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Öğe Carotid artery plaque structure in the context of symptomatic/asymptomatic nature of carotid artery stenosis(Czech Soc Cardiology & Czech Soc Cardiovascular Surgery, 2021) Oztas, Didem Melis; Bilen, Bukem Tanoren; Sener, Leyla Turker; Beyaz, Metin Onur; Ulukan, Mustafa Ozer; Unal, Orcun; Unlu, Mehmet BurcinObjective: In this paper, we examined the relationship between atherosclerotic plaque characteristics and symptomatic carotid artery disease. Material and methods: Twenty-two patients who underwent carotid endarterectomy were enrolled into the study. Thirteen patients were male and remaining 9 patients were female. The mean age was 60.2 +/- 9.6 years. The carotid artery stenosis ranged between 75% and 99%. Eight patients were asymptomatic and remaining 14 patients were symptomatic. Ten patients suffered stroke. One of them had recurrent transient ischemic attacks, 4 patients had dizziness, and one of them had amaurosis fugax. The extracted plaques were evaluated by scanning acoustic microscopy (SAM) and micro-computerized tomography (micro-CT). Results: Smaller acoustic impedance values that reveal collagen-rich plaque formation were detected in patients who had stroke, while higher acoustic impedance values that reveal calcium-rich plaque formation were detected in the asymptomatic patients' plaques. Conclusions: Determination of plaque characteristics with modern radiographic techniques, rather than relying on the degree of stenosis in patients with carotid artery disease, may be helpful to discriminate patients requiring intervention.Öğe The Effect of Renin-Angiotensin Blockers on COVID-19 Related Mortality: A Tertiary Center's Experience(Czech Soc Cardiology & Czech Soc Cardiovascular Surgery, 2022) Oflar, Ersan; Koyuncu, Atilla; Alp, Murat Erdem; Karaosmanogul, Hayat Kumbasar; Unal, Orcun; Beyaz, Metin Onur; Oztas, Didem MelisBackground: The first reports on coronaviruse disease 2019 (COVID-19) revealed an exaggerated mortality rate in hypertensive patients. In this regard, concerns about angiotensin-converting enzyme (ACE) inhibitors' and angiotensin-receptor blockers' (ARBs) have been aroused. Our aim in this study was to evaluate the potential bad outcome effect of hypertension and anti-hypertensive therapy on COVID-19. Methods: 183 patients with polymerase-chain-reaction (PCR)-proven COVID-19, who were admitted to our hospital and consulted to cardiology department between 15th of March and 15th of April 2020 were inclu-ded. Data were recruited from hospital records. Results: Thirty-two out of 183 patients with COVID-19 died in hospital. Hypertension incidence was not sta-tistically different between patients who survived and died (76 [50.3%] vs 19 [59.4%, p = 0.352]). Although the usage rate of ACEI were similar among groups, ARB usage rate was significantly higher in patients who died than survived (11 [34.4%] vs 23 [15.2%], p = 0.011). Binary regression analysis showed an association between ARBs and mortality (OR: 0.032, 95% CI 1.045-2.623, p = 0.032). Conclusion: Our study confirmed previous concerns regarding a potential harmful effects of ARBs on COVID-19 related mortality.Öğe Increased CRP/albumin ratio is associated with superficial venous reflux disease and varicose vein formation(Czech Soc Cardiology & Czech Soc Cardiovascular Surgery, 2021) Unal, Orcun; Oztas, Didem Melis; Beyaz, Metin Onur; Erdinc, Ibrahim; Meric, Mert; Ulukan, Mustafa Ozer; Karakaya, AtalayBackground: It has been recently postulated that inflammation may have an effect on varicose vein development and prognosis, besides increased venous pressure. CRP/albumin (CAR) is a novel inflammatory marker associated with poor prognosis in a various group of patients. Our aim in this study was to investigate the relation between varicose greater saphenous vein (VSM) diameter and CAR. Methods: A total of 150 patients with patients VSM insufficiency (Group 1, n: 114) and normal VSM (n: 36) were included in the study. The diameter of the VSM was measured with B-mode ultrasound, and reflux was quantified based on valve closure time using Doppler spectral tracings. Blood samples were taken during recruitment. The CAR value is determined by dividing the serum CRP level to the albumin level. Results: There were 21 (18.4%) males and 93 (81.5%) females in Group 1 and 7 males and 29 females in Group 2. Mean age of the patients were similar in both groups (48.02 +/- 12.20 years in Group 1 vs. 44.9 +/- 8.92 years in Group 2, p = 0.44). Mean BMI of the patients did not differ significantly (Group 1: 26.4 +/- 3.7 kg/m2 vs. Group 2: 25.7 +/- 4.2 kg/m2, p = 0.13). The mean diameter of VSM was measured 5.70 +/- 0.29 mm in Group 1 whereas 3.21 +/- 0.34 mm in Group 2 (p = 0.0023). Mean CRP and albumin values in Group 1 were 6.18 +/- 4.99 mg/L and 4.45 +/- 0.27 g/dL whereas 4.25 +/- 2.46 mg/L and 6.18 +/- 1.14 g/dL in Group 2, respectively (p value for CRP = 0.049, p value for albumin = 0.074). CRP/albumin was 1.28 +/- 1.34 in Group 1 and 1.11 +/- 1.21 in Group 2, which was not statistically significant (p = 0.58). There was a positive moderately strong correlation between VSM diameter and CRP/albumin ratio as well as superficial venous reflux disease (r: 0.48). Conclusion: CRP/albumin ratio is associated with increased incidence of varicose veins and increased diame-ter of greater saphenous vein; hence, superficial venous reflux disease. The findings support the hypothesis that systemic inflammation may play a role in varicose vein disease.Öğe Issues during coronary and visceral revascularization in patients with Leriche syndrome and thoracoabdominal aneurysm(Wiley, 2021) Oztas, Didem M.; Erdinc, Ibrahim; Beyaz, Metin O.; Onalan, Mehmet A.; Badem, Serdar; Ulukan, Mustafa O.; Unal, Orcun[Abstract Not Available]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.
