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    Is contralateral carotis artery occlusion a risk factor for carotid andarterectomy?
    (Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2016) Reyhanoglu, Hasan; Asgun, Halil Fatih; Ozcan, Kaan; Erturk, Murat; Durmaz, Isa
    Background: In this study, we aimed to investigate whether contralateral carotis artery occlusion poses an additional risk for morbidity and mortality in carotid endarterectomy. Methods: Between September 2010 and March 2015, a total of 135 patients (103 males, 32 females; mean age 68.3 years; range 46 to 92 years) who were operated with the diagnosis of carotid stenosis in our clinic were divided into two groups depending on the presence of an occluded contralateral artery. Thirty-two patients undergoing carotid endarterectomy with contralateral carotid artery occlusion were compared to 103 patients without contralateral occlusion. Baseline demographic characteristics, risk factors, type of surgical technique, postoperative early morbidity and mortality results of both groups were compared. Results: Both groups were similar according to their demographic and perioperative characteristics. There was no statistically significant difference in postoperative neurological [carotid occlusion group (CO) 6.3%, control group 6.8%, p= 0.638] or nonneurological (group CO 15.6%, control group 12.6%, p= 0.430) complications between the two groups. The length of hospital stay did not differ between both groups statistically while length of intensive care unit stay was significantly longer in the group with occlusion (p= 0.029). There was no significant difference in the postoperative mortality between the groups (group CO 0%, control group 1%, p= 0.763). Conclusion: Although morbidity and mortality are expected to be high in patients with contralateral carotid artery occlusion due to the limited cerebral blood supply, there was no significant increase in postoperative neurological complications, particularly. Therefore, we believe that contralateral occlusion does not pose an additional risk for surgery in patients undergoing carotid endarterectomy.
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    Predictive value of platelet-to-lymphocyte ratio in severe degenerative aortic valve stenosis
    (Wolters Kluwer Medknow Publications, 2016) Edem, Efe; Reyhanoglu, Hasan; Kucukukur, Murat; Kirdok, Ali Hikmet; Kinay, Ahmet Ozan; Tekin, Umit Ilker; Ozcan, Kaan
    Background: Aortic valve stenosis (AVS) is the most common cause of left ventricular outflow obstruction, and its prevalence among elderly patients causes a major public health burden. Recently, platelet-to-lymphocyte ratio (PLR) has been recognized as a novel prognostic biomarker that offers information about both aggregation and inflammation pathways. Since PLR indicates inflammation, we hypothesized that PLR may be associated with the severity of AVS due to chronic inflammation pathways that cause stiffness and calcification of the aortic valve. Materials and Methods: We retrospectively enrolled 117 patients with severe degenerative AVS, who underwent aortic valve replacement and 117 control patients in our clinic. PLR was defined as the absolute platelet count divided by the absolute lymphocyte count. Severe AVS was defined as calcification and sclerosis of the valve with a mean pressure gradient of > 40 mmHg. Results: PLR was 197.03 +/- 49.61 in the AVS group and 144.9 +/- 40.35 in the control group, which indicated a statistically significant difference (P < 0.001). A receiver operating characteristic (ROC) curve analysis demonstrated that PLR values over 188 predicted the severity of aortic stenosis with a sensitivity of 87% and a specificity of 70% (95% confidence interval = 0.734- 0.882; P < 0.001; area under ROC curve: 0.808). Conclusion: We suggest that the level of PLR elevation is related to the severity of degenerative AVS, and PLR should be used to monitor patients' inflammatory responses and the efficacy of treatment, which will lead us to more closely monitor this high-risk population to detect severe degenerative AVS at an early stage.