You need Adobe Acrobat Reader to be able to view
the PDF files. You may already have it installed.
If not you can download it from the Adobe
website
here
or by clicking on the graphic.
Endovascular treatment of carotId
artery stenosIs: Cerebral protectIon wIth fIlter devIces
Demirbaş Ö, Batyraliev T,
Kısacıkoğlı B.
Endovascular treatment of carotid artery
stenosis is a new approach and alternative to surgical carotid
endarterectomy. The applicability of this tecnique is increased with
improvement of cerebral protection devices. In this study; applicability,
safety and early-late outcome of angioplasty and stenting of karotid artery
stenosis is presented.
From March 2003 to December
2007, 51 patients (52 hemispheres) treated with angioplasty and stenting for
severe carotid artery stenosis were included the study. 32 male and 19
female and mean age of patients was 67,3. Filter type of cerebral protection
system used all of them. Distribution of filters and stents is like 8 EPI-Wallstent
(Boston Scientific), 27 Angioguard-Precise (Cordis), 13 EmboShield-Xact (Abbott)
ve 4 Spider-Protege (Ev3).
Fifty one patients (52
hemispheres) were treated with balloon dilatation and stenting (technical
success is 100%). There was 30% or less residual diameter stenosis after
prosedure all of them. Asystole developed in 3 patients at stent deployment
or postdilatation phases. Spasm of the filter level distal carotid artery
was observed in 8 patients. Ipsilateral middle cerebral artery branch emboli
developed in one patient during procedure which is treated tPA infusion with
microcatheterization and resolved completely within 3-4 days. 11 patients
had prolonged hypotansion after the presedure. There was no precedural death,
no reperfusion syndrom within first week, no acute stent trombosis and
intracerebral hemorrhage. No stent restenosis was defined with Color Doppler
US examinations performed 6 and 12 months after prosedures in 34 follow-up
patients.
As a result; With increase
of operator experience, development of protection devices, new strategies of
farmacotheraphy endovascular treatment of carotid artery stenosis with
angioplasty and stenting has low mortality and morbidity and became a
feasible and safe treatment method.
PrognosIs
of stable angIna resultIng from restenosIs after percutaneous coronary
InterventIon of saphenous veIn grafts
Fettser D.V, Batyraliev
T, Karben Z.A, Sidorenko B.A, Preobrazhenskıy D.V, Avşar Ö,
Vural A.
The following study
presents the estimate of stable angina frequency after
percutaneous transluminal coronary angioplasty (PTCA) of
vein grafts and detects the risk factors of restenosis and
stable angina development after PTCA. The study covers the
total of 209 cases including 198 cases when the transluminal
coronary angioplasty was performed successfully.
During the
up to 36 months follow-up (23±10 months on average), 25% of
patients had symptoms of stable angina as a result of
restenosis of the vein graft. The group of patients with
stable angina had higher hypercholesterinemia frequency (82%
versus 49%), they were implanted stents significantly more
rarely (47% versus 73%, p=0.035), and residual stenosis was
significantly higher (16%±12% versus 8%±7%, p=0.008). In the
course of the multivariate regression analysis,
hypercholesterinemia (OR: 3.55, 95% CI: 1.64-8.39, p=0.002)
and higher residual stenosis after the intervention (OR:
1.04, 95% CI: 1.01-1.07, p=0.04) proved to be the
significant predictors of stable angina resulted from
restenosis. In the subgroup of patients with
hypercholesterinemia, the tendency of the increase in the
frequency of stable angina among those who were not given
statins did not reach the significant value (52% versus 27%,
p=0.089).
Thereby,
stable angina is recorded in nearly a quarter of cases after
the balloon dilatation of stenoses of vein grafts. To the
most degree, the onset of restenosis and stable angina are
determined by the presence of hypercholesterinemia.
RelatIonshIp between proteIn-S, proteIn-C, antI-thrombIn
III levels, factor V LeIden, the methylenetetrahydrofolate reductase gene
mutatIon and restenosIs after percutaneous translumInal coronary
angIoplasty
Kurt H.İ, Demirtaş M,
Çürük M.A.
Several reports have demonstrated that
genetic factors may be involved in the pathogenesis of restenosis after
percutaneous transluminal coronary angioplasty ( PTCA). To evaluate serum
protein-s (PS), protein-c (PC), anti-thrombin III (AT-III) and Factor V
Leiden (FVL), A mutation in the methylenetetrahydrofolate reductase (MTHFR)
gene as a predictor of restenosis after PTCA
We evaluated 36 patients who
underwent elective single,native and de novo vessel angioplasty.
Angiographic restenosis ( 50% diameter stenosis at 6-month follow-up) is
47.2%. Patients were divided into two groups according to the presence (Grup
I = 17 [47.2%]), absence (Grup II=19 [52.8%] ) of restenosis).
Serum PS (p=0.09, PC
(p=0.44), AT-III(p=0.91) and FVL(p=0.93), mutation in the MTHFR gene
(p= 0.3) were not significantly different in patients with or without
angiographic restenosis. Homozygosity for MTHFR was present in 1
patient (2.3%) and for FVL were 2 patients (5.6%). They were not associated
with increased restenosis in a patients with restenosis who both FVL and
MTHFR were gene mutation
In our study PS, PC,
AT-III, A mutation in the FVL and MTHFR gene are not associated with
restenosis after PTCA.
Methylenetetrahydrofolate reductase gene polymorphIsm, homocysteIne and
folate levels In young patIents wIth myocardIal InfarctIon
Kanadaşı M, Dönmez Y, Çaylı M,
Demirtaş M, Tanrıverdi K, Demir M, Alhan C.
To determine the
significance of Methylenetetrahydrofolate reductase
(MTHFR) gene polymorphism, plasma homocysteine (tHyc) and
folate levels for the incidence of acute myocardial
infarction (AMI) in young patients in Southern Turkey.
Ninety-six
AMI patients with aged <55 years and 77 healthy subjects
were enrolled. Venous blood samples were analysed for plasma
lipid, tHyc, folate and Vitamin B12 levels, and MTHFR gene
polymorphism. MTHFR genotypes were determined as normal
(CC), heterozygous (CT) and homozygous (TT).
TT genotype
frequency, tHyc and folate levels were similar in patients
group and controls. Plasma tHyc and folate levels were
divided into four quartiles. The frequency of AMI was
significantly increased for higher tHyc levels, but there
was no significant association for different folate levels.
Plasma tHyc level higher than 16.05 µmol/l was found to be a
signficant risk factor for AMI.
MTHFR gene
polymorphism and folate do not seem to have significant
effect on the risk for AMI in our region. However, elevated
tHyc increased the risk of AMI.
The frequencIes of faktor V LeIden mutatIon In
coronary artery dIsease
Kurt H.İ, Demirtaş M, Çürük M.A.
The aim of this study
was to evaluate the frequencies of Factor V Leiden (FVL) in
patients with angiographically documented coronary artery
disease (CAD).
In this
study, 102 patinets were enrolled. We used the
polymerase chain Reaction and restriction enzyme digestion
to determine the frequency of FVL mutation. Our study
were enrolled 67 case with CAD (Grup I , 58
men,9 woman and 35 case without CAD
(Grup II, 21 men,14 woman ). Mean age was 41±9 yrs).
Prevalence of FVL heterozigot individuals were 4(6%) in
grupI and 3 (8.6 %) in grupII. The frequency of
FVL mutation was 7.3% in
our reiogon.
As result
of, The presence of FVL were statistically independent
from coronary risk factor. To the best of our knowledge,
this the study, investigating the frequencies of
FVL in Çukurova region. Our findings suggest that while the
frequency of FVL mutation in our trialis similar to the
results of the other studies reported in Turkey.
Refractory AngIna TherapIes: NeurostImulatIon and
enhanced external counterpulsatIon
Batyraliev T, Avşar Ö,
Reobrazhenskii D.V, Besnili F, Karben Z.A.
As the survival of patients
with primary coronary events continues to increase, the
number of patients presenting with coronary artery disease
unsuitable to further revascularization techniques and
symptoms refractory to medical therapy also continues to
rise. The aims of this review were to define the population
of patients with refractory angina pectoris and to present
the therapeutic options currently available for this
condition. Refractory angina pectoris is defined, and
traditional medical therapies are discussed. Then, current
therapeutic options for patients with refractory angina are
extensively reviewed. A multitude of therapeutic options
exist for patients with refractory angina pectoris.
In
randomized trials, neurostimulation has been shown to be
effective in reducing angina symptoms. Enhanced external
counterpulsation is a viable treatment option for select
patients with refractory angina. Further research of
the techniques mentioned in this review is warranted. The
importance of randomized, double-blinded, placebo-controlled
trials cannot be overemphasized, as the placebo effect of
these therapies is probably marked
One coronary artery abnormalIty In patIent applIed prImary PTCA due to acute
myocardIal Infarctus
Tuncer M, Eryonucu B,
Güler N, Gümrükçüoğlu H.A, Şahin M, Güntekin Ü.
Single coronary artery
is a rare congenital anomaly of the coronary circulation
which is often associated with other congenital cardiac
malformations. We report the use of coronary stenting
to treat miyocardial infarction in an anomalous coronary
artery. The patient had a single coronary artery with
anomalous left anterior descending artery arising from the
right sinus of Valsalva and and proximal of right artery was
100% blocked.
Key Word:
Single coronary artery, Acute coronary syndrome, Percutan
intervention
AnchorIng balloon technIque to achIeve guIde wIre
passage through the complex lesIon In prImary coronary angIoplasty of acute
myocardIal InfarctIon
Kılıç H, Akdemir R.
One of the reason for
unsuccessful angioplasty of acute myocardial infarction is
an inability to pass the guidewire through the occlusion. We
performed guidewire manipulation by anchoring a balloon in a
side-branch vessel in order to achieve guidewire
passage through the total occlusion.
