Mustafa Parildar

Ege University, Ismir, İzmir, Turkey

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Publications (75)105.03 Total impact

  • O Balcioglu · S Ertugay · H Bozkaya · M Parildar · H Posacioglu
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    ABSTRACT: Aortic aneurysm is a serious problem in Behçet's disease, but open surgical therapy carries the risk of recurrent pseudoaneurysm. Here the outcomes of endovascular repair and adjunctive immunosuppressive therapy for aortic disease in Behçet's disease are presented. This was a retrospective study. Between 2002 and 2012, nine patients with Behçet's disease (8 male, median age 41 years, range 33-60 years) were treated by endovascular stent grafting for abdominal or thoraco-abdominal aortic pseudoaneurysm. Computed tomography angiography revealed infrarenal pseudoaneurysm in six (66.6%) patients and suprarenal pseudoaneurysm in three (33.3%). Patients received immunosuppressive therapy with oral prednisolone (60 mg/day) and cyclophosphamide (200 mg/day) for 2 weeks or more before the procedure, and intravenous hydrocortisone (200 mg/day) combined with cyclophosphamide (200 mg/day) for 3 days after the procedure. Thereafter, oral immunosuppressive therapy was continued for 2 years. A straight tube graft was implanted in seven patients and a bifurcated graft in two patients. Two stage procedures (debranching before endovascular therapy) were performed in three patients for thoraco-abdominal aortic pseudoaneurysms. Stent grafting was successful in all patients, without any peri-operative complications. However, two patients needed abdominal exploration later: one for seroma around the graft and the other for a fistula between the duodenum and the graft. No recurrence of aneurysm was observed during a mean follow up of 40 ± 16 months. One patient died in the 15th month from a non-vascular cause. Endovascular stent graft implantation and adjunctive immunosuppressive therapy seems to be safe and effective in the treatment of aortic involvement in Behçet's disease, but this approach needs further evaluation. Copyright © 2015 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
    No preview · Article · Aug 2015 · European journal of vascular and endovascular surgery: the official journal of the European Society for Vascular Surgery
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    Serkan Ertugay · Hakan Posacıoglu · Mustafa Parildar · Halil Bozkaya
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    ABSTRACT: Objectives The early dissection of the descending aorta after the repair of aortic coarctation is very rare. Herein, we present a special endovascular technique used for acute type B dissection complicating graft bypass for aortic coarctation. Methods The 48 year-old male patient with the diagnosis of adult type aortic coarctation had bypass procedure between the aortic arch and the descending aorta. Six weeks after the first operation, the patient was readmitted with severe back pain and had the diagnosis of acute type B dissection which involved the descending aorta at the distal part of the graft anastomosis. Results Two separate stent-grafts were deployed respectively 31 × 150 mm and 34 × 200 mm (C-TAG™ WL Gore&Asc., Flagstaff, AZ, USA). The previous Dacron bypass graft was used as a proximal landing zone for the first stent-graft. The distal landing zone for the second stent was the area between the celiac trunk and superior mesenteric artery. Therefore, the covered stent-graft was implanted to the celiac trunk (Viabahn™ 7 × 50 mm WL Gore&Asc, AZ, USA) to maintain its patency before the deployment of the second graft. The segment of coarctation was closed with a vascular plug (Amplatzer™ vascular plug II) to prevent persistent perfusion of aneurysmal false lumen. Conclusion The endovascular approach offers multiple less invasive options based on a patient-specific problem. © 2015 The Authors. Published by Elsevier Ltd on behalf of European Society for Vascular Surgery.
    Preview · Article · Jul 2015
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    ABSTRACT: The aim of the study was to investigate the incidence of contrast medium-induced nephropathy (CIN) and risk factors for CIN following endovascular abdominal aortic aneurysm repair or thoracic endovascular aortic aneurysm repair. After exclusion criteria, 139 (121 males, 18 females) patients aged 20-86 (median 65.5) years who underwent endovascular aortic aneurysm repair between January 2002 and September 2013 were included in this retrospective study. CIN, with ≥25 % increase in serum creatinine levels within 3 days after contrast medium administration, was compared to the patients' demographics, risk factors, type and complexity of the endovascular operation, parameters regarding to the contrast medium, preoperative estimated glomerular filtration rate (eGFR), and preoperative and early postoperative serum parameters. Statistical analyses were performed with Kolmogorov-Smirnov, χ (2) and Student's t tests. CIN, detected in 39 of 139 patients (28 %), was correlated with preoperative eGFR <60 ml/min/1.73 m(2) (P = 0.04) and high preoperative and postoperative serum urea and creatinine levels. Postoperative serum urea levels (P < 0.001) were significant in multivariate analysis. In patients undergoing endovascular aortic aneurysm repair, CIN was correlated with preoperative and postoperative renal impairment, while it was not correlated with the contrast medium dose.
    Full-text · Article · Mar 2015 · Japanese journal of radiology
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    Halil Bozkaya · Celal Cinar · Omer Vedat Unalp · Mustafa Parildar · Ismail Oran
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    ABSTRACT: Kasabach-Merritt syndrome (KMS) is a rare complication of cavernous hemangiomas characterized with anemia, thrombocytopenia, and consumption coagulopathy. This syndrome usually develops due to superficial soft tissue hemangiomas in infancy and childhood. KMS developing secondarily to hepatic hemangioma is very rare. In this report, we aimed to present the treatment of KMS developing secondarily to giant cavernous hemangioma of the liver with transarterial chemoembolization using bleomycin.
    Full-text · Article · Dec 2014 · Wiener klinische Wochenschrift
  • F. H. Besir · H Bozkaya · C Cinar · E Oguz · M Parildar · H Posacioglu

    No preview · Article · Sep 2014 · Scandinavian Journal of Rheumatology
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    ABSTRACT: Aim and background: Delayed hemorrhage after pancreaticoduodenectomy (PD) is still one of the most common causes of mortality. However, the case series regarding interventional treatment of delayed hemorrhage after PD are limited. In this retrospective study, we aimed to evaluate functional outcomes of interventional treatment of late hemorrhages developing after PD. Material and methods: We retrospectively evaluated 16 patients who received endovascular treatment for delayed arterial hemorrhage after PD procedure. Postsurgical nonhemorrhagic complications, time of hemorrhage, site of hemorrhage, endovascular treatment technique, postprocedural complications, and mortality rates were obtained. Results: Mean duration of delayed hemorrhage after PD was 18 days. Computed tomography angiography images for the hemorrhage period were available for 15 patients. We observed extravasation alone in seven patients and pseudoaneurysm alone in five. Pushable coil was used in 15 patients and covered stent in 1. Two patients died due to hepatic failure, and one patient died because of multiple organ dysfunction syndrome (MODS). Conclusions: Delayed hemorrhage after PD is difficult to identify, but accurate and early diagnosis is of vital importance. To date, most appropriate management of this complication remains unclear. Although endovascular treatment techniques may vary for every patient, it is a reliable and effective method for halting hemorrhage. Therefore, interventional procedures must be primarily considered rather than surgical interventions.
    No preview · Article · May 2014 · Wiener klinische Wochenschrift
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    S Akpinar · M Parildar · B Alicioglu
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    ABSTRACT: Type 1 endoleak is one of the most frequent complication usually seen at the initial phase of EVAR procedure. Balloon dilatation is mostly used to oversize the proximal or the distal part of the orifice to stabilize the attachment of the graft stent to the aortic wall. Late onset of type 1 endoleak with graft stents may cause severe lumen compression of the stent and aneurysm enlargement which might cause a serious problem especially in a patient whose graft stents left iliac branch is thrombosed and the left leg is supplied by the bypass graft from right CFA. Although operation was advised by the endovascular specialists the procedure was done in our hospital as the patient preferred the endovascular method instead of open surgery.
    Preview · Article · Nov 2013 · JBR-BTR: organe de la Société royale belge de radiologie (SRBR) = orgaan van de Koninklijke Belgische Vereniging voor Radiologie (KBVR)
  • G Gençdal · R Vardar · H Bozkaya · C Meral · M Parildar · O Ozütemiz

    No preview · Article · Aug 2013 · Endoscopy
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    ABSTRACT: Congenital portosystemic venous shunt is extremely rare and should be treated. Advances in treatment techniques allow for patients to be treated safely. We present a 9-year-old boy with a large congenital portosystemic venous shunt. The shunt was occluded interventionally with the Amplatzer vascular plug II. Our case was unique with its clinical manifestation, the use of a 22-mm Amplatzer vascular plug II, and the presence of the patient's 1-year follow-up.
    No preview · Article · Jul 2013 · Perspectives in Vascular Surgery
  • Celal Cinar · Halil Bozkaya · Mustafa Parildar · Ismail Oran
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    ABSTRACT: Visceral arterial aneurysm and pseudoaneurysm are uncommon forms of vascular disease that have a significant potential for rupture or erosion into an adjacent viscera, resulting in life-threatening hemorrhage. Pseudoaneurysms related to the superior mesenteric artery are a recognized complication of trauma to the vessel, and successful treatment with stenting has been previously described. Percutaneous techniques offer an alternative form of therapy, and the number of reported cases treated with embolization has been rising steadily. We present the case of a 26-year-old patient with a large pseudoaneurysm of the superior mesenteric artery complicated with obstructive jaundice.
    No preview · Article · Jun 2013 · Perspectives in Vascular Surgery
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    ABSTRACT: Purpose: To perform biochemical profiles before and after percutaneous transhepatic biliary drainage (PTBD) and investigate the potential utility of measuring C-reactive protein (CRP), circulating cytokines, and neopterin, a marker of cell-mediated immunity, to predict outcomes of patients with obstructive jaundice. Materials and methods: In a prospective study, 47 patients with obstructive jaundice secondary to malignant lesions were evaluated before, at the fifth hour after, and on the fifth day after PTBD for neopterin, nitrate, tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-10, CRP levels, and liver function. Results: Neopterin levels on day 5 after PTBD were significantly higher than the levels before treatment and at the fifth hour. However, nitrate, cytokine, white blood cell, albumin, and creatinine levels were not significantly different. On the fifth day after PTBD, CRP levels were significantly higher and total bilirubin, direct bilirubin, alkaline phosphatase, aspartate transaminase, and alanine transaminase values were lower than the before-treatment values. Seven patients (15%) died within 30 days after drainage. On the fifth day after PTBD, neopterin, IL-6, IL-10, and creatinine levels were significantly higher and albumin levels were lower in the early mortality group. The performance characteristics of neopterin and creatinine were statistically significant in predicting mortality. Conclusions: Neopterin levels increased after PTBD, indicating cellular immune activation. The nonsignificant change in cytokine levels may be related to low enduring release in malignancy. The extremely elevated levels of neopterin and creatinine after PTBD might serve as harbingers of early death in patients with cholestasis secondary to malignant lesions.
    Full-text · Article · Jun 2013 · Journal of vascular and interventional radiology: JVIR
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    Dataset: ilave yayin
    Memis A · Parildar M · Posacioglu H · Calli C · Engin C · Oguz E · Cinar C · Apaydin AZ · Oran I

    Full-text · Dataset · Apr 2013
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    Dataset: ilave yayin
    Memis A · Parildar M · Posacioglu H · Calli C · Engin C · Oguz E · Cinar C · Apaydin AZ · Oran I

    Full-text · Dataset · Apr 2013
  • C Cinar · H Bozkaya · M Parildar · I Oran
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    ABSTRACT: Vascular injury is an unusual and serious complication of transsphenoidal surgery. We aimed to define the role of angiography and endovascular treatment in patients with vascular injuries occurring during transsphenoidal surgery. During the last ten-year period, we retrospectively evaluated nine patients with vascular injury after transsphenoidal surgery. Eight patients were symptomatic due to vascular injury, while one had only suspicion of vascular injury during surgery. Four patients presented with epistaxis, two with subarachnoid hemorrhage, one with exophthalmos, and one with hemiparesia. Emergency angiography revealed a pseudoaneurysm in four patients, contrast extravasation in two, vessel dissection in one, vessel wall irregularity in one, and arteriovenous fistula in one. All patients but one were treated successfully with parent artery occlusion, with one covered stent implantation, one stent-assisted coiling method, while one patient was managed conservatively. One patient died due to complications related to the primary insult without rebleeding. Vascular injuries suspected intra or postoperatively must be investigated rapidly after transsphenoidal surgery. Endovascular treatment with parent artery occlusion is feasible with acceptable morbidity and mortality rates in the treatment of vascular injuries occurring in transsphenoidal surgery.
    No preview · Article · Mar 2013 · Interventional Neuroradiology
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    Full-text · Article · Jun 2012 · Journal of pediatric gastroenterology and nutrition
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    ABSTRACT: To assess the treatment response of hepatocellular carcinoma (HCC) after transarterial chemoembolization with diffusion-weighted imaging and dynamic contrast-enhanced magnetic resonance (MR) imaging with a 3-T system. Between February 2010 and November 2010, 74 patients were treated with chemoembolization in our interventional radiology unit. Twenty-two patients (29%) who had liver MR imaging including diffusion and dynamic contrast-enhanced MR imaging on a 3-T system before and after transarterial chemoembolization were evaluated retrospectively. Tumor size, arterial enhancement, venous washout, and apparent diffusion coefficient (ADC) values of lesions, peritumoral parenchyma, normal liver parenchyma, and spleen were recorded before and after treatment. The significance of differences between ADC values of responding and nonresponding lesions was calculated. The study included 77 HCC lesions (mean diameter, 31.4 mm) in 20 patients. There was no significant reduction in mean tumor diameter after treatment. Reduction in tumor enhancement in the arterial phase was statistically significant (P = .01). Tumor ADC value increased from 1.10 × 10(-3) mm(2)/s to 1.27 × 10(-3) mm(2)/s after treatment (P < .01), whereas the ADC values for liver and spleen remained unchanged. ADC values from cellular parts of the tumor and necrotic areas also increased after treatment. However, pretreatment ADC values were not reliable to identify responding lesions according to the results of receiver operating characteristic analysis. After transarterial chemoembolization, responding HCC lesions exhibited decreases in arterial enhancement and increases in ADC values in cellular and necrotic areas. Pretreatment ADC values were not predictive of response to chemoembolization.
    No preview · Article · Feb 2012 · Journal of vascular and interventional radiology: JVIR
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    ABSTRACT: The aim of this study was to determine the accuracy of color Doppler ultrasound (CDUS) for endoleak detection and measurement of the aneurysm diameter after endovascular aortic aneurysm repair. Forty-eight CDUS and computed tomographic angiography (CTA) examinations performed concurrently on 29 patients who were treated with endovascular stent grafts for abdominal aortic aneurysms were included in the study. CTA and CDUS findings were retrospectively compared for aneurysm diameter, patency of the graft, and the presence of leaks in the aneurysm's lumen (the so-called "endoleaks"). The stent graft was patent in all patients. Including the follow-up examinations, endoleaks were detected in a total of 17 CTA studies. The sensitivity, specificity, and positive and negative predictive values for CDUS compared with CTA as the gold standard were 100%, 96%, 94.4%, and 100%, respectively. Kappa statistics showed a high level of agreement between CDUS ant CTA examinations (χ = 0.95). The aneurysm diameters measured with CDUS and CTA were significantly different, but within 5 mm of each other in 83% of patients. Provided that a strict CDUS protocol including spectral analysis of perigraft flow is used, CDUS is comparable to CTA for endoleak detection and measurement of the aneurysm diameter.
    No preview · Article · Jun 2011 · Journal of Clinical Ultrasound
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    ABSTRACT: Familial Mediterranean fever (FMF) is the most common autoinflammatory disease characterized by recurrent self-limited attacks of fever, accompanied with peritonitis, pleuritis or arthritis. It is well known that FMF may coexist with vasculitic pathologies, especially with those involving small and medium vessels. Among the vasculitic pathologies reported to be associated with FMF, Henoch-Schönlein purpura and polyarteritis nodosa come the first, possibly followed up by protracted febrile myalgia. However, coexistence of FMF with any large vessel vasculitis has not been reported to date. Here, we present a case with FMF who later developed Takayasu arteritis, with a severe disease course, being resistant to corticosteroids and conventional immunosuppressive agents, and requiring infliximab treatment.
    No preview · Article · Mar 2011 · Rheumatology International
  • Z. Parildar · C. Cinar · B. Barutcuoglu · B. Yilmaz · M. Parildar

    No preview · Article · Feb 2010 · Journal of Vascular and Interventional Radiology
  • C Aksu · G Demirpolat · I Oran · M Parildar · A Memis
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    ABSTRACT: Chronic mesenteric ischemia (CMI) is a life-threatening disorder, which is usually associated with stenosis or occlusion of celiac or mesenteric arteries. To review our experience and to assess short-term results of stent placement in stenotic mesenteric arteries. Primary stent placement was performed in 15 patients who had nausea, vomiting, postprandial pain, and weight loss due to steno-occlusive diseases of mesenteric arteries. After stenting, the patients were followed clinically and with Doppler ultrasound at 1, 6, and 12 months. Symptomatic patients with restenosis were examined with digital subtraction angiography and were referred for retreatment with balloon dilatation. Twenty-three stenoses and 11 occlusions were detected in 15 patients, and 18 stenoses were treated with primary stenting. Single-vessel endovascular treatment was performed in 12 patients. In three patients, two arteries were stented in the same session. Technical success rate was 18/18 (100%). Clinical success was achieved in 13/15 (86.6%) patients. First-month mortality was 13%. During the mean 16.1-month follow-up period, restenoses developed in three patients. One of them was successfully treated with balloon angioplasty. Primary patency was 9/11 (81%) and primary assisted patency was 81% at 12 months. The complication rate was 1/15 patients (0.06%). Our experience suggests that stent placement has a potential role in chronic mesenteric ischemia with low incidence of complications and high technical and clinical success rates.
    No preview · Article · Aug 2009 · Acta Radiologica