Gokhan Ilhan

Recep Tayyip Erdoğan Üniversitesi, Çorum, Rize, Turkey

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Publications (25)35.45 Total impact

  • Berkan Ozpak · Gokhan Ilhan · Barcin Ozcem · Hakan Kara
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    ABSTRACT: Background Anticoagulant treatment is recently being replaced by more aggressive endovascular modalities in the management of acute deep vein thrombosis (DVT). These techniques have been promoted to improve thrombus removal, prolong venous patency, prevent venous insufficiency, and reduce post thrombotic syndrome. The aim of the present study is to overview the short-term results of percutaneous mechanical thrombectomy (PMT) for acute DVT. Methods This retrospective study is based on data from 21 acute DVT patients treated with PMT in the cardiovascular surgery department of a tertiary care center. The average age of patients was 48.76 (range: 27-69). Retrievable inferior vena cava (IVC) filters were administered via right subclavian vein or contralateral femoral vein and withdrawn after PMT procedure. Low-molecular-weight heparin (LMWH) was used for anticoagulation in the first 10 days postoperatively. Results Venous patency was restored in 20/21 patients (95%) at first month, and in 18/21 patients (85%) at sixth month. Valvular competency was preserved in 16 patients (76%). Balloon angioplasty with or without stent implantation was performed in three patients with stenosis in femoral or iliac veins. Conclusion In conclusion, PMT is a safe and effective treatment modality that can be used alone in the treatment of acute DVT of lower extremities in selected cases. Further controlled trials on larger series and reports on long-term results are warranted to document the actual therapeutic potential and safety this endovascular procedure. Georg Thieme Verlag KG Stuttgart · New York.
    The Thoracic and Cardiovascular Surgeon 06/2015; DOI:10.1055/s-0035-1549357 · 1.08 Impact Factor
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    ABSTRACT: Aortic occlusion is rare catastophic pathology with high rates of mortality and severe morbidity. In this study, we aimed to share our experience in the management of aortic occlusion and to assess the outcomes of extra-anatomic bypass procedures. Eighteen patients who had undergone extra-anatomic bypass interventions in the cardiovascular surgery department of our tertiary care center between July 2009 and May 2013 were retrospectively evaluated. All patients were preoperatively assessed with angiograms (conventional, computed tomography, or magnetic resonance angiography) and Doppler ultrasonography. Operations consisted of bilateral femoral thromboembolectomy, axillobifemoral extra-anatomic bypass and femoropopliteal bypass and were performed on an emergency basis. In all patients during early postoperative period successful revascularization outcomes were obtained; however, one of these operated patients died on the 10th postoperative due to multiorgan failure. The patients were followed up for a mean duration of 21.2±9.4 months (range, 6 to 36 months). Amputation was not warranted for any patient during postoperative follow-up. To conclude, acute aortic occlusion is a rare but devastating event and is linked with substantial morbidity and mortality in spite of the recent advances in critical care and vascular surgery. Our results have shown that these hazardous outcomes may be minimized and better rates of graft patency may be achieved with extra-anatomic bypass techniques tailored according to the patient.
    06/2015; 48(3):187-92. DOI:10.5090/kjtcs.2015.48.3.187
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    Gokhan Ilhan · Berkan Ozpak · Tevfik Gunes · Mert Kestelli
    Journal of Thoracic and Cardiovascular Surgery 02/2015; 149(2):647-8. DOI:10.1016/j.jtcvs.2014.10.016 · 3.99 Impact Factor
  • Therapeutic Advances in Cardiovascular Disease 05/2014; 8(3):119-122. DOI:10.1177/1753944714531064 · 2.13 Impact Factor
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    ABSTRACT: The results of surgical approaches are unsatisfactory in patients with a distal arterial bed that is ineligible for revascularization. In this retrospective study, we investigated outcomes in patients who underwent surgical interventions that are reported to induce angiogenesis. 6 patients diagnosed with thromboangiitis obliterans were included in this study. Of these 6 patients, 2 underwent femoropopliteal bypass surgery using reversed great saphenous vein as a conduit. The other 4 underwent ascending venous arterialization (bypass from the popliteal artery to the great saphenous vein at the level of medial malleolus, using reversed great saphenous vein). During the early postoperative period, all of the reversed saphenous vein grafts were occluded. The mean postoperative ankle-brachial index increased from 0.33 to 0.83. During the postoperative period, intermittent claudication disappeared in all patients. Angiograms taken during the postoperative period showed evidence of neovascularization when compared to those taken during preoperative evaluation. Wound healing is an inflammatory process that simultaneously activates angiogenesis. We propose that the improved ankle-brachial index values and neovascularization shown in our patients were associated with this inflammatory process.
    Asian cardiovascular & thoracic annals 01/2014; 22(1):36-9. DOI:10.1177/0218492312468285
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    European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 01/2014; 45(1):209. DOI:10.1093/ejcts/ezt543 · 2.81 Impact Factor
  • Journal of Cardiothoracic Surgery 09/2013; 8(Suppl 1):P49-P49. DOI:10.1186/1749-8090-8-S1-P49 · 1.03 Impact Factor
  • Journal of Cardiothoracic Surgery 09/2013; 8(Suppl 1):P47-P47. DOI:10.1186/1749-8090-8-S1-P47 · 1.03 Impact Factor
  • Journal of Cardiothoracic Surgery 09/2013; 8(Suppl 1):P48-P48. DOI:10.1186/1749-8090-8-S1-P48 · 1.03 Impact Factor
  • Journal of Cardiothoracic Surgery 09/2013; 8(Suppl 1):P46-P46. DOI:10.1186/1749-8090-8-S1-P46 · 1.03 Impact Factor
  • Journal of Cardiothoracic Surgery 09/2013; 8(Suppl 1):P45-P45. DOI:10.1186/1749-8090-8-S1-P45 · 1.03 Impact Factor
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    ABSTRACT: Hyperbaric oxygen (HBO) has been shown to be effective in preventing neurological injuries in animal models of ischaemia, whereas iloprost (IL) prevents ischaemia-related mitochondrial dysfunction and reduces infarction size after focal cerebral ischaemia in animal models. The aim of the present study was to investigate the effect of combined HBO and IL treatment on spinal cord ischaemia-reperfusion (IR) injury by neurological, histopathological and biochemical methods in an experimental study. Eighty New Zealand white male rabbits were randomly allocated into one of five study groups. The HBO group received a single session of HBO treatment and the IL group received an infusion of 25 ng/kg/min IL; the HBO + IL group received both HBO and IL and the control group received only 0.9% saline; the fifth group was the sham group. Levels of S100β protein, neuron-specific enolase (NSE) and nitric oxide (NO) were measured at onset, at the end of ischaemia period and at the 24th and 48th hour of reperfusion. Physical activity was assessed using Tarlov criteria 24, and the spinal cords of the sacrificed rabbits were evaluated histopathologically. Additionally, tissue malondialdehyde (MDA) and antioxidant enzyme activities [total superoxide dismutase (SOD); catalase (CAT) and glutathione peroxidase (GSH-Px) were assessed. Neurological scores in the HBO, IL and HBO + IL groups were statistically significantly better compared with the control group at the 24th (P = 0.001 for all) and 48th hour (P = 0.001 for all). Histopathological scores in the HBO, IL and HBO + IL groups were also significantly better compared with the control group (P = 0.003, 0.001 and 0.001, respectively). Whereas MDA, NSE, S100β protein and NO concentrations were significantly lower, CAT and GSH-PX levels were significantly higher in either sham or treatment groups compared with the control group. Since we demonstrated beneficial effects on spinal cord IR injury, we think that both HBO and IL, either alone or in combination, may be reasonable in the treatment of IR injury. Furthermore, there did not appear to be synergistic effects with combined treatment. More research is needed for practical application in humans, following thoracoabdominal aortic surgery.
    European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 08/2013; 44(5). DOI:10.1093/ejcts/ezt398 · 2.81 Impact Factor
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    ABSTRACT: The objective of this study was to demonstrate the role of major surgery on patients presenting with vascular complications after lumbar disc surgery. A retrospective analysis of seven cases treated surgically in two tertiary care centers between August 2001 and June 2010 was carried out. The average age of patients (three women and four men) was 35.8 ± 7.2. The most common vessel injured was the left common iliac artery occurring in five patients (71.4%), followed by the left common iliac vein injury detected in two patients (28.5%). Transperitoneal approach was preferred in all cases and primary suturing, graft interposition and end-to-end anastomoses were the surgical methods used for the repair of vascular injury. No mortality was seen in our series during the follow-up period of two years; however, the most noteworthy complication was paraplegia occurring in one patient. Vascular injury occurring at lumbar discus surgery has a considerable potential for morbidity and mortality. A high index of suspicion is necessary for early diagnosis. In hemodynamically instable patients, the transperitoneal approach provides better exposure and more effective control of hemorrhage, while minimal angiography and endovascular intervention should be preserved for hemodynamically stable cases.
    Vascular 03/2013; 21(2). DOI:10.1177/1708538113478727 · 1.00 Impact Factor
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    ABSTRACT: Aim. The aim of the study was to evaluate the role of intracoronary shunt during off-pump coronary artery bypass surgery in patients with isolated left anterior descending coronary artery lesion. Methods. Forty patients undergoing off-pump coronary artery bypass using the left internal mammary artery to bypass the left anterior descending coronary artery were randomly assigned to have the bypass performed with intracoronary shunt or by occlusive snaring. Potential damage from the shunt or from snaring was monitored by clinical follow-up, monitoring of cardiac enzymes (cardiac troponin I, CK, CK-MB), electrocardiography, and echocardiography before and 24 h. after the surgery. Left ventricular myocardial biopsies were performed during surgery for histopathological analysis. Results. None of the patients in this study died during or after the surgery. Duration of the anastomosis was significantly longer in the shunt group. No significant difference concerning the preoperative and postoperative CK levels between groups. The preoperative CK-MB levels of the groups were not significantly different, whereas postoperative levels was significantly lower in the shunt group. The preoperative troponin I levels of the groups were not significantly different, whereas postoperative levels was significantly higher in the snare group. Myocardial edema was significantly less in shunt group compared with snare group. There were no electrocardiographic abnormalities, severe CK-MB elevation, or hemodynamic deterioration after the operation in both groups. Conclusion. Intracoronary shunt may have beneficial effects due to the reduction of postoperative troponin I levels and myocardial edema during grafting of the left anterior descending coronary artery. However, further trials need to be performed for the documentation of their impacts precisely.
    The Journal of cardiovascular surgery 01/2013; · 1.37 Impact Factor
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    ABSTRACT: Objectives The aim of this study was to investigate the effects of the vasodilating β-blocker nebivolol and the cardioselective β-blocker metoprolol on nitric oxide (NO) levels at vascular graft endothelium and vasa vasorum compared to controls in patients undergoing coronary artery bypass graft surgery. Design Prospective study. Materials Fifty-five patients were divided into three groups: Nebivolol group (group N, n = 23), metoprolol group (group M, n = 16), control group (group A, n = 16). Group N received nebivolol 5 mg once daily, and Group M received metoprolol 50 mg once daily for 15 days in the preoperative period. Control patients did not use β-blocker therapy. Methods Tissue samples of both left internal mammary artery (LIMA) and saphenous vein grafts were investigated for NO activity using immunohistochemical methods. Results Demographic characteristics and risk factors were similar between groups. We observed highest NO activity in nebivolol group at both endothelial and vasa vasorum samples of LIMA and saphenous veins. NO activity of metoprolol group was similar to controls. Conclusions According to our results, we think that nebivolol may be safer and preferable in order to diminish graft spasm in patients undergoing coronary artery bypass graft surgery due to NO mediated vasodilating effect.
    European journal of vascular and endovascular surgery: the official journal of the European Society for Vascular Surgery 01/2013; 47(2). DOI:10.1016/j.ejvs.2013.11.003 · 3.07 Impact Factor
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    Sahin Bozok · Ozcan Yavaşi · Gokhan Ilhan · Ali Gurbuz
    The western journal of emergency medicine 12/2012; 13(6):527-8. DOI:10.5811/westjem.2012.3.11562
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    ABSTRACT: AIM: To investigate whether α-tocopherol and ascorbic acid have effect on the suppression of inflammation in the early postoperative period after open heart surgery. METHODS: A total of 59 patients who had undergone cardiopulmonary bypass (CPB) in the Cardiovascular Surgery Department of a tertiary center between June 2008 and December 2008 were retrospectively investigated. The study group consisted of 34 patients (25 men, 9 women) to whom ascorbic acid (500 mg/day) and α-tocopherol (300 mg/day) were administered on the day of operation (0th day) and the first four consecutive postoperative days. In contrast, 25 controls (20 men, 5 women) received no additional anti-inflammatory medications. The two groups were compared in terms of demographics, blood parameters such as C-reactive protein (CRP) and white blood cell (WBC) count, and durations of cross-clamp and CPB. RESULTS: In the control group, CRP levels were found to be increased on the first postoperative day (P < 0.001) and CRP levels were correlated with triglyceride levels on the day of operation (P = 0.009) and the first postoperative day (P = 0.021). On the second postoperative day WBC count was found to be decreased (P = 0.008) and correlated with glucose level (P < 0.005). In the study group, CRP levels were found to be inversely correlated with serum high-density lipoprotein (HDL) (P = 0.049) on the first postoperative day and directly correlated with triglyceride levels on the second postoperative day (P = 0.017). Blood glucose levels were found to be increased on the first postoperative day (P = 0.021) and a correlation was detected between WBC count on the fourth postoperative day and doses of ascorbic acid and α-tocopherol (P = 0.027). CONCLUSION: Suppression of the systemic inflammatory response to CPB is a double-edged sword and whether this suppression aids in the attenuation of morbidity and mortality is obscure. In this respect, ascorbic acid and α-tocopherol seem to display some anti-inflammatory effect, but further studies are necessary to reveal the actual therapeutic potential and the complex mechanism related to biochemical and inflammatory parameters.
    Journal of Cardiovascular Medicine 08/2012; 13(11). DOI:10.2459/JCM.0b013e328356a2dc · 1.51 Impact Factor
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    ABSTRACT: Behçet's disease is a multisystemic vasculitis of unknown etiology, which is characterized by recurrent urogenital ulceration, cutaneous eruptions, ocular manifestations, arthritis and vasculitis, and its diagnosis is based on clinical criteria. Herein, we report a case of a patient with Behcet's disease, who was successfully managed with anticoagulant and anti-inflammatory therapy for disseminated venous thrombosis leading to pleural effusion, Budd-Chiari syndrome and central nervous system involvement following coronary artery bypass grafting surgery.
    VASA.: Zeitschrift für Gefässkrankheiten. Journal for vascular diseases 07/2012; 41(4):301-5. DOI:10.1024/0301-1526/a000208 · 1.21 Impact Factor
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    ABSTRACT: The role of multiorgan damage in the mortality caused by ischemic limb injury is still not clarified. The objective of this study was to examine the potential protective effects of hyperbaric oxygen (HBO) and iloprost (IL) therapy on lung damage induced by limb ischemia/reperfusion injury in a rabbit model, using both biochemical and histopathological aspects. Forty New Zealand white rabbits were randomly allocated into one of five study groups: HBO group (single session of HBO treatment); IL group (25 ng/kg/min infusion of IL); HBO + IL group (both HBO and IL); Control group (0.9% saline only); and a sham group. Acute hind limb ischemia-reperfusion was established by clamping the abdominal aorta for 1 h. HBO treatment and IL infusion were administrated during 60 min of ischemia and 60 min of reperfusion period. Blood pH, partial pressure of oxygen, partial pressure of carbon dioxide and levels of bicarbonate, sodium, potassium, creatine kinase, lactate dehydrogenase, and tumor necrosis factor alpha were determined at the end of the reperfusion period. Malondialdehyde was measured in the plasma and lung as an indicator of free radicals. After sacrifice, left lungs were removed and histopathological examination determined the degree of lung injury. In the control group, blood partial pressure of oxygen and bicarbonate levels were significantly lower and creatine kinase, lactate dehydrogenase, malondialdehyde and tumor necrosis factor-α levels were significantly higher than those of the HBO group, IL group, HBO + IL group and sham group. Similarly, the malondialdehyde levels in the lung tissue and plasma levels were significantly lower in the treatment groups compared with the control group. The extent of lung injury according to the histological findings was significantly higher in the control group. These results suggest that both HBO and IL therapies and their combination might be effectively used in the prevention of lung injury after ischemia/reperfusion injury of the lower extremities.
    06/2012; 17(1):14. DOI:10.1186/2047-783X-17-14
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    Sahin Bozok · Mert Kestelli · Gokhan Ilhan · Banu Lafci
    European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 05/2012; 42(2):388-9; author reply 389-90. DOI:10.1093/ejcts/ezs109 · 2.81 Impact Factor

Publication Stats

35 Citations
35.45 Total Impact Points

Institutions

  • 2012–2015
    • Recep Tayyip Erdoğan Üniversitesi
      Çorum, Rize, Turkey
  • 2012–2013
    • Rize University
      Çorum, Rize, Turkey
  • 2008
    • Izmir Bozkaya Research and Training Hospital
      Ismir, İzmir, Turkey