Cytomorphological Effects of Lightweight and Heavyweight Polypropylene Mesh on the Ilioinguinal Nerve: An Experimental Study

This study aimed to investigate the cytomorphological effects of heavyweight and lightweight mesh on the ilioinguinal nerve in an experimental animal model.Methods Sixteen New Zealand male rabbits were included in the study. The left inguinal regions of the first six animals were assigned as controls and the right inguinal regions were assigned as the sham group. The left inguinal regions of the remaining 10 animals were assigned as the lightweight mesh group and the right inguinal regions were assigned as the heavyweight mesh group. No intervention was performed in the control group. In the sham group, only ilioinguinal nerve exploration was performed. In mesh groups, ilioinguinal nerve exploration was performed and the mesh was implanted on the ilioinguinal nerve. After three months, ilioinguinal nerve specimens were excised from both sides for cytomorphological examination.Results Myelin sheath thickening, separation of the myelin layers, and myelin vacuolization were more pronounced in the heavyweight mesh group compared to the lightweight mesh group. The G-ratio was moderately increased in the heavyweight mesh group when compared to other groups. The ratio of fibers with = 9 mu m diameter was higher in the heavyweight mesh group than in the other groups (p<0.05).Conclusion Both of the meshes induce cytomorphological alterations on the adjacent nerve tissues caused by foreign body reaction and compression. Ilioinguinal nerve degeneration was more pronounced in the heavyweight mesh than in the lightweight mesh. Histological alterations on the ilioinguinal nerves caused by different meshes may be related to chronic pain after hernia surgery. We believe our study will serve as a guide for future studies on the topic

Evaluation of endovascular treatment of chronic limb-threatening ischemia for patients in the PLAN gray zone

Objective To compare the results of endovascular therapy for chronic limb-threatening ischemia (CLTI) in patients categorized under the gray and yellow zones of the patient risk, limb severity, and anatomic pattern (PLAN) concept over a 2-year follow-up period. Methods Patients who underwent endovascular therapy for peripheral artery disease and presented with CLTI from February 2017 to February 2019 were retrospectively reviewed. The patients were grouped into yellow and gray zones based on the PLAN concept. Preoperative and postoperative walking distances, Rutherford classes, and postoperative target vessel patency rates were recorded and compared between the groups. Follow-up evaluations were performed at 1, 6, 12, and 24 months post-procedure. Results Of the 387 patients evaluated, the yellow and gray groups comprised 88 patients each. The overall patency rates were similar between the groups (84 (95.45%) vs. 81 (92.05%), respectively). The occlusion-/stenosis-free survival times, amputation-free survival time, and mean survival time were not significantly different. However, the gray group had a significantly higher number of atherectomy interventions (74 vs. 59) and crosser devices used (62 vs. 42). Conclusion Endovascular therapy is an effective treatment option for patients in the gray zone of the PLAN color coding system

sj-pdf-2-imr-10.1177_03000605231211768 - Supplemental material for Evaluation of endovascular treatment of chronic limb-threatening ischemia for patients in the PLAN gray zone

Supplemental material, sj-pdf-2-imr-10.1177_03000605231211768 for Evaluation of endovascular treatment of chronic limb-threatening ischemia for patients in the PLAN gray zone by Ali Baran Budak, Levent Altınay, Orhan Eren Günertem, Muhammet Sefa Sağlam, Emre Külahçıoğlu, Naim Boran Tümer, Betül Keskinkılıç Yağız, Serdar Gökay Terzioğlu, Tonguç Saba, Kanat Özışık and Serdar Günaydın in Journal of International Medical Research</p

sj-pdf-1-imr-10.1177_03000605231211768 - Supplemental material for Evaluation of endovascular treatment of chronic limb-threatening ischemia for patients in the PLAN gray zone

Supplemental material, sj-pdf-1-imr-10.1177_03000605231211768 for Evaluation of endovascular treatment of chronic limb-threatening ischemia for patients in the PLAN gray zone by Ali Baran Budak, Levent Altınay, Orhan Eren Günertem, Muhammet Sefa Sağlam, Emre Külahçıoğlu, Naim Boran Tümer, Betül Keskinkılıç Yağız, Serdar Gökay Terzioğlu, Tonguç Saba, Kanat Özışık and Serdar Günaydın in Journal of International Medical Research</p