Aim To present mid-term results of patients with varicose veins treated with N-butyl cyanoacrylate (VariClose®), a nontumescent endovenous ablation technique. Patients and method Endovenous ablation was performed on 180 patients with saphenous vein incompetence between May and October 2014. One hundred sixty-eight subjects capable of being followed-up for 30 months were included. Patients' pre- and postoperative data were recorded. Results Procedures were performed on the great saphenous vein in 159 patients and on the small saphenous vein in nine patients. Saphenous vein diameters ranged between 5.5 mm and 14 mm. Full ablation was achieved in all patients following the procedure. No complications were encountered. Patients were monitored for 30 months. Ablation rates were 100% at the 3 month, 98.3% at the 6 month, 96.6% at 1 year, and 94.1% at 30 months. Mean venous clinical severity score was 10.2 before procedures, decreasing to 3.9 at 3 months, 4.2 at 6 months, 2.9 at 12 months, and 2.7 at 30 months ( p = 0.000). Conclusion Due to its high success rate, absence of complications, no tumescent anesthesia requirement and high patient satisfaction, endovenous ablation with N-butyl cyanoacrylate is a good method. However, long-term follow-up results are now needed.
GirişTürkiye'de ilk başarılı açık kalp ameliyatı 1960 yılında Hacettepe Üniversitesi Tıp Fakültesi'nde Dr. Mehmet Tekdoğan tarafından yapılmıştır (1). Seri halindeki açık kalp ameliyatlarına ise Dr. Aydın Aytaç tarafından 1962 yılı Haziran ayında Hacettepe Çocuk Hastanesi'nde başlandı. 1962 yılında Milli Türk Tıp Kongresi'nde Cerrahpaşa'dan Dr. Nihat Dorken 4 açık kalp ameliyatı olgusu ve Hacettepe'den Dr. Aydın Aytaç beş olgu sundular (2). Bunu izleyen yıllarda Dr. Yüksel Bozer, Dr. Aydın Aytaç, Dr. Siyami Ersek ve Dr. Kemal Beyazıt öncülüğünde kalp cerrahisi ülkemizde hızlı ve başarılı bir şekilde gelişti. İlk yıllarda sadece büyük şehirlerde gerçekleştirilmekte olan kalp cerrahisi zamanla tüm yurda yayıldı (3, 4). İlk açık kalp ameliyatı Tıp Fakültesi Hastanesinde11 Şubat 2006 Objective: We aimed to represent outcomes of open heart surgeries which began first in April 2006. Material and Methods: One thousand two hundred thirtyeight open heart surgery procedures were performed in two hospitals between February 2006 and April 2012. Mean age was 58.31±14.45. Seventy-one patients underwent emergency surgery. Nine hundred and forty patients underwent coronary artery bypass grafting (CABG) surgery with the diagnosis of coronary artery disease. Coronary artery bypass grafting surgery with carotid artery endarterectomy was performed in 11patients. Two hundred and twenty patients (17.7%) were perated on for heart valve surgery. Aortic surgery was performed in 20 patients. Ascending aorta replacement surgery was performed in 7 patients, descending aorta replacement surgery was performed in 1 patient, ascending aorta replacement surgery and CABG surgery were performed in 1 patient, Bentall and Cabrol surgery procedure was performed in 12 patients. Seven patients were operated on with the diagnosis of myxoma. Congenital heart surgery operation was performed in 52 patients (4.2%). Results:Mean cross clamping time was 68.41±28.71 minutes and mean perfusion time was 96.58±35.99 minutes in patients who had CABG surgery or cardiopulmonary bypass. Mean distal anastomosis number was 2.94±0.9 (1-6). Coronary artery endarterectomy was performed in 102 patients (10.8%). Left ventricule aneurysm was operated on in 11 patients who had CABG surgery. Intraaortic balloon pump was inserted in 62 patients (5%) for low cardiac output. Hospital mortality rate was 4.2%. Mean intensive care unit hospitalization time was 2.3±0.6 days, mean hospitalization time was 6.2±2.4 days. Conclusion:Open heart surgery has continued in 2 centers with accelerating success since February 2006, when surgeries began to be performed.
A 75-year-old man was admitted to the emergency room due to three day history of right lower quadrant pain. On physical examination, he had abdominal tenderness. He had a past medical history of bilaterally enlarged polycystic kidneys and a polycystic liver (Figure 1). A computed tomogram with contrast showed a 6 cm aneurysm of the right thrombosed internal iliac artery aneurysm (IIAA) and large (approximately 12cm) retroperitoneal haematoma formation anterior to the aneurysm ( Figure 2). The patient underwent an immediate laparotomy as he became unstable. Intra-operative findings confirmed rupture of the right IIAA and aneurysm was ligated proximally. Isolated IIAA is rare. Unless rupture occurs, they usually remain asymptomatic. Autosomal dominant polycystic kidney disease (ADPKD) has been associated with several aneurysms, most notably intracranial, but not internal iliac. We present a patient with ruptured IIAA as coincident with ADPKD. IIAA presents late with signs and symptoms of an acute abdomen or local compressive symptoms and has a high incidence of rupture because of its location and being asymptomatic. In addition, the mortality rates (60%) are high. Therefore, in the differential diagnosis of right lower quadrant pain, ruptured IIAA especially in patients with ADPKD should be kept in mind .
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