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Öğe A single center study of the efficacy and safety of Pro-Glide used for closure in thoracic endovascular aortic repair in patients with previous groin intervention(SAGE Publications Ltd, 2025) Gülmez, Recep; Altunova, Mehmet; Şahin, Ahmet Anıl; Çelik, ÖmerBackground: This study aimed to evaluate the efficacy and safety of Pro-Glide, a suture-mediated vascular closure device, regarding technical success and complications in patients who had undergone aortic intervention and had previous groin intervention (PGI). Methods: One hundred and thirty-five patients who underwent percutaneous thoracic endovascular aortic repair via the femoral artery and were closed with the Pro-Glide device were analyzed retrospectively. PGI was defined as a history of open surgical access to the femoral artery or wide sheath (>18 F) placement due to endovascular or valvular intervention. The patients were divided into two groups 38 cases with PGI and 97 cases without PGI. Results: The overall success rate of closure of the femoral artery with Pro-Glide was not statistically significant between the two groups (93.8% vs 92.1%, p =.711). Sheath sizes were compared between the groups and PGI (+) group had significantly higher sheath sizes compared to PGI (−) group (24.3 ± 1.1 F vs 23.8 ± 1.0 F, p =.011). Three patients in the PGI (+) group and six patients in the PGI (−) group experienced technical failure of the percutaneous femoral approach. Femoral complications were seen after the procedures in four patients in the PGI (+) group and four in the PGI (−) group. The PGI (+) group had a higher complication rate when compared to the PGI (−) group; however, this was not statistically significant (p =.181). Conclusion: The present study was conducted on a significantly larger sample compared to previous studies and the findings suggest that the Pro-Glide vascular closure device is a safe option for patients with a history of PGI and may not be considered as a contraindication. © The Author(s) 2024.Öğe Impact of the HALP Score on Long-Term Mortality among Patients Undergoing EVAR(Feray Akbaş, 20.11.2024) Altunova, Mehmet; Evsen, Ali; Demir, Yusuf; Aktemur, Tugba; Erdogan, Onur; Atmaca, Sezgin; Köseoğlu, Mehmet; Uzun, Nedim; Sahın, Anıl; Çelik, ÖmerIntroduction: Endovascular aortic repair (EVAR) is commonly used for abdominal aortic aneurysms, but its mortality rate remains high. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score, which measures hemoglobin, albumin, lymphocyte, and platelet levels, provides prognostic value by reflecting the nutritional status and systemic inflammation. This study aimed to explore the relationship between the HALP score upon admission and long-term mortality in patients with EVAR. Methods: Consecutive patients with EVAR at our tertiary center from October 2010 to August 2021 were retrospectively analyzed. HALP scores were calculated using the following formula: hemoglobin (g/L) × albumin (g/L) × lymphocyte count (/L)/platelet count (/L). In-hospital and long-term mortality data were extracted. Receiver operating characteristic curve analysis identified predictors of in-hospital mortality. Multivariate Cox regression analysis was performed to examine determinants of long-term mortality. Results: Among the 162 participants (mean age: 69.4±8.2 years, 90.1% male), the HALP score was the most significant predictor of inhospital mortality (area under the curve: 0.752, 95% confidence interval: 0.674-0.830; p<0.001). Multivariate Cox regression analysis revealed HALP (p=0.001) and C-reactive protein (p=0.004) as independent determinants of long-term mortality. Conclusion: This study is the first to investigate the association between the HALP score and in-hospital and long-term mortality in EVAR patients. The HALP score is a robust prognostic tool compared with its components and other parameters in this patient population.Öğe Impact of the HALP Score on Long-Term Mortality among Patients Undergoing EVAR(Erkan Mor, 20.11.2024) Altunova, Mehmet; Evsen, Ali; Demir, Yusuf; Aktemur, Tugba; Erdogan, Onur; Atmaca, Sezgin; Köseoğlu, Mehmet; Uzun, Nedim; Sahın, Anıl; Çelık, OmerIntroduction: Endovascular aortic repair (EVAR) is commonly used for abdominal aortic aneurysms, but its mortality rate remains high. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score, which measures hemoglobin, albumin, lymphocyte, and platelet levels, provides prognostic value by reflecting the nutritional status and systemic inflammation. This study aimed to explore the relationship between the HALP score upon admission and long-term mortality in patients with EVAR. Methods: Consecutive patients with EVAR at our tertiary center from October 2010 to August 2021 were retrospectively analyzed. HALP scores were calculated using the following formula: hemoglobin (g/L) × albumin (g/L) × lymphocyte count (/L)/platelet count (/L). In-hospital and long-term mortality data were extracted. Receiver operating characteristic curve analysis identified predictors of in-hospital mortality. Multivariate Cox regression analysis was performed to examine determinants of long-term mortality. Results: Among the 162 participants (mean age: 69.4±8.2 years, 90.1% male), the HALP score was the most significant predictor of inhospital mortality (area under the curve: 0.752, 95% confidence interval: 0.674-0.830; p<0.001). Multivariate Cox regression analysis revealed HALP (p=0.001) and C-reactive protein (p=0.004) as independent determinants of long-term mortality. Conclusion: This study is the first to investigate the association between the HALP score and in-hospital and long-term mortality in EVAR patients. The HALP score is a robust prognostic tool compared with its components and other parameters in this patient population.Öğe Investigating the Frequency of Stent Fracture and its Impact on in-Stent Restenosis in Patients Undergoing Carotid Artery Stenting(Galenos Yayınevi, 23.10.2024) Altunova, Mehmet; Yalcın, Ahmet Arıf; Işık, Ayan; Pıskın, Ferhat Can; Uzun, Nedim; Sahın, Anıl; Demir, Yusuf; Atmaca, Sezgin; Demirci, Gökhan; Erturk, MehmetObjective: This single-center study aimed to assess the incidence and predictors of carotid artery Xact stent fractures (SF) and their impact on in-stent restenosis (ISR) during long-term follow-up. Methods: A cohort of 108 patients (97 males, median age 69.4±8 months) who underwent Xact stent placement for internal carotid artery stenosis between 2013 and 2021 and were diagnosed with SFs through fluoroscopy in 2022 were included. SFs were categorized as types I-V based on fracture characteristics. Follow-up included duplex ultrasound examinations to assess stent patency. Results: The average follow-up duration was 49.2±24.3 months, with ISR observed in 10 patients. Twenty-three SFs (21.3%) were identified: type I (5 patients), type II (7 patients), type III (3 patients), type IV (6 patients), and type V (2 patients). Calcification and stent length significantly predicted SFs (p<0.001; p<0.028). Conclusion: Calcification and stent length are associated with Xact SFs, but SFs do not impact ISR during long-term followup.Öğe Relationship between fragmented QRS complex and long-term cardiovascular outcome in patients with essential hypertension(Turkish Society of Cardiology, 2022) Altunova, Mehmet; Pusuroğlu, Hamdi; Demir, Ali Rıza; Yılmaz, Emre; Çizgici, Ahmet Yaşar; Ertürk, Mehmet; Şahin, Ahmet Anıl; Karakayalı, MuammerBackground: In patients with essential hypertension, fragmented QRS has been associated with many remodeling components that might lead to adverse cardiovascular effects. This study aimed to evaluate the relationship between fragmented QRS and adverse events and its potential long-term prognostic value. Methods: The patients with essential hypertension were divided into two groups according to the presence of fragmented QRS: fragmented QRS (+) and fragmented QRS (?). During long-term follow-up, the relationship of fragmented QRS to coronary artery disease, congestive heart failure, stroke, cardiovascular death, all-cause death, and major adverse cardiovascular and cerebrovascular events was evaluated. Results: The study group included 542 patients with essential hypertension. Fragmented QRS on ECG was observed in 224 (41.3%) patients. Considering the incidence rates at the end of 5.6 ± 1.3 years’ follow-up, the total incidence rate of major adverse cardiovascular and cerebrovascular events (P < .001), coronary artery disease (P < .001), and congestive heart failure (P < .001) were higher in patients with fragmented QRS. No significant difference was observed between the two groups in terms of stroke (P=.734), cardiovascular death (P=1), and all-cause death (P=.574). As a result of multiple cox regression analysis, fragmented QRS (P=.005) was identified as an independent predictor for major adverse cardiovascular and cerebrovascular events development. Conclusion: In patients with hypertension, the presence of fragmented QRS was found as an independent predictor for major adverse cardiovascular and cerebrovascular events development.Öğe A single center study of the efficacy and safety of Pro-Glide used for closure in thoracic endovascular aortic repair in patients with previous groin intervention(Sage Publications Ltd, 2024) Gulmez, Recep; Altunova, Mehmet; Sahin, Ahmet Anil; Celik, OmerBackground: This study aimed to evaluate the efficacy and safety of Pro-Glide, a suture-mediated vascular closure device, regarding technical success and complications in patients who had undergone aortic intervention and had previous groin intervention (PGI). Methods: One hundred and thirty-five patients who underwent percutaneous thoracic endovascular aortic repair via the femoral artery and were closed with the Pro-Glide device were analyzed retrospectively. PGI was defined as a history of open surgical access to the femoral artery or wide sheath (>18 F) placement due to endovascular or valvular intervention. The patients were divided into two groups 38 cases with PGI and 97 cases without PGI. Results: The overall success rate of closure of the femoral artery with Pro-Glide was not statistically significant between the two groups (93.8% vs 92.1%, p = .711). Sheath sizes were compared between the groups and PGI (+) group had significantly higher sheath sizes compared to PGI (-) group (24.3 +/- 1.1 F vs 23.8 +/- 1.0 F, p = .011). Three patients in the PGI (+) group and six patients in the PGI (-) group experienced technical failure of the percutaneous femoral approach. Femoral complications were seen after the procedures in four patients in the PGI (+) group and four in the PGI (-) group. The PGI (+) group had a higher complication rate when compared to the PGI (-) group; however, this was not statistically significant (p = .181). Conclusion: The present study was conducted on a significantly larger sample compared to previous studies and the findings suggest that the Pro-Glide vascular closure device is a safe option for patients with a history of PGI and may not be considered as a contraindication.Öğe Systemic Immune-Inflammatory Index Is Associated with Residual SYNTAX Score in Patients with ST-Segment Elevation Myocardial Infarction(Kare Publ, 2023) Altunova, Mehmet; Karakayali, Muammer; Kahraman, Serkan; Avci, Yalcin; Demirci, Gokhan; Sevinc, Samet; Yazan, SerkanBackground: Systemic immune-inflammatory index (platelet count x neutrophil- lymphocyte ratio) is a new marker that predicts adverse clinical outcomes in coronary artery diseases. Our aim was to investigate the relationship between the systemic immune-inflammatory index and residual SYNTAX score in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.Methods: In this retrospective study, 518 consecutive patients who underwent primary percutaneous coronary intervention (PCI) with the diagnosis of ST-segment elevation myocardial infarction were analyzed. The severity of coronary artery diseases was deter-mined by residual SYNTAX score. In the receiver operating characteristic curve analysis, systemic immune-inflammatory index with an optimal threshold value of 1025.1 could detect the presence of a high residual SYNTAX score; the patients were divided into 2 groups as low (326) and high (192) according to the threshold value. In addition, binary multiple logistic regression analysis methods were used to evaluate independent predictors of high residual SYNTAX score.Results: In binary multiple logistic regression analysis, systemic immune-inflammatory index [odds ratio=6.910; 95% CI=4.203-11.360; P <.001] was an independent predictor of high residual SYNTAX score. In addition, there was a positive correlation between the systemic immune-inflammatory index and residual SYNTAX score (r=0.350, P <.001). In the receiver operating characteristic curve analysis, the systemic immune-inflammatory index with an optimal threshold value of 1025.1 could detect the presence of a high residual SYNTAX score with 73.8% sensitivity and 72.3% specificity.Conclusion: Systemic immune-inflammatory index, an inexpensive and easily measurable laboratory variable, was an independent predictor of the increased residual SYNTAX score in patients with ST-segment elevation myocardial infarction.Öğe The effect of uric acid and albumin ratio in undergoing lower extremity endovascular interventions for peripheral arterial disease related contrast induced nephropathy(Elsevier inc., 2024) Demirci, Gökhan; Şahin, Ahmet Anıl; Altunova, Mehmet; Aktemur, Tuğba; Atmaca, Sezgin; Yalçın, Ahmet ArifBackground: Among patients undergoing percutaneous vascular intervention, contrast- induced nephropathy (CIN) is associated with increased morbidity and mortality. Serum uric acid/albumin ratio (UAR) has emerged as a new marker associated with poor cardiovascular outcomes. We aimed to evaluate the relationship between UAR and CIN occurrence in patients treated for peripheral artery disease. Methods: Patients underwent percutaneous intervention due to peripheral artery disease were enrolled. The primary endpoint was development of contrast related nephropathy. Patients were divided into 2 groups according to the CIN occurrence. Results: A total of 663 patients were enrolled and mean age was 62 +/- 10 years. After the intervention, 45 patients had CIN and 618 patients did not have CIN. Logistic regression analysis was performed to define the parameters of CIN. Male gender, diabetes, UAR, contrast volume, presence of coronary artery disease, and C-reactive protein levels were found significant in univariate analysis. However, only UAR was found significant in multivariate analysis (odds ratio 95% confidence interval: 3.426 (1.059-11.079), (P 1 / 4 0.040)).Therefore, it is the only independent predictor for occurrence of CIN. Conclusions: UAR is a reliable scoring system, which predicts CIN in such patient group. This score is not only cost-effective also simple, which can be easily applied into the clinical practice.Öğe The Relationship of CHADS2 Score with In-stent Restenosis in Patients Undergoing Iliac Artery Stenting(Ali Cangül, 2024) Demirci, Gökhan; Sahın, Anıl; Altunova, Mehmet; Aktemur, Tugba; Tekin, Meltem; Yildiz, Mustafa; Erturk, MehmetAmaç: Aorto-iliyak tıkayıcı hastalığa (AIOD) perkütan müdahale, açık cerrahi yerine onaylanmış bir tedavi seçeneğidir. Ancak stent teknolojisindeki gelişmelere rağmen stent içi restenoz (ISR), özellikle bu hastaların uzun dönem takiplerinde hala potansiyel bir sorun olmaya devam etmektedir. CHADS2 skoru temel olarak atriyal fibrilasyon için bir risk sınıflandırma aracıdır; ancak aterosklerozun şiddeti ve perkütan girişimlerin daha kötü sonuçlarıyla ilişkili olduğu bulunmuştur. Böylece AIOD nedeniyle stent takılan hastalarda CHADS2 skoru ile ISR arasındaki ilişkiyi sorgulamayı amaçladık. Gereç ve Yöntem: Bu çalışma, başarılı ana iliak arter (CIA) ve eksternal iliyak arter (EIA) stent implantasyonu yapılan 419 ardışık hastayı içeren retrospektif, gözlemsel bir çalışmaydı. İşlem sonrası ISR, takip döneminde her hasta için ultrasonografi veya anjiyografi ile değerlendirildi. Daha sonra hastalar ISR (+) ve ISR (–) olmak üzere iki gruba ayrıldı. Her hasta için CHADS2 skoru hesaplandı. Bulgular: 419 hastanın 47'sinde ISR tespit edildi. ISR'si olan hastaların stent çapı daha küçük (8,4±0,9 vs. 7,2±2,8, p=0,005) ve stent uzunluğu daha fazlaydı (80 (59–120) mm vs. 59 (39–100) mm, p<0,001). CHADS2 skoru ISR'si olan hastalarda ISR'si olmayanlara göre anlamlı düzeyde yüksek bulundu (2,04±0,98 vs. 1,45±0,93, p<0,001). KOAH (HR: 2,85, %95 GA: 1,535–5,293, p=0,001), CHADS2 skoru (HR: 1,571, %95 GA: 1,186–2,081, p=0,002) ve stent çapında azalma (HR: 0,582, %95 GA) : 0,366–0,926, p=0,022) bağımsız olarak ISR ile ilişkili olduğu bulundu. Sonuç: Çalışmamız başarılı iliak arter stent implantasyonu yapılan hastalarda KOAH, CHADS2 skoru ve stent çapının ISR ile ilişkili olduğunu gösterdi. Çalışmamıza göre bu basit ve uygulanabilir skorlama sisteminin ISR açısından yüksek riskli hastaları tahmin etmede kullanılabilabilir.
