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  • Küçük Resim
    Öğe
    Effectiveness of endo-vascular treatment in carotid artery stenosis: A single center study
    (2019) Bekin Sarikaya, Pelin Zeynep; Harman, Ali; Ozyer, Umut; Boyvat, Fatih
    Aim: To investigate the safety and effectiveness of endo-vascular stents to treat carotid artery stenosis (CAS).Material and Methods: One-hundred fourteen patients who underwent selective endo-vascular stenting following selective carotid angiography between 2000 and 2014 were analyzed retrospectively. Demographic characteristics; stenosis degree; stent type; use of anti-coagulants and embolism protection system (EPS) during the procedure; pre-dilation and post-dilation during the procedure; use of a vascular occlusion device after the procedure; early complications (30 days); prevalence of re-stenosis of the stent; sixth-month, first-year, second-year, and fifth-year controls; radiologic imaging results; and discharge time were analyzed.Results: Among the patients, 83 (72.8%) were males and 31 (27.2%) were females, and the age range was 41–86 years (mean age: 69±8.7 years). The proportion of concurrent hypertension was higher among females with CAS (p 0.01). The proportion of early complications was higher among the patients with the Nitinol stent than among those with the Wall stent (p = 0.062). Embolic events and infarct development were observed in 13 (11.4%) patients within the first 30 days. Occlusion was detected in 4 of 97 patients (4.1%) who represented controls. While less than 50% stenosis that did not require intervention developed in four (4.1%) patients, more than 50% stenosis was detected in three (3.09%) patients. The likelihood of not developing stenosis was found to be 98% at the end of the first year, 96% at the end of the second year, and 87% at the end of the fifth year. The mean duration of stenosis was 4.86±0.11 years.Conclusion: The proportions of potency and early complications in endo-vascular treatment applied for CAS were similar to those in the literature. Further studies with a larger patient number and a longer duration of follow-up would provide better data concerning the effectiveness of treatment and complications. Keywords: Carotid artery; stenosis; stenting.
  • Küçük Resim
    Öğe
    Surgical and endovascular treatment for mesenteric ischemia
    (2019) Aydin, Huseyin Onur; Ayvazoglu Soy, Ebru Hatice; Avci, Tevfik; Tezcaner, Tugan; Boyvat, Fatih; Yildirim, Sedat
    Aim: Mesenteric ischemia is a rare, highly fatal, surgical emergency. In addition to open surgical (OS) intervention, endovascular treatment (ET) was also recommended for treatment in last years. Surgical resection becomes inevitable in the cases of intestinal ischemia. We aimed to assess patient-related factors and compare treatment outcomes in mesenteric ischemia treated by OS and ET. Material and Methods: Patients treated for mesenteric vascular occlusion at our hospital between 2013 and 2018 were retrospectively evaluated. Duration of symptoms, time from symptom onset to treatment, treatment used and surgery used, re-laparotomy need, duration of intensive care unit stay, duration of hospital stay, and 30-day and 1-year mortality rates were evaluated. Results: Twenty patients with mesenteric ischemia were evaluated. The OS group had a significantly higher CCI score than the ET group (p<0.05). The most common comorbidities in the OS and ET groups were coronary artery disease and hypertension, respectively. The duration of symptoms and time from symptom onset to treatment were significantly shorter in the OS group than the ET group (p<0.05). The OS group most commonly had SMA emboli while the ET group most common had chronic SMA occlusion (p<0.05). Thirty-day and 1-year mortality rates were significantly greater in the OS group than the ET group (p<0.05). Conclusion: Mesenteric ischemia is a highly morbid and fatal condition. ET significantly reduces morbidity and mortality in the face of signs of intestinal ischemia. On the other hand, OS would be inevitable for patients with signs of diffuse peritoneal irritation or those with suspected intestinal necrosis.