Browsing by Author "Akay, Tankut"

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Diagnosis and Treatment of Takayasu Arteritis in Turkey: A Single Center Results
(2015) Akay, Tankut; Harman, Ali; Yucel, Eftal; Ozyer, Umut; Gultekin, Bahadir; 0000-0002-4300-009X; 0000-0002-7386-7110; AAK-9071-2021; ABA-7388-2021; K-9824-2013
Background: This study aims to evaluate clinical, laboratory, and radiological features as well as the surgical and endovascular procedure outcomes of patients with Takayasu arteritis in our hospital. Methods: Hospital records of 38 patients who were followed with the diagnosis of Takayasu arteritis between April 2002 and January 2014 were retrospectively evaluated. Records included the clinical history of Takayasu arteritis, comorbid diseases, laboratory and angiographic findings at the time of diagnosis, and mode of treatment. Results: The female/male ratio was 3.75:1. According to angiographic classification; 11 patients were type 1, three patients were type 2a, three patients were type 2b, four patients were type 3, six patients were type 4, and 11 patients were type 5. Eighteen of 38 patients were administered endovascular or surgical intervention (8 surgeries and 10 endovascular procedures). There was no early mortality. Conclusion: Demographic and angiographic features of our patients were similar to those of Japan and Mediterranean populations. The long-term follow-up of endovascular procedure success, and the management of restenosis may be among challenges to be faced in the future. Bypass surgery remains the gold standard for achieving long-term patency. Endovascular treatment may provide short-term symptom relief in patients who are not suitable for surgical treatment.
Iloprost as an acute kidney injury-triggering agent in severely atherosclerotic patients
(2016) Uyar, Mehtap Erkmen; Yucel, Piril; Ilin, Sena; Bal, Zeynep; Yildirim, Saliha; Uyar, Ahmet Senol; Akay, Tankut; Tutal, Emre; Sezer, Siren; 27841898; AAZ-5795-2021
Background: Iloprost, a stable prostacyclin analog, is used as a rescue therapy for severe peripheral arterial disease (PAD). It has systemic vasodilatory and anti-aggregant effects, with severe vasodilatation potentially causing organ ischaemia when severe atherosclerosis is the underlying cause. In this study, we retrospectively analysed renal outcomes after iloprost infusion therapy in 86 patients. Methods: Eighty-six patients with PAD who received iloprost infusion therapy were retrospectively analysed. Clinical and biochemical parameters were recorded before (initial, Cr1), during (third day, Cr2), and after (14th day following the termination of infusion therapy, Cr3) treatment. Acute kidney injury (AKI) was defined according to KDIGO guidelines as a >= 0.3 mg/dl (26.52 mu mol/l) increase in creatinine levels from baseline within 48 hours. Results: Cr2 (1.46 +/- 0.1 mg/dl) (129.06 +/- 8.84 mu mol/l) and Cr3 (1.53 +/- 0.12 mg/dl) (135.25 +/- 10.61 mu mol/l) creatinine levels were significantly higher compared to the initial value (1.15 +/- 0.6 mg/dl) (101.66 +/- 53.04 mu mol/l). AKI was observed in 36 patients (41.86%) on the third day of iloprost infusion. Logistic regression analysis revealed smoking and not using acetylsalicylic acid as primary predictors (p = 0.02 and p = 0.008, respectively) of AKI during iloprost treatment. On the third infusion day, patients' urinary output significantly increased (1813.30 +/- 1123.46 vs 1545.17 +/- 873.00 cm(3)) and diastolic blood pressure significantly decreased (70.07 +/- 15.50 vs 74.14 +/- 9.42 mmHg) from their initial values. Conclusion: While iloprost treatment is effective in patients with PAD who are not suitable for surgery, severe systemic vasodilatation can cause renal ischaemia, resulting in non-oliguric AKI. Smoking, no acetylsalicylic acid use, and lower diastolic blood pressure are the clinical risk factors for AKI during iloprost treatment.
Management of a Patient in the State of Total Occlusion of Aorta Due to Takayasu Arteritis in Preconceptional and Pregnancy Period
(2021) Gunakan, Emre; Akay, Tankut; Esin, Sertac; 0000-0001-8854-8190; ABI-1707-2020
Objectives: Total aortic occlusion is a severe complication of Takayasu arteritis (TAK). Pregnancy follow-up in the state of total aortic occlusion due to TAK has not been reported before. Case presentation: A 35 year-old nulliparous woman with total aortic occlusion in the distal aorta due to TAK, admitted with pregnancy desire. She had developed a collateral vessel system which has maintained the lower body circulation. She was informed about the potential risks after an evaluation and she admitted to our clinic at the seventh week of pregnancy, and acetylsalicylic acid was prescribed. At 20th gestational week anomaly screening was in normal limits although the uterine artery Doppler had lower S/D, PI and RI values. She was followed-up regularly in every two weeks. Vascular examination was performed by using an ankle brachial index (ABI) by duplex ultrasound. At 20th gestational week ankle brachial index score was 0.8-0.9 which indicates mild disease. Around 28th gestational week her claudication got worse again and ABI was in moderate level (0.5-0.8) and low molecular weight heparin was started. Until 37th gestational week her disease was stable, ABI was above 0.5, her blood pressure was in normal limits, no vascular complication occurred and the baby's growth percentile was at 25th centile. At 37th gestational week a 2,640 g baby was delivered. Patient was discharged without any complications at third post-operative day. Conclusions: Complicated TAK patients may have good obstetric outcomes with a multidisciplinary approach in experienced tertiary centers.
Perioperative planning in the COVID-19 pandemic: Vascular issues
(2020) Akay, Tankut; 0000-0003-1581-5352; 32551152