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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.  
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    The relationship between hyperpolypharmacy and one-year outcomes in patients with critical limb ischemia undergoing below-knee endovascular therapy
    (Sage Publications Ltd, 2023) Altunova, Mehmet; Gulmez, Recep; Karakayali, Muammer; Gurbak, Ismail; Tasbulak, Omer; Demirci, Gokhan; Guler, Arda
    Background Critical limb ischemia (CLI) patients take too many medications because they are elderly and frail patients with multiple comorbidities. Polypharmacy is associated with frailty, although its prognostic significance in CLI patients is unknown. In this study, we aimed to determine the prevalence of hyperpolypharmacy among adults with CLI and its effect on 1-year amputation and mortality.Methods A total of 200 patients with CLI who underwent endovascular therapy (EVT) for below-knee (CTC) lesions were included in this study. Hyperpolypharmacy was defined as using >= 10 drugs. Patients were divided into two groups according to the presence of hyperpolypharmacyResults We detected hyperpolypharmacy in 66 patients. The incidence of 1-year amputation [24 (36.4) versus 12 (9), p<.001] and mortality [28 (42.4) versus 12 (9), p<.001] were higher in patients with hyperpolypharmacy. Univariate and multivariate cox regression analyses were used to determine the independent predictors of amputation and mortality. In the receiver operating characteristic curve analysis, the cut-off value was defined as 10 or more drug use was able to detect the presence of 1-year mortality with 67.5% sensitivity and 79.4% specificity. The Kaplan-Meier method showed a significant difference (rank p <.001 between log groups), and hyperpolypharmacy was associated with 1-year amputation and mortality.Conclusion Hyperpolypharmacy was significantly associated with 1-year mortality and major amputation in CLI patients. Hyperpolypharmacy can be a valuable aid in patient risk assessment in the CLI.