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Öğe An evaluation of the effect of biodegradable stents on restenosis in the treatment of peripheral arterial lesions(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2017) Akgül, Engin; Erdolu, Burak; Vural, Ahmet Hakan; Yümün, Gündüz; Özyazıcıoğlu, Ahmet FatihBackground: This study aims to investigate possible factors which increase the risk of restenosis in patients undergoing biodegradable stenting. Methods: A total of 45 patients (39 males, 6 females; mean age 58 +/- 7.2 years; range 41 to 71 years) in whom femoral artery occlusion was treated by biodegradable stents between January 2010 and December 2012 were retrospectively analyzed. The Ankle Brachial Index scores were recorded at baseline and at one week, one month, sixth month, and one year, postoperatively. The patients were divided into two groups according to the postoperative six-month arterial Doppler ultrasonography findings: group 1 (n=10) had no flow or monophasic flow, and group 2 (n=35) had biphasic or triphasic flow pattern. Additional treatments after postoperative sixth month in group 1 were also noted. Results: Restenosis developed in 10 patients (22%) within postoperative six months. Although the number of smokers was significantly higher in group 1 (p=0.048), no relationship was found between diabetes and restenosis. The presence of coronary artery disease (p=0.049) and elevated triglycerides (p=0.035) were found to be risk factors of restenosis. More than one stenting was a predisposing factor of restenosis (p=0.033). Conclusion: Our study results show that being under the age of 60 years, elevated triglyceride levels, and smoking are the risk factors for restenosis in those with peripheral arterial disease. In addition, the presence of coronary artery disease increases the risk of restenosis. However, biodegradable stent implantation yielded unsatisfactory results in those with long-segment stenosis and advanced disease; therefore, we recommend further large-scale studies to improve the procedural outcomes.Öğe Comparing the effectiveness of neutrophil-lymphocyte ratio as a mortality predictor on middle and advanced age coronary artery bypass graft patients(Kare Publ, 2014) Ay, Derih; Erdolu, Burak; Yümün, Gündüz; Aydın, Ufuk; Demir, Ahmet; Tiryakioglu, Osman; Vural, Ahmet HakanOBJECTIVE: In this study, the effect of neutrophil-lymphocyte ratio (NLR), which is a recently developed inflammatory parameter, as an early stage mortality predictive marker on coronary artery bypass (CABG) patients of various age groups was examined. METHODS: Seventy eight patients under the age of 45 (Group 1) and 80 patients who were older than 45 (Group 2) randomly chosen from the patients who underwent isolated CABG surgery, were examined. The preoperative characteristics and NLRs were noted. The primary end point of the study was determined as all-cause in- hospital mortality. RESULTS: Mortality was observed in 2 patients in Group 1 and 11 patients in Group 2. The threshold value of NLR was 2,47 in the Receiver Operating Characteristic (ROC) curve in Group 1 and there wasn't any significant correlation between preoperative NLR and mortality rates in the patients whose NLRs were above this curve. The threshold value was determined as 4.07 in Group 2 and there was a significant relation between preoperative NLR and mortality (p<0,01). No relation was found between NLR and mortality when all the examined patients were considered (p>0.05). CONCLUSION: NLR that can be easily calculated, can be used as a mortality predictor in the patients of ad vancedage who will undergo isolated CABG procedure.Öğe Deep Sternal Wound Infection after Coronary Artery Bypass Surgery: Management and Risk Factor Analysis for Mortality(Forum Multimedia Publishing, Llc, 2014) Yümün, Gündüz; Erdolu, Burak; Toktaş, Faruk; Eriş, Cüneyt; Ay, Derih; Türk, Tamer; As, Ahmet KağanBackground: Deep sternal wound infection is a life-threatening complication after cardiac surgery. The aim of this study was to investigate the factors leading to mortality, and to explore wound management techniques on deep sternal wound infection after coronary artery bypass surgery. Methods: Between 2008 and 2013, 58 patients with deep sternal wound infection were analyzed. Risk factors for mortality and morbidity including age, gender, body mass index, smoking status, chronic renal failure, hypertension, diabetes, and treatment choice were investigated. Results: In this study, 19 patients (32.7%) were treated by primary surgical closure (PSC), and 39 patients (67.3%) were treated by delayed surgical closure following a vacuum-assisted closure system (VAC). Preoperative patient characteristics were similar between the groups. Fourteen patients (24.1%) died in the postoperative first month. The mortality rate and mean duration of hospitalization in the PSC group was higher than in the VAC group (P = .026, P = .034). Significant risk factors for mortality were additional operation, diabetes mellitus, and a high level of EuroSCORE. Conclusions: Delayed surgical closure following VAC therapy may be associated with shorter hospitalization and lower mortality in patients with deep sternal wound infection. Additional operation, diabetes mellitus, and a high level of EuroSCORE were associated with mortality.Öğe Periferik arteriyel lezyonların tedavisinde biyoeriyebilen stentlerin restenoz üzerine etkisinin değerlendirilmesi(2017) Akgül, Engin; Erdolu, Burak; Vural, Ahmet Hakan; Yümün, Gündüz; Özyazıcıoğlu, Ahmet FatihAmaç: Bu çalışmada biyoeriyebilen stent takılan hastalarda restenoz riskini artıran muhtemel faktörler araştırıldı.Çalış-ma- planı: Ocak 2010 - Aralık 2012 tarihleri arasında femoral arter tıkanıklığı biyoeriyebilen stent ile tedavi edilen toplam 45 hasta (39 erkek, 6 kadın; ort. yaş 58±7.2 yıl; dağılım 41-71 yıl) retrospektif olarak incelendi. Ayak Bileği-Kol İndeks skorları başlangıçta ve ameliyat sonrasında birinci hafta, birinci ay, altıncı ay ve birinci yılda kaydedildi. Hastalar ameliyat sonrası altıncı ay arteriyel Doppler ultrasonografi bulgularına göre iki gruba ayrıldı: grup 1 (n=10) akım yok-monofazik akım ve grup 2 (n=35) bifazik-trifazik akım paternine sahipti. Grup 1’de ameliyat sonrası altıncı aydan sonraki ilave tedaviler de kaydedildi.Bul-gu-lar: Hastaların 10’unda (%22) ilk altı ay içinde restenoz gelişti. Sigara içenlerin sayısı grup 1’de anlamlı düzeyde yüksek olmakla birlikte (p=0.048), diyabet ile restenoz arasında bir ilişki bulunmadı. Koroner arter hastalığı varlığı (p=0.049) ve trigliserit yüksekliği (p=0.035) restenozun risk faktörleri olarak bulundu. Birden fazla stent uygulaması, restenoza yatkınlaştırıcı bir faktördü (p=0.033).Sonuç:- Çalışma bulgularımız periferik arter hastalığı olanlarda 60 yaş altında olmak, trigliserit düzeylerinde artış ve sigara içiciliğinin restenozun risk faktörleri olduğunu göstermektedir. Ayrıca, koroner arter hastalığı varlığı da restenoz riskini artırmaktadır. Ancak, uzun segment darlığı ve ileri evre hastalığı olanlarda biyoeriyebilen uygulaması ile tatmin edici sonuçlar elde edilememiştir; bu nedenle, işleme bağlı sonuçları iyileştirmek için geniş ölçekli çalışmalar gerekmektedir.
