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Öğe Angiographic findings and endovascular interventional procedures in 41 patients with Takayasu's arteritis(B M J Publishing Group, 2004) Aksu, K; Keser, G; Memis, A; Inal, V; Parildar, M; Doganavsargil, EÖğe Angiographic findings and endovascular interventional procedures in 41 patients with Takayasu's arteritis(B M J Publishing Group, 2004) Aksu, K; Keser, G; Memis, A; Inal, V; Parildar, M; Doganavsargil, EÖğe 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, NWe 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.Öğe 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, ABackground: 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.Öğe 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, MEndovascular 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.Öğe Embolization of visceral pseudoaneurysms with platinum coils and N-butyl cyanoacrylate(Springer-Verlag, 2003) Parildar, M; Oran, I; Memis, ABackground: 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.Öğe Embolization of visceral pseudoaneurysms with platinum coils and N-butyl cyanoacrylate(Springer-Verlag, 2003) Parildar, M; Oran, I; Memis, ABackground: 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.Öğe Experience with mesocaval shunt with autologous jugular vein interposition in patients with Budd-Chiari syndrome(H G E Update Medical Publishing S A, 2005) Ilkgul, O; Kilic, M; Icoz, G; Zeytunlu, M; Demirpolat, G; Akyildiz, M; Tokat, Y; Parildar, M; Memis, ABackground/Aims: In the present era of interventional. radiology and liver transplantation, the role of mesocaval shunt surgery for portal hypertension in Budd-Chiari syndrome is reviewed. Methodology: This study analyzed the management of 35 patients with Budd-Chiari syndrome between June 1994 and June 2004 in our institution. During this 10-year interval, 31 of the 35 patients with Budd-Chiari syndrome underwent shunt procedures and four patients underwent liver transplantation. Mesocaval shunts were preferred in 27 patients and seven of these patients required prior caval stenting. One portocaval shunt was performed in a patient having a thrombosed mesocaval shunt. In all mesocaval. shunt procedures the patient's internal jugular vein was used as an interposition graft between the superior mesenteric vein and inferior vena cava. In four patients with thrombosed vena cava a mesoatrial shunt was performed using poly-tetrafluoroethylene graft while four patients with established cirrhosis under-went orthotopic liver transplantation. Results: In the group of mesocaval shunts, 3 patients were lost in the early postoperative period with a mortality rate of 11%, 2 of them due to thrombosed shunts and one of them due to pneumonia. The median follow-up was 42 months (6-120 months) and one patient experienced shunt thrombosis and died afterwards due to the complications of portal hypertension. In the whole series the patency rate of the mesocaval shunt was 89%. Conclusions: Patients with Budd-Chiari syndrome can be managed by a combination of shunt surgery, interventional radiology and liver transplantation. Our results demonstrate the effectiveness of mesocaval shunt procedure with autologous jugular vein interposition to maintain long-term patency and survival.Öğe Fracture of a renal artery stent due to mobile kidney(Springer, 2005) Sahin, S; Memis, A; Parildar, M; Oran, IÖğe Gluteal artery pseudoaneurysm, a rare cause of sciatic pain - Case report and literature review(Lippincott Williams & Wilkins, 2002) Yurtseven, T; Zileli, M; Goker, ENT; Tavmergen, E; Hoscoskun, C; Parildar, MThis article describes a very unusual case of sciatic pain and motor dysfunction resulting from gluteal artery pseudoaneurysm. A 36-year-old woman with primary infertility sustained an iatrogenic injury to her left gluteal artery during transvaginal ultrasound-guided follicle aspiration. Twenty-five days after the procedure she developed severe left sciatic pain and motor dysfunction. Pelvic computed tomography and magnetic resonance imaging revealed a huge pelvic hematoma. Angiography demonstrated a gluteal artery pseudoaneurysm. Because endovascular occlusion of the aneurysm did not relieve the pain, the patient underwent surgery for evacuation of the hematoma and release of the lumbosacral plexus. This eliminated all her sciatic pain and restored her motor dysfunction completely. The English literature details only five other cases of sciatic pain resulting from gluteal artery aneurysm, and these reports are also discussed.Öğe Hemodynamic disorders in internal thoracic artery: How often are they associated with subclavian steal via ipsilateral vertebral artery?(Amer Inst Ultrasound Medicine, 1998) Ozbek, SS; Parildar, MThe scores based on Doppler sonographic spectral features in 14 vertebral arteries with flow reversal and 10 vertebral arteries with normal antegrade flow were correlated with those of ipsilateral internal thoracic (or internal mammary) and subclavian arteries. The statistical analysis revealed significant correlation between the scores of all ipsilateral arteries. We concluded that color duplex ultrasonographic examination of internal thoracic arteries should be carried out in all patients with flow reversal in vertebral arteries. It is especially important in those who are potential candidates or coronary revascularization using in situ internal thoracic artery graft.Öğe 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, MA 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.Öğe Interventional radiological treatment in complications of pancreatitis(Elsevier Sci Ireland Ltd, 2002) Memis, A; Parildar, MPercutaneous interventional therapy plays an important role in treating complications of acute and chronic pancreatitis. With the development of cross-sectional imaging and advanced interventional techniques, percutaneous drainage has become the preferred treatment for pancreatic fluid collections such as acute collections, pseudocysts and abscesses. Abscess and pancreatic hemorrhage are the most life threatening complications of pancreatitis. Massive hemorrhage is rare but frequently lethal. As a rule, bleeding complications of pancreatitis require prompt diagnosis and an aggressive surgical approach. In unstable patients with a severely bleeding pseudoaneurysm, hemostasis can be obtained by occlusion with mechanical devices. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.Öğe Intradural aneurysm caused by arterial injury during surgery - Treatment with coil embolization(Edizioni Centauro, 2001) Oran, I; Parildar, M; Dalbasti, T; Memis, A; Ozdamar, NWe 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.Öğe Isolated pontine infarction due to rhinocerebral mucormycosis(Springer Verlag, 1999) Calli, C; Savas, R; Parildar, M; Pekindil, G; Alper, H; Yunten, NWe report a patient with rhinocerebral mucormycosis whose initial central nervous system involvement was isolated pontine infarction due to basilar arteritis caused by the fungus. The patient was diagnosed and followed by MRI and CT and basilar arteritis was demonstrated well on MRI studies. Involvement of the skull base was shown on CT in the later stage of the disease. The unusual initial presentation of the infection is discussed.Öğe Mesenteric artery aneurysms in intestinal tuberculosis as a cause of lower gastrointestinal bleeding(Springer, 2001) Oran, I; Parildar, M; Memis, AA 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.Öğe Multiple intracranial aneurysms in polyarteritis nodosa: MRI and angiography(Springer, 1999) Oran, I; Memis, A; Parildar, M; Yunten, NIn 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.Öğe 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, OPURPOSE: 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.Öğe 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, OPURPOSE: 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.Öğe Portal venous system aneurysms: Report of five cases(Amer Inst Ultrasound Medicine, 1999) Ozbek, SS; Killi, MR; Pourbagher, MA; Parildar, M; Katranci, N; Solak, AUntil recently aneurysms in the portal venous system were considered to be very rare lesions. This opinion has largely been changed by the increasing number of cases reported in recent years. Ln this paper we report the cases of five patients with portal venous system aneurysms, including one with splenic vein aneurysm. One patient had associated portal hypertension. The reexamination of two patients 2 years later showed no change in the aneurysms. The sonographic features and related literature are reviewed. In the light of this series and the information in the literature, we recommend that portal venous system aneurysms should no longer be considered exceptionally rare entities.
