Browsing by Author "Öğüşlü,U."

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    Article
    Citation Count: 10
    Percutaneous endobiliary ablation of malignant biliary strictures with a novel temperature-controlled radiofrequency ablation device
    (Turkish Society of Radiology, 2021) Uyanık,S.A.; Öğüşlü,U.; Çevik,H.; Atlı,E.; Yılmaz,B.; Gümüş,B.
    PURPOSE We aimed to determine the safety and effectiveness of percutaneous endobiliary radiofrequency ablation of malignant biliary obstructions with a temperature-controlled radiofrequency ablation device. METHODS In this single center retrospective study, a total of 62 consecutive patients with malignant biliary obstruction were evaluated. Thirty patients who underwent endobiliary radiofrequency ablation with metallic stent placement were in the study group and 32 patients who underwent only metallic stenting were in the control group. Outcomes of this study were technical success, complications related to the procedure, stent patency, and overall survival. RESULTS All procedures were technically successful in both groups. There was no procedure-related mortality in either group. Procedural complication rates were similar between the groups. Although statistically not significant, the only two major complications (hemobilia requiring endovascular treatment) were in the control group. Median primary stent patency was significantly longer in the study group than in the control group (223 days vs. 158 days; p = 0.016). Median survival rates were also longer in the study group (246 days vs. 198 days; p = 0.004). CONCLUSION Percutaneous endobiliary radiofrequency ablation is safe and feasible with this novel radiofre-quency ablation device in patients with malignant biliary obstruction. Percutaneous endobiliary radiofrequency ablation has a potential to improve both stent patency and survival. © Turkish Society of Radiology 2021.
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    Article
    Citation Count: 8
    Percutaneous intraductal microwave ablation of malignant biliary strictures: Initial experience
    (American Roentgen Ray Society, 2020) Uyanık,S.A.; Öğüşlü,U.; Yılmaz,B.; Çevik,H.; Atlı,E.; Gümüş,B.
    OBJECTIVE. Metallic stenting of malignant biliary strictures is the preferred method of palliation, because most patients present when the condition is inoperable. Most metallic stents, however, are occluded 6-8 months after deployment. Intraductal radiofrequency ablation has been used in previous studies to improve stent patency. The purpose of this study was to assess a single-center experience with percutaneous intraductal microwave ablation of malignant biliary strictures. MATERIALS AND METHODS. In this retrospective case series study, data on 12 patients with malignant biliary obstruction who underwent percutaneous intraductal microwave ablation followed by metallic stenting were evaluated. Ablation procedures were performed with generator frequencies of 902-928 MHz, power set at 6-10 W, and ablation time of 60-90 seconds in a temperature-controlled manner with target temperature set at 80°C. RESULTS. Causes of malignant biliary obstruction were pancreatic carcinoma in four patients, gastric antrum carcinoma in three, cholangiocarcinoma in two, metastasis in two, and gallbladder carcinoma in one patient. Percutaneous intraductal microwave ablation and metallic stenting were performed successfully in all patients. There was no procedural mortality or major complication. The most common minor complication was abdominal pain. Biliary decompression was achieved in all patients at the end of the first month. The mean follow-up time was 9.4 months. The median primary stent patency period was 231 days. There were two stent occlusions due to sludge formation, and two patients died during follow-up. CONCLUSION. Percutaneous intraductal microwave ablation of malignant biliary strictures is safe and feasible. Prospective randomized controlled studies with long-term results are warranted to determine the effectiveness of this technique in lengthening the stent patency period. © American Roentgen Ray Society
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    Article
    Citation Count: 16
    Radiation doses from head, neck, chest and abdominal CT examinations: An institutional dose report
    (Turkish Society of Radiology, 2021) Atlı,E.; Uyanık,S.A.; Öğüşlü,U.; Cenkeri,H.Ç.; Yılmaz,B.; Gümüş,B.
    PURPOSE We aimed to obtain typical values for head, neck, chest, and abdominal computed tomography (CT) examinations from routine patients in 2018, and to review our data with national and international diagnostic reference levels (DRLs). METHODS Single-phase head, neck, chest, and abdominal CT scans of adults performed in 64-slice CT in 2018 were included in this study. Radiation dose parameters of CT scans were obtained from the picture archiving and communication system of our hospital. Volumetric CT dose index (CTDIvol) and dose length product (DLP) values were recorded. Effective dose (ED) and scan length was calculated. A 16 cm diameter phantom is referenced for head CT, and 32 cm diameter phantom is referenced for neck, chest, and abdominal CT. Descriptive statistics of the variables were given according to the normality testing. RESULTS Median CTDIvol value was 53 mGy for the head, 13.1 mGy for the neck, 8.3 mGy for the chest, and 8.6 mGy for the abdomen. Median DLP value was 988 mGy.cm for the head, 299 mGy.cm for the neck, 314 mGy.cm for the chest, and 457 mGy.cm for the abdomen. Median ED value was 2.07 mSv for the head, 1.76 mSv for the neck, 4.4 mSv for the chest, and 6.8 mSv for the abdomen. Considering national DRLs, median CTDIvol values of head, chest, and abdomen were lower, whereas median DLP and ED values of head and chest were higher. For the abdomen, the median DLP and ED values were lower. CONCLUSION Overall radiation dose parameters obtained in this study points out the need for optimization of head CT examinations in our institution. © Turkish Society of Radiology 2021.
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    Article
    Citation Count: 5
    Retrograde Pedal Access via Occluded Arteries in Endovascular Treatment of Critical Limb Ischemia
    (Elsevier Inc., 2021) Uyanık,S.A.; Öğüşlü,U.; Yılmaz,B.; Çevik,H.; Atlı,E.; Gümüş,B.
    Purpose: To evaluate the feasibility and technical outcomes of retrograde access via occluded pedal arteries in endovascular treatment of critical limb ischemia (CLI) when the conventional antegrade approach fails. Materials and Methods: One hundred fifty-one patients with CLI (age 69 y ± 10.5; 116 men) who were not surgical candidates and were treated via retrograde pedal access between January 2016 and January 2018 were evaluated retrospectively. Seventy patients in whom retrograde access was performed through occluded arteries constituted the occluded group, and 81 patients who were treated via retrograde access from patent arteries constituted the nonoccluded group. Pedal access success, lesion crossing success, angiographic success, overall technical success, and procedure-related complications were evaluated and compared between groups. Results: Pedal access success (74 of 78 vs 83 of 87 attempts; P = .873) and lesion crossing success (64 of 78 vs 77 of 87 lesions; P = .340) were comparable between subgroups. Angiographic success (54 of 78 vs 77 of 87 lesions; P = .012) and overall technical success (48 of 70 vs 72 of 81 patients; P = .004) rates were lower in the occluded group. Procedure-related complications were similar between groups (P = .096). Conclusions: Retrograde pedal access from occluded pedal arteries is a feasible option when an antegrade approach fails in endovascular treatment of CLI. Although it has lower technical success, its use enables angiosome-directed therapy and has the potential to improve the outcomes of the procedure. © 2020 SIR