Person: BALTACIOĞLU, FEYYAZ
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BALTACIOĞLU
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FEYYAZ
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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 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 Open Access Distal middle cerebral artery aneurysms - Endovascular treatment results with literature review(EDIZIONI CENTAURO, 2002-12) BALTACIOĞLU, FEYYAZ; Baltacioglu, F; Cekirge, S; Saatci, I; Ozturk, H; Arat, A; Pamir, N; Ozgen, TIntracranial aneurysms of the distal intracranial arteries are uncommon lesions which are difficult to treat with surgical techniques. Distal middle cerebral artery (MCA) aneurysms constitute approximately 5% of all MCA aneurysms. We report the results of our coil embolization for the treatment of distal MCA aneurysms. Eleven patients (four men and seven women, average age 37 years) with distally located MCA aneurysms were treated. Four of the aneurysms were fusiform in shape and the remainder were saccular. Seven of the aneurysms were in the dominant hemisphere. Four of the seven patients who had saccular aneurysms were treated with selective aneurysm embolization. The remaining seven patients were treated with aneurysmal sac and parent artery coiling. All patients had good retrograde flow into the peripheral branches of the occluded artery. All the procedures were completed successfully without any additional neurological deficits. Coil embolization is a safe and effective technique for the treatment of distal MCA aneurysms. If the parent artery cannot be preserved, pial collaterals can supply adequate blood to prevent neurological deficits.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 Open Access Intraarterial thrombolysis with r-tPA for treatment of anterior circulation acute ischemic stroke - Technical and clinical results(SAGE PUBLICATIONS INC, 2003-09) BALTACIOĞLU, FEYYAZ; Baltacioglu, F; Afsar, N; Ekinci, G; Tuncer-Elmaci, N; Cimsit, NC; Aktan, S; Erzen, CTo investigate factors effecting the safety and recanalization efficacy of local intraarterial (IA) recombinant tissue plasminogen activator (r-tPA) delivery in patients with acute ischemic stroke. Eleven patients with anterior circulation acute ischemic stroke were treated. The neurological status of the patients were graded with the Glasgow Coma Scale (GCS) and National Institute of Health Stroke Scale (NIHSS). All patients underwent a computed tomography (CT) examination at admission. In addition four patients had diffusion-weighted and one patient had a perfusion magnetic resonance (MR) examinations. Patients were treated within six hours from stroke onset. Immediate, six hours, and 24 hours follow-up CT examinations were performed in order to evaluate the haemorrhagic complications and the extent of the ischemic area. The Rankin Scale (RS) was used as an outcome measure. Two of the 11 patients had carotid T occlusion (CTO), nine had middle cerebral artery (MCA) main trunk occlusion. Four patients had symptomatic haemorrhage with a large haematoma rupturing into the ventricles and subarachnoid space. Of these, three patients died within 24 hours. The remaining seven patients had asymptomatic haematomas that were smaller compared to symptomatic ones, and showed regression in size and density on follow-up CTs. At third month five patients had a good outcome and three patients had a poor outcome. In acute ischemic stroke, local IA thrombolysis is a feasible treatment when you select the right patient. Haemorrhage rate does not seem to exceed that occuring in the natural history of the disease and in other treatment modalities.Publication Open Access The effect of selective internal radiation therapy with yttrium-90 resin microspheres on lung carbon monoxide diffusion capacity(SPRINGER, 2017-12) CEYHAN, BERRİN; Ones, Tunc; Eryuksel, Emel; Baltacioglu, Feyyaz; Ceyhan, Berrin; Erdil, Tanju YusufBackground: Selective internal radiation therapy (SIRT) with embolization of branches of the hepatic artery is a valuable therapeutic tool for patients with hepatic malignancies; however, it is also associated with lung injury risk due to shunting. Diffusion capacity of the lungs for carbon monoxide (DLCO) is a clinically significant lung function test, and worsening in DLCO is suggested to reflect a limited gas exchange reserve caused by the potential toxicity of chemoradiotherapy or it may be a marker of related lung injury. This study aimed to examine the changes in DLCO during SIRT with resin microspheres in newly treated and retreated patients. Forty consecutive patients who received SIRT for a variety of malignant conditions were included. All subjects were treated with Yttrium-90 labelled resin microspheres. DLCO tests were performed after the procedures. In addition, patients were specifically followed for radiation pneumonitis. Results: The mean DLCO did not significantly change after the first (82.8 +/- 19.4 vs. 83.1 +/- 20.9, p = 0.921) and the second treatments (87.4 +/- 19.7 vs. 88.6 +/- 23.2, p = 0.256). Proportion of patients with impaired DLCO at baseline was not altered significantly after the first (37.5 vs. 45.0%, p = 0.581) and the second treatments (27.3 vs. 27.3%, p = 1.000). Also, percent change in DLCO values did not correlate with radiation dose, lung shunt fraction, or lung exposure dose (p > 0.05 for all comparisons). None of the patients developed radiation pneumonitis. Conclusions: Our results suggest that no significant change in DLCO in association with SIRT occurs, both after the first or the second treatment sessions. Further larger studies possibly with different protocols are warranted to better delineate DLCO changes after SIRT in a larger spectrum of patients.Publication Open Access Successful endovascular repair of a subclavian artery pseudoaneurysm(1999-09-01) BALTACIOĞLU, FEYYAZ; Akgün, Serdar; Civelek, Ali; Baltacioglu, Feyyaz; Ekici, GazanferPublication Open Access Intraocular Pressure and Retinal Nerve Fibre Layer Thickness Changes After Carotid Artery Stenting(TURKISH OPHTHALMOLOGICAL SOC, 2017-08-09) BALTACIOĞLU, FEYYAZ; Biberoglu, Esra; Eraslan, Muhsin; Baltacioglu, Feyyaz; Midi, IpekObjectives: The aim of this study was to evaluate intraocular pressure (IOP) and retinal nerve fiber layer (RNFL) changes in patients with carotid artery stenosis (CAS) after carotid artery stenting. Materials and Methods: This study was conducted as a cross-sectional, non-randomised clinical case series. Fifteen male patients (mean age: 63.6ae9.1) with CAS and more than 70% carotid artery narrowing were included. All of the patients were followed in the department of neurology and were operated in the interventional radiology division. Eighteen healthy male subjects (mean age: 63.7ae5.3) were included in the control group. All of the healthy subjects had a detailed ophthalmological examination and subjects with any chronic eye disease were excluded from the study. All of the participants had a detailed ophthalmological examination including tonometry using Goldmann applanation tonometry and RNFL analysis using optical coherence tomography (RTVue-100 5.1). Results: There were no ocular ischemic symptoms in any of the participants. The mean IOP value was 15.1ae2.1 mmHg in the control group and 16.6ae2.4 mmHg before stent implantation, 16.4ae2.2 mmHg at 1 week after implantation, 16.6ae2.5 mmHg at 1 month after implantation, and 16.7ae2.9 mmHg at 3 months after implantation in the CAS group. Mean RNFL thickness was 105ae6 mu m in the control group; in the CAS group, mean RNFL thickness values were 98ae27 mu m before stent implantation and 103ae11 mu m, 101ae10 mu m, and 101ae11 mu m at 1 week, 1 month, and 3 months after stenting. There were no significant differences between the CAS group and control group regarding IOP and RNFL thickness values (p> 0.05). IOP and RNFL thickness also did not show any statistically significant changes from preoperative measurements in 3 months postoperative follow-up in the CAS group (p> 0.05). Conclusion: IOP and RNFL thickness remained unchanged after carotid stent implantation in carotid artery stenosis patients with no signs of ocular ischemic syndrome.