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    Impact of the HALP Score on Long-Term Mortality among Patients Undergoing EVAR
    (Galenos Publ House, 2024) Altunova, Mehmet; Evsen, Ali; Demir, Yusuf; Aktemur, Tugba; Erdogan, Onur; Atmaca, Sezgin; Koseoglu, Mehmet
    Introduction: Endovascular aortic repair (EVAR) is commonly used for abdominal aortic aneurysms, but its mortality rate remains high. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score, which measures hemoglobin, albumin, lymphocyte, and platelet levels, provides prognostic value by reflecting the nutritional status and systemic inflammation. This study aimed to explore the relationship between the HALP score upon admission and long-term mortality in patients with EVAR. Methods: Consecutive patients with EVAR at our tertiary center from October 2010 to August 2021 were retrospectively analyzed. HALP scores were calculated using the following formula: hemoglobin (g/L) x albumin (g/L) x lymphocyte count (/L)/platelet count (/L). In-hospital and long-term mortality data were extracted. Receiver operating characteristic curve analysis identified predictors of in-hospital mortality. Multivariate Cox regression analysis was performed to examine determinants of long-term mortality. Results: Among the 162 participants (mean age: 69.4 +/- 8.2 years, 90.1% male), the HALP score was the most significant predictor of inhospital mortality (area under the curve: 0.752, 95% confidence interval: 0.674-0.830; p<0.001). Multivariate Cox regression analysis revealed HALP (p=0.001) and C-reactive protein (p=0.004) as independent determinants of long-term mortality. Conclusion: This study is the first to investigate the association between the HALP score and in-hospital and long-term mortality in EVAR patients. The HALP score is a robust prognostic tool compared with its components and other parameters in this patient population.
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    Long-Term Outcomes of Endovascular Intervention for Iliac Artery Stenosis: A Single-Center Experience
    (2024) Altunova, Mehmet; Tasbulak, Omer; Evsen, Ali; Uzun, Nedim; Demir, Yusuf; Panc, Cafer; Atmaca, Sezgin
    Abstract Objectives: This study aims to evaluate the technical success, safety, and long-term outcomes of iliac artery endovascular procedures performed at our institution between 2017 and 2022 and to investigate potential risk factors associated with in-stent restenosis (ISR). Methods: This single-center, observational, retrospective cohort study included 398 patients who underwent endovascular intervention for symptomatic iliac artery stenosis. Data were obtained from electronic records, and patients were followed up clinically and radiologically. Multivariate Cox regression analysis was used to identify independent predictors of ISR. Results: ISR was observed in 11.3% of patients during a mean follow-up of 34.7 months. Atrial fibrillation (AF) (p=0.019) and stent diameter (p=0.006) emerged as independent determinants of ISR development. Kaplan-Meier analysis showed a significant difference in ISR between patients with and without AF (log-rank p = 0.022). Conclusion: This study highlights AF and stent diameter as independent predictors of ISR in long-term follow-ups after iliac artery stenting. Patients with AF may require closer monitoring, while appropriate stent selection is crucial in minimizing ISR risk. These findings contribute to optimizing patient management strategies in peripheral artery disease.