ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Endovascular and hybrid treatment in the management of vascular disease: experience of a cardiovascular surgery department
Murat Uğur, İbrahim Alp, Gökhan Arslan, Şahin Şenay, İsmail Selçuk, Arif Selçuk, Veysel Temizkan, Alper Uçak, Ahmet Turan Yılmaz
GATA Haydarpaşa Eğitim Hastanesi, Kalp ve Damar Cerrahisi Kliniği, İstanbul, Türkiye
DOI : 10.5606/tgkdc.dergisi.2012.046
Background: This study reports a three year experience of a cardiovascular surgery department in endovascular and hybrid procedures for the treatment of vascular diseases.

Methods: Between October 2007 - December 2010, 66 patients who were treated with endovascular methods in the Department of Cardiovascular Surgery of GATA Haydapasa Training Hospital were included in this study. Fibrinolitic treatment was performed with a guidance of catheter in four cases with acute venous thrombosis. Coil embolization was performed in three patients with infrapopliteal arterial hemorrhage due to trauma, and one patient with splenic artery aneurysm. Thoracic aortic endovascular stent graft implantation was performed on 13 patients. Hybrid procedures including left carotico-subclavian bypass or supraaortic bypasses were performed on seven of them. Stent graft implantation was also performed on 12 patients due to abdominal aortic aneurysm. Simultaneous coronary artery bypass graft (CABG) surgery was performed in three of 11 patients who underwent carotid stent implantation. Two of 22 patients with peripheral arterial stent implantation underwent profundoplasty, while one of them underwent femoropopliteal bypass surgery.

Results: No intraoperative mortality was observed. Complications due to endovascular procedure such as retrograde migration or iliac leg occlusion were treated in the same procedure with an advantage of hybrid operating room. Patients were discharged from the hospital with a mean of 4.9±3.7 days following surgery. One patient who experienced aortoesophageal fistula at two months following thoracic endovascular procedure was operated; however the patient died due to mediastinitis during follow-up visits. Two patient died related to extracardiac or extravascular events during the follow-up period.

Conclusion: The usage of endovascular techniques may offer a lower mortality and morbidity rate especially in high-risk patients. Installation of hybrid operating rooms or interventional laboratories in the cardiovascular surgery department is of utmost importance for the implantation of endovascular procedures.

Keywords : Aneurysm; dissection; endovascular procedures; peripheral arterial disease
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