Ahmet Turan YILMAZ, Murat UĞUR, Veysel TEMİZKAN, Ejder KARDEŞOĞLU, Murat Fatih CAN, Alper UÇAK, İbrahim ALP, Arif SELÇUK

Periferik arter hastalıklarında endovasküler ve hibrid tedavi deneyimlerimiz

Amaç: Bu çalışmada, periferik arter hastalıklarının endovasküler ve hibrid yaklaşım ile tedavisinde edindiğimiz deneyimler sunuldu. Çalışma planı: Mart 2008 - Nisan 2016 tarihleri arasında periferik arter hastalığı nedeniyle kliniğimizde endovasküler tedavi yapılan 86 hasta ve hibrid tedavi yapılan 17 hasta retrospektif olarak incelendi. Tedavi yaklaşımları, tedavi başarıları, komplikasyonları ve prognozları değerlendirildi. Bulgular: İşlemler sırasında mortalite görülmedi. İşlem sonrası hastalar standart heparin tedavisi altında en az altı saat yoğun bakım ünitesinde kaldı. Üç gün düşük molekül ağırlıklı heparin ile antikoagülasyonu takiben ikili oral antiagregan (100 mg asetilsalisilikasit + 75 mg klopidogrel) başlandı. Kontrol Doppler ultrasonografide hastanede yatış süresince stent içi tromboz veya balon uygulanan bölgede restenoza rastlanmadı. Ameliyat öncesi böbrek fonksiyonları normal olan hastaların hiçbirinde ciddi böbrek yetmezliği gelişmedi. Femorodistal girişimlerin neredeyse tamamında antegrad yol kullanılmasına rağmen, hiçbir hastanın girişim yerinde kanama komplikasyonu görülmedi. Hastaların tümü 1 ila 16 günde taburcu edildi. Sonuç: Endovasküler ve hibrid yöntemler; periferik arter hastalıklarının tedavisinde, hibrid salonu bulunan damar cerrahları için güvenli ve konforludur.

Our experiences on endovascular and hybrid treatment of peripheral arterial diseases

Background: This study aims to present our experiences on endovascular and hybrid treatment of peripheral arterial diseases.Methods: Between March 2008 and April 2016, 86 patients who underwent endovascular treatment and 17 patients who underwent hybrid treatment for peripheral arterial disease in our clinic were retrospectively analyzed. The treatment approaches, success of treatments, complications and outcomes of these patients were studied.Results: No mortality was seen during the procedures. Following the procedure, the patients were hospitalized in the intensive care unit under standard heparin treatment for six hours at least. Anticoagulation was maintained with low-molecular-weighted heparin for three days, followed by dual oral antiaggregant (acetylsalicylic acid 100 mg + clopidogrel 75 mg). Repeated Doppler ultrasonography revealed no in-stent thrombosis or restenosis at the site of ballooning during hospitalization. None of the patients with normal renal functions preoperatively experienced severe renal failure. Although nearly all femorodistal interventions were performed in the antegrade way, none of the patients had bleeding complications at the site of intervention. All patients were discharged within 1 to 16 days.Conclusion: Endovascular and hybrid modalities are safe and comfortable in the treatment of peripheral arterial diseases for vascular surgeons having a hybrid room.

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