Wos İndeksli Açık & Kapalı Erişimli Yayınlar
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Item Anticoagulation strategy in patients with atrial fibrillation after carotid endarterectomy(2019) Ugurlucan, Murat; Akay, Hakki Tankut; Erdinc, Ibrahim; Oztas, Didem Melis; Conkbayir, Cenk; Aslim, Erdal; Yildiz, Cenk Eray; Aydin, Kubilay; Alpagut, Ufuk; 30189792Aim: Carotid artery stenosis and atrial fibrillation are diseases of the aging patient population. Literature lacks precise anticoagulation treatment protocols for patients with atrial fibrillation following carotid endarterectomy. We present our experiences with anticoagulation strategy in this particular patient population.Patients and methods: Between June 2001-September 2017, 165 patients with chronic or paroxysmal atrial fibrillation out of 1594 cases from three different institutions whom received Coumadin and aspirin and required carotid endarterectomy were reviewed, respectively. Mean age was 63.47.9 years. Male/female ratio was 102/63. There were 67 diabetic and 138 hypertensive cases.Results: Patients are followed a mean of 64.4 +/- 16.9 months. Early mortality occurred in two patients due to intracranial bleeding and heart failure. Another patient was lost due to intracerebral hemorrhage and 16 other patients died due to various causes in the late follow-up. Three patients required exploration against bleeding.Conclusion: Combination of warfarin with an aim to keep the INR value between 2 and 3, and aspirin at a dosage of 100mg per day seemed feasible and in our modest patient cohort. Further studies including multicenter larger data are warranted in order to establish a precise anticoagulation treatment protocol for patients with atrial fibrillation after carotid endarterectomy.Item POSTOPERATIVE ANTICOAGULANT AND ANTIAGGREGANT STRATEGY FOR THE PATIENTS WITH ATRIAL FIBRILLATION FOLLOWING CAROTID ENDARTERECTOMY-SINGLE CENTER EXPERIENCE(2019) Oztas, Didem Melis; Ugurlucan, Murat; Akay, Hakki Tankut; Erdinc, Ibrahim; Aydin, Kubilay; Alpagut, UfukObjective: Literature does not contain a standard procedure about anticoagulant therapy aimed at patients with atrial fibrillation and carotid artery stenosis following carotid endarterectomy. In this paper, we present our therapy modality at these patients in our clinic. Material and Method: The study includes 424 patients and 498 carotid endarterectomy operations performed by two surgeons with the same technique between June 2010 and December 2017. Fourty-five patients had chronic or paroxysmal atrial fibrillation. Therefore, the patients were receiving Coumadin and aspirin. The median age was 63.4 +/- 7.9. There were 27 female and 18 male patients. Thirty seven patients were hypertensive and 17 patients were diabetic. Nine patients underwent bilateral carotid endarterectomy operations. Thirty three patients were symptomatic. Eleven patients had coronary artery disease and 5 patients had cardiac valvular pathologies. Results: The whole carotid endarterectomy operations were performed under locoregional anesthesia. Early mortality occured in one patient because of hypertensive intracranial bleeding. The median follow up period was 68.4 +/- 19.2 months. One patient was lost due to aging and co-morbid factors and one patient was lost due to malignancy in late follow up period. Three patients required revisions for hematoma at incision region but an active bleeding focus could not be detected. There was no re-stenosis in any patient during follow-up. Conclusion: The large and multi-centered studies are needed for the anticoagulant therapy protocol for the patients with atrial fibrillation following carotid endarterectomy. We prefer combination of warfarin, providing INR value between 2-3, and 100 mg aspirin per day at our patients as therapy modality.