Background & Aim: The aim of this study was to evaluate the outcome of endovascular surgery; aneurysm regrowth, recanalization and need for re-embolization.Methods & Materials/Patients: A retrospective analysis was performed on 64 aneurysms, which have been treated by endovascular surgery from 2011 to 2016. Of those aneurysms 44 were asymptomatic and 20 were ruptured. The risks of endovascular therapy, aneurysm regrowth, recanalization and the need for remobiliza tion were evaluated.Results: The mean observation time was 13 months (ranging from 180 days to 420 days). Complete occlusion at initial intervention was achieved in 50 of 64 aneurysms (78%), 80-85% occlusion was seen in 9 aneurysms (14.2%), <80% occlusion in 5 aneurysms (7.8%). Among 50 aneurysms with complete occlusion, 3 (6%) showed recanalization or neck regrowth at follow up. Among partially occluded aneurysms, 2 (14.2%) showed recanalization or neck regrowth.2 (40%) of 5 aneurysms with less than 80% occ lusion, underwent recoiling.Conclusion: The initial degree of aneurysm occlusion seems to have an influe nce on likelihood of recanalization.

Spontaneous recanalization of a stenotic atherosclerotic lesion is a rare finding. We report a 66-year-old man with severe discrete stenosis at the distal part of the left anterior descending candidated for percutaneous intervention. However, before stent deployment, the patient showed complete relief of the stenotic lesion.

Introduction: P-wave dispersion (PWD) obtained from the standard 12-lead electrocardiography (ECG) is considered to reflect the homogeneity of the atrial electrical activity. The aim of this investigation was to evaluate the effect of percutaneous chronic total occlusion (CTO) revascularization on the parameters of P wave duration and PWD on ECG in cases before and after procedure at 12th months. Methods: We analyzed 90 consecutive CTO cases who were on sinus rhythm and underwent percutaneous coronary intervention (PCI). P-wave maximum (P-max) and P-wave minimum (P-min), P-wave time, and PWD were determined before and twelve months after the CTO intervention. The study population was categorized into two groups as successful and unsuccessful CTO PCI groups. Results: The CTO PCI was successful in 71% of cases (n = 64) and it was unsuccessful in 29% of cases (n = 26). Both groups, except for age and hypertension, were similar in terms of demographic and clinical aspects. CRP levels were significantly elevated in the unsuccessful CTO PCI group. Pre-PCI ECG parameters showed no significant difference. Irrespective of the target vessel revascularization, we observed that PWD and P-max values were significantly lower in the 12th months follow-up. In all Rentrop classes, PWD values were significantly decreased at 12th months follow-up in comparison to the pre-CTO PCI values. Conclusion: This study has determined that PWD and P-max, which are both risk factors for atrial arrhythmias, are significantly reduced within 12th months after successful CTO PCI regardless of the target vessel.

Background: Percutaneous coronary intervention (PCI) of total chronic coronary occlusions (CTOs) still remains a major challenge in interventional cardiology. There is little knowledge in the literature about differences in CTO-PCI between diabetic and nondiabetic patients in the era of third-generation drug-eluting stents (DESs). In this study, we analyzed the impact of diabetes mellitus (DM) on procedural characteristics, complications, and acute outcomes in a cohort of 440 patients. Methods: Between 2012 and 2016, we recruited 440 consecutive patients, 116 of them with DM. All the patients underwent PCI for at least 1 CTO. Antegrade and retrograde CTO recanalization techniques were applied. Only third-generation DESs were used. We used t-tests and the Pearson chi-quadrat test to test the significant differences in the variables between the 2 groups. Results: The patients with DM were older than the nondiabetics (64. 5 y vs. 61. 1 y; P=0. 003), and they suffered more frequently from a chronic kidney disease (7. 1% vs. 2. 4%; P=0. 001). The nondiabetics less frequently had arterial hypertension (75. 3% vs. 89. 7%; P=0. 001); however, they more often had a family liability for CAD (32. 1% vs. 22. 4%; P=0. 050) and had a higher left ventricular ejection fraction (59. 2% vs. 56. 7%; P=0. 011). The success rate was 85. 2% in the patients without DM and 81. 2% in the patients with DM (P=0. 403). The existence of DM had no impact on the procedural success and complication rates. Conclusion: Our study on 440 patients shows that diabetics and nondiabetics have similar success and complication rates after the recanalization of CTOs using third-generation DESs. It is a feasible and safe procedure and can be recommended as an alternative treatment.

Background: The occlusion site of the cerebral artery can help to determine recanalization success, treatment and prognosis in acute stroke patients. In current studies, different measurement techniques and different length values have been considered. We aimed to determine the relationship between the location of occlusion and recanalization success following endovascular therapy of acute middle cerebral artery (MCA) M1 occlusion. Methods: This study was conducted from January 2015 to March 2019. The “ M1 distance-to-thrombus length” was determined on curve-linear reformat reconstruction of the MCA, and measured from the center of internal carotid artery (ICA) bifurcation to the beginning of the thrombus on digital subtraction angiography (DSA). A successful recanalization was defined as ≥ modified thrombolysis in cerebral infarction (mTICI) 2b and full recanalization as mTICI 3. Evaluation of patients at the end of the third month was carried out with modified Rankin Scale (mRS) and mortality. Results: We eventually included 95 patients treated with endovascular therapy. The patients with distance to thrombus (DT) ≤ 13. 2 mm showed significantly higher rates of full recanalization (AUC = 0. 639 ± 0. 06; P = 0. 014, 95% confidence interval [CI]). Additionally, DT could predict successful recanalization with an AUC of 0. 639. The possibility to distinguish unsuccessful recanalization cases after the endovascular treatment by considering DT had 85. 7% sensitivity (95% CI). Of the 82 (86. 3%) patients who were treated with successful recanalization (≥ mTICI 2b), 46 (48. 4%) achieved mRS (0– 3) and 38 (40%) expired at the end of the 3 months. Conclusion: Shorter DT was associated with higher rate of full recanalization (mTICI 3) after endovascular therapy. Having a longer DT reduces the chance of successful recanalization without distal embolism. However, there was no statistically significant effect for DT on a favorable outcome at third months or mortality with endovascular treatment of MCA M1 occlusions.