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Öğe Carotid endarterectomy in the octogenarian with contralateral disease: A single center experience(2014) Goksel, Onur S.; Karatepe, Celalettin; Gok, Emre; Sayin, Omer A.; Kamber, Murat; Çinar, Bayer; Alpagut, UfukBackground: As the growing proportion of octogenarians in the ageing population may lead to a dramatic increase in cerebrovascular disease, preventing and treating stroke will be a serious challenge in the octogenarian. Objectives: We reviewed the outcome of carotid endarterectomy in the octogenarians with or without contralateral carotid stenosis or occlusion and compared the results with a similar cohort of younger age. Material and Methods: From 2005 to 2013, 142 CEAs were performed by a single surgical team on 128 patients were reviewed for early outcome in regards to hospital mortality and stroke. Results: 128 patients (111 males; mean 68.5±9.3 years-old, range 49-85) underwent CEA by the same surgical team. 14 patients had severe bilateral disease and underwent bilateral CEAs Smoking was significantly higher in the nonoctogenarians (6.2% vs. 21.8%, P<0.05). Preoperative history of transient ischemic events was the most common scenario in both octogenarians and the younger patients although preoperative transient neurologic deficits were more prominent in the non-octogenarians (50% vs. 71%, P<0.05). Contralateral carotid artery occlusion was seen in a total of 14 patients (12.5% in the octogenarians vs. 9% in the younger patients, P =0.52). Only one patient in the octogenarian group experienced a lateralizing stroke due to ipsilateral CEA in contrast to 3 patients (lateralizing stroke in 3 patients, lacunar state in one patient) in the younger patients. Conclusions: Carotid endarterectomy, despite the general perception, is a viable option for patients with CCO or bilateral disease even in the octogenarian group.Öğe Vascular Tumors of the Neck in Adults: 10-Year Experience in a Tertiary Center(Forum Multimedia Publishing, Llc, 2020) Goksel, Onur S.; Gok, Emre; Karatepe, Celalettin; Sarilar, Cagla Canbay; Onalan, Mehmet Akif; Beyaz, Metin Onur; Alpagut, UfukIntroduction: The diagnosis and management of vascular lesions of the neck is a challenging task that requires a multidisciplinary approach. This retrospective study assesses the single center experience of vascular tumors of the neck. Materials and methods: Patients diagnosed with a vascular tumor and/or a mass in close proximity to the carotid artery were identified from our records over a 10-year period. The demographic characteristics, clinical features, surgical approach, and outcomes were reviewed. Results: Surgical excision of 17 vascular lesions were performed in 16 patients with a mean age of 51.56 +/- 17.35 years at the time of operation. Intra- and/or postoperative clinical and histological assessment revealed unilateral glomus caroticum (N = 11), glomus vagale (N = 2), bilateral glomus caroticum (N = 1), cavernous hemangioma (N = 1), and carotid sheath tumor (N = 1). In three patients, internal carotid artery, common carotid artery and vagal nerve were sacrificed to facilitate complete tumor excision. During the follow-up period, no tumor recurrences were observed, and the morbidity and mortality were minimal. Conclusion: Preoperative evaluation concerning the size, extent, and anatomical relationships of the tumor thoroughly should be investigated. Multidisciplinary approach involving vascular surgery, otolaryngology, and radiology is preferred to treat these patients for better outcomes. Preoperative embolization in selected cases may decrease estimated blood loss and operative time.