Ahmet Memis

Retrieval of intravascular foreign bodies with goose neck snare

PURPOSE to evaluate the efficacy and advantages of the snare systems in the retrieval of foreign bodies from vascular system. MATERIALS AND METHODS the snare technique has been used for intravascular foreign body retrieval. We performed percutaneous extraction of intravascular foreign bodies using combination multipurpose catheters and a nitinol snare loop. In this report, we evaluated the patients who had performed endovascular device reposition or foreign body retrieval from 1998 to 2001. RESULTS foreign body retrieval was performed in 15 patients. The foreign bodies consisted of seven fractured port catheters, one sheath fragment, one embolization coil, four wire fragments, one pace-maker transducer and one dislocated endovascular stent. In no case were surgical procedures required, and no complications were encountered. CONCLUSION the snare technique is a useful and a safe method as an alternative procedure to surgery. This technique is highly effective with low rate complications.

Interventional radiological treatment in complications of pancreatitis

Percutaneous interventional therapy plays an important role in treating complications of acute and chronic pancreatitis. With the development of cross-sectional imaging and advanced interventional techniques, percutaneous drainage has become the preferred treatment for pancreatic fluid collections such as acute collections, pseudocysts and abscesses. Abscess and pancreatic hemorrhage are the most life threatening complications of pancreatitis. Massive hemorrhage is rare but frequently lethal. As a rule, bleeding complications of pancreatitis require prompt diagnosis and an aggressive surgical approach. In unstable patients with a severely bleeding pseudoaneurysm, hemostasis can be obtained by occlusion with mechanical devices.

Fracture of a Renal Artery Stent Due to Mobile Kidney

Kidney Renal artery stenoses (RAS) are clinically significant lesions because of their potential to compromise renal function and lead to or exacerbate hypertension [1]. There are many reports about percutaneous and surgical treatment of RAS. Although, recently, percutaneous treatment is preferred to surgery because of lower morbidity and mortality rates, it also has its own complications. We report a case of a renal stent fracture caused by a mobile kidney in a 55-year-old woman who had undergone bilateral renal arterial stenting due to hypertension.

Use of Histoacryl and a Covered Nitinol Stent to Treat a Bronchobiliary Fistula

JVIR 2000; 11:1337–1340 BRONCHOBILIARY fistula is an uncommon condition usually seen in endemic regions as a complication of hydatid or amebic disease of the liver (1,2). In western society, trauma, previous surgery, and biliary obstruction are the most frequent causative factors (3,4). Although large series in the literature emphasize the surgical management of the disease, the operative procedures have high mortality and morbidity. Endoscopic or transhepatic biliary drainage has been used successfully to avoid surgical re-exploration in such cases (2,4,5–7). We present a case of bronchobiliary fistula in a patient with previous hepatic resection for hydatid disease and the new onset of common hepatic duct obstruction. The fistula is sealed by Histoacryl (B. Braun, Melsungen, Germany) embolization of leakage in conjunction with covered self-expanding stent implantation.

Endovascular Stent Graft Placement in the Treatment of Ruptured Tuberculous Pseudoaneurysm of the Descending Thoracic Aorta: Case Report and Review of the Literature

We report a successful repair of a ruptured tuberculous pseudoaneurysm of the descending thoracic aorta by endovascular stent graft placement. This procedure is starting to be accepted as an alternative method to surgery, and we review similar cases in the literature.

Nitric oxide and oxidative stress in atherosclerotic renovascular hypertension: effect of endovascular treatment.

PURPOSE Because activation of the renin-angiotensin system leads to an increase in oxidative stress, the authors investigated nitric oxide (NO; nitrite + nitrate), superoxide dismutase (SOD), catalase, and malondialdehyde (MDA) levels and the effect of endovascular treatment on these parameters in patients with atherosclerotic renovascular hypertension. The relationship of NO with blood pressure and renal functional indexes was also investigated. MATERIALS AND METHODS In this prospective cohort study, serum creatinine, NO, SOD, catalase, plasma MDA, urinary microalbumin, and NO levels, and blood pressure were determined in 21 patients with hypertension and unilateral renal artery stenosis caused by atherosclerosis at entry and after 24 hours, 2 weeks, and 6 weeks of endovascular treatment. RESULTS MDA concentrations decreased 24 hours after intervention and remained low 2 and 6 weeks later. In addition, serum SOD and NO and urine NO levels were increased significantly 24 hours after endovascular treatment and decreased after 2 and 6 weeks. However, serum catalase levels did not differ after the intervention. Blood pressures decreased after treatment. There were no significant differences in urinary microalbumin levels, estimated glomerular filtration rates, and creatinine levels after endovascular treatment. CONCLUSIONS Endovascular treatment decreases oxidative stress and may offer new benefits in the treatment of patients with hypertension associated with renal artery stenosis. The decrease in oxidative stress and/or the upregulation of SOD may increase the bioavailability of NO, which in turn may lead to the rapid hypotensive response.

Takayasu arteritis in Turkey

Takayasu arteritis is a non-specific inflammatory process of unknown etiology affecting the aorta and its branches. A retrospective study was done in 14 patients diagnosed as Takayasu arteritis. Eleven patients were female and three were male. Ages ranged from 12 to 30 years. Seven patients had type I arteritis, three patients type II arteritis, and four patients type III Takayasu arteritis. Successful angioplasty was performed in five cases.

Mesenteric Castleman's disease: case report

An asymptomatic case of hyaline vascular–type Castlemans disease localized to the mesentery and detected incidentally by ultrasound is presented. Computed tomographic, angiographic, and histologic findings are reported. This type of Castlemans disease predominates in the thorax and is very rare in the mesentery.

Endovascular Treatment of AVF after Hair Transplantation

Arteriovenous fistula (AVF) of the scalp is a very rare complication of hair transplantation. Only 9 cases have been reported in nearly half a century. The diagnosis is clinical but angiography is necessary for defining the angioarchitecture of the lesion. Due to technical developments, endovascular embolization has become the primary treatment for AVF of the scalp.

Effect of Endovascular Treatment on Nitric Oxide and Renal Function in Takayasu’s Arteritis with Renovascular Hypertension

Background: Renal involvement in Takayasu’s arteritis (TA) effects the disease outcome and endovascular treatment is an effective treatment of choice. We investigated nitric oxide (NO) levels and the effect of endovascular treatment in renovascular hypertensive TA patients. Methods: In five hypertensive patients with renal artery stenosis due to TA, serum creatinine, nitrite, nitrate; urinary microalbumin, nitrite, nitrate measurements and blood pressures were recorded at entry and after 24 h and 6 weeks of endovascular treatment. Results: Serum NO levels were higher in patients than controls (p = 0.008). Serum and urine NO levels increased 24 h after the treatment and decreased after 6 weeks (p = 0.015; p = 0.01, respectively). After the treatment blood pressures decreased. Urinary microalbumin excretions increased after the intervention (p = 0.02) and returned to normal in patients 1 and 4, and decreased in the others. There were no significant differences in estimated glomerular filtration rate (EGFR), serum creatinine, urinary sodium and potassium levels. Conclusion: Increased NO secretion in these patients may contribute to improve the prognosis of renal function through its vasodilator and antiproliferative activities possibly by counterbalancing the excessive vasoconstrictor actions. Endovascular treatment causes a dilatation-induced shear stress that may be responsible for the increased NO release, which in turn leads to the rapid hypotensive response.