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Öğe Angiographic embolization in epistaxis: Our clinical experience and results(2021) Cicek, Mehmet Turan; Yildirim, Ismail Okan; Bayindir, Tuba; Sarac, Kaya; Tan, Mehmet; Aslan, Mehmet; Ozer Ozturk, EbruAbstract: Aim: Nosebleed, more commonly called epistaxis is a general clinical problem, and the most of bleedings can be treated non-invasive approach. However, because of persistent and sometimes life-threatening bleeding, additional treatment such as super-selective embolization may be required. In this study, we report our data on the endovascular treatment of persistent epistaxis. Materials and Methods: Between January 2010 and December 2019, all patients who were followed up at Inonu University Turgut Ozal Medical Center Otorhinolaryngology Clinic due to recurrent persistent nosebleed and required endovascular treatment were retrospectively screened. Demographic data, cause of epistaxis, localization of the bleeding, the clinical significance of the bleeding, interventional approach, complications related to treatment, and results were evaluated. Results: All of 18 patients with intractable epistaxis were included in the study. Depending on the etiology of epistaxis, patients were determined into three groups: idiopathic epistaxis (10/18), iatrogenic or traumatic epistaxis (7/18), and nasopharyngeal cancer (1/18). Nine of 18 patients required blood transfusions. The internal maxillary artery was embolized unilaterally in 12 of 18 (66%) and bilaterally in 2 of 18 (11%) procedures. Four patients were not embolized because of bleeding originated from ethmoidal branches of the ophthalmic artery. These four patients were operated on (endoscopic ethmoidectomy and bleeding control). Long-term success rates of embolization were 14 of 14. Major complications (transient hemiparesis) occurred in one patient after embolization. Conclusion: Endovascular approach proves to be effective for intractable and fatal epistaxis. Embolization has a good risk-benefit ratio in persistent bleeding. However, if bleeding is originated by the ethmoidal branches of the ophthalmic artery, embolization may not be performed to avoid visual complications.Öğe Angiographic Morphology of Anterior Communicating Artery Aneurysms and Their Association with Rupture Risk(Turkish Neurosurgical Soc, 2021) Kaya, Veysel; Kolu, Mehmet; Kaya, Ahmet Turan; Gezer, Mehmet; Sarac, Kaya; Tetik, Bora; Yildirim, Ismail OkanAIM: To estimate the rupture risk of anterior communicating artery (AComA) and AComA-related aneurysms according to their localization, angiographic architecture, and morphological features. MATERIAL and METHODS: In this study, 124 patients with AComA and AComA-related anterior system aneurysms were retrospectively evaluated. The aneurysms were classified according to their morphological appearance and angiographic architecture. The size, size ratio, angiographic architecture, and aneurysmal dome orientation of ruptured and non-ruptured aneurysms were compared using digital subtraction angiography (DSA) 3D images. RESULTS: There was a significant relationship between rupture risk and the size ratio (p=0.043), morphological properties of the aneurysm (p<0.001), aneurysm dome orientation (OR 1.29, 95% CI 1.32-6.818), and aneurysm type according to the angiographical architecture (p<0.005). CONCLUSION: In determining the rupture risk of AComA and AComA-related aneurysms, size alone is not a sufficient parameter with aneurysm morphology proving to be more efficacious. Grouping of aneurysms according to angioarchitecture, and its significant correlation with aneurysm rupture, may help to understand the underlying mechanisms in the formation and rupture of aneurysms. From this, more specific treatment protocols can be created, helping to improve the clinical evaluation of AComA aneurysms.Öğe Can diffusion weighted magnetic resonance imaging (DW-MRI) be an alternative to 18f-FDG PET/CT (18f fluorodeoxyglucose positron emission tomography) in nasopharyngeal cancers?(Scientific Publishers India, 2017) Yildirim, Ismail Okan; Ekici, Kemal; Dogan, Metin; Temelli, Oztun; Kekilli, Ersoy; Saglik, Semih; Erbay, FatihObjective: This study aimed to evaluate correlations, if any, between the ADC (Apparent Diffusion Coefficient) measurements in MRI (Magnetic Resonance Imaging) and SUV max (Standardized Uptake Value) in F-18-FDG PET/CT in patients with nasopharyngeal cancers and to investigate whether DW-MRI (Diffusion Weighted MRI) can be an alternative to F-18-FDG PET/CT in the evaluation of the response to treatment and prognosis in those patients. Methods: This study was performed between January 2015 and February 2016 at Inonu University Medical Faculty, Department of Radiology on 22 patients who were diagnosed with nasopharyngeal cancer by histopathological evaluation at Department of Pathology of the same faculty. Diffusion weighted images were obtained using 1.5 T MRI in all patients. F-18-FDG PET/CT images were obtained approximately 1-2 weeks after the diffusion-weighted images. Results: Two groups were created according to the histological subtypes as keratinized (n: 8) and non-keratinized (n: 14) among the 22 cases with a definitive histopathological diagnosis of nasopharyngeal cancer. No statistical difference was found between the groups in terms of SUVmax, SUVmean and ADC mean values (p> 0.05). ADC mean values measured in patients with nasopharyngeal cancer were statistically significantly and negatively correlated with SUV max (r=-0.619, p< 0.001) and SUV mean values (r=-0.677, p< 0.001). Conclusion: Even though there are anatomic and patient-related limitations of the DW-MRI in nasopharyngeal cancers, we suggest that it may be a complementary and alternative method of F-18-FDG PET/CT in the evaluation of treatment response and prognosis detection in nasopharyngeal cancers.Öğe Computed Tomography Diagnostic Abilities for Open-Globe Injuries in Pediatric Versus Adult Patients(Lippincott Williams & Wilkins, 2021) Dikci, Seyhan; Yildirim, Ismail Okan; Firat, Murat; Firat, Penpe Gul; Demirel, Soner; Yilmaz, Turgut; Tuncer, IlknurObjectives The aim of this study was to compare the role of computed tomography (CT) in the diagnosis of open-globe trauma and intraocular foreign body (IOFB) in pediatric and adult age groups. Methods Medical records of cases with open-globe trauma at Inonu University Hospital's Ophthalmology Emergency Service were retrospectively evaluated. Preoperative orbital CT images of the cases obtained at emergency services and their clinical and/or surgical findings were compared in pediatric and adult groups. Results We included 47 eyes of 47 cases aged 18 years and below (pediatric group) and 85 eyes of 82 cases over 18 years (adult group). The mean +/- SD age was 10.80 +/- 5.11 years (range, 2-18 years) in the pediatric group and 46.34 +/- 19.01 years (range, 19-82 years) in the adult group. Computed tomography images revealed 21.7% of the cases with corneal lacerations, 55.5% with scleral lacerations, and 91.6% with corneoscleral lacerations in the pediatric group, whereas the respective numbers were 48.4%, 66.6%, and 61.9% in the adult group. The detection rates of corneal penetrations and vitreous hemorrhage with CT were significantly lower in the pediatric group than in the adult group (P < 0.05). The CT scans diagnosed 66.6% of the pediatric cases and 90% of the adult cases with an IOFB. Conclusions Corneal lacerations and IOFBs can be missed, especially in the pediatric group, because the eye is smaller in adults. Pediatric patients with a history of ocular trauma should undergo an examination under general anesthesia followed by surgical exploration if necessary.Öğe Concurrence of polyostotic fibrous dysplasia and spinal aspergillus in non-immunocompromised adult patient: Case report(Inonu University Faculty of Medicine Department of Neurosurgery, Malatya, Turkey, 2017) Pasahan, Ramazan; Durak, Mehmet Akif; Aladag, Mehmet Arif; Akatli, Ayşe Nur; Yildirim, Ismail OkanÖz: Aspergillus, a rare agent in spinal infections, is often transmitted via inhalation. It can be traced as an infectious agent in immuno- compromised patients. While in non-immunocompromised patients, it is highly unlikely to cause spondylodiscitis. Radiological find- ings remind tuberculosis. The recommended medical treatment is applied with Itraconazole and Amphotericin B. Surgical indication involves the presence of progressive neurological deficit, instability and biopsy requirement. Fibrous dysplasia was first reported in 1938 by Lichtenstein and is a benign developmental disorder of the skeletal system with uncertain etiology. Polyostotic type involved more than one bone, while the monostotic type occurs by involving only one bone structure. Spinal involvement may lead to collapse fractures and deformity development and the most common complaint is pain. In our case, these two disorders occur concurrently, causing bone destruction and severe pain, and no similar cases were found in the literature.Öğe Concurrence of polyostotic fibrous dysplasia and spinal aspergillus in non-immunocompromised adult patient:case report(2017) Pasahan, Ramazan; Durak, Mehmet Akif; Aladag, Mehmet Arif; Akatli, Ayşe Nur; Yildirim, Ismail OkanAspergillus, a rare agent in spinal infections, is often transmitted via inhalation. It can be traced as an infectious agent in immunocompromised patients. While in non-immunocompromised patients, it is highly unlikely to cause spondylodiscitis. Radiological findings remind tuberculosis. The recommended medical treatment is applied with Itraconazole and Amphotericin B. Surgical indication involves the presence of progressive neurological deficit, instability and biopsy requirement. Fibrous dysplasia was first reported in 1938 by Lichtenstein and is a benign developmental disorder of the skeletal system with uncertain etiology. Polyostotic type involved more than one bone, while the monostotic type occurs by involving only one bone structure. Spinal involvement may lead to collapse fractures and deformity development and the most common complaint is pain. In our case, these two disorders occur concurrently, causing bone destruction and severe pain, and no similar cases were found in the literature.Öğe Conventional and ZOOMit DWI for Evaluation of Testis in Patients With Ipsilateral Varicocele(Amer Roentgen Ray Soc, 2017) Yildirim, Ismail Okan; Saglik, Semih; Celik, HseyinOBJECTIVE. The current study aimed to investigate the effects of varicocele on testis parenchyma by using ZOOMit DWI and conventional DWI and to compare both diffusion methods. SUBJECTS AND METHODS. Forty-five patients with unilateral varicocele diagnosed by physical examination and color Doppler ultrasound between July 2015 and December 2015 and 32 healthy volunteers were included in the study. ZOOMit and conventional DWI were performed for all patients with a 3-T MRI scanner. RESULTS. Apparent diffusion coefficient (ADC) values calculated using both conventional and ZOOMit DWI decreased in the patients with varicocele of the testis, when compared with the healthy volunteer control group. Furthermore, it was determined that conventional and ZOOMit ADC values for the contralateral side without varicocele also decreased when compared with the healthy volunteer control group (p < 0.05). However, there was no statistically significant difference between testes with or without varicocele in terms of conventional ADC values (p = 0.183), whereas ZOOMit ADC values for testes with varicocele were found to be statistically significantly lower than those for testes without varicocele (p < 0.05). A significant negative correlation was found between venous diameter measured both at rest and during the Valsalva maneuver and ZOOMit ADC values in testes with varicocele. CONCLUSION. For patients with varicocele, conventional and ZOOMit DWI may be predictive of histopathologic changes in the testis, and ZOOMit DWI may be more effective in the diagnosis, treatment, and postoperative response in patients with varicocele when compared with conventional DWI.Öğe Deep learning model developed by multiparametric MRI in differential diagnosis of parotid gland tumors(Springer, 2022) Gunduz, Emrah; Alcin, Omer Faruk; Kizilay, Ahmet; Yildirim, Ismail OkanPurpose To create a new artificial intelligence approach based on deep learning (DL) from multiparametric MRI in the differential diagnosis of common parotid tumors. Methods Parotid tumors were classified using the InceptionResNetV2 DL model and majority voting approach with MRI images of 123 patients. The study was conducted in three stages. At stage I, the classification of the control, pleomorphic adenoma, Warthin tumor and malignant tumor (MT) groups was examined, and two approaches in which MRI sequences were given in combined and non-combined forms were established. At stage II, the classification of the benign tumor, MT and control groups was made. At stage III, patients with a tumor in the parotid gland and those with a healthy parotid gland were classified. Results A stage I, the accuracy value for classification in the non-combined and combined approaches was 86.43% and 92.86%, respectively. This value at stage II and stage III was found respectively as 92.14% and 99.29%. Conclusions The approach presented in this study classifies parotid tumors automatically and with high accuracy using DL models.Öğe Effectiveness of Diffusion Tensor Imaging in Determining Cervical Spondylotic Myelopathy(Turkish Neurosurgical Soc, 2021) Er Ulubaba, Hilal; Saglik, Semih; Yildirim, Ismail Okan; Durak, Mehmet AkifAIM: To determine the effectiveness of diffusion tensor imaging (DTI) in diagnosing cervical spondylotic myelopathy (CSM) in patients with no findings detected in conventional magnetic resonance imaging (MRI). MATERIAL and METHODS: Fifty-four patients who presented for cervical MRI between January 2016 and June 2016, with symptoms such as neck pain, paresis, and numbness in hands, were included in the study. The patients were split into four groups based on their degrees of spinal stenosis. The obtained data were examined using special software and color-coded fractional anisotropy (FA), and apparent diffusion coefficient (ADC) maps were formed. Through these maps, using regions of interest (ROIs), FA and ADC values were calculated and the contribution of these values to the diagnosis was evaluated statistically. RESULTS: When all grades of cervical spinal canal stenosis were compared, a statistically significant negative correlation between spinal canal stenosis degree and FA values, and a positive correlation between stenosis degree and ADC values were noted (p<0.001). In the comparison of stenotic levels and non-stenotic levels for the grade 2 patient group, there was a statistically significant decrease in FA values and an increase in ADC values in stenotic levels compared with prestenotic and poststenotic levels (p<0.05). CONCLUSION: DTI and quantitative FA and ADC measurements are candidate imaging techniques for the diagnosis of early-stage CSM, which shows no findings in conventional MRI, and determining the degree of spinal cord injury.Öğe Endovascular Treatment of Carotid Pseudoaneurysm Bleeding Due to Parapharyngeal Abscess(Lippincott Williams & Wilkins, 2020) Cicek, Mehmet Turan; Yildirim, Ismail Okan; Gunduz, EmrahCarotid artery pseudoaneurysm are a rare complication of deep neck infections, especially in the antibiotic era. Although it is rare, it may result in life-threatening conditions. Here, the authors present a case of pseudoaneurysm of the carotid artery caused by parapharyngeal abscess and causing massive oropharyngeal bleeding and treat with endovascular approach in a 40-year-old woman presenting with neck swelling and fever.Öğe Endovascular treatment of ruptured anterior circulation aneurysms within 24 hours: Clinical and angiographic results(2020) Kolu, Mehmet; Cigdem, Gulyara; Dere, Osman; Kaya, Veysel; Yildirim, Ismail Okan; Sarac, KayaAim: In this study, angiographic and clinical results after endovascular treatment were evaluated in patients with a ruptured brain aneurysm.Materials and Methods: A total of 32 patients, who admitted to the hospital between May 2018 and January 2020 due to aneurysmal subarachnoid hemorrhage (SAH), were included in the study. Cranial digital subtraction angiography (DSA) imaging was performed within the first 24 hours to patients with SAH detected on computed tomography and endovascular embolization was performed in 32 patients, who were considered as suitable for endovascular treatment. The pretreatment clinical scorings of the patients were evaluated according to the Hunt-Hess scale. Aneurysm occlusion was performed according to the Raymond-Ray classification. The patients were evaluated with the clinical outcome modified ranking scale (mRS) during their follow-up periods.Results: The endovascular treatment was successfully performed in all patients. In the first angiograms for control purposes after embolization, it was seen that the aneurysms were completely closed (RR1) in 81.25%, partial neck remained (RR2) in 12.5%, and the aneurysms were closed incompletely (RR3) in 6.25% of the patients. Intraprocedural complications developed in five patients (15.6%). There was an aneurysmal rupture in 1 patient (3.1%) and thromboembolic complications in 4 patients (12.5%). The procedure-related morbidity and mortality rates were 9.3% and 3.1%, respectively. No patients had postprocedural hemorrhagic complications. In the 3rd month, mRS was 0 in 21 (65.6%) patients, 1 (3.1%) in 1 patient, and 2 (6.25%) in 2 patients. A total of 11 (34.3%) patients died. A second procedure was performed in 2 (6.25%) of the patients who were followed because there was an RR3 residue.Conclusion: The endovascular embolization process can be applied in the treatment of intracranial aneurysms causing subarachnoid hemorrhage, and it is a safe and effective treatment method.Öğe Evaluation of Prostatic Artery Embolization Efficiency in Benign Prostatic Hyperplasia Patients with High Comorbidity(Galenos Yayincilik, 2018) Yildirim, Ismail Okan; Duman, Enes; Firat, Ali; Celik, Huseyin; Sarac, KayaObjective: The purpose of this study was to evaluate efficacy outcomes following prostate artery embolization (PAE) for the treatment of benign prostatic hyperplasia (BPH) patients with high comorbidity. Materials and Methods: This retrospective study included 22 patients treated with PAE from May 2015 to June 2017. Patients with Charlson comorbidity index >= 2, International Prostate Symptom Score (IPSS) >12, prostate specific antigen (PSA) levels <4 ng/mL or between 4 and 10 ng/mL with negative prostate biopsy and total prostate volume (TPV) >90 cm(3) were included. Total PSA, maximum flow rate (Q(max)), TPV, IPSS, post-voiding residual (PVR) values were recorded in all patients in the urology clinic before PAE and at 3 and 6 months after PAE. Results: The average patient age was 73.86 +/- 6.25 years and operative time was 80 minutes (range, 60-120 min). Pre-PAE and 6-month post-PAE values were: IPSS: 25.18 +/- 6.75 an d 11.27 +/- 3.29 (p<0.05), Q(max): 8.31 +/- 3.12 and 17.22 +/- 3.23 (p<0.05), PVR: 87.9 +/- 19.25 and 25.86 +/- 7.72 (p<0.05), TPV: 134.45 +/- 57.56 and 86 +/- 15.4 (p<0.05), and PSA: 3.89 +/- 1.26 and 2.11 +/- 1.06 (p<0.05). Embolization was performed unilaterally due to atherosclerosis and strictures in the internal iliac artery branches in 2 patients. After the procedure, 2 patients experienced transient hematuria which did not require bladder irrigation, 1 patient had acute urinary retention due to dysuria, and 1 patient had transient hematospermia. Conclusion: PAE may be an alternative treatment method in BPH patients with high comorbidity.Öğe Evaluation of prostatic artery embolization efficiency in benign prostatic hyperplasia patients withhigh comorbidity(Galenos yayıncılık, erkan mor, molla guranı cad 21-1, fındıkzade, ıstanbul 34093, turkey, 2018) Yildirim, Ismail Okan; Duman, Enes; Firat, Ali; Celik, Huseyin; Sarac, KayaObjective: The purpose of this study was to evaluate efficacy outcomes following prostate artery embolization (PAE) for the treatment of benign prostatic hyperplasia (BPH) patients with high comorbidity. Materials and Methods: This retrospective study included 22 patients treated with PAE from May 2015 to June 2017. Patients with Charlson comorbidity index >= 2, International Prostate Symptom Score (IPSS) >12, prostate specific antigen (PSA) levels <4 ng/mL or between 4 and 10 ng/mL with negative prostate biopsy and total prostate volume (TPV) >90 cm(3) were included. Total PSA, maximum flow rate (Q(max)), TPV, IPSS, post-voiding residual (PVR) values were recorded in all patients in the urology clinic before PAE and at 3 and 6 months after PAE. Results: The average patient age was 73.86 +/- 6.25 years and operative time was 80 minutes (range, 60-120 min). Pre-PAE and 6-month post-PAE values were: IPSS: 25.18 +/- 6.75 an d 11.27 +/- 3.29 (p<0.05), Q(max): 8.31 +/- 3.12 and 17.22 +/- 3.23 (p<0.05), PVR: 87.9 +/- 19.25 and 25.86 +/- 7.72 (p<0.05), TPV: 134.45 +/- 57.56 and 86 +/- 15.4 (p<0.05), and PSA: 3.89 +/- 1.26 and 2.11 +/- 1.06 (p<0.05). Embolization was performed unilaterally due to atherosclerosis and strictures in the internal iliac artery branches in 2 patients. After the procedure, 2 patients experienced transient hematuria which did not require bladder irrigation, 1 patient had acute urinary retention due to dysuria, and 1 patient had transient hematospermia. Conclusion: PAE may be an alternative treatment method in BPH patients with high comorbidity.Öğe A hypertensive girl with failure to thrive accompanied by gastrointestinal symptoms: Answers(Springer, 2021) Selcuk, Senay Zirhli; Elmas, Ahmet Taner; Yildirim, Ismail Okan; Sigirci, Ahmet; Sozeri, Betul; Tabel, Yilmaz[Abstract Not Available]Öğe A hypertensive girl with failure to thrive accompanied by gastrointestinal symptoms: Questions(Springer, 2021) Selcuk, Senay Zirhli; Elmas, Ahmet Taner; Yildirim, Ismail Okan; Sigirci, Ahmet; Sozeri, Betul; Tabel, Yilmaz[Abstract Not Available]Öğe Letter to the Editor regarding recurrent sebaceous carcinoma of the eyelid: Outcome after postoperative reirradiation(Wiley-Blackwell, 2016) Dogan, Metin; Yildirim, Ismail Okan[Abstract Not Available]Öğe Letter to the Editor: regarding Lipomatous ependymoma: report of a rare differentiation pattern with a comprehensive review of literature(Springer Japan Kk, 2016) Dogan, Metin; Yildirim, Ismail Okan; Dogan, Derya Gumus[Abstract Not Available]Öğe Living Donor Kidney Transplantation: Why Potential Donors and Recipients do not Achieve it. Malatya Algorithm(Asoc Regional Dialisis Trasplantes Renales, 2020) Simsek, Arife; Dogan, Sait Murat; Gurbu, Huseyin; Ulutas, Ozkan; Toplu, Sibel; Turgut, Asli; Yildirim, Ismail OkanIntroduction: In some countries, organ donation is not widespread enough due to medical, cultural, ethical and socioeconomic factors. Living-donor kidney transplant constitutes the main source of kidney donation. Aim: To evaluate the causes of cancellation of living-donor kidney transplant and improve the effectiveness of transplant programs. Methods: Medical records of possible donors and recipients who were evaluated for living-donor kidney transplant at a tertiary medical center between November 2010 and September 2019 were reviewed retrospectively. Results: Evaluations were performed on 364 potential donors and 338 living-donor kidney transplant recipients; 207 of the latter (61.24%) underwent living-donor kidney transplant. Immune disorders represented the majority of cancellations (38.84%). Fifty-six donors (15.38%) were rejected mainly due to renal disorders (39%). Conclusion: Timely referral of patients to transplant centers must be guaranteed in order to overcome immune problems. Transplant centers should invest in programs adequate both for their resources and for their patients: paired kidney exchange, desensitization protocols, future research, etc.Öğe Management of non-vascular complications following renal transplantation using percutaneous approach(Edizioni Luigi Pozzi, 2018) Yildirim, Ismail Okan; Berktas, Bayram; Saglik, Semih; Piskin, Turgut; Dogan, Murat; Sahin, Idris; Taskapan, HulyaOBJECTIVE: Non-vascular complications following renal transplantation can cause graft failure. In this study, we present our two-year experience with percutaneous treatment for non-vascular complications following renal transplantation. PATIENTS AND METHODS: A total of 30 patients who underwent percutaneous radiological treatment between March 2014 and July 2016 were included in the study. RESULTS: Following renal transplantation, a total of 36 percutaneous radiological procedures which includes hydronephrosis secondary to ureteral stricture (n. 15), clinical symptom producing lymphocele due to pressure (14) and creatinine elevated nondilated grafts (n. 7) after excluding other reasons of creatinine elevation, were performed. Six patients received percutaneous treatment for both ureteral stricture and lymphocele. The patients underwent balloon dilatation and double-J ureteral stent due to ureteral stricture. The mean pre- and post-procedural creatinine levels were 4.36 +/- 2.84mg/dL and 2.17 +/- 1.24 mg/dL respectively (p=0.004), indicating a significant difference. For lymphocele treatment, sclerosing agents were injected and lymphatic leakage areas were injected with percutaneous glue. The mean pre- and post-procedural creatinine values were 2.97 +/- 1.78 mg/dL and 1.75 +/- 1.18 respectively (p=0.002), indicating a significant difference. Nephrostomy catheters were placed for patients with elevated creatinine levels and non-dilated collecting system. The mean pre- and post- nephrostomy creatinine levels were 3.55 +/- 2.36 mg/dL and 2.57 +/- 1.82 mg/dL respectively (p>0.05), indicating no statistically significant difference. CONCLUSION: The results of our study suggest that percutaneous treatment is an effective method for the treatment of non-vascular complications following renal transplantation, and, therefore, should be the first option for the preservation of graft functions.Öğe Management of non-vascular complications following renal transplantation using percutaneousapproach(Edızıonı luıgı pozzı, vıa panama 68, 00198 rome, ıtaly, 2018) Yildirim, Ismail Okan; Berktas, Bayram; Saglik, Semih; Piskin, Turgut; Dogan, Murat; Sahin, Idris; Taskapan, Hulya; Sarac, KayaOBJECTIVE: Non-vascular complications following renal transplantation can cause graft failure. In this study, we present our two-year experience with percutaneous treatment for non-vascular complications following renal transplantation. PATIENTS AND METHODS: A total of 30 patients who underwent percutaneous radiological treatment between March 2014 and July 2016 were included in the study. RESULTS: Following renal transplantation, a total of 36 percutaneous radiological procedures which includes hydronephrosis secondary to ureteral stricture (n. 15), clinical symptom producing lymphocele due to pressure (14) and creatinine elevated nondilated grafts (n. 7) after excluding other reasons of creatinine elevation, were performed. Six patients received percutaneous treatment for both ureteral stricture and lymphocele. The patients underwent balloon dilatation and double-J ureteral stent due to ureteral stricture. The mean pre- and post-procedural creatinine levels were 4.36 +/- 2.84mg/dL and 2.17 +/- 1.24 mg/dL respectively (p=0.004), indicating a significant difference. For lymphocele treatment, sclerosing agents were injected and lymphatic leakage areas were injected with percutaneous glue. The mean pre- and post-procedural creatinine values were 2.97 +/- 1.78 mg/dL and 1.75 +/- 1.18 respectively (p=0.002), indicating a significant difference. Nephrostomy catheters were placed for patients with elevated creatinine levels and non-dilated collecting system. The mean pre- and post- nephrostomy creatinine levels were 3.55 +/- 2.36 mg/dL and 2.57 +/- 1.82 mg/dL respectively (p>0.05), indicating no statistically significant difference. CONCLUSION: The results of our study suggest that percutaneous treatment is an effective method for the treatment of non-vascular complications following renal transplantation, and, therefore, should be the first option for the preservation of graft functions.
