoracic aorta are still potentially life-threatening situations. The conventional operation is still associated with morbidity. Endovascular stent graft repair offers an alternative to conventional operation for management of aortic diseases. Our aim was to report our experience with endovascular stent graft repair of thoracic aortic aneurysms. Patients and Methods Between November 2002 and October 2005, endovascular stent graft repair was performed in 26 patients: post-traumatic aortic aneurysm (n = 4), Type B dissection (n = 3) and descending thoracic aortic aneurysm (n = 19). The deployed stent graft systems were Talent-Medtronic (n = 14) and Excluder-Gore (n=12). Results Successful deployment of the stent grafts in the appropriate position was achieved in all patients. There was neither hospital mortality nor paraplegia. Late and non-procedure related death occurred in only one patient (3.8%). An average of 40% shrinkage of the aneurysmal space was observed. There was no early mortality and endoleaks. The median intensive care unit and hospital stay times were 1 and 7 days (range 4-13 days), respectively. Post-operative computed tomography scans were obtained in all patients and complete thrombosis was observed in the false lumen of dissecan aneurysms (n = 3) and sac of saccular aneurysms in 25 patients. Mean follow up time was 17.1 ± 5.4 months. Conclusions Endovascular stent graft treatment for treatment of thoracic aorta aneurysm, Type B dissection and traumatic disease of the thoracic aorta is technically feasible. Although the short and mid-term results are encouraging the long term results will determine the future of this treatment.
Background: We evaluated the role of pre‐emptive stellate ganglion block (SGB) in preventing rad... more Background: We evaluated the role of pre‐emptive stellate ganglion block (SGB) in preventing radial artery spasm and increasing radial artery graft patency in patients undergoing off‐pump coronary artery bypass surgery.Methods: In this prospective randomized study, 100 patients were divided into two equal groups (n= 50). In group A, SGB was achieved using 10 ml of ropivacaine and, in group B, SGB was not performed. Radial artery blood flow was measured pre‐ and intra‐operatively. Post‐operative clinical determinants (S–T segment elevation, use of inotropic agents, incidence of atrial fibrillation) were recorded. Early coronary angiography was performed.Results: According to blood flowmeter measurements, the radial artery blood flow was significantly increased in patients with SGB. The incidence of atrial fibrillation, the need for inotropic agents and S–T segment elevation were all decreased in the SGB group. Angiographic intervention revealed that the incidence of graft spasm wa...
Turkish Journal of Thoracic and Cardiovascular Surgery, 2021
These evidence-based guidelines from the Turkish Society of Cardiovascular Surgery, National Soci... more These evidence-based guidelines from the Turkish Society of Cardiovascular Surgery, National Society of Vascular and Endovascular Surgery, and Phlebology Society intend to support clinicians in best decisions regarding the treatment of venous thromboembolism (VTE). The Editor was selected by the three national societies and was tasked with the recruitment of the recognized panel. All financial support was solely derived from the sponsoring societies without the direct involvement of industry or other external stakeholders. The panel prioritized clinical questions and outcomes according to their importance for clinicians in terms of VTE. The panel agreed on 42 recommendations under 15 headings for the diagnosis, initial management, secondary prevention of VTE, and treatment of recurrent VTE events. Important recommendations included the use of ultrasonography, preference for home treatment over hospital treatment for uncomplicated VTE, preference for direct oral anticoagulants (DOACs...
Venous aneurysm is very rare espacially inferior vena cava (IVC) aneurysm is extremely rare. Etio... more Venous aneurysm is very rare espacially inferior vena cava (IVC) aneurysm is extremely rare. Etiology is not clear and risk factors can be inflammatory disease, thrombosis, trauma and long term complication of long term right heart failure. Angiography with computer tomography (CTA), magnetic resonance angiography (MRA) and convantionel venography can use for diagnose. 30 years old male patient admistered to clinic for lower abdominal pain for a month. Largest diameter in subhepatic region and left renal vein were 67mm and 26mm respectively. Literature there were limited numbers of case described. Because of this reason there was no quide or no adopted treatment aprroach was defined. Hardest and challenging part is giving the decision of treatment.
Pulmonary artery angiosarcoma (PAA) is an extremely rare malignancy that arises from endothelial ... more Pulmonary artery angiosarcoma (PAA) is an extremely rare malignancy that arises from endothelial cells. The pulmonary trunk is the most common anatomic site of these tumors. However, so far, there have only been a few examples of PAA reported. PAAs are aggressive and have a bad prognosis, thus early diagnosis is critical. In this study, we present the case of a 27-year-old male who was initially diagnosed with acute pulmonary thromboembolism (PTE) before being diagnosed with chronic thromboembolic pulmonary hypertension (CTEPH). Pulmonary endarterectomy was performed, and PAA was diagnosed histopathologically. The patient died three months after diagnosis.
Direct oral anticoagulants have become a reasonable treatment option replacing warfarin in preven... more Direct oral anticoagulants have become a reasonable treatment option replacing warfarin in preventing stroke in patients with non-valvular atrial fibrillation and in treating and preventing venous thromboembolism. This article aims to summarize the rationale behind the development of direct oral anticoagulants and to review the key pharmacological properties, clinical and reallife data of the factor Xa inhibitor edoxaban, that may contribute to improving patient outcomes in cardiovascular clinical practice.
The COVID-19 pandemic has presented a great challenge for the healthcare systems and healthcare w... more The COVID-19 pandemic has presented a great challenge for the healthcare systems and healthcare workers worldwide. The resources and the infrastructure of the healthcare systems are reorganized to provide care for abundant number of pandemic patients. All elective procedures and treatments have either cancelled or postponed. Treatment of lower extremity ulcers may be misclassified as non-essential during this pandemic; however, without regular best wound care, these ulcers are at a great risk of becoming quickly infected, which may lead to an increased rate of septicemia, amputations, and even deaths in this fragile patient population. In this review, we discuss the treatment strategies for lower leg ulcers and vascular pathologies during pandemic and provide an algorithm for triage which may be a useful guide for vascular surgeons.
It is a hypothesis that autoimmune factors directed against endothelial cells play a role in deve... more It is a hypothesis that autoimmune factors directed against endothelial cells play a role in developing venous insufficiency. We investigated the association between anti-endothelial cell antibodies (AECA) and the development of venous insufficiency and varicose veins. Patients, methods: 44 patients were evaluated with clinical examination and duplex ultrasound for diagnosing chronic venous insufficiency and varicose veins and 120 healthy volunteers were assigned as the control group without evidence of chronic venous insufficiency and varicose veins. All sera samples were analysed by using slides, each containing biochips coated with frozen sections of HUVEC (human umblical vein endothelial cells) and capillary-rich tissue such as skeletal muscle (Euroimmun, FB 1960–1005–2, Germany). If a positive reaction is obtained, specific antibodies of class IgA, IgG, IgM attach to the antigens. In a second step, the bound antibodies are stained with fluorescein labeled antihuman antibodies a...
The Effects of Gabapentin on Intraoperative Cooperation, Stress Response and Postoperative Analge... more The Effects of Gabapentin on Intraoperative Cooperation, Stress Response and Postoperative Analgesia in Patients Undergoing Carotid Endartectomy with Regional AnesthesiaObjective: The aim of this study was to evaluate the effects of gabapentin on intraoperative cooperation, surgical stres response, and postoperative analgesia in patients undergoing carotid endareterctomy (CEA) with regional anesthesia.Material and Methods: After approval of the Ethics Committee of the hospital, and patients’ informed consents were obtained, 34 ASA 2-3 patients over 50 years of age who were scheduled for elective CEA under regional anesthesia were randomly assigned to one of the two groups. Patients receiving a single oral 600 mg of gabapentin (Neurontin®, Pfizer) 1 hour prior to surgery constituted the study group, and patients without gabapentin therapy were considered as the control group. Clinical neurologic evaluation of the patients was performed during surgery. The patients’ heamodynamic parame...
Objectives Total aortic occlusion is a severe complication of Takayasu arteritis (TAK). Pregnancy... more Objectives Total aortic occlusion is a severe complication of Takayasu arteritis (TAK). Pregnancy follow-up in the state of total aortic occlusion due to TAK has not been reported before. Case presentation A 35 year-old nulliparous woman with total aortic occlusion in the distal aorta due to TAK, admitted with pregnancy desire. She had developed a collateral vessel system which has maintained the lower body circulation. She was informed about the potential risks after an evaluation and she admitted to our clinic at the seventh week of pregnancy, and acetylsalicylic acid was prescribed. At 20th gestational week anomaly screening was in normal limits although the uterine artery Doppler had lower S/D, PI and RI values. She was followed-up regularly in every two weeks. Vascular examination was performed by using an ankle brachial index (ABI) by duplex ultrasound. At 20th gestational week ankle brachial index score was 0.8–0.9 which indicates mild disease. Around 28th gestational week he...
Bu çalışmada karotis arter darlığında izlediğimiz tedavi yöntemlerimiz ve tedavi sonrası tekrarla... more Bu çalışmada karotis arter darlığında izlediğimiz tedavi yöntemlerimiz ve tedavi sonrası tekrarlayan darlıklardaki yaklaşımlarımız sunuldu. Hastalar ve Yöntemler: Ocak 2003-Haziran 2017 tarihleri arasında karotis arter darlığı nedeni ile müdahale edilen 557 hasta (304 erkek, 253 kadın; ort. yaş 68.2 yıl; dağılım, 54-82 yıl) retrospektif olarak değerlendirildi. Toplam 392 hastaya karotis arter endarterektomisi (KAE) yapılırken, 165 hastaya karotis arter stentleme (KAS) uygulandı. Toplam 392 hastanın 34'üne (%8.6) eversiyon, 188'ine (%47.2) yama ile kapatma ve 170'ine (%43.3) primer kapatma yapıldı. Karotis arter stentleme yapılan 165 hastanın 114'üne (%69) wallstent ve 51'ine (%31) nitinol stent uygulandı. Her iki grupta tekrarlayan karotis arter darlıkları (KAR) ve tedavi yöntemlerinin riskleri incelendi. Bulgular: Toplam 29 hastada (%5.2) KAR saptandı. Bu hastaların sekizi (%4.84) KAS grubundan iken, 21'i (%5.35) KAE grubunda idi. Primer kapatma yapılan hastalarda tekrar müdahale ihtiyacı %9.4 oranında (n=16) iken, bu oran eversiyon yapılan hastalarda %5.88 (n=2) idi. Yama ile kapatılan hasta grubunda tekrar müdahale ihtiyacı ise %1.59 (n=3) idi. Tekrarlayan karotis arter darlığı gelişen 26 hastaya endovasküler girişim yapılırken, iki hastaya tekrar cerrahi girişim yapıldı. Cerrahi girişim yapılan hasta grubunda mortalite izlenmedi. İki hastada da yalnızca sinir hasarı görüldü. Tekrarlayan karotis arter darlığı nedeni ile endovasküler girişim yapılan hasta grubunda da mortalite izlenmedi; ancak bir hastada majör inme gelişti. Sonuç: Karotis arter darlıklarında altın standart tedavi yöntemi KAE'dir. Komorbidite ve mortalitesi yüksek olan hastalar ve KAR'de endovasküler tedavi yöntemleri KAE'ye iyi bir alternatiftir.
Canadian respiratory journal : journal of the Canadian Thoracic Society, 2006
To evaluate the role of preserved pleural integrity in postoperative pain and respiratory functio... more To evaluate the role of preserved pleural integrity in postoperative pain and respiratory functional status in patients undergoing coronary revascularization. Two hundred forty patients undergoing on-pump coronary artery bypass grafting between March 2004 and February 2005 were included in the present study. The patients were prospectively randomized and divided into either an opened pleura (OP) group (n=120, patients with an OP) or a closed pleura (CP) group (n=120, patients whose pleural integrity was preserved). Preoperative patient characteristics were similar. Postoperative respiratory functions were compared between the groups by chest x-rays, respiratory functional tests and arterial blood gas analyses. Postoperative pain was compared by using a multidimensional pain score. All the tests were examined by the same blinded clinician. The mean age of the patients was 60.4+/-8.8 years. Postoperative bleeding and the duration of hospital stay were markedly higher in the OP group t...
Renal dysfunction is associated with markedly increased risk for both mortality and morbidity in ... more Renal dysfunction is associated with markedly increased risk for both mortality and morbidity in patients undergoing coronary artery bypass surgery (CABG), especially in elderly patients. In the current study, we aimed to determine the impact of prophylactic preoperative hemodialysis on operative outcome in patients with mild renal dysfunction. Between March 2002 and May 2005 a total of 64 patients, all of whom were more than 70 years of age and with preoperative creatinine levels greater than 2 mg/ dL, underwent primary elective on pump coronary artery bypass surgery. The mean age was 76.3 ± 6.4 (range 70-83). The patients were prospectively allocated into two groups. Group A was the dialysis group (31 patients) and preoperative prophylactic hemodialysis was carried out in all patients. Group B (33 patients) was taken as a control group without preoperative hemodialysis. During the present study, 10 patients died (15.6%) in the hospital. In the postoperative period mean levels of creatinine were found to be decreased in dialysis group. (2.3 ± 0.8 mg/dL vs. 3.4 ± 0.2 mg/, P = 0.037). The incidence of overall morbidity (such as acute renal failure, need of postoperative dialysis, low cardiac output and multiple organ failure) were also found to be decreased in dialysis group. We conclude from the present study that preoperative renal dysfunction and advanced age increase the risk of mortality and morbidity after on-pump coronary artery bypass surgery. We believe that perioperative prophylactic hemodialysis is an easy and effective method and it decreases both operative mortality and morbidity in elderly patients with renal dysfunction.
To evaluate the impact of interpleural analgesia (IP) on postthoracotomy pain and respiratory fun... more To evaluate the impact of interpleural analgesia (IP) on postthoracotomy pain and respiratory function as an alternative to thoracic epidural analgesia (TEA). Prospective, randomized study. Tertiary-care military hospital. Sixty young patients scheduled for elective thoracic surgery (correction of aorta coarctation and patent ductus arteriosus). Patients were randomized into two groups to receive either IP or TEA for postthoracotomy pain management. Patients in the IP group (n = 30) had a catheter inserted between the parietal and visceral pleura by a surgeon, and 0.2% ropivacaine was given through this catheter. In the TEA group, ropivacaine was administered through a thoracic epidural catheter. The impact of both methods on pain control, respiratory function, and pulmonary complications was analyzed and compared. The frequency of atelectasis and pleural effusion was also significantly high in the IP group (P < 0.01). Respiratory function and postoperative pain scores were better in the TEA group (P < 0.01). Arterial blood gas analysis on the fifth postoperative day was significantly better in the TEA group. Thoracic epidural analgesia has more beneficial effects on respiratory function and postoperative pain after thoracotomy than does IP.
Cerebral swelling after cardiopulmonary bypass might trigger a critical cerebral consequence resu... more Cerebral swelling after cardiopulmonary bypass might trigger a critical cerebral consequence resulting from intracranial spaceoccupying lesion. We experienced a 75-year-old woman who suffered from a delayed left hemiplegia after mitral valve replacement. Urgent diagnostic imaging revealed the presence of a brain tumor with perifocal cerebral edema. Fluid shifts occurring within a few days after the cardiopulmonary bypass, manifesting the focal cerebral edema, played a key role in this unique clinical course.
The International Journal of Cardiovascular Imaging, 2006
Objective Aneurysms of the thoracic aorta are still potentially life-threatening situations. The ... more Objective Aneurysms of the thoracic aorta are still potentially life-threatening situations. The conventional operation is still associated with morbidity. Endovascular stent graft repair offers an alternative to conventional operation for management of aortic diseases. Our aim was to report our experience with endovascular stent graft repair of thoracic aortic aneurysms. Patients and Methods Between November 2002 and October 2005, endovascular stent graft repair was performed in 26 patients: post-traumatic aortic aneurysm (n = 4), Type B dissection (n = 3) and descending thoracic aortic aneurysm (n = 19). The deployed stent graft systems were Talent-Medtronic (n = 14) and Excluder-Gore (n=12). Results Successful deployment of the stent grafts in the appropriate position was achieved in all patients. There was neither hospital mortality nor paraplegia. Late and non-procedure related death occurred in only one patient (3.8%). An average of 40% shrinkage of the aneurysmal space was observed. There was no early mortality and endoleaks. The median intensive care unit and hospital stay times were 1 and 7 days (range 4-13 days), respectively. Post-operative computed tomography scans were obtained in all patients and complete thrombosis was observed in the false lumen of dissecan aneurysms (n = 3) and sac of saccular aneurysms in 25 patients. Mean follow up time was 17.1 ± 5.4 months. Conclusions Endovascular stent graft treatment for treatment of thoracic aorta aneurysm, Type B dissection and traumatic disease of the thoracic aorta is technically feasible. Although the short and mid-term results are encouraging the long term results will determine the future of this treatment.
Background: We evaluated the role of pre‐emptive stellate ganglion block (SGB) in preventing rad... more Background: We evaluated the role of pre‐emptive stellate ganglion block (SGB) in preventing radial artery spasm and increasing radial artery graft patency in patients undergoing off‐pump coronary artery bypass surgery.Methods: In this prospective randomized study, 100 patients were divided into two equal groups (n= 50). In group A, SGB was achieved using 10 ml of ropivacaine and, in group B, SGB was not performed. Radial artery blood flow was measured pre‐ and intra‐operatively. Post‐operative clinical determinants (S–T segment elevation, use of inotropic agents, incidence of atrial fibrillation) were recorded. Early coronary angiography was performed.Results: According to blood flowmeter measurements, the radial artery blood flow was significantly increased in patients with SGB. The incidence of atrial fibrillation, the need for inotropic agents and S–T segment elevation were all decreased in the SGB group. Angiographic intervention revealed that the incidence of graft spasm wa...
Turkish Journal of Thoracic and Cardiovascular Surgery, 2021
These evidence-based guidelines from the Turkish Society of Cardiovascular Surgery, National Soci... more These evidence-based guidelines from the Turkish Society of Cardiovascular Surgery, National Society of Vascular and Endovascular Surgery, and Phlebology Society intend to support clinicians in best decisions regarding the treatment of venous thromboembolism (VTE). The Editor was selected by the three national societies and was tasked with the recruitment of the recognized panel. All financial support was solely derived from the sponsoring societies without the direct involvement of industry or other external stakeholders. The panel prioritized clinical questions and outcomes according to their importance for clinicians in terms of VTE. The panel agreed on 42 recommendations under 15 headings for the diagnosis, initial management, secondary prevention of VTE, and treatment of recurrent VTE events. Important recommendations included the use of ultrasonography, preference for home treatment over hospital treatment for uncomplicated VTE, preference for direct oral anticoagulants (DOACs...
Venous aneurysm is very rare espacially inferior vena cava (IVC) aneurysm is extremely rare. Etio... more Venous aneurysm is very rare espacially inferior vena cava (IVC) aneurysm is extremely rare. Etiology is not clear and risk factors can be inflammatory disease, thrombosis, trauma and long term complication of long term right heart failure. Angiography with computer tomography (CTA), magnetic resonance angiography (MRA) and convantionel venography can use for diagnose. 30 years old male patient admistered to clinic for lower abdominal pain for a month. Largest diameter in subhepatic region and left renal vein were 67mm and 26mm respectively. Literature there were limited numbers of case described. Because of this reason there was no quide or no adopted treatment aprroach was defined. Hardest and challenging part is giving the decision of treatment.
Pulmonary artery angiosarcoma (PAA) is an extremely rare malignancy that arises from endothelial ... more Pulmonary artery angiosarcoma (PAA) is an extremely rare malignancy that arises from endothelial cells. The pulmonary trunk is the most common anatomic site of these tumors. However, so far, there have only been a few examples of PAA reported. PAAs are aggressive and have a bad prognosis, thus early diagnosis is critical. In this study, we present the case of a 27-year-old male who was initially diagnosed with acute pulmonary thromboembolism (PTE) before being diagnosed with chronic thromboembolic pulmonary hypertension (CTEPH). Pulmonary endarterectomy was performed, and PAA was diagnosed histopathologically. The patient died three months after diagnosis.
Direct oral anticoagulants have become a reasonable treatment option replacing warfarin in preven... more Direct oral anticoagulants have become a reasonable treatment option replacing warfarin in preventing stroke in patients with non-valvular atrial fibrillation and in treating and preventing venous thromboembolism. This article aims to summarize the rationale behind the development of direct oral anticoagulants and to review the key pharmacological properties, clinical and reallife data of the factor Xa inhibitor edoxaban, that may contribute to improving patient outcomes in cardiovascular clinical practice.
The COVID-19 pandemic has presented a great challenge for the healthcare systems and healthcare w... more The COVID-19 pandemic has presented a great challenge for the healthcare systems and healthcare workers worldwide. The resources and the infrastructure of the healthcare systems are reorganized to provide care for abundant number of pandemic patients. All elective procedures and treatments have either cancelled or postponed. Treatment of lower extremity ulcers may be misclassified as non-essential during this pandemic; however, without regular best wound care, these ulcers are at a great risk of becoming quickly infected, which may lead to an increased rate of septicemia, amputations, and even deaths in this fragile patient population. In this review, we discuss the treatment strategies for lower leg ulcers and vascular pathologies during pandemic and provide an algorithm for triage which may be a useful guide for vascular surgeons.
It is a hypothesis that autoimmune factors directed against endothelial cells play a role in deve... more It is a hypothesis that autoimmune factors directed against endothelial cells play a role in developing venous insufficiency. We investigated the association between anti-endothelial cell antibodies (AECA) and the development of venous insufficiency and varicose veins. Patients, methods: 44 patients were evaluated with clinical examination and duplex ultrasound for diagnosing chronic venous insufficiency and varicose veins and 120 healthy volunteers were assigned as the control group without evidence of chronic venous insufficiency and varicose veins. All sera samples were analysed by using slides, each containing biochips coated with frozen sections of HUVEC (human umblical vein endothelial cells) and capillary-rich tissue such as skeletal muscle (Euroimmun, FB 1960–1005–2, Germany). If a positive reaction is obtained, specific antibodies of class IgA, IgG, IgM attach to the antigens. In a second step, the bound antibodies are stained with fluorescein labeled antihuman antibodies a...
The Effects of Gabapentin on Intraoperative Cooperation, Stress Response and Postoperative Analge... more The Effects of Gabapentin on Intraoperative Cooperation, Stress Response and Postoperative Analgesia in Patients Undergoing Carotid Endartectomy with Regional AnesthesiaObjective: The aim of this study was to evaluate the effects of gabapentin on intraoperative cooperation, surgical stres response, and postoperative analgesia in patients undergoing carotid endareterctomy (CEA) with regional anesthesia.Material and Methods: After approval of the Ethics Committee of the hospital, and patients’ informed consents were obtained, 34 ASA 2-3 patients over 50 years of age who were scheduled for elective CEA under regional anesthesia were randomly assigned to one of the two groups. Patients receiving a single oral 600 mg of gabapentin (Neurontin®, Pfizer) 1 hour prior to surgery constituted the study group, and patients without gabapentin therapy were considered as the control group. Clinical neurologic evaluation of the patients was performed during surgery. The patients’ heamodynamic parame...
Objectives Total aortic occlusion is a severe complication of Takayasu arteritis (TAK). Pregnancy... more Objectives Total aortic occlusion is a severe complication of Takayasu arteritis (TAK). Pregnancy follow-up in the state of total aortic occlusion due to TAK has not been reported before. Case presentation A 35 year-old nulliparous woman with total aortic occlusion in the distal aorta due to TAK, admitted with pregnancy desire. She had developed a collateral vessel system which has maintained the lower body circulation. She was informed about the potential risks after an evaluation and she admitted to our clinic at the seventh week of pregnancy, and acetylsalicylic acid was prescribed. At 20th gestational week anomaly screening was in normal limits although the uterine artery Doppler had lower S/D, PI and RI values. She was followed-up regularly in every two weeks. Vascular examination was performed by using an ankle brachial index (ABI) by duplex ultrasound. At 20th gestational week ankle brachial index score was 0.8–0.9 which indicates mild disease. Around 28th gestational week he...
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