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  • Küçük Resim
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    The Incidence and Risk Factors for the Presence of Type 1B or Type 3 Utero-ovarian Anastomoses During Uterine Artery Embolization
    (Selçuk Üniversitesi, 2024 Şubat) Çay, Ferdi; Eldem, Gonca; Çil, Barbaros Erhan; Peynircioğlu, Bora
    ABSTRACT Background/Aims: Demonstration of possible utero-ovarian anastomoses (UOA) before or during uterine artery embolization (UAE) is important to preserve ovarian reserve. This study aimed to evaluate the incidence and risk factors for the presence of type 1b or type 3 UOA in patients undergoing UAE for the treatment of uterine myomas. Methods: Procedural angiographies of patients who underwent UAE were evaluated in a single academic center. Patients’ demographics, indication for UAE, presence and type of UOA, presence of adnexal pathology at preprocedural MRI, history of pelvic surgery, and total uterine volume at preprocedural MRI were retrospectively evaluated. Analysis of the aforementioned variables between patients with and without UOA was performed. Results: This study included 30 patients with a mean age of 41.97±5.72 years (range 32 - 56). UOA was found in 17 (56.6%) patients, 10 (33.3%) of them were type 1b, and 7 (23.3%) of them were type 3. Five patients (17.2%) had adnexal pathology at pre-procedural MRI and 12 patients (40%) had a history of pelvic surgery. The mean total uterine volume was 607.1 cm3. In the analysis of variables between patients with and without UOA, UOA presence was significantly higher in patients with a history of pelvic surgery (p=0.005). All of the patients with a history of myomectomy were found to have type 1b or type 3 UOA. No significant relation between UOA and age, the presence of adnexal pathology, and uterine volume were detected. Conclusion: Utero-ovarian anastomoses are commonly encountered during UAE. A history of pelvic surgery was found to be a risk factor for the presence of type 1b and type 3 UOA.
  • Küçük Resim
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    Portal vein embolization with different embolic agents for right hepatectomy
    (AVES, 2012) Peynircioğlu, Bora; Çil, Barbaros; Özkan, Fuat; Koç, Osman; Akıncı, Devrim; Abbasoğlu, Osman; Hamaloğlu, Erhan
    Background/aims: We aimed to retrospectively evaluate our experience in portal vein embolization that induces hypertrophy of the future liver remnant before right hepatectomy and to determine the differences in outcome with respect to the embolic agents used. Methods: Twenty right portal vein embolization procedures performed in our institution between 2004 and 2009 were reviewed in this study. The average patient age was 59 years (range: 45-72 years). Embolization was performed through a right portal vein percutaneous access with use of the combination of several agents. Computed tomography volumetry was performed before and 4-6 weeks after the procedure to measure total liver volume and future liver remnant. Results: There was no major complication related to the embolization procedures. After embolization, future liver remnant total liver volume ratio increased to 12.7%, which was statistically significant. No significant difference was noted in hypertrophic outcomes between alcohol and the other embolic agents. Although five patients had sufficient future liver remnant, they did not undergo subsequent hepatectomy for a variety of reasons. Conclusions: According to our results, the mean increase in the size of the future liver remnant was greater than reported in previous studies of portal vein embolization. Despite the limited patient number of our study, we believe that portal vein embolization is helpful especially in gray-zone patients who may be a good candidate for surgical resection and thus possible cure. However, randomized, controlled studies with hypertrophy-inducing agents are needed.