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    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, Ömer
    Introduction: 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.
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    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, Omer
    Introduction: 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.
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    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, Mehmet
    Objective: 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.
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    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 Arif
    Background: 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.