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    Aortic origin of right hepatic artery and superior mesenteric origin of splenic artery: two rare variations demonstrated angiographically
    (Springer-Verlag, 2001) Oran, I; Yesildag, A; Memis, A
    Anatomical variations of the celiac trunk and superior mesenteric artery are not infrequent. Knowledge of the existing aberrations is important in planning and conducting surgical of radiological procedures. A case of right hepatic artery arising independently from the aorta supplying an hepatocellular carcinoma was identified, through which transarterial chemoembolization was successfully performed. A second case is presented with a common splenomesenteric trunk branching into the splenic and superior mesenteric arteries. These two cases represent exceptional arterial variations in the upper abdomen.
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    Arterial supply of liver segment IV
    (Springer-Verlag, 2000) Oran, I
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    Carotid steal: Report of ten cases
    (Amer Inst Ultrasound Medicine, 1998) Ozbek, SS; Memis, A; Killi, R; Pourbagher, MA; Demirpolat, G; Oran, I; Pourbagher, A
    The blood flow may be diverted from the external to the internal carotid artery via the carotid bulb in the absence of flow in the common carotid artery. We aimed to investigate the prevalence, hemodynamics, and clinical features of this condition. Reviewing the records of color duplex ultrasonographic examinations, we found carotid steal in 12 carotid arteries of 10 patients. In three patients flow in the ipsilateral external carotid artery was bidirectional. The steal had been demonstrated angiographically in six patients. The cause of the phenomenon was atherosclerosis, Takayasu arteritis, or trauma. Awareness of this pathway of collateral circulation may contribute to diagnostic work-up and expand management alternatives.
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    Catheter and MR angiography of persistent trigeminal artery associated with occipital arteriovenous malformation
    (Pergamon-Elsevier Science Ltd, 2000) Oran, I; Parildar, M; Memis, A; Yunten, N
    We present a patient with an occipital arteriovenous malformation fed by the posterior cerebral artery coexisting with an ipsilateral persistent trigeminal artery. These anomalies were well demonstrated by MR angiography and confirmed by catheter angiography. (C) 2000 Elsevier Science Ltd. All rights reserved.
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    Effect of endovascular treatment on nitric oxide and renal function in Takayasu's arteritis with renovascular hypertension
    (Karger, 2002) Parildar, Z; Gulter, C; Parildar, M; Oran, I; Erdener, D; Memis, A
    Background: Renal involvement in Takayasu's arteritis (TA) effects the disease outcome and endovascular treatment is an effective treatment of choice. We investigated nitric oxide (NO) levels and the effect of endovascular treatment in renovascular hypertensive TA patients. Methods: In five hypertensive patients with renal artery stenosis due to TA, serum creatinine, nitrite, nitrate; urinary microalbumin, nitrite, nitrate measurements and blood pressures were recorded at entry and after 24 h and 6 weeks of endovascular treatment. Results: Serum NO levels were higher in patients than controls (p = 0.008). Serum and urine NO levels increased 24 h after the treatment and decreased after 6 weeks (p = 0.015; p = 0.01, respectively). After the treatment blood pressures decreased. Urinary microalbumin excretions increased after the intervention (p = 0.02) and returned to normal in patients 1 and 4, and decreased in the other:. There were no significant differences in estimated glomerular filtration rate (EGFR), serum creatinine, urinary sodium and potassium levels. Conclusion: Increased NO secretion in these patients may contribute to improve the prognosis of renal function through its vasodilator and antiproliferative activities possibly by counterbalancing the excessive vasoconstrictor actions. Endovascular treatment causes a dilatation-induced shear stress that may be responsible for the increased NO release, which in turn leads to the rapid hypotensive response. Copyright (C) 2002 S. Karger AG, Basel.
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    Embolisation of both fistulae through the same carotid artery tear in a patient with bilateral traumatic caroticocavernous fistulae
    (Springer-Verlag, 2004) Oran, I; Bozkaya, H; Parildar, M
    Endovascular treatment of traumatic caroticocavernous fistulae (CCF) may present technical difficulties with specific angiographic dilemmas. We report endovascular techniques used in a patient with bilateral post-traumatic CCF, high-flow on one side, and slow-flow on the other. Complete closure of both was achieved through the same carotid artery tear. To our knowledge, transarterial venous coil embolisation of a low-flow fistula through a contralateral carotid artery tear, with transarterial detachable balloon embolisation of the ipsilateral high-flow fistula has not been described previously.
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    Embolization of visceral pseudoaneurysms with platinum coils and N-butyl cyanoacrylate
    (Springer-Verlag, 2003) Parildar, M; Oran, I; Memis, A
    Background: We evaluated the efficacy of transcatheter embolization in visceral artery pseudoaneurysms with platinum coils and N-butyl-cyano-acrylate (NBCA). Methods: Over the past 7 years, 20 patients were treated by transcatheter embolization in the same sitting with diagnostic angiography. Four right hepatic, one cystic, two gastroduodenal, one cavernosal artery, three superior mesenteric artery branch, and 11 renal artery branch pseudoaneurysms were included in the study. Results: Surgery was completely avoided in 19 patients. In the remaining patient with a superior mesenteric artery branch pseudoaneurysm, endovascular embolization was unsuccessful. Eighteen pseudoaneurysms were thrombosed with coil embolization alone. The remaining three pseudoaneurysms needed NBCA embolization. Two patients died from sepsis within 5 weeks after embolization. Conclusion: Emergent diagnosis and treatment are essential in visceral artery pseudoaneurysms because of the high rate of death, Transcatheter embolization with platinum coils is an efficient, safe treatment of choice. NBCA may be used to avoid proximal embolization of the visceral arteries that could not be catheterized selectively because of tortuosity, vessel size, or anatomic location.
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    Embolization of visceral pseudoaneurysms with platinum coils and N-butyl cyanoacrylate
    (Springer-Verlag, 2003) Parildar, M; Oran, I; Memis, A
    Background: We evaluated the efficacy of transcatheter embolization in visceral artery pseudoaneurysms with platinum coils and N-butyl-cyano-acrylate (NBCA). Methods: Over the past 7 years, 20 patients were treated by transcatheter embolization in the same sitting with diagnostic angiography. Four right hepatic, one cystic, two gastroduodenal, one cavernosal artery, three superior mesenteric artery branch, and 11 renal artery branch pseudoaneurysms were included in the study. Results: Surgery was completely avoided in 19 patients. In the remaining patient with a superior mesenteric artery branch pseudoaneurysm, endovascular embolization was unsuccessful. Eighteen pseudoaneurysms were thrombosed with coil embolization alone. The remaining three pseudoaneurysms needed NBCA embolization. Two patients died from sepsis within 5 weeks after embolization. Conclusion: Emergent diagnosis and treatment are essential in visceral artery pseudoaneurysms because of the high rate of death, Transcatheter embolization with platinum coils is an efficient, safe treatment of choice. NBCA may be used to avoid proximal embolization of the visceral arteries that could not be catheterized selectively because of tortuosity, vessel size, or anatomic location.
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    Fracture of a renal artery stent due to mobile kidney
    (Springer, 2005) Sahin, S; Memis, A; Parildar, M; Oran, I
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    Hypertrophic cranial pachymeningitis involving dural sinuses: a pseudo signal-void appearance on MRI
    (Elsevier Sci Ireland Ltd, 1999) Yunten, N; Oran, I; Calli, C; Parildar, M
    A case of hypertrophic cranial pachymeningitis with an unusual and misleading manifestation is reported. CT detected calcified tentorium and superior sagittal sinus. MR imaging and MR angiography depicted tentorial thickening as well as occlusion of all major dural sinuses. Fibrocalcific occlusion of dural sinuses showed interestingly signal-void appearance on spin-echo images which could readily be interpreted as being patent sinuses. (C) 1999 Published by Elsevier Science Ireland Ltd. All rights reserved.
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    Intradural aneurysm caused by arterial injury during surgery - Treatment with coil embolization
    (Edizioni Centauro, 2001) Oran, I; Parildar, M; Dalbasti, T; Memis, A; Ozdamar, N
    We described a patient with subarachnoid hemorrhage due to a ruptured intradural aneurysm caused by arterial injury during surgery and severe symptomatic vasospasm. The iatrogenic posttraumatic aneurysm was occluded by using GDC with preservation of parent artery followed by intraarterial infusion of papaverine to treat vasospasm as an one-stage procedure. This resulted in significant angiographic resolution of the vasospasm and the patient's clinical outcome was excellent. Endovascular approach to posttraumatic intracranial aneurysms and endosaccular GDC embolization of aneurysm with concomitant intraarterial papaverine infusion to treat vasospasm are discussed.
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    Management of patients with malignant obstructive jaundice - Nursing perspective from the interventional radiology room
    (Lippincott Williams & Wilkins, 2000) Oran, NT; Oran, I; Memis, A
    Most patients with obstructive jaundice caused by primary pancreaticobiliary malignancies and metastatic disease cannot be cured by surgical resection when diagnosed. Biliary drainage in the management of obstructive jaundice therefore represents one of the most important issues in the palliative treatment of these patients. For more than 20 years, percutaneous transhepatic biliary drainage procedures have allowed a nonsurgical approach to the management of malignant biliary obstruction. Improvements in radiologic access systems have extended the use of the percutaneous biliary approach, especially since the advent of metallic stents. Nursing care of these patients before, during, and after the percutaneous biliary intervention is challenging. Patient and family need to be educated about the aim and consequences of the procedure as well as its complications. To care for these patients, the nurse must understand the techniques of percutaneous transhepatic biliary drainage. The purpose of this article is briefly to review the etiology of biliary obstruction, the current treatments to relieve obstructive jaundice, and the basic steps of biliary intervention techniques. The nursing management throughout the procedure, the patient preparation before the procedure, and most importantly, the postprocedural nursing care are discussed.
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    Mesenteric artery aneurysms in intestinal tuberculosis as a cause of lower gastrointestinal bleeding
    (Springer, 2001) Oran, I; Parildar, M; Memis, A
    A 41-year-old woman with intestinal tuberculosis developed massive lower gastrointestinal hemorrhage. Angiographic examinations showed two aneurysms arising from the proximal branches of the superior mesenteric artery, one of which was resected and the other one was successfully embolized with microcoils. Understanding the angiographic features of the disease with gastrointestinal hemorrhage helps in making an appropriate clinical decision for the treatment strategy.
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    Multiple intracranial aneurysms in polyarteritis nodosa: MRI and angiography
    (Springer, 1999) Oran, I; Memis, A; Parildar, M; Yunten, N
    In polyarteritis nodosa involvement of the central nervous system is infrequent; small cerebral infarcts are the most common neuroradiological finding. We report a 10-year-old boy with polyarteritis nodosa and intracranial haemorrhage. MRI showed an intracerebral haemorrhage. Angiography revealed two peripheral aneurysms in the posterior cerebral circulation, previously reported on only two occasions, and multiple microaneurysms in the hepatic, renal, mesenteric and even the lumbar arteries.
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    A new criterion in differentiation of pancreatitis and pancreatic carcinoma: Artery-to-vein ratio using the superior mesenteric vessels
    (Springer Verlag, 1996) Elmas, N; Yorulmaz, I; Oran, I; Oyar, O; Ozutemiz, O; Ozer, H
    Evaluation of infiltration of the superior mesenteric vein (SMV) and artery (SMA) fat planes has been considered in differentiating pancreatic carcinoma from pancreatitis. Some pancreatitis cases, however, can cause perivascular fat plane obliteration due to extension of the inflammatory process, mimicking appearances of carcinoma. This study investigated the diameters of SMV and SMA on CT scans, just caudal to the origin of SMA and portal confluens, in 68 pancreatitis and in 48 pancreatic carcinoma patients, SMA-to-SMV diameters (A/V diameter) were compared and ratios were obtained. In conclusion, it appears that when the A/V ratio is over 1.0, a malignant condition can be suspected. This may be used as a secondary criterion in the differential diagnosis of pancreatitis and pancreatic carcinoma.
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    Nitric oxide and oxidative stress in atherosclerotic renovascular hypertension: Effect of endovascular treatment
    (Lippincott Williams & Wilkins, 2003) Parildar, M; Parildar, Z; Oran, I; Kabaroglu, C; Memis, A; Bayindir, O
    PURPOSE: Because activation of the renin-angiotensin system leads to an increase in oxidative stress, the authors investigated nitric oxide (NO; nitrite + nitrate), superoxide dismutase (SOD), catalase, and malondialdehyde (MDA) levels and the effect of endovascular treatment on these parameters in patients with atherosclerotic renovascular hypertension. The relationship of NO with blood pressure and renal functional indexes was also investigated. MATERIALS AND METHODS: In this prospective cohort study, serum creatinine, NO, SOD, catalase, plasma MDA, urinary microalbumin, and NO levels, and blood pressure were determined in 21 patients with hypertension and unilateral renal artery stenosis caused by atherosclerosis at entry and after 24 hours, 2 weeks, and 6 weeks of endovascular treatment. RESULTS: MDA concentrations decreased 24 hours after intervention and remained low 2 and 6 weeks later. In addition, serum SOD and NO and urine NO levels were increased significantly 24 hours after endovascular treatment and decreased after 2 and 6 weeks. However, serum catalase levels did not differ after the intervention. Blood pressures decreased after treatment. There were no significant differences in urinary microalbumin levels, estimated glomerular filtration rates, and creatinine levels after endovascular treatment. CONCLUSIONS: Endovascular treatment decreases oxidative stress and may offer new benefits in the treatment of patients with hypertension associated with renal artery stenosis. The decrease in oxidative stress and/or the upregulation of SOD may increase the bioavailability of NO, which in turn may lead to the rapid hypotensive response.
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    Nitric oxide and oxidative stress in atherosclerotic renovascular hypertension: Effect of endovascular treatment
    (Lippincott Williams & Wilkins, 2003) Parildar, M; Parildar, Z; Oran, I; Kabaroglu, C; Memis, A; Bayindir, O
    PURPOSE: Because activation of the renin-angiotensin system leads to an increase in oxidative stress, the authors investigated nitric oxide (NO; nitrite + nitrate), superoxide dismutase (SOD), catalase, and malondialdehyde (MDA) levels and the effect of endovascular treatment on these parameters in patients with atherosclerotic renovascular hypertension. The relationship of NO with blood pressure and renal functional indexes was also investigated. MATERIALS AND METHODS: In this prospective cohort study, serum creatinine, NO, SOD, catalase, plasma MDA, urinary microalbumin, and NO levels, and blood pressure were determined in 21 patients with hypertension and unilateral renal artery stenosis caused by atherosclerosis at entry and after 24 hours, 2 weeks, and 6 weeks of endovascular treatment. RESULTS: MDA concentrations decreased 24 hours after intervention and remained low 2 and 6 weeks later. In addition, serum SOD and NO and urine NO levels were increased significantly 24 hours after endovascular treatment and decreased after 2 and 6 weeks. However, serum catalase levels did not differ after the intervention. Blood pressures decreased after treatment. There were no significant differences in urinary microalbumin levels, estimated glomerular filtration rates, and creatinine levels after endovascular treatment. CONCLUSIONS: Endovascular treatment decreases oxidative stress and may offer new benefits in the treatment of patients with hypertension associated with renal artery stenosis. The decrease in oxidative stress and/or the upregulation of SOD may increase the bioavailability of NO, which in turn may lead to the rapid hypotensive response.
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    Posttraumatic intradural internal carotid artery-cavernous sinus fistula associated with ipsilateral carotid dissection - Transarterial embolization with detachable coils
    (Edizioni Centauro, 2004) Oran, I; Parildar, M; Memis, A; Dalbasti, T
    We describe a relatively unusual case of traumatic direct carotid-cavernous fistula in association with a giant intradural venous pouch and ipsilateral carotid dissection, related to carotid artery fistula located in the supraclinoid segment just below the origin of posterior communicating artery. Endovascular therapy could be accomplished by use of detachable coils transarterially. Awareness of an unusual intradural origin of a carotid-cavernous sinus fistula and the possibility of an embolization should be kept in mind.
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    Pre-treatment of anaphylaxis, does it really work?
    (Cambridge Univ Press, 2005) Derbent, A; Ergun, S; Uyar, M; Oran, I
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