Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Endovascular Treatment of Vascular Injuries in the Craniocervical Region With a Graft Stent: A Single-Center Experience(2023) Tanburoglu, Anil; Andic, Cagatay; 37869052Aim: We aimed to evaluate the efficacy and safety of graft stent implantation in the endovascular treatment of vascular injuries in the craniocervical area.Materials and methods: This study was carried out through the retrospective screening of eight (two females and six males) patients' records. Patients who used graft stents as an endovascular method were included in the study. The mean age of the patients was 43.6 years (with a range of 15-69 years). Due to different mechanisms, the patients had vascular injuries in the craniocervical region, and graft stent implantation was performed between 2010 and 2022. We evaluated patient demographics, admission symptoms, trauma mechanisms, angiographic findings, treatment modalities and materials, patient outcomes, and follow-up periods.Results: Due to iatrogenesis for four patients, penetrating trauma for three patients, and blunt trauma for one patient, injuries were present in the right internal carotid artery {ICA} (n=1), left ICA (n=1), left common carotid artery {CCA} (n=3), right CCA (n=1), right vertebral artery (n=1), and left vertebral artery (n=1). Angiographically, pseudoaneurysm was detected in seven patients, and vascular rupture was detected in one patient using contrast agent extravasation. All patients who underwent the endovascular method had technical success. Since bleeding from the external carotid artery branches was seen in two patients, these branches were embolized with coils. No radiologically or neurologically pathological findings were recorded during the follow-up period (with a range of one week to 12 years).Conclusion: Graft stent use in the endovascular treatment of craniocervical vascular injuries is an operable, safe, and promising option, especially in patients with pseudoaneurysms and active bleeding.Item Anterior Hepatic Grooves Accompanied by Chilaiditi Sign: A Retrospective Radiological Analysis of A Neglected Anatomical Fact(2015) Yavuz, Alpaslan; Batur, Abdussamet; Bulut, Mehmet Deniz; Bora, Aydin; Goya, Cemil; Andic, Cagatay; Beyazal, Mehmet; Olmez, Sehmus; 0000-0003-2865-9379; 0000-0002-7288-3936; 0000-0001-8581-8685; 0000-0001-8581-8685; 0000-0002-8796-988X; 25672511; JPK-9408-2023; ABG-1212-2020; AAC-1482-2020; AAM-3180-2021; AAM-1671-2021; H-3947-2014To evaluate anterior hepatic grooves (AHGs) associated with hepato-diaphragmatic mesocolic indentations (Chilaiditi sign) and to delineate the incidence and potential clinical significance of this association. Between November 2011 and June 2014, abdominal computed tomography examinations of 2,314 patients with varied indications were retrospectively reviewed. Patients were surveyed consecutively for the Chilaiditi sign and syndrome, and cases with grooves at the antero-inferior hepatic surface enclosing the adjacent mesocolic indents were determined. The incidence of AHGs and their predominance by gender and age were determined. The potential clinical significance of AHGs associated with Chilaiditi syndrome and their possible effect on liver volume were assessed. The incidences of AHGs were similar between genders (p = .461 and p = .646) and age (p = .113 and .621, respectively) among total cohort and patients with Chilaiditi sign, respectively. There was no significant correlation between AHGs and Chilaiditi syndrome (p = .506); no efficacies of AHGs to liver volume were assessed (p = .413). The AHGs are rare adaptive changes in shape of the liver without a significant effect on liver volume. This overlooked phenomenon is likely derived from the Chilaiditi sign, but has no significant correlation with Chilaiditi syndrome. Future studies with extended series are encouraged to reveal the possible significance of this phenomenon based on concerned surgical interventions.Item Positive Clinical Outcomes of The Saphenous Vein Interposition Technique for Ruptured Popliteal Artery Aneurysm(2014) Coskun, Isa; Demirturk, Orhan Saim; Tunel, Huseyin Ali; Andic, Cagatay; Gulcan, Oner; https://orcid.org/0000-0003-1175-1961; https://orcid.org/0000-0001-8581-8685; 24682572; AAD-5531-2021; AAM-3180-2021Popliteal artery aneurysms (PAAs) can be treated successfully by surgical and endovascular methods; however, the best treatment strategy for a ruptured PAA has yet to be established. We assessed the clinical results of using saphenous vein interposition to treat ruptured PAAs in our hospital. The subjects of this study were seven men (average age 59 years, range 43-71 years), who underwent emergency surgery for a ruptured PAA at our hospital between January 2007 and November 2012. The patients were assessed after 1, 6, and 12 months, postoperatively. All included patients underwent saphenous vein graft interposition via a medial approach. No complications or graft thromboses were encountered in the immediate postoperative period. The patients were discharged after an average of 4 days postoperatively (range 3-5 days). The patients were followed up for an average of 32 months (range 2-60 months). The medium-term graft patency was 100 %. No patients suffered early or medium-term limb loss and there was no mortality. Based on our positive results, saphenous vein graft interposition should be considered as the first choice of surgical treatment for a ruptured PAA.Item Ultrasound-Guided Supraclavicular Brachial Plexus Block for Analgesia during Endovascular Treatment of Dysfunctional Hemodialysis Fistulas(2014) Gedikoglu, Murat; Andic, Cagatay; Guzelmansur, Ismail; Oguzkurt, Levent; Eker, Hatice Evren; https://orcid.org/0000-0002-9884-3190; https://orcid.org/0000-0001-8581-8685; https://orcid.org/0000-0002-7901-0185; 24985719; AAM-3180-2021; AAI-8769-2021Purpose: To evaluate prospectively the efficacy and safety of ultrasound (US)-guided supraclavicular brachial plexus block (BPB) for analgesia during endovascular treatment of dysfunctional hemodialysis fistulas. Materials and Methods: US-guided supraclavicular BPB was performed before endovascular treatment of dysfunctional hemodialysis fistulas in 40 consecutive patients. After BPB, standard interventional procedures were performed for treatment of dysfunctional hemodialysis fistulas. A visual analog scale (0-10) was used to assess pain related to performance of BPB immediately after the endovascular procedure. Patient satisfaction and operator satisfaction during the procedure were also assessed after the procedure. Results: Satisfactory regional anesthesia and analgesia were achieved in all patients without a need for supplemental intravenous analgesia. The mean onset time for complete block was 5.4 minutes +/- 2.6. Pain scores were 0 (no pain) in 26 patients and 1-3 (mild, annoying pain) in 14 patients. The patient's satisfaction with pain control was recorded as satisfied (very well) in all cases. The operator's satisfaction with this anesthetic technique was also recorded as satisfied (very well) in all cases. Complications related to the block procedure did not occur in any patient. Conclusions: US-guided supraclavicular BPB can be used safely to provide analgesia during endovascular treatment of dysfunctional hemodialysis fistulas in adult patients.Item Endovenous Laser Ablation and Sclerotherapy for Incompetent Vein of Giacomini(2014) Guzelmansur, Ismail; Oguzkurt, Levent; Koca, Nihal; Andic, Cagatay; Gedikoglu, Murat; Ozkan, Ugur; https://orcid.org/0000-0001-8581-8685; 23846579; AAM-1671-2021Purpose: To retrospectively evaluate the feasibility and effectiveness of endovenous laser ablation or ultrasound-guided foam sclerotherapy for Giacomini vein insufficiency. This is the largest cohort of patients treated for Giacomini vein insufficiency with endovenous laser ablation or ultrasound-guided foam sclerotherapy. Material and methods: Over a three-year period, 23 females and nine males (age range, 19-67 years) treated for Giacomini vein insufficiency with or without saphenous vein insufficiency were retrospectively reviewed. Diagnosis of venous insufficiency was made by color Doppler ultrasonography. Symptomatic insufficiency of the Giacomini vein or the saphenous veins was treated with endovenous laser ablation. Ultrasound-guided foam sclerotherapy was used for tortuous incompetent Giacomini veins. The venous disease was categorized according to the clinical, etiological, anatomical, and pathological classification, and clinical severity was graded with the venous clinical severity score. Follow-up included clinical examination and color Doppler ultrasonography. Results: Thirty-nine limbs in 32 patients were treated (25 endovenous laser ablation and seven ultrasound-guided foam sclerotherapy). All procedures were technically successful. One patient in the ultrasound-guided foam sclerotherapy group had a recurrence with successful repeated treatment. Recurrence was not seen in the endovenous laser ablation group. No complications were observed. All patients had resolution and improvement in 100% of their symptoms at 12 months of follow-up. Conclusion: Giacomini vein insufficiency is mostly seen with insufficiency of the great saphenous vein and can be effectively treated with endovenous laser ablation or ultrasound-guided foam sclerotherapy.Item Anesthesia Management and Sugammadex Experience in A Neonate For Galen Vein Aneurysm(2016) Ozmete, Ozlem; Bali, Cagla; Ergenoglu, Pinar; Andic, Cagatay; Aribogan, Anis; https://orcid.org/0000-0001-5845-699X; https://orcid.org/0000-0003-2615-1918; https://orcid.org/0000-0002-6366-941X; https://orcid.org/0000-0001-8581-8685; https://orcid.org/0000-0002-4419-5693; 27185673; AAI-7779-2021; AAI-8790-2021; GON-8465-2022; AAM-3180-2021; S-8336-2019Item Efficacy of Endovascular Treatment and Feasibility of Stent-Assisted Coiling in the Presence of Severe and Symptomatic Vasospasm(2017) Andic, Cagatay; Kardes, Ozgur; Durdag, Emre; Gedikoglu, Murat; Akin, Sule; 0000-0001-8581-8685; 0000-0003-2854-941X; 0000-0001-6939-5491; 0000-0001-6423-1076; 27811177; AAM-3180-2021; P-5895-2018; AAK-1734-2021; AAJ-2094-2021Background and purpose In patients with aneurysmal subarachnoid hemorrhage, deciding the optimal treatment strategy is challenging in the presence of severe and symptomatic vasospasm and the existing literature is limited. The purpose of this study was to evaluate the safety and effectiveness of endovascular treatment of intracranial aneurysms and the feasibility of stent-assisted coiling during severe and symptomatic vasospasm. Materials and methods Fifteen consecutive patients with 18 aneurysms who underwent endovascular treatment during severe and symptomatic vasospasm were included in the study. Patient and aneurysm characteristics, treatment technique, and clinical and angiographic outcomes were retrospectively evaluated. Results Aneurysms were treated by the following techniques: single catheter coiling in 9, stent-assisted coiling in 8 (3 aneurysms with Y-configuration double stents), and balloon-assisted coiling in 1. All patients showed angiographic improvement of vasospasm after treatment including a noticeable dilation of the spastic parent arteries following deployment of the stents. According to the immediate post-treatment angiography results, 14 aneurysms (77.8%) had class I occlusion and 4 (22.2%) had class II occlusion. Three patients died during the course of subarachnoid hemorrhage. Mortality was related to the poor grade (Hunt and Hess grade V) and cardiovascular complications in two and refractory vasospasm one patient. The remaining patients had favorable clinical outcomes at follow-up (modified Rankin Scale 0-2). Conclusions Endovascular treatment of intracranial aneurysms during severe and symptomatic vasospasm is safe and effective. Stent-assisted coiling in the presence of severe vasospasm is also feasible in wide-necked aneurysms with the additional benefits of mechanical vasodilation.Item Safety and efficacy of angio-seal use in patients with acute ischemic stroke who received thrombolytic therapy and underwent mechanical thrombectomy(2022) Tanburoglu, Anil; Karluka, Ismail; Mazican, Mustafa; Andic, CagatayPurpose: This study aims to evaluate the efficacy and safety of closure of the femoral artery access site using the Angio-Seal Vascular Closure Device in patients who underwent bridging intravenous thrombolytic therapy and subsequent mechanical thrombectomy (MT). Materials and Methods: The retrospective, observational study was performed in patients who were diagnosed with acute ischemic stroke and treated with MT after bridging IVT between September 2018 and September 2021. A total of 97 patients whose femoral artery access sites were closed with Angio-Seal after the procedure was performed were included in the study. Primary demographic data, accompanying risk factors, major and minor complication rates, frequency distributions of categorical variables, and descriptive statistics of quantitative data were calculated and recorded. Results: It was found that 96.9% of the patients did not have major complications, where 97.9% did not have minor complications either. Successful hemostasis was achieved in the groin region in all patients. Major complications observed were recorded as follows: 1 (1%) pseudo-aneurysm, 1 (%) inguinal incision site infection, and 1 (1%) Angio-Seal placement failure. No major complications were observed in 98.2% of those using 6 Fr (French) Angio-Seal and 95.1% of those using 8 Fr Angio-Seal. Conclusion: The findings of the study indicate that Angio-Seal is an effective and safe method for providing groin hemostasis in patients with acute ischemic strokeItem Long-term clinical and angiographic follow-up results of the dual-layer flow diverter device (FRED) for the treatment of intracranial aneurysms in a multicenter study(2021) Dinc, Hasan; Saatci, Isil; Oguz, Sukru; Baltacioglu, Feyyaz; Yildiz, Altan; Donmez, Halil; Belet, Umit; Onal, Baran; Andic, Cagatay; Koc, Osman; Kocak, Omer; Koroglu, Mert; Cetin, Mustafa; Cekirge, H. Saruhan; https://orcid.org/0000-0001-8581-8685; 33392735; AAM-3180-2021Purpose Our aim was to determine the long-term safety and efficacy of the Flow Re-Direction Endoluminal Device (FRED) in this multicenter study with prospective design. Materials-method This study included 136 consecutive patients with 155 aneurysms treated between March 2013 and June 2016 in 10 centers. Twenty-two (16.2%) patients presented with rupture of the index aneurysm. Large/giant aneurysms comprised 1/3 of the cohort. Adjuvant coil use during the treatment was 15.5%. The effectiveness measure in the study was the percentage of aneurysms with stable occlusion at follow-up. Results Vascular imaging follow-up was performed at least once in 131/136 (96.3%) patients with 148/155 (95.5%) aneurysms up to 75 months (mean: 37.3 months; median: 36 months according to latest follow-up), and 102/155(65.8%) aneurysms in 90/136 (66.2%) patients had >= 24-month control. According to the latest controls, the overall stable occlusion rate was 91.9% (95% CI, 87.5 to 96.3%). Three out of 148 aneurysms with follow-up were retreated (2%, 95% CI 0.0 to 4.3%). Adverse events were noted in 19/136 (14%, 95% CI, 9 to 21%) patients with a morbidity of 1.5% (95% CI, 0.0 to 3.5%). Mortality was 1/136 (0.7%, 95% CI, 0.02 to 2.2%) and was unrelated to aneurysm treatment. In-stent stenosis (ISS) was detected in 10/131 of the patients with follow-up (7.6%, 95% CI; 3.1 to 12.2%), only one being symptomatic. No adverse events have occurred in any of the patients with follow-up after 24 months, except the one resulting from ISS. Conclusion In the treatment of cerebral aneurysms which were candidates for flow diversion technique, this study showed long-term efficacy of FRED with good safety and occlusion rates.Item Effect of decompressive hemicraniectomy in patients with acute middle cerebral artery infarction 2050(2021) Suner, Halil İbrahim; Tanburoglu, Anil; Durdag, Emre; Civi, Soner; Gunesli Yetisken, Aylin; Kardes, Ozgur; Andic, Cagatay; Tufan, Kadir; 0000-0002-5957-8611; 0000-0003-2854-941X; 0000-0001-9627-3502; 0000-0001-8581-8685; 33890450; AAJ-5381-2021; P-5895-2018; AAK-1876-2021; AAM-1671-2021Background/aim: We aimed to determine in which cases this procedure may be more effective based on the data of patients who underwent decompressive hemicraniectomy (DHC). Material and methods: Overall, 47 patients who underwent DHC due to acute middle cerebral artery (MCA) infarction between January 2014 and january 2019 were retrospectively investigated. These patients were divided into two groups: those who died after DHC (Group A) and those who survived DHC (Group B). The groups were compared in terms of various parameters. We investigated whether the patient's modified Rankin scale (mRS) status changed depending on age (> 60 and < 60 years). Results: The median age of all patients was 65 (37-80) years; groups A and B had median ages of 66.5 (37-80) and 61 (44-79) years (p = 0.111), respectively; 55.3% patients were male. The elapsed times until hospitalization after the onset of symptoms were 4.5 and 3 h in groups A and B, respectively (p = 0.014). The median GCS score at the time of admission was 7 (5-12) and 10 (8-14) in groups A and B, respectively (p = 0.0001). At the time of admission, 63.3% patients in group A had anisocoria, whereas no patient in group B had anisocoria (p = 0.0001). In postoperative period, 40% patients in group A and all patients in group B received AC/AA treatment. The survival of patients aged < 60 and > 60 years who underwent DHC for MCA infraction was 61.5% and 26.5%, respectively (p = 0,041). The median mRS of patients < 60 and > 60 years were 4 (1-6) and 6 (1-6), respectively (p = 0.018). Conclusion: Age, DHC timing, and elapsed time until hospitalization or access to treatment directly affect the functional outcome and survival in MCA-infarcted patients who underwent DHC. In patients in whom the medical treatment fails, early DHC administration will increase survival without waiting for neurological worsening once herniation is detected radiologically.
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