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Öğe Carotid artery screening in asymptomatic individuals of different ethnic origins(Czech Soc Cardiology & Czech Soc Cardiovascular Surgery, 2022) Beyaz, Metin Onur; Onalan, Mehmet Akif; Oztas, Didem Melis; Ugurlucan, MuratBackground and aims: Certain chronic conditions such as hypertension, diabetes mellitus (DM), hyperchole-sterolemia, and smoking were well defined as a risk factor for carotid stenosis. However, the development of carotid stenosis in different ethnic groups has not been researched adequately. This study aims to evaluate the carotid artery stenosis in patients of different ethnic origins. Methods: This prospective study included 246 (61.2%) Turkish natives and 153 (39.8%) Syrian immigrants, and carried out during March and September 2018 in Istanbul. All of the 399 participants were between the age of 50 and 65 years, and have at least one of the risk factors of hypertension, hyperlipidemia, DM, obesity, heavy socio-economic stress, and smoking. Patients were examined for bilateral carotid arterial system with Doppler ultrasound. Results: The mean age of the patients were 54.2 +/- 7.2, and there were 50.4% of women. Hypertension was the foremost risk factor of both groups (41.1% vs. 47.7%, p = 0.596). Smoking was higher among Turkish natives (p = 0.022). Hyperlipidemia, DM, and stress were similar between the groups (p >0.05). The overweight and obesity rates were also similar among Turkish natives and Syrian immigrants (p = 0.071 and p = 0.279). Patients with mild (<50%), moderate (50-70%) and severe (>70%) carotid stenosis were 332 (83.2%), 33 (8.3%) and 34 (8.6%). No statistical significance was found between the two ethnic groups in terms of the severity of carotid stenosis (p >0.05). Conclusion: Syrian immigrants and Turkish natives have a similar rate of moderate and severe carotid artery stenosis. It can be explained by racial similarity and having a similar risk factor.Öğe Efficiency of Prophylactic Ablation of the Tributary Venous Pathways Draining Around the Saphenofemoral Junction to Decrease the Rate of Future Varicose Vein and Symptoms Occurence(Elsevier Science Inc, 2021) Ulukan, Mustafa Ozer; Karakaya, Atalay; Erkanli, Korhan; Beyaz, Metin Onur; Oztas, Didem Melis; Ugurlucan, MuratBackground: There are various other collaterals draining into the venous system around the saphenofemoral junction in addition to the great saphenous vein. We aimed to determine the efficiency of prophylactic ablation of tributary veins in long term varicose vein and symptom recurrence. Methods: Two hundred and sixty-three consecutive patients whom underwent radiofrequency ablation therapy for the treatment of superficial venous reflux disease were investigated. There were 129 patients who received isolated great saphenous vein ablation (Group A) where as 134 patients underwent ablation of the other tributary veins in addition to the great saphenous vein (Group B) between June 2015 and January 2017. The tributary superficial veins; refluxing and/or not refluxing, draining into the saphenofemoral junction were selectively catheterized and ablated in Group B. Patients are followed at least 1 year after the procedures regulary and researched for recurrence of varciose veins and symptoms. Results: Gender, mean age, body mass index, diameter of the great saphenous veins, small saphenous vein disease, and grade of deep venous insufficiency did not differ significantly between the two groups. The mean number of tributary veins were similar in both groups (n: 1.9 +/- 0.4 in Group A vs. n: 1.8 +/- 0.7 in Group B) which were detected preoperatively as well as during the procedure. The mean number of ablated tributary venous pathways could be 1.4 +/- 0.6 in Group B. During the follow up period symptoms related with varicose veins recurred in 19 patients in Group A where as in 7 patients in Group B ( P < 0.05). Three of these symptomatic patients in Group B were the ones in whom the tributary pathways could not be catheterized ablated where as 14 patients in Group A were diagnosed with newly refluxing tributary pathways. All the symptomatic patients in both groups were managed medically and/or with additional interventions. Conclusion: The absence of any fascial unsheathing and the parietal weakness are suggestive of a lower resistance of the tributary veins wall, so collapse and size of veins make it more complex to catheterization regarding to great saphenous vein. Ablation of the tributary superficial venous pathways during the treatment of great saphenous vein reflux disease decreased the rate of recurrence of superficial venous reflux disease and patients symtoms in our modest cohort.Öğe Follow-up Results of Endovascular Aneurysm Repair Following Abdominal Visceral Debranching(Soc Brasil Cirurgia Cardiovasc, 2022) Oztas, Didem Melis; Ugurlucan, Murat; Sayin, Omer Ali; Ekiz, Feza; Onal, Yilmaz; Beyaz, Metin Onur; Umutlu, MuzafferIntroduction: The aim of this study is to present a series of six cases with thoracoabdominal aneurysm treated with hybrid technique in our center. Methods: Between May 2015 and December 2018, the data of six patients with thoracoabdominal aneurysms and various comorbidities who underwent visceral debranching followed by endovascular aortic aneurysm repair were reviewed retrospectively. Results: Patients' mean age was 65.3 +/- 19.6 years. All of them were male. Comorbidities were old age, congestive heart failure, coronary artery disease, chronic obstructive pulmonary disease, previous surgical interventions, and/or esophageal hemangioma. Except for one patient who underwent coronary artery bypass grafting (inflow was taken from ascending aorta), debranching was performed from the right iliac artery. Debranching of four visceral arteries (superior mesenteric artery, celiac trunk, and bilateral renal right arteries) was performed in three patients, of three visceral arteries (superior mesenteric artery, celiac trunk, right renal artery) was performed in one, and of two visceral arteries (superior mesenteric artery, celiac trunk) was performed in two patients. Great saphenous vein and 6-mm polytetrafluoroethylene grafts were used in one and five patients, respectively, for debranching. Endovascular aneurysm repair was performed following debranching procedures as soon as the patients were stabilized. In total, three patients died at the early, mid, and long-term follow-up due to multiorgan failure, pneumonia, and unknown reasons. Conclusion: Hybrid repair of thoracoabdominal aneurysms may be an alternative to fenestrated or branched endovascular stent grafts in patients with increased risk factors for open surgical thoracoabdominal aneurysm repair; however, the procedure requires experience and care.Öğe Identifying the optimal monopolar electrocautery output power in pedicular internal thoracic artery harvesting: 20 or 40 watts?(Clinics Cardive Publ Pty Ltd, 2022) Ata, Emin Can; Senturk, Gozde Erkanli; Saygi, Halil Ibrahim; Ulukan, Mustafa Ozer; Ugurlucan, Murat; Erkanli, Korhan; Beyaz, Metin OnurBackground: Monopolar electrocautery is an important tool for harvesting the pedicular internal thoracic artery (ITA) in cardiac surgery. The different power outputs of cautery may affect graft integrity and long-term patency. This study aimed to identify the optimal threshold of electrocautery power for ITA harvest. Methods: This prospective study included 30 patients who underwent elective coronary artery bypass surgery at the Medipol Mega University Hospital. The ITA was harvested by monopolar electrocautery after a median sternotomy. The output of cautery was adjusted at 20 W in group A and 40 W in group B. Three to 4 cm of a distal ITA sample from each patient was examined under a light microscope by two independent pathologists. Results: The ITA harvest time was longer in group A (21.2 +/- 7.5 vs 10.3 +/- 8.1 min, p < 0.001) than in group B. ITA free flow was similar in the two groups (43.6 +/- 48.7 vs 51.7 +/- 45.0 ml/min, p = 0.762). Mild to moderate injury in the endothelial and sub-endothelial sample was more frequent in the low-cautery group (p = 0.0037). Conclusion: ITA endothelial integrity was found to be better preserved with 40W electrocautery. Moreover, 20W of monop-olar electrocautery may not be safe in pedicular ITA harvesting.Öğe Preliminary Results of a New Illuminated Radiofrequency Ablation Catheter for the Treatment of Great Saphenous Vein Reflux Disease(Sage Publications Inc, 2022) Beyaz, Metin Onur; Oztas, Didem Melis; Ulukan, Mustafa Ozer; Arslan, Hasan Murat; Unal, Orcun; Ugurlucan, MuratIntroduction: In the current study, we present single surgeon experience of a new radiofrequency ablation system, the catheter, and the device. Patients and Methods: The new system, which comprises a generator and an intervally illuminated radiofrequency ablation catheter, was used for the treatment of 272 consecutive patients with chronic venous insufficiency of the great saphenous vein between November 2017 and October 2018. Mean age of the patients was 53.40 +/- 11.91 years. Mean saphenous vein diameter was 8.51 +/- 2.45 mm. Bilateral great saphenous vein reflux disease was present in 19% (51 cases) of the patients. At the end of the procedure, the closure of the great saphenous vein was confirmed with Doppler ultrasonography. Results: Procedures could be successfully performed in all, except 1 obese (BMI> 30 kg/m(2)) male patient. At the 3rd month, outpatient clinic follow-up control Doppler USG revealed successful ablation of the treated great saphenous vein in 260 patients (96%), whereas in 12 cases (4%), there was continuing reflux. The diameters of the saphenous veins in these patients ranged between 6.9 mm and 19.5 (mean: 10.68 +/- 3.41) mm. Ten patients could be treated successfully with ablation with the same device controlled both at the interventional section as well as on the 3rd month outpatient clinic follow-up. The remaining patients underwent high ligation of the great saphenous vein. Paresthesia occurred in 1 patient and had been permanent. Hematoma occurred in a male patient and resolved spontaneously. Conclusion: Preliminary results of our new radiofrequency ablation device with illumination guidance for the treatment of great saphenous vein reflux disease indicated successful results with enhanced physician utilization, comfort, and reliability.