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Item Rise of serum troponin levels following uncomplicated elective percutaneous coronary interventions in patients without clinical and procedural signs suggestive of myocardial necrosis(TERMEDIA PUBLISHING HOUSE LTD, 2016-01-01) Buturak, Ali; Degirmencioglu, Aleks; Surgit, Ozgur; Demir, Ali Riza; Karakurt, Huseyin; Erturk, Mehmet; Yazici, Selcuk; Serteser, Mustafa; Norgaz, Tugrul; Gorgulu, SevketIntroduction: The new definition of periprocedural myocardial infarction (type 4a MI) excludes patients without angina and electrocardiographic or echocardiographic changes suggestive of myocardial ischemia even though significant serum troponin elevations occur following percutaneous coronary intervention (PCI). Aim: To evaluate the incidence and predictors of serum troponin rise following elective PCI in patients without clinical and procedural signs suggestive of myocardial necrosis by using a high-sensitivite troponin assay (hsTnT). Material and methods: Three hundred and four patients (mean age: 60.8 +/- 8.8 years, 204 male) undergoing elective PCI were enrolled. Patients with periprocedural angina, electrocardiographic or echocardiographic signs indicating myocardial ischemia or a visible procedural complication such as dissection or side branch occlusion were excluded. Mild-moderate periprocedural myocardial injury (PMI) and severe PMI were defined as post-PCI (12 h later) elevation of serum hsTnT concentrations to the range of 14-70 ng/l and > 70 ng/l, respectively. Results: The median pre-procedural hsTnT level was 9.7 ng/l (interquartile range: 7.1-12.2 ng/l). Serum hsTnT concentration elevated (p < 0.001) to 19.4 ng/l (IQR: 12.0-38.8 ng/l) 12 h after PCI. Mild-moderate PMI and severe PMI were detected in 49.3\% and 12.2\% of patients, respectively. Post-procedural hsTnT levels were significantly higher in multivessel PCI, overlapping stenting, predilatation and postdilatation subgroups. In addition, post-procedural hsTnT levels were correlated (r = 0.340Item Feasibility of GRACE and TIMI Scores in Predicting the Extension of Coronary Artery Disease in Patients with Non ST Elevation Myocardial Infarction(2013-01-01) Aksu, Hale Unal; Gorgulu, Sevket; Oner, Ender; Erturk, Mehmet; Celik, Omer; Aksu, HuseyinItem The long-term incidence and predictors of radial artery occlusion following a transradial coronary procedure(VIA MEDICA, 2014-01-01) Buturak, Ali; Gorgulu, Sevket; Norgaz, Tugrul; Voyvoda, Nuray; Sahingoz, Yusuf; Degirmencioglu, Aleks; Dagdelen, SinanBackground: Radial artery occlusion (RAO) is an infrequent complication of transradial coronary procedures (TRA). To our knowledge, there is no satisfactory data regarding the late term incidence and predictors of RAO in the literature. Our aim was to establish the long-term incidence of radial artery occlusion and investigate its predictors. Methods: This was a single center prospective study. A total number of 409 consecutive patients undergoing their first TRA were recruited. Clinical and procedural data were all recorded. Doppler ultrasound examination was performed at 6-15 months following the intervention. Results: RAO was detected in 67 patients and 342 patients maintained radial artery patency. The overall RAO incidence was 16.4\% at late term. Patients with RAO were younger than the patients with patent radial arteries (55.9 +/- 9.7 vs. 59.1 +/- 9.4 years, p = 0.014). The incidence of RAO in hypertensive patients (9.8\%) was lower (p < 0.001) than the observed incidence (23\%) in non-hypertensive patients. RAO group had higher rate (28\%, p = 0.027) of post-procedural access site pain. Regression analysis revealed that hypertension was negative while post-procedural access site pain was positive independent predictors for RAO. In addition, the relative risk for RAO also increased significantly (p < 0.001) when the ratio of sheath/artery diameter (S/A) was > 1. Conclusions: The present study reveals that the long-term incidence of RAO is 16.4\%. Hypertension, post-procedural access site pain and S/A ratio > 1 are independent predictors of RAO at late term.Item A case of radial arteriovenous fistula during coronary angiography(TURKISH SOC CARDIOLOGY, 2013-01-01) Gorgulu, Sevket; Norgaz, Tugrul; Sahingoz, YusufItem Rational guidewire use in the coronary chronic total occlusion interventions(SPRINGER, 2020-01-01) Karabulut, Ahmet; Gorgulu, Sevket; Kocagoz, TanilBackground: Procedures for coronary chronic total occlusion (CTO) are still a clinical challenge with relatively lower success rates. Recent advances in the biotechnology and introduction of CTO-dedicated guidewires have increased the procedural success rate of CTO interventions. Herein, we aimed to reveal the clinical and angiographic predictors of the crossability of the initial guidewire choice and rational guidewire usage in CTO interventions. A total of 177 patients with an indication for a coronary CTO procedure were included in this study. The use of 1-3 guidewires and crossing of the CTO lesion with the initial guidewire choice was defined as rational guidewire usage. The CTO lesions were classified according to the Japanese chronic total occlusion registry (J-CTO) and EuroCTO scores for evaluating the difficulty of the procedures. Then, a statistical analysis was performed to assess the initial guidewire choice, crossability, and contributors to rational guidewire usage. Results: The mean J-CTO score was 1.42 +/- 1.16, and the mean EuroCTO score was 1.44 +/- 1.18. The success rate of the procedures was 90.4\%. The initial guidewire choice crossed the lesion in 44.1\% of the cases, in which 1-3 guidewires were used (82.1\%). The crossability of the polymeric and moderate stiff tip guidewires was higher (82.1\% and 64.1\%, respectively), and the Pilot series was the most successful brand (36.2\%). Logistic regression analysis confirmed that J-CTO score, procedural technique, guidewire type, and stiffness of the tip were the major predictors of rational guidewire usage. Conclusion: Our analysis showed that the use of polymeric and moderate stiff tip guidewires, particularly the Pilot brand, were associated with rational guidewire usage in easy and intermediate difficulty CTO cases.Item The Long Term Incidence and Predictors of Radial Artery Occlusion Following a Transradial Coronary Procedure(2013-01-01) Buturak, Ali; Gorgulu, Sevket; Norgaz, Tugrul; Voyvoda, Nuray; Sahingoz, Yusuf; Degirmencioglu, Alex; Demirci, Yasemin; Dagdelen, SinanItem Can an observational case-controlled study assess survival benefits in a group of patients undergoing CABG or medical treatment sufficiently?/Survival of patients with well-developed collaterals undergoing CABG or medical treatment: an observational case-controlled study(AVES YAYINCILIK, 2012-01-01) Norgaz, Tugrul; Gorgulu, SevketItem Late Myocardial Ischemia Induced by a Large Fistula Between Left Internal Mammary Graft and Left Pulmonary Vein System(GALENOS PUBL HOUSE, 2012-01-01) Dagdelen, Sinan; Norgaz, Tugrul; Gorgulu, SevketItem Impressions from EuroPCR Course 2017(TURKISH SOC CARDIOLOGY, 2017-01-01) Gorgulu, Sevket