Carotid artery stenosis (CAS) is primarily caused by atherosclerotic plaque. Progressive inflammation may contribute to the rupture of an atherosclerotic plaque. The platelet-to-lymphocyte ratio (PLR) is a new and simple marker that indicates inflammation. In this study, we aimed to investigate the use of the PLR to determine the severity of CAS. One hundred forty patients were chosen from among patients who underwent carotid angiography in our institution. Symptomatic patients with stenosis >50% in the carotid arteries and asymptomatic patients with stenosis >80% were diagnosed via carotid angiography as having critical stenosis. Patients were classified into two groups. Group 1 included patients who had critical CAS, whereas Group 2 included patients with noncritical CAS, as determined by carotid angiography. Correlations between the PLR and the severity of CAS were analyzed. There were no significant differences in sex and age between the two groups. The PLR was 162.5 ± 84.7 in the noncritical CAS group patients and 94.9 ± 60.3 in the critical CAS group patients (p < 0.0001). The PLR value of 117.1 had 89% sensitivity and 68% specificity for CAS [95% confidence interval, 0.043-0.159; area under the curve, 0.101 ± 0.03)]. In this study, we have shown that PLR values may be associated with critical stenosis in at least one of the carotid arteries. Furthermore, PLR values may be used to predict critical stenosis in the carotid arteries.

Background: The comparison of outcomes of mini‐crush (MCT) versus double kissing crush (DKC) techniques for complex left main bifurcation (LMB) lesions is still lacking. This investigation aimed to assess the long‐term outcomes of patients who underwent MCT or DKC for LMB disease. Methods: From 2014 to 2024, patients who underwent percutaneous coronary intervention for complex LMB lesions were retrospectively collected. The primary end point was major adverse cardiac events as the combination of cardiac death, target vessel myocardial infarction, or clinically driven target lesion revascularization during follow‐up. The secondary end point was measured as major adverse cardiovascular and cerebral events including all‐cause death, target vessel revascularization, target vessel myocardial infarction, stent thrombosis, and stroke. Results: This large‐scale multicenter (n=13) observational study included a total of 531 consecutive patients (men: 405 [76.3%], mean age: 63.16±11.26 years) with complex LMB lesions who underwent percutaneous coronary intervention. The initial revascularization strategy was MCT in 313 (59%) patients and DKC in 218 (41%) patients. The number of balloons used (5.91±1.53 versus 6.72±1.70, P <0.001) and procedure time (66.60±24.20 versus 72.97±19.97 minutes, P <0.001) were notably lower in the MCT group. In the overall population, the long‐term major adverse cardiac events (hazard ratio [HR], 0.704; P =0.169) and major adverse cardiovascular and cerebral events (HR, 0.660; P =0.079) did not differ in individuals with complex LMB lesions treated with MCT and DKC. Other end points were also comparable between the 2 groups. Conclusions: In complex LMB lesions, risk‐adjusted major adverse cardiac events and major adverse cardiovascular and cerebral events rates were comparable between both techniques, with a nonsignificant trend favoring DKC at long‐term follow‐up. Registration: URL: https://www.clinicaltrials.gov ; Unique Identifier: NCT06546748.

Objective: Atrial fibrillation is a common cardiac arrhythmia and is an important risk factor for ischemic stroke and heart failure. Thyroid hormones have important effects on the cardiovascular system. In this study, we aimed to evaluate the relationship between atrial fibrillation (AF) and thyroid disorders. Materials and Methods: 587 newly diagnosed AF patients who applied to the Cardiology Clinic between January and December 2022 were included in this study. Thyroid function tests of the patients were examined. Results: The mean age of the patients included in the study was 62.2 ± 9.8 years. 62% of the patients were female, and 38% were male. Euthyroid in 539 patients (91.7%), hypothyroidism in 2 patients (0.3%), subclinical hypothyroidism in 11 patients (2%), hyperthyroidism in 23 patients (3.9%), and subclinical hyperthyroidism in 12 patients (2.1%). Conclusion: Atrial Fibrillation is associated with both hyperthyroidism and hypothyroidism. Thyroid dysfunctions are more common in patients with AF than in the normal population. Patients with AF should be screened for thyroid disorders.

Background: Chronic total occlusions with ambiguous proximal caps present a significant challenge in endovascular interventions of patients with Buerger’s disease. Objective: We aimed to evaluate the effectiveness of transpedal retrograde wire just marker technique in patients with Buerger’s disease presenting proximal cap ambiguity and flush occlusions. Methods: Seventeen patients with the diagnosis of Buerger’s disease who had below the knee artery chronic total occlusions with ambiguous proximal caps were enrolled. Procedural success, post-intervention Rutherford stage, wound scores, pedal loop scores, and amputation rates were recorded. Results: Final study group consisted of 13 patients after exclusion of 4 patients due to pedal loop formation failure and severe vasospasm preventing equipment advancement. Post-intervention angiographic success rate was 100%. The post-intervention Rutherford stage showed excellent improvement (mean preprocedural Rutherford stage = 5 vs mean post-intervention Rutherford stage = 2; p = 0.003). Additionally, the average Saint Elian Wound Score System (SEWSS) decreased significantly (Preprocedural 14.9 ± 4.0 vs Postprocedural 11.3 ± 4.7, p < 0.001) after the interventions. Two patients had a major amputation during the follow-up indicating that higher post-intervention pedal loop scores are associated with higher amputation rates. Conclusions: Transpedal retrograde wire just marker technique is an effective and practical method for revascularization of below the knee artery occlusions with ambiguous proximal caps. Including pedal loop angioplasty as a routine part of this technique can significantly increase blood supply to the pedal arch., thereby enhancing the likelihood of wound healing.

Thromboangiitis obliterans (TAO) is a nonatherosclerotic vasculitis predominantly affecting young male smokers, commonly involving arteries of the extremities.TAO in the upper extremity presents distinct clinical challenges because of its impact on functionality and the complexity of treatment. A 46-year-old man who was a heavy smoker presented with a 6 × 4 cm ulceration on the left hand. Peripheral angiography was performed to confirm the diagnosis and assess the arterial anatomy. After revascularization of radial and ulnar arteries and the palmar arch, blood flow was successfully restored through both the radial and ulnar arteries into the palmar arch. In this report, we describe a case successfully managed with complete upper extremity revascularization, highlighting the interventional strategy and its clinical outcomes. TAO may affect the upper extremities, and there is no definitive treatment for upper extremity involvement. Percutaneous interventions and palmar arch angioplasty help prevent amputation and accelerate wound healing.

Objective: Patients with a history of coronary artery bypass grafting (CABG) often present with advanced age, comorbidities, and diffuse atherosclerosis, making coronary angiography more complex. While the transfemoral route has been traditionally preferred, transradial access has emerged as a safer and more comfortable alternative. Recently, transulnar access has also gained interest, especially when radial access is not feasible. To compare the efficacy and safety of transulnar versus transradial access in CABG patients undergoing coronary angiography.Method: In this retrospective, single-center study, 37 post-CABG patients who underwent coronary angiography between 2022 and 2024 via left radial (n=18) or left ulnar (n=19) access were evaluated. Baseline demographics, risk factors, laboratory data, procedural parameters, and complications were analyzed. All procedures were performed with 6 Fr catheters.Results: The groups were comparable in terms of demographics, risk factors, and laboratory findings. There were no significant differences in procedure time, fluoroscopy duration, radiation dose, or catheter use. However, puncture time was significantly shorter in the transradial group (15.8 ± 8 vs. 28.2 ± 17 min, p=0.007). No major complications occurred in either group. Femoral crossover was more frequent in the transulnar group, though not statistically significant (21.1% vs. 0%, p=0.059).Conclusions: Transulnar access is a safe and effective alternative to transradial Access in CABG patients undergoing coronary angiography. While puncture time was longer in the transulnar group, overall procedural success and safety were comparable. Transulnar access may be especially useful when radial access is limited