Saydam O, et al. Ann Surg Treat Res. 2020 May;98(5):270-276. https://doi.org/10.4174/astr.2020.98.5.270

Serefli D, et al. Ann Surg Treat Res. 2021 Oct;101(4):247-255. https://doi.org/10.4174/astr.2021.101.4.247

The aim was to report the mid-term outcomes of Jetstream™ rotational atherectomy device in complex femoropopliteal lesions. Between November 2016 and April 2018, 55 patients who were treated with rotational atherectomy and adjunctive balloon angioplasty due to complex femoropopliteal lesions were retrospectively scanned. Fifty-five patients who underwent endovascular treatment with rotational atherectomy for chronic total occlusive femoropopliteal lesions were included in the study. Technical success rate was 100%. The mean age was 63 (±10.5) years. The cohort included 25 (45.4%) diabetics and 45 (81.8%) current smokers. The mean length of the lesions was 20.8 ± 11.2 cm. Chronic total occlusive lesions were detected in 35 (63.6%) patients, and mixed-type steno-occlusive lesions were detected in 20 patients (36.4%). Thirty-three (60%) lesions were moderate or severely calcified. Adjunctive balloon angioplasty was performed with plain old balloon angioplasty (POBA) on 31 (56.4%) patients and with drug-coated balloon angioplasty on 24 (43.6%) patients. After adjunctive balloon angioplasty, flow limiting dissection was observed in 20 (36.3%) patients, and 17 (30.9%) patients needed stent implantation. The Kaplan–Meier analysis method estimated that the overall primary patency rates at 12 and 24 months were 81.8% and 70.9%, respectively. Overall, secondary patency rates at 12 and 24 months were 94.5% and 80%. No statistically significant differences of 24-month primary patency and secondary patency rates were found between patients treated with drug-coated balloon angioplasty and POBA as an adjunctive therapy, even though primary patency (83.3% vs. 61.3%, p = .06) and secondary patency (91.7% vs. 71%, p = .56) rates of drug-coated balloon angioplasty were slightly higher than POBA. Patients with claudication had better primary patency (90.5% vs. 58.8%, p = .001) and secondary patency (100% vs. 67.6%, p = .004) rates than patients with critical limb ischemia at 24 months. Significant differences between patients who did and did not stop smoking were found in 24-month primary patency (57% vs. 88%, p = .007) and secondary patency (67% vs. 96%, p = .007). Six patients underwent unplanned amputation. There were eight (14.5%) mortalities during follow-up. Rotational atherectomy with adjunctive balloon angioplasty has satisfactory technical success rates and mid-term outcomes. As an adjunctive method, there was no difference between drug-coated balloon angioplasty s and POBAs. Smoking cessation is always the first-step treatment to improve mid-term patency results. Patients with critical limb ischemia have worse patency results compared to the patients with claudication.

Background/aim: Hypoplastic left heart syndrome (HUTS) is a rare pathology with a very high mortality rate. The present study aimed to share our initial experience with the ductus arteriosus stenting procedure using the pulmonary trunk approach in the treatment of HLHS, as well as provide some technical suggestions and discuss complications and their management. Materials and methods: The medical records of 9 neonates (age range: 1-8 days) with HLHS, who were operated on within a 12-month period, were reviewed retrospectively. Preprocedural planning was performed by computed tomography angiography and echocardiography. The operations were performed in a hybrid surgery room by interventional radiologists and pediatric vascular surgeons. Balloon-expandable stents were used in all of the operations. Results: All operations were successfully completed without any intraoperative mortality. All intraoperative complications were managed successfully during the stenting procedure. Conclusion: Stage 1 hybrid palliation for HLHS is a safe and effective procedure when several key points are kept in mind.

OBJECTIVES: Mitral annular disjunction is a recognized risk factor for malignant ventricular arrhythmias in patients with mitral valve prolapse. This study aimed to evaluate the impact of mitral valve surgery on the burden of supraventricular and ventricular ectopic activity in patients with mitral annular disjunction. METHODS: Data from 32 patients who underwent mitral valve surgery between 2017 and 2024 were retrospectively analysed. The primary end-point was the change in the burden of supraventricular and ventricular ectopy following surgery. The secondary end-point was to assess whether this change differed according to the extent of the mitral annular disjunction distance. RESULTS: The mean age of the patients was 38.8 ± 14 years, and 53.1% were female. The vast majority (96.9%) underwent successful mitral valve repair. The mean cardiopulmonary bypass and aortic cross-clamp times were 133.3 ± 38 min and 95.8 ± 32 min, respectively. Postoperatively, the mean burden of supraventricular ectopy decreased from 13.8% to 3.7%, and ventricular ectopy burden decreased from 7.1% to 2.1%. Among patients with a mitral annular disjunction distance ≥8.5 mm, both supraventricular and ventricular ectopic activity significantly declined. In contrast, for those with a mitral annular disjunction distance <8.5 mm, a significant reduction was observed only in ventricular ectopy, with no statistically significant change in supraventricular ectopy. CONCLUSIONS: Mitral valve surgery is associated with a substantial reduction in both supraventricular and ventricular ectopic activity in patients with mitral annular disjunction. Furthermore, a mitral annular disjunction distance greater than 8.5 mm appears to be a predictor of a more pronounced reduction in arrhythmic burden following surgery.

Objectives: In this study, we aimed to compare the outcomes of endovascular treatment (ET) and femoropopliteal artery bypass (FPB) in patients with Trans-Atlantic Inter-Society Consensus (TASC) II type C femoropopliteal lesions. Patients and methods: A total of 149 patients with symptomatic TASC II type C femoropopliteal lesions who underwent invasive treatment between January 2012 and January 2017 were retrospectively analyzed. The patients were divided into two groups as the ET group (n=46; 34 males, 12 females; mean age: 64.3±10.3 years) and the FPB group (n=103; 82 males, 21 females; mean age: 62.9±8.2 years). Primary and secondary patency rates at 6, 12, and 24 months were evaluated. Results: The primary success rates for ET and FPB were 100%. Primary patency at 6, 12, and 24 months were 93.5%, 89.0%, 69.5%, respectively for ET and 86.4%, 81.5%, 72.8%, respectively for FPB (p>0.05). Secondary patency rates at 6, 12, and 24 months were 97.8%, 93.5%, %84.8, respectively for ET and 96.1%, 90.3%, 79.6%, respectively for FPB group (p=0.41). The length of hospital stay was significantly longer in the FPB group (p<0.001). The cost of treatment was significantly higher in the FBP group (p=0.02). Conclusion: In TASC II type C patients, ET is a safe therapeutic option with lower in-hospital stay and treatment expenses and similar primary and secondary patency rates to FPB.