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    Carotid artery screening in high risk asymptomatic individuals: outcomes of 3000 carotid screening
    (Mexican Acad Surgery, 2022) Onur-Beyaz, Metin; Demir, Ibrahim; Can-Ata, Emin
    Objectives: The primary aims of the study to evaluate the efficacy of carotid screening tests to identify asymptomatic carotid artery stenosis among high-risk patients and early prevention of stroke. Background: The estimated prevalence of asymptomatic severe carotid stenosis (>_70%) in the general adult population ranges up to 3.1%. However, the prevalence is higher in comorbid individuals. This makes it important to perform screening testing for early diagnosis and treatment in predetermined high-risk patients. Material and methods: In this prospective study, 3000 selected patients screened during March 2017 and September 2018 at the most populated family health center. Participants selected among registered individuals who have at least one of the risk factors such as hypertension, hyperlipidemia, diabetes mellitus, obesity, and smoking. All the participants were asymptomatic and above the age of 55. Bilateral carotid artery screening performed by Duplex Ultrasonography (DUSG) at the first call and one year later. Patients with severe carotid and/or coronary artery stenosis treated by surgical revascularization or stent implantation in the light of the latest guidelines. Conclusion: Carotid screening among high-risk asymptomatic individuals is of great importance to identify severe carotid artery as well as coronary artery stenosis. Patient education during screening may play a crucial role in preventing the disease.
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    Comparison of atherectomy, drug-eluting balloon, and combined treatment efficiency by near infrared spectroscopy
    (Mexican Acad Surgery, 2021) Onur-Beyaz, Metin; Demir, Ibrahim; Ozer-Ulukan, M.
    Atherosclerosis is a systemic pathology involving the entire vascular system. Smoking, hyperlipidemia, diabetes mellitus, advanced age, and hypertension are known risk factors for the development of atherosclerosis. Surgical treatment in peripheral arterial disease (PAD) has been replaced by endovascular treatment options in recent years due to mortality and morbidity. In our study, we aimed to present the effectiveness of atherectomy, drug-eluting balloon, and combined therapy with values determined by near-infrared spectroscopy (NOS) in patients they have atherosclerotic PAD. Materials and methods: Patients with intermittent claudication or critical leg ischemia (Rutherford class 3 or more) have been viewed in the study. There were 30 male and 9 female patients. Patients were followed up before, at the 1st h after and at the 3rd month after the procedure, with simultaneous ankle-brachial pressure index (ABPI), walking distance measurements, and measurement of tissue oxygenation by NIRS method. Results: When patients with similar post-operative ABPI measurements were evaluated with MRS, venous oxygenation was observed higher in patients used treatment methods combined with atherectomy. According to these results, we thought that treatment methods combined with atherectomy have increased microcirculation and collateral circulation more than other methods.
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    Foreign body embolization by the aortic root due to a fire gun injury: A case report of a 10-year-old asymptomatic patient
    (Mexican Acad Surgery, 2022) Kaya, Sefer; Oruc, Dilan; Anil-Unal, Ekin; Demir, Ibrahim; Onur-Beyaz, Metin
    Foreign body embolies that origin arterial system have mostly seen symptomatic and that's why they require emergency surgery. However, asymptomatic cases are followed conservatively, they can cause vascular-related end-organ pathologies as time passes. Foreign body migration from the ascending aorta to the end-organ artery is a very rare in literature after a fire gun injury. In symptomatic cases, emergency surgery should be planned immediately. In asymptomatic cases, the risks and benefits should first be considered before any surgical approach.
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    Upper extremıty arterıal aneurysms: Etıology, management, and outcome
    (Mexican Acad Surgery, 2022) Onur-Beyaz, Metin; Demir, Ibrahim; Can-Ata, Emin
    Background: Upper extremity arterial aneurysms are not common clinical conditions. It may causes ischemic gangrene or limb losses as a result of thromboembolic events due to endothelial damage. In this study, we aimed to investigate the etiology, management, and long-term outcome. Methods: A total of 55 upper extremity aneurysms between January 2009 and April 2018 were retrospectively investigated. The mean age was 41 +/- 13 years, and the women and men were 13 (23.6%) and 42 (76.4%). The mean follow-up was 43 +/- 18 months. Results: The incidence of pseudoaneurysm was higher than the true aneurysm (64.5% vs. 35.5%). 30 (84%) patients who had pseudoaneurysm repaired primerely and 6 (16%) patients had patchplasty. About 58% of the true aneurysm caused by blunt trauma. 4 (21%) true brachial aneurysm patients were required emergency intervention due to distal ischemia. 16 (84.2%) patients operated using by saphenous vein graft. The primary and secondary patency was 87.5% and 93.8%. No limb or life loss occurred during follow-up. Conclusion: Pseudoaneurysms are more common among upper limb aneurysms and they occur mostly by iatrogenic causes. Blunt trauma can be main cause of the true aneurysm. Surgical resection of the aneurysm and interposition of saphenous vein graft provides excellent results in the long-term.