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Öğe An evaluation of the neutrophil-to-lymphocyte ratio as a prognostic and predictive marker in thromboangiitis obliterans(2018) Altun, Gokalp; Hemsinli, DogusAim: The aim of this study was to investigate whether the neutrophil/lymphocyte ratio is an independent predictor of poor prognosis, mortality, co-morbidities, critical limb ischmemia, amputation, or a potential prognostic biomarker predicting pathological and survival outcomes in thromboangiitis obliterans. We also investigated whether there was any relation between an increased neutrophil/lymphocyte ratio in patients with Buerger’s disease and amputation, the ultimate outcome of poor prognosis. Material and Methods: The hospital records of patients treated, followed-up and diagnosed with thromboangiitis obliterans were analyzed retrospectively. Surgical procedures performed and medical treatments applied were recorded from patients’ clinical data. Extremities exposed to the disease during its course were identified. Amputations were recorded as minor and major. Neutrophil and lymphocyte values were recorded from peripheral blood samples at time of first presentation to hospital, with the neutrophil/ lymphocyte ratio being calculated from these. One hundred ten subjects were finally enrolled as the patient group (TAO; n=110). A control group (n=49) was established consisting of smoker volunteers with no health problems. Statistical changes in neutrophil/ lymphocyte ratio values between the groups were investigated. Results: No statistically significant difference was observed between the two groups’ basic characteristics. In terms of neutrophil/ lymphocyte ratio values, a statistically significant increase was observed in the patient group compared to the control group. We observed no statistical correlation between amputations and neutrophil/lymphocyte ratio values. Conclusions: We think that the neutrophil / lymphocyte ratio, obtained easily and cheaply from routine peripheral blood samples, may be of clinical benefit in thromboangiitis obliterans.Öğe Great saphenous varicose vein treatment with endovenous ablation techniques: A comparison of EVLA and RF(2020) Hemsinli, Dogus; Karakisi, Sedat Ozan; Ergene, SabanAim: In this study, we compared the clinical follow-up results and complication and success rates of patients undergoing 1470 nm wavelength endovenous laser ablation (EVLA) or radiofrequency ablation (RFA) in our clinic.Material and Methods: The records of 581 patients treated in our clinic due to clinical symptoms arising from great saphenous vein insufficiency between January 2014 and September 2018 were examined retrospectively. Three hundred fifty-seven of these patients treated with EVLA or RFA and with no deficient data were included in the study. Patients with reflux in the saphenofemoral junction lasting at least 0.5 sec, with a great saphenous vein diameter of at least 7 mm, 2 cm distal to the saphenofemoral junction, and of at least 5.5 mm at knee level, and with CEAP stage C2-C5 were scheduled for endovenous ablation. The patients were randomly distributed between the established EVLA and RFA treatment groups. Data for patients’ diagnostic and therapeutic processes were recorded and evaluated in the light of information in the literature. Results: The EVLA group consisted of 86 patients (42 male, 44 female; mean age 46 years, range 26-71), and the RFA group of 271 (113 male, 158 female; mean age 43.3 years; range 20-77). The mean follow-up time was 27.2 months. No significant differences were determined in terms of patients’ demographic data, preoperative additional diagnoses, CEAP classification values, duration of reflux, or proximal and distal great saphenous vein diameter values. Thrombophlebitis developed in 14 patients and ecchymosis/hematoma in 32. No significant difference was observed between the groups in terms of complications. Great saphenous vein occlusion rates at Doppler ultrasonography six months after treatment were 91.8% in the EVLA group and 94% in the RFA group (p=0.46). Conclusion: Our results suggest that neither of the two endovenous ablation methods is superior to the other.Öğe Our experience of endovascular treatment in coronary subclavian steal syndrome with a review of the literature(2019) Erden, Tuncay; Hemsinli, DogusAim: The purpose of this study was to assess the effectiveness of endovascular treatment in patients with coronary subclavian steal syndrome. Material and Methods: The archive records for six patients diagnosed with coronary subclavian steal syndrome and treated using the endovascular method between January 2012 and August 2017 were examined retrospectively. Data concerning diagnosis and treatment were recorded and evaluated in the light of the current literature. Results: All patients had undergone coronary artery bypass graft surgery at external centers a mean 5.7 years previously. Angiography revealed severe stenosis in the proximal subclavian artery in three patients and total occlusion in three. One hundred percent success was achieved in the three patients with stenosis by establishing full patency by means of a stent procedure. Full patency was also established in two of the three patients with total occlusion using the stent procedure. The symptoms of the five patients treated successfully resolved post-procedurally. No restenosis findings were encountered at clinical and Doppler ultrasonography followups. Conclusion: While surgical options predominated in the early years in the treatment of coronary subclavian steal syndrome, endovascular techniques are widely employed today. However, surgical therapeutic alternatives are still important for patients in whom success cannot be achieved with the endovascular method.Öğe The role of vascular elastography and carotid artery intima media thickness methods in the determination of non-syndromic ascending thoracic aortic aneurysm(2018) Hemsinli, Dogus; Ata Korkmaz, Hatice Ayca; Baki, Gaye; Vuralkan, Erkan; Kaplan, Safiye Tuba; Kul, Selim; Turkmen, Inan UtkuAim: The role of atherosclerosis in the pathogenesis of ascending thoracic aortic aneurysms is still uncertain. Ultrasonic elastography is a new diagnostic method, the use of which has diversified considerably in recent years. An increase in intima media thickness in the carotid arteries is an early finding of atherosclerosis. Our purpose was to investigate the effect of atherosclerosis in the development of ascending thoracic aortic aneurysms and to be able to recommend a non-invasive and inexpensive scanning method aiming at early diagnosis. Material and Methods: Thirty-three patients with ascending thoracic aortic aneurysms (aTAA group) and 40 patients with normal measurement (control group) values were included in the study. The carotid artery intima media thicknessof carotid arteries were measured using B mode ultrasonography. Elastographic examination of the intima-media was then performed. Results: Body mass index, past smoking status, hypertension, presence of coronary artery disease and hyperlipidemia were higher in the aTAA group than in the control group (p<0.05). No significant difference was determined between these two groups’ ultrasonic elastography or intima media thickness in the carotid arteries values (p<0.05). Conclusions: Our findings suggest that the effect of atherosclerosis in the pathogenesis of ascending thoracic aortic aneurysms is limited. Vascular ultrasonic elastography and intima media thickness determination in the carotid arteries appear not to be effective in the evaluation of ascending thoracic aortic aneurysms.
