Başkent Üniversitesi Yayınları

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Author: search.filters.author.Boyvat, Fatih

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    Interventional Radiology in Liver Transplant
    (Başkent Üniversitesi, 2008-06) Boyvat, Fatih; Haberal, Mehmet; Karakayali, Hamdi; Aytekin, Cuneyt
    An increased number of transplant centers now actively perform deceased-donor as well as living-related liver transplants. Although postoperative vascular and nonvascular complications after liver transplant have been well documented, early diagnosis and intervention are important to increase graft and recipient survival. With improvements in interventional radiologic techniques and a multidisciplinary approach to liver transplant, management of complications by percutaneous and endovascular techniques is possible with less morbidity and mortality. This article outlines the recent developments in, and applications of, interventional radiologic techniques in liver transplant patients.
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    Endovascular Treatment of Active Bleeding after Liver Transplant
    (Başkent Üniversitesi, 2007-06) Harman, Ali; Boyvat, Fatih; Hasdogan, Baris; Aytekin, Cuneyt; Karakayali, Hamdi; Haberal, Mehmet
    Objectives: To evaluate the incidence of active bleeding complications following transplant and the efficacy of interventional radiologic management. Materials and Methods: Between June 2000 and February 2007, 14 liver transplant patients with active bleeding were treated via endovascular techniques (coils, glue, or graft-covered stents). Active bleeding was spontaneous in 6 patients through the inferior epigastric artery (n=1), the inferior phrenic artery (n=1), the superior mesenteric artery (n=2), the internal mammary artery (n=1), and the hepatic artery (n=1). In 8 patients, active bleeding was due to transhepatic biliary or endovascular interventions. Hemobilia (n=2) due to pseudoaneurysm formation after transhepatic biliary interventions was embolized with coils. Hepatic artery rupture was observed in 6 patients during endovascular interventions performed on hepatic artery stenosis or thrombosis that had been treated with graft-covered stents. Technical success, clinical improvement, and complications were documented. Results: Active bleeding was stopped by endovascular intervention in 13 of 14 patients. Embolizations with coils or glue were successful. In 1 patient with hepatic artery bleeding, the graft-covered stent failed to seal the rupture site, and this patient underwent reoperation. Conclusion: Arterial bleeding complications after liver transplant during the early and late postoperative period, due either to spontaneous active bleeding or to percutaneous or endovascular interventions, can be successfully managed with interventional radiologic techniques.
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    Renal Autotransplantation for Complex Renal Arterial Disease: A Case Report
    (Başkent Üniversitesi, 2006-12) Sevmis, Sinasi; Karakayali, Hamdi; Boyvat, Fatih; Colak, Turan; Aydogan, Cem; Gencoglu, E. Arzu; Haberal, Mehmet
    A renal artery aneurysm in a stenotic renal artery is a rare clinical entity with an incidence of 0.015% to 1% in patients with renovascular hypertension. Interventional stent placement is the first line of treatment for simple aneurysms of the proximal renal artery. However, renal autotransplantation has been used as an alternative treatment for complex lesions and for lesions originating from the distal renal artery. We present a patient with a renal artery aneurysm, renal artery stenosis of the segmental branches of the left kidney, and occlusion of the right renal artery. The surgical strategy included renal explantation, ex vivo renal preservation, ex vivo reconstruction of the 2 renal artery branches, and renal heterotopic autotransplantation. We conclude that renal autotransplantation is a safe and effective surgical procedure for patients with complex renal arterial disease.