Fakülteler / Faculties

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    Safety and efficacy of angio-seal use in patients with acute ischemic stroke who received thrombolytic therapy and underwent mechanical thrombectomy
    (2022) Tanburoglu, Anil; Karluka, Ismail; Mazican, Mustafa; Andic, Cagatay
    Purpose: This study aims to evaluate the efficacy and safety of closure of the femoral artery access site using the Angio-Seal Vascular Closure Device in patients who underwent bridging intravenous thrombolytic therapy and subsequent mechanical thrombectomy (MT). Materials and Methods: The retrospective, observational study was performed in patients who were diagnosed with acute ischemic stroke and treated with MT after bridging IVT between September 2018 and September 2021. A total of 97 patients whose femoral artery access sites were closed with Angio-Seal after the procedure was performed were included in the study. Primary demographic data, accompanying risk factors, major and minor complication rates, frequency distributions of categorical variables, and descriptive statistics of quantitative data were calculated and recorded. Results: It was found that 96.9% of the patients did not have major complications, where 97.9% did not have minor complications either. Successful hemostasis was achieved in the groin region in all patients. Major complications observed were recorded as follows: 1 (1%) pseudo-aneurysm, 1 (%) inguinal incision site infection, and 1 (1%) Angio-Seal placement failure. No major complications were observed in 98.2% of those using 6 Fr (French) Angio-Seal and 95.1% of those using 8 Fr Angio-Seal. Conclusion: The findings of the study indicate that Angio-Seal is an effective and safe method for providing groin hemostasis in patients with acute ischemic stroke
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    Effect of decompressive hemicraniectomy in patients with acute middle cerebral artery infarction 2050
    (2021) Suner, Halil İbrahim; Tanburoglu, Anil; Durdag, Emre; Civi, Soner; Gunesli Yetisken, Aylin; Kardes, Ozgur; Andic, Cagatay; Tufan, Kadir; 0000-0002-5957-8611; 0000-0003-2854-941X; 0000-0001-9627-3502; 0000-0001-8581-8685; 33890450; AAJ-5381-2021; P-5895-2018; AAK-1876-2021; AAM-1671-2021
    Background/aim: We aimed to determine in which cases this procedure may be more effective based on the data of patients who underwent decompressive hemicraniectomy (DHC). Material and methods: Overall, 47 patients who underwent DHC due to acute middle cerebral artery (MCA) infarction between January 2014 and january 2019 were retrospectively investigated. These patients were divided into two groups: those who died after DHC (Group A) and those who survived DHC (Group B). The groups were compared in terms of various parameters. We investigated whether the patient's modified Rankin scale (mRS) status changed depending on age (> 60 and < 60 years). Results: The median age of all patients was 65 (37-80) years; groups A and B had median ages of 66.5 (37-80) and 61 (44-79) years (p = 0.111), respectively; 55.3% patients were male. The elapsed times until hospitalization after the onset of symptoms were 4.5 and 3 h in groups A and B, respectively (p = 0.014). The median GCS score at the time of admission was 7 (5-12) and 10 (8-14) in groups A and B, respectively (p = 0.0001). At the time of admission, 63.3% patients in group A had anisocoria, whereas no patient in group B had anisocoria (p = 0.0001). In postoperative period, 40% patients in group A and all patients in group B received AC/AA treatment. The survival of patients aged < 60 and > 60 years who underwent DHC for MCA infraction was 61.5% and 26.5%, respectively (p = 0,041). The median mRS of patients < 60 and > 60 years were 4 (1-6) and 6 (1-6), respectively (p = 0.018). Conclusion: Age, DHC timing, and elapsed time until hospitalization or access to treatment directly affect the functional outcome and survival in MCA-infarcted patients who underwent DHC. In patients in whom the medical treatment fails, early DHC administration will increase survival without waiting for neurological worsening once herniation is detected radiologically.