Browsing by Author "Guler, N"

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Comparison of the Effects of Desflurane and Sevoflurane on the Qtc Interval and Qt Dispersion
(Taylor & Francis Ltd, 2005) Silay, E; Kati, I; Tekin, M; Guler, N; Huseyinoglu, UA; Coskuner, I; Yagmur, C
Objective -The effects of desflurane and sevoflurane on QT interval and QT dispersion have been investigated in a prospective, double-blind, randomized study of patients undergoing noncardiac surgery. Interventions - Sixty American Society of Anaesthesiologists physical status I-II adult patients were randomly assigned to two groups. Anaesthesia was induced with inhalation of desflurane (desflurane group) or sevoflurane (sevoflurane group) in increasing concentrations to 3 minimal alveolar concentration level. The maintenance of anaesthesia was provided with 2 minimal alveolar concentration agents in both groups until the end of the study. Electrocardiogram, heart rate and blood pressure were recorded as follows: before premedication, before induction, I and 3 min after the induction of anaesthesia, after the administration of vecuronium and after the tracheal intubation. The induction times and the complications were recorded. Measurements and results -The QTc interval was significantly more prolonged with desflurane than with sevoflurane at the first and third minute after the induction, and at the third minute after the administration of vecuronium.There were no significant differences in the QT dispersion between the two groups. Heart rate and blood pressure were found to be significantly higher in the desflurane group. Conclusion -The QTc interval was more prolonged with desflurane than sevoflurane, and QT dispersion was normal with both agents.
Current Role of Laser Angioplasty of Restenotic Coronary Stents
(Sage Publications inc, 2006) Batyraliev, TA; Pershukov, IV; Niyazova-Karben, ZA; Karaus, A; Calenici, O; Guler, N; Sidorenko, BA
Treatment of in-stent restenosis (ISR) with conventional percutaneous transluminal coronary angioplasty (PTCA) causes significant recurrent neointimal tissue growth in 30-85%. Therefore, laser ablation of intrastent neointimal hyperplasia before balloon dilation can be an attractive alternative. However, the long-term outcomes of such treatment have not been studied thoroughly enough. This prospective case-control study evaluated angiographic and clinical outcomes of PTCA alone and a combination of excimer laser coronary angioplasty (ELCA) and adjunct PTCA in 125 patients with ISR. ELCA was performed before balloon dilation in 67 patients, PTCA alone was performed in 58 patients. Basic demographic and clinical data were comparable in both groups. Lesions included in ELCA group were longer (17.1 +/- 9.9 vs 13.6 +/- 9.1 mm; p = 0.034), more complex (36.5% type C stenoses vs 14.3%; p = 0.006), and more frequently had reduced distal blood flow (TIMI < 3: 18.9% vs 4.8%; p=0.025) compared to lesions in the PTCA group. Immediate angiographic results of PTCA and ELCA + PTCA appeared to be comparable. PTCA alone was successful in 57 patients (98.3%), ELCA + PTCA, in 66 patients (98.5%). The rates of hospital complications were comparable (3.0% in ELCA group vs 8.6% in PTCA group). The 1-year follow-up showed that the rates of major adverse cardiac events (MACE) were comparable in the 2 groups (37.3% in ELCA group vs 46.6% in PTCA group). The rates of target vessel revascularization (TVR) within 1 year after the intervention were also similar in the 2 groups (32.8% vs 34.5%). The data mean that ELCA in patients with complex ISR is efficient and safe. Despite a higher complexity of lesions in the ELCA group, no increase in the rate of complications was registered.
Effectiveness of Excimer Laser Coronary Angioplasty in Treatment of Patients With In-Stent Restenosis
(Izdatelstvo Meditsina, 2003) Pershukov, IV; Niyazova-Karben, ZA; Batyraliev, TA; Eryonucu, B; Guler, N; Temamogullari, A; Sidorenko, BA
In-stent restenosis (ISR), when treated with balloon angioplasty (PTCA) alone, has an angiographic recurrence rate of 30-85%. Ablating the hypertrophic neointimal tissue prior to PTCA is an attractive alternative, however late outcomes of such treatment have not been fully determined. This multicenter case control study assessed angiographic and clinical outcomes of 137 consecutive procedures in 125 patients treated for ISR with either PTCA alone (n=58) or excimer laser assisted coronary angioplasty (ELCA, n=67). Demographics were similar. Lesions selected for ELCA compared with those selected for \PTCA were longer (17.1+/-9.9 mm vs. 13.6+/-9.1 mm; p=0,034), more complex (ACC/AHA type C: 36,5% vs. 14,3%; p=0,006), and with reduced antegrade flow (TIMI flow <3: 18,9% vs. 4,8%; p=0,025). IELCA- and PTCA treated patients had similar rates of procedural success (98,5 and 98,3%, respectively, p=1,0), major clinical complications (3,0% and 8,6%; respectively, NS), major cardiac events at 1 year (37,3 and 46,6%. respectively, ISIS), and target lesion revascularization (32,8 and. 34,5%; respectively, NS). These data suggest that ELCA in patients with complex in-stent restenosis is as safe and effective as PTCA. Despite higher lesion complexity in ELCA-treated patients, no increase in event rates was observed.
The Effects of Short Term (3 Weeks) Testosterone Treatment on Serum Inflammatory Markers in Men Undergoing Coronary Artery Stenting
(Elsevier Ireland Ltd, 2006) Guler, N; Batyraliev, T; Dulger, H; Ozkara, C; Tuncer, M; Aslan, S; Agirbasli, M
Objective: Inflammation markers can predict restenosis after successful intracoronary stenting. There is evidence that testosterone suppresses the expression of the inflammatory cytokines. We hypothesized that testosterone therapy after coronary stenting can reduce the inflammation markers. Methods: We selected 41 men with coronary artery disease who underwent successful stent implantation for a > 70% diameter stenosis of a major coronary artery. Patients, who had stable angina and positive exercise test results, were recruited after diagnostic coronary angiography. Twenty-five men were treated with 3 doses of i.m. testosterone administration once a week for 3 weeks following diagnostic angiography. Sixteen patients were recruited as a control group and they received standard therapy. First venous blood samples were obtained after angiography. Stents were implanted 3 weeks after diagnostic angiography. Second venous blood samples were taken 24 h after the coronary stenting. Results: Baseline biochemical or hematological parameters were similar between the control and treatment groups. After coronary stenting, free testosterone, total testosterone, and sex hormone binding globulin were significantly elevated in the testosterone group (P < 0.0001, P < 0.0001 and P=0.02; respectively). After coronary stent implantation, there was a significant increase in IL-6 and CRP levels in the control group only (P=0.02 and P=0.038), while TNF-alpha levels were increased significantly in both groups (P=0.016 and P=0.014; respectively). Statistical analysis revealed that testosterone treatment prior to stent implantation attenuated IL-6 and hs-CRP levels significantly (P=0.042 and P=0.043; respectively). Conclusions: The present study shows that 3 weeks testosterone treatment prior to intracoronary stenting results in a significant suppression in hs-CPP and IL-6 levels after the stent implantation. (c) 2005 Elsevier Ireland Ltd. All rights reserved.
Excimer Laser Coronary Angioplasty in Treatment of Patients With In-Stent Restenosis
(Excerpta Medica inc, 2003) Pershukov, IV; Niyazova-Karben, ZA; Batyraliev, TA; Eryonucu, B; Guler, N; Temamogullari, A; Sidorenko, BA
Prognosis of Unstable Angina Resulting From Restenosis After Percutaneous Angioplasty of Saphenous Vein Grafts
(Russian Heart Failure Soc, 2004) Peresypko, MK; Niyazova-Karben, ZA; Petrakova, LN; Batyraliev, TA; Pershukov, IV; Guler, N; Sidorenko, BA
Aim. To assess frequency of unstable angina due to restenosis after percutaneous angioplasty of venous grafts and to elucidate risk factors of its development. Material and methods. Percutaneous interventions were successfully performed in 100 out of 106 patients with venous graft stenoses. These patients were followed up for 17+/-11 (maximum 36) months. Results. Unstable angina due to venous graft restenosis developed in 24% of patients. Patients with unstable angina compared with those without were characterized by higher frequency of hyperlipidemia (83 vs. 51%, respectively, p=0.032), lower rate of stenting (46 and 72%, respectively, p=0.032), greater residual stenosis (15+/-13 and 9+/-8%, respectively, p=0.008). At multifactorial regression analysis the following factors were significant predictors of unstable angina: hyperlipidemia (odds ratio [OR] 3.55, 95% confidence interval [CI] 1.64-8.39), and residual stenosis after intervention (OR 1.04, 95% CI 1.01-1.07, p=0.04). In a subgroup of patients with hyperlipidemia there was a tendency to greater rate of unstable angina among patients not taking statins compared with users of statin (50 and 29%, respectively, p=0.083). Conclusion. Unstable angina developed in 1/4 of patients after balloon dilatation of venous grafts and hyperlipidemia was its most powerful predictor.
The Risk of Subacute Thrombosis After Drug-Eluting Stenting in the Real World
(Excerpta Medica inc, 2006) Pershukov, IV; Batyraliev, TA; Guler, N; Dokumaci, B; Levitsky, IV; Samko, AN; Besnili, F