Pub Date : 2022-11-15DOI: 10.9739/tjvs.2022.09.019
A. Budak, T. Gençpınar, E. Dogan, Sahin Totan, H. T. Akay
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.
{"title":"Edoxaban in cardiovascular medicine from scientific evidence to clinical practice","authors":"A. Budak, T. Gençpınar, E. Dogan, Sahin Totan, H. T. Akay","doi":"10.9739/tjvs.2022.09.019","DOIUrl":"https://doi.org/10.9739/tjvs.2022.09.019","url":null,"abstract":"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.","PeriodicalId":23982,"journal":{"name":"Turkish Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84696004","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}
Effect Of Surgical Techniques In The Treatment Of Small Saphenous Vein Insufficiency On Clinical Outcomes
小隐静脉不全手术治疗技术对临床疗效的影响
{"title":"Effect Of Surgical Techniques In The Treatment Of Small Saphenous Vein Insufficiency On Clinical Outcomes","authors":"A. Engin, F. Islamoglu","doi":"10.9739/tjvs.2022.1304","DOIUrl":"https://doi.org/10.9739/tjvs.2022.1304","url":null,"abstract":"Effect Of Surgical Techniques In The Treatment Of Small Saphenous Vein Insufficiency On Clinical Outcomes","PeriodicalId":23982,"journal":{"name":"Turkish Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84661143","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}
Transfusion of blood components can save lives, but like all therapeutics, it carries risks and costs. Therefore, transfusion should be used judiciously. Patient blood management provides safe and rational use of blood and blood products and is designed to improve patient outcomes by minimizing unnecessary exposure to blood products. In this review, perioperative patient blood management and techniques to minimize blood loss during vascular surgery are discussed.
{"title":"Patient blood management strategies in vascular surgery","authors":"Ş. Albeyoğlu","doi":"10.9739/tjvs.2022.1299","DOIUrl":"https://doi.org/10.9739/tjvs.2022.1299","url":null,"abstract":"Transfusion of blood components can save lives, but like all therapeutics, it carries risks and costs. Therefore, transfusion should be used judiciously. Patient blood management provides safe and rational use of blood and blood products and is designed to improve patient outcomes by minimizing unnecessary exposure to blood products. In this review, perioperative patient blood management and techniques to minimize blood loss during vascular surgery are discussed.","PeriodicalId":23982,"journal":{"name":"Turkish Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80731185","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 : 2022-11-15DOI: 10.9739/tjvs.2022.09.015
S. Mola, G. Aşkın, Bahadir Aytekin, Sabir Hasanzade, Abdullah Kusay Girgin, Naim Boran Tumer, E. Unal, H. Iscan
Aim: In our study, we aimed not only if CO2 is a safe and effective vascular roadmap for EVAR procedure instead of ICM but if it is a feasible opportunity for patients with hostile neck anatomy as well. Material and Methods: From January 2019 to July 2022, 42 patients with renal insufficiency had elective EVAR procedures for infrarenal abdominal aortic aneurysm in our Cardiovascular Surgery Clinic with CO2-guided DSA. Results: There were no conversions to open surgery or no need for ICM for the CO2-guided DSA. Technical success for CO2 guidance EVAR was 100% with the second shot. There was no decline in GFR values, only one patient showed transient manifestations of CIN without need for hemodialysis. Conclusion: CO2 DSA is a safe and effective technique that can guide not only the standard but endovascular procedures with a hostile neck for renal insufficiency below the diaphragm allowing virtually unlimited images. With modern automated closed systems, CO2-specific complications will be negligible if the operator has experience with the limitations and contraindications of the technique.
{"title":"Endovascular aortic repair via carbon-dioxide imaging in renal insufficiency?","authors":"S. Mola, G. Aşkın, Bahadir Aytekin, Sabir Hasanzade, Abdullah Kusay Girgin, Naim Boran Tumer, E. Unal, H. Iscan","doi":"10.9739/tjvs.2022.09.015","DOIUrl":"https://doi.org/10.9739/tjvs.2022.09.015","url":null,"abstract":"Aim: In our study, we aimed not only if CO2 is a safe and effective vascular roadmap for EVAR procedure instead of ICM but if it is a feasible opportunity for patients with hostile neck anatomy as well. Material and Methods: From January 2019 to July 2022, 42 patients with renal insufficiency had elective EVAR procedures for infrarenal abdominal aortic aneurysm in our Cardiovascular Surgery Clinic with CO2-guided DSA. Results: There were no conversions to open surgery or no need for ICM for the CO2-guided DSA. Technical success for CO2 guidance EVAR was 100% with the second shot. There was no decline in GFR values, only one patient showed transient manifestations of CIN without need for hemodialysis. Conclusion: CO2 DSA is a safe and effective technique that can guide not only the standard but endovascular procedures with a hostile neck for renal insufficiency below the diaphragm allowing virtually unlimited images. With modern automated closed systems, CO2-specific complications will be negligible if the operator has experience with the limitations and contraindications of the technique.","PeriodicalId":23982,"journal":{"name":"Turkish Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91431980","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 : 2022-11-15DOI: 10.9739/tjvs.2022.09.017
G. Aşkın, S. Mola, Bahadir Aytekin, Sabir Hasanzade, Naim Boran Tumer, H. L. Mavioğlu, H. Iscan
Aim: Blunt traumatic thoracic aortic injury (BTTAI) is a catastrophic life-threatening surgical emergency and the second most common cause of death in trauma patients. We retrospectively revealed our results for endovascularly treated BTTAI with early and long-term results. Material and Methods: During January 2009 and January 2022, patients from the emergency department with diagnosed BTTAI were retrospectively revealed. 38 patients all male except two, experienced BTTAI. 5 patients had grade IV, and 21 patients had grade III aortic injuries. Results: Mean age of the patients was 41.7±12.5 years. Technical success was 100%. Early mortality was 7.9%. The mean follow-up period was 49.7±18.3 months. In the follow-up period, there were no TEVAR-related complications. Conclusion: TEVAR is the most suitable treatment for BTTAI in the modern era. Left subclavian artery (LSA) intentional coverage may be performed however surgeon modified fenestrated stent graft (SMFSG) is an effective, economic, fast, and readily available technique for LSA revascularization without additional time.
{"title":"Endovascular therapy in blunt traumatic aortic injuries","authors":"G. Aşkın, S. Mola, Bahadir Aytekin, Sabir Hasanzade, Naim Boran Tumer, H. L. Mavioğlu, H. Iscan","doi":"10.9739/tjvs.2022.09.017","DOIUrl":"https://doi.org/10.9739/tjvs.2022.09.017","url":null,"abstract":"Aim: Blunt traumatic thoracic aortic injury (BTTAI) is a catastrophic life-threatening surgical emergency and the second most common cause of death in trauma patients. We retrospectively revealed our results for endovascularly treated BTTAI with early and long-term results. Material and Methods: During January 2009 and January 2022, patients from the emergency department with diagnosed BTTAI were retrospectively revealed. 38 patients all male except two, experienced BTTAI. 5 patients had grade IV, and 21 patients had grade III aortic injuries. Results: Mean age of the patients was 41.7±12.5 years. Technical success was 100%. Early mortality was 7.9%. The mean follow-up period was 49.7±18.3 months. In the follow-up period, there were no TEVAR-related complications. Conclusion: TEVAR is the most suitable treatment for BTTAI in the modern era. Left subclavian artery (LSA) intentional coverage may be performed however surgeon modified fenestrated stent graft (SMFSG) is an effective, economic, fast, and readily available technique for LSA revascularization without additional time.","PeriodicalId":23982,"journal":{"name":"Turkish Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88761541","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}
Congratulations to the authors for their effort [1]. Endovascular treatment for central venous occlusions, which cause many vascular access problems among hemodialysis patients, has increased in recent years. Although most of these procedures have been applied via forearm vessels, there were studies reporting the use of the transfemoral approach in complicated cases [2,3]. In the publication, the authors reported that they applied a fistulogram by using a 6 Fr sheath from forearm veins and diagnosed the occlusion site. After the fistulogram, the authors used transfemoral access for other invasive procedures not to injure forearm vessels. We conclude that the invasive endovascular procedures for treating the occluded segment could be completed via the same access point, and the transfemoral approach must not be a routine route for access and reserved for more complicated cases or when the forearm is unavailable.
{"title":"Proximal venous outflow obstructions and transfemoral approach in patients with arteriovenous fistula","authors":"Ersin Çelik, A. Çora","doi":"10.9739/tjvs.2022.1260","DOIUrl":"https://doi.org/10.9739/tjvs.2022.1260","url":null,"abstract":"Congratulations to the authors for their effort [1]. Endovascular treatment for central venous occlusions, which cause many vascular access problems among hemodialysis patients, has increased in recent years. Although most of these procedures have been applied via forearm vessels, there were studies reporting the use of the transfemoral approach in complicated cases [2,3]. In the publication, the authors reported that they applied a fistulogram by using a 6 Fr sheath from forearm veins and diagnosed the occlusion site. After the fistulogram, the authors used transfemoral access for other invasive procedures not to injure forearm vessels. We conclude that the invasive endovascular procedures for treating the occluded segment could be completed via the same access point, and the transfemoral approach must not be a routine route for access and reserved for more complicated cases or when the forearm is unavailable.","PeriodicalId":23982,"journal":{"name":"Turkish Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89172128","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, E. Ayva, I. Oguzulgen, Gokhan Kahraman, B. Gültekin, O. Hekimoglu
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.
{"title":"Pulmonary artery angiosarcoma mimicking chronic thromboembolic pulmonary hypertension","authors":"H. T. Akay, E. Ayva, I. Oguzulgen, Gokhan Kahraman, B. Gültekin, O. Hekimoglu","doi":"10.9739/tjvs.2022.09.07","DOIUrl":"https://doi.org/10.9739/tjvs.2022.09.07","url":null,"abstract":"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.","PeriodicalId":23982,"journal":{"name":"Turkish Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81248392","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}
A. Topçu, F. Yiğit, Gozde Ozturk Altunyurt, A. Batırel, M. Rabus
Aim: This study aimed to investigate whether the D-dimer / fibrinogen ratio (DDFR) measured on admission could be used as a diagnostic marker of pulmonary embolism (PE) in coronavirus disease 2019 (COVID-19) patients. Material and Methods: This single-center, retrospective, case-control study was conducted with 204 COVID-19 patients (131 males, 73 females; mean age: 62±15.4 years; range, 28 to 97 years) between October 18, 2020, and December 18, 2020. Patients were followed during the hospital stay and for 30 days after discharge. The primary outcome was the occurrence of radiologically confirmed PE. The DDFR was calculated using the following formula: DDFR=D-dimer (ng/mL) / fibrinogen (mg/dL). Results: Six (2.9%) patients experienced PE during the follow-up. D-dimer had 63.6% sensitivity and 76.2% specificity on admission to predict thromboembolism at a cut-off of 1,375 ng/mL (area under the curve (AUC)=0.687, 95% confidence interval (CI): 0.530-0.845, p<0.05). The DDFR had 75% sensitivity and 90.5% specificity on admission to predict thromboembolism at a cut-off of 5.41 (AUC =0.846, 95% CI: 0.728-0.965, p<0.05). Conclusion: A measurement of DDFR on admission does not provide incremental value over D-dimer to recognize patients who are at risk of developing PE during and early after hospitalization for COVID-19.
{"title":"Association Of D-Dimer/Fibrinogen Ratio With Pulmonary Embolism In COVID-19 Patients","authors":"A. Topçu, F. Yiğit, Gozde Ozturk Altunyurt, A. Batırel, M. Rabus","doi":"10.9739/tjvs.2022.1261","DOIUrl":"https://doi.org/10.9739/tjvs.2022.1261","url":null,"abstract":"Aim: This study aimed to investigate whether the D-dimer / fibrinogen ratio (DDFR) measured on admission could be used as a diagnostic marker of pulmonary embolism (PE) in coronavirus disease 2019 (COVID-19) patients. Material and Methods: This single-center, retrospective, case-control study was conducted with 204 COVID-19 patients (131 males, 73 females; mean age: 62±15.4 years; range, 28 to 97 years) between October 18, 2020, and December 18, 2020. Patients were followed during the hospital stay and for 30 days after discharge. The primary outcome was the occurrence of radiologically confirmed PE. The DDFR was calculated using the following formula: DDFR=D-dimer (ng/mL) / fibrinogen (mg/dL). Results: Six (2.9%) patients experienced PE during the follow-up. D-dimer had 63.6% sensitivity and 76.2% specificity on admission to predict thromboembolism at a cut-off of 1,375 ng/mL (area under the curve (AUC)=0.687, 95% confidence interval (CI): 0.530-0.845, p<0.05). The DDFR had 75% sensitivity and 90.5% specificity on admission to predict thromboembolism at a cut-off of 5.41 (AUC =0.846, 95% CI: 0.728-0.965, p<0.05). Conclusion: A measurement of DDFR on admission does not provide incremental value over D-dimer to recognize patients who are at risk of developing PE during and early after hospitalization for COVID-19.","PeriodicalId":23982,"journal":{"name":"Turkish Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89671863","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: Treatment of infrapopliteal peripheral arterial disease is still challenging. Rotational atherectomy (RA) is a novel option that aims removal of calcium from the lumen and improvement in outcomes. Material and Methods: Data of 27 patients (19 males, 8 females; mean age: 59.8±13.7 years; range, 25 to 79 years) with infrapopliteal occlusions treated by RA between January 2017 and December 2019 was retrospectively collected. The Global Limb Anatomic Staging System (GLASS) and the Rutherford classification (RC) were used for evaluation. The objective performance goals of Conte et al. (major adverse limb event [MALE] and major adverse cardiovascular event [MACE]) were used for assessing outcome performance. Visits were scheduled at 1, 6, 12, 18, and 24 months after treatment. In each visit, symptoms, RC, wound status, smoking status, lifestyle modifications, and medications were questioned, laboratory tests and Doppler ultrasonography were carried out, and the next visit was planned. Results: Device success was 88.89%, whereas procedural success was 100%. Unanticipated amputation rate was 11.1% in the 12-month follow-up. Over half of the patients (66.67%) showed RC improvement with a mean change of 3±1.17. Thirty-day safety endpoints were as follows: MALE, MACE, and amputation rates were 12.5%, 0%, and 8.33%, respectively. One-year efficacy endpoints were as follows: freedom from MALE+perioperative death was 71.42%, amputation-free survival was 76.19%, freedom from reintervention (amputation was 75%, limb salvage was 80%, and survival was 90.47%. Associations between RC (5-6) and calcification, chronic renal insufficiency and amputation, being a nonsmoker and failure to improve RC, and smoking and high infrapopliteal GLASS were found. Smoking cessation came with RC improvement in every case. Nonquitters experienced worsening more often compared to quitters (0% vs. 25%). Conclusion: Rotational atherectomy is feasible and effective in infrapopliteal chronic total occlusions. Closer follow-up is suggested for nonsmokers and patients with chronic renal insufficiency or advanced GLASS stages as they are prone to unfavorable clinical results. Quitting smoking should be underlined with its potential positive clinical effect even after the procedure.
目的:髌下外周动脉疾病的治疗仍然具有挑战性。旋转动脉粥样硬化切除术(RA)是一种新颖的选择，旨在从腔内去除钙并改善预后。材料与方法:27例患者资料(男19例，女8例;平均年龄59.8±13.7岁;回顾性收集2017年1月至2019年12月期间接受RA治疗的髌下闭塞患者。采用全球肢体解剖分期系统(GLASS)和Rutherford分类(RC)进行评估。采用Conte等人的客观表现目标(主要肢体不良事件[MALE]和主要心血管不良事件[MACE])评估结局表现。随访时间分别为治疗后1、6、12、18和24个月。每次就诊时，询问症状、RC、伤口状况、吸烟状况、生活方式改变和药物，进行实验室检查和多普勒超声检查，并计划下一次就诊。结果:器械成功率为88.89%，手术成功率为100%。随访12个月，意外截肢率为11.1%。超过一半(66.67%)的患者RC改善，平均变化为3±1.17。30天的安全终点如下:MALE、MACE和截肢率分别为12.5%、0%和8.33%。1年疗效终点为:男性男性患者+围手术期死亡发生率为71.42%，无截肢生存率为76.19%，无再干预(截肢率为75%，肢体保留率为80%，生存率为90.47%)。研究发现RC(5-6)与钙化、慢性肾功能不全和截肢、不吸烟和改善RC失败、吸烟和高腘下GLASS之间存在关联。在每一种情况下，戒烟都会带来RC的改善。与戒烟者相比，不戒烟者更容易出现病情恶化(0% vs. 25%)。结论:旋转动脉粥样硬化切除术治疗膝下慢性全闭塞是可行且有效的。建议对不吸烟者和慢性肾功能不全或晚期GLASS患者进行更密切的随访，因为他们容易出现不利的临床结果。即使在手术后，戒烟也应强调其潜在的积极临床效果。
{"title":"Rotational atherectomy for below the knee lesions in critical limb threatening ischemia: Is it a wild goose chase?","authors":"Aysen Yaprak Engin, Deniz Şerefli","doi":"10.9739/tjvs.2022.1301","DOIUrl":"https://doi.org/10.9739/tjvs.2022.1301","url":null,"abstract":"Aim: Treatment of infrapopliteal peripheral arterial disease is still challenging. Rotational atherectomy (RA) is a novel option that aims removal of calcium from the lumen and improvement in outcomes. Material and Methods: Data of 27 patients (19 males, 8 females; mean age: 59.8±13.7 years; range, 25 to 79 years) with infrapopliteal occlusions treated by RA between January 2017 and December 2019 was retrospectively collected. The Global Limb Anatomic Staging System (GLASS) and the Rutherford classification (RC) were used for evaluation. The objective performance goals of Conte et al. (major adverse limb event [MALE] and major adverse cardiovascular event [MACE]) were used for assessing outcome performance. Visits were scheduled at 1, 6, 12, 18, and 24 months after treatment. In each visit, symptoms, RC, wound status, smoking status, lifestyle modifications, and medications were questioned, laboratory tests and Doppler ultrasonography were carried out, and the next visit was planned. Results: Device success was 88.89%, whereas procedural success was 100%. Unanticipated amputation rate was 11.1% in the 12-month follow-up. Over half of the patients (66.67%) showed RC improvement with a mean change of 3±1.17. Thirty-day safety endpoints were as follows: MALE, MACE, and amputation rates were 12.5%, 0%, and 8.33%, respectively. One-year efficacy endpoints were as follows: freedom from MALE+perioperative death was 71.42%, amputation-free survival was 76.19%, freedom from reintervention (amputation was 75%, limb salvage was 80%, and survival was 90.47%. Associations between RC (5-6) and calcification, chronic renal insufficiency and amputation, being a nonsmoker and failure to improve RC, and smoking and high infrapopliteal GLASS were found. Smoking cessation came with RC improvement in every case. Nonquitters experienced worsening more often compared to quitters (0% vs. 25%). Conclusion: Rotational atherectomy is feasible and effective in infrapopliteal chronic total occlusions. Closer follow-up is suggested for nonsmokers and patients with chronic renal insufficiency or advanced GLASS stages as they are prone to unfavorable clinical results. Quitting smoking should be underlined with its potential positive clinical effect even after the procedure.","PeriodicalId":23982,"journal":{"name":"Turkish Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85280448","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}
{"title":"The relationship between platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio and prognosis in carotid artery endarterectomy","authors":"Tolga Baş","doi":"10.9739/tjvs.2022.1143","DOIUrl":"https://doi.org/10.9739/tjvs.2022.1143","url":null,"abstract":"","PeriodicalId":23982,"journal":{"name":"Turkish Journal of Vascular Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78952902","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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