Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Simultaneous balloon angioplasty and stent implantation in supraaortic multiple stenosis(2020) Gunesli, Aylin; Akgul, ErolPurpose: The aim of this study was to evaluate the success and complications of endovascular treatment in supraaortic multiple stenotic lesions Materials and Methods: The study was planned as a retrospectively. The records of patients who underwent percutaneous interventional treatment for multiple stenosis in the supraaortic vessels between January 1, 2004 and December 31, 2009 were reviewed. Percutaneous endovascular intervention was decided with doppler ultrasonography, magnetic resonance imaging, computed tomography or digital subtraction angiography provided that more than 50% stenosis was detected in the supraaortic vessels. Patients with at least 2 severe stenosis who underwent multiple interventional procedures in one session were included in the study. Results: A total of 34 patients (mean age 60.4 +/- 12.5 years and 6 female (17.4%)) were included in the study. A total of 74 lesions were treated in 34 patients. Stents were used in all procedures. No mortality or serious morbidity was observed during follow-up. The technical success of the procedure was 100%. Restenosis was observed in 4 patients (11.7%) at a mean follow-up of 29.5 +/- 18.3 months. Three of these patients were re-treated. Conclusion: According to the results of our study, endovascular intervention can be safely performed in occlusive atherosclerotic vascular disease of the supraaortic branches. Mortality and morbidity of this treatment is very low. In patients with restenosis during follow-up, re-intervention can be performed safely. If multiple lesions are present in the same patient group, multiple interventions are a safe treatment option.Item Endovascular treatment of an iliac artery rupture caused by invasive Salmonella spondylodiscitis(2014) Kursun, Ebru; Turunc, Tuba; Ozkan, Ugur; Demiroglu, Yusuf Ziya; 25230272The rate of non-typhoid Salmonella infections has increased remarkably in recent years. Endovascular system infection is one of the most serious forms of extraintestinal Salmonella infection. The abdominal aorta is frequently involved, while bone and joint involvement are rarely seen. We present a rare case of successful endovascular treatment of a left iliac artery rupture and pseudoaneurysm both occurring due to the direct invasion of lumbar spondylodiscitis caused by Salmonella typhimurium.Item Angiographic Morphometry of Internal Carotid Artery Circulation in Turkish Children(2015) Arat, Yonca Ozkan; Arat, Anil; Aydin, Kubilay; 26242339AIM: Knowledge of cerebrovascular morphology is integral in planning neuroendovascular interventions, especially for procedures involving placement of stents, flow diverters or stentrievers. There is insufficient data on angiographic normative values of cerebral circulation in the pediatric age group since angiograms are uncommonly performed in children except for arteriovenous malformations in which arterial dimensions are larger than normal. We aimed to measure the diameters of internal carotid circulation (ICC) arteries on digital subtraction angiograms of pediatric patients and determine the growth trends. MATERIAL and METHODS: This is a retrospective cross-sectional study measurements of ICC arteries of 64 pediatric patients (4- 122 months) with retinoblastoma undergoing intra-arterial chemotherapy. RESULTS: Petrous, cavernous, supraclinoid and choroidal segments of internal carotid artery (ICA) and anterior cerebral artery (ACA) diameters had significant correlation with age. Most of the growth was noted in the first 36-48 months of life. Middle cerebral artery (MCA) diameter did not show significant correlation with age. 87% of the adult diameter of the MCA was attained in the first 6 months of life. ICC arteries reached 81% to 99% of adult sizes in the first 48 months of life. On the contrary, the main iliac artery was only 59% of the adult diameter at this age group. CONCLUSION: Use of current intracranial stents in children appears tolerable due to the growth pattern of ICC arteries. Based on this data, the current armamentarium of intracranial stents or stent-like devices is sufficient to cover the need in the pediatric population.Item Endovascular Treatment of Wide Necked Ruptured Saccular Aneurysms with Flow-Diverter Stent(2017) Duman, Enes; Coven, Ilker; Yildirim, Erkan; Yilmaz, Cem; Pinar, H.Ulas; 0000-0002-2353-8044; 0000-0003-0473-6763; 0000-0002-9057-722X; 27593785; AAK-2948-2021; Q-2420-2015; ABI-3856-2020AIM: Flow diverter (FD) stents have been used in the treatment of unruptured intracranial aneurysms. There are a few studies that report the use of these devices in ruptured blister-like aneurysms. We present 5 consecutive patients, who had ruptured intracranial wide necked or side branch close to the neck of saccular aneurysms, with no other treatment options, treated with FD stents and coil embolization. MATERIAL and METHODS: Between September 2012 and April 2015, 139 ruptured aneurysms of 133 consequent patients were treated. Of these, 48 were surgically treated aneurysms. Five of the remaining 85 aneurysms treated with FD stents. Three aneurysms were in the posterior communicating artery, and 2 were in the supraclinoid internal carotid artery (ICA). Partial coil embolization was performed in addition to FD stents in three patients. All patients were treated in the first 3 days after bleeding. RESULTS: Technical success was 100%. Inappropriate deployment of silk stent and partial thrombus formation occurred in one patient due to the jailed micro-catheter. Inappropriate apposition of stent was corrected with a balloon, and the thrombus resolved with tirofiban, tissue plasminogen activator (t-PA) injections. No other complication or death occurred related to the procedure. One patient who had a giant ICA aneurysm and Fisher grade 4 bleeding died due to vasospasm, cerebral edema and sepsis on the postoperative 13th day. The other patients were followed-up uneventfully with computed tomography angiography (CTA) at 6th month and digital subtraction angiography (DSA) at 12th month. CONCLUSION: FD stents can be used in the treatment of ruptured large wide necked or side branch close to the neck of saccular aneurysms when other treatment options can not be used.Item Endovascular Treatment of a Patient with Moyamoya Disease and Seckel Syndrome: A Case Report(2018) Andic, Cagatay; Gunesli, Aylin; Alkan, Ozlem; Erol, Ilknur; Suner, Halil Ibrahim; 30090148Seckel syndrome and Moyamoya diseases are different entities that rarely associated with each other. Several cases presenting with both these diseases were reported. Intracerebral artery aneurysms and collateral vessels can be seen with Moyamoya. They are commonly treated with medical treatment. We present a 12-years old patient with both Seckel syndrome and Moyamoya disease presented with middle cerebral artery aneurysm which was treated with endovascular modalities.