Aim: Thoracoabdominal aortic aneurysm (TAAA) and Mesenteric ischemia (MI) are multifactorial and hereditary diseases which also have associations with systemic atherosclerosis and genetic factors. As it is known, mortality and morbidity rates are very high for open surgery; therefore, hybrid approach, with better outcomes, has become more popular as a new alternative treatment option for TAAA patients. The aim of the study was to compare the graft patencies of all patients who underwent visceral revascularization with different aetiology. Material and Methods: 34 patients who underwent visceral revascularization, either for MI (n:16) or TAAA hybrid procedure(n:18) were included in this study. All data was collected retrospectively and was analysed with SPSS 21.0 software program. Chi-square and Fischer tests were used in the analysis of qualitative data; and results with a p value below 0.05 were considered as statistically significant. Results: There was no significant difference between two patient groups in terms of graft patency rates. All type 2 endoleaks were resolved spontaneously in control CT angiography and no migration was observed in patients. Conclusion: In line with the results obtained, it has been revealed that visceral revascularization surgery can be used not only for the final treatment of MI, but also as a step in the hybrid approaches of TAA.
{"title":"Abdominal revascularization patency outcomes of thoracoabdominal aortic aneurysm and mesenteric ischaemia","authors":"Zehra Kursunlu, O. Balcioglu, H. Posacioglu","doi":"10.9739/tjvs2022.09.016","DOIUrl":"https://doi.org/10.9739/tjvs2022.09.016","url":null,"abstract":"Aim: Thoracoabdominal aortic aneurysm (TAAA) and Mesenteric ischemia (MI) are multifactorial and hereditary diseases which also have associations with systemic atherosclerosis and genetic factors. As it is known, mortality and morbidity rates are very high for open surgery; therefore, hybrid approach, with better outcomes, has become more popular as a new alternative treatment option for TAAA patients. The aim of the study was to compare the graft patencies of all patients who underwent visceral revascularization with different aetiology. Material and Methods: 34 patients who underwent visceral revascularization, either for MI (n:16) or TAAA hybrid procedure(n:18) were included in this study. All data was collected retrospectively and was analysed with SPSS 21.0 software program. Chi-square and Fischer tests were used in the analysis of qualitative data; and results with a p value below 0.05 were considered as statistically significant. Results: There was no significant difference between two patient groups in terms of graft patency rates. All type 2 endoleaks were resolved spontaneously in control CT angiography and no migration was observed in patients. Conclusion: In line with the results obtained, it has been revealed that visceral revascularization surgery can be used not only for the final treatment of MI, but also as a step in the hybrid approaches of TAA.","PeriodicalId":23982,"journal":{"name":"Turkish Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82651690","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: This study aims to evaluate the considerations that should be taken into account when choosing a surgical method and the early results of six methods used for repair in patients who underwent surgical repair due to arteriovenous fistula (AVF) aneurysms. Material and Methods: One hundred and five patients who underwent AVF aneurysm repair between 2012 and 2020 were reviewed retrospectively. Methods for surgical repair were used according to the etiology: Plication, Arteriotomy constrictions and plication, Aneurysm excision and creation of a new fistula, Saphenous vein or synthetic graft interposition, End-to-end anastomosis and plication after aneurysm excision, Banding method. Results: Sixty-one of the cases were male and 44 were female. The mean age was 56.6 (27-75) years. The total number of surgeries was 119, including the surgeries and reoperations performed in 2 planned sessions. As surgical method, 44 Plication, 13 Arteriotomy constrictions and plication, 10 Aneurysm excision and creation of a new fistula, 25 Saphenous vein or synthetic graft interposition, 13 End-to-end anastomosis and plication after aneurysm excision and 14 Banding methods were used. AVF flow of 38 patients was measured to be over 1700 ml/min, and 34 of these patients had an arteriotomy length of more than 7 mm. In patients who underwent repair due to high flow rate, an average of 30-65% flow reduction was achieved compared to the preoperative period. In the first postoperative 3 months, 7 (6%) patients required reoperation. Fistula loss did not occur in any of the patients who underwent repair. Conclusion: The etiology of aneurysm, flow rate, aneurysm localization, and the presence of intimal hyperplasia or chronic thrombus are important in choosing an aneurysm repair method. We think that the results will be positively affected if the surgical method is determined according to the association of one or few of these factors.
{"title":"Six different surgical method options according to etiology in repair of arteriovenous fistula aneurysms","authors":"M. Işık, Ömer Tanyeli̇","doi":"10.9739/tjvs2022.10.024","DOIUrl":"https://doi.org/10.9739/tjvs2022.10.024","url":null,"abstract":"Aim: This study aims to evaluate the considerations that should be taken into account when choosing a surgical method and the early results of six methods used for repair in patients who underwent surgical repair due to arteriovenous fistula (AVF) aneurysms. Material and Methods: One hundred and five patients who underwent AVF aneurysm repair between 2012 and 2020 were reviewed retrospectively. Methods for surgical repair were used according to the etiology: Plication, Arteriotomy constrictions and plication, Aneurysm excision and creation of a new fistula, Saphenous vein or synthetic graft interposition, End-to-end anastomosis and plication after aneurysm excision, Banding method. Results: Sixty-one of the cases were male and 44 were female. The mean age was 56.6 (27-75) years. The total number of surgeries was 119, including the surgeries and reoperations performed in 2 planned sessions. As surgical method, 44 Plication, 13 Arteriotomy constrictions and plication, 10 Aneurysm excision and creation of a new fistula, 25 Saphenous vein or synthetic graft interposition, 13 End-to-end anastomosis and plication after aneurysm excision and 14 Banding methods were used. AVF flow of 38 patients was measured to be over 1700 ml/min, and 34 of these patients had an arteriotomy length of more than 7 mm. In patients who underwent repair due to high flow rate, an average of 30-65% flow reduction was achieved compared to the preoperative period. In the first postoperative 3 months, 7 (6%) patients required reoperation. Fistula loss did not occur in any of the patients who underwent repair. Conclusion: The etiology of aneurysm, flow rate, aneurysm localization, and the presence of intimal hyperplasia or chronic thrombus are important in choosing an aneurysm repair method. We think that the results will be positively affected if the surgical method is determined according to the association of one or few of these factors.","PeriodicalId":23982,"journal":{"name":"Turkish Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82544021","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: The purpose of this research was to investigate the early outcomes of pharmacomechanical thrombectomy (PMT) with the Mantis device and adjunctive catheter-directed thrombolysis (CDT) for the treatment of acute iliofemoral deep vein thrombosis (IFDVT). Material and Methods: Twenty patients with symptomatic acute IFDVT were successfully treated with the Mantis rotational thrombectomy device and CDT, between August 2020 and March 2021. Patients' demographical, clinical and follow-up data were obtained and analysed retrospectively. Villalta and Pain Severity scores were utilized to assess the patients for the occurrence of post-thrombotic syndrome (PTS). Results: The procedural success rate was 100%. All cases presented early clinical improvement. No device related complications were encountered. Reocclusion was observed in 3 (15%) patients. Pre-procedural median pain score was 7 (range: 6–8) and 1 (range: 0–7) at 12-month following thrombectomy (P < .001). Pre-procedural median Villalta score was 7 (range: 3–11) and 1 (range: 0–13) at 12-month following thrombectomy (P<.001). At 12-month follow-up, no PTS was reported in 15 (75%) patients, mild PTS was reported in 2 (10%) patients, moderate PTS was reported in 2 (10%) patients and no severe PTS was observed. Conclusion: The Mantis PMT system with CDT seems to be an efficient treatment approach for acute IFDVT with encouraging early results.
{"title":"Early outcomes of mantis pharmacomechanical thrombectomy system combined with catheter-directed thrombolysis for treatment of acute iliofemoral deep vein thrombosis","authors":"Görkem Yiğit","doi":"10.9739/tjvs2022.11.028","DOIUrl":"https://doi.org/10.9739/tjvs2022.11.028","url":null,"abstract":"Aim: The purpose of this research was to investigate the early outcomes of pharmacomechanical thrombectomy (PMT) with the Mantis device and adjunctive catheter-directed thrombolysis (CDT) for the treatment of acute iliofemoral deep vein thrombosis (IFDVT). Material and Methods: Twenty patients with symptomatic acute IFDVT were successfully treated with the Mantis rotational thrombectomy device and CDT, between August 2020 and March 2021. Patients' demographical, clinical and follow-up data were obtained and analysed retrospectively. Villalta and Pain Severity scores were utilized to assess the patients for the occurrence of post-thrombotic syndrome (PTS). Results: The procedural success rate was 100%. All cases presented early clinical improvement. No device related complications were encountered. Reocclusion was observed in 3 (15%) patients. Pre-procedural median pain score was 7 (range: 6–8) and 1 (range: 0–7) at 12-month following thrombectomy (P < .001). Pre-procedural median Villalta score was 7 (range: 3–11) and 1 (range: 0–13) at 12-month following thrombectomy (P<.001). At 12-month follow-up, no PTS was reported in 15 (75%) patients, mild PTS was reported in 2 (10%) patients, moderate PTS was reported in 2 (10%) patients and no severe PTS was observed. Conclusion: The Mantis PMT system with CDT seems to be an efficient treatment approach for acute IFDVT with encouraging early results.","PeriodicalId":23982,"journal":{"name":"Turkish Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85837862","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 : 2023-03-22DOI: 10.9739/tjvs.2022.10.022
Oruç Alper Onk
Aim: In this study, the mid-term results of the pharmacomechanical thrombolysis treatment administered in patients with iliofemoral acute-subacute (patients with symptoms less than 21 days old whose DVT was diagnosed with physical examination and duplex ultrasonography) deep vein thrombus (DVT) were investigated. The cases were evaluated in terms of disease-related quality of life, and the presence of post-thrombotic syndrome (PTS) which occurred in patients after previous DVT and treatment, and if present, its severity was determined. Material and Methods: Disease-related status of 40 patients (24 males, 16 females; mean age 44; age interval 20-80 years) treated due to iliofemoral acute-subacute DVT with interventional method between July 2013 and January 2017 were retrospectively analyzed two years after the interventional treatment. These patients were considered as mid-term patients. The patients were evaluated with VEINES-QOL/Sym quality of life scale and the Villalta scale. The occurrence and severity of PTS, the presence of venous ulcer, and the diameter difference between legs were evaluated. Results: No venous ulcer was present in our cases. In the evaluation made with Villalta scale, PTS was not observed in 20 out of 40 cases, mild PTS was found in 15, moderate PTS in 4, and severe PTS was observed in 1 case. Conclusion: We have concluded that pharmacomechanical thrombolysis treatment administered in well-selected patients reduced the severity of PTS and increased the quality of life associated with disease in DVT treatment.
{"title":"The effects of pharmacomechanical thrombolysis treatment administered to patients with iliofemoral deep vein thrombus","authors":"Oruç Alper Onk","doi":"10.9739/tjvs.2022.10.022","DOIUrl":"https://doi.org/10.9739/tjvs.2022.10.022","url":null,"abstract":"Aim: In this study, the mid-term results of the pharmacomechanical thrombolysis treatment administered in patients with iliofemoral acute-subacute (patients with symptoms less than 21 days old whose DVT was diagnosed with physical examination and duplex ultrasonography) deep vein thrombus (DVT) were investigated. The cases were evaluated in terms of disease-related quality of life, and the presence of post-thrombotic syndrome (PTS) which occurred in patients after previous DVT and treatment, and if present, its severity was determined. Material and Methods: Disease-related status of 40 patients (24 males, 16 females; mean age 44; age interval 20-80 years) treated due to iliofemoral acute-subacute DVT with interventional method between July 2013 and January 2017 were retrospectively analyzed two years after the interventional treatment. These patients were considered as mid-term patients. The patients were evaluated with VEINES-QOL/Sym quality of life scale and the Villalta scale. The occurrence and severity of PTS, the presence of venous ulcer, and the diameter difference between legs were evaluated. Results: No venous ulcer was present in our cases. In the evaluation made with Villalta scale, PTS was not observed in 20 out of 40 cases, mild PTS was found in 15, moderate PTS in 4, and severe PTS was observed in 1 case. Conclusion: We have concluded that pharmacomechanical thrombolysis treatment administered in well-selected patients reduced the severity of PTS and increased the quality of life associated with disease in DVT treatment.","PeriodicalId":23982,"journal":{"name":"Turkish Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79010465","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}
Mugisha Kyaruzi, U. Aydin, Muhammed Bayram, Ersin Kadiroğulları, Mustafa Can Kaplan
Aim: Technological developments on endovascular stents have increased the percutaneous repair of abdominal aortic aneurysm(AAAs). Open repair of abdominal aneurysm remains as the first option for treatment of aneurysm with compromising necks that need suprarenal aortic clamping(SAC). Open surgical repair with suprarenal aortic clamping may be associated with renal ischemia that may lead into renal injury. Our study focused on our clinical experience on the use of custodiol solution for renal protection during open repair of abdominal aortic aneurysm with suprarenal aortic clamping. Material and Methods: Our study consisted of 25 patients who underwent open repair for abdominal aortic aneurysm with suprarenal aortic clamping. During the repair, cold custodiol solution was used for renal protection in all patients. Outcomes included postoperative renal functions, mortality, hospital stay, need of postoperative dialysis and readmission due to renal injury. Results: 2 (8%) of our patients died, 2 patients (8%) experienced acute renal injury, hemodialysis was required in 8 patients (32%). There were 3 cases of morbidity, which included ileus in one patient, pneumonia in one patient and wound infection in one patient. Graft interposition was performed in one patient (4%) while aortobifemoral bypass was performed in 24 patients (96%). Conclusion: In our clinical experience, cold custadiol solution has shown to be safe as a renal protective solution during suprarenal aortic clamping in open repair of abdominal aortic aneurysm with well-preserved perioperative renal functions.
{"title":"Our clinical experience on renal protection with custadiol solution during juxtarenal clamping in open repair of abdominal aorta aneurysm","authors":"Mugisha Kyaruzi, U. Aydin, Muhammed Bayram, Ersin Kadiroğulları, Mustafa Can Kaplan","doi":"10.9739/tjvs2022.12.031","DOIUrl":"https://doi.org/10.9739/tjvs2022.12.031","url":null,"abstract":"Aim: Technological developments on endovascular stents have increased the percutaneous repair of abdominal aortic aneurysm(AAAs). Open repair of abdominal aneurysm remains as the first option for treatment of aneurysm with compromising necks that need suprarenal aortic clamping(SAC). Open surgical repair with suprarenal aortic clamping may be associated with renal ischemia that may lead into renal injury. Our study focused on our clinical experience on the use of custodiol solution for renal protection during open repair of abdominal aortic aneurysm with suprarenal aortic clamping. Material and Methods: Our study consisted of 25 patients who underwent open repair for abdominal aortic aneurysm with suprarenal aortic clamping. During the repair, cold custodiol solution was used for renal protection in all patients. Outcomes included postoperative renal functions, mortality, hospital stay, need of postoperative dialysis and readmission due to renal injury. Results: 2 (8%) of our patients died, 2 patients (8%) experienced acute renal injury, hemodialysis was required in 8 patients (32%). There were 3 cases of morbidity, which included ileus in one patient, pneumonia in one patient and wound infection in one patient. Graft interposition was performed in one patient (4%) while aortobifemoral bypass was performed in 24 patients (96%). Conclusion: In our clinical experience, cold custadiol solution has shown to be safe as a renal protective solution during suprarenal aortic clamping in open repair of abdominal aortic aneurysm with well-preserved perioperative renal functions.","PeriodicalId":23982,"journal":{"name":"Turkish Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74296388","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 : 2023-03-22DOI: 10.9739/tjvs.2022.09.018
O. Balcioglu, N. Usanase, B. Uzun, I. Ozsahin, Dilber Uzun Ozsahin
Aim: Annually, millions of people die from kidney diseases making it a serious public health concern. Patients with renal insufficiency have hemostatic defects that enhance their risk of thrombosis and bleeding. Evaluating the advantages and hazards of anticoagulant thromboprophylaxis is challenging. Material and Methods: By using the fuzzy preference ranking organization method for enrichment evaluation (fuzzy PROMETHEE) and fuzzy multi-criteria optimization and compromise solution (fuzzy VIKOR), which are analytical multi-criteria decision-making (MCDM) techniques, this study aims to analyze diverse types of anticoagulants; specifically, Vitamin K-Antagonist (warfarin) and direct oral anticoagulants namely; Dabigatran, Rivaroxaban, Apixaban, and Edoxaban, by considering various criteria. Results: Direct oral anticoagulants outperformed warfarin in terms of safety and effectiveness. Among all the analyzed anticoagulants, Apixaban was found to be the best-ranked anticoagulant with both fuzzy PROMETHEE and fuzzy VIKOR, with a net flow of 0.0064 and the lowest Qj value of 0.0000, respectively, compared with other alternatives depending on the selected criteria while warfarin was found to be the least ranked anticoagulant with a net flow of -0.0043 and the highest number of Qj being 1, respectively. Conclusion: The MCDM techniques used were effective, highly accurate, and sensitive in the comparison of anticoagulant therapy for venous thrombosis in renal insufficiency based on the chosen criteria. The proper use of a safe and effective anticoagulant will boost better performance not only in patients’ survival and well-being but also in the health care center.
{"title":"A comparative analysis of DOACs vs warfarin for venous thromboembolism treatment in renal insufficiency","authors":"O. Balcioglu, N. Usanase, B. Uzun, I. Ozsahin, Dilber Uzun Ozsahin","doi":"10.9739/tjvs.2022.09.018","DOIUrl":"https://doi.org/10.9739/tjvs.2022.09.018","url":null,"abstract":"Aim: Annually, millions of people die from kidney diseases making it a serious public health concern. Patients with renal insufficiency have hemostatic defects that enhance their risk of thrombosis and bleeding. Evaluating the advantages and hazards of anticoagulant thromboprophylaxis is challenging. Material and Methods: By using the fuzzy preference ranking organization method for enrichment evaluation (fuzzy PROMETHEE) and fuzzy multi-criteria optimization and compromise solution (fuzzy VIKOR), which are analytical multi-criteria decision-making (MCDM) techniques, this study aims to analyze diverse types of anticoagulants; specifically, Vitamin K-Antagonist (warfarin) and direct oral anticoagulants namely; Dabigatran, Rivaroxaban, Apixaban, and Edoxaban, by considering various criteria. Results: Direct oral anticoagulants outperformed warfarin in terms of safety and effectiveness. Among all the analyzed anticoagulants, Apixaban was found to be the best-ranked anticoagulant with both fuzzy PROMETHEE and fuzzy VIKOR, with a net flow of 0.0064 and the lowest Qj value of 0.0000, respectively, compared with other alternatives depending on the selected criteria while warfarin was found to be the least ranked anticoagulant with a net flow of -0.0043 and the highest number of Qj being 1, respectively. Conclusion: The MCDM techniques used were effective, highly accurate, and sensitive in the comparison of anticoagulant therapy for venous thrombosis in renal insufficiency based on the chosen criteria. The proper use of a safe and effective anticoagulant will boost better performance not only in patients’ survival and well-being but also in the health care center.","PeriodicalId":23982,"journal":{"name":"Turkish Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80811530","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}
All over the world, except during the war period, firearm injuries are encountered in daily life at varying rates depending on the region and country. In addition, late-term vascular complications may occur in injuries with a less traumatic appearance. In this present case report, we aimed to evaluate the hybrid treatment of giant pseudoaneurysm and arteriovenous fistula (AVf) in the left superficial femoral artery (SFA), which developed in a patient who had a pellet shot on his left thigh eight years ago. Postsurgical management was straightforward; the patient received antibiotherapy with ampicillin and sulbactam acid for 7 days, acetylsalicylic acid 100mg per day, and anticoagulant treatment with low molecular weight heparin for 1 month. The patient was examined in the cardiovascular surgery polyclinic on the 5th day after discharge uneventfully. Although endovascular treatment methods are widely used today in the treatment of vascular injuries, surgery still maintains its importance. In some special patient groups, a combination of these two treatment methods may be preferred.
{"title":"Hybrid management of lower limb huge pseudoaneurysm with arteriovenous fistula presenting 8 years after gunshot injury","authors":"M. Engin, O. Guvenc, U. Aydın, Y. Ata","doi":"10.9739/tjvs2022.10.026","DOIUrl":"https://doi.org/10.9739/tjvs2022.10.026","url":null,"abstract":"All over the world, except during the war period, firearm injuries are encountered in daily life at varying rates depending on the region and country. In addition, late-term vascular complications may occur in injuries with a less traumatic appearance. In this present case report, we aimed to evaluate the hybrid treatment of giant pseudoaneurysm and arteriovenous fistula (AVf) in the left superficial femoral artery (SFA), which developed in a patient who had a pellet shot on his left thigh eight years ago. Postsurgical management was straightforward; the patient received antibiotherapy with ampicillin and sulbactam acid for 7 days, acetylsalicylic acid 100mg per day, and anticoagulant treatment with low molecular weight heparin for 1 month. The patient was examined in the cardiovascular surgery polyclinic on the 5th day after discharge uneventfully. Although endovascular treatment methods are widely used today in the treatment of vascular injuries, surgery still maintains its importance. In some special patient groups, a combination of these two treatment methods may be preferred.","PeriodicalId":23982,"journal":{"name":"Turkish Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78280961","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}
H. T. Akay, O. Unal, S. Doganci, A. Bozkurt, N. Erdil, M. Şırlak, E. Uğuz
Aim: Venous thromboembolism (VTE) is a relatively common public health problem. In addition to increasing mortality due to complications, it also causes an increase in the cost of the country's economy and loss of labor due to the morbidity it creates. Considering that the recurrence of VTE is a common condition, the importance of this disease for the society increases even more. Although we have come a long way in treatment and follow-up, we see that VTE and its related complications maintain their place as a significant risk factor in the society at increasing rates. Material and Methods: This is an additional analysis of a multicentral, retrospective descriptive study, CAT-TR (Assessment of Patient Characteristic in Cancer Associated Venous Thrombosis in Turkey). The aim of the CAT-TR study was to evaluate patient characteristic and treatment patterns of cancer-induced VTE in Turkey. This article aims to evaluate the incidence and prevalence of cancer-induced VTE in two regions of Turkey between January 01, 2016 and December 31, 2019. Results: In our study, the 4-year prevalence of Deep Venous Thrombosis (DVT) and Pulmonary Embolism (PE) in Central Anatolia and Marmara was 86.43, 103.56 and 105.68, 98.04 per 100.000 people, respectively. The cumulative incidence of cancer-related VTE in the Central Anatolian and Marmara populations is 17.22 and 6.71 per 100.000 people, respectively. Conclusion: The values we found in the prevalence and incidence study of VTE will be very valuable in terms of being a reference for us in the treatment and prevention of the disease. We believe that this study will shed light on new studies for diseases that may cause VTE in larger populations and strategies to be followed in prevention.
{"title":"Prevalence and incidence of deep venous thrombosis and pulmonary embolism in 2 regions in Turkey (A sub-analysis of CAT-TR study)","authors":"H. T. Akay, O. Unal, S. Doganci, A. Bozkurt, N. Erdil, M. Şırlak, E. Uğuz","doi":"10.9739/tjvs.2023.01.04","DOIUrl":"https://doi.org/10.9739/tjvs.2023.01.04","url":null,"abstract":"Aim: Venous thromboembolism (VTE) is a relatively common public health problem. In addition to increasing mortality due to complications, it also causes an increase in the cost of the country's economy and loss of labor due to the morbidity it creates. Considering that the recurrence of VTE is a common condition, the importance of this disease for the society increases even more. Although we have come a long way in treatment and follow-up, we see that VTE and its related complications maintain their place as a significant risk factor in the society at increasing rates. Material and Methods: This is an additional analysis of a multicentral, retrospective descriptive study, CAT-TR (Assessment of Patient Characteristic in Cancer Associated Venous Thrombosis in Turkey). The aim of the CAT-TR study was to evaluate patient characteristic and treatment patterns of cancer-induced VTE in Turkey. This article aims to evaluate the incidence and prevalence of cancer-induced VTE in two regions of Turkey between January 01, 2016 and December 31, 2019. Results: In our study, the 4-year prevalence of Deep Venous Thrombosis (DVT) and Pulmonary Embolism (PE) in Central Anatolia and Marmara was 86.43, 103.56 and 105.68, 98.04 per 100.000 people, respectively. The cumulative incidence of cancer-related VTE in the Central Anatolian and Marmara populations is 17.22 and 6.71 per 100.000 people, respectively. Conclusion: The values we found in the prevalence and incidence study of VTE will be very valuable in terms of being a reference for us in the treatment and prevention of the disease. We believe that this study will shed light on new studies for diseases that may cause VTE in larger populations and strategies to be followed in prevention.","PeriodicalId":23982,"journal":{"name":"Turkish Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90941382","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}
Sabir Hasanzade, Yunus Emre Ergin, Murat Gevrek, Naim Boran Tumer, H. L. Mavioğlu, H. Iscan
Aim: Thoracic aortic pathologies describe a wide spectrum of potentially life-threatening diseases almost always in a comorbid aged patient cohort. Thoracic endovascular aortic repair (TEVAR) is a less invasive treatment choice, offering reduced mortality and morbidity compared to open surgery. We decided to reveal our experience over safety and efficacy data with Lifetech Ankura™ Thoracic endografts with early and midterm outcomes, retrospectivelytiology. Material and Methods: Between January 2018 and January 2023, for a 5-year period, 203 patients who experienced TEVAR procedure with Lifetech Ankura™ Thoracic endograft were retrospectively evaluated. For the patients who required revascularization of the vessel branches originating from the aortic segments, all types of assistive techniques were performed. Intentional coverage of Left subclavian artery was also performed mostly in urgent patients. Results: 251 endografts were implanted in 203 patients. The most frequent aortic pathologies were the thoracic aortic fusiform aneurysm (56.6%) and type B aortic dissection (25.6%), respectively. Early (30-day/in-hospital) mortality occurred in 9 patients in total (4.4%). Technical success rate was 100%, and there was no conversion to open surgery. No other major adverse event, including cerebral, cardiac, or renal complication requiring dialysis, was observed. The average intensive care unit time was 16.9±11 hours (2-160), length of stay was 5.1±3.2 days. CSF drainage was performed in 51 patients inserted before the procedure prophylactically (25.1%). All patients who survived the operation were followed for 18.6±9.3 months. In the follow up period, four patients needed extension for endoleaks and two additive petticoat procedures were performed. One patient who had TEVAR due to a malperfused type B aortic dissection in the acute phase experienced RTAD 2 weeks after the initial procedure. Conclusion: TEVAR with LifeTech Ankura™ Thoracic Stent Graft system provides a safe, effective, and durable treatment with successful early outcomes and technical success. Wide spectrum in length and non-identical radiopaque proximal markers seem to facilitate some advanced endovascular skills. Long-term durability of the endograft should be tested.
{"title":"Early and midterm outcomes of thoracic endovascular aortic repair with Lifetech Ankura™ thoracic endograft: A single tertiary center experience","authors":"Sabir Hasanzade, Yunus Emre Ergin, Murat Gevrek, Naim Boran Tumer, H. L. Mavioğlu, H. Iscan","doi":"10.9739/tjvs.2023.02.05","DOIUrl":"https://doi.org/10.9739/tjvs.2023.02.05","url":null,"abstract":"Aim: Thoracic aortic pathologies describe a wide spectrum of potentially life-threatening diseases almost always in a comorbid aged patient cohort. Thoracic endovascular aortic repair (TEVAR) is a less invasive treatment choice, offering reduced mortality and morbidity compared to open surgery. We decided to reveal our experience over safety and efficacy data with Lifetech Ankura™ Thoracic endografts with early and midterm outcomes, retrospectivelytiology. Material and Methods: Between January 2018 and January 2023, for a 5-year period, 203 patients who experienced TEVAR procedure with Lifetech Ankura™ Thoracic endograft were retrospectively evaluated. For the patients who required revascularization of the vessel branches originating from the aortic segments, all types of assistive techniques were performed. Intentional coverage of Left subclavian artery was also performed mostly in urgent patients. Results: 251 endografts were implanted in 203 patients. The most frequent aortic pathologies were the thoracic aortic fusiform aneurysm (56.6%) and type B aortic dissection (25.6%), respectively. Early (30-day/in-hospital) mortality occurred in 9 patients in total (4.4%). Technical success rate was 100%, and there was no conversion to open surgery. No other major adverse event, including cerebral, cardiac, or renal complication requiring dialysis, was observed. The average intensive care unit time was 16.9±11 hours (2-160), length of stay was 5.1±3.2 days. CSF drainage was performed in 51 patients inserted before the procedure prophylactically (25.1%). All patients who survived the operation were followed for 18.6±9.3 months. In the follow up period, four patients needed extension for endoleaks and two additive petticoat procedures were performed. One patient who had TEVAR due to a malperfused type B aortic dissection in the acute phase experienced RTAD 2 weeks after the initial procedure. Conclusion: TEVAR with LifeTech Ankura™ Thoracic Stent Graft system provides a safe, effective, and durable treatment with successful early outcomes and technical success. Wide spectrum in length and non-identical radiopaque proximal markers seem to facilitate some advanced endovascular skills. Long-term durability of the endograft should be tested.","PeriodicalId":23982,"journal":{"name":"Turkish Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91359958","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}
F. Borulu, Oğuzhan Birdal, E. Calik, Hakan Usta, B. Erkut
Aortic dissection and aneurysms are one of the most important life-threatening diseases. After ascending aortic replacement, one of the life-saving urgent surgeries for Type I aortic dissection, aneurysmatic dilatation is usually observed in the remaining portions of the aorta over time. Open surgical repair for these patients still carries a 30% mortality rate despite improvements in open surgical methods, graft materials, and technological options. Endovascular repair provides promising results in high-risk patients. A 72-year-old female patient who underwent ascending aortic replacement for type 1 aortic dissection 9 years ago was admitted to our clinic with the diagnosis of symptomatic aneurysmal dilatation in the thoracic and abdominal aortic segments. We present this case in which we used the Cardiatis® Multilayer Flow Modulator stent to conduct endovascular repair.
{"title":"Endovascular aortic repair with Cardiatis® multilayer flow modulator in a patient undergone ascending aortic replacement for type I aortic dissection","authors":"F. Borulu, Oğuzhan Birdal, E. Calik, Hakan Usta, B. Erkut","doi":"10.9739/tjvs.2023.02.06","DOIUrl":"https://doi.org/10.9739/tjvs.2023.02.06","url":null,"abstract":"Aortic dissection and aneurysms are one of the most important life-threatening diseases. After ascending aortic replacement, one of the life-saving urgent surgeries for Type I aortic dissection, aneurysmatic dilatation is usually observed in the remaining portions of the aorta over time. Open surgical repair for these patients still carries a 30% mortality rate despite improvements in open surgical methods, graft materials, and technological options. Endovascular repair provides promising results in high-risk patients. A 72-year-old female patient who underwent ascending aortic replacement for type 1 aortic dissection 9 years ago was admitted to our clinic with the diagnosis of symptomatic aneurysmal dilatation in the thoracic and abdominal aortic segments. We present this case in which we used the Cardiatis® Multilayer Flow Modulator stent to conduct endovascular repair.","PeriodicalId":23982,"journal":{"name":"Turkish Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81934012","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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