Dizaltı periferik arteriyel hastalığa cerrahi yaklaşım
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Dosyalar
Tarih
2008
Dergi Başlığı
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Cilt Başlığı
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmanın amacı, dizaltı periferik baypas cerrahisi uygulanan hastalara cerrahi yaklaşımımızı değerlendirmektir. Yöntem: Haziran 2005 ile Ağustos 2007 tarihleri arasında kliniğimizde dizaltı periferik baypas cerrahisi uygulanan 21 hasta cerrahi yaklaşımımız açısından değerlendirilmiştir. Hastaların ikisi bayan, diğerleri erkektir. Yaş ortalaması 6015.4 yıldır. Tüm hastalarda greft olarak otojen safen ven kullanılmıştır. Postoperatif dönemde hastalara Dextran 40 infüzyonu ve düşük molekül ağırlıklı heparin verilmiştir. Postoperatif ilk gün aspirin, klopidogrel ve statin tedaviye eklenmiştir. Greft açıklığı, manyetik rezonans anjiyografi (MRA) ile değerlendirilmiştir. Bulgular: Erkek hastaların tümünde sigara anamnezi mevcuttur. Öyküde, daha önce 11 hastaya uygulanan periferik damar cerrahisi bulunmaktadır ve en sık uygulanmış damar cerrahisi femoral embolektomidir. Hastalar ortalama 12.77.5 ay takip edilmiştir. Distal damar yatağı kötü olan bir hastanın cerrahi uygulanan alt ekstremitesi operasyondan 16 gün sonra dizaltı amputasyona gitmiştir. Diğer hastaların greftlerinin açık olduğu MRA ile gösterilmiştir. Sonuç: Dizaltı revaskülarizasyon yöntemleri için, safen ven greftinin kullanılmasının, etkin postoperatif antitrombotik tedavinin ve epidural anestezinin greft açıklığını sağlamada önemli etkenler olduğu düşünülebilir. MRA, greft açıklığını değerlendirmede değerli bir yöntemdir. (Damar Cer Der 2008;17(l): 1-8).
Purpose: The purpose of this study to evaluate our surgical management on patients who were applied below the knee bypass surgery. Methods: From June 2005 to August 2007, 21 patients who had below knee bypass surgery were evaluated for our management strategy. Nineteen of them were male, 2 were female. The average age of the patients was 60 ± 15.4 years. Autogenous saphenous veins were used as a graft in all patients. Postoperatively, dextran 40 infusion and low molecular weight heparin were performed. The day after surgery, aspirin, clopidogrel and statin were added to treatment. Magnetic resonance angiography (MRA) was performed to evaluate graft patency. Results: All of male patients were smoker. In history, 11 of patients had previous peripheral vascular operation and the most frequent of them was femoral embolectomy. Patients were followed up 12 J ± 7.5 months on average. One of the patients who had bad distal vascular bed underwent below the knee amputation on postoperative 16th day. Remaining patients were evaluated with MRA and graft patency was shown. Conclusion: Using saphenous vein graft, effective postoperative antithrombotic therapy, and epidural anesthesia for below the knee revascularization procedure could be though important factors to maintain graft patency. MRA is a valuable method for assessment of graft patency. (Turkish J Vase Sur 2008;17(l):l-8).
Purpose: The purpose of this study to evaluate our surgical management on patients who were applied below the knee bypass surgery. Methods: From June 2005 to August 2007, 21 patients who had below knee bypass surgery were evaluated for our management strategy. Nineteen of them were male, 2 were female. The average age of the patients was 60 ± 15.4 years. Autogenous saphenous veins were used as a graft in all patients. Postoperatively, dextran 40 infusion and low molecular weight heparin were performed. The day after surgery, aspirin, clopidogrel and statin were added to treatment. Magnetic resonance angiography (MRA) was performed to evaluate graft patency. Results: All of male patients were smoker. In history, 11 of patients had previous peripheral vascular operation and the most frequent of them was femoral embolectomy. Patients were followed up 12 J ± 7.5 months on average. One of the patients who had bad distal vascular bed underwent below the knee amputation on postoperative 16th day. Remaining patients were evaluated with MRA and graft patency was shown. Conclusion: Using saphenous vein graft, effective postoperative antithrombotic therapy, and epidural anesthesia for below the knee revascularization procedure could be though important factors to maintain graft patency. MRA is a valuable method for assessment of graft patency. (Turkish J Vase Sur 2008;17(l):l-8).
Açıklama
Anahtar Kelimeler
Cerrahi
Kaynak
Damar Cerrahi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
17
Sayı
1
Künye
Narin, C., Ege, E., Sarkılar, G., Önoğlu, R., Sarıgül, A., Yeniterzi, M. (2008). Dizaltı periferik arteriyel hastalığa cerrahi yaklaşım. Damar Cerrahi Dergisi, 17(1), 1-8.
