Browsing by Author "Kiymaz, Adem"

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Basilic Vein Transposition Fistulas Versus Prosthetic Bridge Grafts in Patients With End-Stage Renal Failure
(Elsevier Science inc, 2011) Basel, Halil; Ekim, Hasan; Odabasi, Dolunay; Kiymaz, Adem; Aydin, Cemalettin; Dostbil, Aysenur
Background: Basilic vein transposition fistulas (BVTFs) and prosthetic bridge grafts (PBGs) provide good vascular access for hemodialysis. To evaluate the patency and complication rates after arteriovenous fistula formation, a concurrent series of patients was reviewed. Methods: Between September 2003 and September 2009, 147 hemodialysis access procedures were performed in 147 consecutive patients at Van Research and Training Hospital and Yuzuncu Yil University Hospital, Van, Turkey. All access procedures were planned on the basis of preoperative duplex scans of arm and forearm veins. Functional patency was defined as the ability to cannulate hemodialysis patients successfully. Primary and secondary cumulative functional patency rates of BVTFs and PBGs were determined with life-table analysis and differences were analyzed with retrospective study. Differences in revision rates, including thrombolysis thrombectomies and operative revisions, were analyzed with the Fisher exact t-test. Results: Mean follow-up was 15 months (range, 3-24 months). Risk factors were similar between the two groups. BVTFs had better patency at 15 months. The dialysis access complications were higher in the PBG group versus BVTF group, and the PBG group had a higher infection rate than the BVTF group. Conclusion: The primary and secondary patency rates were superior in the BVTF group. Our data strongly support the contention that as long as the patient is a candidate for an upper arm BVTF based on anatomical criteria, BVTF always be considered before a PBG.
A Comparison Between Minilaparotomy and Conventional Approach for the Surgical Therapy of Aortailiac Occlusive Disease
(Professional Medical Publications, 2010) Odabasi, Dolunay; Ekim, Hasan; Kiymaz, Adem
Objective: To search for less traumatizing measures for Aortic Occlusive Disease (AOD) surgeries to improve the recovery from surgery. Another objective was comparison of retroperitoneal minilaparotomy (RML) with conventional transperitoneal classic median laparotomy (TCML) with respect to per-operative and post-operative outcome and complications. Methodology:. It was a retrospective comparative study. All patients undergoing AOD surgery were enrolled. Our comparative data of 20 patients who had AOD surgery by TCML (TCML group) performed from January 2003 to December 2006 and 20 cases of patients who had AOD surgery by RML (RLM group) performed from January 2006 to December 2009 is presented. Chi-square and Fischer test with significance of p value being taken at 0.05 were used for categorical data, while student's t test was used for continuous data. Results: Mean age, gender, the operation and aortic occlusion time was similar between the TCML and RLM groups. The length of stay in the intensive care unit (ICU) and total hospital stay in the RLM group was statistically shorter compared to the TCML group(p<0.05). Major complications were rare in both the groups. Conclusion: During AOD surgery, RLM appears to be an attractive alternative to traditional TCLM with fewer complications.
Should We Use Saphenous Vein Graft Instead of Synthetic Graft for Creation of Secondary Arteriovenous Fistula in Hemodialysis Dependent End Stage Renal Failure Patients
(Baycinar Medical Publ-baycinar Tibbi Yayincilik, 2012) Odabasi, Dolunay; Ari, Elif; Kiymaz, Adem; Ekim, Hasan
Background: Patient groups with secondary arteriovenous fistula (AVF) management with saphenous vein (SV) graft and polytetrafluoroethylene (PTFE) graft for hemodialysis (HD) were reviewed in terms of patency and complication rate. Methods: Forty HD access procedures were performed in 40 consecutive patients between January 2006 and January 2010. All access procedures were planned on the basis of preoperative duplex ultrasonography (USG) scans of arm and forearm veins. Functional patency was defined as ability to cannulate for HD successfully for the patient. Primary and secondary cumulative functional patency of SV and PTFE grafts were determined with Kaplan Meier test; differences in patency rates were analyzed with Log Rank test and differences in revision rates including thrombolysis, thrombectomies and operative revisions were analyzed with the Z test and the Fisher's exact t-test. Results: Mean follow-up was 48 months (range 43-54 months). Risk factors were similar between the two groups. Saphenous vein graft had better patency rates. The HD access complications were higher in SV graft group, while infection and thrombosis were higher in PTFE group. Conclusion: Our data strongly support the necessity that SV graft should be considered initially, compared to PTFE graft, for the patient who is a candidate for an upper arm secondary AVF creation based on anatomical criteria.
Surgical Repair of Delayed Chronic Type a Dissection After Previous Coronary Artery Bypass Grafting
(Professional Medical Publications, 2011) Odabasi, Dolunay; Kiymaz, Adem; Ekim, Hasan; Basel, Halil
We report of a 57 years-old woman who had undergone coronary artery bypass three years previously. Computed tomography (CT) revealed that the ascending aorta was dilated to about 7cm in diameter, with type A dissection. Angiography revealed that left internal thoracic artery (LITA) graft to left anterior descending artery (LAD) and saphenous vein grafts to posterior descending artery (PDA) branch of the right coronary artery (RCA) and second obtuse marginal (OM) branch of the circumflex artery (CX) correspondingly were patent. Though the risk of surgical treatment via repeat median sternotomy is usually very high in these cases, we successfully performed the reoperation using profound hypothermic circulatory arrest. We dissected the mediastinum by using a sternum retractor for ITA and saphenous vein grafts dissection. We didn't use cardioplegia during profound hypothermic circulation.