Background: This study aimed to evaluate the efficacy and safety of total coronary revascularization via left anterior thoracotomy (TCRAT) by comparing it to conventional coronary artery bypass grafting (CABG) with median sternotomy. Methods: In this retrospective study, 108 patients (95 males, 13 females; mean age: 57.1±8.8; range, 41 to 75 years) who underwent TCRAT (Group 1) and 154 patients (126 males, 28 females; mean age: 61.2±9.8; range, 31 to 79) who underwent conventional CABG (Group 2) between February 1, 2021, and September 1, 2022, were evaluated. The operations were performed by the same surgical team. Preoperative, operative, and postoperative data of patients and mid-term follow-up data were analyzed. Results: Mean cardiopulmonary bypass and cross-clamp times, respectively, were 167.70±68.93 and 77.03±38.18 min in Group 1 and 106.64±38.27 and 62.21±24.06 min in Group 2 (p<0.001). During the postoperative period, the all-cause mortality rate was 5.8% (n=9) in Group 2, while it was 0.9% (n=1) in Group 1; there was a statistically significant difference between the two groups (p=0.037). Nevertheless, the mean preoperative EuroSCORE (European System for Cardiac Operative Risk Evaluation) II was 2.59±2.3 in Group 2, which was significantly higher than the mean EuroSCORE II of Group 1 (1.37±1.5; p<0.001). The mean hospitalization duration for Group 2 was 6.99±3.37 days, and the mean hospitalization duration for Group 1 was 6.77±4.24 days. Duration of hospitalization was statistically significantly shorter in Group 1 (p=0.047). In addition, the mean perioperative number of erythrocyte suspension transfusions in Group 1 was 1.51±1.74, while it was 1.86±1.75 in Group 2. Significantly fewer erythrocyte suspension transfusions were performed in Group 1 (p=0.033). Conclusion: The findings of our study indicate that TCRAT is a safe and viable technique when performed on a select patient group compared to the conventional method.

Intravascular shrapnel or bullet embolization after a gunshot injury is rare, with fewer than 200 cases reported over the past century. Military injuries typically have high energy transfer, making this phenomenon less prevalent. A 22-year-old military personnel presented with chronic leg ischemia resulting from arterial bullet embolization. Before 4 months, he had sustained a military injury and subsequently required hospitalization for pneumohemothorax. A 21-mm bullet obstructing the popliteal artery caused chronic leg ischemia and was scheduled for elective vascular surgery. Physicians should be aware of potential bullet embolization indications in gunshot wound patients to prevent complications, ensuring early detection and appropriate treatment for successful management.

Cases of embedded unexploded ordnance are extremely rare and pose a risk to bystanders and health providers. A patient arrived at the Role 2 medical facility in the Turkish army, whose left arm was amputated due to a terrorist attack and major hemorrhages had been halted by clamping of the left subclavian artery and vein. A piece of metal wire running from the lateral chest wall was detected as an unexploded ordnance piece and it was removed surgically. In these challenging cases, safety principles should be acknowledged. Highlighting the basic precautions is important for similar scenarios and increases awareness of the utmost importance.

Background: Ischemia–reperfusion (IR) injury, a process involving the disruption and subsequent restoration of blood flow, is a significant contributing factor to both cardiovascular diseases and broader tissue damage. Carnosine, a natural dipeptide notably abundant in muscle tissue and recognized for its antioxidant attributes, may offer protective benefits against the deleterious effects of IR injury. Methods: A total of 24 rats were randomly allocated into four distinct groups: control, carnosine control, IR, and Carnosine + IR. The IR and Carnosine + IR groups underwent a simulated blood flow blockage lasting 120 min, followed by 120 min of reperfusion. Animals in the carnosine‐treated groups received 250 mg/kg of carnosine via intraperitoneal injection prior to the experimental procedure. Muscle tissue samples were subsequently analyzed to quantify markers indicative of oxidative stress, inflammation, and cellular demise. Results: Our findings demonstrated that, when compared to control groups, the IR group exhibited a significant elevation in key markers of oxidative stress (total oxidant status [TOS], Oxidative Stress Index [OSI]), inflammation (myeloperoxidase [MPO]), and cell death (TUNEL, Necrosis, Edema). Specifically, the IR group presented with a TOS of 8.72 ± 0.97 μmol/L, an OSI of 2.03 ± 0.18, and an MPO level of 75.93 ± 5.72 U/L, contrasting with control values of 4.23 ± 0.56 μmol/L, 1.01 ± 0.13, and 43.26 ± 5.7 U/L, respectively. Histopathological assessments corroborated these findings, revealing severe necrosis (2.50 ± 0.55), edema (2.00 ± 0.63), and notable inflammatory cell infiltration (2.67 ± 0.52) within the IR group. Furthermore, apoptosis (quantified by TUNEL assay) was significantly increased to 18.83 ± 1.47% in the IR group. Carnosine administration in the Carnosine + IR group led to a substantial reduction in all these adverse markers, bringing their levels closer to those observed in the control groups. For instance, in the Carnosine + IR group, TOS decreased to 5.63 ± 0.87 μmol/L, OSI to 1.24 ± 0.25, and MPO to 55.91 ± 3.45 U/L. Similarly, histopathological scores for necrosis, edema, and inflammatory cell infiltration were markedly lower in the Carnosine + IR group. Conclusion: Our experimental findings strongly suggest that exogenously administered carnosine significantly reduces oxidative stress, suppresses inflammation, and attenuates cell death in skeletal muscle subjected to IR injury. These results highlight carnosine’s promising therapeutic potential as a pharmacological agent for mitigating tissue damage in ischemic conditions.

Objectives: Primary saphenous vein insufficiency, a common cause of chronic venous disease, negatively affects quality of life. Endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) have replaced open surgery as minimally invasive treatments because of their high success rates and low complication risks. However, it remains unclear how much concomitant miniphlebectomy and additional truncal vein ablation contribute to the outcomes of these two techniques. This study compared early- and mid-term outcomes of EVLA and RFA, and evaluated the effects of miniphlebectomy, truncal vein ablation, and comorbidities on treatment success.Materials and Methods: This retrospective single-center study included 498 lower extremities treated with endovenous thermal ablation between January 2021 and February 2026. Patients underwent EVLA (n=400) or RFA (n=98). All procedures were performed by the same surgeon, and concomitant ambulatory miniphlebectomy was performed in all patients. Clinical and duplex ultrasonographic findings obtained at the six-month follow-up were analyzed to assess treatment success, recurrence, and deep vein thrombosis (DVT).Results: The overall anatomical success rate was 98.19% (97.75% for EVLA, 100% for RFA; p=0.216). Overall DVT and recurrence rates were 0.40% and 1.41%, respectively. Treatment success did not differ between isolated and multitruncal vein ablation (p>0.05) or by comorbidity status (p=1.000). A great saphenous vein diameter of ≥8 mm showed a trend toward higher recurrence, though not statistically significant (p=0.086).Conclusion: EVLA and RFA demonstrated comparable efficacy and safety in the treatment of primary saphenous vein insufficiency. Concomitant miniphlebectomy and additional truncal vein ablation, when indicated, did not adversely affect treatment success.