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    Effects of Coronary Angiography and Femoral Arterial Access on Endothelial Functions
    (Lippincott Williams & Wilkins, 2011) Tulmac, Murat; Ozer, Nurtac; Simsek, Vedat; Dogru, Mehmet Tolga; Ebinc, Haksun
    Background: Impairment of endothelial function is an independent predictor of coronary events. The aim of this study was to clarify the influence of arterial access and coronary angiography on endothelial function. Methods: Eighteen patients with stable angina pectoris who underwent coronary angiography were included in this study. Brachial artery flow-mediated dilatation of patients was measured before angiography, after femoral arterial sheath insertion, and after coronary angiography. Results: Of 18 patients, 11 had angiographically apparent atherosclerosis. Flow-mediated dilatation after femoral arterial sheath insertion (mean +/- SD, 6.62% +/- 3.87%) was found to be significantly lower than either before (10.62% +/- 5.18%) or after coronary angiography (11.66% +/- 5.30%; P = 0.007 and P = 0.001, respectively). Basal and postangiographic flow-mediated dilatation values were similar. Flow-mediated dilatation significantly decreased after sheath insertion in the group with angiographically normal coronary arteries (14.47% +/- 4.34% vs 5.98 +/- 4.00%, respectively; P = 0.006), whereas the difference was not significant in patients with CAD (8.17% +/- 4.16% vs 7.03% +/- 3.92%, respectively). Conclusions: Coronary angiography did not result in endothelial vasomotor dysfunction. Femoral arterial sheath insertion during coronary angiography was associated with a short-lived endothelial dysfunction. Larger studies are needed to interpret the effect of coronary atherosclerosis on attenuation of endothelial response against arterial wall injury.
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    Uncomplicated retainment of metal coronary bulldog clips recognized five years after coronary artery bypass graft surgery
    (Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2011) Tulmac, Murat; Ozer, Nurtac; Ebinc, Haksun; Simsek, Vedat; Dogru, M. Tolga
    We report a patient with retained metal coronary bulldog clips in the mediastinum during coronary artery bypass surgery which was recognized during coronary angiography following the diagnosis of unstable angina pectoris after an uncomplicated period of five years. This case suggests that conservative management of patients with postoperatively recognized retained foreign material should be kept in mind as an alternative to reoperation.