Browsing by Author "Tanircan, Muhammed Rasit"

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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.