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    Fill and aspirate foam sclerotherapy (FAFS): a new approach for sclerotherapy of large superficial varicosities concomitant to endovenous laser ablation of truncal vein
    (W B SAUNDERS CO LTD, 2015) Atasoy, M. M.
    AIM: To define and assess the short-term clinical feasibility of fill and aspirate foam sclerotherapy (FAFS) for treating large superficial varicose veins concomitant to endovenous laser ablation (EVLA). MATERIALS AND METHODS: Twenty-seven patients who refused to have phlebectomies with great saphenous vein reflux and large superficial varicosities were included in the study. Both EVLA and FAFS were performed concomitantly. FAFS is a technique in which all or most of the bubbles and blood foam mixture are removed from the targeted large varicose veins immediately after the foam has caused sufficient damage to the endothelial cells. Patients were reviewed 1 month and 6 months after the treatment. Improvement in the clinical, aetiological, anatomical, and pathological classification (CEAP), and clinical severity was graded using the revised venous clinical severity score (rVCSS) and cosmetic results were investigated at the 6 month visit. RESULTS: Ablation of GSV was performed in 27 limbs in 27 patients (19 males, 70.3%; mean age 44 years; range 21-69 years). All patients had a technically successful FAFS treatment. The CEAP classification score, the rVCSS values, and the cosmetic results showed prominent improvement 6 months after the treatment. There were no significant complications, such as stroke, skin burns, necrosis, paresthesia, deep-vein thrombosis, or allergic reaction. None of the patients experienced neurological events. CONCLUSION: FAFS is a promising safe and effective technique for treating large superficial varicosities concomitant to EVLA of the truncal veins with excellent clinical results. Randomized prospective studies with larger series are required to compare the FAFS with ambulatory phlebectomy and standard foam sclerotherapy. (C) 2014 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
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    Rare use of Atrieve Vascular Snare (TM) for percutaneous transcatheter retrieval of central venous port catheter fragments
    (ELSEVIER MASSON, CORPORATION OFFICE, 2015) Nas, O. F.; Kacar, E.; Dogan, N.; Atasoy, M. M.; Erdogan, C.
    Central venous port catheters and peripherally inserted central catheters (PICC lines) are implanted in the central venous system usually for administration of chemotherapeutic agents and parenteral nutrition [1,2]. Long-term use of these catheters may cause such complications as occlusion, thrombosis, infection, fracture and intravascular dislocation of the catheter [2,3]. The incidence of intravascular dislocation of port catheters is rare( 0-3.1%) [1,3]. Fragments of a fractured port catheter might migrate towards the heart or pulmonary artery and cause embolization in the distal region of the organ resulting in mortality [1,4]. Therefore, port catheter fragments must be retrieved as soon as possible[ 1]. Percutaneous retrieval, removal by open thoracotomy and long-term anticoagulant therapy are the treatment options for fractured port catheters. Among these options, percutaneous transcatheter retrieval is usually a safe and effective method [1,5]. In this study, we report the retrieval of port catheter fragments extending from the superior vena cava to the right cardiac cavities using a three-loop 6F 12-20 mm snare( Atrieve Vascular Snare (TM); Angiotech, Gainesville, FL, United States) in two patients who complained of chest pain.
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    Single dose ivabradine versus intravenous metoprolol for heart rate reduction before coronary computed tomography angiography (CCTA) in patients receiving long-term calcium channel-blocker therapy
    (SAGE PUBLICATIONS LTD, 2014) Celik, O.; Atasoy, M. M.; Erturk, M.; Yalcin, A. A.; Aksu, H. U.; Diker, M.; Akturk, I. F.; Atasoy, I.
    Background: In patients with contraindication for beta-blockers who are also under long-term calcium channel-blocker therapy for any reason, ivabradine may be used as an alternative treatment to achieve the target heart rate. Purpose: To assess whether single dose oral ivabradine in patients referred for coronary computed tomography angiography (CCTA) is safe and can significantly decrease heart rate compared to intravenous (i.v.) metoprolol in patients receiving long-term calcium channel-blocker therapy. Material and Methods: One-hundred and twenty patients who were under calcium channel-blocker therapy referred for CCTA were randomized to premedication with single dose (15 mg) ivabradine (n 63) or i. v. metoprolol (5-10 mg) (n = 62). Hearth rate (HR) was assessed at admission (HR1), prescan (HR2), and during CCTA scan (HR3) for all patients. Blood pressure (BP) was measured before medication (BP1) and immediately before CCTA scan (BP2). Results: Although the HR averages of two groups were not significantly different before medication (HRIv1 = 80 +/- 7 bpm vs. HR beta 1 = 81 +/- 7 bpm; P 0.42), significant HR reduction was observed in the ivabradine group (HRIv3 = 62 +/- 7 bpm) when compared to the metoprolol group (HR beta 3 = 66 +/- 6 bpm; P = 0.001). Decreases in HR forivabradine (18 +/- 6 bpm) was significantly higher than for metoprolol (15 +/- 4 bpm; P = 0.003) without relevant sideeffects. Ivabradine showed no significant effect on either systolic BP or diastolic BP (siBPIv1, 139 +/- 10; siBPIv2, 138 +/- 10; P = 0.260; diBPIv1, 81 +/- 7; diBPIv2, 81 +/- 6; P = 0.59). Nevertheless, metoprolol group demonstrated significant reduction in both SiBP and DiBP (siBP beta 1, 136 +/- 11; siBP beta 2 130 +/- 11; P < 0.001; diBP beta 1, 81 +/- 6; diBP beta 2, 78 +/- 6; P < 0.001). Conclusion: Single dose ivabradine is safe and significantly more effective than i. v. metoprolol in decreasing HR in patients under calcium channel-blocker therapy.