Ertan Vuruşkan

Gaziantep University

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Erhan Saraçoğlu

Gaziantep Children's Hospital

Murat Sucu

Gaziantep University

İV

İrfan Veysel Düzen

Gaziantep University

Gökhan Altunbaş

Gaziantep University

Emre Akkaya

Istanbul University

Mehmet Küçükosmanoğlu

Sağlık Bilimleri Üniversitesi

Fatma Yılmaz Çoşkun

Gaziantep University

İS

İsa Sıncer

Bolu Abant İzzet Baysal University

Mehmet Kaplan

Gaziantep University

YÇ

Yusuf Çekici

University of Health Sciences Antigua

Cooperative Institutions

Gaziantep University

Sağlık Bilimleri Üniversitesi

Gaziantep Children's Hospital

Institute of Cardiology

State Hospital

Sivas State Hospital

University of Health Sciences

Dr. Siyami Ersek Göğüs Kalp Ve Damar Cerrahisi Eğitim Ve Araştırma Hastanesi

University of Health Science

Istanbul University

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Intracardiac echocardiography-guided device closure of atrial septal defects: our initial experience

Turk Kardiyoloji Dernegi Arsivi-Archives of the Turkish Society of Cardiology (2011)

Emre Akkaya Ertan Vuruşkan Ibrahim A. Aksoy İdris Ardıç Mehmet Küçükosmanoğlu

Although intracardiac echocardiography (ICE) has long been used for various cardiologic interventions, its utilization has been quite limited in Turkey. We assessed our experience with the use of ICE during transcatheter closure of secundum atrial septal defects (ASD).Fourteen patients (8 females, 6 males; mean age 34 years; range 15 to 62 years) underwent transcatheter device closure of ASD with ICE guidance. Before the procedure, 13 patients were examined by transesophageal echocardiography (TEE). Intracardiac echocardiography was used to evaluate the interatrial septum, defect size, the relationship of the septal occluder with neighboring structures before its release, and residual shunts after device release.Using short- and long-axis ICE images, the anteroposterior and superoinferior rims of the ASD, coronary sinus, and pulmonary vein openings were successfully visualized in all the patients. Defect diameters measured by ICE were closely correlated with those measured by TEE (97%) and balloon sizing (95%). The defects were closed successfully in 13 patients; the procedure was terminated in one patient due to the prolapse of both discs into the left atrium. There was no procedural complication. One patient experienced gastrointestinal hemorrhage that required blood transfusion two days after the procedure. No residual shunts were observed on follow-up transthoracic echocardiographic examinations one and six months after the procedure.Having high image quality and color Doppler features, ICE is quite functional in determining defect size, position of the septal occluder and its relationship with neighboring structures; thus, it is a reliable alternative to TEE which is used routinely in transcatheter closure of ASDs.

Septum secundum

Interatrial septum

Heart septal defect

10.5543/tkda.2011.01576

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Citations (3)

Oxidative injury associated with stenting of asymptomatic carotid artery stenosis

VASA (2017)

Erhan Saraçoğlu Ertan Vuruşkan Yusuf Çekici Salih Kılıç Halil Ay

After carotid artery stenting (CAS), neurological complications that cannot be explained with imaging methods may develop. In our study we aimed to show, using oxidative stress markers, isolated oxidative damage and resulting neurological findings following CAS in patients with asymptomatic carotid artery stenosis.We included 131 neurologically asymptomatic patients requiring CAS. The neurological findings were evaluated using the modified Rankin Scale (mRS) prior to the procedure, one hour post-procedure, and two days after. Patients with elevated mRS scores but with or without typical hyperintense lesions observed on an MRI and with changes of oxidative stress marker levels at the time (Δtotal-thiol, Δtotal antioxidative status [TAS], and Δtotal oxidant status [TOS]) were evaluated.In the neurological examination carried out one hour prior to the procedure, there were 92 patients with mRS = 0, 20 with mRS = 1, and 12 with mRS = 2. When Δtotal-thiol, ΔTAS, and ΔTOS values and the mRS were compared, it was observed that as the difference in oxidative parameters increased, clinical deterioration also increased proportionally (p = 0.001).We demonstrate a possible correlation between oxidative damage and neurological findings after CAS which could not be explained by routine imaging methods.

10.1024/0301-1526/a000621

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Comparison of periprocedural and long term outcomes of proximal versus distal cerebral protection method during carotid artery stenting

VASA (2015)

Zeynep Baştuğ Gül Emre Akkaya Ertan Vuruşkan Özgür Akgül Hamdi Püşüroğlu

The aim of this study was to assess the periprocedural and one-year outcomes of two different cerebral protection systems used during carotid artery stenting (CAS).We enrolled 90 consecutive patients with carotid artery stenosis who underwent CAS with a proximal flow blockage protection system (mean age 69.7 ± 8) or distal protection with a filter (mean age 70.8 ± 7).CAS was performed successively on 89 patients (99 %). Adverse events were defined as major stroke, minor stroke, transient ischemic attack (TIA), myocardial infarction, and death. Two strokes, one TIA, one death, and one myocardial infarction were observed in-hospital. There were no significant differences in safety or benefits between the proximal flow blockage embolic protection system (n = 45) and the distal filter protection system (n = 45) in terms of clinically apparent cerebral embolism, TIA, death, or myocardial infarction during the periprocedural stage or during the one-year follow-up period.Although it has been shown that the proximal flow blockage cerebral protection system decreases the risk of silent cerebral embolism, it has no advantage over the distal filter protection system in terms of adverse cerebrovascular or cardiac events during the periprocedural stage or during the long-term follow-up period.

Stroke

Cerebral embolism

Carotid stenting

10.1024/0301-1526/a000445

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Procedural and Early Outcomes of Two Re-entry Devices for Subintimal Recanalization of Aortoiliac and Femoropopliteal Chronic Total Occlusions

Korean Circulation Journal (2016)

Ertan Vuruşkan Erhan Saraçoğlu

Subintimal angioplasty is a common treatment choice for chronic total occlusions (CTO) in the iliac and femoropopliteal arteries. This article describes the technical aspects and early outcomes of two different re-entry devices and comparison with manual re-entry technique.A retrospective review of 61 patients (re-entry group) treated with Outback or Pioneer Plus catheters was carried out. A matched cohort of patients (n=62) who underwent lower extremity interventions without the use of re-entry devices (manual re-entry group) were also analyzed (overall 123 patients were analyzed). Procedural success, procedural durations, patency estimates, ankle-brachial indices, and complications were analyzed.Sixty-one patients underwent Outback or Pioneer Plus guided subintimal recanalization. After the procedure, ankle-brachial indices significantly increased in all patients during follow-up. Primary patency for the entire cohort was 83% in the first month. When the re-entry device group was compared with manual re-entry group, no difference was found with respect to success, complication, and patencies between the two groups during follow-up. However, procedure duration and the amount of contrast agent used was significantly decreased in re-entry groups (p<0.001). Also, re-entry time was significantly decreased in Pioneer plus group according to Outback group (p<0.001).Recanalization of CTO using re-entry devices for aortoiliac or femoropopliteal arteries is safe and effective. These devices shorten the procedure time, the re-entry time, reduce radiation risk, and reduce the amount of contrast agent employed.

10.4070/kcj.2016.0310

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Elabela as a Novel Marker; Well-Correlated with WIfI Amputation Risk Score in Patients with Lower Extremity Arterial Disease

The Anatolian Journal of Cardiology (2020)

Mehmet Kaplan Fethi Yavuz Gizem Kaplan Nurbanu Bursa Ertan Vuruşkan

Worldwide, over 200 million people are diagnosed with lower extremity arterial disease (LEAD). LEAD significantly increases the risk of death and amputation of the lower limb. A new classification system (WIfI) has been proposed to initially assess all patients with ischemic rest pain or wounds and also predicts 1-year amputation risk. Elabela is a bioactive peptide and a part of the apelinergic system, which has beneficial effects on body fluid homeostasis and cardiovascular health. We aimed to investigate serum Elabela levels in LEAD.A total of 119 subjects were enrolled in this cross-sectional study, 60 of whom were in the LEAD group and 59 in the control group. All participants underwent physical examination and routine biochemical tests, including serum Elabela levels. Additionally, the LEAD group was divided into subgroups according to the Rutherford classification, ankle-brachial index (ABI) values, and WIfI risk scores.Serum low-density lipoprotein, Elabela, and high-sensitivity C-reactive protein (Hs-CRP) levels were statistically higher in the LEAD group (p=0.002, p<0.001, and p<0.001, respectively). In the Rutherford classification, as the stage increased, Elabela and Hs-CRP levels increased similarly (p<0.001). Elabela levels were statistically found to be positively correlated with Hs-CRP and WIfI amputation score but negatively correlated with ABI (p<0.001).Serum Elabela level, which is known to be increased in inflammatory processes, has the potential in predicting low extremity arterial obstruction and WIfI amputation risk in LEAD patients.

10.14744/anatoljcardiol.2020.17329

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Evaluation of subclinical left ventricular dysfunction in overweight people with 3D-speckle tracking echocardiography

The Anatolian Journal of Cardiology (2019)

Mustafa Doğduş Salih Kılıç Ertan Vuruşkan

Obesity is associated with cardiovascular risk factors and is a major predictor of cardiovascular disease and mortality. This global burden affects myocardial function by inducing structural and functional alterations. Although subclinical left ventricular (LV) dysfunction is known in obese subjects, there is not sufficient information about overweight people. The aim of the present study was to evaluate subclinical LV dysfunction in overweight people with three-dimensional speckle-tracking echocardiography (3D-STE).One hundred eighteen consecutive patients between 18 and 80 years old were enrolled into the study. Patients were divided into three groups according to body mass index (BMI): normal (BMI: 18.5-24.9 kg/m2) (n=35), overweight (BMI: 25-29.9 kg/m2) (n=43), and obese (BMI ≥30 kg/m2) (n=40). 3D-STE was performed, and global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), and global area strain (GAS) were measured. 3D-STE results were compared between the groups.The mean age of the patients was 60.97+-8.94 years, and 55.1% of the patient population were male. Mean GCS was -13.5, GLS was -11.9, GRS was 32.3, and GAS was -22. As BMI increased, GCS and all other strain parameters were significantly worse [p<0.001 (normal-overweight), p<0.001 (normal-obese), and p<0.001 (overweight-obese) for GCS, GLS, GRS, and GAS]. A positive linear correlation was observed between BMI and all measured strain parameters (r=0.673, p<0.001 for BMI and GCS).3D-STE is a non-invasive parameter to detect subclinical LV dysfunction, and global strain values are significantly correlated with BMI. Subclinical LV dysfunction was detected in overweight people in addition to obese subjects.

Subclinical infection

Speckle tracking echocardiography

10.14744/anatoljcardiol.2018.40456

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Citations (20)

Author`s Reply.

PubMed (2019)

Mustafa Doğduş Salih Kılıç Ertan Vuruşkan

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Treatment of thrombotic subclavian artery stenosis involving vertebral artery ostium with maximum protection