Browsing by Author "Odabaşi, D."

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Arteriovenous Fistula Aneuryms Seen More Frequently at Brachial Region in End Stage Renal Failure Patients
(2011) Odabaşi, D.; Ari, E.; Ekim, H.
Objective: The aim of this study is to evaluate the aneursysm developing in arteriovenous fistula's (AVF) in end stage renal failure (ESRF) patients and to emphasize the importance of using the distal portions of extremities for AVF operations as possible. Material and Methods: Between January 2006 and January 2011 200 patients who have ESRF disease had 232 AVF operations. AVF operation conducted 113 (56%) of the patients were male and 87 (44%) were female. 17 (62%) of the patients were male and 10 (38%) of the patients were female who had anuerysm developed. Patients evaluated according to their sex, age, ESRF duration, AVF localizations. Results: The mean age of male patients was 41.50 ± 16.53, and female patients was 43.37 ±17.65 who had aneurysm in AVF's. The mean duration ESRF of male patients was 53±26 months and female patients was 56 ± 24 months. AVF localizations of 27 patients who had aneurysms are; right radial AVF 2 (7%), right high AVF 2 (7%), right brachial AVF 8 (29%), left radial AVF 1 (3%), left high radial AVF 5 (18%), left brachial AVF 9 (33%). The mean fistula flow of the male patients was 1332 ± 411 mL/min and female patients was 1117 ± 326 mL/min. Aneurysm developed 17 (15%) in 113 male patients, 10 (11%) in 87 female patients. High output cardiac failure developed 2 (11%) in 17 aneurysm developed male patients, 1 (10%) in 10 aneurysm developed female patients. Conclusion: Aneurysm developed significantly more in brachial region compared to forearm. It is the forearm if feasible vessels recieved to be preferred for AVF operation having regard the risk of aneursym development. Copyright © 2011 by Türkiye Klinikleri.
B-Vak Shows Positive Impact on Arterio-Venous Fistula Patency
(2012) Odabaşi, D.; Caner, Ş.; Ekima, H.
Objective: The purpose of this study is to investigate the effect of B-VAK (Mini Wound Drainage System) application to prevent hematoma after arterio-venous fistula (AVF) surgery on AVF patency. Material and Methods: In our clinic between January 2008 and January 2011, 100 patients who were diagnosed as end stage renal failure (ESRF) AVFs created, purposed for hemodialysis (HD) treatment After randomization 50 patients had B-VAX application (Group 1). Groups compared according to hematoma and fistula thrombosis. Results: There were 28 (56%) male, 22 (44%) female in B-VAX applied patients (Group 1). Average age was 34,1 ± 14. Avenge ESRF duration was 86±34 months. Average AVF flow was 470±107 mL. There were hematoma in 4 (8%) and thrombosis in 3 (6%) patients. After averaged 26±4 months fallow-up 7 (14%) patients AVF's became nonfunctional. There were 26 (%52) male, 24 (%48) female in Group 2. Average age was 34,1 ± 14 Average ESRF duration was 83 ± 31months. Average AVF flow was 490±110 mL. There were hematoma in 9 (18%) and thrombosis in 7 (14%) patients. After avaraged 24 ± 4 months fallow-up 11(22%) patients AVF's became nonfunctional. Conclusion: Hematoma is the principal cause of early failure of AVF creation in ESRF patients who needs HD treatment and B-VAX application may serve positive impact in patency of AVF by decreasing the incidence of hematoma. Copyright © 2012 by Turkiye Klinikleri.
Cardiac Tamponade Surgery, Which Method To Choose
(2011) Odabaşi, D.; Gümrükçüog̈lu, H.A.; Kiymaz, A.; Ekim, H.
Objective: Cardiac tamponade (CT) represents a life-threatening condition and different methods are applied in the surgical treatment. We have reviewed the results of 100 patients who had subxiphoid pericardial drainage, pericardio-peritoneal window and thoracotomy after the diagnosis of CT. Material and Methods: The study group consisted of 100 patients diagnosed with CT from January 2005 to January 2011 at our institution. Subxiphoid pericardial drainage was performed in 35 (35%) patients (group A). Pericardio-peritoneal window performed in 20 (20%) patients (group B). Thoracotomy was performed in 45 (45%) patients (group C). Data on medical history, characteristics of the pericardial fluid, treatment strategy and follow-up data were collected. Results: Malignant diseases, tuberculosis and idiopathic were primary cause of tamponade (57%, 17% and 15% respectively). Major and minor complications were as fallows; group A: 5%, 5%; group B: 5%, 10%; group C: 4%, 13% respectively. Recurrance ≤ 90 day were as fallows; group A: 20%; group B: 15%; group C: 6%. Thirty day morbidity; group A: 11%, group B: 15%, group C: 20%. Mortality; grup A: 20%, group B: 25%, group C: 22%. Conclusion: Major complication rates of these methods are close to each other, but more invasive method of thoracotomy, which has the lowest recurrence rates and requires the operating room environment. Implementation in intensive care unit and under local anesthesia and are the most importanat advantages of subxiphoid pericardial drainage and pericardio-peritoneal window methods. Copyright © 2011 by Türkiye Klinikleri.
Effects of Perioperative Statin Treatment on Postoperative Atrial Fibrillation and Cardiac Mortality in Patients Undergoing Coronary Artery Bypass Grafting: a Propensity Score Analysis
(Medical Association of Zenica-Doboj Canton, 2015) Kunt, A.; Özcan, S.; Küçüker, A.; Odabaşi, D.; Kunt, A.S.
Aim To evaluate the effect of perioperative statin treatment on postoperative atrial fibrillation and cardiac mortality in patients undergoing coronary artery bypass grafting. Methods A total of 1890 patients who underwent isolated coronary artery bypass were analyzed retrospectively, of which 425 patients (22.4%) older than 70 were included in the study. The demographic properties, preoperative, operative and postoperative data and other medications of these patients were recorded. Continuous preoperative and postoperative atorvastatin therapy were received by 124 (29.17%) patients; 301 (70.82%) patients were matched to a control group (no-statin group). The two groups were matched by propensity score analysis in terms of atrial fibrillation development and cardiac mortality. Results Medical history, medical treatment, cardiovascular history, and operative characteristics demonstrated significant heterogeneity in both groups. Postoperative atrial fibrillation was similar in both groups. Before propensity score matching, the percentages of patients in postoperative atrial fibrillation with respect to Ator- vastain-group and No-statin-group were 13.71 and 10.3 respectively; however, those were 13.71 and 14.51 after matching. In a multivariate regression analysis, five-vessel bypass (odds ratio OR, 2.354; 95% confidence interval CI, 0.99 to 5.57) was an independent predictor of postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting. In-hospital mortality was higher in the Atorvastatin-group compared with the No-statin- group: 124 (8.9%) versus 301 (3.7%), respectively; p=0.027). Conclusion Perioperative atorvastatin treatment is not found to be associated with reduced postoperative atrial fibrillation and cardiac mortality in patients undergoing isolated coronary artery bypass grafting above the age of seventy years. © 2015, Medical Association of Zenica-Doboj Canton, All rights reserved.
Efficacy of Chronic Statin Therapy on Major Cardiac Events After Coronary Artery Bypass Grafting: Low-Dose Versus High-Dose
(Medical Association of Zenica-Doboj Canton, 2015) Kunt, A.; Özcan, S.; Küçüker, A.; Odabaşi, D.; Kunt, A.S.
Aim To investigate whether chronic statin treatment after coronary artery bypass grafting (CABG) protects patients from major cardiac events and provides percutaneous coronary intervention (PCI) free survival. Methods A total of 232 patients with previous CABG and chronic statin therapy were selected retrospectively and were divided into two groups according to a dosage of atorvastatin per day, e. g., 20 mg or 40 mg. Groups were compared for the major cardiac events and freedom from PCI by Kaplan Meier analysis as the primary end point. Patency of grafts including left internal thoracic artery (LITA) and saphenous vein (SVG) and progression of non-grafted native vessel disease were also evaluated as secondary end points. Results Cardiac mortality, periprocedural myocardial infarction (MI), target vessel revascularization and percutaneous coronary intervention free survival were as follows: 2.9% versus 2.1% (p=1.000); 16.1% versus 21.1% (p=0.331); 56.93% versus 52.63% (p>0.005); 58.4% versus 63.2% (log-rank test; p= 0.347) in atorvastatin 20 mg and atorvastatin 40 mg groups, respectively. However, these results were not statistically significant between two groups (p>0.005). Patency of openness of grafts including LITA and SVG and progression of non-grafted native vessel disease were similar between groups (p=0.112, p=0.779, p=0.379 and p=0.663, respectively). Conclusion Low-dose long-term statin treatment had similar outcomes on major cardiac events and identical rate of freedom from percutaneous coronary intervention after coronary artery bypass grafting compared with high-dose long-term statin treatment. It is better to start from low dose statin treatment after surgical interventions. © 2015, Medical Association of Zenica-Doboj Canton, All rights reserved.
Primary Aneurysm of the Greater Saphenous Vein: Case Report and Literature Review
(2010) Ekim, H.; Başel, H.; Odabaşi, D.; Özen, S.
Primary venous aneurysm is a rare vascular abnormality that can occur throughout the venous system. We report a proximal greater saphenous vein aneurysm in a twenty one-year old male. A venous duplex ultrasonographic examination showed a fusiform venous aneurysm (5 cm in diameter) of the proximal greater saphenous vein containing occluding thrombus adherent to its wall and extending to saphenofemoral junction. Operation was performed due to apparent symptoms and the potential risk for thromboembolic complications. Aneurysm was exposed through a vertical left femoral incision. It was totally filled with thrombi. Histopathological examination of the aneurysmal wall demonstrated fibrocellular thickening with irregular vascular proliferation with multiple reduplications of internal elastic lamina. Because of the risk of thromboembolism, saphenous vein aneurysm containing occluding thrombus extending to saphenofemoral junction should be treated surgically.
Should We Use Basilic Vein Transposition Instead of Prosthetic Graft for Creation of Secondary Arterio-Venous Fistula in Hemodialysis Dependent End Stage Renal Failure Patients
(2011) Odabaşi, D.; Ekim, H.; Ari, E.
Objective: Every end stage renal failure (ESRF) patient needs vascular access for hemodialysis (HD). Secondary arterio-venous fistula (AVF) constitution with prosthetic graft (PG) or basilic vein transposition (BVT) are good alternatives for patients who lost the chance of radio-cephalic arterio-venous fistula (RCAVF) or brachio-cephalic arterio-venous fistula (BCAVF). To evaluate the patency and complication rates after AVF formation a concurrent series of patients were reviewed. Material and Methods: From January 2006 to January 2010, 40 secondary HD access procedures were performed in 40 consecutive patients. All access procedures were planned on the basis of preoperative duplex ultrasonography (USG) scans of arm and forearm. Functional patency was defined as ability to cannulate for HD patient successfully. Primary and secondary cumulative functional patency of PG's and BVT's were determined with Kaplan Meier test, differences were analyzed with Log Rank test, differences in revision rates including thrombolysis, thrombectomies and operative revisions were analyzed with the Z test and the Fisher exact t-test. Results: Mean follow up was 48 (43-54 months) months. Risk factors were similar between the two groups. BVT group has the better patency ratings. Steal syndrome and odema were higher in BVT group. Conclusion: As long as the patient is a candidate for an upper arm secondary AVF creation based on anatomical criteria BVT is always be considered before a PG. Copyright © 2011 by Türkiye Klinikleri.
Spontaneous Pneumothorax and Pneumomediastinum in Pregnancy: a Case Report
(Turkish Society of Obstetrics and Gynecology, 2014) Karadaş, S.; Okyay, A.G.; Odabaşi, D.; Selvi, F.
Spontaneous acute pneumothorax may occur as a result of spontaneous rupture of subpleural blebs or bullae and it is extremely rare during pregnancy. Bilateral pneumothorax and pneumomediastinum were detected in a young pregnant woman admitted with the complaints of swelling and pain on her neck and upper thorax following 2 days of dyspnea. Nasal oxygen, analgesics and antiemetics were used as needed during ten days of hospitalization. Physical findings, chest x-ray and oxygen saturation improved at the end of this period. Since supportive treatment was sufficient, invasive treatments such as surgery or thorax tube were not required. Although rare, pneumothoax should be remembered in any pregnant woman with dyspnea and chest-pain and must be confirmed radiographically to distinguish it from other diseases and conditions. In this report, a case of spontaneous acute pneumothorax and pneumomediastinum in a 10 week primigravida is presented.