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Öğe COVID-19 olgusunda karotis arterde tromboemboli(2022) Taghiyeva, Aida; Çınar, Celal; Oran, İsmailAkut inme bulgularıyla hastaneye başvuran COVİD-19’ lu bir hastada servikal internal karotis arter ve intrakranial arteriyel yatakta (orta serebral arter M2 segmenti) akut tromboembolinin BT anjiografi bulguları sunulmuştur.Öğe Digital subtraction angiography and multislice computed tomography angiography for cervicocranial vessels: comparison of radiation doses(2019) Özdemir, H. İbrahim; Çınar, Celal; Bozkaya, Halil; Topal, Selçuk; Oran, İsmailAim: In this study our purpose was to compare the digital subtraction angiography (DSA) and computed tomography angiography (CTA) techniques in terms of the superiority of diagnosis and radiation doses. Materials and Methods: Forty-six patients (21 men, 25 women) who were subjected to both digital subtraction angiography (DSA) and computed tomography (CT) neck-brain angiographic examinations between January and December 2014 were screened retrospectively. Radiation dose records taken from the cards provided by DSA and CT devices were reviewed. The total DSA [DSA+ tri-dimension (3D) DSA], DSA, 3D-DSA and CTA dose reports were examined separately. Generated 3D images were evaluated by two radiologists who had experience in neuro radiology and interventional radiology at least for five years. Independent samples test and in dual comparisons the paired samples test, were used for statistical analyses. Results: Comparison made between DSA and CTA radiation doses has found that the total dose of total DSA (DSA+3D DSA) was three times and the DSA doses were two times higher than the CTA dose. There was no statistical difference between 3D DSA and CTA doses. CTA is less sensitive than DSA; four of 68 intracranial aneurisms could not be demonstrated with CTA. The radiation doses received by patients did not change with gender. Conclusion: CTA contains less radiation doses in the diagnosis of intracranial aneurisms, but its sensitivity, however, is lower than DSA.Öğe Endovascular Management of Iatrogenic Vascular Injury in the Craniocervical Region(2018) Aydın, Elçin; Gök, Mustafa; Esenkaya, Asım; Çınar, Celal; Oran, İsmailAIm: To evaluate iatrogenic vascular injuries in the craniocervical region and their endovascular management. mATERIAl and mEThODS: Twenty-one patients (9 women, 12 men) with a mean age of 53.6 years (range 16-87 years), who underwent endovascular embolization for iatrogenic vascular injury in the craniocervical region between December 2000 and October 2015, were included in this retrospective study. Types of iatrogenic injuries, etiologies that caused these injuries and details of endovascular managements were reported. RESulTS: the etiologies of the vascular injuries were as follows: transsphenoidal surgery (n=9), skull-base surgery (n=2), cholesteatoma surgery (n=1), tracheostomy (n=2), central venous catheterization (n=2), oropharyngeal tumor operation (n=1), endovascular treatment of internal carotid artery (ICA) stenosis (n=1), suprasellar epidermoid tumor operation (n=1), sphenoid sinus tumor surgery (n=1), and speech prosthesis device placement (n=1). the types of vascular injuries diagnosed at the time of angiography were; 2 occlusions, 2 stenoses, 2 dissections, 1 carotid cavernous fistula, 8 artery rupture with extravasation, and 9 pseudoaneurysms. Endovascular management of these vascular injuries were; parent artery occlusion (PAO) (n=15), aneurysm occlusion (n=3), covered stent (n=1) and conservative management (n=2). All patients except two were successfully treated. No patient had bleeding within a 30-day period after angiography. Long-term follow-up was available in all patients without occurrence of re-bleeding. One patient died due to complications related to primary vascular injury. CONCluSION: Although iatrogenic vascular injuries are rare, early diagnosis and management may be lifesaving. Endovascular techniques are reliable and safe in most of the patients.Öğe Endovascular Management of Iatrogenic Vascular Injury in the Craniocervical Region(2018) Aydın, Elçin; Gök, Mustafa; Esenkaya, Asım; Çınar, Celal; Oran, İsmailAIm: To evaluate iatrogenic vascular injuries in the craniocervical region and their endovascular management. mATERIAl and mEThODS: Twenty-one patients (9 women, 12 men) with a mean age of 53.6 years (range 16-87 years), who underwent endovascular embolization for iatrogenic vascular injury in the craniocervical region between December 2000 and October 2015, were included in this retrospective study. Types of iatrogenic injuries, etiologies that caused these injuries and details of endovascular managements were reported. RESulTS: The etiologies of the vascular injuries were as follows: transsphenoidal surgery (n=9), skull-base surgery (n=2), cholesteatoma surgery (n=1), tracheostomy (n=2), central venous catheterization (n=2), oropharyngeal tumor operation (n=1), endovascular treatment of internal carotid artery (ICA) stenosis (n=1), suprasellar epidermoid tumor operation (n=1), sphenoid sinus tumor surgery (n=1), and speech prosthesis device placement (n=1). The types of vascular injuries diagnosed at the time of angiography were; 2 occlusions, 2 stenoses, 2 dissections, 1 carotid cavernous fistula, 8 artery rupture with extravasation, and 9 pseudoaneurysms. Endovascular management of these vascular injuries were; parent artery occlusion (PAO) (n=15), aneurysm occlusion (n=3), covered stent (n=1) and conservative management (n=2). All patients except two were successfully treated. No patient had bleeding within a 30-day period after angiography. Long-term follow-up was available in all patients without occurrence of re-bleeding. One patient died due to complications related to primary vascular injury. CONCluSION: Although iatrogenic vascular injuries are rare, early diagnosis and management may be lifesaving. Endovascular techniques are reliable and safe in most of the patients.Öğe Iatrogenic Vascular Injuries Due to Spinal Surgeries: Endovascular Perspective(2018) Gök, Mustafa; Aydın, Elçin; Güneyli, Serkan; Akay, Ali; Çınar, Celal; Oran, İsmailAIM: Iatrogenic vascular injuries due to spinal surgeries are rare but serious complications. Surgical management of these injuries is challenging with high morbidity rates. in this study we aim to present the results of endovascular management of iatrogenic vascular injuries due to spinal surgeries. MATERIAL and METHODS: We retrospectively reviewed 11 patients (5 male, 6 female) who had vascular injuries due to cervical and lumbar spinal surgeries. Clinical findings were bleeding (n=5), leg edema (n=6) and right heart failure with severe dyspnea (n=1). the age range of the patients were between 42-67 (mean: 57.1). Six patients were reviewed with imaging before the procedures and the rest of the patients (n=5) were directly referred to the angiography unit for diagnosis and possible endovascular treatment. RESULTS: the types of surgeries were; cervical surgery (n=5) and lumbar disc operation (n=6). the type of vascular injuries were; vertebral artery stenosis (n=1), vertebral artery pseudoaneurysm (n=3), vertebral artery occlusion (n=1) and iliac arteriovenous fistula (n=6). the type of endovascular treatments were; parent artery occlusion (PAO) (n=2), covered stent graft implantation (n=6) and intrasaccular coil embolization of pseudoaneurysm (n=1). the remaining 2 patients were managed conservatively. No major complications or mortality occured during endovascular interventions. No bleeding or ischemia occured in the follow-up period. CONCLUSION: Iatrogenic vascular injuries due to spinal surgeries are rare but serious complications. Endovascular interventions are safe and effective in the diagnosis and treatment of such vascular injuries.Öğe Iatrogenic Vascular Injuries Due to Spinal Surgeries: Endovascular Perspective(2018) Gök, Mustafa; Aydın, Elçin; Güneyli, Serkan; Akay, Ali; Çınar, Celal; Oran, İsmailAIM: Iatrogenic vascular injuries due to spinal surgeries are rare but serious complications. Surgical management of these injuries is challenging with high morbidity rates. In this study we aim to present the results of endovascular management of iatrogenic vascular injuries due to spinal surgeries. MATERIAL and METHODS: We retrospectively reviewed 11 patients (5 male, 6 female) who had vascular injuries due to cervical and lumbar spinal surgeries. Clinical findings were bleeding (n=5), leg edema (n=6) and right heart failure with severe dyspnea (n=1). The age range of the patients were between 42-67 (mean: 57.1). Six patients were reviewed with imaging before the procedures and the rest of the patients (n=5) were directly referred to the angiography unit for diagnosis and possible endovascular treatment. RESULTS: The types of surgeries were; cervical surgery (n=5) and lumbar disc operation (n=6). The type of vascular injuries were; vertebral artery stenosis (n=1), vertebral artery pseudoaneurysm (n=3), vertebral artery occlusion (n=1) and iliac arteriovenous fistula (n=6). The type of endovascular treatments were; parent artery occlusion (PAO) (n=2), covered stent graft implantation (n=6) and intrasaccular coil embolization of pseudoaneurysm (n=1). The remaining 2 patients were managed conservatively. No major complications or mortality occured during endovascular interventions. No bleeding or ischemia occured in the follow-up period. CONCLUSION: Iatrogenic vascular injuries due to spinal surgeries are rare but serious complications. Endovascular interventions are safe and effective in the diagnosis and treatment of such vascular injuries.Öğe Imaging findings and endovascular management of iatrogenic hepatic arterial injuries(2015) Güneyli, Serkan; Gök, Mustafa; Çınar, Celal; Bozkaya, Halil; Korkmaz, Mehmet; Parıldar, Mustafa; Oran, İsmailIatrogenic hepatic arterial injuries (IHAIs) include pseudoaneurysm, extravasation, arteriovenous fistula, arteriobiliary fistula, and dissection. IHAIs are usually demonstrated following percutaneous transhepatic biliary drainage, percutaneous liver biopsy, liver surgery, chemoembolization, radio-embolization, and endoscopic retrograde cholangiopancreatography. the latency period between the intervention and diagnosis varies. the most common symptom is hemorrhage, and the most common lesion is pseudoaneurysm. Computed tomography angiography (CTA) is mostly per-formed prior to angiography, and IHAIs are demonstrated on CTA in most of the patients. Patients with IHAI are mostly treated by coils, but some patients may be treated by liquid embolic materials or stent-grafts. CTA can also be used in the follow-up period. Endovascular treatment is a safe and minimally invasive treatment option with high success rates.Öğe Intrakraniyal Dissekan ve Travmatik Anevrizmalarda Tedavi(2022) Çınar, Celal; Oran, İsmailAnevrizma damar duvarındaki primer gene- tik bozukluğa bağlı lokal defekt, arteroskleroz, enfeksiyon, travma, neoplasm, inflamasyon, otoimmun ve hemodinamik hastalıklar gibi çoğu ekstravasküler nedenlerin etkisi ile gelişmektedir. Anevrizma damar duvarında farklı neden- lerle zayıflamış olan bir noktada meydana gelen dışarı doğru fokal bir genişlemedir. İntrakranial anevrizmalar yetişkinlerde anjiyografi ve otopsi verilerine göre %0,5-6 oranında görül- mektedir. Son yıllarda nöroradyolojik görüntü- leme yöntemlerinin klinik kullanıma daha fazla girmesiyle asemptomatik ve kanamamış anev- rizmaların görülme sıklığı giderek artmıştır. İntrakranial anevrizmaların anterior dolaşımda yaklaşık %85-90, posterior dolaşımda ise %10-15 sıklıkta görülmektedir. Anevrizmalar boyutlarına, morfolojik yapılarına ve etiyoloji- lerine göre sınıflandırabilir [1]. Anevrizmalar morfolojik olarak sakküler, fusiform ve dissekan anevrizmalar olarak üçe ayrılmaktadırlar. Her bir tipin orijini ve klinik prezentasyonu farklı olduğundan kendilerine özgü farklı özellikleri bulunmaktadır [2]. Etiyolojilerine göre ise inflamatuvar (miko- tik, sifilitik, bakteriyel vb), neoplastik, travma- tik, kalıtsal hastalıkları ile ilişkili, radyoterapiye sekonder, aterosklerotik veya hipertansif ve arteriovenöz malformasyona bağlı anevriz- malar olarak sınıflandırılabilirler [3]. Burada yayında özellikle intrakranial arteriyel yapı- larda daha nadir görülen ve endovasküler olarak tedavileri diğer anevrizma türlerine göre daha zor olan travmatik ve disekan anevrizmaların endovasküler tedavisinden bahsedilecektir.Öğe Nöroendovasküler Girişimsel Tedavilerde Anti-trombotik İlaç Kullanımı(2018) Oran, İsmail; Çınar, Celal[Özet Yok]Öğe Pediatrik Konjenital Vasküler Malformasyonlarda Endovasküler Tedavi(2018) Çınar, Celal; Oran, İsmail[Özet Yok]Öğe Serebral venöz tromboz: dural arteriyovenöz malformasyona bağlı bir serebral venöz tromboz olgusu nedeniyle gözden geçirme.(2008) Akkuş, Dilek Evyapan; Güllüoğlu, Halil; Oran, İsmail…Öğe Tendon patolojilerinde manyetik rezonans görüntüleme ve ultrasonografik değerlendirme(Ege Üniversitesi, 1996) Oran, İsmail; Memiş, Ayşenur[Abstarct Not Available]Öğe Total ımprovement of ophthalmic findings with treatment in a case with ıatrogenic carotid-cavernous fistula(2012) Çetin, Ebru Nevin; Saraç, Gülden; Avunduk, Avni Murat; Sitti, İlkay; Çırak, Bayram; Oran, İsmailKırk beş yaşında erkek hasta, sol gözde kapak ödemi ve bulanık görme şikayeti ile başvurdu. Bir ay önce sellar ve parasellar kitle nedeniyle opere edilen hastanın görme kesinliği sol gözde 0.7 idi. Sol gözde ayrıca belirgin kapak ödemi, kemozis, episkleral vasküler injeksiyon, proptozis, retinal venlerde hafif konjesyon ve kıvrımlanma artışı saptandı. Göz içi basıncı 35mmHg ölçülen sol gözde, hareketlerin her yöne kısıtlı olduğu izlendi. Orbital manyetik rezonans (MR) görüntülemede sol proptozis; kraniyal venöz MR anjiografide, karotikokavernöz fistül ile uyumlu olarak, sol karotid arter ve kavernöz sinus komşuluğunda vasküler yapıda kıvrımlanma artışı ve genişleme, ayrıca üst oftalmik vende genişleme saptandı. Sol iatrojenik karotikokavernöz fistül tanısıyla endovasküler greft-stent implantasyonu yapılan hastanın, işlem sonrası 3. haftada sol gözde görme keskinliğinin tam olduğu, proptozis ve göz hareketlerindeki kısıtlılığın ortadan kalktığı izlendi. (Turk J Ophthalmol 2012; 42: 393-6)
