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Objectives: Besides the well-known risk factors for atherosclerosis and cardiovascular disorders, hyperho-mocystinemia is a recently defined factor that acts in pathogenesis of atherosclerotic diseases. It also plays role in development of end-stage renal disease. Homocysteine causes endothelial cell damage and proliferation in vascular smooth muscle cells. In this study, we aimed to document the relationship between serum homocyteine levels and postoperative outcomes and occurrence of postoperative adverse events in patients undergoing on-pump cardiac surgery. Materials and Methods: Forty patients undergoing on-pump cardiac surgery were included in the study. Serum homocysteine levels were measured preoperatively. Then, patients were divided into two groups; first group included patients with homocyteine levels below 15 mmol/l and second above. Cross-clamp and car-diopulmonary bypass times, intubation times, intensive care unit and hospital length of stay and occurrence of postoperative adverse events were compared between the two groups. Results: The mean age of the patients was 57.0 ± 2.3 and mean body mass index (BMI) was 26.8 ± 4.1. There were 30 male (75%) and 10 female (25%) patients. The mean preoperative Hcy level was 18.6 ± 10.5 mmol/l. Twenty one patient (52.5%) had Hcy levels below 15 mmol/l and 19 (47.5%) had above 15 mmol/l. The preoperative demographic characteristics of the patients were comparable in two groups. Intubation times, intensive care unit and hospital length of stay were not different between the groups. There was not statistically significant difference between the groups when postoperative renal functions designated by serum creatinine levels and urine output, mortality, occurrence of stroke and mesenteric vascular events were compared. Conclusions: We did not observe any relationship between elevated levels of homocysteine and postopera-tive stoke, renal failure and other adverse events. We believe that further studies with increased number of patients should be performed.

134ay-Thurner syndrome (MTS) or iliac vein compression syndrome occurs due to compression of left common iliac vein by right common iliac artery, anterior to lumbar vertebrae. 1 In this syndrome, there is increased risk for deep vein thrombosis (DVT), chronic venous stasis ulcers, and pulmonary embolism. 1 These patients have persistent left lower extremity swelling with or without deep vein thrombosis. The risk of DVT in the left lower extremity increases three to eight fold in MTS. 2 Upon clinical suspicion, the diagnosis of MTS can be confirmed by iliac venography, which is the gold standard for the diagnosis of MTS. 3 There are many different treatment options like conservative management, endovascular technics, and surgery.

Background: In this study, we shared the implementation success and clinical results for 38 patients treated with the cleaner™ pharmacomechanical thrombectomy device. Objectives: The impact and results of pharmacomechanical thrombectomy treatment on patients with deep vein thrombosis in the symptomatic acute and subacute phases were assessed. Patients and Methods: Pharmacomechanical thrombectomy treatment was applied in a single session for 38 patients with lower extremity deep vein thrombosis in the acute and subacute phases between May 2012 and June 2014. Venography was performed and each assessment was made based on lysis rates and clinical results. Results: Deep vein thrombosis was found in the left lower extremity in 25 patients (65%) and in the right lower extremity in 13 patients (35%). No patient was found to have bilateral deep vein thrombosis. Thrombus localization was in the iliofemoral area in 17 patients (44%), the iliocaval area in three patients (8%), and the femoropopliteal area in 18 patients (56%). When thrombus resolution was assessed at the end of the process, grade III and grade II lysis was achieved in 36 (94%) out of 38 patients. Complete resolution was achieved in 28 patients (74%) in the acute and subacute groups. Conclusion: Pharmacomechanical thrombectomy provides very satisfactory results in a single procedure, as a new method in the treatment of acute and subacute deep vein thrombosis.

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