PubMed İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4810
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Item Carotid artery stenosis in asymptomatic patients undergoing coronary artery bypass grafting: who and when should be screened?(2021) Ozyalcin, Sertan; Diken, Adem Ilkay; Yalcinkaya, Adnan; Turkmen, Ufuk; 0000-0002-8782-7603; 33078919; ABE-8722-2020BACKGROUND Carotid artery stenosis (CAS) is one of the major causes of stroke in coronary artery bypass grafting (CABG). AIMS The aim of this study was to determine which age groups require screening for CAS using carotid duplex ultrasound in asymptomatic patients undergoing CABG. METHODS We included 644 neurologically asymptomatic consecutive patients (mean [SD] age, 63.9 [8.8] years; men, 453 [70.3%]) who underwent elective isolated CABG between June 2015 and June 2020. Clinical, demographic, and radiological data as well as coronary angiography results were retrospectively reviewed. Patients were classified into 4 age groups: 40 to 50, 51 to 60, 61 to 70, and >70 years, as well as 3 groups depending on the CAS degree: 50% or less, 50% to 70%, and 70% or greater. Regression analysis was applied across the selected parameters to identify risk factors for significant CAS, and receiver operating characteristic analysis, to determine cutoff age and SYNTAX score of patients who had to be screened before CABG. RESULTS Overall, 8 (1.1%) patients included in the present study had stroke following CABG. Cutoff values of the SYNTAX score and CAS of 70% or greater were found to be 27 and 64 years, respectively. The sensitivity and specificity of the cutoff value were 98.4% to 98.3% and 74.3% to 55.1%, respectively. The area under the curve was 0.98 and 0.73, respectively. CONCLUSIONS Based on the receiver operating characteristic analysis, we recommended to perform screening for CAS in patients older than 64 years and with a SYNTAX score of 27 or higher, even if they are asymptomatic.Item Structural Analysis of the Retina and Choroid before and after Carotid Artery Surgery(2019) Bayar, Sezin Akca; Ozturker, Zeynep Kayaarasi; Pinarci, Eylem Yaman; Ercan, Zeynep Eylul; Akay, Hakki Tankut; Yilmaz, Gursel; 0000-0002-9915-3781; 31507205; AAQ-3136-2020Purpose: To evaluate retinal and choroidal changes in patients with internal carotid artery stenosis who had undergone carotid artery stenting or endarterectomy. Methods: The study included 43 patients with internal carotid artery (ICA) stenosis that required stenting or endarterectomy and 40 healthy controls. Patients were divided into two groups according to the degree of stenosis evaluated by magnetic resonance angiography. Group 1 consisted of patients having ICA stenosis of 50 to 70%, and Group 2 has more than 70%. Enhanced depth imaging optical coherence tomography (EDI-OCT) was used to measure the retinal thickness (RT) and choroidal thickness (CT) in all subjects before surgery and at 1, 3, and 6 months after surgery. Results: Subfoveal and parafoveal CT were significantly lower in patients with ICA stenosis than the control group (p < .05, respectively). Patients with 50-70% stenosis had a significant increase in the CT at 1, 3, and 6 months after ICA stenting or endarterectomy (p < .05). Patients with >%70 stenosis did not have a significant increase in the CT at any time after ICA stenting or endarterectomy. Retinal thickness was not statistically different between the patients with ICA stenosis and the control subjects, and RT showed no significant change in patients with ICA stenosis before and after the surgery. Conclusion: Choroidal thickness was significantly thinner in patients with internal carotid artery stenosis. ICA stenting provided a recovery in the choroidal thickness in patients with moderate to advanced stenosis.