Background We have made a retrospective evaluation of the results of the cyanoacrylate ablation technique which has recently started to be used in the treatment of giant saphenous vein insufficiency today and in which tumescent anesthesia is not required. Methods Giant saphenous vein was treated in 50 patients between September 2015 and September 2016 by using endovenous cyanoacrylate ablation. In the procedure, tumescent anesthesia and varsity socks were not used. Control duplex ultrasound evaluation was performed in the post-procedural 1st, 6th and 12th months. Venous Clinical Severity Score and Aberdeen Varicose Vein Questionnaire scores were evaluated. Results In the 50 patients who were treated, full closure was observed in giant saphenous vein in 47 (94%) patients in the 12th month control duplex ultrasound. The mean age of the patients was 46.4 (20-70) and 30 (60%) of them were female. The median Venous Clinical Severity Score scores in the 1st, 6th and 12th months were 3, 2 and 1, respectively ( p < 0.001); the median Aberdeen Varicose Vein Questionnaire scores in the 1st, 6th and 12th months were 7, 5 and 4, respectively ( p < 0.001). In the access site, two (4%) patients developed phlebitis and one (2%) developed ecchymosis. However, deep venous thrombosis, pulmonary embolism and paresthesia were not observed. Conclusion Considering the early period results in the treatment of giant saphenous vein insufficiency, cyanoacrylate ablation makes a more reliable alternative than endovenous thermal ablation methods in that it does not require tumescent anesthesia and it has a low incidence of adverse effects.

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ÖZAmaç: Bu çalışmada abdominal aort anevrizmalarının endovasküler tamirinde orta dönem sonuçlarımız bildirildi. Ça lış ma pla nı:Ocak 2006-Aralık 2013 tarihleri arasında abdominal aort anevrizması yırtığı nedeniyle elektif veya acil endovasküler aort tamiri yapılan toplam 203 hasta (187 erkek, 16 kadın; ort. yaş 69.1±8.8 yıl; dağılım 38-89 yıl) retrospektif olarak incelendi. Mortalite, morbidite, sağkalım oranları, ortalama ameliyat süresi, ortalama mekanik ventilasyon süresi, ortalama yoğun bakım ünitesinde ve hastanede kalış süresi, kaçak tipi ve insidansı, kontrast nefropati oranları, çıplak metal uçlu stent greftlerin kullanımı ve aort çapının kaçak üzerindeki etkileri, komplikasyon oranları ve ikincil girişim oranları kaydedildi. Mortalite oranları ve yaşam kalitesi aynı zaman dilimi içinde açık cerrahi ile karşılaştırıldı. Bul gu lar:Gruplar arasında mortalite oranları açısından anlamlı bir fark yoktu. Sonuçlar kısa dönemde endovasküler aort tamiri lehine olmakla birlikte, yaşam kalitesi açısından uzun dönemde anlamlı bir fark gözlenmedi.So nuç: Endovasküler aort tamiri, abdominal aort anevrizmalı ve eşlik eden hastalığı ve yüksek mortalite riski olan hastalarda bir tedavi seçeneği olabilir. Çalışma sonuçlarımıza göre, EVAR tedavisinde komplikasyon ve ikincil girişim oranları stent greft teknolojisinin gelişmesi, cerrahın deneyimi ve uygun anatomili hastaların seçilmesi ile azaltılabilir.Anah tarsöz cük ler: Abdominal aort anevrizması; konvansiyonel cerrahi tedavi; endovasküler tedavi. ABSTRACTBackground:This study aims to report our mid-term results of endovascular repair of abdominal aortic aneurysms. Methods:Between January 2006 and December 2013, a total of 203 patients (187 males, 16 females; mean 69.1±8.8 years; range 38 to 89 years) who underwent endovascular aortic repair electively or emergently due to a ruptured abdominal aortic aneurysm were retrospectively analyzed. Mortality, morbidity, survival rates, mean duration of operation, mean duration of mechanical ventilation, mean length of intensive care unit and hospital stays, the type and incidence of endoleaks, contrast nephropathy rates, effects of use of stent grafts with bare-metal tips and aortic diameter on endoleak, complication rates, and secondary intervention rates were recorded. The mortality rates and quality of life were compared with that of open surgery within the same period of time. Results:There was no significant difference in the mortality rates between the groups. No significant difference was observed in the quality of life in the long-term, although the results were in favor of endovascular aortic repair in short-term. Conclusion:Endovascular aortic repair can be selected as a treatment option in abdominal aortic aneurysm patients with co-morbidities and high mortality risk. Based on our study results, the rates of complication and secondary intervention in EVAR treatment can be reduced with improved stent graft technology, operator experience, and selection of patients with suitable anatomy.

Background Here, we report the mid-term results of endovascular treatment of isolated dissection of the abdominal aorta, which is a very rare pathology. Materials and methods A total of 11 patients (4 males (36.3%) and 7 females (63.6%)) aged 42-72 (mean, 60.3 ± 10.45) years with isolated dissection of the abdominal aorta underwent endovascular stent-graft treatment at our institution between August 2010 and September 2015. Eight patients were symptomatic, and the remaining three were asymptomatic. The asymptomatic patients had aortic aneurysms coexisting with dissection. Eight patients without aneurysm had spontaneous dissections, and the most common symptom was unresponsive abdominal pain. Results The mean abdominal aorta diameter was 46.7 ± 20.6 (range, 31.2-100.9) mm and the mean dissection length was 71.1 ± 47.3 (range, 17-162) mm. Aorto-bi-iliac stent grafts were used in all patients, and were placed successfully under spinal anesthesia in all but one (90.9%) patient. Occlusion developed in one patient due to compression of the aorto-bi-iliac graft. Right-left femoral-femoral bypass was performed in this patient, who could not be placed on the opposite side. In addition, the graft was placed in one patient using the left renal artery chimney technique. No intraoperative mortality occurred, and open surgery was not required. In addition, no death occurred and no additional intervention was required during the mean follow-up period of 25.5 ± 17.1 (range, 6-60) months. Conclusion Limited data regarding endovascular treatment of isolated dissection of the abdominal aorta are available in the literature. Based on data obtained in a limited number of patients, we consider endovascular aortic repair to be a good alternative to surgery due to its low morbidity and mortality rates.

Background No work has been reported on the use of video websites to learn about deep vein thrombosis and the value of education using them. We examined the characteristics and scientific accuracy of videos related to deep vein thrombosis on YouTube. Methods YouTube was surveyed using no filter and the key words 'deep vein thrombosis' and 'leg vein clot' in June 2016. The videos evaluated were divided into three groups in terms of their scientific content, accuracy, and currency: useful, partly useful, and useless. Results Of the 1200 videos watched, 715 (59.58%) were excluded with the exclusion criteria. Although most of the videos uploaded (22.9%, n = 111) were created by physicians, the number of views for website-based videos was significantly higher (p = 0.002). When the uploaded videos were assessed in terms of their usefulness, videos from physicians and hospitals were statistically more useful than other videos (p < 0.001). Conclusions For videos created by medical professionals to be of higher quality, we believe they should be more up-to-date and comprehensive, and contain animations about treatment modalities and early diagnosis in particular.