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Öğe Changes in blood biochemistry thrombosis parameters 24 hours after stent-assisted endovascular treatment of intracranial aneurysms(Sage Publications Inc, 2024) Cinar, Celal; Oran, Ismail; Ozdemir, Halil Ibrahim; Kusbeci, Mahmut; Kavakli, Ramazan Kaan; Tobu, Mahmut; Parildar, ZuhalBackground and purpose This study aims to elucidate the early changes in blood biochemistry thrombosis parameters following stent-assisted endovascular treatment of intracranial aneurysms.Methods Consecutive patients with unruptured aneurysms undergoing stent implantation during endovascular treatment were included in this prospective study with approval from the local ethics committee. Blood samples were collected immediately before and 24 h after the procedure for biochemical analysis, including basic thrombosis indicators, bleeding tests, and a complete blood count.Results The study included 80 patients (60 women, 20 men) with 134 aneurysms. A total of 135 stents (110 flow-diverting, 25 standard) were used. Additionally, intrasaccular coiling was utilized in 28 aneurysms among 27 patients. Following the procedure, there was a significant decrease in activated partial thromboplastin time, fibrinogen, hemoglobin, and platelet levels, and a significant increase in prothrombin time, D-dimer, von Willebrand factor (vWF) activity/antigen ratio, and leukocyte levels in all patients. Correlation analyses revealed significant positive associations between platelet and fibrinogen levels, and a negative association between D-dimer and fibrinogen levels in the coil (-) group. Additionally, there was a significant negative correlation between aneurysm volume and vWF activity/antigen ratio, and procedure duration and thrombocyte count, while a positive association was found between aneurysm number and leukocyte count in the coil (-) group.Conclusions Analysis of blood chemistry alterations indicates that intravascular thrombosis occurs in the intracranial circulation following stent-assisted endovascular treatment of intracranial aneurysms. This thrombotic process is more pronounced in patients whose aneurysms were left open (i.e. flow-diverting stent alone).Öğe Comprehensive evaluation of management strategies and rupture status in partially thrombosed aneurysms: a systematic review and meta-analysis(Bmj publishing group, 2024) Elek, Alperen; Allahverdiyev, Irshad; Ozcinar, Kenan Kerem; Yazici, Adem C.; Cinar, Celal; Kusbeci, Mahmut; Ozturk, Egemen; Oran, IsmailBackground This meta-analysis aims to evaluate and compare the clinical and angiographic outcomes of different management strategies for partially thrombosed intracranial aneurysms (PTIAs).Methods A systematic review was conducted using MEDLINE, Scopus, and Web of Science databases up to September 2024. Studies providing clinical and angiographic outcomes of PTIAs were included. Favorable outcomes were defined as those reported directly in the studies or, when the modified Rankin Scale (mRS) was available, as an mRS score of 0-2. Statistical analysis was conducted using R, with pooled estimates under a random-effects model.Results Eighteen studies involving 362 patients with 363 PTIAs were analyzed. Favorable neurological outcomes were observed in 76% of patients, while 20% experienced procedure-related complications. Recurrence occurred in 36% of cases, and retreatment was required in 23%. Mortality was low at 0.8%. Subgroup analysis revealed that reconstructive approaches were associated with higher rates of favorable outcomes (72%) and lower complication rates (21%) compared with deconstructive methods (60% and 28%, respectively). Among the reconstructive techniques, flow diverter stenting showed the highest rate of favorable outcomes (82%), while simple coiling had the lowest (71%). Additionally, unruptured PTIAs had a significantly better prognosis, with 69% achieving favorable outcomes, fewer complications (22% vs 51% for ruptured), and lower mortality (0.8% vs 27%) compared with ruptured aneurysms. Among the reconstructive techniques, flow diverter stenting showed the best outcomes.Conclusion PTIAs treated with reconstructive approaches that are unruptured, non-giant, and located in the anterior circulation show higher rates of favorable neurological outcomes with acceptable complications. However, outcomes, complications, and occlusion rates are slightly worse compared with typical non-thrombotic saccular aneurysms, indicating that these aneurysms pose a greater challenge.Öğe Doppler ultrasound- guided gyrectomy in the management of arterialised developmental venous anomalies(Ma Healthcare Ltd, 2024) Elek, Alperen; Ozgiray, Erkin; Cinar, Celal; Kusbeci, Mahmut[Abstarct Not Available]Öğe A heterogeneous liver lesion in a 48-year-old woman(Aves, 2017) Kusbeci, Mahmut; Buldur, Serhat; Mutlu, Eren; Uguz, Alper; Guneyli, Serkan; Bozkaya, Halil; Cinar, Celal; Unalp, Omer Vedat; Sozbilen, MuratÖğe Long-Term Outcomes of Transarterial Chemoembolization of Giant Liver Hemangiomas with Lipiodol-Bleomycin Emulsion(Springer, 2024) Kusbeci, Mahmut; Elek, Alperen; Ozturk, Egemen; Bozkaya, Halil; Cinar, Celal; Parildar, Mustafa; Oran, IsmailPurpose To evaluate the safety, efficacy, and long-term outcomes of transarterial chemoembolization (TACE) with bleomycin-Lipiodol for giant liver hemangiomas. Materials and Methods Single-center retrospective study from 1998 to January 2020, including patients with giant liver hemangiomas treated with bleomycin-Lipiodol TACE and followed up >36 months. The exclusion criteria were defined as patients who had been treated but had no available follow-up above 3 years and patients who had previously been treated with any other treatment method. Clinical success was defined as the disappearance of symptoms and radiological success (responded vs. non-responded groups) as a more than 50% decrease in the volume of the giant hemangioma in follow-up CT or MRI compared to the baseline images. Results A total of 121 patients were included. The mean maximum diameter of the hemangiomas decreased from 122 (range: 40-300) to 73 mm (range: 15-240), and the mean volume reduced from 984.4 (range: 30-7312) to 286.6 cm(3) (range: 1-3835). There were 106 patients in the responded group, while only 15 patients were in the non-responded group. No significant difference was found in size and volume change percentages across these two groups based on gender, age, lesion size, lesion volume, lesion number, and second TACE. When the follow-up period was stratified in 5-year periods, the maximum volume decrease was observed in the first 5-year period and then remained constant up to > 15 years. Conclusion TACE with bleomycin-Lipiodol is safe, reducing the size and volume of giant liver hemangiomas with stable results in the long-term follow-up.Öğe Successful treatment of a basilar artery fenestration aneurysm using a kissing flow diverter stent(Ma Healthcare Ltd, 2024) Elek, Alperen; Cinar, Celal; Kusbeci, Mahmut; Oran, Ismail[Abstarct Not Available]
