Aydın TUNCAY, Rifat OZMEN, Deniz ELCİK, Halis YILMAZ, Joma SULAİMAN

KAN BİYOKİMYASI VE HEMATOLOJİK PARAMETRELERİN PSÖDOANEVRİZMA GELİŞİMİNE ETKİSİ

AMAÇ: Koroner arter hastalığı halen önde gelen sağlık sorunlarından biridir. Bu durum, kalp hastalıkları için tanı ve tedavi prosedürlerinde artışa sebep olmaktadır. Bununla birlikte, bu prosedürlerle ilişkili komplikasyonlarda da artışa sebep olmaktadır. Bu komplikasyonlardan biri psödoanevrizmalardır. Bu çalışmada, kliniğimizde psödoanevrizma ameliyatı geçiren hastalarda koroner anjiyografiden önce alınan periferik tam kan sayımlarının sonuçlarına göre psödoanevrizmanın gelişimini öngörmede hematolojik ve biyokimyasal parametrelerin yararlı olup olmayacağını tartışmayı amaçladık.GEREÇ VE YÖNTEM: Ocak 2017-Aralık 2019 tarihleri arasında hastanemizde koroner arter hastalığı ön tanısı ile elektif koroner anjiyografi yapılan 7368 hastanın verileri retrospektif olarak incelendi. Çalışmamıza dahil edilme kriterlerini karşılayan 88 hastanın verileri incelendi.BULGULAR: Psödoanevrizma erkek cinsiyet(%60), sağ alt ekstremite(%76.4) ve ana femoral arterde(%71.4) daha sıktı. Grup 1 ile karşılaştırıldığında psödoanevrizma gelişen Grup 2'de işlemden önce beyaz küre sayısı (WBC) (p: 0.042) ve Nötrofil lenfosit oranı (NLR) (p: 0.029) değerleri ve kan üre azotu (BUN) (p:0.050) yüksekti, Hemoglobin (Hb) (p<0.001), hematokrit htc(p<0.001), albumin(p: 0.026) değerleri düşüktü ve istatistiksel olarak anlamlı fark vardı. Platelet Pletekrit Oranı (PPR) (p: 0.205), Platelet Nötrofil Oranı (PNR)(p: 0.205), platelet(p: 0.103), total protein(p: 0.061), kreatin (p:0.060) ve Platekrit(p: 0.151) değerleri arasında istatistiksel olarak anlamlı bir fark yoktu.SONUÇ: Periferik vasküler müdahalenin yapılacağı riskli hasta gruplarında; İşlem öncesi kan değerlerinden artmış NLR ve düşük albümin seviyeleri, psödoanevrizmanın gelişimini öngörmede bir rehber olabilir.

Anahtar Kelimeler:

Psödoanevrizma, Koroner arter hastalığı, Damar yaralanması

THE EFFECT OF BLOOD BIOCHEMISTRY AND HEMATOLOGICAL PARAMETERS ON THE DEVELOPMENT OF PSEUDOANEURYSM

OBJECTIVE: Coronary artery disease is still one of the leading health problems. This causes an increase in the diagnosis and treatment procedures for heart diseases. However, it also causes an increase in complications associated with these procedures. One of these complications is pseudoaneurysms. In this study, we aimed to discuss whether hematological and biochemical parameters can be useful in predicting the development of pseudoaneurysm according to the results of peripheral whole blood counts taken before coronary angiography in patients who underwent pseudoaneurysm surgery in our clinic.MATERIAL AND METHODS: The data of 7368 patients who underwent elective coronary angiography with a preliminary diagnosis of coronary artery disease in our hospital between January 2017 and December 2019 were retrospectively reviewed. Data of 88 patients who met the inclusion criteria in our study were examined.RESULTS: Pseudoaneurysm was more frequently located in the male gender (% 60), right lower externity (% 76.4) and the common femoral artery (%71.4). When compared to Group 1, in Group 2, which developed pseudoaneurysm, The patients in group 2 who developed pseudoaneurysm compared to group 1, white blood cell count (WBC) (p: 0.042), Neutrophil to Lymphocite Ratio (NLR) (p: 0.029) and blood urea nitrogen (BUN) (p: 0.050) values were higher before the procedure, Hemoglobin (Hb) (p<0.001), Hematocrit (htc) (p<0.001), and albumin (p: 0.026) values were lower and there was a statistically significant difference. There was no statistically significant difference between Platelet to Platecrite Ratio (PPR) (p: 0.205), Platelet to Neutrophil Ratio (PNR) (p: 0.205), platelet (p: 0.103), total protein (p: 0.061), creatine (p:0.060) and Platecrit (p: 0.151) values.

Keywords:

Pseudoaneurysm, Coronary artery disease, Vascular injury,

PDF

___

Referans1.Akay Hk, Korun O, Aslım E ve ark. Kateterizasyon Sonrası Gelişen İyatrojenik Femoral Arter Psödoanevrizma Tedavisi Deneyimlerimiz.(Clinical Experience in Postangiographic Iatrojenic Femoral Pseudoaneurysm Manangemnet). Damar Cerrahisi Dergisi 2012;21(2):120-3
Referans2Yasim A, Eroğlu E. Periferik psödoanevrizmaların tedavisinde endovasküler stent greft uygulamaları: Bir kalp ve damar cerrahisi merkezinin altı yıllık sonuçları (Endovascular stent graft implantation for treatment of peripheral pseudoaneurysms: Six-year results of a cardiovascular surgery center). Damar Cerrahi Dergisi 2017;26(2):45-49
Reeferans3.Yoo T, Starr JE, Go MR, et al. Ultrasound-Guided Thrombin Injection Is a Safe and Effective Treatment for Femoral Artery Pseudoaneurysm in the Morbidly Obese. Vasc Endovascular Surg 2017;51:368-372.
Referans4.Kazaz H, Celkan MA, Üstünsoy H ve ark. Periferik arter pseudoanevrizmalarının etiyolojik sınıflaması, klinik ve cerrahi yaklaşım: 104 olguluk klinik deneyimimiz. Turkish J Vasc Surg 2006; 15: 17-20.
Referans5.Ahmad F, Turner SA, Torrie P, et al.. Iatrogenic femoral artery pseudoaneurysms--a review of current methods of diagnosis and treatment. Clin Radiol 2008;63:1310-6.
Referans 6.Stone PA, Martinez M, Thompson SN, et al. Ten-year experience of vascular surgeon management of iatrogenic pseudoaneurysms: Do anticoagulant and/or antiplatelet medications matter? Ann Vasc Surg 2016;30:45-51.
Referans7.Biswas S, McNerney P, Kiproff P. Pseudoaneurysm of the Profunda Femoris Artery following Blunt Trauma Treated by Endovascular Coil Embolization: Review of Two Cases and Relevant Literature. Case Rep Emerg Med 2017;2017:8079674.
Referans8.Luther A, Kumar A, Negi KN. Peripheral Arterial Pseudoaneurysms-a 10-Year Clinical Study. Indian J Surg 2015;77:603-7. Referans 9. Stone PA, Campbell JE, AbuRahma AF. Femoral pseudoaneurysms after percutaneous access. J Vasc Surg 2014;60:1359-66.
Referans10. Kaczynski J, Beveridge E, Holdsworth RJ. Iatrogenic pseudoaneurysm of the peroneal artery:Case report. BMJ Case Rep 2016. doi:10.1136/bcr-2016-215836.
Referans11. Sbarouni E, Georgiadou P, Kosmas E, et al. Platelet to lymphocyte ratio in acute aortic dissection. J Clin Lab Anal. 2018;32:e22447.
Referans12. Velioğlu Y, Yüksel. Utility of platelet-to-lymphocyte ratio to support the diagnosis of acute deep vein thrombosis. Turkish Journal of Thoracic and Cardiovascular Surgery 2019;27(4):493-498
Referans13. Sargın M, Mete MT, Erdoğan SB, et al. Neutrophil-to-lymphocyte ratio for early renal failure under extracorporeal membrane oxygenation support for postcardiotomy shock. Turkish Journal of Thoracic and Cardiovascular Surgery 2019;27(3):314-319.
Referans14. Cay N, Unal O, Kartal MG, et al. Increased level of red blood cell distribution width is associated with deep venous thrombosis. Blood Coagul Fibrinolysis 2013;24:727-31.
Referans15. Gulcan M, Varol E, Etli M, et al. Mean platelet volume is increased in patients with deep vein thrombosis. Clin Appl Thromb Hemost 2012;18:427-30.
Referans16. Cil H, Yavuz C, Islamoglu Y, et al. Platelet count and mean platelet volume inpatients with in-hospital deep venous thrombosis. Clin Appl Thromb Hemost 2012;18:650-3.
Referans17. Kordzadeh A, Malietzis G, Browne T, et.al. Neutrophil to lymphocyte ratio (NLR) of five predicts 30-day morbidity in ruptured abdominal aortic aneurysms (rAAA): A retrospective cohort study. International Journal of Surgery 15 (2015) 45-48
Referans18.Morello F, Cavalot G, Giachino F, et al. White blood cell and platelet count as adjuncts to standard clinical evaluation for risk assessment in patients at low probability of acute aortic syndrome. Eur Heart J Cardiovasc Care. 2017;6:389‐395.
Referans19. Stoppe C, Goetzenich A, Whitman G, et al. Role of nutrition support in adult cardiac surgery: a consensus statement from an International Multidisciplinary Expert Group on Nutrition in Cardiac Surgery. Critical Care (2017) 21:131.
Referans20. Chermesh I, Hajos J, Mashiach T, et al. Malnutrition in cardiac surgery: food for thought. Eur J Prev Cardiol. 2014;21:475–83.
Referans21. Sanchez JA, Sanchez LL, Dudrick SJ. Nutritional considerations in adult cardiothoracic surgical patients. Surg Clin North Am. 2011;91:857–75. İx
Referans22. Lomivorotov VV, Efremov SM, Boboshko VA, et al. Evaluation of nutritional screening tools for patients scheduled for cardiac surgery. Nutrition. 2013;29:436–42.
Referans23. Lomivorotov VV, Efremov SM, Boboshko VA, et al. Prognostic value of nutritional screening tools for patients scheduled for cardiac surgery. Interact Cardiovasc Thorac Surg. 2013;16:612–8.