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    A preliminary study for evaluation of SARS-COV-2 RNA present on atherosclerotic plaques SARS-CoV-2 on the atherosclerotic plaques
    (Bayrakol Medical Publisher, 2023) Donbaloglu, Mehmet Okan; Gurkan, Selami; Gur, Ozcan; Uyar, Yavuz; Artik, Yakup
    Aim: The aim of this study is to investigate the presence of SARS-CoV-2 RNA genome in atherosclerotic plaques in patients with a history of COVID-19 who are scheduled for surgery due to peripheral artery disease. Material and Methods: Between the relevant dates, 40 patients with COVID-19 disease who were operated for peripheral artery disease in our clinic were included in the study. Of the 40 samples, 20 were aortic tissue and 20 were endothelial tissue. These tissues consist of samples taken from the patient at the Cardiovascular Surgery Department. The samples were transferred to the Microbiology laboratory and extracted by PCR procedure. Laboratory diagnosis with the kit was performed by multiplex RT-qPCR targeting SARS-CoV-2 ORF1ab and N genes in a real-time PCR device. Results: Eight out of 20 patients in the endothelial group were female and 12 were male. Ten out of 20 patients in the aortic group were female and 10 were male. All samples were found as negative by PCR for SARS-CoV-2 at two study groups (aortic and endothelial tissues). Discussion: This valuable study was conducted under limited resources and challenging pandemic conditions. We believe that this study will serve as a preliminary investigation shedding light on the effects of atherosclerotic plaques in patients with COVID-19 and PCR positivity in long-term and large-scale cases.
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    An old but still valuable technique for popliteal artery stenosis: Endarterectomy via the posterior approach
    (Lippincott Williams & Wilkins, 2024) Huseyin, Serhat; Guclu, Orkut; Reyhancan, Adem; Yuksel, Volkan; Gurkan, Selami; Canbaz, Suat
    Isolated popliteal artery occlusions are rare compared with femoropopliteal occlusive diseases. Although endovascular procedures have gained importance in treatment, conventional surgery remains the gold standard. In this study, we reviewed popliteal endarterectomy and patch plasty using a posterior approach. Fourteen patients who underwent surgery for isolated popliteal artery occlusions were retrospectively examined. Patients were assessed in terms of age, sex, and risk factors, such as accompanying diseases and smoking, surgical method and anesthesia, incision type, preoperative and postoperative pulse examination, ankle-brachial indices, patency, wound infection, postoperative complications, and the treatment applied. Twelve (85.7%) patients were male, and 2 (14.3%) were female. Limb ischemia was critical (ABI < 0.7) in 11 (78.5%) patients. The average duration of postoperative hospitalization was 8 +/- 3.7 days on average, and the average length of follow-up was 17 +/- 3.4 months. Thrombosis and complications requiring secondary intervention did not develop during the early postoperative period. While the patency rate in the first 6 months of follow-up was 100%, it was 92.8% in the 1st year and 85.7% in the 2nd year. Surgical treatment with the posterior approach in isolated popliteal artery lesions is preferred by vascular surgeons as a prioritized treatment method, with a sufficient recanalization rate and low perioperative morbidity and mortality rates. Furthermore, it is promising because it does not prevent below-knee femoropopliteal bypass, which is the subsequent stage of treatment. Moreover, the great saphenous vein was protected, and the acceptable early- and mid-term results were encouraging.
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    Antegrade and retrograde access in the endovascular treatment of femoropopliteal chronic total occlusions
    (Turkish National Vascular and Endovascular Surgery Society, 2023) Donbaloglu, Mehmet Okan; Gurkan, Selami; Gur, Ozcan
    Aim: In this study, the aim was to investigate whether antegrade or retrograde approaches are superior in the endovascular treatment of femoropopliteal chronic total occlusions (CTO). Material and Methods: A total of 437 patients who were diagnosed with CTO in the femoropopliteal region and who subsequently underwent endovascular procedures between February 2019 and April 2022 were evaluated retrospectively. The patients were grouped as antegrade access and retrograde access. All patients were classified according to the Rutherford and TASC (Transatlantic Intersociety Consensus II) classification. The patients were followed for 2 years. Above-ankle amputation and >50% stenosis in the target vessel were considered a failure. ABI, improvement in clinical symptoms, and limb salvage were evaluated in controls. Results: Antegrade approach was performed in 218 of the endovascular procedures. Antegrade recanalization was successful in 201 patients (92.2%), and failed antegrade attempt was seen in 17 because the lesion could not be crossed. Retrograde approach was used in 197 of endovascular interventions. Successful retrograde recanalization was unsuccessful in 185 patients (93.9%), and retrograde intervention was unsuccessful in 12 patients because the lesion could not be crossed. When the two-year restenosis numbers were examined, it was 61 (30.3%) in the antegrade group, while it was 49 (25.5%) in the retrograde group, and there was a significant difference between the groups. When the one-year stent occlusions between the groups were examined, it was 14 (6.9%) in the antegrade group and 8 (4.1%) in the retrograde group, and there was a statistically significant difference between the groups. Conclusion: The retrograde approach is as effective and safe as the antegrade approach in the treatment of femoropopliteal CTO. It should be noted that it can be used as an alternative method without the need for any support device, especially in cases where the antegrade approach is unsuccessful. © @Author(s).