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    Evaluation of the association between silent ischemic lesions and stent design in carotid stenting applications
    (Assoc Medica Brasileira, 2023) Yabalak, Ahmet; Yılmaz, Murat
    OBJECTIVE: Minor ischemic events and silent ischemic lesions are more common in carotid stenting than in endarterectomy. These silent ischemic lesions are also associated with stroke risk and cognitive impairment, so it is important to understand the factors that increase the risk and develop strategies to reduce the risk. We aimed to evaluate the association between carotid stent design and silent ischemic lesion development.METHODS: The files of the patients who underwent carotid stenting between January 2020 and April 2022 were scanned. Patients with diffusion MR images taken within the postoperative 24 h were included in the study, while those undergoing acute stent placement were excluded. The patients were divided into two groups: those with open-cell stents and those with closed-cell stents.RESULTS: A total of 65 patients, including 39 patients undergoing open-cell stenting and 26 patients undergoing closed-cell stenting, were included in the study. There was no significant difference in demographic data and vascular risk factors between the groups. New ischemic lesions were detected in 29 (74.4%) patients in the open-cell stent group and 10 (38.4%) patients in the closed-cell stent group and were significantly higher in the open-cell group. There was no significant difference between the two groups in terms of major and minor ischemic events and stent restenosis at the 3-month follow-up.CONCLUSION: The rate of new ischemic lesion development was found to be significantly higher in carotid stent procedures performed with an open-cell Protege stent than in those performed with a closed-cell Wallstent stent.
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    Evaluation of the relationship between computed tomography angiography collateral scores and clinical outcome
    (Assoc Arquivos Neuro- Psiquiatria, 2024) Yabalak, Ahmet; Ögün, Muhammed Nur; Önalan, Ayşenur; Yılmaz, Murat; Tokmak, Hilmiye; Ersoy, Sadettin; Bilgili, Fatma
    Background The relationship between collateral circulation and prognosis after endovascular treatment in anterior circulation strokes has been reported in many studies. Objective In this study, we aimed to compare the predictive power of clinical outcome by comparing five different collateral scores that are frequently used. Methods Among the patients who underwent endovascular treatment in our clinic between November 2019 and December 2021, patients with premorbid mRS < 3, intracranial ICA and/or MCA M1 occlusion, and a pre-procedural multiphase CTA examination were included in the study. Demographic, technical, and duration information about the procedure, major events after the procedure, and clinical outcomes at 3 months were recorded. The mCTA, Tan, Maas, Miteff, and rLMC collateral scores of the patients were evaluated. Results Clinical outcome at 3 months were good in 37 of the 68 patients included in the study (mRS <= 2). Only the mCTA and rLMC collateral scores were statistically significantly higher in those with a good clinical outcome. Significant correlation with 3-month mRS was detected only in mCTA and rLMC scores. Although rLMC and mCTA collateral scores showed a statistically significant association with prognosis, they were not sufficient to be an independent predictor of prognosis. Conclusion mCTA and rLMC were found to have the highest predictive power of clinical outcome and the highest correlation with the 3-month clinical outcome. Our study suggests that it would be beneficial to develop a new scoring system over multiphase CTA, which combines regional and temporal evaluation, which are the strengths of both collateral scoring.
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    Investigation of electrocorticogram recordings in an experimental model of penicillin-induced epilepsy in female rats at different stages of the oestrus cycle
    (Wiley, 2022) Çetinkaya, Ayhan; Kara, Sinem; Bozat, Bihter Gökçe; Yabalak, Ahmet
    Meeting Abstract
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    Investigation of penicillin-induced epilepsy model in female rats with different estrous cycles by ECoG method
    (Wolters Kluwer Medknow Publications, 2023) Cetinkaya, Ayhan; Kara, Sinem; Bozat, Bihter; Yabalak, Ahmet
    Aim: Epilepsy is a chronic neurological disease characterized by recurrent seizures resulting from an imbalance in neuronal excitation. It is known that there is a tendency for seizures to cluster in both men and women at certain periods. This study aims to compare electrocorticogram (ECoG) recordings in an experimentally induced epilepsy model using penicillin, conducted at different estrous cycles of female rats. Subjects and Methods: Prior to commencing the epilepsy experiments, vaginal smears were collected from the animals every morning for 1 week, at the same time each day, for cytological examination. After confirming that the estrous cycles (proestrus, estrous stage, metestrus, and diestrus) of the animals were normal and healthy, the experiment was initiated. Additionally, H and E staining was performed on the ovaries of the rats sacrificed at the end of the experiment to validate the estrous cycle phases. A total of 32 adult female Wistar rats were divided into four groups (proestrus, estrus, metestrus, and diestrus), each consisting of eight rats. The penicillin-induced epilepsy model involved anesthetizing the rats with 1.25 mg/kg urethane intraperitoneally, followed by the injection of penicillin G (500 IU, 2.5 mu L, i.c.) into the cortex region through a skull opening. ECoG recordings were conducted using PowerLab analysis for 180 min. Statistical analysis of the results was performed using the SPSS program version 22 (IBM Corp., Armonk, NY, USA). One-way analysis of variance (ANOVA) and independent samples t-test were employed for groups with normally distributed data, while the Kruskal-Wallis test and Mann-Whitney U-test were used for groups with nonnormally distributed data. Statistical significance was set at P < 0.05. Results: Histological evaluation confirmed that vaginal smears and ovarian histopathology were consistent with each other, validating the data pertaining to the groups. In the ECoG recording results, the spike-wave frequency between 6 and 10 min was higher in the metestrus group compared to the proestrus (P = 0.004), estrus (P = 0.046), and diestrus (P = 0.025) groups. No significant differences were observed among the groups in terms of spike-wave amplitude and latency. Conclusion: Our study using a penicillin-induced epilepsy model in female Wistar rats demonstrated that the spike-wave frequency was highest during the metestrus phase. This finding provides valuable insights for future studies aiming to understand and mitigate the sensitivity observed during the metestrus phase, which is characterized by rapid progesterone withdrawal.