Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

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2014 - 20183

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Author: search.filters.author.Yabanoglu, HakanSubject: search.filters.subject.Hemodialysis

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    Management of Symptomatic Arterial and Venous Aneurysms in Hemodialysis Patients Related To Arteriovenous Fistulas
    (2018) Avci, Tevfik; Yabanoglu, Hakan; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0001-5225-959X; https://orcid.org/0000-0002-1161-3369; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-3462-7632; AAF-1698-2021; AAJ-7865-2021; AAE-1041-2021; AAJ-8097-2021
    AIM: Our aim in this study is to present the management of the symptomatic aneurysms that are related to AVF. MATERIAL AND METHODS: Between January 2011 and January 2017, 50 patients who were operated due to symptomatic AVF aneurysms were evaluated. Forty-four (88%) patients' fistulas were closed for symptomatic venous aneurysm. In 6 (12%) patients true brachial artery aneurysm were present and a segmental artery resection with its repair was performed. RESULTS: The most common symptomatic aneurysm was seen on the brachiocephalic fistula (n=32, 64%). The symptoms of the patients were; aneurysm thrombosis (n=15, 30%), steal syndrome (n=9, 18%), rupture/massive bleeding (n=7, 14%), infection (n=7, 14%), skin necrosis (n=5, 10%), venous hypertension (n=4, 8%) and high output cardiac failure (n=1, 2%). Nine (18%) patients had two or more symptoms. While the mean duration of dialysis of patients who underwent venous aneurysmectomy was 69 +/- 4.2 years, patients who underwent arterial aneurysmectomy and brachial artery repair was 11.7 +/- 3.6 years (p = 0.012). DISCUSSION: Arterial aneurysm is a rare complication of vascular access. Although it causes serious symptoms including those of related such as thrombosis, ischemia, nerve compression, the most important complication is aneurysm rupture. Therefore, preoperative evaluation and appropriate surgical interventions will prevent morbidities that may arise. CONCLUSION: The choice of a treatment modality in patients with a symptomatic arteriovenous fistula aneurysms is to maintain the continuity of the arteriovenous fistula but when acute bleeding occurs in an unstable patient, ligation of fistula should be considered.
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    Surgical Interventions for Late Complications of Arteriovenous Fistulas
    (2014) Belli, Sedat; Yabanoglu, Hakan; Aydogan, Cem; Parlakgumus, Alper; Yildirim, Sedat; Haberal, Mehmet; 25058786
    Our aim was to determine the most effective surgical treatment for arteriovenous fistula (AVF) complications after all other methods of salvage have failed. We evaluated 110 patients for 139 complications that occurred after the initial AVF placement and for whom surgical intervention was the last hope for retaining fistula access. Vascular steal syndrome and venous hypertension were the most common complications seen in our patients. The anastomoses of 17 of the vascular steal syndrome cases were narrowed either by stitches or by a polytetrafluoroethylene graft. The second most performed revision surgery was excision of the aneurysm and repair with primary suturing, followed by excision of the aneurysm and interposition grafting. Successful surgical outcomes were achieved in 111 of 139 procedures after revision surgery without constructing a new AVF. AVF salvage surgery is of paramount importance in order to increase the patency rate, which prolongs survival and increases the patient's quality of life.
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    Impact of surgeon factor on radiocephalic fistula patency rates
    (2016) Arer, Ilker Murat; Yabanoglu, Hakan; 26900457
    Introduction: Hemodialysis with arteriovenous fistula (AVF) has been widely accepted treatment modality for patients with chronic renal failure (CRF). Radiocephalic fistulas are considered to be the most desirable for the initial vascular access. The aim of this study is to investigate the surgeon factor on radiocephalic fistula patency rates. Methods: A total of 186 patients with diagnosis of CRF underwent Radiocephalic fistula for hemodialysis access were included. Patients were divided into 2 groups according to operating surgeon. Patients were evaluated according to demographic characteristics, secondary patency rates, second AVF creation and complications. Results: Mean age was 57.7 +/- 14.8 years. The most common etiology of CRF was idiopathic (66.6%). 40 (75.5%) patients in group 1 and 122 (91.7%) patients in group 2 were pre-dialysis patients (p < 0.05). Overall secondary patency rate was 77.4%. Patients in group 1 and group 2 have secondary patency rates of 83% and 75.2%, respectively (p = 0.458). Second AVF creation was done in 2 (3.8%) patients in group 1 and 23 (17.3%) patients in group 2 (p < 0.05). Postoperative complication rate was 9.6%. Conclusion: Operating surgeon is not a major factor of secondary patency in radiocephalic arteriovenous fistulas. (C) 2015 The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Limited.