Pub Date : 2024-03-27DOI: 10.9739/tjvs.2023.09.028
Ozgur Altinbas, Mehmet Isik
Radial artery is one of the intervention cites for coronary angiography and has an increased tendency according to the successful results in the literature. However, some undesirable clinical situations may occur by using this route as with every invasive intervention. In this study, we presented a patient who had left upper limb ischemia following transradial angiography. An intimal flap with an approximate length of 15 cm was removed during embolectomy from the brachial artery. After multiple embolectomy procedures, axillo-brachial bypass was performed using the saphenous vein. However, ischemia in the forearm did not improve and limb loss occurred.
{"title":"Undesirable complication after transradial coronary angiography: A case report","authors":"Ozgur Altinbas, Mehmet Isik","doi":"10.9739/tjvs.2023.09.028","DOIUrl":"https://doi.org/10.9739/tjvs.2023.09.028","url":null,"abstract":"Radial artery is one of the intervention cites for coronary angiography and has an increased tendency according to the successful results in the literature. However, some undesirable clinical situations may occur by using this route as with every invasive intervention. In this study, we presented a patient who had left upper limb ischemia following transradial angiography. An intimal flap with an approximate length of 15 cm was removed during embolectomy from the brachial artery. After multiple embolectomy procedures, axillo-brachial bypass was performed using the saphenous vein. However, ischemia in the forearm did not improve and limb loss occurred.","PeriodicalId":23982,"journal":{"name":"Turkish Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140373932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Deniz, S. Mola, Alp Yildirim, Murat Gevrek, Bahadır Aytekin, H. Iscan
Aim: Lifelong monitoring is essential to detect aorta-related complications. Yet, patient non-compliance with surveillance programs poses a significant obstacle. We explored reasons for adherence by engaging in clear, patient-centred communication and analyzed factors contributing to non-compliance. Material and Methods: In 2019, our clinic conducted elective EVAR procedures on 50 patients. They were informed of annual surveillance, including hospital visits, starting with a first-month appointment post-discharge. Patients with no or only one follow-up were deemed non-compliant, while two to three follow-ups indicated moderate compliance, and four to seven follow-ups qualified as high compliance. We recorded each patient's age, education level and demographics. We retrospectively assessed the factors on their compliance level as our first outcome. The second was to explore whether the survey could enlighten any reasons from the patient's perspective. Results: The average age of our cohort was 68.8±8.45 years, with only three females. Non-attendance at follow-ups was observed in 8 patients (16%). Seventy percent (35 patients) complied with at least two appointments. Residing in the same city markedly increased compliance by 20 times (p<0.001). Older age appeared to influence compliance positively, on the borderline significantly (p=0.057). The primary motivation for attendance was adherence to doctor recommendations (n=14), while the predominant reason for non-attendance was patients’ feeling well (n=29). Notably, patients with lower compliance than predicted more frequently cited COVID-19 as a deterrent (p=0.02). Conclusion: Residence within the same city positively influences follow-up compliance. The national databases might be helpful tools for enhancing the surveillance anywhere the patients live. The existing hypotheses by healthcare professionals about patient follow-up compliance are only partially corroborated. Incorporating the patient's perspective into these models may be helpful in comprehensively understanding the underlying factors.
{"title":"The factors influencing compliance in post-EVAR surveillance regarding the perspectives of practitioners and patients","authors":"G. Deniz, S. Mola, Alp Yildirim, Murat Gevrek, Bahadır Aytekin, H. Iscan","doi":"10.9739/tjvs.2024.02.06","DOIUrl":"https://doi.org/10.9739/tjvs.2024.02.06","url":null,"abstract":"Aim: Lifelong monitoring is essential to detect aorta-related complications. Yet, patient non-compliance with surveillance programs poses a significant obstacle. We explored reasons for adherence by engaging in clear, patient-centred communication and analyzed factors contributing to non-compliance. Material and Methods: In 2019, our clinic conducted elective EVAR procedures on 50 patients. They were informed of annual surveillance, including hospital visits, starting with a first-month appointment post-discharge. Patients with no or only one follow-up were deemed non-compliant, while two to three follow-ups indicated moderate compliance, and four to seven follow-ups qualified as high compliance. We recorded each patient's age, education level and demographics. We retrospectively assessed the factors on their compliance level as our first outcome. The second was to explore whether the survey could enlighten any reasons from the patient's perspective. Results: The average age of our cohort was 68.8±8.45 years, with only three females. Non-attendance at follow-ups was observed in 8 patients (16%). Seventy percent (35 patients) complied with at least two appointments. Residing in the same city markedly increased compliance by 20 times (p<0.001). Older age appeared to influence compliance positively, on the borderline significantly (p=0.057). The primary motivation for attendance was adherence to doctor recommendations (n=14), while the predominant reason for non-attendance was patients’ feeling well (n=29). Notably, patients with lower compliance than predicted more frequently cited COVID-19 as a deterrent (p=0.02). Conclusion: Residence within the same city positively influences follow-up compliance. The national databases might be helpful tools for enhancing the surveillance anywhere the patients live. The existing hypotheses by healthcare professionals about patient follow-up compliance are only partially corroborated. Incorporating the patient's perspective into these models may be helpful in comprehensively understanding the underlying factors.","PeriodicalId":23982,"journal":{"name":"Turkish Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140373987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-27DOI: 10.9739/tjvs.2023.09.030
Mustafa Can Kaplan, Ersin Kadiroğulları, S. Guler, B. Timur, Kemal Kutanis, Emre Yaşar, Batuhan Yazici, Unal Aydin
Aim: Our study aims to share the reintervention results of patients who were operated with the diagnosis of Type A aortic dissection and to examine the factors that cause reintervention. Material and Methods: In our single-center retrospective study, 244 patients who underwent surgery due to Type A aortic dissection between November 2010 and June 2021 were included. Results for patients who underwent reintervention and factors which caused reintervention were compared with demographic data, preoperative, intraoperative and postoperative variables. Results: A total of 142 patients were included in the study and 15.5% of them underwent reintervention. Reoperation was performed in 8 (36.4%) of 22 patients who underwent reintervention, while thoracic aortic endovascular repair was performed in 14 (63.6%) patients. Post-procedure mortality was observed in 5 (22.7%) of the patients who underwent reintervention. The mean age of the patients who underwent reintervention was 46.6±13.2 and there was a statistically significant (p<0.05) difference between the groups (p: 0.026). Results that were significant for reintervention were multivariate analysis with cox regression and it was shown that the persistence of postoperative hypertension with total arch surgery was a risk factor for reintervention (p: 0.03, p: 0.008). Conclusion: Type A aortic dissection is not considered to be completely cured after the first operation. It is necessary to evaluate the patients in terms of reintervention with close follow-up. We propose that patients who underwent total arch surgery during the first operation and hypertension in the postoperative period are risk factors for reintervention.
{"title":"Investigation of factors affecting reintervention after type A aortic dissection","authors":"Mustafa Can Kaplan, Ersin Kadiroğulları, S. Guler, B. Timur, Kemal Kutanis, Emre Yaşar, Batuhan Yazici, Unal Aydin","doi":"10.9739/tjvs.2023.09.030","DOIUrl":"https://doi.org/10.9739/tjvs.2023.09.030","url":null,"abstract":"Aim: Our study aims to share the reintervention results of patients who were operated with the diagnosis of Type A aortic dissection and to examine the factors that cause reintervention. Material and Methods: In our single-center retrospective study, 244 patients who underwent surgery due to Type A aortic dissection between November 2010 and June 2021 were included. Results for patients who underwent reintervention and factors which caused reintervention were compared with demographic data, preoperative, intraoperative and postoperative variables. Results: A total of 142 patients were included in the study and 15.5% of them underwent reintervention. Reoperation was performed in 8 (36.4%) of 22 patients who underwent reintervention, while thoracic aortic endovascular repair was performed in 14 (63.6%) patients. Post-procedure mortality was observed in 5 (22.7%) of the patients who underwent reintervention. The mean age of the patients who underwent reintervention was 46.6±13.2 and there was a statistically significant (p<0.05) difference between the groups (p: 0.026). Results that were significant for reintervention were multivariate analysis with cox regression and it was shown that the persistence of postoperative hypertension with total arch surgery was a risk factor for reintervention (p: 0.03, p: 0.008). Conclusion: Type A aortic dissection is not considered to be completely cured after the first operation. It is necessary to evaluate the patients in terms of reintervention with close follow-up. We propose that patients who underwent total arch surgery during the first operation and hypertension in the postoperative period are risk factors for reintervention.","PeriodicalId":23982,"journal":{"name":"Turkish Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140376006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In surgical cases, various complications may occur depending on the degree of difficulty and experience. In this case report, we present a 24-year-old patient who was operated 5 years ago for an epidermoid cyst in the right neck region and developed loss of strength in the right arm. Angiography revealed total occlusion of the right subclavian artery and right carotid-subclavian bypass was performed. It was aimed to emphasize the necessity of a multidisciplinary approach for the successful surgery of the case and the solution of developing complications.
{"title":"Carotid-subclavian bypass in the treatment of subclavian artery occlusion during epidermoid cyst excision: A case report","authors":"Mehmet Isik, N. Gormus","doi":"10.9739/tjvs.2024.02.09","DOIUrl":"https://doi.org/10.9739/tjvs.2024.02.09","url":null,"abstract":"In surgical cases, various complications may occur depending on the degree of difficulty and experience. In this case report, we present a 24-year-old patient who was operated 5 years ago for an epidermoid cyst in the right neck region and developed loss of strength in the right arm. Angiography revealed total occlusion of the right subclavian artery and right carotid-subclavian bypass was performed. It was aimed to emphasize the necessity of a multidisciplinary approach for the successful surgery of the case and the solution of developing complications.","PeriodicalId":23982,"journal":{"name":"Turkish Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140376056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-27DOI: 10.9739/tjvs.2023.11.034
Nadide Ors Yildirim, E. Kadan, A. K. Yildirim, Okan Ali Aksoy, Berk Alp Goksel, Gokhan Ozkan, M. Burak Eskin, Vedat Yıldırım
Aim: Tramadol is a weak centrally acting opioid analgesic with µ-opioid receptor agonist effects. It has been explored for its analgesic efficacy through various in-vitro and in-vivo studies. The skin, as the body’s largest organ and the protector barrier, is vulnerable to injuries and wounds that can cause significant challenges due to pain, economic burdens and psychological implications. Successful healing of wound involves complex processes and it is influenced by factors such as angiogenesis and nitric oxide levels. This study investigates the effects of tramadol on wound healing in experimental ischemic wound models in rats. Material and Methods: Two 6 mm ischemic wound models were created on the backs of 30 male Wistar Albino rats, with wound areas cut along the long edges and a sterile silicone material placed between the panniculus carnosus fascia and paraspinosus muscle. Rats were randomized into Tramadol, Control, and Sham groups. The wounds were imaged using a "SONY ILCE-7" camera on days 0, 3, 6, 10, and 14. Wound areas and healing percentages were calculated from the images and recorded for statistical purposes. After 14 days, the animals were sacrificed under general anesthesia for histopathological examination of tissue samples. CD31 and VEGF antibodies were used to evaluate the density and morphology of vascular structures. Results: Tramadol administration accelerated the healing of wound surface area. Significant differences were found between groups in terms of inflammation, and data recorded in CD34, CD31, and VEGF-stained preparations. Conclusion: The study found that tramadol positively contributes to wound healing in the acute phase of ischemic wounds by affecting various processes.
{"title":"Effects of systemically administered tramadol hydrochloride on random pattern skin flap survival in rats","authors":"Nadide Ors Yildirim, E. Kadan, A. K. Yildirim, Okan Ali Aksoy, Berk Alp Goksel, Gokhan Ozkan, M. Burak Eskin, Vedat Yıldırım","doi":"10.9739/tjvs.2023.11.034","DOIUrl":"https://doi.org/10.9739/tjvs.2023.11.034","url":null,"abstract":"Aim: Tramadol is a weak centrally acting opioid analgesic with µ-opioid receptor agonist effects. It has been explored for its analgesic efficacy through various in-vitro and in-vivo studies. The skin, as the body’s largest organ and the protector barrier, is vulnerable to injuries and wounds that can cause significant challenges due to pain, economic burdens and psychological implications. Successful healing of wound involves complex processes and it is influenced by factors such as angiogenesis and nitric oxide levels. This study investigates the effects of tramadol on wound healing in experimental ischemic wound models in rats. Material and Methods: Two 6 mm ischemic wound models were created on the backs of 30 male Wistar Albino rats, with wound areas cut along the long edges and a sterile silicone material placed between the panniculus carnosus fascia and paraspinosus muscle. Rats were randomized into Tramadol, Control, and Sham groups. The wounds were imaged using a \"SONY ILCE-7\" camera on days 0, 3, 6, 10, and 14. Wound areas and healing percentages were calculated from the images and recorded for statistical purposes. After 14 days, the animals were sacrificed under general anesthesia for histopathological examination of tissue samples. CD31 and VEGF antibodies were used to evaluate the density and morphology of vascular structures. Results: Tramadol administration accelerated the healing of wound surface area. Significant differences were found between groups in terms of inflammation, and data recorded in CD34, CD31, and VEGF-stained preparations. Conclusion: The study found that tramadol positively contributes to wound healing in the acute phase of ischemic wounds by affecting various processes.","PeriodicalId":23982,"journal":{"name":"Turkish Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140376193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-27DOI: 10.9739/tjvs.2023.11.033
H. T. Akay, S. Yavas, E. Uğuz, M. Şırlak, E. Ozcinar, A. Yener, Adnan Yalcinkaya, Senol Yavuz, K. K. Ozsin, M. Kaygin, Unal Aydin, U. Kisa, Adil Polat, A. A. Kavala, Emrah Oguz, T. Calkavur, Ismail Yurekli, S. Bayrak, Omer Tanyeli, Kaptanıderya Tayfur, Sefer Usta, Ibrahim Ozsoyler, Suat Karaca, B. Erdal, N. Erdil
Aim: Chronic venous insufficiency (CVI) is a condition that results from obstruction, valve insufficiency, dysfunction of calf muscle pump, or their combinations. This study analyzed the risk factors and demographic characteristics of CVI in nurses in Türkiye. Additionally, it seeks to identify the total number of patients treated at medical centers in 2022 and assess the prevalence of CVI. Material and Methods: This multicenter, descriptive, and cross-sectional study was conducted with the participation of nurses working in 18 centers. Nurses completed a questionnaire that included their demographic information and venous insufficiency risk factors, and the Venous Insufficiency Epidemiological and Economic Study-Quality of Life Questionnaire. Researchers also completed the Standard CEAP Form Section C. The cases were divided into 2 groups: CVI (-) group (n=776, 43.5%) and CVI (+) group (n=1010, 56.5%). Results: A total of 1786 nurses participated in this study. Older age (>30-39 years), female gender, ≥2 pregnancies, ≥2 childbirths, years in the profession (>5-15 years), family history, and night cramps were identified as risk factors for CVI (p<0.001). No significant difference was found between smoking, body mass index, and CVI status (p>0.05). Hypertension, diabetes, and a history of deep vein thrombosis were the most common coexisting diseases. With a one-unit increase in age, risk of CVI increased 1.1-fold, family history of VV increased CVI risk 1.9-fold and presence of nocturnal night cramps increased risk of CVI 2.6-fold. The prevalence of CVI in 2022 was found to be 22.66% in this study. Conclusion: Older age, female gender, ≥2 pregnancies, ≥2 childbirths, years in the profession, family history, and night cramps are identified as risk factors for CVI in nurses. Common comorbid diseases include hypertension, diabetes, and a history of DVT. Pregnancy, particularly with multiple occurrences, stands out as a critical period for CVI. Reported symptoms in CVI (+) nurses include leg pain, swelling, heaviness, restless legs, and throbbing. Nurses demonstrate a higher incidence of CVI compared to other professions, highlighting an occupational risk. These findings stress the importance of preventive measures for nurses.
{"title":"Risk factors for chronic venous insufficiency in nurses in Türkiye - NueVo TR","authors":"H. T. Akay, S. Yavas, E. Uğuz, M. Şırlak, E. Ozcinar, A. Yener, Adnan Yalcinkaya, Senol Yavuz, K. K. Ozsin, M. Kaygin, Unal Aydin, U. Kisa, Adil Polat, A. A. Kavala, Emrah Oguz, T. Calkavur, Ismail Yurekli, S. Bayrak, Omer Tanyeli, Kaptanıderya Tayfur, Sefer Usta, Ibrahim Ozsoyler, Suat Karaca, B. Erdal, N. Erdil","doi":"10.9739/tjvs.2023.11.033","DOIUrl":"https://doi.org/10.9739/tjvs.2023.11.033","url":null,"abstract":"Aim: Chronic venous insufficiency (CVI) is a condition that results from obstruction, valve insufficiency, dysfunction of calf muscle pump, or their combinations. This study analyzed the risk factors and demographic characteristics of CVI in nurses in Türkiye. Additionally, it seeks to identify the total number of patients treated at medical centers in 2022 and assess the prevalence of CVI. Material and Methods: This multicenter, descriptive, and cross-sectional study was conducted with the participation of nurses working in 18 centers. Nurses completed a questionnaire that included their demographic information and venous insufficiency risk factors, and the Venous Insufficiency Epidemiological and Economic Study-Quality of Life Questionnaire. Researchers also completed the Standard CEAP Form Section C. The cases were divided into 2 groups: CVI (-) group (n=776, 43.5%) and CVI (+) group (n=1010, 56.5%). Results: A total of 1786 nurses participated in this study. Older age (>30-39 years), female gender, ≥2 pregnancies, ≥2 childbirths, years in the profession (>5-15 years), family history, and night cramps were identified as risk factors for CVI (p<0.001). No significant difference was found between smoking, body mass index, and CVI status (p>0.05). Hypertension, diabetes, and a history of deep vein thrombosis were the most common coexisting diseases. With a one-unit increase in age, risk of CVI increased 1.1-fold, family history of VV increased CVI risk 1.9-fold and presence of nocturnal night cramps increased risk of CVI 2.6-fold. The prevalence of CVI in 2022 was found to be 22.66% in this study. Conclusion: Older age, female gender, ≥2 pregnancies, ≥2 childbirths, years in the profession, family history, and night cramps are identified as risk factors for CVI in nurses. Common comorbid diseases include hypertension, diabetes, and a history of DVT. Pregnancy, particularly with multiple occurrences, stands out as a critical period for CVI. Reported symptoms in CVI (+) nurses include leg pain, swelling, heaviness, restless legs, and throbbing. Nurses demonstrate a higher incidence of CVI compared to other professions, highlighting an occupational risk. These findings stress the importance of preventive measures for nurses.","PeriodicalId":23982,"journal":{"name":"Turkish Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140375409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ayla Ece Çelikten, Sabir Hasanzade, Enis Burak Gul, Murat Gevrek, Görkem Yiğit, H. Iscan
Aim: Endovascular aneurysm repair (EVAR) has become a preferred method for accessing anatomically suitable abdominal aortic aneurysms in recent years. Advances in techniques and materials have led to the management of more challenging cases. Anatomical difficulties in the structure of the aneurysm neck can adversely affect the success of the procedure. In this study, we aimed to evaluate early and midterm outcomes in patients with wide-necked infrarenal abdominal aortic aneurysms treated with 34 mm or 36 mm EVAR endografts. Material and Methods: We evaluated infrarenal abdominal aortic aneurysms treated with 34 mm or 36 mm long EVAR allografts between January 2019 and January 2023 at Ankara Bilkent City Hospital Cardiovascular Surgery Clinic. We included and assessed patients with a neck diameter of 28 mm or greater using follow-up computed tomography angiography (CTA). We evaluated early and midterm morbidity and mortality as well as endovascular complications such as endoleak or migration. Results: A total of 58 patients with wide-neck infrarenal abdominal aortic aneurysms underwent 34 mm or 36 mm EVAR endograft deployment. There was no early mortality. The mean follow-up period was 21.7±6.4 months. Eight patients were found to have endoleaks—four had type 2 endoleaks, two had type 1b endoleaks, one had type 3 endoleak and one had type 1a endoleak. Except for type 2 endoleaks, all patients underwent endovascular reintervention. Conclusion: Our study demonstrated the successful application of 34 mm or 36 mm long endografts to patients with abdominal aortic aneurysms with a wide neck diameter. Regarding the midterm outcomes, standard EVAR procedures with large endografts are feasible and have successful outcomes.
{"title":"Early and midterm outcomes of EVAR with 34 and 36 mm large endograft sizes: A single tertiary center study","authors":"Ayla Ece Çelikten, Sabir Hasanzade, Enis Burak Gul, Murat Gevrek, Görkem Yiğit, H. Iscan","doi":"10.9739/tjvs.2024.01.01","DOIUrl":"https://doi.org/10.9739/tjvs.2024.01.01","url":null,"abstract":"Aim: Endovascular aneurysm repair (EVAR) has become a preferred method for accessing anatomically suitable abdominal aortic aneurysms in recent years. Advances in techniques and materials have led to the management of more challenging cases. Anatomical difficulties in the structure of the aneurysm neck can adversely affect the success of the procedure. In this study, we aimed to evaluate early and midterm outcomes in patients with wide-necked infrarenal abdominal aortic aneurysms treated with 34 mm or 36 mm EVAR endografts. Material and Methods: We evaluated infrarenal abdominal aortic aneurysms treated with 34 mm or 36 mm long EVAR allografts between January 2019 and January 2023 at Ankara Bilkent City Hospital Cardiovascular Surgery Clinic. We included and assessed patients with a neck diameter of 28 mm or greater using follow-up computed tomography angiography (CTA). We evaluated early and midterm morbidity and mortality as well as endovascular complications such as endoleak or migration. Results: A total of 58 patients with wide-neck infrarenal abdominal aortic aneurysms underwent 34 mm or 36 mm EVAR endograft deployment. There was no early mortality. The mean follow-up period was 21.7±6.4 months. Eight patients were found to have endoleaks—four had type 2 endoleaks, two had type 1b endoleaks, one had type 3 endoleak and one had type 1a endoleak. Except for type 2 endoleaks, all patients underwent endovascular reintervention. Conclusion: Our study demonstrated the successful application of 34 mm or 36 mm long endografts to patients with abdominal aortic aneurysms with a wide neck diameter. Regarding the midterm outcomes, standard EVAR procedures with large endografts are feasible and have successful outcomes.","PeriodicalId":23982,"journal":{"name":"Turkish Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140376178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-27DOI: 10.9739/tjvs.2024.02.010
H. T. Akay, D. S. Beyazpinar, B. Gültekin, Arif Okay Karslioglu, Denizhan Akpinar, Endri Balla, Ecem Tugba Yamac, Elsad Mansımzade, A. N. Haberal Reyhan, Atila Sezgin
Aim: Infrainguinal bypass surgery stands as the predominant open surgical procedure for lower limb revascularization and is reserved for cases of intermittent claudication (IC) that have proven unresponsive to maximal medical management. Polypropylene monofilament sutures have been widely used for peripheral vascular surgery operations. Aim of this study is comparing this new type of suture with propylene sutures. Material and Methods: Between January 2022 and December 2022, two cohorts who underwent suprapopliteal femoropopliteal bypass surgery, each comprising 15 patients were included in the study. In Group I (polytetrafluoroethylene (PTFE) Group), PTFE served as the suture material, whereas in Group 2 (Non PTFE Group), polypropylene sutures were employed. All preoperative demographics, perioperative and postoperative data were collected carefully. Results: All patients underwent surgical interventions due to either rest pain or ischemic ulcers. Among the 30 patients, 11 fell into Fontaine class 4, while 19 were categorized as Fontaine class 3. Out of the 30 patients, 18 received cilostazol treatment. The mean age of the patient cohort was 66.97±7.4 years, with a mean body mass index of 29.03±6.2. When we compared the two groups, no statistically significant difference was found between groups according to demographic data. In the evaluation of intraoperative data, the mean operation time was 88.7±9.37 minutes, and the mean hemostasis time was 5.8±2.8 minutes. Group I (PTFE group) exhibited significantly lower hemostasis time and drainage levels on the first and second postoperative days (p<0.0001, p=0.03, and p=0.017, respectively). The use of absorbable hemostats were significantly less in PTFE suture group. Conclusion: The selection of sutures significantly influences the achievement of soft tissue approximation, reduced inflammation, suture hole leakage and capsule formation.
{"title":"Compari̇son of PTFE sutures with polypropylene sutures in suprapopliteal femoropopliteal bypass with PTFE grafts","authors":"H. T. Akay, D. S. Beyazpinar, B. Gültekin, Arif Okay Karslioglu, Denizhan Akpinar, Endri Balla, Ecem Tugba Yamac, Elsad Mansımzade, A. N. Haberal Reyhan, Atila Sezgin","doi":"10.9739/tjvs.2024.02.010","DOIUrl":"https://doi.org/10.9739/tjvs.2024.02.010","url":null,"abstract":"Aim: Infrainguinal bypass surgery stands as the predominant open surgical procedure for lower limb revascularization and is reserved for cases of intermittent claudication (IC) that have proven unresponsive to maximal medical management. Polypropylene monofilament sutures have been widely used for peripheral vascular surgery operations. Aim of this study is comparing this new type of suture with propylene sutures. Material and Methods: Between January 2022 and December 2022, two cohorts who underwent suprapopliteal femoropopliteal bypass surgery, each comprising 15 patients were included in the study. In Group I (polytetrafluoroethylene (PTFE) Group), PTFE served as the suture material, whereas in Group 2 (Non PTFE Group), polypropylene sutures were employed. All preoperative demographics, perioperative and postoperative data were collected carefully. Results: All patients underwent surgical interventions due to either rest pain or ischemic ulcers. Among the 30 patients, 11 fell into Fontaine class 4, while 19 were categorized as Fontaine class 3. Out of the 30 patients, 18 received cilostazol treatment. The mean age of the patient cohort was 66.97±7.4 years, with a mean body mass index of 29.03±6.2. When we compared the two groups, no statistically significant difference was found between groups according to demographic data. In the evaluation of intraoperative data, the mean operation time was 88.7±9.37 minutes, and the mean hemostasis time was 5.8±2.8 minutes. Group I (PTFE group) exhibited significantly lower hemostasis time and drainage levels on the first and second postoperative days (p<0.0001, p=0.03, and p=0.017, respectively). The use of absorbable hemostats were significantly less in PTFE suture group. Conclusion: The selection of sutures significantly influences the achievement of soft tissue approximation, reduced inflammation, suture hole leakage and capsule formation.","PeriodicalId":23982,"journal":{"name":"Turkish Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140377114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aim: Acute aortic dissection type A (AADA) is a life-threatening emergency with high mortality rates. Surgical intervention is the preferred and potentially life-saving treatment, but perioperative mortality remains a significant concern. Identifying the risk factors associated with surgical mortality, morbidity, and survival rates is essential. Therefore, this study aimed to characterize the preoperative and intraoperative risk factors for death during surgical repair of AADA. Material and Methods: We included 64 consecutive patients who underwent surgical repair between April 2013 and March 2021 in a tertiary heart center. Perioperative characteristics and variables were collected and analyzed to find any correlation between them and in-hospital Outcomes. Results: Aortic dissection surgery was performed on an average of 8 patients annually, accounting for approximately 1.7% (64/3757) of all open-heart surgery cases. The in-hospital mortality rate was 28% (18/64). The main predisposing factors for in-hospital death were cardiac failure (11.1%), stroke (16.7%), uncontrollable hemorrhage (27.8%), renal failure (11.1%), respiratory failure (11.1%), and postoperative multi-organ failure (22.2%). We found no associations between cardiopulmonary bypass duration and mortality. During the routine use of cerebral protective perfusion, we did not encounter any cases of coma. Left ventricular hypertrophy, a short distance of intimal tear to the aortic valve, and renal failure were associated with postoperative bleeding tendency. Conclusion: Our study showed that multiple factors such as heart failure, uncontrolled bleeding, and respiratory failure increase in-hospital mortality of patients with dissection of aorta type A, but duration of surgery does not have any association with in-hospital death.
{"title":"Factors associated with in-hospital mortality and morbidity of patients with dissection of aorta type A, undergoing repair surgery","authors":"Behnam Askari, Behzad Rahimi, S. Masudi, Sirvan Mohammadian, Kiana Askari, Reza Hajizadeh","doi":"10.9739/tjvs.2023.12.035","DOIUrl":"https://doi.org/10.9739/tjvs.2023.12.035","url":null,"abstract":"Aim: Acute aortic dissection type A (AADA) is a life-threatening emergency with high mortality rates. Surgical intervention is the preferred and potentially life-saving treatment, but perioperative mortality remains a significant concern. Identifying the risk factors associated with surgical mortality, morbidity, and survival rates is essential. Therefore, this study aimed to characterize the preoperative and intraoperative risk factors for death during surgical repair of AADA. Material and Methods: We included 64 consecutive patients who underwent surgical repair between April 2013 and March 2021 in a tertiary heart center. Perioperative characteristics and variables were collected and analyzed to find any correlation between them and in-hospital Outcomes. Results: Aortic dissection surgery was performed on an average of 8 patients annually, accounting for approximately 1.7% (64/3757) of all open-heart surgery cases. The in-hospital mortality rate was 28% (18/64). The main predisposing factors for in-hospital death were cardiac failure (11.1%), stroke (16.7%), uncontrollable hemorrhage (27.8%), renal failure (11.1%), respiratory failure (11.1%), and postoperative multi-organ failure (22.2%). We found no associations between cardiopulmonary bypass duration and mortality. During the routine use of cerebral protective perfusion, we did not encounter any cases of coma. Left ventricular hypertrophy, a short distance of intimal tear to the aortic valve, and renal failure were associated with postoperative bleeding tendency. Conclusion: Our study showed that multiple factors such as heart failure, uncontrolled bleeding, and respiratory failure increase in-hospital mortality of patients with dissection of aorta type A, but duration of surgery does not have any association with in-hospital death.","PeriodicalId":23982,"journal":{"name":"Turkish Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140377322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01DOI: 10.9739/tjvs.1970.01.219
Tobias Hirsch
The paired leg and pelvic veins as well as the gonadal and renal veins flow into the unpaired inferior vena cava. The abdominal aorta splits into two iliac branches. This results in numerous crossings of the closely adjacent vessels and causes hemodynamic effects. The reason behind this lies in the embryological development. Early on in human development, primitive arteries and veins form from a capillary network. The limb, renal and testicular veins as well as the inferior vena cava develop from the cardinal vein system and are initially created in pairs. Remodelling and regression processes in the cardinal venous system during embryonic development explain the special anatomy of the retroperitoneal veins as well as the pathophysiological conditions underlying the various forms of PeVD.
{"title":"The natural history of pelvic veins","authors":"Tobias Hirsch","doi":"10.9739/tjvs.1970.01.219","DOIUrl":"https://doi.org/10.9739/tjvs.1970.01.219","url":null,"abstract":"The paired leg and pelvic veins as well as the gonadal and renal veins flow into the unpaired inferior vena cava. The abdominal aorta splits into two iliac branches. This results in numerous crossings of the closely adjacent vessels and causes hemodynamic effects. The reason behind this lies in the embryological development. Early on in human development, primitive arteries and veins form from a capillary network. The limb, renal and testicular veins as well as the inferior vena cava develop from the cardinal vein system and are initially created in pairs. Remodelling and regression processes in the cardinal venous system during embryonic development explain the special anatomy of the retroperitoneal veins as well as the pathophysiological conditions underlying the various forms of PeVD.","PeriodicalId":23982,"journal":{"name":"Turkish Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139014469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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