Spontaneous left iliac vein rupture — case report

Spontaneous iliac vein rupture is an uncommon cause of retroperitoneal haematoma. Most common concomitant pathology reported was deep vein thrombosis or thrombophlebitis and followed by May-Thurner Syndrome. In this particular case, we observed findings parallel to literature. A 61-year-old female patient complaining of abdominal and back pain was admitted to the emergency room. She was a smoker and except that medical history revealed only chronic obstructive pulmonary disease. Also, she had no history of trauma. She suffered from sudden left abdominal and back pain without evident cause. On arrival, her vitals were normal. An abdominopelvic computed tomography (CT) showed large haematoma in the lower abdominal cavity. Retroperitoneal exploration revealed large haematoma and left external iliac vein rupture. The vein was repaired primarily. Postoperative follow-up visit at one month after surgery showed that the patient was doing well. Iliac vein rupture should be taken into account in middle-aged or elderly women with acute onset abdominal pain and acute DVT

Chronic leg swelling and palpitation as a late complication of post-traumatic arteriovenous fistula: A case report

Introduction: Chronic post-traumatic arteriovenous fistula (AVF) is a late complication of vascular injury and can be presented with symptoms of congestive heart failure, venous hypertension and distal ischaemia. We present an unusual case of chronic leg swelling in adult caused by post-traumatic AVF. Case presentation: A 52 year old white-male patient complained of palpitation, pain and swollen right leg. Arterial pulses distally from the groin were present. His medical history revealed him to have sustained gunshot injury of the left thigh 5 years before. Angiography showed a large AVF between superficial femoral artery and femoral vein. The patient underwent surgical repair of AVF with ligation of AVF between superficial femoral artery under spinal anaesthesia. Completion angiography confirmed AVF exclusion. Leg swelling healed within a month. Conclusion: Post-traumatic fistula should be obliterated as soon as possible. Untreated fistula results in complications including renin-mediated hypertension and high-output heart failure, venous and/or arterial insufficiency. Keywords: Cardiovascular disease, Trauma, Arteriovenous fistula, Lower extremit

Validation of German Aortic Valve Score in a Multi-Surgeon Single Center

WOS: 000408048400005PubMed: 28492787Objective: Risk assessment for operative mortality is mandatory for all cardiac operations. For some operation types such as aortic valve repair, EuroSCORE II overestimates the mortality rate and a new scoring system (German AV score) has been developed for a more accurate assessment of operative risk. In this study, we aimed to validate German Aortic Valve Score in our clinic in patients undergoing isolated aortic valve replacement. Methods: A total of 35 patients who underwent isolated open aortic valve replacement between 2010 and 2013 were included. Patients with concomitant procedures and transcatheter aortic valve implantation were excluded. Patients' data were collected and analyzed retrospectively. Patients' risk scores EuroSCORE II were calculated online according to criteria described by EuroSCORE taskforce, Aortic Valve Scores were also calculated. Results: The mean age of patients was 61.14 +/- 13.25 years (range 29-80 years). The number of female patients was 14 (40%) and body mass index of 25 (71.43%) patients was in range of 22-35. Mean German Aortic Valve Score was 1.05 +/- 0.96 (min: 0 max: 4.98) and mean EuroSCORE was 2.30 +/- 2.60 (min: 0.62, max: 2.30). The Aortic Valve Score scale showed better discriminative capacity (AUC 0.647, 95% CI 0.439-0.854). The goodness of fit was x(2)HL[Aortic Valve Score]= 16.63; P= 0.436). EuroSCORE II scale had shown less discriminative capacity (AUC 0.397, 95% CI 0.200-0.597). The goodness of fit was good for both scales. The goodness of fit was x(2)HL[EuroSCORE II]= 30.10; P= 0.610. Conclusion: In conclusion, German AV score applies to our population with high predictive accuracy and goodness of fit

Validation of German Aortic Valve Score in a Multi-Surgeon Single Center

Abstract OBJECTIVE: Risk assessment for operative mortality is mandatory for all cardiac operations. For some operation types such as aortic valve repair, EuroSCORE II overestimates the mortality rate and a new scoring system (German AV score) has been developed for a more accurate assessment of operative risk. In this study, we aimed to validate German Aortic Valve Score in our clinic in patients undergoing isolated aortic valve replacement. METHODS: A total of 35 patients who underwent isolated open aortic valve replacement between 2010 and 2013 were included. Patients with concomitant procedures and transcatheter aortic valve implantation were excluded. Patients' data were collected and analyzed retrospectively. Patients' risk scores EuroSCORE II were calculated online according to criteria described by EuroSCORE taskforce, Aortic Valve Scores were also calculated. RESULTS: The mean age of patients was 61.14±13.25 years (range 29-80 years). The number of female patients was 14 (40%) and body mass index of 25 (71.43%) patients was in range of 22-35. Mean German Aortic Valve Score was 1.05±0.96 (min: 0 max: 4.98) and mean EuroSCORE was 2.30±2.60 (min: 0.62, max: 2.30). The Aortic Valve Score scale showed better discriminative capacity (AUC 0.647, 95% CI 0.439-0.854). The goodness of fit was x2HL=16.63; P=0.436). EuroSCORE II scale had shown less discriminative capacity (AUC 0.397, 95% CI 0.200-0.597). The goodness of fit was good for both scales. The goodness of fit was x2HL=30.10; P=0.610. CONCLUSION: In conclusion, German AV score applies to our population with high predictive accuracy and goodness of fit

Radiobasilic Versus Brachiobasilic Transposition on the Upper Arm to Avoid Steal Syndrome

WOS: 000367377600002PubMed: 26713498Background: Although the proximal radial artery has been reported as an alternative inflow to prevent steal syndrome, brachiobasilic fistula has been reported to be associated with steal syndrome in 10-20% of cases. We aimed to compare proximal radiobasilic arteriovenous fistula (AVF) with brachiobasilic AVFs on the upper arm in terms of steal syndrome and outcomes. Material/Method: We used our institutional operative record database to identify 94 patients in whom brachiobasilic AVF (n=40) and radiobasilic AVF (n=54) were placed between January 2009 and December 2013. Postoperative complications such as steal syndrome, venous hypertension, and aneurysm were recorded. Results: Steal syndrome was determined to occur less frequently in the radiobasilic AVF group (0% vs. 10%, P=0.03). The rates of other complications (bleeding, aneurysm, venous hypertension) between the 2 groups were similar, as were the patency rates. Conclusions: Radiobasilic AVF was effective in reducing steal syndrome, with similar early and late outcomes

Ekstrakranial karotis arter hastalığına uygulanan endarterektomi kısa dönem sonuçları

Uǧur, Oǧuz ( Aksaray, Yazar )Aim: Recently published papers regarding the treatment of carotid artery stenosis are in contradiction with previous trials. Some experts have argued that this evidence supports a conservative approach to carotid revascularization (carotid endarterectomy or carotid stenting) in asymptomatic patients. The objective of this study is to evaluate outcomes of carotid endarterectomy based on preoperative symptom status. Material and Methods: This retrospective study included patients underwent carotid endarterectomy to internal carotid artery between August 2008 and August 2015. Patients were divided into two groups according to preoperative symptoms. Asymptomatic group consisted of 41 patients with no preoperative neurological symptoms, and symptomatic group of 62 patients with preoperative neurological symptoms (vertigo, amaurosis fugax, transient ischemic attack and ischemic stroke). Postoperatively, all patients received standard therapy in line with the recommendation of the guidelines. Results: One hundred and three patients were enrolled in this study. The mean age of patients was 68.20±9.79 (range, 41-86) years, and 27 (26.2%) of them were female. There were no statistically significant difference in terms of demographic characteristics between the groups except risk groups; asymptomatic group had more high risk grouped patients (p=0.001). Asymptomatic group was associated with statistically significantly more postoperative mortality compared with symptomatic group (p=0.028). None of the preoperative variables were related to postoperative stroke. In symptomatic group, postoperative stroke was seen in the patients who had preoperative transient ischemic attack and major stroke. Conclusion: Time of surgical treatment in asymptomatic carotid artery disease should be planned according to patients’ cardiac risk factors.Amaç: Yakın zamanda yayınlanan karotis arter darlığı tedavisindeki çalışmalar eski sonuçlarla çelişmektedir. Bazı uzmanlar, bu bulguların asemptomatik hastalarda karotis revaskülarizasyona (karotis endarterektomi veya karotis stentleme) konservatif yaklaşımı desteklediğini ifade etmektedir. Bu çalışmanın amacı karotis endarterektomi sonuçlarının preoperatif semptom durumuna dayalı olarak incelenmesidir. Gereç ve Yöntemler: Bu retrospektif çalışmaya Ağustos 2008 ve Ağustos 2015 tarihleri arasında internal karotis arter darlığına karotis endarterektomi uygulanan hastalar dahil edilmiştir. Hastalar preoperative semptomlarına göre iki gruba ayrıldı. Asemptomatik grup preoperatif nörolojik semptomu bulunmayan 41 hasta içermekte ve semptomatik grup preoperatif nörolojik semptomu (vertigo, amorozis fugax, geçici iskemik atak ve iskemik inme) olan 62 hasta içermekte idi. Postoperatif dönemde tüm hastalara kılavuzların önerisine uygun olarak standart tedavi uygulandı. Bulgular: Bu çalışmaya 103 hasta dahil edildi. Hastaların ortalama yaşı 68,20±9,79 (aralık, 41-86) yıl ve 27 (%26,2)’si kadın idi. Gruplar arasında, risk grubu dışında demografik özellikler açısından istatiksel anlamlı farklılık yoktu; asemptomatik grupta yüksek riskli olarak gruplanan hasta daha fazlaydı (p=0,001). Asemptomatik grupta, semptomatik grup ile karşılaştırıldığında postoperatif mortalite istatistiksel olarak anlamlı şekilde daha fazla görüldü (p=0,028). Preoperatif değişkenlerinin hiç biri postoperatif inme ile ilişkili değildi. Semptomatik grupta, postoperatif inme preoperatif geçici iskemik atak ve majör inme olan hastalarda görüldü. Sonuç: Asemptomatik karotis arter hastalığında cerrahi tedavinin zamanlaması hastanın kardiak risk faktörlerine göre yapılmalıdır