ÖZObjectives: The aims of this study were to evaluate the biopsy methods used in terms of safety, and effectiveness as well as incidence, and severity of complications. Materials and Methods:This study was conducted as a prospective, observational study with the participation of five centers in Turkey. Any patient complaints and/or complications were also recorded. The patients' pain severity was determined by an established scoring method.Results: This research included 221 chronic hepatitis patients and 12 physicians. With regard to the biopsies, 71.9% were ultrasoundguided and 28.1% were blind biopsies. 71% of patients had complaints (mostly pain) and 19.9% developed complications; however, no mortality occurred. It was observed that patient's complaints were significantly correlated with the physician's age, level of biopsy experience, and number of biopsies performed yearly. It was determined that the biopsy method was not affective factor in terms of the development of severe pain after biopsy. The use of a 16G biopsy needle was found to increase the probability of severe pain occurrence by about eight times. Conclusion: Severe pain was not affected by the biopsy method or patient-specific factors, and was a result of the size of the biopsy needle used and the characteristics of the practitioner. Keywords: Liver, viral hepatitis, biopsy, complication Amaç: Bu çalışmada karaciğer biyopsi yöntemlerinin güvenilirliği, etkinliği ve komplikasyonların şiddetinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler:Bu araştırma Türkiye'de beş merkezin katılımıyla prospektif ve gözlemsel olarak gerçekleştirilmiştir. Hastaların şikayetleri ve/veya komplikasyonlar kaydedilmiştir. Hastaların ağrı şiddeti puanlama yöntemi ile belirlenmiştir. Bulgular: Çalışmaya 221 kronik viral hepatit hastası ve 12 hekim katılmıştır. Biyopsilerin %71,9'u ultrasonografi eşliğinde, %28,1 kör biyopsi yöntemi ile yapılmıştır. Hastaların %71'inde şikayet (çoğunluğu ağrı) ve %19,9'unda komplikasyon gelişmiştir. Ancak mortalite gözlenmemiştir. Biyopsiyi yapan hekimin yaş grubu, biyopsi deneyim süresi ve yıllık biyopsi sayısı ile şikayetlerin oluşması arasında anlamlı ilişki saptanmıştır. Biyopsi sonrası şiddetli ağrı gelişimi açısından biyopsi yönteminin etkili bir faktör olmadığı belirlenmiştir. Şiddetli ağrı varlığını 16G biyopsi iğnesi kullanmanın yaklaşık sekiz kat arttırdığı saptanmıştır. Sonuç: Şiddetli ağrının biyopsi yöntemi veya hastaya özgü faktörlerden etkilenmemekte, kullanılan biyopsi iğnesi ve uygulayıcının özelliklerinden kaynaklanmaktadır.
Background We assessed the safety and efficacy of flow diverter stents (FDSs) in the treatment of recanalized or residual intracranial aneurysms treated endovascularly. Materials & Methods Patients whose recanalized or residual aneurysms were treated with FDSs in five tertiary hospitals were reviewed retrospectively. The patients’ demographic data, aneurysm characteristics, types of previous treatment, and clinical complications, or serious adverse events associated with FDSs, as well as the results of neurological and angiographic follow-up assessments, were recorded. Results Eighty-six patients (37 males) with 87 aneurysms were included in this study. Eighty (91.9%) aneurysms were in the anterior and seven (8.1%) in the posterior circulation. The initial treatment methods were the primary coiling or balloon remodeling technique in 69 (79.3%) and stent-assisted coiling in 18 (20.7%) aneurysms. The endovascular procedure was successful in all patients. Complications occurred in four patients, for a total complication rate of 4.6%. A technical complication developed in one patient (1.2%). An in-stent thrombosis treated with tirofiban was seen in two cases. Late in-stent stenosis exceeding 50% was treated with balloon angioplasty in one patient. The mean length of follow-up was 21.0 months. The first angiographic follow-up (3–6 months) revealed the complete occlusion of 74 aneurysms (85.1%). While 76 aneurysms (87.4%) were occluded at the last angiographic follow-up (mean: 26.0 months), 11 aneurysms (12.6%) were still filling. Morbimortality was zero. Conclusion The drawback of endovascular treatment is aneurysmal remnants or recurrences, which is safely and durably amenable to flow diversion.
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