Browsing by Author "Odabasi, Dolunay"

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Adipose Tissue Derived Stem Cell Therapy for Diabetic Foot
(Excerpta Medica inc-elsevier Science inc, 2014) Odabasi, Dolunay; Gur, Ali Kemal; Kunt, Aysegul; Kunt, Alper Sami
The Analyses of Arteriovenous Fistula Complication in Short and Long Term in Our Clinic
(Karger, 2010) Basel, Halil; Odabasi, Dolunay; Ekim, Hasan
The Association of Aneurysms Related To Arteriovenous Fistulas and Chronic Hepatitis C Virus Infection in Maintenance Hemodialysis
(Baycinar Medical Publ-baycinar Tibbi Yayincilik, 2014) Odabasi, Dolunay; Gur, Ali Kemal
Background: This study aims to investigate a possible association of aneurysm of arteriovenous fistulas (AVFs) and chronic hepatitis C virus (HCV) infection in maintenance hemodialysis (HD) patients. Methods: In this cross-sectional study, 179 HD patients with AVFs who were referred to Van Yuzuncu Yil University Hospital between January 2010 and December 2010 were evaluated. Data including age, sex, duration of renal failure, number of operated fistulas, number of patients with aneurysmal fistulas and chronic HCV infection were recorded. Doppler ultrasonography was performed to determine AVF patency and aneurysm flow. Results: Thirthy-three patients (group A) had aneurysm and 21 (group A1) of these patients had chronic HCV infection, while 12 (group A2) had no chronic HCV infection. Hundred and forty-six patients (group B) had no aneurysm. Of these patients, 15 (group B1) had chronic HCV infection, while 131 (group B2) had no chronic HCV infection. There were no statistical differences in age, sex, and duration of renal failure between the groups. The mean AVF flow was higher in group A1 (856 +/- 123 ml/min) compared to group A2 (560 +/- 98 ml/min) (p<0.05). The mean AVF flow was also higher in group B1 (536 +/- 54 ml/min) compared to group B2 (373 +/- 47 ml/min) (p<0.05). Criyoglobulinemia positivity was statistically significant in aneurysmal AVFs (group A1 and A2) than nonaneurysmal AVFs (group B1 and B2) (p<0.001). Conclusion: Our results demonstrated that aneurysm of AVFs in maintenance HD patients was associated with chronic HCV infection.
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.
Clinical and Echocardiographic Follow-Up in Pregnant Patients With Valvular Heart Disease
(Turkish Soc Cardiology, 2013) Gumrukcuoglu, Hasan Ali; Guler, Ayse; Odabasi, Dolunay; Simsek, Hakki; Sahin, Musa; Akdag, Serkan; Tuncer, Mustafa
Objectives: Pregnancy associated cardiovascular changes may result in a significant hemodynamic burden and can lead to morbidity and even mortality in women with cardiac disease. The present study aimed to evaluate clinical and echocardiographic follow-up in pregnant patients with valvular heart disease (VHD). Study design: The medical records of pregnant patients diagnosed with VHD from January 2004 to January 2011 were screened. Demographic characteristics including history of cardiac intervention performed during pregnancy, pulmonary edema, and maternal and fetal mortality, and cesarean section (C/S) history were collected from the hospital database and clinical records of the cardiology and obstetrics departments. The echocardiographic examination was carried out at presentation, 3rd trimester, and 1 month after delivery. The outcomes evaluated were cardiac intervention, pulmonary edema, and both fetal and maternal mortality during pregnancy and C/S. Results: We evaluated the outcomes of 884 pregnant patients with VHD. Adverse clinical outcomes including death, pulmonary edema, and valvular interventions were frequent among patients with severe VHD, whereas no adverse clinical outcome was observed in patients with mild-moderate VHD (n=49, 5.5% vs. n=0, 0%, p<0.001). In patients with severe VHD, clinical outcomes were frequent among patients with valve stenosis, but lower among patients with regurgitation [death 4 (0.45%) vs. 0 (0%); pulmonary edema (15 (1.7%) vs. 13 (1.5%); valvular intervention 11 (1.2%) vs. 6 (0.7%); respectively). Conclusion: Valvular heart disease is associated with fetal/maternal morbidity and mortality. Pregnant with severe VHD constitute a high-risk group in which life-threatening complications are likely to occur in the course of pregnancy.
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.
Comparison of One- and Two-Stage Basilic Vein Transposition for Arterio-Venous Fistula Formation in Haemodialysis Patients: Preliminary Results
(Clinics Cardive Publ Pty Ltd, 2013) Ozcan, Sedat; Gur, Ali Kemal; Yener, Ali Umit; Odabasi, Dolunay
Objective: This study aimed to compare the results of one-and two-stage basilic vein transposition (BVT) in haemodialysis patients. Methods: This was a non-randomised, retrospective study between January 2007 and January 2012 on 96 patients who were diagnosed with end-stage renal failure (ESRF) (54 males, 42 females; mean age 43.6 +/- 14 years) and underwent one- or two-stage BVT in our clinic. All patients who were not eligible for a native radio-cephalic or brachio-cephalic arterio-venous fistula (AVF) were scheduled for one-or two-stage BVT after arterial (brachial, radial and ulnar) and venous (basilic and cephalic) Doppler ultrasonography. Patients were retrospectively divided into two groups: group 1, basilic vein diameter > 3 mm and patients who underwent one-stage BVT; and group 2, basilic vein diameter < 3 mm and patients who underwent two-stage BVT. In group 1, the basilic vein with a single incision was anastomosed to the brachial artery, followed by superficialisation. In group 2, the basilic vein was anastomosed to the brachial artery and they underwent the superficialisation procedure one month postoperatively. Fistula maturation and postoperative complications were assessed. Results: The mean diameter of the basilic vein was statistically significantly higher in group 1 (3.46 +/- 0.2 mm) than in group 2 (2.79 +/- 0.1 mm) (p < 0.05). In terms of postoperative complications, thrombosis, haemorrhage and haematoma were significantly higher in group 1 (34, 36 and 17%, respectively) than in group 2 (23, 14 and 6%, respectively) (p < 0.05). The rate of fistula maturation was significantly lower in group 1 (66%), compared to group 2 (77%) (p < 0.05). Time to fistula maturation was significantly shorter in group 1 (mean 41 +/- 14 days), compared to group 2 (mean 64 +/- 28 days) (p < 0.05). Conclusion: Two-stage BVT was superior to one-stage BVT due to its lower rate of postoperative complications and higher fistula maturation, despite its disadvantage of late fistula use. Although the diameter of the basilic vein was larger in patients who underwent one-stage BVT, we observed that one-stage BVT was disadvantageous in terms of postoperative complications and fistula maturation.
The Efficiency and The Confidence of The Single Dose Outpatient Low Molecular Weight Heparin Treatment of Deep Vein Thrombosis
(Karger, 2010) Odabasi, Dolunay; Basel, Halil; Ekim, Hasan
Emergent Surgical Retrieval of an Embolized Septal Occluder From the Main Pulmonary Artery
(Professional Medical Publications, 2011) Ekim, Hasan; Odabasi, Dolunay; Gunes, Yilmaz; Basel, Halil
Surgical closure of ASD has been used for over 50 years and appears to be a safe and effective operation. However, over the past decade, transcatheter closure techniques have been increasingly practiced. We present a case of 51-year old woman with atrial septal defect (ASD). She presented with progressive decrease in exercise tolerance. Echocardiographic examination showed the ASD and a 26mm septal occluder device (Cardio-fix septal occluder) was successfully deployed under fluoroscopic and echocardiographic guidance. However, the patient suddenly complained of palpitation and sustained ventricular tachycardia thirty minutes after the procedure. A repeat echocardiographic examination confirmed embolization of the device into main pulmonary artery. Due to failure of capture of the device via multisnare, the patient was immediately taken to the operating room for removal of the device and surgical closure of the defect. The embolized device was grasped and retrieved from proximal pulmonary artery between index and middle fingers inserted into the main pulmonary artery via the tricuspid and pulmonary valves. The ASD was closed by running nonabsorbable polypropylene suture. Postoperative recovery was uneventful. The patient was discharged home after a total of six days of hospitalization.
Impact of Elevated Serum Estradiol/Free Testosterone Ratio on Male Varicose Veins in a Prospective Study
(Springer Wien, 2015) Ozcan, Sedat; Odabasi, Dolunay; Kurt, Tolga; Gur, Ali Kemal; Kunt, Aysegul; Balaharoglu, Yavuz; Kunt, Alper Sami
Although some studies indicate an association between increased levels of estradiol and varicose veins in women, the role of sex hormones on varicose veins have a question mark in men. We investigated estradiol-2/free testosterone (E2/fT) ratio relationship on varicosity in 100 male patients dividing them into two groups. Group A (n = 46) had varicose veins with endocrinological problems, especially infertility, whereas group B (n = 54) also had varicose veins but no endocrinological problems. Venous blood samples were drawn from both groups in the morning to detect the levels of serum estradiol (E2), androstenedione, dehydroepiandrostenedione sulphate and free testosterone (fT). Patient history, physical examination, colour duplex ultrasound of both limbs and classification of CEAP were performed in both groups. Serum E2/fT ratio was calculated in correspondence with CEAP classification. CEAP classification is the varicosity classification, and it is concerned about the clinical class (C), etiology (E), anatomical distribution (A) and underlying pathophysiology (P). E2/fT ratio was significantly higher in group A (4.18 +/- A 0.54) compared with group B (2.98 +/- A 0.36). Moreover, there is a high correlation between serum E2/fT ratio and CEAP clinical classification in group A (4) compared with group B (2). Serum E2/fT ratio is associated with varicose veins in male patients.
Isolated Tricuspid Valve Repair for Libman-Sacks Endocarditis
(Wiley-blackwell, 2014) Gur, Ali Kemal; Odabasi, Dolunay; Kunt, Ayse Gul; Kunt, Alper Sami
Cardiac involvement is a well-known complication of systemic lupus erythematosus (SLE), which can involve most cardiac components, including pericardium, conduction system, myocardium, heart valves, and coronary arteries. Libman-Sacks (verrucous) endocarditis is the characteristic cardiac valvular manifestation. Although isolated tricuspid valve involvement is quite rare, we report a patient with SLE who had tricuspid stenosis caused by Libman-Sacks endocarditis. The patient underwent successful commisurotomy and Kay annuloplasty on the tricuspid valve under cardiopulmonary bypass.
Late Thoracic Endovascular Stent Graft Repair After Complicated Acute Type B Dissection
(Baycinar Medical Publ-baycinar Tibbi Yayincilik, 2016) Ozcan, Sedat; Kunt, Aysegul; Odabasi, Dolunay
Thoracic endovascular stent repair is a life-saving treatment option for patients with complicated type B aortic dissection. In this article, we present a 32-yearold male case referred with ruptured acute type B aortic dissection after injury. Thoracic endovascular stent graft repair was successfully performed 72 hours following the onset of complicated acute type B aortic dissection.
Management of Cardiac Tamponade: a Comperative Study Between Echo-Guided Pericardiocentesis and Surgery-A Report of 100 Patients
(Hindawi Ltd, 2011) Gumrukcuoglu, Hasan Ali; Odabasi, Dolunay; Akdag, Serkan; Ekim, Hasan
Background. Cardiac tamponade (CT) represents a life-threatening condition, and the optimal method of draining accumulated pericardial fluid remains controversial. We have reviewed 100 patients with CT at our institution over a five-year period and compared the results of echo-guided pericardiocentesis, primary surgical treatment, and surgical treatment following pericardiocentesis with regard to functional outcomes. Methods. The study group consisted of 100 patients with CT attending Yuzuncu Yil University from January 2005 to January 2010 who underwent one of the 3 treatment options (echo-guided pericardiocentesis, primary surgical treatment, and surgical treatment following pericardiocentesis). CT was defined by clinical and echocardiographic criteria. Data on medical history, characteristics of the pericardial fluid, treatment strategy, and followup data were collected. Results. Echo-guided pericardiocentesis was performed in 38 (38%) patients (Group A), primary surgical treatment was preformed in 36 (36%) patients (Group B), and surgical treatment following pericardiocentesis was performed in 26 (26%) patients (Group C). Idiopathic andmalignant diseases were primary cause of tamponade (28% and 28%, resp.), followed by tuberculosis (14%). Total complication rates, 30-daymortality, and totalmortality rates were highest in Group C. Recurrence of tamponade before 90 days was highest in Group A. Conclusions. According to our results, minimal invasive procedure echo-guided pericardiocentesis should be the first choice because of lower complication and mortality rates especially in idiopathic cases and in patients with hemodynamic instability. Surgical approach might be performed for traumatic cases, purulent, recurrent, or malign effusions with higher complication and mortality rates.
Management of Combined Femoral Artery and Vein Injuries
(Professional Medical Publications, 2010) Ekim, Hasan; Odabasi, Dolunay
Objectives: The aim of this study was to review our experience with combined injuries to the femoral artery and vein, and to analyze the role of venous repair. Methodology: Thirty two patients with penetrating injuries of the both femoral artery and vein underwent surgical management at our hospital from May 1999 to August 2009. Primary vascular repair was carried out whenever possible; if not possible the interposition graft was used. Results: This study group consisted of 27 males and 5 females, ranging in age from 15 to 72 years with a mean age of 28.3 years. The mechanism of injury included gunshot wounds in 18 patients and stab wounds in 14 patients. Primary arterial repair was performed in 17 patients. Autogenous saphenous vein graft was used in nine patients and vein patch in two patients. Polytetraflouroethylene (PTFE) graft was used in four patients. All patients had associated venous injuries of which 24 patients had primary venous repair, five had vein graft interposition, and two had PTFE graft interposition. Seven patients had fasciotomies. Graft thrombosis occurred in three arterial repairs. Above-knee amputation was required in two patients with femur fracture. Conclusion: Patients with combined femoral artery and vein injuries can be managed successfully with clinical assessment alone. In these dual vascular injuries, both the femoral artery and vein injuries should be repaired to avoid complications. If venous ligation becomes compulsory, adjuvant therapies and techniques should be recommended such as the use of fasciotomy, anticoagulation treatment, elevation of the lower limb and compression stockings.
Management of Giant Venous Aneurysms Secondary To Arteriovenous Fistula in Hemodialysis Patients
(Professional Medical Publications, 2011) Ekim, Hasan; Odabasi, Dolunay; Basel, Halil; Aydin, Cemalettin
Objective: An aneurysmal fistula can continue to provide hemodialysis access for along time, but giant aneurysms should be operated on to prevent complication. The purpose of this study was to describe our experience of the surgical management of giant venous aneurysms that have developed as a complication of dialysis access. Methodology: Twenty patients with giant venous aneurysms of the AVF underwent surgical procedures at our hospital from December 2003 to December 2010. The diagnoses were made by physical examination and Color Doppler Ultrasonography. Results: There were 12 male and 8 female patients ranging in age from 29 to 68 years with a mean age of 44.6 +/- 12.3 years. Plication of the aneurysmal dilatations was performed in 17 patients. In two patients, aneurysmal dilatations were excised with restoration of the artery. The remaining one patient who received a successful renal transplantation was also associated with brachial artery aneurysm. Venous aneurysmal dilatations were excised and arterial aneurysms were repaired. All patients experienced a marked decrease in the size of venous dilatations. There were no vascular complications during the follow-up period. Conclusion: We suggest that plication is safe and effective in controlling venous dilatation and achieving patency. Reinforcing the suture line using an external mesh may not be required. However, prospective randomized studies will be required to assess the long-term outcomes.
Management of Popliteal Artery Injuries
(Karger, 2010) Basel, Halil; Odabasi, Dolunay
Management of Traumatic Popliteal Vein Injuries
(Elsevier Sci Ltd, 2012) Ekim, Hasan; Basel, Halil; Odabasi, Dolunay
Purpose: The aim of this study was to evaluate different repair methods of popliteal vein injuries, and to assess the relationship between early patency and surgical outcome. Methods: Thirty patients with popliteal vein injuries underwent surgical repair procedure at our hospital from March 2000 to April 2010. Patients who were haemodynamically unstable and those with massive bleeding from limb wounds were taken directly to the operating room. Stable patients underwent preoperative colour-flow duplex ultrasonography (CFDU). Results: Our study group consisted of 26 males and 4 females, ranging in age from 17 to 60 years with a mean age of 25.3 +/- 5.9 years. The mechanism of trauma was penetrating in 27 patients and blunt in the remaining 3 patients. Treatment included primary venous repair in 11 cases, end-to-end anastomosis in 8, interposition vein graft in 10, and interposition polytetrafluoroethylene (PTFE) graft in 1. There were 26 patients with associated arterial injury, of which 4 cases had primary repair, 9 had end-to-end anastomosis, 11 had saphenous vein graft interposition, and 2 had PTFE graft interposition. Associated bone fracture was seen in 6 patients. There were no deaths. One patient required a below-knee amputation. Postoperative CFDU revealed thrombosed venous repair in 7 cases without any sequelae. Conclusion: Popliteal venous injuries can be repaired with minimal downside and a good early patency rate. Additionally, transient venous patency allows for establishment of venous and lymphatic collateralisation. Alternatively, venous ligation should be considered only in unstable patients who refuse blood transfusion (Jehovah's witnesses). In these victims, adjuvant management may be required such as the use of fasciotomy and anticoagulation treatment. (C) 2011 Elsevier Ltd. All rights reserved.
Our Experiences in the Surgical Treatment of Venous Aneurysms Appearing as Secondary To the Upper Extremity Arteriovenous Fistula on Patients With Chronic Renal Failure
(Carbone Editore, 2014) Ozcan, Sedat; Odabasi, Dolunay; Kutay, Veysel
Background: Aneurysmal arterio venous fistulas used for hemodialyses for longer periods of time, but giant arteriovenous fistula aneurysms should be treated surgically to avoid the complications. In this report, we aimed to present our experiences in the surgical treatment of giant venous aneurysmal that is an important complication of arteriovenous fistulas, forming for the purpose of hemodialysis in the upper extremity. Material and methods: In 16 patients with chronic renal failure and developing giant venous aneurysm after arterio venous fistula, surgical intervention was planned. The diagnosis was confirmed by a detailed physical examination and arterial-venous color doppler ultrasonography Results: In our study, 10 male and 6 female patients were included. The average age of patients was 41.6 +/- 11.4 (26-58). Plication process for aneurysmal dilatation was performed in 12 patients. Aneurysmal segment was resected in 3 patients for arterial repair process. Venous aneurysmal dilatations were resected, arterial aneurysms were repaired surgically. All patients have achieved significant declines in the sizes of venous dilatation. Any vascular complications were encountered during the postoperative period. Conclusion: After our surgical experiences, we think that plication is a safe and effective method in the control of venous dilatation and ensuring openness.
Outcomes of De Vega Versus Biodegradable Ring Annuloplasty in the Surgical Treatment of Tricuspid Regurgitation (mid-Term Results)
(Forum Multimedia Publishing, Llc, 2010) Basel, Halil; Aydin, Unal; Kutlu, Hakan; Dostbil, Aysenur; Karadag, Melike; Odabasi, Dolunay; Aydin, Cemalettin
Purpose: The aim of this study was to compare De Vega semicircular annuloplasty and a new biodegradable ring annuloplasty technique in patients requiring surgical intervention for tricuspid valve disease with concomitant disease of the mitral valve. Methods: Between January 2004 and May 2008, 129 consecutive patients underwent annuloplasty procedures to correct tricuspid valve regurgitation during a concomitant mitral valve operation requiring replacement. Additionally, 24 patients underwent aortic valve replacement (AVR), 11 underwent coronary artery bypass grafting (CABG), 5 underwent AVR plus CABG, 3 underwent mitral valve replacement plus atrial septal defect (ASD) closure, and 2 underwent ASD closure. The patients in this study were assigned to 2 groups: Kalangos ring annuloplasty was performed in 67 patients (group 1), and De Vega semicircular annuloplasty was performed in the remaining 62 patients (group 2). Results: Both tricuspid valve repair techniques produced a low rate of complications; however, the number of patients who developed residual tricuspid regurgitation was significantly lower in group 1. Conclusion: The biodegradable ring annuloplasty technique may be used easily and safely in moderate and severe cases of tricuspid regurgitation; however, larger clinical series are necessary to confirm our promising results.
Renal Cell Carcinoma Extending Into the Inferior Caval Vein: Report of Two Cases
(Professional Medical Publications, 2010) Basel, Halil; Gecit, Ilhan; Odabasi, Dolunay; Ceylan, Kadir; Ekim, Hasan; Taken, Kerem
Renal cell carcinoma (RCC) is rare neoplasm and rarely extends to IVC. Perinephric and venous system invasion is an important prognostic sign for RCC. The tumor may grow intraluminally into the renal vein and Inferior Vena Cava (IVC) as an extension of primary tumor. In this report, we present two unusual case of venous system involvement, invasion of RCC into SVC. RCC with tumor thrombus extension into the IVC remains a difficult operative challenge. However surgical intervention should be performed. Our cases were successfully operated and their post operative recovery was uneventful.