Mean platelet volume is associated with disease severity in patients with obstructive sleep apnea syndrome

OBJECTIVE: Obstructive sleep apnea syndrome is associated with cardiovascular diseases and thromboembolic events. The mean platelet volume (MPV) is a predictor of cardiovascular thromboembolic events. The aim of the present study is to investigate the association between the MPV and disease severity in patients with obstructive sleep apnea syndrome. METHODS: We prospectively included 194 obstructive sleep apnea syndrome patients without cardiovascular disease (mean age 56.5±12.5 years) who were undergoing sleep tests. An overnight full laboratory polisomnography examination was conducted on each patient. The patients were divided into 3 groups according to the apnea-hypopnea index (AHI): (1) AHIlow group: 5≤AH

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entitled “The relationship between visible thrombus aspiration material with no-reflow and in-hospital mortality ratio in patients with anterior ST-elevation myocardial infarction treated with primary percutaneous coronary intervention,” published in the Archives of the Turkish Society of Cardiology.[1] As we noted in the discussion section, “the lower in-hospital mortality of patients with VTA [visible thrombus aspiration] in our study may also be associated with a shorter door-to-balloon time, lower Killip class, and better TIMI [Thrombolysis in Myocardial Infarction] flow after TA [thrombus aspiration].” Delayed door-balloon time can be a reason for a higher Killip classification in patients without VTA, and these decompensated patients, naturally, cannot undergo revascularization during ST elevation myocardial infarction

Anterior miyokart enfarktüsü nedeniyle primer perkütan koroner girişim uygulanan hastalarda trombüs aspirasyonu ile görülebilir aspirat gelmesinin no reflow ve hastane içi mortalite ile ilişkisi

Objective: The benefit of intracoronary thrombus aspiration (TA) during primary percutaneous coronary intervention (pPCI) in patients with ST-segment elevation myocardial infarction (STEMI) is not yet fully clear. The aim of this study was to investigate the clinical impact of visible thrombus aspiration (VTA) material. Methods: A total of 295 patients with a Thrombolysis in Myocardial Infarction (TIMI) flow score of 0 or 1 after an anterior STEMI were included in the study. Manual TA devices were used before performing PCI. The patients were divided into 2 groups: (1) visible thrombus aspiration (VTA) group and (2) non-visible thrombus aspiration (non-VTA) group. No-reflow was defined as TIMI grade 0, 1, or 2 flow, or TIMI grade 3 with a myocardial blush of grade 0 or 1. The primary endpoint was the occurrence of no-reflow. Results: VTA was retrieved in 178 (60.3%) of the patients. A no-reflow determination was significantly less frequent in the VTA group (p<0.001). The ejection fraction and ST-segment resolution values were higher, and the in-hospital mortality, Killip class II-IV rating, and post-pPCI TIMI frame count were lower in the VTA group (p<0.05 for each). Conclusion: VTA predicted a lower rate of in-hospital mortality and no-reflow in patients with anterior STEMI who underwent pPCI.Objective: The benefit of intracoronary thrombus aspiration (TA) during primary percutaneous coronary intervention (pPCI) in patients with ST-segment elevation myocardial infarction (STEMI) is not yet fully clear. The aim of this study was to investigate the clinical impact of visible thrombus aspiration (VTA) material. Methods: A total of 295 patients with a Thrombolysis in Myocardial Infarction (TIMI) flow score of 0 or 1 after an anterior STEMI were included in the study. Manual TA devices were used before performing PCI. The patients were divided into 2 groups: (1) visible thrombus aspiration (VTA) group and (2) non-visible thrombus aspiration (non-VTA) group. No-reflow was defined as TIMI grade 0, 1, or 2 flow, or TIMI grade 3 with a myocardial blush of grade 0 or 1. The primary endpoint was the occurrence of no-reflow. Results: VTA was retrieved in 178 (60.3%) of the patients. A no-reflow determination was significantly less frequent in the VTA group (p<0.001). The ejection fraction and ST-segment resolution values were higher, and the in-hospital mortality, Killip class II-IV rating, and post-pPCI TIMI frame count were lower in the VTA group (p<0.05 for each). Conclusion: VTA predicted a lower rate of in-hospital mortality and no-reflow in patients with anterior STEMI who underwent pPCI.Amaç: Primer perkütan girişim (PKG) sırasında uygulanan trombüs aspirasyonun faydası hala tartışmalıdır. Biz bu çalışmada görülebilir trombüs aspiratının klinik olarak etkisini araştırmayı amaçladık. Yöntemler: Çalışmaya prospektif olarak 295 TIMI 0 veya I olan anteriyor ST segment yükselmeli miyokart enfarktüslü hasta dahil edildi. Trombüs aspirasyonu için PKG öncesinde manuel trombüs aspirasyon cihazları kullanıldı. Hastalar görülebilir aspirat elde edilenler ve görülebilir aspirat elde edilmeyenler olmak üzere iki gruba ayrıldı. No-reflow bulgusu, görülebilir aspirat elde edilen grupta anlamlı olarak düşük izlendi. Bulgular: Görülebilir trombüs aspirasyonu tüm hastaların 178’inde (%60.3) elde edildi. No reflow belirgin anlamlı olarak görülebilir trombüas aspirasyonu grubunda düşük izlendi (p<0.001). Ejeksiyon fraksiyonu, ST segment rezülosyonu anlamlı olarak görülebilir trombüs aspirasyonu sağlanan grupta yüksek bulunurken hastane içi mortalite, Killip II-IV ve PKG sonrasındaki TIMI frame count belirgin olarak görülebilir trombüs aspirasyonu elde edilmeyen gruba göre düşük izlendi (hepsi için p<0.05). Sonuç: Görülebilir trombüs aspirasyonu elde edilmesi anterior ST elevasyonlu miyokart enfarktüslü hastalarda kısa dönem klinik sonuçlar ve prognoz hakkında bilgi sağlayabilir.Amaç: Primer perkütan girişim (PKG) sırasında uygulanan trombüs aspirasyonun faydası hala tartışmalıdır. Biz bu çalışmada görülebilir trombüs aspiratının klinik olarak etkisini araştırmayı amaçladık. Yöntemler: Çalışmaya prospektif olarak 295 TIMI 0 veya I olan anteriyor ST segment yükselmeli miyokart enfarktüslü hasta dahil edildi. Trombüs aspirasyonu için PKG öncesinde manuel trombüs aspirasyon cihazları kullanıldı. Hastalar görülebilir aspirat elde edilenler ve görülebilir aspirat elde edilmeyenler olmak üzere iki gruba ayrıldı. No-reflow bulgusu, görülebilir aspirat elde edilen grupta anlamlı olarak düşük izlendi. Bulgular: Görülebilir trombüs aspirasyonu tüm hastaların 178’inde (%60.3) elde edildi. No reflow belirgin anlamlı olarak görülebilir trombüas aspirasyonu grubunda düşük izlendi (p<0.001). Ejeksiyon fraksiyonu, ST segment rezülosyonu anlamlı olarak görülebilir trombüs aspirasyonu sağlanan grupta yüksek bulunurken hastane içi mortalite, Killip II-IV ve PKG sonrasındaki TIMI frame count belirgin olarak görülebilir trombüs aspirasyonu elde edilmeyen gruba göre düşük izlendi (hepsi için p<0.05). Sonuç: Görülebilir trombüs aspirasyonu elde edilmesi anterior ST elevasyonlu miyokart enfarktüslü hastalarda kısa dönem klinik sonuçlar ve prognoz hakkında bilgi sağlayabilir

Possibility of Middle Meningeal Artery-to-Petrous Internal Carotid Artery Bypass: An Anatomic Study

The possibility of creating a middle meningeal artery (MMA)-to-petrous internal carotid artery (ICA) bypass was investigated in six cadavers (bilaterally). Such a procedure could be used to treat patients with high cervical vascular lesions and those with tumors of the infratemporal fossa invading the high cervical ICA. After a frontotemporal craniotomy, the foramen spinosum and foramen ovale were exposed extradurally. Immediately posterior to the foramen ovale and medial to the foramen spinosum, the petrous portion of the ICA was exposed with a diamond-tipped drill. The MMA was lifted from its groove, and a sufficient length was transected to perform a bypass with the petrous ICA medially. The mean width of the MMA at the site of anastomosis was 2.3 ± 0.35 mm. The mean length of MMA from the foramen spinosum to the site of the anastomosis was 9.6 ± 1.7 mm. Based on these measurements, width and length of MMA appear to be sufficient for a bypass with petrous ICA

Mean platelet volume is associated with disease severity in patients with obstructive sleep apnea syndrome

OBJECTIVE: Obstructive sleep apnea syndrome is associated with cardiovascular diseases and thromboembolic events. The mean platelet volume (MPV) is a predictor of cardiovascular thromboembolic events. The aim of the present study is to investigate the association between the MPV and disease severity in patients with obstructive sleep apnea syndrome. METHODS: We prospectively included 194 obstructive sleep apnea syndrome patients without cardiovascular disease (mean age 56.5±12.5 years) who were undergoing sleep tests. An overnight full laboratory polisomnography examination was conducted on each patient. The patients were divided into 3 groups according to the apnea-hypopnea index (AHI): (1) AHIlow group: 5≤AHI30. RESULTS: The highest MPV values were found in the AHIhigh group compared with other groups (p<0.05 for all). Multiple linear regression analysis indicated that the MPV was associated with the AHI (β=0.500, p<0.001) and the high sensitivity C-reactive protein (hs-CRP) level (β=0.194, p=0.010). CONCLUSION: The MPV is independently associated with both disease severity and inflammation in patients with obstructive sleep apnea syndrome