Researcher:
Peker, Ahmet

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Doctor

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Ahmet

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Peker

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Peker, Ahmet

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    High-frequency optical coherence tomography predictors of aneurysm occlusion following flow diverter treatment in a preclinical model
    (BMJ Publishing Group) King, Robert M.; Anagnostakou, Vania; Raskett, Christopher M.; Arends, Jennifer M.; Dixit, Harish G.; Ughi, Giovanni J.; Puri, Ajit S.; Gounis, Matthew J.; Shazeeb, Mohammed Salman; N/A; Peker, Ahmet; Doctor; N/A; Koç University Hospital; N/A
    Background High-frequency optical coherence tomography (HF-OCT) is an intravascular imaging method that allows for volumetric imaging of flow diverters in vivo. Objective To examine the hypothesis that a threshold for both volume and area of communicating malapposition can be predictive of early aneurysm occlusion. Methods Fifty-two rabbits underwent elastase aneurysm formation, followed by treatment with a flow diverter. At the time of implant, HF-OCT was acquired to study the rate and degree of communicating malapposition. Treated aneurysms were allowed to heal for either 90 or 180 days and euthanized following catheter angiography. Healing was dichotomized into aneurysm remnant or neck remnant/complete occlusion. Communicating malapposition was measured by HF-OCT using a semi-automatic algorithm able to detect any points where the flow diverter was more than 50 mu m from the vessel wall. This was then summed across image slices to either a volume or area. Finally, a subsampled population was used to train a statistical classifier for the larger dataset. Results No difference in occlusion rate was found between device type or follow-up time (p=0.28 and p=0.67, respectively). Both volume and area of malapposition were significantly lower in aneurysms with a good outcome (p<0.001, both). From the statistical model, a volume of less than 0.56 mm(3) or a normalized area less than 0.69 as quantified by HF-OCT was predictive of occlusion (p<0.001, each). Conclusions HF-OCT allows for measurements of both volume and area of malapposition and, from these measurements, an accurate prediction for early aneurysm occlusion can be made.
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    Ultrasonography view for acute ankle injury: comparison of ultrasonography and magnetic resonance imaging
    (Springer) Ergun, Tugrul; Aybay, Muhsin N.; Turan, Kaya; Muratoglu, Osman G.; Cabuk, Haluk; N/A; Peker, Ahmet; Doctor; N/A; Koç University Hospital; N/A
    Introduction We aim to asses the diagnostic performance of ankle ultrasonography in patients presenting with acute ankle sprain injury, with comparison to MRI (Manyetik Rezonans Imaging). Materials and methods The study included patients who applied to the hospital within 48 h after an ankle sprain, and who presented with signs of pain, swelling, and tenderness in the ankle. Ankle ultrasonography examination was performed and an ankle MRI took place the same day. Results 30 patients were included in the study. 53.3% (n = 16) were female. The mean age was 30 +/- 6.4 years. The ultrasonography examination determined 76.6% (n = 23) of the patients to have anterior talofibular ligament (ATFL) injury, 33.3% to have (n = 10) CFL injury, and 33.3% to have (n = 10) anterior inferior tibia-fibular ligament (AITFL) injury. The MRI of the patients determined 73.3% (n = 22) of the patients to have ATFL injury, 43.3% (n = 13) to have calcaneal fibular ligament (CFL) injury, and 33.3% to have (n = 10) AITFL injury. The ATFL, CFL, and AITFL injuries diagnosed on ultrasonography correlated with the MRI results (ICC = 0.875, ICC = 0.879, and ICC = 0.858). However, among the ATFL injuries observed on MRI, 26.6% (n = 8) were grade I, 26.6% (n = 8) were grade II, and 20% (n = 6) were grade III injuries. Of the ATFL injuries observed on ultrasonography, 46.6% (n = 14) were grade I, 8.6% (n = 2) were grade II, and 30.4% (n = 7) were grade III injuries. Conclusions Findings on all types of ATFL, CFL and AITFL appear to have a higher degree of correlation. Ultrasonography could have an added role as a triaging tool, to fast-track MRI.