Volkan Çakır - Academia.edu (original) (raw)

Papers by Volkan Çakır

Turkish Journal Of Neurology

A 55-year-old man presented with coma induced by spontaneous intracranial hypotension (SIH). In m... more A 55-year-old man presented with coma induced by spontaneous intracranial hypotension (SIH). In magnetic resonance imaging, sagging and restricted diffusion in the splenium of the corpus callosum, diffuse pachymeningeal enhancement, and bilateral subdural hematomas were observed. Cerebrospinal fluid leakage was detected in the thoracic region and the patient was treated with a targeted epidural blood patch. After the treatment, the lesion in the corpus callosum disappeared without any residual abnormality and the patient fully recovered. SIH can be life-threatening and result in various clinical manifestations from mild orthostatic headache to deep coma. Targeted epidural blood patch treatment seems effective and lifesaving. SIH should be considered in the differential diagnosis of transient corpus callosum splenium lesion.

International Journal of Scientific Research and Management

Purpose: Current knowledge concerning the use of uterine artery embolization (UAE) in large uteri... more Purpose: Current knowledge concerning the use of uterine artery embolization (UAE) in large uterine fibroids is limited with the majority of studies being limited to case reports. The present retrospective study aimed to investigate the impact of UAE on symptoms and tumor size in symptomatic women with at least one large uterine fibroid. Methods: 39 patients undergoing UAE for symptomatic large uterine fibroids (>5cm) were consecutively enrolled in this study. All patients underwent a detailed physical examination and contrast-enhanced pelvic MRI at 3, 6 and 12 months after the procedure. Results: Compared to baseline values (7.8 ± 2.4 cm), the mean diameter of the fibroids significantly reduced at 3rd (5.5 ± 1.7 cm), 6th (4.2 ± 1.3 cm) and 12th (3.1 ± 0.6 cm) months follow-up (p<0.005 for each compared to baseline) implying a 60 % reduction in tumor size at 12 months compared to baseline measurements. At the end of the 12 months follow-up, complete necrosis of the fibroid was...

Journal of Vascular and Interventional Radiology

Journal of Ankara University Faculty of Medicine

Akut taşlı kolesistit (ATK) en sık cerrahi acillerden birisidir (1). Günümüzde tedavisinde konser... more Akut taşlı kolesistit (ATK) en sık cerrahi acillerden birisidir (1). Günümüzde tedavisinde konservatif yöntemler, perkütan kolesistostomi (PK) veya cerrahi uygulanabilmektedir. Uygulanacak tedaviyi belirleyen temel unsurlar hastanın yaşı, komorbiditeleri ve bununla da ilişkili olan CCI (Charlson Komorbidite İndeksi) ve ASA-PS (Amerikan Anestezi Uzmanları Derneği-Fiziksel Durum Sınıflandırması) skorları, akut kolesistit (AK) şiddet indeksi ile olayın başlangıcı ile başvuru arasındaki süre gibi faktörlerdir. Tedavi konusunda üzerinde uzlaşılan en temel nokta, cerrahiye uygun hastalarda erken yapılacak laparoskopik kolesistektominin (LK) en uygun tedavi olduğudur. Ancak yaşlı hastalarda veya cerrahiye uygun olmayan yüksek riskli hastalarda uygulanacak tedavi ile ilgili tartışmalar sürmektedir (2-4). Objectives: To investigate the efficacy, safety, recurrence and reintervention rates of percutaneous cholecystostomy (PC) in elderly patients with acute calculous cholecystitis (ACC). Materials and Methods: The data of the patients over 65 years of age who were diagnosed with ACC and between August 2013 and April 2017 were obtained by means of the hospital registry system. Results: A total of 53 ACC patients were treated with PC. 49 (92.4%) of the patients were clinically relieved within 48-72 hours. The 30-day mortality rate associated with PC was 7.5%. 2 (3.8%) patients had postoperative pneumonia and 4 (7.5%) patients had catheter dislocation. Seventeen (32%) patients underwent elective cholecystectomy and 8 (15%) patients underwent emergency cholecystectomy. Conclusion: PC is an effective treatment in high risk elderly patients. It can act as a "bridge treatment" from an emergency to elective surgery.

Canadian Urological Association Journal, 2015

Percutaneous nephrolithotomy (PCNL) is the first-line treatment for kidney stones. Colon perforat... more Percutaneous nephrolithotomy (PCNL) is the first-line treatment for kidney stones. Colon perforation is a rare, but dangerous, complication. Colonic perforation might be very serious if it is not found early. After an unsuccessful extracorporeal shockwave lithotripsy, a 45-year-old female underwent a left-sided PCNL for two 1-cm kidney stones in the left kidney upper pole calyx. During dilatation, a colon perforation was suspected. The procedure was finished by inserting a 14Fr re-entry catheter into the colon. On postoperative day 5, a fluoroscopy was performed by injecting contrast dye through the re-entry catheter, which showed a fistula formation between skin and colon. The catheter was removed completely. A 16Fr external drainage catheter was inserted over the guidewire through the fistula tract. The fistula was closed by introducing prepared absorbable hemostatic gelatin powder (Spongostan) particles into the fistula tract through the catheter. Fistula tracks can be closed ear...

Heart, Lung and Circulation, 2015

We aimed to investigate the extent to which measurements of flow volume (FV) with colour flow dup... more We aimed to investigate the extent to which measurements of flow volume (FV) with colour flow duplex ultrasonography (CDU) could predict tissue perfusion. A 68 year-old male patient was admitted to our clinic complaining of intermittent claudication in the right leg. Digital subtraction angiography showed total occlusion of the right femoral artery. The right popliteal artery (PA) was filling by collaterals. CDU showed that the FV in the right PA was higher than in the left. Arterial-venous FV measurement with CDU should be performed rather than the detection of arterial stenosis to assess whether intervention is necessary.

CardioVascular and Interventional Radiology, 2014

Purpose The purpose of this study was to compare the efficacy of percutaneous aspiration thrombec... more Purpose The purpose of this study was to compare the efficacy of percutaneous aspiration thrombectomy (PAT) followed by standard anticoagulant therapy, with anticoagulation therapy alone, for the treatment of acute proximal lower extremity deep vein thrombosis. Methods In this randomised, prospective study, 42 patients with acute proximal iliofemoral deep vein thrombosis documented via Doppler ultrasound examination, were separated into an interventional treatment group (16 males, 5 females, average age 51 years) and a medical treatment group (13 males, 8 females, average age 59 years). In the interventional group, PAT with largelumen 9-F diameter catheterisation was applied, after initiation of standard anticoagulant therapy. Balloon angioplasty (n 19) and stent implementation (n: 14) were used to treat patients with residual stenosis ([50 %) after PAT. Prophylactic IVC filters were placed in two patients. The thrombus clearance status of the venous system was evaluated by venography. In both the medical and interven

CardioVascular and Interventional Radiology, 2010

This study sought to compare the most frequently used embolic particles in an animal model. In 16... more This study sought to compare the most frequently used embolic particles in an animal model. In 16 New Zealand white rabbits, right renal arteries were embolized using four different embolic particles (polyvinyl alcohol [PVA] particles, 150-250 lm; PVA microspheres [PVAMs], 150-300 lm; Tris-acryl gelatin microspheres [TGMs], 100-300 lm; expanding microspheres [EXMs], 50-100 lm). Quantity of embolic material used, embolization time, and angiographic patterns were documented. Fourteen days later, a control angiography was done to document angiographic recanalization and all animals were sacrificed. Histopathological specimens were analyzed for microscopic appearance and granulometric size of the particles, extravasation of the particles, perivascular inflammation, and neocapillarization. The volume of the infarct area in each kidney was calculated. Results revealed a significantly lesser amount of embolic material used in the EXM group (p = 0.020). The angiographic recanalization rate in the EXM group (100%), compared with the PVA (0%) and TGM (0%) groups, was found to be statistically significant (p = 0.014). Although 75% of the renal arteries embolized with PVAMs were recanalized, this was not found to be statistically significant (p = 0.071). Occlusion levels in the PVA group were more proximal than with any of the microspheres. While there was no extravasation in the TGM group, extravasation rates in the PVA, PVAM, and EXM groups were 50%, 25%, and 75%, respectively. A mild degree of inflammation was noted in the PVA, PVAM, and TGM groups. EXMs caused a moderate degree of inflammation in two kidneys (50%). There was neocapillarization in the vessel lumen in all kidneys in the PVA and PVAM groups. The difference was significant (p = 0.014) compared with the TGM and EXM groups, which did not have any neocapillarization. Regarding infarct area volumes, the difference among the groups was significant (p = 0.022). EXMs caused significantly (p = 0.021) less infarction than the other embolic agents. We conclude that EXMs are less efficient due to a high recanalization rate and lesser volume of infarct compared with the other embolic agents in the rabbit kidney model. The most efficient embolization was seen in kidneys embolized with TGMs.

Cardiovascular and …, 2010

Abdominal Radiology, 2016

The objective of our study was to prospectively evaluate the diagnostic performance of strain ela... more The objective of our study was to prospectively evaluate the diagnostic performance of strain elastography for differentiation between renal cell carcinomas (RCCs) and transitional cell carcinomas (TCCs) of kidney. A total of 99 consecutive patients who were referred to our hospital because of a newly diagnosed solid renal mass suspicious for malignancy on radiological screenings were evaluated with sonography, including strain elastography. Strain elastography was used to compare the stiffness of the renal masses and renal cortex. The ratio of strain in a renal mass and nearby renal cortex was defined as the strain index value. Mean strain index values for RCCs and TCCs were compared, and mean strain index values between histological subtypes of RCC were also compared. Although TCCs were smaller than RCCs (p &amp;lt; 0.001), there were no significant differences in gender distribution and mean age of the patients, and mean probe-tumor distance between RCC and TCC. The mean strain index value ±SD for TCC (5.18 ± 1.12) was significantly higher than the value for RCC (4.04 ± 0.72; p &amp;lt; 0.001). Mean strain index value for papillary cell carcinomas (4.09 ± 0.45) was slightly higher than that for clear cell carcinomas (3.85 ± 0.78): however, the difference was not statistically significant (p = 0.51). Strain elastography can be used as a valuable imaging technique for preoperative differentiation between RCC and TCC of kidney.

Interventional Cardiology Clinics, 2014

ABSTRACT Review Article: