Objective This study aimed to investigate the efficacy of foam sclerotherapy in the treatment of tortuous Great Saphenous Vein (GSV) insufficiency. Methods In this prospective non-randomized study 62 patients with tortuous GSV insufficiency were included. All patients were delivered sclerosant agent in the form of foam into the GSV through a cannula above the knee level. Characteristics of patients, diameter of veins, reflux grades, Venous Clinical Severity Score (VCSS) and Clinical, Etiological, Anatomical, Pathological (CEAP) scores, concentration of sclerosant agent, complications and follow-up results were recorded. Results Foam sclerotheraphy was performed with 100% technical success in all patients at operative room. There were no allergic reactions or neurological complications during and after the operations. Ecchymosis was the most common complication with 37.1% frequency. . VCSS scores significantly decreased from 6.43% to 2.53%, during follow-up from initial admission to sixth months, respectively ( P<0.05).In the first month parameters, successful occlusion rate was 88.7%, whereas its rate was 82.3% in sixth month. Recanalization rate significantly increased from 11.3% to 17.7% during follow-up from first to sixth months, respectively ( P<0.05). Conclusions Due to its low complication rate, low cost, acceptable total occlusion rate and reproducibility; Foam sclerotherapy can be considered a reliable treatment for patients with tortuous GSV insufficiency.
Hydatid cysts can be located in any organ or tissue system. Cardiac hydatid cyst is a rare, but fatal pathology. A 21-year-old male Syrian refugee patient with no previous known medical conditions was admitted to the hospital for chest pain and shortness of breath. He had increasing leg pain for 12 hours. Hydatid cyst rupture was detected on echocardiography. The peripheral artery thrombus and hydatid cyst membrane were removed with the embolectomy. The patient had renal and cranial infarctions. He underwent fasciotomy due to compartment syndrome. In conclusion, delayed diagnosis and treatment of cardiac hydatid cysts may result in a poor prognosis associated with the risk of rupture and is responsible for the spread of infection throughout the body as a result of the rupture. Even if there is an early diagnosis, surgical treatment supported by medical treatment is recommended very early.
Amaç: Koroner bypass cerrahisinde anastomoz kalitesi ve uzun dönem açıklık sağlanabilmesi için pek çok teknik geliştirilmiştir. Bu çalışmada yeni bir teknik olan doğal Y greft tekniği ile klasik sequential tekniğinin erken dönem sonuçları ve operatif verileri karşılaştırılmıştır. Yöntemler: Mart 2015 ile Nisan 2018 yılları arasında safen ven ile sequential anastomoz ve safen ven ile Y greft yapılan üçten fazla distal anastomoz yapılmış koroner baypas cerrahisi uyguladığımız hastalar geriye dönük olarak taranmıştır. Kırk hastaya sequential anastomoz tekniği ile baypas yapılmışken, 45 hastaya “doğal Y greft” tekniği ile baypas yapıldığını gördük. Arşiv taraması ile hastaların demografik verileri, operasyon verileri, ameliyat sonrası takip verileri ile komplikasyon ve mortalite oranları karşılaştırılmıştır. Bulgular: Hastaların demografik ve ameliyat sonrası verileri arasında istatistiki olarak anlamlı fark bulunamazken, kross-klemp süreleri ve distal anastomoz başına geçen kross-klemp süreleri arasında istatistiki olarak anlamlı fark bulunmuştur. Sequential grubunda ortalama kross klemp süresi 64.85 ± 13.32 dk. iken, doğal Y greft grubunda bu süre ortalama 58.82 ± 11.49 dk. olarak bulunmuştur (P=.03). Distal anastomoz başına geçen kross klemp süresi ise sequential grubunda ortalama 15.66 ± 2.51 dk. iken, doğal Y greft grubunda bu süre ortalama 14.38 ± 2.23 dk. olarak bulunmuştur (P=0.01). Sonuç: Yeni bir teknik olan doğal Y greft, distal anastomozlar için daha fazla konfor sağlayarak kross klemp süresini kısaltabilir. Sequential tekniğine göre diamond şeklinde anastomoz yapma zorunluluğu olmadığından daha kısa öğrenme süreci sunabilir. Erken dönem morbidite ve mortalite açısından sequential tekniğine göre fark bulunmamışken, uzun dönem takipler ve invaziv görüntüleme yapılmış çalışmalara ihtiyaç vardır.
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