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PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY AND NON-CORONARY
INTERVENTIONS IN EUROPE AND TURKEY BETWEEN 1992-2001
Özmen F, Atalar E,
Özer N.
In both Europe and Turkey
between years of 1992-2001, to collect the inteventional cardiology data and
to research the progression in period of 10 years.
Between
the European countries who sends their results regularly and whose
percutaneous intervention numbers are not low, including Turkey, the datum
of 16 countries were studied carefully.
Between
the years of 1992 till 2001 coronary angiography has reached from 628.893 to
1.771.000 (from 1.424 to 3.371 per million people). Coronary angioplasty
rose from 137.885 to 573.210 (from 288 to 1.453 per miillion people) and
intracoronary stent increased from 3.237 to 473.202. Between Eurepean
countries in 2001 the most percutaneous interventions was done in Germany
(coronary angiography 611.682, coronary angioplasty 195.280 and
intracoronary stent 148.157). In the yeaers of 2001 in Turkey, coronary
angiography, coronary angioplasty and intracoronary stent numbers in
respectively were 131.039, 32.937 and 27.459.
In the
last 10 years, the complications after percutaneous coronary angioplasty
have decreased at an important degree. Acute myocardial infarction lessened
from 1.5 % to 1.1 % in 2001 and need of emergency coronary bypass surgery
decreased from 1.2% to 0.2%. There is not a meaningful change at the rate of
death the years of 1992 and 2001 (0.5% vs 0.6%).
In spite
of increasing usage of the new diagnostic devices every passing years, there
is a decrease in using the new therapeutic devices. In 2000, 5.850 new
therapeutic devices in Europe, 668 new devices in Turkey were used. The
importance within the percutaneous coronary interventions remained about 2
per cent.
The
mitral valvuloplasty which is one of the non-coronary interventions, after
the years following 1992, gradually decreased both in Turkey and Europe. The
mitral valvuloplasty which was 683 in 1993 in Turkey lowered to 503 in 2001
and which was 3.438 in 1992 in European countries lowered to 1.598 in 2000.
The number of valvuloplasties decreases in respect to the years.
In the
countries of Eurepean and in Turkey interventional cardiology develops every
passing years.This deve-lopment especially has experienced in intracoronary
stents and the new devices have lost their importance thoroghly after the
applications of intracoronary stents.
RELATIONSHIP BETWEEN THE SLOW CORONARY FLOW PHENOMENON AND
CAROTID ARTERY INTIMA MEDIA THICKNESS
Avşar
Ö.
This study was planned to investigate the
relationship between slow coronary flow phenomenon and the
carotid artery intima media thickness which is an indicator
of early atherosclerotic changes in vascular tree.
Consecutive patients (n=203) who were
free of any coronary lesions in coronary angiograms were
enrolled. The patients were groupped as slow flow (57) and
normal flow (146) groups according to the corrected timi
frame count of lad. Cimt was measured via computer software
regarding far-wall method in both common carotid arteries.
Maximum and mean cimt values were compared between the two
groups.
Maximum and mean cimt values were
0,835±0,115 ve 0,684±0,091 mm for normal flow group and
1,017±0,115 ve 0,818±0,088 mm for slow flow group
respectively (p< 0,001). Using 0,926 as the cut-off value
for maximum cimt positive and negative predictive values of
slow flow were 82,5 % and 81 % (CI: 0,813-0,929).
Multivariate analysis revealed that sex, hypertension,
diabetes, body mass index and cimt were independent
predictors of slow coronary flow.
We find out that cimt and
ctfc are strongly correlated. This implies that slow
coronary flow could be an early marker of subclinical
atherosclerosis. so patients with slow flow should be
followed-up prospectively for possibility of manifest
atherosclerosis.
Disk devices have
been used for many years. Atrial septal defects (ASDs), vary in anatomy and
size; therefore conventional disk devices might not be appropriate for all
defects. Placement of the centering device is easier in large central
defects; on the other hand multiple direct placement and the regular
buttoned device was more appropriate. Many large ASDs have inadequate
septal rim; in such cases neither the regular nor the centering buttoned
device could offer enough support, although the transcatheter.
The ButtonSeal centering on demand device has been used in 230 patients age
1.5-75 years (med.10). Defect size varied from 8 to 30 mm (med.16), and
device size from 25 to 60 mm (med. 35). All cases except for 5 with
significant residual shunts, resulted in effective occlusions (160 full
occlusions, 65 trivial shunts). Re-intervention was required for the 5 cases
with significant shunts. Most trivial shunts became full occlusions on
follow-up.
Patent foramen ovale (PFO) is a thin, membranous, flexible
and flap-like congenital, oblique channel between septum
primum and septum secundum. Patent foramen ovale, which was
considered an innocent physiologic sign in the past, has
presently been reported to be associated with such diseases
as ischemic stroke, paradox emboly,decompression disease,
fat emboly, obstructive sleep apnea syndrome,
platypnea-orthodeoxia syndrome, temporary global amnesia and
migraine.
In the light of the recent studies, PFO
is considered a congenital pathology that causes or worsens
the clinics of cardiovascular ad other systemic diseases
requiring close follow-up. PFO may gain higher clinical
significance with further studies. In this paper, we
examined the physiopathology and clinical significance of
PFO, as well as the di-seases it is associated with, its
treatment and prognosis.
EXTRACARDIAC COMPLICATIONS OF PERCUTANEOUS CORONARY
INTERVENTIONS
Akgül
F, Batyraliev T, Serçelik A.
Coronary balloon angioplasty using the
percutaneous approach was first performed by Andreas
Gruentzing in 1977. Since then, millions of patients have
undergone diagnostic or therapeutic catheterization.
Technological advences in the design of catheters and
devices have allowed a more aggressive approach to
percutaneous coronary intervention and as a result, the
frequency of extracardiac complications has risen. The most
common extracardiac complications following percutaneous
coronary interventions are bleeding, hematoma,
pseudoaneurysm and arteriovenous fistula. These
complications, the pertinent risk factors during and after
the procedure should be identified and aggressive measures
should be taken. A number of risk factors for
extracardiac complications after percutaneous coronary
interventions have been identified. The most important risk
factors are older age, female gender, obesity, hypertension,
excessive anticoagulation, multiple interventions during the
same hospitalization and catheter insertion in the
superficial or deep femoral artery.
SURGICAL APPROACH TO A PATIENT WITH GIANT CAROTID BODY TUMOR:
CASE REPORT
Ulaş
M.M, Lafçı G, Sevük U, Taşkaya E, Çağlı K, Kaplan S.
Carotid body tumors are rare tumors arising from
embriologic neural crest and, mainly they have benign
character. İf untreated, these tumors tend to surround the
external and internal carotid arteries. They are found on
the lateral neck, frequently in the carotid bifurcation.
They originate from paraganglionic cells of carotid
body, which is located in the carotid bifurcation. In this
case we aimed to explain a rare giant carotid body tumor,
its treatment and our surgical management.
Key Words: Carotid body tumor,
Treatment, Surgery, Prognosis, Mass extirpation
Akbulut E, Serçelik A, Mavi A, Karben Z, Gümüşburun E,
Batyraliev T.
We
report the case of a 79-years-woman who had unusual thoracic
aorta in "C" shape. In arteriography, the thoracic aorta
extended downward normally as low as the fifth thoracic
vertebra then it run towards the right side about angulus
costae. At the ninth thoracic vertebra level, it run towards
the left side on the diaphragma, at the tenth thoracic
vertebra level, then, it traveled downward normally. In this
part of the thoracic aorta was concave towards to right
side, 7.5-8 cm. This patient had no dexrocardia and situs
invertus or other congenital anomaly.
It is important to know clinically the
unusual shape of the thoracic aorta because of the closed
relation of the aorta in thorax.
Key Words:
Thoracic aorta, The course of thoracic aorta
