Yazar "Oran, Ismail" seçeneğine göre listele
Listeleniyor 1 - 20 / 73
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Aggregometry Response to Half-dose Prasugrel in Flow-diverting Stent Implantation(Springer Heidelberg, 2020) Oran, Ismail; Cinar, Celal; Gok, Mustafa; Duzgun, FatihPurpose the aim of this study was to determine whether half-dose loading (30/mg) of prasugrel is sufficient to achieve adequate platelet inhibition, and whether such a loading dose of prasugrel together with aspirin followed by a 10/mg/day prasugrel maintenance, could serve as a first-line antiplatelet strategy for patients undergoing flow-diverting stent (FDS) implantation. Methods Data from a group of consecutive patients treated for intracranial aneurysm with FDS were retrospectively collected. Platelet P2Y12 receptor responsiveness was assessed by a rapid platelet function test just prior to the procedure. All ischemic and hemorrhagic complications as well as morbidity and mortality rates were documented. Results A total of 138 patients with 153 aneurysms (32 were symptomatic and 121 were incidental) underwent FDS treatment in a total of 147 loading sessions. Adequate platelet inhibition was obtained in 136/138 (98.5%) patients and 145/147 (98.6%) loading sessions. Overall, there was one case of (hemorrhagic) mortality (0.7%), one of (ischemic) morbidity (0.7%), one of symptomatic (hemorrhagic) clinical complications without permanent deficits (0.7%), and six transient ischemic attacks (4.1%). the 6-month control angiography, available for all patients, revealed a 95.4% aneurysm occlusion rate. Conclusion Half-dose (30/mg) prasugrel loading results in effective platelet P2Y12 receptor inhibition in more than 98% of patients. Dual antiaggregant loading with half dose prasugrel followed by prasugrel maintenance as a first-line therapy appears to be feasible in patients treated with FDS implantation for intracranial aneurysm.Öğe Applications of the Amplatzer Vascular Plug to various vascular lesions(Turkish Soc Radiology, 2014) Guneyli, Serkan; Cinar, Celal; Bozkaya, Halil; Parildar, Mustafa; Oran, IsmailThe Amplatzer (R) Vascular Plug (AVP) can be used to embolize medium-to-large high-flow vessels in various locations. Between 2009 and 2012, 41 AVPs (device size, 6-22 mm in diameter) were used to achieve occlusion in 31 patients (24 males, seven females) aged 9-92 years (mean age, 54.5 years). The locations and indications for embolotherapy were as follows: internal iliac artery embolization before stent-graft repair for aorto-iliac (n=6) and common iliac artery (n=3) aneurysms, subclavian artery embolization before stent-graft repair for thoracic aorta (n=3) and arcus aorta (n=1) aneurysms, brachiocephalic trunk embolization before stent-graft repair for a thoracic aorta aneurysm (n=1), embolization of aneurysms and pseudoaneurysms (n=5), embolization for carotid blow-out syndrome (n=3), closure of arteriovenous fistula (n=8), and closure of a portosystemic fistula (n=1). Of the 41 AVPs, 30 were AVP 2 and 11 were AVP 4. The mean follow-up duration was 4.7 months (range, 1-24 months). During follow-up, there was one migration, one insufficient embolization, and one recanalization. The remaining vascular lesions were successfully excluded from the circulation. The AVP, which can be used in a wide spectrum of pathologies, is easy to use and causes few complications. This essay presents our experience with the AVP.Öğe Behcet's disease-associated aneurysm of the internal carotid artery within the cavernous sinus: Report of a patient(Taylor & Francis Inc, 2007) Goekcay, Figen; Celebisoy, Nese; Oran, Ismail; Aksu, KenanBehcet's disease ( BD) is a type of vasculitis with a chronic relapsing course that affects arteries and veins of all sizes. Intracranial aneurysms are rare manifestations. We report a patient with the diagnosis of BD, who had a fusiform aneurysm of the internal carotid artery at the level of the sinus cavernosus. He presented with sinus cavernosus syndrome findings. The aneurysm was treated endovascularly.Öğe Blister aneurysms(Journal Neurological Sciences, 2009) Oktar, Nezih; Oran, Ismail; Ozdamar, Nurcan; Dalbasti, TayfunThe majority of saccular cerebral aneurysms arise at arterial branchings; those arising elsewhere are rare. Blister aneurysms are elusive and technically challenging rare lesions characterized by a hemispherical shape and fragile walls for both neurosurgeon and endovascular radiologist to treat. Blister aneurysms also exhibit rapid change in size and morphology in followup angiograms. Small size of blood-blister aneurysm and atypical location may result in incomplete visualization of these lesions. Therefore, multiple oblique views are essential during angiography. The weak nature and small size of blister aneurysms with a broad neck renders endovascular treatment technically challenging. Wrapping with cellulose fabric (Bemsheet) and holding clipping technique could be chosen as the optimal surgical modality for prevention of rebleeding from these lesions.Öğe Brain infarction in a young patient with Buerger's disease - a case of cerebral thromboangiitis obliterans(Asean Neurological Assoc, 2016) Aydin, Elcin; Cinar, Celal; Bozkaya, Halil; Oran, IsmailBuerger's disease (BD) or thromboangiitis obliterans is a vasculitis that most commonly affects the small and medium-sized arteries and veins in the extremities. 1 It is most frequently seen in the young men who smoke and is associated with low socioeconomic status. BD is diagnosed on the basis of the clinical findings; the pathogenesis is not completely be understood. 1-4 In this report, we aim to present the clinical, magnetic resonance imaging (MRI) and angiographic findings of a 30-year-old man with ischemic stroke as a rare complication of BD.Öğe Carotid Endarterectomy versus Carotid Artery Stenting Findings in Regard to Neuroclinical Outcomes and Diffusion-Weighted Imaging(Texas Heart Inst, 2008) Posacioglu, Hakan; Engin, Cagatay; Cinar, Celal; Apaydin, Anil Z.; Oran, Ismail; Parildar, Mustafa; Calli, Cem; Oguz, Emrah; Memis, AhmetThe purpose of our study was to evaluate prospectively the frequency and significance of brain lesions after elective carotid endarterectomy (CAE) and carotid artery stenting (CAS) by using diffusion-weighted magnetic resonance imaging (DW MRI) and then to correlate imaging findings with neuroclinical outcomes. From February 2003 through March 2005, 95 consecutive patients underwent surgical endarterectomy or CAS (with a cerebral protection device) at our institution. A total of 59 CAE procedures were performed in 46 consecutive patients (mean age, 65.8 +/- 9 yr), and 56 CAS procedures were performed in 49 consecutive patients (mean age, 66.3 +/- 9 yr). Diffusion-weighted magnetic resonance imaging of the brain was performed in all patients within 24 hours of the procedure, both before and after. The post-procedural stroke rate was slightly higher in the CAS group, but this difference was not significant (5.4% vs 0). One early and I late death occurred in the stent group. Although the incidence of ischemic lesions was similar in both groups (surgery group, 12.5%; stent group, 73.5%), new DIN MRI lesions were higher in the endarterectomy group (27.1% vs 12.5%, P=0.041). This difference was due chiefly to nonischemic lesions such as hemorrhage and watershed ischemia. In the analysis of patients with embolic ischemia, incidences of symptomatic stroke (P=0.046) and large infarct (P=0.013) were higher in the stent group. When we used protective devices during CAS, the incidence of embolic complications was similar to that of surgical enarterectomy. On the other hand, the clinical results of CAS need improvement. (Tex Heart Inst J 2008;35(4):395-401)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 Congenital and Acquired Renal Arteriovenous Malformations: Curative Embolization with Onyx(Kowsar Publ, 2017) Guneyli, Serkan; Cinar, Celal; Bozkaya, Halil; Korkmaz, Mehmet; Acar, Turker; Parildar, Mustafa; Oran, IsmailRenal arteriovenous malformations are rare, as is their embolization with Onyx. Endovascular curative embolization of renal arteriovenous malformations with Onyx is a relatively new procedure. Herein we present two cases of congenital and one case of acquired renal arteriovenous malformation embolized with Onyx 18 and their good results in the follow-up period. We used detachable microcatheters, which may be more advantageous than the nondetachable ones, during the superselective embolizations. Onyx, as an efficient embolic material, can be commonly used for curative embolization of the renal arteriovenous malformations.Öğe Developmental venous anomaly (DVA) with arterial component: a rare cause of intracranial haemorrhage(Springer, 2009) Oran, Ismail; Kiroglu, Yilmaz; Yurt, Alaattin; Ozer, Fisun Demircivi; Acar, Feridun; Dalbasti, Tayfun; Yagci, Baki; Sirikci, Akif; Calli, CemTo examine the clinical and radiologic findings of patients with developmental venous anomaly (DVA) associated with intracranial haemorrhage but unrelated to cavernoma. Computed tomography (CT) was used to obtain intracranial images from seven patients ranging in age from 6 to 51 years. Magnetic resonance imaging (MRI) was then performed on six patients, and two patients were further examined via CT angiography. Finally, digital subtraction angiography (DSA) was performed to confirm the initial diagnosis. CT showed intraparenchymal supratentorial haemorrhage in all patients. The combined imaging modalities eventually confirmed a diagnosis of arterialised DVA in four patients and arterialised DVA associated with arteriovenus malformation (AVM) in three. Two patients were managed symptomatically, two underwent radiosurgery, one underwent surgery, one underwent combined embolisation plus radiosurgery and the remaining patient underwent combined embolisation plus surgery. Two patients died, one as a result of re-bleeding, and the other due to radiation necrosis. The mean follow-up period was 33 months (6 months to 6 years) for the remaining five patients with favourable outcome. DVA associated with intraparenchymal haemorrhage, but not related to cavernoma, was confirmed. Though very rare, DVA may present with non-cavernoma-related haemorrhage in the form of arterialised DVA or DVA with AVM.Öğe Eagle Syndrome Presenting with Neurological Symptoms(Turkish Neurosurgical Soc, 2018) Aydin, Elcin; Quliyev, Huseyin; Cinar, Celal; Bozkaya, Halil; Oran, IsmailAIM: Eagle syndrome is a rare entity that causes recurrent throat pain, neck pain, dysphagia, or facial pain due to an elongated styloid process or calcified stylohyoid ligament. Clinical findings related to lower cranial nerve compression have also been reported. In some cases, it is reported that carotid artery compression or dissection can be seen due to elongated styloid process and this is called carotid artery syndrome. Carotid artery compression causes flow reduction and carotidynia or neurological symptoms can be seen. Dural sinuses and the jugular vein can be compressed. Eagle syndrome with neurological symptoms has been rarely reported. MATERIAL and METHODS: The data of 5 patients (aged between 22 and 68 years), who presented to the hospital with various neurological symptoms, were retrospectively reviewed. Each patient underwent computed tomography (CT) that revealed a long styloid process. RESULTS: An elongated styloid process caused neurological symptoms. Two patients had venous compression by the styloid process and the other patients had transient ischemic attacks due to internal carotid artery compression by the styloid process. Only one patient underwent surgical removal. All patients' outcomes were good after treatment and no symptoms remained. CONCLUSION: Eagle syndrome may be presented with neurological symptoms. It should be kept in mind in the differential diagnosis of patients who have neurological symptoms without any objective etiological factors. To the best of our knowledge, Eagle syndrome with arterial and venous compression due to elongated styloid process has not been previously presented in the literature.Öğe Edaravone Leads To Increased Internal Luminal Vascular Circumference Following Subarachnoid Hemorrhage in An Animal Model of Vasospasm(Journal Neurological Sciences, 2012) Mete, Mesut; Ozer, Fusun Demircivi; Duransoy, Yusuf Kurtulus; Kocaman, Umit; Oran, Ismail; Demirtas, Eren; Selcuki, MehmetPurpose: Cerebral vasospasm is the leading cause of morbidity and mortality following subarachnoid hemorrhage. Although a number of factors have been examined in clinical and experimental studies, the agent(s) responsible for developing and diminishing vasospasm remain poorly understood. Here, the role of edaravone, an antioxidant agent, was evaluated for its ability to diminish vasospasm in an animal model of subarachnoid hemorrhage. Materials and Methods: A rat basilar artery subarachnoid hemorrhage model was used. Rats were divided into three groups: sham (n=7; Group 1), subarachnoid hemorrhage (n=7 Group 2), and subarachnoid hemorrhage plus edaravone (4 mg/kg intraperitoneally, n=7; Group 3). At the end of the seventh day, the rats were sacrificed, their brains were removed, and sections were taken from the basilar artery. These were examined using a light microscope, comparing the internal luminal circumference of the basilar artery of each group. Results: The circumference was largest in Group 1, followed by Group 3 and then Group 2. That of Group 3 was 2% higher than that of Group 2, but this difference was not statistically significant. Conclusion: This animal model for vasospasm suggests that edaravone helps enlarge internal luminal circumference following vasospasm caused by subarachnoid hemorrhage. It may do this by blocking lipid peroxidation and thereby reducing the effects of oxyhemoglobin and reactive oxygen species.Öğe Effect of coiling on aneurysm neck hemorheology in flow diverter stent-assisted treatment of intracranial aneurysms(Springer, 2026) Tercanli, Muhammed Furkan; Olcay, Ali Bahadir; Elek, Alperen; Oran, IsmailBackground Flow diverter (FD) stent-assisted coil embolization (FDAC) is widely used for the treatment of wide-necked, large and complex intracranial aneurysms (IA), yet its local hemodynamic effects at the level of blood flow between stent struts remain poorly defined. This study aimed to evaluate the effect of FD deployment and different coil density distributions on between-strut hemodynamics. Methods Computational fluid dynamics simulations were performed under five conditions: untreated, FD-only, and FD-assisted coiling with three configurations of coil density distribution (Updown, Downstream, and Upstream). Blood flow was modeled as laminar, transient, incompressible, and non-Newtonian using the Carreau-Yasuda rheological model. Primary outcomes were maximum and average shear stress and shear strain rate between FD struts, as well as aneurysm wall shear stress (WSS), viscosity, and Oscillatory Shear Index (OSI). Results Eight real patient-specific unruptured IA geometries were reconstructed. Stent deployment markedly increased between-strut hemodynamic loading. Maximum between-strut shear stress increased from 22.44 +/- 16.38 Pa in the untreated condition to 234.87 +/- 211.86 Pa after stenting (p < 0.01), while maximum shear strain rate increased from 6352 +/- 4711 s(-)& sup1; to 67,220 +/- 61,525 s(-)& sup1; (p < 0.01). Coil addition significantly reduced between-strut shear stress and shear strain rate in all configurations relative to FD alone (all p <= 0.01), with mean reductions of approximately 49-52%. Downstream and upstream configurations provided significantly greater reduction in maximum between-strut shear stress and strain rate than the Updown configuration (p = 0.031 and p = 0.047, respectively); however, the corresponding omnibus tests were not significant, and these directional differences are therefore reported as exploratory. Coil addition significantly reduced the average aneurysm WSS relative to the FD alone across all configurations (p < 0.01) but did not significantly reduce the maximum WSS relative to the FD alone. Time-averaged mean and maximum dynamic viscosity increased significantly from normal to FD-alone (p <= 0.031) and further increased markedly after coil deployment (all p <= 0.016 vs. FD-alone), with no significant differences among coil configurations (p >= 0.1). OSI did not differ significantly. Conclusion Adjunctive coil placement reduces FD-induced thrombogenic shear stress by approximately 50%; differences among coil-density configurations were modest relative to interpatient variability and should be considered exploratory and hypothesis-generating.Öğe Endovascular management of iatrogenic renal arterial lesions and clinical outcomes(Turkish Soc Radiology, 2015) Guneyli, Serkan; Gok, Mustafa; Bozkaya, Halil; Cinar, Celal; Tizro, Arastu; Korkmaz, Mehmet; Akin, Yigit; Parildar, Mustafa; Oran, IsmailPURPOSE We aimed to evaluate iatrogenic renal arterial lesions, including pseudoaneurysm, arteriovenous fistula, and arteriocaliceal fistula, their management by endovascular embolization, and the clinical results. METHODS Fifty-five patients (forty males, fifteen females) with a median age of 40 years (range, 8-85 years), who underwent endovascular embolization of iatrogenic renal arterial lesions between March 2003 and December 2013 were included in this retrospective study. Types of iatrogenic lesions and details of embolization procedures were reported. Estimated glomerular filtration rate (eGFR), renal function tests, hemoglobin, and hematocrit levels before and after embolization were recorded and compared. RESULTS Median follow-up was 24 months. We identified 53 pseudoaneurysms, 30 arteriovenous fistulas, and 11 arteriocaliceal fistulas in 55 patients, after percutaneous nephrolithotomy (n=26), renal biopsy (n=21), nephrostomy (n=3), renal surgery (n=3), and extracorporeal shock wave lithotripsy (n=2). Median number of pseudoaneurysms was 1 (range, 1-4) with a median size of 7 mm (range, 1.5-35 mm). Fifty-one patients underwent coil embolization. Median number of coils was 5 (range, 2-21) and median renal parenchymal loss was 5% (range, 1%-50%). There were no significant differences between pre-and postoperative eGFR and serum parameters. CONCLUSION Iatrogenic renal arterial lesion can be a life threatening condition. Superselective coil embolization is a safe, minimally invasive treatment option with minimal renal parenchymal loss and without significant change in renal function.Öğe Endovascular management of iatrogenic renal arterial lesions and clinical outcomes(Turkish Soc Radiology, 2015) Guneyli, Serkan; Gok, Mustafa; Bozkaya, Halil; Cinar, Celal; Tizro, Arastu; Korkmaz, Mehmet; Akin, Yigit; Parildar, Mustafa; Oran, IsmailPURPOSE We aimed to evaluate iatrogenic renal arterial lesions, including pseudoaneurysm, arteriovenous fistula, and arteriocaliceal fistula, their management by endovascular embolization, and the clinical results. METHODS Fifty-five patients (forty males, fifteen females) with a median age of 40 years (range, 8-85 years), who underwent endovascular embolization of iatrogenic renal arterial lesions between March 2003 and December 2013 were included in this retrospective study. Types of iatrogenic lesions and details of embolization procedures were reported. Estimated glomerular filtration rate (eGFR), renal function tests, hemoglobin, and hematocrit levels before and after embolization were recorded and compared. RESULTS Median follow-up was 24 months. We identified 53 pseudoaneurysms, 30 arteriovenous fistulas, and 11 arteriocaliceal fistulas in 55 patients, after percutaneous nephrolithotomy (n=26), renal biopsy (n=21), nephrostomy (n=3), renal surgery (n=3), and extracorporeal shock wave lithotripsy (n=2). Median number of pseudoaneurysms was 1 (range, 1-4) with a median size of 7 mm (range, 1.5-35 mm). Fifty-one patients underwent coil embolization. Median number of coils was 5 (range, 2-21) and median renal parenchymal loss was 5% (range, 1%-50%). There were no significant differences between pre-and postoperative eGFR and serum parameters. CONCLUSION Iatrogenic renal arterial lesion can be a life threatening condition. Superselective coil embolization is a safe, minimally invasive treatment option with minimal renal parenchymal loss and without significant change in renal function.Öğe Endovascular management of iatrogenic renal arterial lesions and clinical outcomes(Turkish Soc Radiology, 2015) Guneyli, Serkan; Gok, Mustafa; Bozkaya, Halil; Cinar, Celal; Tizro, Arastu; Korkmaz, Mehmet; Akin, Yigit; Parildar, Mustafa; Oran, IsmailPURPOSE We aimed to evaluate iatrogenic renal arterial lesions, including pseudoaneurysm, arteriovenous fistula, and arteriocaliceal fistula, their management by endovascular embolization, and the clinical results. METHODS Fifty-five patients (forty males, fifteen females) with a median age of 40 years (range, 8-85 years), who underwent endovascular embolization of iatrogenic renal arterial lesions between March 2003 and December 2013 were included in this retrospective study. Types of iatrogenic lesions and details of embolization procedures were reported. Estimated glomerular filtration rate (eGFR), renal function tests, hemoglobin, and hematocrit levels before and after embolization were recorded and compared. RESULTS Median follow-up was 24 months. We identified 53 pseudoaneurysms, 30 arteriovenous fistulas, and 11 arteriocaliceal fistulas in 55 patients, after percutaneous nephrolithotomy (n=26), renal biopsy (n=21), nephrostomy (n=3), renal surgery (n=3), and extracorporeal shock wave lithotripsy (n=2). Median number of pseudoaneurysms was 1 (range, 1-4) with a median size of 7 mm (range, 1.5-35 mm). Fifty-one patients underwent coil embolization. Median number of coils was 5 (range, 2-21) and median renal parenchymal loss was 5% (range, 1%-50%). There were no significant differences between pre-and postoperative eGFR and serum parameters. CONCLUSION Iatrogenic renal arterial lesion can be a life threatening condition. Superselective coil embolization is a safe, minimally invasive treatment option with minimal renal parenchymal loss and without significant change in renal function.Öğe Endovascular Management of Iatrogenic Vascular Injury in the Craniocervical Region(Turkish Neurosurgical Soc, 2018) Aydin, Elcin; Gok, Mustafa; Esenkaya, Asim; Cinar, Celal; Oran, IsmailAIM: 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 Occlusion of Intracranial Pial Arteriovenous Fistula: Technical Aspects(Turkish Neurosurgical Soc, 2025) Cinar, Celal; Kusbeci, Mahmut; Elek, Alperen; Ozturk, Egemen; Oran, IsmailAIM: To evaluate pial arteriovenous fistulas (AVFs), focusing on the radio-anatomic architecture and contemporary endovascular devices and techniques. MATERIAL and METHODS: Sixteen patients with congenital pial AVFs who underwent endovascular treatment between 2002 and 2023 at a single institution were included in this review. This retrospective study was approved by the Institutional Review Board. The study was descriptive and involved no statistical comparisons. RESULTS: The study included 16 patients (6 female patients, 10 male patients) with a mean age of 19.93 +/- 21.1 years (range: 1-63 years). Nine (56.25%) were pediatric patients, six (37.5%) of whom were younger than 5 years. Five patients (31.25%) had more than one feeding artery, whereas 11 (68.75%) had a single feeding artery. One patient had two separate fistulas. All fistulas were successfully occluded without complications. Four patients (25%) were treated with glue alone, four (25%) with coils alone, five (31.25%) with a non-adhesive liquid agent alone, and three (18.75%) with a combination of coils and a non-adhesive liquid agent. Venous sinus thrombosis occurred in two patients (12.5%) in the early postoperative period; both cases resolved without permanent deficits. CONCLUSION: Pial AVF is a rare intracranial vascular malformation. Endovascular treatment using liquid embolic agents, coils, or a combination of these techniques is effective.Öğe Endovascular Procedure in Managing Vascular Complications of Type IV Ehlers-Danlos Syndrome: Case Report(Springer Nature, 2024) Avarand, Mohammad; Çinar, Çelal; Oran, IsmailThis study explores the management methods and approaches for patients with vascular Ehlers-Danlos Syndrome (vEDS) in a minimally invasive manner. In this paper, we presented two cases diagnosed with vEDS that presented with multiple aneurysms during their lives which were managed intravascularly, and outcomes were expressed. Two young male cases diagnosed with vEDS complained of numerous femoral, axillar, vertebral, and superior mesenteric artery aneurysms which were managed endovascularly with stent-grafts, coils, and plugs. We aimed to state that managing vascular complications in vEDS patients may be done minimally invasive with no major traditional surgery and should contain a multidisciplinary approach. © 2025 Elsevier B.V., All rights reserved.Öğe Endovascular treatment modalities for basilar artery fenestration aneurysms: experience of two centers and literature review(Tubitak Scientific & Technical Research Council Turkey, 2021) Korkmaz, Mehmet; Cinar, Celal; Nas, Omer Fatih; Hakyemez, Bahattin; Oran, IsmailBackground/aim: The aim of this study is to present our experience on various endovascular treatment modalities of basilar fenestration aneurysms and reviewing our findings together with literature data. Materials and methods: A total of 26 basilar artery fenestration (BAF) aneurysms in 24 patients were endovascularly treated in two different neurointerventional radiology clinics. All patients had been evaluated with computed tomography (CT), CT angiography, and digital subtraction angiography before the procedure. Results: Aneurysms of all patients were successfully occluded (technical success rate 100%). Procedure-related complications were seen in two patients. Our comprehensive literature research revealed that studies related with the topic are composed mostly of case reports. In the literature, a total of 113 BAF aneurysms of 101 patients had been treated endovascularly in 46 studies between 1993 and 2019. Success rate of the treatment was reported as 97%, clinical success rate as 91%, and complication rate as 8.8%, while these rates are 100%, 92%, and 7.6% in our study, respectively. Conclusion: Although the number of cases is low in our study, to our knowledge, it is the widest series in the literature until today. Our results demonstrate that BAF aneurysms can be treated successfully and safely with different endovascular techniques, with more stent use in recent years.
