Objectives: Dilation of superficial veins and valvular insufficiency cause the common condition, varicose veins (VVs) on the lower extremities. The treatment modalities for VVS include endovascular thermal ablation techniques using laser, steam and radiofrequency, surgery, foam sclerotherapy, which has various adverse effects. N-butyl cyanoacrylate (NBCA) is a relatively novel polymerizating agent that is used for the treatment of VVs. The aim of this study is to evaluate and present the 24 months outcomes results of endovenous NBCA treatment in 116 patients with VV. Methods: This is a prospective study on 116 patients (71 females, 45 males), treated in a single-center between August 2017 and March 2019. NBCA administration (Venablock ® , Invamed, Turkey) was carried out with local anesthesia under ultrasound guidance. All patients were scheduled for follow-up evaluation at 2 weeks, 3, 6, 9, 12, and 24 months. Clinical assessment, VCSS, and ultrasound were performed on patients in the follow-up visits. Results: The mean follow-up period was 16.27 ± 5.62 months. The preoperative and postoperative VCSS values were 6.93 ± 2.60 and 2.40 ± 1.12, respectively (p < 0.0001). The patients with a greater GSV diameter experienced an unfavorable outcome following the NBCA procedure (p < 0.001). The overall complication rate was 12.9%. The complete occlusion was achieved in 101 (87.0%) patients. Conclusions: The NBCA administration is a safe treatment method for the VVs, and provides a satisfactory occlusion ratio with improved outcomes.
Background. Stainless steel wires are still commonly used as a sternum closure technique. However, it can cause fatal complications due to rupture and dehiscence. It was anticipated that the sternal Cable System (Pioneer Surgical Technology Inc., Marquette, MI, USA) could provide a better sternal fixation and reduce the possible complications. Materials and Method. A total of 100 patients (57 male, 43 female) at high risk of dehiscence were included in this prospective observational study. Among those with EuroSCORE value of 4 and above, patients with chronic lung disease, chronic kidney disease, diabetes mellitus, obesity, smoking, body mass index, advanced age, and resurgery were operated in two separate centers. Standard steel wires ( n : 51) used for sternotomy were compared with the sternal cable ( n : 49). Early and late sternal dehiscence rates were compared in the study. The relationship between risk factors causing dehiscence and both methods was assessed statistically. Results. Early dehiscence rates were 6.4% in those closed with a sternal cable ( n : 3) and 11.8% in those closed with a sternal wire ( n : 6) ( p < 0.05 )). In risky patients, body mass index was the most determining parameter in terms of sternum dehiscence risk. Conclusion. In risky patients, we recommend the sternal cable system as a good and reliable closure technique to achieve a more stable and compact sternum.
Gastrointestinal bleeding due to colonic angiodysplasia can be associated with calcified aortic stenosis. This association is referred to as Heyde's syndrome. Aortic valve replacement can prevent recurrent gastrointestinal bleeding in these cases. We describe the case of a 46-year-old woman with congestive heart failure related to aortic stenosis, and severe anemia, with multiple angiodysplasias on the ileum and colon. After aortic valve replacement, there were no further episodes of bleeding and her hemoglobin levels normalized.
Background: In this study, we shared the implementation success and clinical results for 38 patients treated with the cleaner™ pharmacomechanical thrombectomy device. Objectives: The impact and results of pharmacomechanical thrombectomy treatment on patients with deep vein thrombosis in the symptomatic acute and subacute phases were assessed. Patients and Methods: Pharmacomechanical thrombectomy treatment was applied in a single session for 38 patients with lower extremity deep vein thrombosis in the acute and subacute phases between May 2012 and June 2014. Venography was performed and each assessment was made based on lysis rates and clinical results. Results: Deep vein thrombosis was found in the left lower extremity in 25 patients (65%) and in the right lower extremity in 13 patients (35%). No patient was found to have bilateral deep vein thrombosis. Thrombus localization was in the iliofemoral area in 17 patients (44%), the iliocaval area in three patients (8%), and the femoropopliteal area in 18 patients (56%). When thrombus resolution was assessed at the end of the process, grade III and grade II lysis was achieved in 36 (94%) out of 38 patients. Complete resolution was achieved in 28 patients (74%) in the acute and subacute groups. Conclusion: Pharmacomechanical thrombectomy provides very satisfactory results in a single procedure, as a new method in the treatment of acute and subacute deep vein thrombosis.
Venous thromboembolism (VTE) is associated with increased mortality and morbidity in cancer patients, and VTE development is among the most frequent causes of death in cancer patients. In this study, we evaluated the efficacy of enoxaparin and tinzaparin on thrombosis development in 36 cancer patients. Of 36 the cases, 14 were given enoxaparin (single dose, 6000 anti-Xa/0.6 ml, s.c.), and 22 were given tinzaparin (single dose 20.000 IU/0.7 ml, s.c.). The improvement was observed following the treatment in Doppler ultrasonography and the resolution of VTE was clinically detectable. We did not observe any signs of a new thrombus development or bleeding in the patient group. We detected a longer survival time in patients with enoxaparin treatment (p<0.05). We conclude that low-molecular-weight heparins are an efficient treatment method for VTE in cancer patients.
Aim: Cardiac traumas are of great danger as they have life threatening potential. Although the patient may have normal vital signs at the time of admission the rate of mortality rate has been reported up to 69%. We believe that conducting the initial evaluation and early intervention by a cardiac surgeon may have an impact on decreased mortality. Material and methods: This study has been conducted with 22 patients that have been admitted with cardiac trauma history. The subjects who were operated after applying to emergency service have been enrolled in this retrospective analysis. İndividuals died due to cardiac arrest at admission have been excluded from the study. The subjects with penetrating cardiac injury who have undergone sternotomy or thoracotomy has been included in the analysis. Results: At the time of admission 4 patients has been presented with shock and 2 patients had been administered resuscitation due to cardiac arrest. The gun shot wound cases were 27% (n=6) and of these cases 3 of them were alive while the remaining 3 died. The stab wound cases were 73% (n=16) withh a higher survival rate of 75% (n=4/16). Thoracotomy has been conducted less than sternotomy as the rate was 13.6% (n=3) versus 86.4% (n=19). The overall rate of mortality has been found as 32% (n=7). Conclusıon: According to the results of this study one can say that conducting initial intervention to cardiac trauma patients by a cardiac surgeon reduced the rate of mortality and morbidity.
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