1.Midterm results of kissing stent reconstruction of the aortoiliac bifurcation
Deniz SEREFLI ; Onur SAYDAM ; A. Yaprak ENGIN ; Mehmet ATAY
Annals of Surgical Treatment and Research 2021;101(4):247-255
Purpose:
One subset of peripheral arterial disease is aortoiliac occlusive diseases (AIOD). AIOD is the term for all arterial lesions between the infrarenal distal aorta and common femoral artery. Implantation of kissing stents (KS) with covered stents (CS), bare-metal stents (BMS) is one of the endovascular treatment (ET) modalities for AIOD involving aortic bifurcation. In this study, we report the outcomes of the KS technique in infrarenal AIOD.
Methods:
Between January 2014 and September 2017, 31 patients who underwent ET were treated with KS technique either with balloon-expandable BMS or balloon-expandable CS. Technical details, clinical success, complications, and patency at follow-up were documented.
Results:
The majority of patients were male (77.4%), and the median age was 62 years (range, 45–78 years). All patients were classified according to the TASC II criteria. Eight patients (25.8%) were classified as TASC B. Fifteen patients (48.4%) were classified as TASC C, and 8 patients (25.8%) were classified as TASC D. These 23 patients were classified as complex AIOD group. BMS was used in 17 patients (54.8%), and CS was used in 14 patients (45.2%). Technical and clinical success was achieved in 100% of treated cases. The median follow-up was 24 months (range, 24–34 months). Primary patency rates at 12, 18, and 24 months after ET were 100%, 96.8%, and 90.3%, respectively.
Conclusion
We found that the KS technique has satisfying 24-month results, even in complex AIOD lesions, with high technical success and acceptable midterm patency.
2.Ultrasound-guided thrombin injection for treatment of iatrogenic femoral artery pseudoaneurysms compared with open surgery: first experiences from a single institution
Onur SAYDAM ; Deniz SEREFLI ; A. Yaprak ENGIN ; Mehmet ATAY
Annals of Surgical Treatment and Research 2020;98(5):270-276
Purpose:
The frequency of iatrogenic femoral artery pseudoaneurysm (FAP) diagnoses has recently increased due to the growing use of diagnostic and interventional procedures involving large diameter sheaths, as well as more potent anticoagulation procedures. In this study, we aimed to present our experience with ultrasound-guided thrombin injection (UGTI) in patients with iatrogenic FAP.
Methods:
We studied patients with FAP who were under anticoagulant or antiplatelet therapies preoperatively, or who had received a loading dose during an interventional procedure. The outcomes of patients with FAP treated with UGTI were compared with those of patients who underwent open surgical repair for pseudoaneurysms.
Results:
Among the 55 patients included in this study, 24 had UGTI while 31 had open surgery. The success rate was 95.8% when taking into consideration primary and secondary attempts. The mean duration of the procedure was shorter in patients with UGTI (10.1 ± 3.54 minutes) when compared with those who underwent open surgery (76.55 ± 26.74 minutes, P ≤ 0.001). In addition, the total complication frequency was significantly higher in the open surgery group (P = 0.005), as was their length of hospital stay (P < 0.001). Cost analysis showed significant differences between UGTI ($227.50 ± $82.90) and open surgery ($471.20 ± $437.60, P = 0.01).
Conclusion
We have found that UGTI is the safer and more effective choice of treatment in appropriate patients with FAP, as opposed to surgery.
3.Factors Associated with Mammographic Density in Postmenopausal Women.
Emel Kiyak CAGLAYAN ; Kasim CAGLAYAN ; Ismet ALKIS ; Ergin ARSLAN ; Aylin OKUR ; Oktay BANLI ; Yaprak ENGIN-USTUN
Journal of Menopausal Medicine 2015;21(2):82-88
OBJECTIVES: Breast density increases the risk of breast cancer, but also in the interpretation of mammography is also important. This study examine the risk factors affecting breast density in postmenopausal women. METHODS: Between January 2013 and January 2014, 215 patients admitted to The Clinics of Gynecology and Obstetrics with complaints of menopause were taken. According to the results of mammography, Group I (non-dense, n = 175) and Group II (dense, n = 40) were created. The informations of the caseswere analyzed retrospectively. RESULTS: In Group I, body mass index (BMI), number of pregnancies, parity were significantly higher than group II (P < 0.05). In group II, the withdrawal period of menstruation and progesterone levels were significantly higher (P < 0.05). In logistic regression analysis, BMI for dense breasts and number of pregnancies were found to be an independent risk factor (P < 0.05). CONCLUSION: Increased BMI, pregnancy and parity, result of reduction in density , but longer duration of menopause and increased progesterone cause an increase in density. BMI and the number of pregnancy was found to be independent risk factors for reducing breast density.
Body Mass Index
;
Breast
;
Breast Neoplasms
;
Female
;
Gynecology
;
Humans
;
Logistic Models
;
Mammography
;
Menopause
;
Menstruation
;
Obstetrics
;
Parity
;
Postmenopause
;
Pregnancy
;
Progesterone
;
Retrospective Studies
;
Risk Factors
4.Postmenopausal Osteoporosis Is Associated with Serum Chemerin and Irisin but Not with Apolipoprotein M Levels.
Yaprak ENGIN-ÜSTÜN ; Emel Kıyak ÇAĞLAYAN ; Ayşe Yeşim GÖÇMEN ; Muhammed Fevzi POLAT
Journal of Menopausal Medicine 2016;22(2):76-79
OBJECTIVES: The objective of this study was to describe the levels of chemerin, irisin and apolipoprotein M (apoM) in women with postmenopausal osteoporosis. METHODS: The study included 88 women with postmenopausal osteoporosis. Based on World Health Organization criteria, women with a T-score of ≤–2.5 were defined as osteoporotic. In this case-control study, postmenopausal women with T-score >–1 were selected as controls (n = 88) and case-matched in a 1:1 ratio based on age (within 2 years) and body mass index (BMI) (within 1.0 kg/m2). ApoM, irisin and chemerin levels were determined by a commercially available enzyme-linked immunosorbent assay (ELISA) kit. RESULTS: There were no significant differences in age, BMI, parity, cholesterol and apoM levels between the two groups. C-reactive protein levels were significantly increased in women with osteoporosis. Serum chemerin levels (240.1 ± 46.1 vs. 261.5 ± 50.8 ng/mL) were significantly lower in the women with osteoporosis, as compared to the controls (P = 0.004). Serum irisin levels were also decreased in women with osteoporosis (0.7 ± 0.2 vs. 0.8 ± 0.2 ng/mL; P = 0.007). CONCLUSION: In the present study, osteoporosis was associated with decreased levels of circulating chemerin and irisin. These findings suggested that adipokines might play a role in the pathogenesis of osteoporosis.
Adipokines
;
Apolipoproteins*
;
Body Mass Index
;
C-Reactive Protein
;
Case-Control Studies
;
Cholesterol
;
Enzyme-Linked Immunosorbent Assay
;
Female
;
Humans
;
Osteoporosis
;
Osteoporosis, Postmenopausal*
;
Parity
;
World Health Organization
5.Evaluation of Bone Density Measurement in Type 2 Diabetic Postmenopausal Women with Hypertension and Hyperlipidemia.
Emel Kiyak CAGLAYAN ; Yaprak ENGIN-USTUN ; Nagihan SARI ; Seyhan KARACAVUS ; Levent SECKIN ; Mustafa KARA
Journal of Menopausal Medicine 2015;21(1):36-40
OBJECTIVES: The aim of the study was to compare bone mineral density (BMD) in healthy postmenopausal women to BMD in type 2 diabetic hypertensive postmenopausal women with hyperlipidemia. METHODS: Fifty type 2 diabetic and hypertensive postmenopausal women with hyperlipidemia and 51 age and body mass index (BMI) matched healthy postmenopausal women were included. Lumbar spine and femoral neck BMD were noted in both groups. BMD was measured using dual energy X-ray absorptiometry (DXA). Serum alkaline phosphatase (ALP), calcium and phosphorous were also measured. Pearson correlation coefficients were used to establish the relationship between various clinical characteristics. RESULTS: There were no significant differences between two groups in respect to lumbar and vertebral BMD values, age, BMI, gravidity, parity. Serum cholesterol and fasting glucose levels were significantly different between each groups (P = 0.0001, P = 0.002). CONCLUSION: We found that, accompanying chronic diseases such as diabetes, hypertension and hyperlipidemia don't affect the BMD measurements at postmenopausal period. So these postmenopausal women don't have excess risk regarding osteoporosis.
Absorptiometry, Photon
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Alkaline Phosphatase
;
Body Mass Index
;
Bone Density*
;
Calcium
;
Cholesterol
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Chronic Disease
;
Fasting
;
Female
;
Femur Neck
;
Glucose
;
Gravidity
;
Humans
;
Hyperlipidemias*
;
Hypertension*
;
Osteoporosis
;
Parity
;
Postmenopause
;
Spine