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    Computed tomography findings of massive air embolism caused by cavitary lesion
    (Galenos Publishing House, 2023) Özer, Hamza; Genez, Samet
    A 23-year-old male patient had tetraplegia owing to a spinal cord injury after a traffic accident. In the intensive care unit, a tracheostomy was performed on the patient, who developed massive hemoptysis during follow-up. The patient was taken for urgent bronchoscopic evaluation by the thoracic surgeon, but no intervention could be carried out due to massive bleeding. A computed tomography angiography (CTA) was performed to determine the etiology of the bleeding. The chest CTA revealed that the heart’s four chambers and the arterial and venous vascular systems, including the portal venous system, were completely filled with air (Figures 1a, 1b, and 1c). Additionally, cavitary lesions, consolidation areas, and treein-bud appearance were observed in both lung parenchymas, and pneumothorax was detected on the right side.
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    Incidental findings detected on magnetic resonance imaging scans of the cervical, thoracic and lumbar spine of patients prediagnosed with discopathy
    (Marmara University, 2023) Kaya, Samet Sancar; Hatırlı, Hakan; Şahin, Muhammed Azad; Genez, Samet; Okçu, Mehmet
    Objective: To determine the frequency and types of incidental findings on magnetic resonance imaging (MRI) scans of the cervical, thoracic, and lumbar spine in patients with intervertebral discopathy. Patients and Methods: This retrospective study included 1000 patients (513 females and 487 males, with a mean age of 50.5 years) with clinically suspected intervertebral discopathy who underwent MRI. Any abnormal findings and congenital anomalies/anatomical variations unrelated to the primary complaint were referred to as incidental findings. Frequency distributions of the assessed imaging characteristics were calculated.Results: Of the 1000 patients, 192 (19.2%) patients were presented with incidental findings. The positive findings in the thoracic spine (26%) were higher than those in the lumbar (19.8%) and cervical spine (13.7%). The study found vertebral haemangioma to be the most common finding, followed by Schmorl's nodes in the thoracic and lumbar spine. Thyroid nodules constituted the most common finding in the cervical spine, followed by vertebral haemangioma. Renal cysts in the thoracic and lumbar spine and thyroid nodules in the cervical spine were the most frequent extraspinal findings. Conclusion: Incidental findings are commonly detected during MRI examination of intervertebral discs, and most are benign findings. However, incidental findings including clinically essential findings can alter the patient's treatment or affect the patient's life. Therefore, it is crucial to systematically evaluate MRIs without focusing solely on the spine and report incidental findings detected on MRI.
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    Retrieval of n-Butyl Cyanoacrylate Cast Migrated to the Dorsalis Pedis and Posterior Tibial Artery During Embolization of the Deep Circumflex Iliac Artery Using the Stent Retriever Device: A Case Report
    (Sage Publications Inc, 2024) Genez, Samet; Yilmazsoy, Yunus; Ozer, Hamza
    N-butyl cyanoacrylate (NBCA) is commonly used in interventional radiology procedures for its efficacy in vessel occlusion, yet it poses risks of embolic material migration. We present a unique case of NBCA cast migration during deep circumflex iliac artery (DCIA) embolization, leading to occlusion of the dorsalis pedis and posterior tibial arteries, subsequently retrieved using a stent retriever device. A 68-year-old woman with a history of heart valve replacement presented with a large intramuscular hematoma. N-butyl cyanoacrylate embolization of DCIA resulted in cast migration, occluding distal arteries. Retrieval was attempted using a stent retriever device, successfully restoring arterial flow. N-butyl cyanoacrylate use necessitates attention to vascular anatomy and test injections to mitigate complications. Stent retriever devices, originally designed for acute stroke thrombectomy, offer a viable solution for embolic material retrieval in vascular interventions. This case highlights successful NBCA cast retrieval in lower extremity arterial occlusion using a stent retriever device. Prompt recognition and intervention are crucial in mitigating complications associated with NBCA use. Stent retriever devices present a valuable tool for NBCA cast retrieval, preserving arterial perfusion in affected areas. Clinical Impact This case highlights the innovative application of stent retriever devices for retrieving migrated NBCA casts, traditionally used for stroke management in peripheral arterial occlusions. This adaptation offers clinicians a new, effective tool for managing embolization complications, such as unintended material migration that can cause severe ischemia. Implementing this technique could change clinical practice by providing a reliable method to swiftly address and resolve potentially limb-threatening situations, thereby improving patient outcomes and procedural safety. This advancement in interventional radiology enhances clinicians' ability to handle complex embolic events with greater confidence and efficacy.