Browsing by Author "Oguslu,U."

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Citation Count: 0
Comparison of supraclavicular brachiocephalic and femoral vein approaches for tunneled dialysis catheter placement in patients with thrombosed internal jugular veins
(John Wiley and Sons Inc, 2024) Oguslu,U.; Gümüş,B.; Yalçin,M.; Sahin,O.Z.; Yilmaz,G.
Introduction: There is still debate on the best access route in case of bilateral internal jugular vein thrombosis. We aimed to compare the safety, effectiveness, and outcomes of tunneled dialysis catheter placement via supraclavicular brachiocephalic and femoral vein approaches in patients with bilateral internal jugular vein thrombosis. Methods: Between January 2018 and December 2021, data of the patients in whom tunneled dialysis catheters were placed via the supraclavicular brachiocephalic vein (n = 42) and femoral vein (n = 57) approaches were extracted. Patient demographics, technical and clinical success rates, complications, and outcomes were noted. The Likert scale was used to assess patient satisfaction. Findings: Forty two (42.4%) patients were men, and the mean age was 61.9 (range, 12–93) years. The technical and clinical success rate was 100% for both groups. No major complication was encountered. The mean follow-up period was 497.5 (range, 32–1698) catheter days. Thirty-day patency was similar for the brachiocephalic vein and femoral vein group (40 [95.2%] vs. 55 [96.5%], p = 0.754). Also, primary and cumulative patency rates were comparable (p = 0.158; p = 0.660). The infection rate was 2.6 and 4.1 per 1000 catheter days for the brachiocephalic vein and femoral vein group. The infection-free survival was significantly higher in the brachiocephalic vein group (71.9% vs. 35.3% at 12 months, p < 0.001). Patient satisfaction was higher in the brachiocephalic vein group (median satisfaction, 5 vs. 4, p < 0.001). Discussion: Both supraclavicular brachiocephalic vein and femoral vein approaches have high technical and clinical success with comparable patency rates. However, low infection rate and high patient satisfaction make the supraclavicular brachiocephalic vein approach a reasonable alternative before proceeding to the femoral vein access. © 2023 International Society for Hemodialysis.
Citation Count: 0
Endovascular recanalization and remodeling of abdominal aorta stent graft chronic total occlusion after failed extra-anatomic bypass surgery
(SAGE Publications Ltd, 2022) Oguslu,U.; Uyanik,S.A.; Çevik Cenkeri,H.; Atli,E.; Yilmaz,B.; Gümüş,B.
Objectives: Chronic total occlusion (CTO) of the EVAR graft is a rare and serious complication. Traditionally, surgical intervention with prosthetic graft replacement or bypass graft implantation is performed. However, there are limited data in endovascular era. Methods: We present a case of a 68-year-old male with a history of late EVAR graft occlusion treated with multiple surgical interventions (femorofemoral crossover, extra-anatomic bypass surgery, and thrombectomy) five years ago. Color Doppler ultrasound (CDUS) and computed tomography (CT) angiography revealed thrombosis of the entire bypass graft. Endovascular recanalization and remodeling of the abdominal stent graft CTO was performed with a combination of bare stents and stent grafts. Rupture of the stent graft occurred on the right limb. A second covered stent was placed. Results: At 12-month follow-up, the patient was symptom free. Color Doppler ultrasound surveillance showed patent aortic stent graft and downstream arteries. Conclusions: Endovascular recanalization of aortic stent graft CTO is a viable option in patients with failed bypass graft. © The Author(s) 2021.
Citation Count: 0
Endovascular Recanalization of the Chronically Occluded Native Superficial Artery After Failed Bypass Graft: Midterm Results
(Elsevier Inc., 2022) Oguslu,U.; Uyanik,S.A.; Cenkeri,H.Ç.; Atli,E.; Yilmaz,B.; Gümüş,B.
Purpose: To evaluate the safety, effectiveness, and outcomes of endovascular recanalization of chronic total occlusion (CTO) of the superficial femoral artery (SFA) in patients with critical limb ischemia (CLI) after failed surgical bypass graft. Methods: Endovascular recanalization of SFA CTO was performed for 26 consecutive CLI patients with failed bypass grafts from 2016 to 2020. Patient demographics, bypass and lesion characteristics, procedural data, technical, and clinical outcomes were evaluated. Results: The technical success rate was 96.2% (25/26). Retrograde arterial access was used in 16 (61.6%) patients. Additional tibial and iliac angioplasty was performed in 15 and 2 patients, respectively. Fifteen complications occurred in 10 patients, including thrombosis, embolism, vessel rupture, dissection, arteriovenous fistula, and pseudoaneurysm. Pain relief and wound healing were achieved in 22 patients. The primary, assisted primary, and secondary patency rates were 95.5%, 100%, and 100% at 6 months, 81.8%, 95.5%, and 100% at 12 months, and 76.7%, 82.7%, and 87.5% at 24 months, respectively. By univariate analysis, hyperlipidemia (hazard ratio = 7.82; 95% CI: 1.27–48.04, P = .026) was found to be the only significant risk factor related to primary patency loss. Amputation-free survival and limb salvage rates were 100% and 100% at 6 months, 100% and 100% at 12 months, and 87.1% and 93.8% at 24 months, respectively. Conclusions: Endovascular recanalization of SFA CTO in CLI patients with graft failures is effective with high technical success rates. Acceptable limb salvage and amputation-free survival rates make this technique a reasonable alternative to repeat surgery for high-risk patients. © 2021 SIR
Citation Count: 5
Endovascular treatment of hepatic arterioportal fistula complicated with giant portal vein aneurysm via percutaneous transhepatic US guided hepatic artery access: a case report and review of the literature
(Springer Science and Business Media Deutschland GmbH, 2019) Oguslu,U.; Uyanik,S.A.; Gümüş,B.
Background: Hepatic arterioportal fistulas are rare, abnormal, direct communications between hepatic artery and portal venous system. Treatment options shifted from surgery to endovascular interventions. Catheterization may be challenging. We report a case of a hepatic arterioportal fistula treated successfuly with Amplatzer Vascular Plug II via percutaneous transhepatic hepatic artery access after failed transfemoral approach. Case presentation: 58 year old woman presented with right heart failure, kidney insufficiency and massive ascites related to portal hypertension caused by hepatic arterioportal fistula. She had a history of previous abdominal surgery. Colour Doppler ultrasound and computed tomography revealed a giant portal vein aneurysm related to large hepatic areterioportal fistula. Endovascular treatment was planned. Catheterization of the hepatic artery could not be realized due to severe tortuosity and angulation of the celiac artery and its branches. Access to the hepatic artery was obtained directly via percutaneous transhepatic route and fistula site was embolized with Amplatzer Vascular Plug II and coils. Immediate thrombosis of the aneurysm sac and draining portal vein was observed. Patients clinical status improved dramatically. Conclusion: Transcatheter embolization is the first choice of the treatment of hepatic arterioportal fistulas but the type of the therapy should be tailored to the patient and interventional radiologist should decide the access site depending on his own experience if the routine endovascular access can not be obtained. © 2019, The Author(s).
Citation Count: 0
The Prevalence of Open and Closed Posterior Superior Iliac Spine
(Turkish Neurosurgical Society, 2021) Atli,E.; Uyanik,S.A.; Oguslu,U.; Cenkeri,H.C.; Yilmaz,B.; Gumus,B.
AIM: To determine the prevalence of open and closed posterior superior iliac spine (PSIS) using lower abdominal computed tomography (CT) examinations. MATERIAL and METHODS: Eight hundred and fifty (M/F:464/386) adult patients who underwent lower abdominal CT between January 2018 and December 2018 were evaluated retrospectively. One radiologist reviewed CT images of patient pelvises to assess the presence of open and closed PSIS. RESULTS: The mean age of all patients was 52.7 ± 18 years. Of the 850 patients, 522 (61.5%) had open PSIS, while 328 (38.5%) had closed PSIS. The distribution of open and closed PSIS by gender was 57.5% and 42.5% in males and 66% and 34% in females, respectively. CONCLUSION: Overall, open PSIS is more common than closed PSIS. The closed PSIS is seen more often in males than in females. If an anteromedial sacral (S)-1 screw direction is chosen for posterior fusion with rod-screw fixation, it is essential to obtain CT images for evaluation of PSIS. © 2021. All Rights Reserved.
Citation Count: 1
Transhepatic pharmacomechanical thrombectomy of symptomatic acute noncirrhotic, nonmalignant portomesenteric venous thrombosis: Midterm results
(American Roentgen Ray Society, 2021) Oguslu,U.; Uyanik,S.A.; Cenkeri,H.Ç.; Atli,E.; Yilmaz,B.; Gümüş,B.
OBJECTIVE. The purpose of this study was to evaluate the safety and efficacy of transhepatic pharmacomechanical thrombectomy of symptomatic acute portomesenteric venous thrombosis. MATERIALS AND METHODS. Transhepatic pharmacomechanical thrombectomy (catheter-directed thrombolysis with mechanical thrombectomy) was performed in the treatment of nine patients with symptomatic acute noncirrhotic, nonmalignant portomesenteric venous thrombosis. The medical records, imaging examinations, technique of transhepatic pharmacomechanical thrombectomy, and clinical outcomes were reviewed. RESULTS. The mean follow-up period was 23.1 months (range, 8–34) months. Successful recanalization of the portomesenteric venous thrombosis, restoration of hepatopetal portal flow, clinically significant improvement in the signs and symptoms of acute mesenteric ischemia, and prevention of bowel resection were achieved in all patients. The most frequent minor complication (in three patients) was minor hemorrhage through the transhepatic access track. No procedure-related major complications occurred during hospitalization. No patient had rethrombosis or complications related to portal hypertension due to portomesenteric venous thrombosis. One patient died of massive pulmonary embolism on the 7th day after treatment. Cavernous transformation of the right portal vein occurred in one patient. CONCLUSION. Transhepatic pharmacomechanical thrombectomy is a safe and effective method of treatment of symptomatic acute portomesenteric venous thrombosis and prevention of bowel infarction. © American Roentgen Ray Society