Browsing by Author "Karahan, Mehmet Zulkuf"

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Citation - WoS: 11
Citation - Scopus: 11
Comparison of Pain Levels of Traditional Radial, Distal Radial, and Transfemoral Coronary Catheterization
(Assoc Medica Brasileira, 2023) Aslan, Muzaffer; Gunlu, Serhat; Karahan, Mehmet Zulkuf; Kilic, Raif; Guzel, Tuncay; Aktan, Adem; Arslan, Bayram
OBJECTIVE: The aim of our study was to compare the traditional radial artery, distal radial artery, and transfemoral artery, which are vascular access sites for coronary angiography, in terms of pain level using the visual analog scale.METHODS: Between April 2021 and May 2022, consecutive patients from three centers were included in our study. A total of 540 patients, 180 from each of the traditional radial artery, distal radial artery , and transfemoral artery groups, were included. The visual analog scale was applied to the patients as soon as they were taken to bed. RESULTS: When the visual analog scale was compared between the groups, it was found to be significantly different (transfemoral artery: 2.7 & PLUSMN;1.6, traditional radial artery: 3.9 & PLUSMN;1.9, and distal radial artery: 4.9 & PLUSMN;2.1, respectively, p<0.001). When the patients were classified as mild, moderate, and severe based on the visual analog scale score, a significant difference was found between the groups in terms of body mass index, process time, access time, and number of punctures (p<0.001). Based on the receiver operating characteristic analysis, body mass index>29.8 kg/m2 predicted severe pain with 72.5% sensitivity and 73.2% specificity [(area under the curve: 0.770, 95%CI: 0.724-0.815, p<0.0001)].CONCLUSION: In our study, we found that the femoral approach caused less access site pain and a high body mass index predicts severe pain.
Citation - WoS: 2
Citation - Scopus: 2
The Effect of Aortic Angulation on Clinical Outcomes of Patients Undergoing Transcatheter Aortic Valve Replacement
(Soc Brasil Cirurgia Cardiovasc, 2024) Aktan, Adem; Demir, Muhammed; Aslan, Burhan; Guzel, Tuncay; Karahan, Mehmet Zulkuf; Kilic, Raif; Ertas, Faruk
Introduction: The aim of this study was to assess the impact of aortic angulation (AA) on periprocedural and in -hospital complications as well as mortality of patients undergoing Evolut (TM) R valve implantation. Methods: A retrospective study was conducted on 264 patients who underwent transfemoral-approach transcatheter aortic valve replacement with self-expandable valve at our hospital between August 2015 and August 2022. These patients underwent multislice computer tomography scans to evaluate AA. Transcatheter aortic valve replacement endpoints, device success, and clinical events were assessed according to the definitions provided by the Valve Academic Research Consortium -3. Cumulative events included paravalvular leak, permanent pacemaker implantation, new-onset stroke, and in -hospital mortality. Patients were divided into two groups, AA <= 48(degrees) and AA > 48(degrees), based on the mean AA measurement (48.3 +/- 8.8) on multislice computer tomography. Results: Multivariable logistic regression analysis was performed to identify predictors of cumulative events, utilizing variables with a P-value < 0.2 obtained from univariable logistic regression analysis, including AA, age, hypertension, chronic renal failure, and heart failure. AA (odds ratio [OR]: 1.73, 95% confidence interval [CI]: 0.89-3.38, P=0.104), age (OR: 1.04, 95% CI: 0.99-1.10, P=0.099), hypertension (OR: 1.66, 95% CI: 0.82-3.33, P=0.155), chronic renal failure (OR: 1.82, 95% CI: 0.92-3.61, P=0.084), and heart failure (OR: 0.57, 95% CI: 0.27-1.21, P=0.145) were not found to be significantly associated with cumulative events in the multivariable logistic regression analysis. Conclusion: This study demonstrated that increased AA does not have a significant impact on intraprocedural and periprocedural complications of patients with new generation self-expandable valves implanted.
Impact of 5-and 6-Fr Sheaths on Hemostasis Duration and Access Site Complications in Distal Transradial Approach
(Wiley, 2025) Aktan, Adem; Kilic, Raif; Guzel, Tuncay; Evsen, Ali; Acun, Baris; Tanircan, Muhammed Rasit; Karahan, Mehmet Zulkuf
Background: The distal transradial approach (dTRA) is increasingly preferred for coronary angiography (CAG) and/or per-cutaneous coronary intervention (PCI) because of its advantages in patient comfort and vascular access. However, the effect of sheath size on these outcomes remains unclear.
Aim: To compare the effects of 5-French (Fr) and 6-Fr sheaths in dTRA on vascular complications, hemostasis duration, and patient comfort.
Methods: A retrospective analysis was conducted on patients who underwent dTRA for CAG between January 2020 and October 2023. Participants were categorized into two groups based on sheath size (5- vs. 6-Fr). Data on procedural details, complications, hemostasis duration, and patient discomfort were collected.
Result: A total of 228 patients were included, with 72 in the 5-Fr group and 156 in the 6-Fr group. The study found no significant difference in vascular complications between the two groups (p = 0.18). However, hemostasis duration was significantly shorter in the 5-Fr group compared to the 6-Fr group (97.8 +/- 27.6 vs. 122.0 +/- 24.9 min; p < 0.001). Severe pain was more frequent in the 6-Fr group (p = 0.036). Regression analysis showed that severe pain, puncture time, and the use of P2Y12 receptor antagonists (P2Y12 inhibitors) were significantly associated with vascular complications (p < 0.05).
Conclusion: In our study, sheath size-specifically the comparison between 5- and 6-Fr-did not significantly affect vascular complications in the dTRA. However, using a 5-Fr sheath may reduce hemostasis time and patient discomfort compared to a 6-Fr sheath. Procedural factors such as puncture time and severe pain, as well as P2Y12 inhibitor use, should be carefully considered to minimize complications. These findings support the safe application of the dTRA with sheath size tailored to individual patient characteristics.
Ultrasound-Guided Regional Anesthesia in Permanent Pacemaker Implantation: an Observational Study
(MDPI, 2025) Akelma, Hakan; Celik, Enes; Ipek, Yusuf; Turgut, Mehmet Ali; Tanircan, Muhammed Rasit; Aktan, Adem; Karahan, Mehmet Zulkuf
Background and Objectives: When pacemakers were first introduced, their indications and implantation techniques were quite limited. Over 400,000 permanent pacemakers are implanted annually worldwide, mostly under local anesthesia (LA), which is preferred for its hemodynamic stability. However, inadequate LA often leads to excessive use of local anesthetics or analgesics. This study evaluates the efficacy of combining interscalene brachial plexus block (ISB) and superficial cervical plexus block (SCPB) as regional anesthesia (RA) techniques during permanent pacemaker implantation compared to LA. Materials and Methods: A total of 42 patients were divided into RA and LA groups. The RA group underwent ISB and SCPB under ultrasound guidance, while the LA group received traditional local anesthetic methods. Results: The RA group exhibited superior pain control, reduced analgesic requirements, and higher satisfaction rates compared to the LA group. Ultrasound guidance enhanced block success rates and minimized complications. Conclusions: ISB and SCPB offer a superior alternative to LA for pacemaker implantation, especially in patients with anxiety or insufficient LA response.