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BALTACIOĞLU, FEYYAZ

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BALTACIOĞLU

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2020 - 202315
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    PublicationOpen Access
    Safety and Efficacy of the FRED Jr Flow Re-Direction Endoluminal Device for Intracranial Aneurysms: Retrospective Multicenter Experience With Emphasis on Midterm Results
    (2021-10-01) BALTACIOĞLU, FEYYAZ; Jesser, Jessica; Alberalar, Nilüfer D.; Kizilkilic, Osman; Saatci, Isil; Baltacioglu, Feyyaz; Özlük, Enes; Killer-Oberpfalzer, Monika; Vollherbst, Dominik F.; Islak, Civan; Cekirge, Saruhan H.; Bendszus, Martin; Möhlenbruch, Markus; Koçer, Naci
    Background and Purpose: Flow diversion is increasingly used as an endovascular treatment for intracranial aneurysms. In this retrospective multicenter study, we analyzed the safety and efficacy of the treatment of intracranial, unruptured, or previously treated but recanalized aneurysms using Flow Re-Direction Endoluminal Device (FRED) Jr with emphasis on midterm results. Materials and Methods: Clinical and radiological records of 150 patients harboring 159 aneurysms treated with FRED Jr at six centers between October 2014 and February 2020 were reviewed and consecutively included. Clinical outcome was measured by using the modified Rankin Scale (mRS). Anatomical results were assessed according to the O'Kelly-Marotta (OKM) scale and the Cekirge-Saatci Classification (CSC) scale. Results: The overall complication rate was 24/159 (16%). Thrombotic-ischemic events occurred in 18/159 treatments (11%). These resulted in long-term neurological sequelae in two patients (1%) with worsening from pre-treatment mRS 0–2 and mRS 4 after treatment. Complete or near-complete occlusion of the treated aneurysm according to the OKM scale was reached in 54% (85/158) at 6-month, in 68% (90/133) at 1-year, and in 83% (77/93) at 2-year follow-up, respectively. The rates of narrowing or occlusion of a vessel branch originating from the treated aneurysm according to the CSC scale were 11% (12/108) at 6-month, 20% (17/87) at 1-year, and 23% (13/57) at 2-year follow-up, respectively, with all cases being asymptomatic. Conclusions: In this retrospective multicenter study, FRED Jr was safe and effective in the midterm occlusion of cerebral aneurysms. Most importantly, it was associated with a high rate of good clinical outcome.
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    PublicationOpen Access
    Unexpected radiation pneumonitis after SIRT with significant decrease in DLCO with internal radiation exposure: a case report
    (BMC, 2020-12) TÜRELİ, DERYA; Kesim, Selin; Ones, Tunc; Eryuksel, Emel; Baltacioglu, Feyyaz; Tureli, Derya; Ozguven, Salih; Erdil, Tanju Yusuf
    Background In the last years, Selective Internal Radiation Therapy (SIRT), using biocompatible Yttrium-90 (90Y) labeled microspheres have emerged for the treatment of malignant hepatic tumors. Unfortunately, a significant part of 90Y-labeled microspheres may shunt to the lungs after intraarterial injection. It can be predictable by infusing technetium-99 m-labeled macro-aggregated albumin particles through a catheter placed in the proper hepatic artery depending on the lobe to be treated with performing a quantitative lung scintigraphy. Radiation pneumonitis (RP) can occur 1 to 6 months after the therapy, which is a rare but severe complication of SIRT. Prompt timing of steroid treatment is important due to its high mortality rate. On the other hand, pulmonary diffusion capacity measured by carbon monoxide (DLCO) is an excellent way to measure the diffusing capacity because carbon monoxide is present in minimal amount in venous blood and binds to hemoglobin in the same manner as oxygen. Some authors reported that the most consistent changes after radiation therapy (RT) are recorded with this quantitative reproducible test. The relationship between the proportional reductions in DLCO and the severity of RP developing after this therapy may prove to be clinically significant. Case presentation We herein present a patient who developed RP after SIRT that could be quantified using DLCO. To the best of our knowledge, this case is the first who developed unexpected RP after SIRT with significant decrease in DLCO with internal radiation exposure. Conclusions RP is a very rare complication and may lead to a fatal outcome. Decline in DLCO could be a valuable parameter for follow-up and to identify potential candidates for RP and could be also another trigger for administration of steroid therapy with prompt timing in this patient group.
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    PublicationOpen Access
    Coronary arterial involvement can be observed in a significant subset of takayasu's arteritis patients by coronary ct-angiography
    (2022-06-01) ÇİNÇİN, AHMET ALTUĞ; BALTACIOĞLU, FEYYAZ; AKDENİZ DOĞAN, ZEYNEP DENİZ; DİRESKENELİ, RAFİ HANER; ALİBAZ ÖNER, FATMA; Abacar K., Cincin A., Baltacioglu F., AKDENİZ DOĞAN Z. D. , Sevik G., DİRESKENELİ R. H. , Alibaz-Oner. F.
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    PublicationOpen Access
    Reliability of coeliac and superior mesenteric artery origin level in lumbosacral transitional vertebrae detection and vertebral numbering
    (2022-01-01) BALTACIOĞLU, FEYYAZ; BIYIKLI, ERHAN; Biyikli E., Sever I. H., BALTACIOĞLU F.
    the detection of lumbosacral transitional vertebrae (LSTV) and vertebral enumeration. Patients and Methods: Institutional review board approval was obtained. Routine lumbar magnetic resonance (MR) imaging that included sagittal cervicothoracic scout images in 972 cases were evaluated retrospectively. Six segments were created in the vertebral column with 7 lines. CA and SMA ostiums were localized in these segments. Results: Coeliac artery and SMA levels were detected more caudally in lumbarized S1 and more cranially in sacralized L5 cases compared to non-LSTV cases. Conclusion: Coeliac artery and SMA origin levels as anatomical markers are not dependable for vertebral numbering due to their wide variability
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    PublicationOpen Access
    Ocular blood flow and choroidal thickness changes after carotid artery stenting
    (CONSEL BRASIL OFTALMOLOGIA, 2020) BALTACIOĞLU, FEYYAZ; Biberoglu, Esra; Eraslan, Muhsin; Midi, Ipek; Baltacioglu, Feyyaz; Bitargil, Macit
    Purposes: To evaluate changes in ocular blood flow and subfoveal choroidal thickness in patients with symptomatic carotid artery stenosis after carotid artery stenting. Methods: We included 15 men (mean age, 63.6 +/- 9.1 years) with symptomatic carotid artery stenosis and 18 healthy volunteers (all men; mean age, 63.7 +/- 5.3 years). All participants underwent detailed ophthalmologic examinations including choroidal thickness measurement using enhanced depth-imaging optic coherence tomography. The patients also underwent posterior ciliary artery blood flow measurements using color Doppler ultrasonography before and after carotid artery stenting. Results: Patients lacked ocular ischemic symptoms. Their peak systolic and end-diastolic velocities increased to 10.1 +/- 13.1 (p=0.005) and 3.9 +/- 6.3 (p=0.064) cm/s, respectively, after the procedure. Subfoveal choroidal thicknesses were significantly thinner in patients with carotid artery stenosis than those in the healthy controls (p=0.01). But during the first week post-procedure, the subfoveal choroidal thicknesses increased significantly (p=0.04). The peak systolic velocities of the posterior ciliary arteries increased significantly after carotid artery stenting (p=0.005). We found a significant negative correlation between the mean increase in peak systolic velocity values after treatment and the mean preprocedural subfoveal choroidal thickness in the study group (p=0.025, r=-0.61 7). Conclusions: In patients with carotid artery stenosis, the subfoveal choroid is thinner than that in healthy controls. The subfoveal choroidal thickness increases after carotid artery stenting. Carotid artery stenting treatment increases the blood flow to the posterior ciliary artery, and the preprocedural subfoveal choroidal thickness may be a good predictor of the postprocedural peak systolic velocity of the posterior ciliary artery.
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    Kolorektal kanser için geç kalibre cam mikroküreler ile tedavi etkinliğinin kantitatif PET/BT tabanlı değerlendirilmesi
    (2023-04-26) KESİM, SELİN; SOYDEMİR, EFE; BALABAN GENÇ, ZEYNEP CEREN; BALTACIOĞLU, FEYYAZ; ÖZDEMİR, BERDAN; ÖZGÜVEN, SALİH; FİLİZOĞLU, NUH; ENGÜR, CEREN ÖZGE; TUROĞLU, HALİL TURGUT; ERDİL, TANJU YUSUF; ÇİMŞİT, NURİ ÇAGATAY; ÖNEŞ, TUNÇ; Kesim S., Soydemir E., Balaban Genç Z. C., Baltacıoğlu F., Kıssa T. N., Özdemir B., Özgüven S., Filizoğlu N., Niftaliyeva K., Engür C. Ö., et al.
    Amaç: Transarteriyel radyoembolizasyonda (TARE) kullanılan Y-90 ile işaretli cam mikroküreler, kalibrasyon tarihinden 12 gün sonrasına kadar kullanılabilir. Metastatik kolorektal kanser (mKRK) olgularında yarı ömrü uzadıkça daha düşük spesifik aktivitede ve daha fazla sayıda mikroküre ile farklı bir tedavi opsiyonu sunan bu geç kalibreY-90 cam mikroküreler için literatür bilgisi sınırlıdır. mKRK olguları için tedaviye yanıtın değerlendirilmesinde florodeoksiglukoz (FDG) pozitron emisyon tomografi (PET)/bilgisayarlı tomografi (BT) ve bu görüntüleme yöntemi ile elde edilen kantitatif değerlendirme kriterleri olan metabolik tümör volümü (MTV) ve total lezyon glikoliz (TLG) kavramları nekrotik tümör dokusundan bağımsız olarak tümör yükünü daha doğru bir biçimde saptamaktadır. Bu çalışmada, geç kalibre Y-90 cam mikroküreler ile TARE uygulanan olgularda tedavi etkinliğini tedavi öncesi/sonrası FDG PET/BT görüntülemelerinden elde edilen kantitatif ölçümler ile değerlendirmeyi amaçladık. Yöntem: Çalışmaya geç kalibre Y-90 cam mikroküreler ile tedavi edilen toplam 77 mKRK olgusu/93 TARE seansı dahil edildi. Tüm tedaviler için SimplicitY-90™ yazılımı kullanılarak gerekli dozimetrik hesaplamalar yapıldı (Şekil 1). Tedavi öncesi ve tedavi sonrası 9-10. hafta FDG PET/BT görüntülemeleri gerçekleştirilerek \"bazal\" ve \"takip\" MTV ve TLG değerleri hesaplandı. (MTV/Gray)x100 ve (TLG/Gray)x100 değerleri (birim MTV/TLG için absorbe edilen doz sabit değeri) hesaplandı. Olgular \"Tedaviye Tam Yanıt-TY\", \"Parsiyel Yanıt-PY\", \"Stabil Hastalık-StH\" ve \"Progrese HastalıkPH\" olmak üzere 4 ayrı grupta değerlendirildi ve \"Hastalık Kontrol OranıHKO\" hesaplandı(Şekil 2). Genel sağkalım (GS) ve ilk tedavi sonrası sağkalım (İTSS) süreleri belirlendi. Doz/toksisite profili için olgular tedavi sonrası 2, 4, 8. haftalarda CTCAE skorlama sistemi ile değerlendirildi. TARE’ye bağlı kronik hepatotoksisite olasılığı açısından olgular tedavi sonrası en az 6 ay takip edildi. Bulgular: Doksan üç tedavi için: On olguda TY; 36 olguda PY; 33 olguda StH; 14 olguda PH saptandı. HKO %84,9 olarak bulundu. Tedavi öncesi birim TLG ve MTV değeri için absorbe edilen doz maruziyeti arttığında tedaviye yanıt oranında istatistiksel olarak anlamlı artış saptandı (p=0,004 vep=0,005). Karaciğere ulaşan mikroküre sayısında artış ile tedavi yanıtı arasında tüm olgular birlikte değerlendirildiğinde anlamlı bir istatistiksel ilişki kurulamazken(p=0,131)TY ve PY olgularında; StH ve PH olgularına kıyasla karaciğere ulaşan mikroküre sayısında anlamlı bir artış dikkati çekti (p=0,022). Tedavi öncesi birim TLG ve MTV değeri için absorbe edilen doz maruziyeti arttığında gerek GS gerekse İTSS sürelerinin istatistiksel olarak anlamlı bir artış gösterdi (p=0,003 ve p=0,007, Şekil 3). Doz/toksisite profili için yapılan değerlendirmede geç postkalibre Y-90 cam mikroküre tedavisinin klinik olarak anlamlı sayılabilecek ek yan etki/hayati risk oluşturmadı görüldü. Bununla birlikte, karaciğere ulaşan mikroküre sayısı arttıkça sağlıklı karaciğer parankiminin radyasyon maruziyetinin artış gösterdiği dikkati çekti (p<0.001). Sonuç: Çalışmamız, geniş bir kohortta geç postkalibre Y-90 cam mikrokürelerin tedavi etkinliğini/güvenliğini göstermiştir. F-18FDG PET/BT ile elde edilen kantitatif ölçümler ışığında, etkin bir tedavi/daha uzun GS elde edebilmek için güvenilir absorbe edilen doz maruziyetinin ve karaciğere ulaşan mikroküre sayısının MTV ve TLG kavramları ile olan ilişkisi, geç kalibre cam mikroküreler için literatürde ilk kez ayrıntılı ve net bir şekilde ortaya konmuştur. Anahtar Kelimeler: Transarteriyel radyoembolizasyon, metastatik kolorektal kanser, geç kalibre Y-90 cam mikroküreler, total lezyon glikolizi, metabolik tümör volümü
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    Does concomitant prolactin measurement increase the accuracy of inferior petrosal sinus sampling?
    (SPRINGER, 2022) YAVUZ, DİLEK; Apaydin, Tugce; Yasar, Mehmet; Baltacioglu, Feyyaz; Haklar, Goncagul; Yavuz, Dilek Gogas
    Introduction Prolactin (PRL) measurement during inferior petrosal sinus sampling (IPSS) can be helpful to improve the accuracy. We aimed to evaluate the effect of measuring PRL levels as a predictor for the accuracy of IPSS and evaluate its impact on the lateralization of adenomas. Methods In this retrospective cohort study, we reviewed 51 patients who had undergone IPSS for the investigation of ACTH-dependent hypercortisolism. Results Forty-nine patients had proven Cushing's disease (CD), one had EAS, and the remaining one patient had adrenal adenoma. Forty-seven patients had an above 2 ACTH IPS/P ratio at baseline, and all the post-corticotropin-releasing hormone (CRH) ACTH IPS/P ratios of patients with proven CD were above 3. In these two patients whose ACTH IPS/P ratio at baseline was below 2, PRL IPS/P ratios were above 1.8 in only the dominant side, which was considered secondary to a prolactin intersinus gradient due to the biological effects of the tumor. PRL-adjusted ACTH IPS/P ratios were > 1.3 in all patients with proven CD; it was 0.7 in the patient with EAS. Surgically confirmed positive lateralization was observed in 55.1% of patients with the ACTH gradient, but when PRL-adjusted ACTH IPS/IPS ratios were used in addition to the ACTH gradient, the ratio increased to 67.3%. Conclusion Although PRL-adjusted ACTH IPS/P ratios can be helpful to improve the accuracy of results during IPSS procedures, a prolactin intersinus gradient towards the ACTH-dominant side in patients with CD may invalidate PRL as an indicator of pituitary venous outflow.
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    First clinical multicenter experience with the new Pipeline Vantage flow diverter
    (2023-01-01) BALTACIOĞLU, FEYYAZ; Vollherbst D. F., Cekirge H. S., Saatci I., BALTACIOĞLU F., Onal B., KOÇ O., Rautio R., Sinisalo M., Tomasello A., Vega P., et al.
    Background Flow diversion is an innovative and increasingly used technique for the treatment of intracranial aneurysms. New flow diverters (FDs) are being introduced to improve the safety and efficacy of this treatment. The aim of this study was to assess the safety, feasibility, and efficacy of the new Pipeline Vantage (PV) FD. Methods Patients with intracranial aneurysms treated with the PV at 10 international neurovascular centers were retrospectively analyzed. Patient and aneurysm characteristics, procedural parameters, complications, and the grade of occlusion were assessed. Results 60 patients with 70 aneurysms (5.0% with acute hemorrhage, 90.0% located in the anterior circulation) were included. 82 PVs were implanted in 61 treatment sessions. The PV could be successfully implanted in all treatments. Additional coiling was performed in 18.6%, and in-stent balloon angioplasty (to enhance the vessel wall apposition) in 24.6%. Periprocedural technical complications occurred in 24.6% of the treatments, were predominantly FD deployment problems, and were all asymptomatic. The overall symptomatic complication rate was 8.2% and the neurological symptomatic complication rate was 3.3%. Only one symptomatic complication was device-related (perforator artery infarctions leading to stroke). After a mean follow-up of 7.1 months, the rate of complete aneurysm occlusion was 77.9%. One patient (1.7%) died due to aneurysmal subarachnoid hemorrhage which occurred before treatment, unrelated to the procedure. Conclusions The new PV FD is safe and feasible for the treatment of intracranial aneurysms. The short-term occlusion rates are promising but need further assessment in prospective long-term follow-up studies.
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    Is it Possible to Increase Survival of Patients with Intrahepatic Cholangiocarcinoma? A Case Report
    (SPRINGER, 2021) BALTACIOĞLU, FEYYAZ; Oguz, Sukru; Kucukaslan, Hakan; Topaloglu, Serdar; Ones, Tunc; Baltacioglu, Feyyaz; Cobanoglu, Umit; Calik, Adnan
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    PublicationOpen Access
    Practicality and potential restrictions of unresectable hepatocellular carcinoma prognostic index
    (2022-09-01) DEMİRTAŞ, COŞKUN ÖZER; ÖZDOĞAN, OSMAN CAVİT; BALTACIOĞLU, FEYYAZ; ÖNEŞ, TUNÇ; YUMUK, PERRAN FULDEN; DULUNDU, ENDER; GÜNDÜZ, FEYZA; DEMİRTAŞ C. Ö. , Ricco G., ÖZDOĞAN O. C. , BALTACIOĞLU F., ÖNEŞ T., YUMUK P. F. , DULUNDU E., Uzun S., Colombatto P., Oliveri F., et al.