Wos İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4807
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Item Anticoagulation strategy in patients with atrial fibrillation after carotid endarterectomy(2019) Ugurlucan, Murat; Akay, Hakki Tankut; Erdinc, Ibrahim; Oztas, Didem Melis; Conkbayir, Cenk; Aslim, Erdal; Yildiz, Cenk Eray; Aydin, Kubilay; Alpagut, Ufuk; 30189792Aim: Carotid artery stenosis and atrial fibrillation are diseases of the aging patient population. Literature lacks precise anticoagulation treatment protocols for patients with atrial fibrillation following carotid endarterectomy. We present our experiences with anticoagulation strategy in this particular patient population.Patients and methods: Between June 2001-September 2017, 165 patients with chronic or paroxysmal atrial fibrillation out of 1594 cases from three different institutions whom received Coumadin and aspirin and required carotid endarterectomy were reviewed, respectively. Mean age was 63.47.9 years. Male/female ratio was 102/63. There were 67 diabetic and 138 hypertensive cases.Results: Patients are followed a mean of 64.4 +/- 16.9 months. Early mortality occurred in two patients due to intracranial bleeding and heart failure. Another patient was lost due to intracerebral hemorrhage and 16 other patients died due to various causes in the late follow-up. Three patients required exploration against bleeding.Conclusion: Combination of warfarin with an aim to keep the INR value between 2 and 3, and aspirin at a dosage of 100mg per day seemed feasible and in our modest patient cohort. Further studies including multicenter larger data are warranted in order to establish a precise anticoagulation treatment protocol for patients with atrial fibrillation after carotid endarterectomy.Item Cerebrovascular complications of transorbital penetrating intracranial injuries(2015) Arat, Yonca Ozkan; Arat, Anil; Aydin, Kubilay; 26374414BACKGROUND: Cerebrovascular trauma secondary to transorbital intracranial penetrating injury (TIPVI) is rare. Relatively benign initial presentation may mask the underlying life-threatening vascular injury in transorbital intracranial penetrations. The aim of this study was to evaluate clinical features and endovascular treatment of TIPVI. METHODS: Six patients with angiographic documentation of TIPVI in subacute/chronic phase were reviewed retrospectively. Five were treated endovascularly; however endovascular treatment was aborted in one and conservative management was pursued. RESULTS: Except for one case presenting with vision loss and mild stroke, no significant neurologic deficit was present. Vascular lesions included two cases of carotid-cavernous fistulas, three traumatic aneurysms of cavernous carotid, anterior and middle cerebral arteries and a unique case of coalescing cavernous aneurysms following a through-and-through injury in which the aneurysms united within the thrombosed cavernous sinus on follow up. Fistulas were treated with covered stents, aneurysms with parent artery occlusion or flow diverters. All patients had uneventful recoveries. CONCLUSION: TIPVI may present in a delayed fashion after a seemingly benign presentation. A high index of suspicion is critical to rule out TIPVI with vascular imaging. Transcatheter angiographic techniques allow for both diagnosis and treatment of TIPVI with favorable results.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.