Person: BALTACIOĞLU, FEYYAZ
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BALTACIOĞLU
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FEYYAZ
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Publication Metadata only Acute Obstructive Hydrocephalus due to a Giant Posterior Cerebral Artery Aneurysm in a Pediatric Patient(S. Karger AG, 2018) DAĞÇINAR, ADNAN; Sarica C., Tanrikulu B., Sahin Y., Daǧçlnar A., Baltacioglu F., Bayri Y.Introduction: Intracranial aneurysms are very rare in children. Although subarachnoidal hemorrhage (SAH) is by far the most common presentation of aneurysms in the majority of the pediatric case series, it is not rare for an unruptured aneurysm to present with a mass effect. Acute hydrocephalus is a common finding following aneurysmal SAH. However, this malady may develop even in the absence of SAH but secondary to direct obstruction by a giant aneurysm. This situation is extremely rare in children, with only a few known case reports in the literature. Case Report: We report the case of a 10-year-old girl who presented with signs and symptoms of acute hydrocephalus; further radiological evaluation revealed obstructive hydrocephalus and a giant posterior cerebral artery aneurysm. Following endovascular treatment of the aneurysm, hydrocephalus was completely resolved, and the patient was symptom free. Conclusion: Although they are very rare, giant intracranial aneurysms must be kept in mind during the differential diagnosis of pediatric acute hydrocephalus cases. Hydrocephalus may resolve spontaneously after the successful treatment of these aneurysms. © 2018 S. Karger AG, Basel. Copyright: All rights reserved.Publication Metadata only Stent-assisted coil embolization of challenging intracranial aneurysms: initial and mid-term results with low-profile ACCLINO devices(SPRINGER WIEN, 2016) TÜRELİ, DERYA; Tureli, Derya; Sabet, Soheil; Senol, Serkan; Andac, Nurten; Donmez, Halil; Geyik, Serdar; Baltacioglu, Feyyaz; Cekirge, SaruhanStent-assisted coiling using low-profile, self-expandable and retrievable stents is a valid option in endovascular treatment of challenging intracranial aneurysms. This study aims to evaluate the feasibility and efficacy of ACCLINO 1.9 F and ACCLINO Flex stent systems, designed for use as adjunctive products in coil embolization of intracranial aneurysms. Case files of 47 patients, and 52 aneurysms in total, treated with at least one ACCLINO 1.9 F or ACCLINO Flex stent were retrospectively evaluated. Technical success, complications, and angiographic outcomes were assessed based on immediate post-procedural controls along with 6th and 12th month angiograms. Mechanical untoward event rate, including asymptomatic complications, is 9.6 % (five out of 52 aneurysms). Failed dual-stenting attempt rate is 15.4 % (two out of 13). Overall procedure-related morbidity is 4.2 % with no neurologic sequelae. Initial occlusion rate is 90.4 % (47 aneurysms). One patient had residual filling in the aneurysm neck, which was stable throughout follow-up. The remaining four cases had spontaneous follow-up occlusion. Recanalization rate at 6th month is 2.1 % with one aneurysm requiring retreatment. One patient was lost to follow-up. There is no mortality associated with treatment. Stent-assisted coil embolization with ACCLINO stents in single or dual configurations is a feasible treatment option for challenging intracranial aneurysms. Follow-up results are encouraging; techniques were effective in complex cases and there were no clinically significant adverse outcomes.Publication Metadata only Transarterial microcatheter glue embolization of the bronchial artery for life-threatening hemoptysis: Technical and clinical results(ELSEVIER IRELAND LTD, 2010) BALTACIOĞLU, FEYYAZ; Baltacioglu, Feyyaz; Cimsit, Nuri Cagatay; Bostanci, Korkut; Yuksel, Mustafa; Kodalli, NihatObjectives: To report our experience with transarterial glue embolization of the bronchial artery for life-threatening hemoptysis. Materials and methods: Twenty-five patients underwent bronchial artery embolization, using coaxial microcatheter technique, with a liquid agent, n-butyl-2-cyanoacrylate (NBCA), named glue, for life-threatening hemoptysis. The technical and clinical outcomes were followed in terms of immediate control of bleeding, recurrence of hemoptysis and complications of the procedure. Results: Four patients had acute hemoptysis when they were evaluated. The average number of arteries embolized per patient was 2.9. BAEs were successful in controlling hemoptysis immediately in all 25 patients (100%) and in 24 patients (96%) at 1 month follow-ups. One patient had recurrent hemoptysis on the tenth day after embolization. The follow-up time ranged from 2 to 63 months (mean 14 months). Six patients (25%) died all as a result of their disease process. Bleeding recurred in 3 patients after 30 days (7th, 11th, 12th months). One patient had vomitting attacks with dysphagia after the procedure that lasted 24 h. Three patients had transient thoracic pain lasting 3-5 days. There were no procedure related spinal or vascular complications. Conclusions: Glue embolization with microcatheter technique is a safe and effective treatment in cases of life-threatening hemoptysis with a very high rate of success and low rate of complications. (C) 2008 Elsevier Ireland Ltd. All rights reserved.Publication Open Access Super-Selective Embolization of Vesical Arteries with Micro-Catheter Technique in the Treatment of Intractable Hemorrhage due to Bladder Cancer(GALENOS YAYINCILIK, 2016-03-30) BALTACIOĞLU, FEYYAZ; Sahin, Bahadir; Sulukaya, Muhammed; Tinay, Ilker; Tanidir, Yiloren; Baltacioglu, Feyyaz; Turkeri, LeventObjective: We aimed to share our experience about the super-selective embolization of the vesical artery performed with micro-catheter technique which was used as a palliative approach to control intractable hematuria in patients with bladder cancer. Materials and Methods: Super-selective embolization of the vesical artery with micro-catheter technique was performed in 12 bladder cancer patients whose hematuria could not be controlled with other palliative methods in our clinic. Hemoglobin levels, blood transfusion amounts, complications and urethral catheter removal duration before and after embolization were evaluated. Results: The average age of the patients was 73.3 (65-85, range) years. For the embolization process, n-butyl-2cyaboacrylate (glue) was used as the primary method in 3 patients and polyvinylalcohol (PVA) particle was used in the remaining 9 patients. In two of the patients whose hematuria could not be controlled after PVA embolization glue embolization was performed as the secondary procedure within one week. Super-selective embolization of the vesical artery with micro-catheter technique was performed in all of our cases. In 4 cases, embolization of the vesical artery was performed only to the side of the tumor, which was determined with cystoscopy. Bilateral embolization was performed to the remaining 8 cases. The average hemoglobin value before and after the embolization procedure was 7.9 g/dL and 9.2 g/dL, respectively. The average blood transfusion amounts before and after the procedure were 4 (2-15) and 2.3 (1-4) units erythrocyte/whole blood, respectively. The average urethral catheter duration after the procedure was 7 (2-16) days in 10 patients, who were treated one single embolization session. Urethral catheters were removed once the hematuria dissolved completely. There were no major complications or mortality related to the treatment after the embolization procedure. Conclusion: Super-selective embolization of the vesical artery performed with micro-catheter technique is a safe and effective alternative in patients with intractable hematuria due to bladder cancer whose hematuria could not be controlled with other palliative methods.Publication Metadata only Is any landmark reliable in vertebral enumeration? A study of 3.0-Tesla lumbar MRI comparing skeletal, neural, and vascular markers(ELSEVIER SCIENCE INC, 2014) TÜRELİ, DERYA; Tureli, Derya; Ekinci, Gazanfer; Baltacioglu, FeyyazPurpose: This study aimed to determine the reliability of the iliolumbar ligament (ILL), 12th costa, aortic bifurcation (AB), Tight renal artery (RRA), and conus medullaris (CM) for numbering of vertebral segments. Subjects and methods: Five hundred five patients underwent routine lumbar MRI examinations including a cervicothoracic sagittal scout and T1 and T2-weighted sagittal and axial turbo spin echo images. Images were evaluated by two radiologists separately. Results: The identifiability of ILL and 12th costa were 85.7% and 48.1%. AB, RRA, and CM were located more caudally in lumbarized S1 and more cranially in sacralized L5 cases. Conclusion: Landmarks suggested by previous studies are not reliable alternatives to cervicothoracic scout images due to wide ranges of distribution and inconsistencies in identification. (C) 2014 Elsevier Inc. All rights reserved.Publication Open Access Resistant pediatric priapism: A real challenge for the urologist(CANADIAN UROLOGICAL ASSOCIATION, 2015-08-10) ŞEKERCİ, ÇAĞRI AKIN; Sekerci, Cagri Akin; Akbal, Cem; Sener, Tarik Emre; Sahan, Ahmet; Sahin, Bahadir; Baltacioglu, Feyyaz; Simsek, FerruhPriapism in pediatric patients is a rare entity. We present an 8-year-old boy with known cerebral palsy. He came to the emergency department with sustained painful erection for 12 hours. Physical examination showed rigid penis. Blood count and biochemical analysis were normal. Although penile Doppler ultrasound revealed normal arterial and venous flow, cavernosal blood gas was hypoxic. A total of 50 mL of dark blood was aspirated, and 2 mL of 0.001% adrenalin solution was applied to both corpus cavernosum, twice within 20 minutes, which eventually did not achieve detumescence. A distal Winter shunt was performed at the end of which the penis was semi-flaccid. By the 18th hour of surgery, the penis re-gained painful erection status, so an Al-Ghorab shunt was performed. After the Al-Ghorab shunt, the penis was still in the semi-flaccid state. The next day, an angiography was performed and an arteriovenous fistula was discovered and treated by embolization. The flaccid state was achieved and the patient was discharged the day after the embolization.Publication Metadata only Utility of Interobserver Agreement Statistics in Establishing Radiology Resident Learning Curves During Self-directed Radiologic Anatomy Training(ELSEVIER SCIENCE INC, 2015) BALTACIOĞLU, FEYYAZ; Tureli, Derya; Altas, Hilal; Cengic, Ismet; Ekinci, Gazanfer; Baltacioglu, FeyyazRationale and Objectives: The aim of the study was to ascertain the learning curves for the radiology residents when first introduced to an anatomic structure in magnetic resonance images (MRI) to which they have not been previously exposed to. Materials and Methods: The iliolumbar ligament is a good marker for testing learning curves of radiology residents because the ligament is not part of a routine lumbar MRI reporting and has high variability in detection. Four radiologists, three residents without previous training and one mentor, studied standard axial T1- and T2-weighted images of routine lumbar MRI examinations. Radiologists had to define iliolumbar ligament while blinded to each other's findings. Interobserver agreement analyses, namely Cohen and Fleiss kappa statistics, were performed for groups of 20 cases to evaluate the self-learning curve of radiology residents. Results: Mean kappa values of resident-mentor pairs were 0.431, 0.608, 0.604, 0.826, and 0.963 in the analysis of successive groups (P <.001). The results indicate that the concordance between the experienced and inexperienced radiologists started as weak (kappa <0.5) and gradually became very acceptable (kappa >0.8). Therefore, a junior radiology resident can obtain enough experience in identifying a rather ambiguous anatomic structure in routine MRI after a brief instruction of a few minutes by a mentor and studying approximately 80 cases by oneself. Conclusions: Implementing this methodology will help radiology educators obtain more concrete ideas on the optimal time and effort required for supported self-directed visual learning processes in resident education.Publication Open Access Demographic, procedural and 30-day safety results from the WEB Intra-saccular Therapy Study (WEB-IT)(BMJ PUBLISHING GROUP, 2017-12) BALTACIOĞLU, FEYYAZ; Fiorella, David; Molyneux, Andrew; Coon, Alexander; Szikora, Istvan; Saatci, Isil; Baltacioglu, Feyyaz; Sultan, Ali; Arthur, AdamIntroduction The Woven EndoBridge (WEB) represents a novel intrasaccular therapeutic option for the treatment of intracranial wide-necked bifurcation aneurysms (WNBAs). The WEB-IT Study is a pivotal Investigational Device Exemption (IDE) study to determine the safety and effectiveness of the WEB device for the treatment of WNBAs located in the anterior and posterior intracranial circulations. We present the patient demographics, procedural characteristics, and 30-day adverse event data for the US WEB-IT study. Methods WEB-IT is a prospective multicenter single-arm interventional study conducted at 25 US and 6 international centers. The study enrolled 150 adults with WNBAs of the anterior and posterior intracranial circulations. All patients were intended to receive a WEB device delivered via standard endovascular neurosurgical embolization techniques. The study was conducted under Good Clinical Practices and included independent adjudication effectiveness outcomes and all adverse events. Results One hundred and fifty patients enrolled at 27 investigational sites underwent attempted treatment with the WEB. Mean age was 59 years (range 29-79) and 110 (73.3%) of the patients were female. Treated aneurysms were located at the basilar apex (n=59, 39.3%), middle cerebral artery bifurcation (n=45, 30%), anterior communicating artery (n=40, 26.7%), and internal carotid artery terminus (n=6, 4%). Average aneurysm size was 6.4 mm (range 3.6-11.4) with a mean neck size of 4.8 mm (range 2.0-8.2, mean dome to neck ratio 1.34). Nine patients presented with ruptured aneurysms. Of the enrolled patients, 98.7% were treated successfully with WEB devices. Mean +/- SD fluoroscopy time was 30.2 +/- 15.7 min. One primary safety event (PSE) (0.7%)-a delayed parenchymal hemorrhage 22 days after treatment-occurred between the index procedure and 30-day follow-up. In addition to the single PSE, there were seven (4.7%) minor ischemic strokes (5 resolved without sequelae and 2 had a modified Rankin Scale score of 1 at 30 days), five (2.7%) transient ischemic attacks, and two (1.3%) minor subarachnoid hemorrhages, which did not meet the prospectively established criteria for PSEs. Conclusions The WEB device can be used to treat WNBAs with a high level of procedural safety and a high degree of technical success.Publication Open Access Management of Massive Hemorrhage after Percutaneous Nephrolithotomy: Angioembolization or Renorrhaphy(GALENOS YAYINCILIK, 2015-12-05) BALTACIOĞLU, FEYYAZ; Tuncer, Murat; Faydaci, Gokhan; Eryildirim, Bilal; Camur, Emre; Tuncer, Elif O.; Baltacioglu, Feyyaz; Ozgul, Aydin; Sarica, KemalObjective We present two treatment modalities, selective renal angioembolization and renorraphy, in massive renal hemorrage after percutaneous nephrolithotomy (PCNL) that could not be controlled by conservative methods. Materials and Methods One thousand two-hundred patients, who had undergone PCNL between January 2003 and February 2014, were retrospectively reviewed. From these cases, we selected patients with massive post procedural bleeding that could not be taken under control by conservative methods and we reviewed their clinical course and treatment results. Results Bleeding could not controlled by conservative methods in 6 patients and, angioembolization was done succesfully. In 3 patients, angioembolization was not available. Renorraphy was performed in 2 patients and nephrectomy in 1 patient at first attempt. Renorraphy could not solve the problem of massive hemorrage and these 2 patients eventually underwent nephrectomy. Conclusion Renal angiography and embolization is an effective and safe method and renorraphy should not be the first option in massive bleeding after PCNL that can not be taken under control by conservative methods.Publication Metadata only Malign Hypertension in Childhood: Moyamoya Disease: Case Report(2016) BALTACIOĞLU, FEYYAZ; Güven, Serçin; Öztaşkin, Sinem; Karalar, Özge; Baltacioğlu, Feyyaz; Gökçe, İbrahim; Alpay, Harika