Early and midterm results of the retrograde transpopliteal approach as the first-line treatment for total occlusions of iliofemoral arteries.

OBJECTIVE: This study aims to present our early and midterm results regarding the use of the retrograde popliteal artery approach as the first-line treatment for patients with total occlusions of the iliac or femoropopliteal arteries. PATIENTS AND METHODS: Between July 2017 and July 2019, 84 patients underwent transpopliteal retrograde subintimal recanalization for iliac and femoral artery occlusive disease. RESULTS: The procedure was technically successful in 92.9% of the patients and had a complication rate of 5.95%. Complications, including stent thrombosis, dissection, and rupture, were treated successfully. No hematomas were observed at the puncture site. The primary patency rates at 6, 12, and 18 months were 86.9%, 82.1%, and 77%, respectively. CONCLUSIONS: With respectable early and midterm results, the retrograde popliteal artery approach can be considered a primary treatment option for iliac or femoropopliteal arteries' recanalization in selected patients.

Effects of pleural opening on respiratory function tests in cardiac surgery: a prospective study.

PURPOSE: To show the effects on lung function of the opening pleura in patients undergoing cardiac surgery. SUBJECTS AND METHODS: 66 patients were included. Patients were allocated into two groups. In group 1 (n=21) pleura was intact, in group 2 (n=45) pleura was opened. Both groups were compared prospectively in terms of preoperative and on the post-operative 5th day pulmonary function tests (PFT), preoperative, postoperative first and fifth day arterial blood gas analysis, preoperative and postoperative first day mixt venous oxygen saturation, bleeding, operation periods, pulmonary complications, intensive care and hospital stay period and mortality. RESULTS: There was significant decrease in all PFT indicators on 5th post-operative day in group 2 (p < 0.01). Although there was a significant decrease in FEV1 on 5th post-operative day in group 1 (p < 0.001), other pulmonary functions parameters were not change significantly (p > 0.025). In group 2 much more decline in pulmonary function test parameters than group 1 were observed (p < 0.05). There was not statistically significant difference in blood gas analysis and mixed venous oxygen saturation values in group 1 (p > 0.05). But in group 2 except pH and PaCO2, other blood gas measurements were significantly decreased on the postoperative first and fifth day (p < 0.008). In group 2 except pH and PCO2, other parameters were less than the other Group (p < 0.01). The drained amount was still significantly higher in group 2 (p < 0.001). The frequency of the revision due to bleeding was observed much more in group 2. CONCLUSIONS: Protection of the integrity of pleura may have positive effects on pulmonary functions in cardiac surgery.