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Sample records for anterior communicating artery

  1. Totally thrombosed giant anterior communicating artery aneurysm

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    V R Roopesh Kumar

    2015-01-01

    Full Text Available Giant anterior communicating artery aneurysmsarerare. Apatient presented with visual dysfunction, gait ataxia and urinary incontinence. MRI showed a giant suprasellar mass.At surgery, the lesion was identified as being an aneurysm arising from the anterior communicating artery.The difficulty in preoperative diagnosis and relevant literature are reviewed.

  2. Microanatomy of the perforators of the anterior communicating artery complex.

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    Camuscu, H; Dujovny, M; Abd el-Bary, T; Beristain, X; Viñas, F C

    1997-12-01

    We describe the microanatomy of the perforating arteries arising from the anterior communicating artery complex (5 mm distal of the anterior cerebral artery, the anterior communicating artery, and 5 mm proximal of the distal anterior cerebral artery). Thirteen unfixed human brains were used in this study. The origin and number of perforators are described, as is the site of brain penetration, and results are correlated with previous studies. The hemodynamics of blood flow in relation to the formation of an anterior communicating artery aneurysm and different surgical approaches are mentioned. The neuropsychological outcome after aneurysm clipping with regards to the pattern of blood supply from the anterior cerebral artery complex is also discussed. PMID:9427956

  3. Treatment of ruptured anterior communicating artery aneurysms with GDCs

    International Nuclear Information System (INIS)

    Objective: To summarize 45 cases of ruptured anterior communicating artery aneurysms treated with GDCs. Methods: All aneurysms were embolized with GDCs. Results: Complete embolization was achieved in 25 aneurysms, subtotal in 14, and partial in 6. Two cases were cured by the second time embolization. One case of recurrent aneurysm after G DC treatment was curved by surgical clipping. Brain infarction was noted in 7 cases after the endovascular procedure, and one of them died of pneumonia, another one remained in permanent coma. 1-20 months follow up showed stable result. 4 of 5 cases with multi-intracranial aneurysms had been treated with on of this procedure. Conclusions: The result of endo vascular treatment of anterior communicating artery aneurysms in the early period after rupture was good. Although there was a relatively high risk of local brain infarction, the clinical outcome was satisfactory

  4. Steal phenomenon through the anterior communicating artery in Moyamoya disease

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    Lim, Soo Mee [Ewha Womans University, Department of Radiology, Mok-dong Hospital, College of Medicine, Seoul (Korea); Chae, Eun Jin; Kim, Min Yeong; Kim, Sang Joon; Choi, Choong Gon; Pyun, Hae Wook; Suh, Dae Chul [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea); Kim, Jae Kyun [Seoul Veterans Hospital, Department of Radiology, Seoul (Korea); Ahn, Jae Sung; Ra, Young-Shin [University of Ulsan, Asan Medical Center, Department of Neurosurgery, College of Medicine, Seoul (Korea); Kim, Jong-Uk; Hahm, Kyung Don [University of Ulsan, Asan Medical Center, Department of Anesthesiology, College of Medicine, Seoul (Korea)

    2007-01-15

    Branch occlusion of the anterior cerebral artery (ACA) is regarded as a part of Moyamoya disease. The purpose of this study is to define the ACA steal phenomenon (SP) in Moyamoya disease and to evaluate temporal changes according to the disease progression. From 139 Moyamoya patients we defined ACASP as narrowing of the ipsilateral A1-2 junction while preserving the anterior communicating artery and supplying the contralateral ACA cortical branches with the development of leptomeningeal collaterals by the ipsilateral middle cerebral artery into the hypoperfused ipsilateral ACA territory. Direction of the steal related to the stage in both hemispheres by Suzuki classification was statistically analyzed using the binomial test based on binomial distribution. Follow-ups of ACASP were evaluated in five patients. We identified ACASP in 13 (9%) patients (male:female=7:6, mean age 18 years, range: 2-58 years) of the 139 study patients. The presenting pattern was ischemic in 12 and hemorrhagic in one. The direction of SP occurred from the hemisphere in the lower to the higher stage of Suzuki classification (two-tail P value=0.0002). After revascularization surgery, ACASP disappeared or diminished. ACASP may occur in bilaterally different stages of Moyamoya disease as a transient self-adaptive process. It regresses after revascularization surgery. (orig.)

  5. A study of the hemodynamics of anterior communicating artery aneurysms

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    Cebral, Juan R.; Castro, Marcelo A.; Putman, Christopher M.

    2006-03-01

    In this study, the effects of unequal physiologic flow conditions in the internal carotid arteries on the intra-aneurysmal hemodynamics of anterior communicating artery aneurysms were investigated. Patient-specific vascular computational fluid dynamics models of five cerebral aneurysms were constructed from bilateral 3D rotational angiography images. The aneurysmal hemodynamics was analyzed under a range of physiologic flow conditions including the effects of unequal mean flows and phase shifts between the flow waveforms of the left and right internal carotid arteries. A total of five simulations were performed for each patient, and unsteady wall shear stress (WSS) maps were created for each flow condition. Time dependent curves of average WSS magnitude over selected regions on the aneurysms were constructed and used to analyze the influence of the inflow conditions. It was found that mean flow imbalances in the feeding vessels tend to shift the regions of elevated WSS (flow impingement region) towards the dominating inflow jet and to change the magnitude of the WSS peaks. However, the overall qualitative appearance of the WSS distribution and velocity simulations is not substantially affected. In contrast, phase differences tend to increase the temporal complexity of the hemodynamic patterns and to destabilize the intra-aneurysmal flow pattern. However, these effects are less important when the A1 confluence is less symmetric, i.e. dominated by one of the A1 segments. Conditions affecting the flow characteristics in the parent arteries of cerebral aneurysms with more than one avenue of inflow should be incorporated into flow models.

  6. Anterior communicating artery aneurysm associated with an infraoptic course of anterior cerebral artery and rare variant of the persistent trigeminal artery: a case report and literature review.

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    Turkoglu, Erhan; Arat, Anıl; Patel, Nirav; Kertmen, Hayri; Başkaya, Mustafa K

    2011-05-01

    Infraoptic course of the precommunicating segment of the anterior cerebral artery (A1) is a rare anomaly. Furthermore, the presence of this anomaly associated with persistent trigeminal artery variant has been reported in the literature only once. We present a patient who had infraoptic course of A1 associated with an ipsilateral persistent trigeminal artery variant arising from the right internal carotid artery with no apparent connection to the basilar artery. The persistent trigeminal artery variant supplied to the right posteroinferior cerebellar artery territory. The patient also had hypoplastic left vertebral artery, superior cerebellar arteries originating from posterior cerebellar arteries bilaterally, and a bilobed aneurysm of the anterior communicating artery. The aneurysm was clipped and the infraoptic course was verified during the surgery. The post-operative course was uneventful and a follow-up arteriogram on the 7th postoperative day revealed successful obliteration of the aneurysm. We reviewed the literature with respect to presentation, associated vascular anomalies, imaging, associated cerebral aneurysms and other cerebral abnormalities, and treatment of the associated aneurysms. A discussion of the embryogenesis of this rare anomaly is also provided. PMID:21269759

  7. Hemodynamic patterns of anterior communicating artery aneurysms: a possible association with rupture

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    Castro, Marcelo A.; Putman, Christopher M.; Cebral, Juan R.

    2007-03-01

    The aim of this study is to characterize the different flows present at anterior communicating artery (AcoA) aneurysms and investigate possible associations with rupture. For that purpose, patient-specific computational models of 26 AcoA aneurysms were constructed from 3D rotational angiography images. Bilateral images were acquired in 15 patients who had both A1 segments of the anterior cerebral arteries and models were created by fusing the reconstructed left and right arterial trees. Computational fluid dynamics simulations were performed under pulsatile flow conditions. Visualizations of the flow velocity pattern were created to classify the aneurysms into the following flow types: A) inflow from both A1 segments, B) flow jet in the parent artery splits into three secondary jets, one enters the aneurysm and the other two are directed to the A2 segments, C) the parent artery jet splits into two secondary jets, one is directed to one of the A2 segments and the other enters the aneurysm before being directed to the other A2 segment, and D) the parent artery jet enters the aneurysm before being directed towards the A2 segments. The maximum wall shear stress in the aneurysm at the systolic peak (MWSS) was calculated. Most aneurysms in group A were unruptured and had the lowest MWSS. Group B had the same number of unruptured and ruptured aneurysms, and a low MWSS. Groups C and D had high rupture ratios, being the average MWSS significantly higher in group C. Finally, it was found that the MWSS was higher for ruptured aneurysms of all flow types.

  8. Predictor′s analysis of anterior circulation cerebral infarction after the endovascular treatment of anterior communicating artery aneurysms

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    Liqian Sun

    2014-01-01

    Full Text Available Background: Despite increasing acceptance of endovascular coiling for treating anterior communicating artery (ACoA aneurysms, anterior circulation cerebral infarction (ACI after embolization remains a limitation. With higher incidence, higher morbidity and higher mortality, it is one of the main factors influencing the ACoA aneurysms prognosis. Determining the risk factors leading to ACI after embolization will have clinical significance. Through retrospective case analysis, this study investigated the risk factors related to ACI after embolization in order to provide information to serve the clinical practice. Materials and Methods: A retrospective review was performed of patients who had undergone coiling of ACoA aneurysms from 2008 to 2012. All patients had ruptured prior to the completion of embolization. Cases with acute stroke symptoms without alternative diagnoses after embolization were diagnosed as ACI. A total of 32 risk factors such as age, sex, hypertension, diabetes mellitus, modified Fisher grade, Hunt-Hess grade, ventricular hemorrhage, etc. were analyzed using univariate and logistic regression analysis. Results: Univariate analysis showed that negative fluid volume balance (P = 0.041 <0.05 and modified Fisher grade (P = 0.049 <0.05 reached statistical significance, suggesting that they might be risk factors for ACI after embolization. Multiple logistic regression analysis showed that modified Fisher grade was significantly associated with ACI after embolization, suggesting that it was an independent risk factor (odds ratios (OR: 4.968, 95% confidence intervals (CI: 1.013-24.360, P = 0.048. Conclusion: Modified Fisher grade is an independent risk factor for ACI after embolization.

  9. Computational analysis of anterior communicating artery aneurysm shear stress before and after aneurysm formation

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    Castro, Marcelo A.; Putman, Christopher M.; Cebral, Juan R.

    2011-12-01

    It is widely accepted that complexity in the flow pattern at the anterior communicating artery (AComA) is associated with the high rate of aneurysm formation at that location observed in large studies. The purpose of this work is to study associations between hemodynamic patterns, and AComA aneurysm initiation by comparing hemodynamics in the aneurysm and the normal model where the aneurysm was computationally removed. Vascular models of both right and left circulation were independently reconstructed from three-dimensional rotational angiography images using deformable models after image registration of both images, and fused using a surface merging algorithm. The geometric models were then used to generate high-quality volumetric finite element grids of tetrahedra with an advancing front technique. For each patient, the second anatomical model was created by digitally removing the aneurysm. It was iteratively achieved by applying a Laplacian smoothing filter and remeshing the surface. Finite element blood flow numerical simulations were performed for both the pathological and normal models under the same personalized pulsatile flow conditions imposed at the inlets of both models. The Navier-Stokes equations were numerically integrated by using a finite-element formulation. It was observed that aneurysms initiated in regions of high and moderate WSS in the counterpart normal models. Adjacent or close to those regions, low WSS portions of the arterial wall were not affected by the disease. These results are in line with previous observations at other vascular locations.

  10. Serial position learning effects in patients with aneurysms of the anterior communicating artery.

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    Stefanova, Elka; Kostic, Vladimir S; Ziropadja, Ljubomir; Markovic, Milan; Ocic, Gordana

    2002-08-01

    Ruptured and repaired Anterior Communicating Artery (ACoA) aneurysm can result in devastating impairments involving memory, executive function, confabulation, and personality changes. This study tested serial position learning effects (SPEs) in patients following repaired and ruptured ACoA aneurysm, using results on the Rey Auditory Verbal Learning Test (RAVLT). Thirty patients with ruptured aneurysms of the ACoA and 31 matched controls were included in the study. The primacy-recency effects were maintained during five learning trials in ACoA group, albeit at an overall lower level than in the controls. There was no difference in primacy-recency relation across five learning trials in ACoA group. On the delayed recall trial the patient group demonstrated neither a primacy, nor a recency phenomenon, reflecting a lack of recall of any parts of the word list. This kind of primacy-recency profile across learning trials in ACoA group has no similarity with SPE results in frontal lesion groups, or with SPE distributions in other amnesic disorders, despite the fact that memory and executive deficits were evident in our ACoA group. PMID:12187451

  11. Pituitary dysfunction in survivors of spontaneous subarachnoid hemorrhage of anterior communicating artery and middle cerebral artery aneurysms: A comparative study

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    Pinaki Dutta

    2012-01-01

    Full Text Available Background: The data on incidence of hypopituitarism after SAH are conflicting. Furthermore, it is still not known whether there is any difference in hormonal deficiencies between SAH due to anterior communicating artery (A-com and middle cerebral artery (MCA aneurysms. Materials and Methods: This study includes both retrospective and prospective arms. The data collected included baseline demographic profile, clinical severity on admission to the hospital by the Hunt and Hess grading system and World Federation of Neurological Surgeons (WFNS grading, radiological severity of bleed by the Fisher′s classification, and treatment details. All the patients underwent detailed hormonal evaluation at baseline and 6 months in prospective group while at the end of 1 year in the retrospective group. Hormonal deficiencies between patients with A-com and MCA aneurysmal SAH were compared using appropriate statistical tests. Results: Of 60 patients studied, 47 patients (A-com: 28 and MCA: 19 were in the retrospective group, while 13 patients (A-com-9, MCA-4 were in the prospective group. The baseline data were comparable between the two groups. At or after 6 months follow-up, 19 (31.6% patients, 10 patients with A-com and 9 patients with MCA aneurysmal SAH, had some form of hormone deficiency. Furthermore, there was no difference in endocrine dysfunctions between the two groups. There was no correlation between the severity of hormonal deficiency and the clinical severity of SAH grade by Hunt and Hess and radiological grade of SAH by Fisher′s grade. Conclusion: Hormonal deficiencies are not uncommon in patients with SAH. There is no difference in hormonal deficiencies and severity of hypopituitarism in patients with SAH due to A-com and MCA bleed.

  12. [Cognitive dysfunction following anterior communicating artery aneurysm rupture. Comparison with alcoholic Korsakoff syndrome on neuropsychological performance].

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    Mimura, M; Kato, M; Yoshimasu, H; Kashima, H

    1995-08-01

    The present study aims to compare neuropsychological performance of patients following anterior communicating artery aneurysm rupture (ACoA) with that of patients with alcoholic Korsakoff syndrome (AKS). Fifteen ACoA patients and ten age-and education-matched AKS patients were included in the study. All the patients were tested at least one year post onset of their illness at a stable condition. The WAIS and forward digit span scores of AKS were also matched to ACoA, and simple attention and general intelligence were well preserved both in ACoA and AKS. Frontal function as measured by the Wisconsin card sorting test (Keio version) (KWCST) was equivalently impaired in the two groups. Anterograde memory as measured by Wechsler memory scale subtests, serial seven word learning test, Rey auditory verbal learning test, and logical memorizing test (Luria's paired word-picture association), was more severely impaired in AKS than ACoA in contrast to the comparable attention, intelligence, and frontal function: (1) memory tasks with low correlations to KWCST (serial word learning tasks and paired verbal associates), reflecting primary simple serial memorizing, and (2) memory tasks with high correlations to KWCST (logical memory and logical memorizing), reflecting higher and complicated strategic mnemonic activities. However, the correlations between these anterograde memory subtests and KWCST were substantially equivalent in ACoA and AKS. This suggests that the differences in anterograde amnesia demonstrated in ACoA and AKS may be of quantitative, not of qualitative property. The extent of deficits in semantic encoding as measured by Wickens' release from proactive interference paradigm (PI release) was also milder in ACoA than AKS. Both AKS and ACoA failed to show PI release in contrast to normal PI release demonstrated in age-matched ten healthy subjects. PI release in ACoA, however, was in between AKS and healthy subjects. The results were interpreted in the light of a

  13. [A case of Rathke's cleft cyst in association with anterior communicating artery aneurysm presenting a rare visual field defect].

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    Yuki, K; Katsuzo, K; Ikawa, F; Takeshita, S; Hamasaki, O; Tohru, U

    1996-05-01

    We report a case of Rathke's cleft cyst associated with anterior communicating artery aneurysm. The patient was 60-year-old woman who developed visual disturbance two months before admission to our hospital. Visual acuity on the right was 0.06 and on the left was 0.08. The visual fields showed a complete temporal hemianopsia on the left eye and an incomplete temporal hemianopsia of the right eye with a central defect of the temporal visual field. CT and MR imagings showed an intra- and suprasellar mass lesion with no enhancement. Angiography showed bilateral A1 elevations and anterior communicating artery aneurysm. The operation was performed through interhemispheric approach. Suprasellar cystic mass compressed upward the optic nerves and chiasm, and aneurysmal dome stuck in the central region of chiasm. This anatomical disorders affected to the optic chiasm resulted in a rare visual field defect. Neck clipping of aneurysm and opening of the cyst were performed. A diagnosis of Rathke's cleft cyst was made. Following surgery, her visual fields resolved but she suffered from diabetes insipidus. PMID:8672308

  14. Aphasia following anterior cerebral artery occlusion

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    We have report two cases of aphasia that had infarcts in the distribution of the left or right anterior cerebral artery, as confirmed by computed tomography. Case 1 is a right-handed, 65-year-old man in whom computerized tomographic scanning revealed an infarction of the territory of the left anterior cerebral artery after the clipping of the anterior communicating artery aneurysm. The standard language test of aphasia (SLTA) revealed non-fluent aphasia with dysarthria, good comprehension, almost normal repetition with good articulation, and a defectiveness in writing. This syndrome was considered an instance of transcortical motor aphasia. Although three years had passed from the onset, his aphasia did not show any improvement. Case 2 is a 37-year-old man who is right-handed but who can use his left hand as well. He was admitted because of subarachnoid hemorrhage from an anterior communicating aneurysm. Because of postoperative spasm, an infarction in the distribution of the right anterior cerebral artery developed. He was totally unable to express himself vocally, but he could use written language quite well to express his ideas and had a good comprehension of spoken language. This clinical picture was considered that of an aphemia. After several weeks, his vocalization returned, but the initial output was still hypophonic. (J.P.N.)

  15. Spontaneous Thrombosis in Giant Aneurysm of the Anterior Communicating Artery Complex in Pediatric Age: Five-Year Follow-Up

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    Vítor M. Gonçalves

    2014-01-01

    Full Text Available Intracranial aneurysms are rare in the pediatric population, especially in infancy, representing less than 1% of all aneurysms. In this age group, they are more frequent at the carotid bifurcation and in the posterior circulation, with a greater number of giant aneurysms and spontaneous aneurysm thrombosis when compared with the adults. They are life-threatening, and, therefore, early investigation, characterization of the lesion, and treatment are essential. The appropriate management depends on the child’s condition, aneurysm characteristics, and the experience of a multidisciplinary team. Noninvasive and radiation-free imagiological studies play an important role in the diagnosis and follow-up of these young patients. We present the case of a 3-month-old boy with an intracranial hemorrhage secondary to the rupture of a giant aneurysm of the anterior communicating artery complex, with spontaneous thrombosis, which is a rare situation due to its location. A conservative approach was assumed and noninvasive evolutive imagiological studies revealed a reduction in the thrombosed aneurysm size and no signs of recanalization. The child recovered to his baseline neurological condition and has had no rehemorrhage until 5 years of follow-up.

  16. Radiological Changes in Infantile Dissecting Anterior Communicating Artery Aneurysm Treated Endovascularly : A Case Report and Five-Year Follow-Up

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    Yatomi, Kenji; Oishi, Hidenori; Yamamoto, Munetaka; Suga, Yasuo; NONAKA, Senshu; Yoshida, Kensaku; Arai, Hajime

    2014-01-01

    Intracranial aneurysms are extremely rare in infants, and to our knowledge only seven infants treated for ruptured spontaneous dissecting aneurysms have been reported. Good outcomes have been achieved with endovascular treatment of infantile aneurysm. We the endovascular treatment of a one-month-old girl for ruptured dissecting aneurysm located in the anterior communicating artery, and the unique radiological changes that were observed during the perioperative and follow-up periods. These cha...

  17. Anomalous right coronary artery arising from left anterior descending artery

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    M.L. Sreenivas Kumar

    2012-07-01

    Full Text Available A 54-year-old male patient presented with acute myocardial infarction involving left anterior descending and right coronary artery territories. Coronary angiogram showed a single coronary artery with right coronary artery arising from left anterior descending artery (LAD, which coursed anterior to right ventricular outflow tract and thrombotic lesion in mid left anterior descending artery before origin of right coronary artery. The patient was treated with thrombolytic therapy and glycoprotein IIb/IIIa inhibitors. Anomalous origin of right coronary artery as a branch of LAD is a very rare type of congenital coronary artery anomalies. It is important to recognize this anomaly as it can be associated with extensive myocardial ischemia and sudden cardiac death in young persons even without atherosclerosis.

  18. Left Anterior Descending Artery-Pulmonary Artery Fistula

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    Turan Ege

    2011-12-01

    Full Text Available Despite the fact that coronary arteriovenous fistulas constitute approximately half (48% of coronary artery anomalies, they are rarely seen anomalies. In this report,we aim to present a coronary arteriovenous fistula case detected during a coronary angiography between left anterior descending artery and pulmonary artery.

  19. A rare anomaly of the anterior communicating artery complex hidden by a large broad-neck aneurysm and disclosed by three-dimensional rotational angiography

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    Double fenestration of the anterior communicating artery (ACoA) complex associated with an aneurysm is a very rare finding and is usually caused by ACoA duplication and the presence of a median artery of the corpus callosum (MACC). We present a patient in whom double fenestration was not associated with ACoA duplication or even with MACC, representing therefore, a previously unreported anatomic variation. A 43 year old woman experienced sudden headache and the CT scans showed subarachnoid haemorrhage (SAH). On admission, her clinical condition was consistent with Hunt and Hess grade II. Conventional digital subtraction angiography (DSA) was performed and revealed multiple intracranial aneurysms arising from both middle cerebral arteries (MCA) and from the ACoA. Three-dimensional rotational angiography (3D-RA) disclosed a double fenestration of the ACoA complex which was missed by DSA. The patient underwent a classic pterional approach in order to achieve occlusion of both left MCA and ACoA aneurysms by surgical clipping. The post-operative period was uneventful. A rare anatomical variation characterised by a double fenestration not associated with ACoA duplication or MACC is described. The DSA images missed the double fenestration which was disclosed by 3D-RA, indicating the importance of 3D-RA in the diagnosis and surgical planning of intracranial aneurysms. (author)

  20. Anterior Tibial Artery Pseudoaneurysm: Case Report

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    Funda Tor

    2012-06-01

    Full Text Available The aneurysmsatic changes of the infrapopliteal arteries are rarely seen. They are pseudoaneurysms rather than true aneursyms. The most important cause of them is trauma. There is not a standart treatment for infrapopliteal aneursyms. In this study, we have evaluated a case operated for anterior tibial artery pseudoaneurysm developed after penetrant trauma and diagnosed two weeks later. [Cukurova Med J 2012; 37(3.000: 172-175

  1. Anatomic variations of anterior cerebral artery cortical branches.

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    Stefani, M A; Schneider, F L; Marrone, A C; Severino, A G; Jackowski, A P; Wallace, M C

    2000-01-01

    The anterior cerebral artery (ACA) is a major vessel responsible for the blood supply to the interhemispheric region. The ACA segment after the anterior communicating artery (AComA) origin is called the distal ACA and has central and cortical branches. The cortical branches are distributed in the different regions of the orbital and medial part of the brain. The objects of this study are the anatomical variations found in the distal ACA. In 76 hemispheres the ACA distal branches were injected with latex and dissected under microscope magnification. Vessel diameters and distances between vessel origins and anterior communicating artery were recorded and analyzed. Microsurgical dissection was carried out to demonstrate anatomic variations of these vessels. Average diameter of ACA at origin was 2.61 +/- 0.34 mm and average diameter of cortical branches diameter ranged from 0.79 +/- 0.27 mm to 1.84 +/- 0.3 mm. Distances between vessel origin and AComA ranged from 7.68 +/- 3.91 mm (orbitofrontal) to 112.6 +/- 11.63 mm (inferior internal parietal). This study found anatomical variations: a single (azygos) ACA was present in one case and three in three cases. Crossing branches of the distal ACA to the contralateral hemisphere were present in 26% of the cases. In some cases a single ACA may supply the posterior hemispheric region through crossing branches. This calls attention to potential bilateral brain infarcts due to a single unilateral ACA occlusion. PMID:10873213

  2. Carotid-anterior cerebral artery anastomosis on MR angiography: a university hospital-based study

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    Uchino, Akira; Saito, Naoko; Okada, Yoshitaka; Inoue, Kaiji [Saitama Medical University International Medical Center, Department of Diagnostic Radiology, Hidaka, Saitama (Japan)

    2012-01-15

    Rarely in the anterior circulation, an anastomosis of the carotid and anterior cerebral arteries occurs when an anomalous branch arises from the ophthalmic segment of the internal carotid artery and anastomoses with the A1-A2 junction of the anterior communicating artery. Right-side predominance is known. To our knowledge, the incidence of carotid-anterior cerebral artery anastomosis has not been reported, so we researched cases in our institution records to determine incidence and investigated characteristic features of the condition on magnetic resonance (MR) angiography. To isolate such cases, we retrospectively reviewed cranial MR angiographic images of 3,491 consecutive patients in our institution. We found three cases with carotid-anterior cerebral artery anastomosis (two men, one woman), representing an incidence of 0.086%. The anastomosis was on the right in all three cases. A normal A1 segment of the anterior cerebral artery (ACA) was present in two cases but could not be identified in the remaining case on MR angiographic images that included source images. Two of the three patients demonstrated associated arterial variations in their carotid systems. On MR angiography, we observed a 0.086% incidence of carotid-anterior cerebral artery anastomosis in our institution and reaffirmed the right-side predominance of this anomaly. We found a high frequency of other associated arterial variations in the carotid system. (orig.)

  3. Anterior cerebral artery territory infarctions presenting with ascending tetraparesis.

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    Okamoto, Kensho; Hamada, Eri; Okuda, Bungo

    2004-01-01

    We describe a patient with ascending tetraparesis following stroke. The patient presented initially with spastic paraparesis which acutely evolved to tetraparesis with abulia. Magnetic resonance imaging revealed acute infarctions in the bilateral medial frontal regions but not in the brainstem or spinal cord. Multiple infarctions in the anterior cerebral artery territory appeared to originate from artery to artery embolism. The present case provides distinct clinical features of anterior cerebral artery syndrome which mimic myelopathy or brainstem lesions. PMID:17903956

  4. Stent-assisted coil embolization for anterior communicating artery aneurysms%支架辅助弹簧圈栓塞治疗前交通动脉动脉瘤

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    刘佳强; 李真保; 方兴根

    2014-01-01

    前交通动脉(anterior communicating artery,ACoA)动脉瘤是最常见的颅内动脉瘤之一.宽颈ACoA动脉瘤的介入治疗仍然具有挑战性.几种颅内支架的相继问世以及多种支架技术的创新和发展,使得支架辅助弹簧圈栓塞逐渐成为治疗宽颈ACoA动脉瘤的首选技术之一.文章就ACoA动脉瘤的几种支架辅助弹簧圈栓塞技术进行了综述.%Anterior communicating artery (AcomA) aneurysm is one of the most common intracranial aneurysms.Interventional treatment of wide-neck AcomA aneurysms remains challenging.With the emergence of several intracranial stents and the innovation and development of a variety of stent technologies,stentassisted coiling (SAC) embolization has gradually become one of the preferable techniques for the treatment of wide-neck AcomA aneurysms.This article reviews several SAC embolization techniques of AcomA aneurysms.

  5. [Large distal anterior cerebral artery aneurysm associated with azygos anterior cerebral artery: case report].

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    Suzuki, Y; Kawamata, T; Matsumoto, H; Kunii, N; Matsumoto, K

    1998-10-01

    A 51-year-old woman presented with a distal anterior cerebral artery aneurysm (DACAA) manifesting as severe headache and monoparesis of the left lower limb. Computed tomography revealed subarachnoid hemorrhage in the interhemispheric fissure, bilateral sylvian fissures, and basal cistern, and a hematoma in the supracallosal region. Angiography showed a large aneurysm (23 x 18 mm) located on the distal end of the azygos anterior cerebral artery (azygos ACA) at the supracallosal portion. T2-weighted magnetic resonance imaging demonstrated the hematoma as a mixed intensity mass, compressing the corpus callosum downward, and the aneurysm as a flow void anterior to the hematoma. Unilateral frontoparietal parasagittal craniotomy was performed with a horse-shoe shaped incision. The aneurysm was clipped via the interhemispheric approach, and the hematoma was aspirated. Postoperative angiography showed disappearance of the aneurysm and intact azygos ACA. The patient was discharged with mild monoparesis, paresthesia of the left lower limb and diagnostic dyspraxia. DACAA almost always arises at or near the genu of the corpus callosum and is often associated with vascular anomaly. In the literature, 22 of 26 cases of large and giant DACAA were located at or near the genu, but only 3 cases, including ours, in the supracallosal area. 11 cases were associated with azygos ACA. Therefore, hemodynamic stress caused by vascular anomaly may be involved in the formation of large or giant DACAA in contrast with cases of normal DACAA. PMID:9789300

  6. Bilateral anterior choroidal artery infarction presenting with progressive somnolence.

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    van Son, Brechtje; Vandevenne, Jan; Viaene, Pieter

    2014-09-01

    A 55-year-old woman was admitted with a 3 days history of increasing lethargy with bradyphrenia and apathy. She progressively developed severe somnolence with marked abulia, right hemiparesis, right hemianopsia, and pseudobulbar palsy. Brain magnetic resonance imaging showed the rare image of bilateral acute anterior choroidal artery infarction. Pseudobulbar mutism and in rare cases abulia have been described in acute anterior choroidal artery infarction contralateral to an older lesion in mirror position. Although neurologic deterioration is not infrequent in anterior choroidal artery territory infarcts, the absence of focal neurologic signs on admission is rare and did not raise suspicion of acute stroke. PMID:25106836

  7. Moyamoya disease associated with an anterior inferior cerebellar artery arising from a persistent trigeminal artery

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    Uchino, A.; Sawada, A.; Takase, Y.; Kudo, S. [Department of Radiology, Saga Medical School, 5-1-1, Nabeshima, Saga, 849-8501 (Japan); Koizumi, T. [Department of Neurosurgery, Saga Medical School, 5-1-1, Nabeshima, Saga, 849-8501 (Japan)

    2002-07-01

    The authors present a case of moyamoya disease associated with a persistent trigeminal artery from which the anterior inferior cerebellar artery arose. We reviewed previously reported cases of moyamoya disease associated with persistent carotid-basilar arterial anastomosis and investigated the embryology of this rare arterial variation. (orig.)

  8. Transluminal color-coded three-dimensional magnetic resonance angiography for visualization of signal Intensity distribution pattern within an unruptured cerebral aneurysm: preliminarily assessment with anterior communicating artery aneurysms

    International Nuclear Information System (INIS)

    The natural history of unruptured cerebral aneurysm is not known; also unknown is the potential growth and rupture in any individual aneurysm. The authors have developed transluminal color-coded three-dimensional magnetic resonance angiography (MRA) obtained by a time-of-flight sequence to investigate the interaction between the intra-aneurysmal signal intensity distribution patterns and configuration of unruptured cerebral aneurysms. Transluminal color-coded images were reconstructed from volume data of source magnetic resonance angiography by using a parallel volume-rendering algorithm with transluminal imaging technique. By selecting a numerical threshold range from a signal intensity opacity chart of the three-dimensional volume-rendering dataset several areas of signal intensity were depicted, assigned different colors, and visualized transparently through the walls of parent arteries and an aneurysm. Patterns of signal intensity distribution were analyzed with three operated cases of an unruptured anterior communicating artery aneurysm and compared with the actual configurations observed at microneurosurgery. A little difference in marginal features of an aneurysm was observed; however, transluminal color-coded images visualized the complex signal intensity distribution within an aneurysm in conjunction with aneurysmal geometry. Transluminal color-coded three-dimensional magnetic resonance angiography can thus provide numerical analysis of the interaction between spatial signal intensity distribution patterns and aneurysmal configurations and may offer an alternative and practical method to investigate the patient-specific natural history of individual unruptured cerebral aneurysms. (orig.)

  9. Abnormal origin of the ophthalmic artery from the anterior cerebral artery: Neuroradiological and intraoperative findings

    International Nuclear Information System (INIS)

    A 7-year old male child with an abnormal ophthalmic artery arising from the A1 segment of the anterior cerebral artery is described. The patient suffered growth inhibition which was thought to be caused by a craniobasal cystic lesion affecting the hypothalamus. Preoperative angiograms revealed no vascular abnormalities. The right ophthalmic artery, however, could not be identified. During resection of a large arachnoid cyst the ophthalmic artery was found to arise from the A1 segment of the anterior cerebral artery. To the best of our knowledge, this exact anomaly has not previously been reported. The clinical, neuroradiological and intraoperative findings are presented. (orig.)

  10. Endovascular treatment of axillary artery dissection following anterior shoulder dislocation.

    Science.gov (United States)

    Fass, G; Barchiche, M Reda; Lemaitre, J; De Quin, I; Goffin, C; Bricart, R; Bellens, B

    2008-01-01

    Injury to the axillary artery is a rare complication of anterior shoulder dislocation. Open surgical repair is technically demanding because of the anatomical position of the vessel and the propensity for concomitant injuries. Standard surgical exposure techniques involve extensive dissection, including a combination of supraclavicular or infraclavicular incision, median sternotomy, and thoracotomy causing significant morbidity and mortality rates. Endovascular techniques may offer an alternative to these surgically demanding procedures. We present a patient with a traumatic dissection of the axillary artery following anterior shoulder dislocation who was successfully managed with an endovascular stent. PMID:18411587

  11. A single coronary artery with the right coronary artery originating from the left anterior descending artery detected by cardiac CT: A case report

    International Nuclear Information System (INIS)

    The right coronary artery arising from the left anterior descending artery is a rare coronary artery anomaly. In a 56 year old female, an anomaly with the right coronary artery, originating from the left anterior descending artery, coursing anteriorly to the pulmonary artery was detected by cardiac CT. Therefore, we hereby report a case of the single left coronary artery diagnosed by a 64 slice multidetector cardiac CT

  12. Occlusion of the anterior cerebral artery after head trauma

    OpenAIRE

    2013-01-01

    Intracranial arterial occlusion is rarely encountered in association with head injury. Only six cases of traumatic occlusion of the anterior cerebral artery (ACA) have previously been reported. In this paper, the authors describe a case of a posttraumatic occlusion of ACA. A 35-year-old male presented to the emergency room with severe head injury. Computed tomography (CT) scan displayed diffuse brain swelling with multiple skull fractures. Follow up CT scan showed extensive cerebral infarctio...

  13. Proximity of arteries to the anterior ulna with changing flexion.

    Science.gov (United States)

    Enad, Jerome G; Douglas, Thomas J; Ruland, Robert T

    2015-04-01

    During surgery for elbow fracture, wires and screws crossing the elbow from posterior to anterior place the brachial and ulnar arteries at risk for inadvertent penetration. The authors' goal was to define the sagittal proximity of the brachial and ulnar arteries to the proximal ulna throughout an arc of elbow motion using dynamic fluoroscopy. The brachial artery was injected with barium in 10 fresh-frozen cadaveric elbows. Sagittal fluoroscopic images were obtained at elbow flexion angles of 0°, 30°, 60°, 90°, and 120°. Two measurements were obtained at each flexion angle: (1) the distance between the coronoid tip and the brachial artery and (2) the distance between the coronoid base and the ulnar artery. One-way analysis of variance was used to compare mean distances for each flexion angle within each measurement group. A coronal image identified the mediolateral course of the brachial artery. The distance from the coronoid tip to the brachial artery significantly increased with increasing flexion from 0° to 60° (P120° (P<.002). The brachial artery traversed lateral to the coronoid in 9 of 10 specimens. The brachial and ulnar arteries are located further from the coronoid with increasing elbow flexion to at least 60°, and the brachial artery is typically located lateral to the coronoid in the coronal plane. These measurements can be used as surgical guides to reduce the risk of arterial injury during olecranon fracture surgery. PMID:25901616

  14. Atypical presentation of popliteal artery entrapment syndrome: involvement of the anterior tibial artery.

    Science.gov (United States)

    Bou, Steven; Day, Carly

    2014-11-01

    Popliteal artery entrapment syndrome (PAES) is a rare condition that should be suspected in a young patient with exertional lower extremity pain. We report the case of an 18-year-old female volleyball player with bilateral exertional lower extremity pain who had been previously diagnosed with tendinitis and periostitis. Diagnostic studies showed entrapment of the left popliteal artery and the left anterior tibial artery. To our knowledge, there has only been 1 previous report of anterior tibial artery involvement in PAES. PMID:24880061

  15. Anterior ethmoidal artery emerging anterior to bulla ethmoidalis: An abnormal anatomical variation in Waardenburg's syndrome

    OpenAIRE

    Wong, Danny K. C.; Shao, Angus; Campbell, Raewyn; Douglas, Richard

    2014-01-01

    In endoscopic sinus surgery, the anterior ethmoidal artery (AEA) is usually identified as it traverses obliquely across the fovea ethmoidalis, posterior to the bulla ethmoidalis and anterior to or within the ground lamella's attachment to the skull base. Injury to the AEA may result in hemorrhage, retraction of the AEA into the orbit, and a retrobulbar hematoma. The resulting increase in intraorbital pressure may threaten vision. Waardenburg's syndrome (WS) is a rare congenital, autosomal dom...

  16. Dual anterior descending coronary artery associated with coronary artery disease

    Directory of Open Access Journals (Sweden)

    Siqueira Luciane da L. V.

    2003-01-01

    Full Text Available The patient is a male with risk factors for coronary artery disease, who was referred for cardiac catheterization after acute myocardial infarction in the inferior wall. The patient underwent transluminal coronary angioplasty in the right coronary artery with successful stent implantation.

  17. Anterior spinal artery syndrome of the cervical hemicord.

    Science.gov (United States)

    Baumgartner, R W; Waespe, W

    1992-01-01

    Three patients developed signs of a unilateral cervical cord lesion 6 to 36 h after the acute onset of severe cervico-brachial pain. The neurological deficit progressed over 6 to 18 h. On the painful side a central Horner's syndrome, a hemiparesis with plegia of the hand, and a slight pallhypaesthesia were found. On the opposite side thermhypaesthesia and hypalgesia were noted with a level at the dermatome C5 or C6. T2-weighted MR images revealed in one patient a small area of increased signal intensity restricted to one half of the cervical cord, and electromyography in another patient showed after 6 months evidence of segmental chronic denervation. Both abnormalities were found at the clinically expected level. The findings are consistent with a small infarction of the cervical cord in the perfusion territory of a central (sulco-commissural) artery, a duplicated anterior spinal artery or an anterior spinal branch of the vertebral artery. PMID:1315578

  18. Dual left anterior descending artery with anomalous origin of long LAD from pulmonary artery - rare coronary anomaly detected on computed tomography coronary angiography

    Science.gov (United States)

    Vohra, Aditi; Narula, Harneet

    2016-01-01

    Dual left anterior descending artery is a rare coronary artery anomaly showing two left anterior descending arteries. Short anterior descending artery usually arises from the left coronary artery, while long anterior descending artery has anomalous origin and course. Dual left anterior descending artery with origin of long anterior descending artery from the pulmonary artery (ALCAPA) is a very rare coronary artery anomaly which has not been reported previously in the literature. We present the computed tomography coronary angiographic findings of this rare case in a young female patient who presented with atypical chest pain.

  19. Break into left anterior descending coronary artery suggest myocardial bridging.

    Science.gov (United States)

    Siniscalchi, Carmine; Basaglia, Manuela; Gaibazzi, Nicola

    2016-01-01

    A 67 year-old woman presented with stable effort angina. A resting electrocardiogram was inconclusive. High-dose dipyridamole contrast-echocardiography shows normal left ventricular wall motion after 0.84mg/kg/6min dipyridamole. At rest a turbolent flow demonstrable by color aliasing, appeared in the territory of the left anterior descending coronary artery (LAD) during the diastolic phase. PMID:27163904

  20. Application of multiple intraoperative monitoring techniques in microsurgery for anterior communicating aneurysms

    Directory of Open Access Journals (Sweden)

    NI Wei

    2012-02-01

    Full Text Available Objective To evaluate the efficacy of combined multiple intraoperative monitoring techniques including transcranial Doppler (TCD, indocyanine green angiography (ICGA and neuroelectrophysiological monitoring consisting of somatosensory evoked potential (SEP and motor evoked potential (MEP in the surgical management of anterior communicating aneurysm. Methods Clinical data were analyzed for the 23 patients who underwent microsurgery for anterior communicating aneurysms with assistance of combined multiple intraoperative monitoring techniques. Twenty-three patients [12 males, 11 females; mean age 52 (range 44-63 years] underwent aneurysm clipping via modified pterional approach. Total vein anaesthesia was used for all patients. Propofol, fentanyl and scoline were administrated before intubation. Remifentanil and propofol were used throughout the procedure. Internal carotid artery and A1 segment of anterior cerebral artery were exposed successively. The parent artery, perforating artery and aneurysm were carefully recognized after the A1 segment was temporarily occluded. The temporary clip was removed after the aneurysm being clipped. Neuroelectrophysiological monitoring, ICGA and TCD were applied for intraoperative monitoring. Results All of the 23 aneurysms were successfully clipped. MEP changes were seen in 6 patients during the temporary occlusion of A1 segment, which directed neurosurgeon to pause for its recovery. TCD and ICGA detected A2 segment or anterior communicating artery stenosis in 2 patients and residual aneurysm in 1 patient during clipping procedure, which directed neurosurgeons to readjust aneurysmal clips. Postoperative transient hemiparalysis were observed in 1 patient with modified Rankin Scale level 1 at discharge. No hemorrhagic or ischemic events were observed in other 22 patients with modified Rankin Scale level 0 at discharge. Conclusion Combined multiple intraoperative monitoring techniques may provide important

  1. CTA study on relationship between dominant A1 segment and the anterior communicating artery aneurysm%大脑前动脉 A1段优势征与前交通动脉瘤关系的 CTA 研究

    Institute of Scientific and Technical Information of China (English)

    王洪生; 陈晓峰; 陈斌; 殷尚炯; 赵佩林; 王志明

    2015-01-01

    目的:探讨大脑前动脉水平段( A1段)优势征与前交通动脉瘤( ACoAA )形成的关系。方法分析173例患者的64排CT血管成像(CTA)检查资料,并按CTA结果分为ACoAA组(83例)与正常对照组(90例)。观察指标:有无动脉瘤,动脉瘤的部位、形态、大小和瘤颈宽度、瘤顶指向及瘤体与周围结构的关系等,判定结果与手术及DSA结果进行对照。同时观察大脑前动脉A1段是否发育不良或缺如,是否存在一侧大脑前动脉A1段优势征。结果 ACoAA组中显示一侧大脑前动脉A1段优势征者的比率达80.7%,明显高于正常对照组的16.7%(P<0.05)。结论一侧大脑前动脉A1段优势征,另一侧A1段发育不良或缺如与ACoAA的发生有密切关系。%Objective To investigate the relationship between the dominant A 1 segment and presence of the anterior communicating artery aneurysm .Methods The data of 64-slice computed tomography angiography ( CTA ) of 173 cases were analysed retrospectively .The 173 cases were divided into anterior communicating artery aneurysm (ACoAA) group(83 cases) and control group (90 cases).The observation items were the presence of aneurysm and the location , shape, size, neck, axis point of every one aneurysm and the relationship of aneurysms to parent vessels and other branches and bone structure .The results of aneurysms were compared with clipping or coiling , at the same time, to observe the A1 segment of anterior cerebral artery whether had dysplasia or absence , whether existed the dominance of A 1 segment of anterior cerebral artery .Results The rate of display the dominance of A1 segment of anterior cerebral artery (80.7%) in the ACoAA group was higher than that in the control group (16.7%) ( P <0.05 ).Conclusion The development of the anterior communicating artery aneurysm closely related with the the dominance of A 1 segment of anterior cerebral artery and the dysplasia or

  2. Superficial temporal artery to proximal posterior cerebral artery bypass through the anterior temporal approach

    Directory of Open Access Journals (Sweden)

    Satoru Takeuchi

    2015-01-01

    Full Text Available Background: The superficial temporal artery (STA to proximal posterior cerebral artery (PCA (P2 segment bypass is one of the most difficult procedures to perform because the proximal PCA is located deep and high within the ambient cistern. STA to proximal PCA bypass is usually performed through a subtemporal approach or posterior transpetrosal approach, and rarely through a transsylvian approach. The aim of this study was to describe the operative technique of STA to proximal PCA bypass through a modified transsylvian approach (anterior temporal approach. Methods: STA to proximal PCA bypass was performed through an anterior temporal approach in three patients with intracranial aneurysm. We describe the details of the surgical technique. Results: The STA was successfully anastomosed to the proximal PCA in all cases. One patient suffered hemiparesis and aphasia due to infarction in the anterior thalamoperforating artery territory. Conclusions: STA to proximal PCA bypass can be performed through an anterior temporal approach in selected patients. We recommend that every precaution, including complete hemostasis, placement of cellulose sponges beneath the recipient artery to elevate the site of the anastomosis, and placement of a continuous drainage tube at the bottom of the operative field to avoid blood contamination during the anastomosis, should be taken to shorten the temporary occlusion time.

  3. 前交通动脉动脉瘤的分型及其显微手术治疗%Classification and microsurgical treatment of anterior communicating artery aneurysms

    Institute of Scientific and Technical Information of China (English)

    王雷; 田道锋; 陈治标; 徐海涛; 黄书岚; 蔡强; 吴立权; 陈谦学

    2011-01-01

    目的 探讨前交通动脉(ACoA)动脉瘤的临床分型及其显微手术治疗.方法 回顾性分析2007年7月至2010年4月显微手术夹闭的154例ACoA动脉瘤患者的临床资料,根据瘤顶指向将动脉瘤分为指向前方型、指向上方型、指向后方型、指向下方型和复杂指向型共五型.结果 出院时按GOS评分,预后良好(GOS4~5分)134例(87.01%),差(2~3分)12例(7.79%),死亡(1分)8例(5.19%).146例患者术后随访6个月~3年,无再出血及死亡病例.结论ACoA动脉瘤瘤顶指向复杂多变,根据其瘤顶指向类型进行个体化手术治疗有利于提高患者生存率和生活质量.%Objective To investigate the clinical classification and microsurgical treatment strategy of anterior communicating artery (ACoA) aneurysms.Method The clinical data of 154 patients with 159 ACoA aneurysms, who were treated by microsurgery in our department from July, 2007 to April, 2010, were analyzed retrospectively.Results According to the directions of the aneurysmal tops projection, one hundred and fifty-nine aneurysms were divided into 5 types including forward types (33 aneurysms, 20.8%), upward type (41, 25.8%), backward type (35, 22.0%), downward type (27, 17.0%) and complex type (23, 14.5%).According to GOS, of 154 patients with ACoA aneurysms, 134 were recovered well (GOS, 4~5 points), 12 bad (GOS, 2~3 points) and 8 died.Conclusions The directions of the aneurysmal tops projection are complex and varied.The curative effect of microsurgery on the patients with ACoA aneurysms can be improved by the individualized treatment plan which is developed according the directions of ACoA anuerysmal tops projection.

  4. Anomalous origin of the right coronary artery from the left anterior descending coronary artery: a case report.

    Science.gov (United States)

    Moretti, C; De Felice, F; Mazza, A; Borello, G

    1999-08-01

    We report on a 59-year-old man with effort angina of recent onset and a very uncommon right coronary artery originating from the middle portion of the left anterior descending; a tight stenosis of the left anterior descending coronary artery was also detected which involved the origin of the aberrant vessel. PMID:10488454

  5. Anterior humeral circumflex artery avulsion with brachial plexus injury following an isolated traumatic anterior shoulder dislocation.

    Science.gov (United States)

    Shah, Rohi; Koris, Jacob; Wazir, Akhlaq; Srinivasan, Shyamsundar S

    2016-01-01

    A 70-year-old man presented to accident and emergency with an isolated anteriorly dislocated shoulder, in the absence of a concomitant fracture. There was no neurovascular deficit at presentation, and the shoulder was reduced under sedation, using the Kocher's technique. Following this, the patient developed signs of hypovolaemic shock. Clinical examination revealed an expanding fullness in the deltopectoral area, with compromise of the limb neurovascular status. CT imaging confirmed an expanding haematoma from the axillary vessels, restricting left lung expansion. Once resuscitated, the patient was transferred to theatre for exploration of the bleeding vessels. Intraoperative findings included an avulsed anterior circumflex humeral artery that was subsequently ligated. Postoperatively, the patient developed axillary, radial, median and ulnar nerve neuropraxia, which improved clinically prior to discharge. The patient was ultimately discharged home after a lengthy inpatient stay. PMID:26969353

  6. Identification of the segmental artery feeding the anterior spinal artery. Correlation between helical CT and angiography

    International Nuclear Information System (INIS)

    We investigated whether identification of the segmental artery feeding the anterior spinal artery (ASA) is possible by single-slice helical CT. Enhanced CT and angiography were performed in 14 patients with retroperitoneal, liver, or bone tumor. A single-slice helical CT scanner with 7 mm collimation and a 1.0 helical pitch was used. Scanning was started 25 to 30 sec after an intravenous injection of 100 ml of contrast medium at a rate of 3.0 ml/sec. We predicted the segmental artery feeding the ASA in all 14 patients using enhanced CT images. In 12 of the 14 patients, the segmental artery feeding the ASA was angiographically identified. In 7 of these 12 patients, the level of the segmental artery feeding the ASA identified on segmental arteriogram was the same level as that predicted by enhanced CT. In the remaining 5 patients, the level of the segmental artery feeding the ASA identified on segmental arteriogram was one level higher or lower than the predicted spinal level. We could identify the segmental artery feeding the ASA by detailed examination and interpretation of single-slice helical CT images. (author)

  7. A case of tetralogy of Fallot associated with left anterior descending coronary artery to pulmonary artery fistula

    Directory of Open Access Journals (Sweden)

    Chander Mohan Mittal

    2011-01-01

    Full Text Available Presence of coronary to pulmonary artery fistula is generally a feature of pulmonary atresia with ventricular septal defect. We present a rare case of left anterior descending coronary artery to pulmonary artery fistula in a patient of tetralogy of Fallot.

  8. Anatomy and radiology of the anterior inferior cerebellar artery

    International Nuclear Information System (INIS)

    This study describes the variations of the Anterior Inferior Cerebellar Artery (AICA) and identifies its types of appearance in normal angiograms as well as in angiograms of patients suffering from posterior fossa tumours or from ischemic lesions in the vertebro-basilar territory. For this purpose a study of 20 normal specimens was undertaken. Four main types of the AICA are distinguished. One hundred normal vertebral angiograms, made between 1976 and 1982 in the Valeriuskliniek and the Academisch Ziekenhuis der Vrije Univesiteit are reviewed. The AICA's are classified in the same way as in the anatomical study. The same classification was used in the analysis of 41 vertebral angiograms of patients with posterior fossa tumours and nine angiograms of patients with ischemic disturbances in the posterior cranial fossa. (Auth.)

  9. Anterior Hox Genes in Cardiac Development and Great Artery Patterning

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    Brigitte Laforest

    2014-03-01

    Full Text Available During early development, the heart tube grows by progressive addition of progenitor cells to the arterial and venous poles. These cardiac progenitor cells, originally identified in 2001, are located in the splanchnic mesoderm in a region termed the second heart field (SHF. Since its discovery, our view of heart development has been refined and it is well established that perturbation in the addition of SHF cells results in a spectrum of congenital heart defects. We have previously shown that anterior Hox genes, including Hoxb1, Hoxa1 and Hoxa3, are expressed in distinct subdomains of the SHF that contribute to atrial and subpulmonary myocardium. It is well known that Hox proteins exert their function through interaction with members of the TALE family, including Pbx and Meis factors. The expression profile of Pbx and Meis factors overlaps with that of anterior Hox factors in the embryonic heart, and recent data suggest that they may interact together during cardiac development. This review aims to bring together recent findings in vertebrates that strongly suggest an important function for Hox, Pbx and Meis factors in heart development and disease.

  10. Avoidance of patent anterior grafts at revisional coronary artery surgery: use of a lateral thoracotomy approach.

    OpenAIRE

    Walker, W S; Sang, C T

    1986-01-01

    The use of a right or left lateral thoracotomy is described as an alternative approach to revisional coronary artery surgery for patients with patent anterior grafts. Five patients underwent successful revisional coronary artery grafting with a total of three internal mammary artery grafts and three saphenous vein grafts. This is a safe technique in patients for whom repeat median sternotomy is potentially hazardous, notably those with patent anterior grafts or close apposition of the heart t...

  11. A Lumped Parameter Method to Calculate the Effect of Internal Carotid Artery Occlusion on Anterior Cerebral Artery Pressure Waveform

    OpenAIRE

    Abdi, M.; Navidbakhsh, M.; Razmkon, A.

    2016-01-01

    Background and Objective Numerical modeling of biological structures would be very helpful tool to analyze hundreds of human body phenomena and also diseases diagnosis. One physiologic phenomenon is blood circulatory system and heart hemodynamic performance that can be simulated by utilizing lumped method. In this study, we can predict hemodynamic behavior of one artery of circulatory system (anterior cerebral artery) when disease such as internal carotid artery occlusion is occurred. Method ...

  12. Pseudoaneurysm of the anterior tibial artery: A rare complication of proximal tibial steinman pin insertion

    OpenAIRE

    Tarun Suri; Vineet Dabas; Sumit Sural; Anil Dhal

    2011-01-01

    An anterior tibial artery pseudoaneurysm is a rare and unexpected complication of Steinmann pin insertion. We describe the case of an 18-year-old boy, who sustained such an injury to the anterior tibial artery during this procedure. Diagnosis was confirmed on a magnetic resonance (MR) angiogram. Aneurysmal sac excision with lateral repair of the vessel wall was performed. Postoperatively, a good flow was documented on a follow-up MR angiogram. This case highlights a major and unexpected compl...

  13. A case of angiographically occult, distal small anterior inferior cerebellar artery aneurysm

    OpenAIRE

    Hisashi Kubota; Yasuhiro Sanada; Kazuhiro Nagatsuka; Amami Kato

    2015-01-01

    Background: A small aneurysm at an unusual location, such as a distal anterior inferior cerebellar artery (AICA) aneurysm, may conceal as a computed tomography angiography (CTA) and digital subtraction angiography (DSA)-occult aneurysm. Case Description: We herein present the case of a patient suffering from a subarachnoid hemorrhage (SAH) with two aneurysms in which the AICA aneurysm was negative by CTA and DSA. CTA demonstrated a right anterior choroidal artery aneurysm, which was revea...

  14. Motor recovery by anterior choroidal artery territory in a patient with middle cerebral artery infarct

    Institute of Scientific and Technical Information of China (English)

    Ji Heon Hong; Sung Ho Jang

    2010-01-01

    In this study,the uninjured periventricular area of a female patient who presented with complete paralysis of the left extremities following middle cerebral artery infarction was analyzed using diffusion tensor tractography,transcranial magnetic stimulation,and functional magnetic resonance imaging.Diffusion tensor tractography revealed interrupted corticospinal tract at the infarct lesion in the corona radiata at 2 weeks after onset,which descended through the spared periventricular area at 6 months after onset.Transcranial magnetic stimulation and functional magnetic resonance imaging revealed a motor pathway of the affected hand that was compatible with the lateral corticospinal tract.At 6 months after onset,motor function in the affected extremities recovered to normal levels,which suggested that motor function in the affected hand recovered by the corticospinal tract that passed through the spared periventricular area.The arterial territory of the spared periventricular area corresponded with the anterior choroidal artery.These results suggest that care should be taken in spared periventricular areas in patients with lesions at the corona radiata level.

  15. A case of emotional facial palsy with ipsilateral anterior inferior cerebellar artery territory infarction.

    Directory of Open Access Journals (Sweden)

    Khurana D

    2002-01-01

    Full Text Available Emotional facial palsy (EFP commonly results from anterolateral thalamic or striatocapsular infarcts. Its occurrence in brainstem lesions is uncommon, with previously reported cases being restricted to superior cerebellar artery infarction (3 cases. We report an unusual case of EFP ipsilateral to an anterior inferior cerebellar artery infarction, which opens new insights into the facial corticobulbar tract pathway.

  16. Percutaneous Coronary Intervention of A Stenotic Left Anterior Descending Artery with Anomalous Origin of Right Coronary Artery

    Directory of Open Access Journals (Sweden)

    Shu-Kai Hsueh

    2009-10-01

    Full Text Available The anomalous origin of the right coronary artery (RCA from the left anterior descending(LAD artery is rare. We report a case of single coronary artery with proximal LADsevere stenosis. The RCA originated from an unreported course of conal branch from theLAD. This anomalous RCA also had collaterals from left circumflex. Coronary interventionwas successfully carried out on a severe stenosis at the proximal LAD artery. To the best ofour knowledge the scenario of anomalous course and intervention is still to be reported.

  17. Brainstem hemorrhage following clipping of anterior communicating aneurysm: Is lumbar drain responsible?

    Directory of Open Access Journals (Sweden)

    Arindom Kakati

    2012-01-01

    Full Text Available Remote brainstem hemorrhage is an extremely rare complication following supratentorial surgery. We describe here a 55-year-old patient with ruptured anterior communicating artery aneurysm, who underwent an uneventful clipping of the aneurysm, and had a lumbar drainage intra-operatively to facilitate brain relaxation. In the postoperative period, he developed pontomesencephalic hemorrhage, and had a fatal outcome. The potential causative factors are discussed, and the relevant literature reviewed. This is probably the first reported case of this complication in the literature.

  18. Occipital Artery Arising from the Anterior Aspect of the Internal Carotid Artery Identified by Three-Dimensional Computed Tomography Angiography

    International Nuclear Information System (INIS)

    Variation of the branches of the external carotid artery (ECA) is well known, but it is extremely rare for the occipital artery (OA) to arise from the internal carotid artery (ICA). A 87-year-old man was found to have this anatomical variation on the right side by threedimensional computed tomography angiography for vascular mapping of the carotid arteries before superselective intra-arterial catheterization for advanced tongue cancer. Imaging showed the OA arose from the anterior aspect of the right ICA with the origin located 8.8 mm distal from the carotid bifurcation. The inner diameter of the origin of the OA was 2.1 mm and the angle between the OA and the ICA was 62 degrees. It is important to recognize this anatomic variation of the branches of the ECA before head and neck microsurgical reconstruction or superselective intra-arterial chemotherapy for oral cancer

  19. Novel variant of dual left anterior descending artery arising from single right coronary artery anomaly presenting with angina inversa

    Science.gov (United States)

    Arslan, Gokhan; Iyisoy, Atilla; Bingol, Hakan

    2015-01-01

    A 55-year-old female without a history of coronary artery disease, hypertensive for the past 17 years, was admitted with resting chest pain. Electrocardiography revealed a negative T-wave in anterior chest leads. Coronary angiography visualised anomalous coronary anatomy, with a common origin of the right coronary artery and the left main coronary artery in the right sinus of Valsalva serving as a common coronary trunk. It should be emphasised that T-wave abnormalities and chest angina may be related to this congenital coronary anomaly. PMID:26702282

  20. Pseudoaneurysm of the anterior tibial artery: A rare complication of proximal tibial steinman pin insertion

    Directory of Open Access Journals (Sweden)

    Tarun Suri

    2011-01-01

    Full Text Available An anterior tibial artery pseudoaneurysm is a rare and unexpected complication of Steinmann pin insertion. We describe the case of an 18-year-old boy, who sustained such an injury to the anterior tibial artery during this procedure. Diagnosis was confirmed on a magnetic resonance (MR angiogram. Aneurysmal sac excision with lateral repair of the vessel wall was performed. Postoperatively, a good flow was documented on a follow-up MR angiogram. This case highlights a major and unexpected complication of a so-called minor procedure. Too posterior a pin placement in the proximal tibia should be avoided to prevent such injuries.

  1. Anterior Tibial Artery Pseudoaneurysm following Ankle Arthroscopy in a Hemophiliac Patient.

    Science.gov (United States)

    Chamseddin, Khalil H; Kirkwood, Melissa L

    2016-07-01

    Arthroscopy of the foot and ankle is a common orthopedic procedure with low complication rates. Arterial injuries from these procedures are an even more rare subset of the complications. Hemophilia A is a genetic disorder of aberrant coagulation, which leads to increased risk of bleeding even after minor trauma. We present the second case of anterior tibial artery pseudoaneurysm formation secondary to ankle arthroscopy in a hemophiliac patient and suggest that these individuals are at higher risk for developing complications associated with arterial injury. Furthermore, potential risk factors include port placement, anatomic variation of the vessels, and nature of the arthroscopic procedure. We recommend steps to prevent complications in hemophiliac patients. PMID:27174350

  2. The Changed Route of Anterior Tibial Artery due to Healed Fracture

    OpenAIRE

    Kemal Gökkuş; Ergin Sagtas; Nuri Comert; Mehmet Bekir Unal; Murat Baloglu

    2016-01-01

    We would like to highlight unusual sequelae of healed distal third diaphyseal tibia fracture that was treated conservatively 36 years ago, in which we incidentally detected peripheral CT angiography. The anterior tibial artery was enveloped three-quarterly by the healing callus of the bone (distal tibia).

  3. The Changed Route of Anterior Tibial Artery due to Healed Fracture

    Science.gov (United States)

    Gökkuş, Kemal; Sagtas, Ergin; Comert, Nuri; Unal, Mehmet Bekir; Baloglu, Murat

    2016-01-01

    We would like to highlight unusual sequelae of healed distal third diaphyseal tibia fracture that was treated conservatively 36 years ago, in which we incidentally detected peripheral CT angiography. The anterior tibial artery was enveloped three-quarterly by the healing callus of the bone (distal tibia). PMID:27019760

  4. The Changed Route of Anterior Tibial Artery due to Healed Fracture

    Directory of Open Access Journals (Sweden)

    Kemal Gökkuş

    2016-01-01

    Full Text Available We would like to highlight unusual sequelae of healed distal third diaphyseal tibia fracture that was treated conservatively 36 years ago, in which we incidentally detected peripheral CT angiography. The anterior tibial artery was enveloped three-quarterly by the healing callus of the bone (distal tibia.

  5. Preserving the superior rectal artery in laparoscopic [correction of laparoscopis] anterior resection for complete rectal prolapse.

    Science.gov (United States)

    Ignjatovic, D; Bergamaschi, R

    2002-01-01

    Anterior resection for the treatment of full thickness rectal prolapse has been around for over four decades. 1 However, its use has been limited due to fear of anastomotic leakage and related morbidity. It has been shown that high anterior resection is preferable to its low counterpart as the latter increases complication rates. 2 Although sparing the inferior mesenteric artery in sigmoid resection for diverticular disease has been shown to decrease leak rates in a randomized setting, 3 vascular division is current practice. We shall challenged this current practice of dividing the mesorectum in anterior resection for complete rectal prolapse developing a technique that allows the preservation of the superior rectal artery. PMID:12587465

  6. MRI of anterior spinal artery syndrome of the cervical spinal cord

    International Nuclear Information System (INIS)

    Cervical spinal cord lesions in the anterior spinal artery syndrome were delineated on magnetic resonance images (MRI) in four patients. The lesion was always seen anteriorly in the cervical cord. On T2-weighted images, the lesions appeared hyperintense relative to the normal spinal cord, while on T1-weighted images, two chronic lesions appeared hypointense, with local atrophy of the cord. In one case, repeated T1-weighted images showed no signal abnormality 4 days after the ictus, but the lesion became hypointense 18 days later, when contrast enhancement was also recognized after injection of Gd-DTPA; this sequence of intensity changes was similar to that of cerebral infarction. The extent of the lesion seen MRI correlated closely with neurological findings in all cases. Although the findings may not be specific, MRI is now the modality of choice for confirming the diagnosis in patients suspected of having an anterior spinal artery syndrome. (orig.)

  7. Superficial peroneal neurocutaneous flap based on an anterior tibial artery perforator for forefoot reconstruction.

    Science.gov (United States)

    Wang, Chun-Yang; Chai, Yi-Min; Wen, Gen; Han, Pei; Cheng, Liang

    2015-06-01

    The distally based superficial peroneal neurocutaneous (SPNC) island flap has been widely used for foot reconstruction. It is based on the descending branch of the peroneal artery perforator. However, damage to the perimalleolar vascularization or anatomic variations of the descending branch often causes flap necrosis. Because septocutaneous perforators from the anterior tibial artery participate in the vascular network of superficial peroneal nerve in the distal lower leg, a modified SPNC flap is designed based on the anterior tibial artery perforator. Seven patients with soft tissue defect over the forefoot were treated by this modified technique. Six patients had accompanied injuries at the lateral perimalleolar region, and 1 patient had an anatomic variation of the descending branch of the peroneal artery perforator. The size of defect ranged from 12 × 5 to 15 × 9 cm. All 7 flaps survived completely without complications. The size of the flaps ranged from 13 × 6 to 16 × 10 cm. No severe venous congestion occurred. The mean follow-up was 9.4 months (range, 6-14 months). All patients were satisfied with the texture and color of the flaps. Two patients complained about the thickness of the flaps, but did not want further operation. The donor sites healed uneventfully and no painful neuroma occurred. In conclusion, the modified SPNC flap based on an anterior tibial artery perforator is a feasible salvage procedure when the traditional design is unreliable. It can provide sufficient and superior coverage for large forefoot defect. PMID:25969973

  8. Coronary spasm as the cause of myocardial ischaemia in a patient with anomalous origin of the left anterior descending artery from the proximal right coronary artery.

    Science.gov (United States)

    Nakazato, Jun; Hirata, Kazuhito; Wake, Minoru

    2014-01-01

    A 49-year-old woman developed angina at rest. A CT of the coronary artery revealed that the left anterior descending artery arose from the right coronary artery, and traversed between the aorta and pulmonary trunk. An exercise stress myocardial scintigraphy did not reproduce myocardial ischaemia or anginal symptoms. A coronary angiography did not show any atherosclerotic changes. Finally, an ergotamine provocation test for vasospasm revealed diffuse severe spasm in the right coronary artery and the left anterior descending artery. Surgical correction of the anomaly was deferred and the patient was managed with medications to control spasm with good clinical outcome. PMID:24920513

  9. Predominant location of coronary artery atherosclerosis in the left anterior descending artery. The impact of septal perforators and the myocardial bridging effect

    OpenAIRE

    Wasilewski, Jarosław; Niedziela, Jacek; Osadnik, Tadeusz; Duszańska, Agata; Sraga, Wojciech; Desperak, Piotr; Myga-Porosiło, Jolanta; Jackowska, Zuzanna; Nowakowski, Andrzej; Głowacki, Jan

    2015-01-01

    Introduction Coronary artery atherosclerosis presents characteristic patterns of plaque distribution despite systemic exposure to risk factors. We hypothesized that local hemodynamic forces induced by the systolic compression of intramuscular septal perforators could be involved in atherosclerotic processes in the left anterior descending artery (LAD) adjacent to the septal perforators’ origin. Therefore we studied the spatial distribution of atherosclerosis in coronary arteries, especially i...

  10. Access to the ophthalmic artery by retrograde approach through the posterior communicating artery for intra-arterial chemotherapy of retinoblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Pham, Chi-Tuan; Blanc, Raphael; Pistocchi, Silvia; Bartolini, Bruno; Piotin, Michel [Fondation Rothschild Hospital, Department of Interventional Neuroradiology, Paris (France); Lumbroso-Le Rouic, Livia [Institut Curie, Department of Ocular Oncology, Paris (France)

    2012-08-15

    Intra-arterial infusion of chemotherapy into the ophthalmic artery for treatment of retinoblastoma has been realized after catheterization of the internal carotid and temporary balloon occlusion beyond the orifice of the ophthalmic artery, or more recently after superselective canulation of the ophthalmic artery by a microcatheter. The superselective catheterization of the ophthalmic artery could be cumbersome because of the implantation of the ostium on the carotid siphon or because of the tortuosity of the carotid siphon. We report our experience of using a retrograde approach through the posterior communicating artery that allows a more direct angle of access to the origin of the ophthalmic artery. (orig.)

  11. Access to the ophthalmic artery by retrograde approach through the posterior communicating artery for intra-arterial chemotherapy of retinoblastoma

    International Nuclear Information System (INIS)

    Intra-arterial infusion of chemotherapy into the ophthalmic artery for treatment of retinoblastoma has been realized after catheterization of the internal carotid and temporary balloon occlusion beyond the orifice of the ophthalmic artery, or more recently after superselective canulation of the ophthalmic artery by a microcatheter. The superselective catheterization of the ophthalmic artery could be cumbersome because of the implantation of the ostium on the carotid siphon or because of the tortuosity of the carotid siphon. We report our experience of using a retrograde approach through the posterior communicating artery that allows a more direct angle of access to the origin of the ophthalmic artery. (orig.)

  12. Value of Acceleration Flow in the Left Anterior Descending Coronary Artery for the Detection of Coronary Artery Stenosis by Transthoracic Coronary Color Doppler Echocardiography

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Whether the localized flow acceleration occurs in the resting stenotic left anterior descending coronary artery was explored and its value for detection of coronary stenosis estimated.Blood flow in the left anterior descending coronary arteries in 45 patients was detected by transthoracic color Doppler echocardiograph and multipoint pulse Doppler spectrums were recorded in the same segment. The ratio of the maximal peak diastolic velocity to the minimal peak diastolic velocity was calculated. The ratio ≥1.5 was the cutoff value for the presence of localized acceleration flow.There were 23 patients with localized acceleration flow examined by echocardiography. Twenty of them were found to have luminal diameter stenosis (60 %- 98 %) in the left anterior descending coronary arteries by coronary angiography and 3 patients were normal. There were 22 patients without localized acceleration flow examined by echocardiography. Eighteen of them had no or <60% stenosis. Four patients had serious stenosis (≥95 %) or occluded segments in the left anterior descending coronary arteries on coronary angiography. The ratio of the maximal peak diastolic velocity to the minimal peak diastolic velocity was significantly higher in patients with left anterior descending coronary artery stenosis than that in those without stenosis (1.9±0.3 vs 1.3±0.2, P<0.01) and it correlated significantly with left anterior descending coronary artery stenosis (r=0.77, P<0.01). The specificity by using the ratio≥1.5 for stenosis detection was 85.7 % (18/21), and the sensitivity was 83.3 % (20/24). This study demonstrated that local blood flow velocity was increased in the resting stenotic left anterior descending coronary artery. Transthoracic color Doppler echocardiography is a reliable noninvasive method to detect localized acceleration flow in the left anterior descending coronary artery stenosis and it is useful in the noninvasive diagnosis of stenosis in the left anterior descending

  13. A correlation study of geometric parameters of the saccular aneurysm at the anterior communicating artery and the risk of rupture%前交通动脉囊性动脉瘤几何学指标与破裂风险的相关性研究

    Institute of Scientific and Technical Information of China (English)

    王凯; 刘杰; 于建林; 杨莎莎; 宋爱华; 高亦深; 尚彦国

    2015-01-01

    Objective To evaluate the correlation between the anterior communicating artery aneurysm and the risk of rupture through measuring and analyzing its geometric parameters.Methods The anterior communicating artery aneurysms were divided into either a ruptured group or an unruptured group.The maximum tumor size ratio (SR)/diameter of parent artery,flow angle (FA),parentdaughter angle (PDA),volume-to-ostium ratio (VOR),A1/A2 diameter ratio,a ratio of aneurysm volume to bounding sphere volume (AVSV) were measured by computer software,and statistical analysis was performed by using SPSS 19.0 software.Results The mean SR,VOR,A1/A2,and AVSV of the ruptured group were higher than those of the unruptured group (P < 0.05) and PDA of the rupture group was less than that of the unruptured group (P < 0.05);Multivariate analysis results showed that there were no significant differences in SR,FA,PDA,VOR,A1/A2,and AVSV between the 2 groups (P > 0.05).Conclusions The geometry parameters have the objective significance for the evaluation of the risk of aneurysm rupture,and the bigger the values of SR,VOR,A1/A2,AVSV,the more easily ruptured aneurysm,and the smaller the value of PDA,the more easily ruptured aneurysm.%目的 通过测量分析前交通动脉瘤的几何学指标,评估其与破裂风险的相关性.方法 将前交通动脉瘤分为破裂组和未破裂组,通过计算机软件测量最大瘤体长度/载瘤动脉直径(SR)、流入角(FA)、子母角(PDA)、动脉瘤体积/瘤颈面积(VOR)、A1直径/A2直径(A1/A2)、动脉瘤体积/假想最小球体积(AVSV)并应用SPSS19.0软件进行统计学分析.结果 破裂组SR、VOR、A1/A2、AVSV的均值均大于未破裂组(P<0.05),破裂组PDA小于未破裂组(P<0.05);多因素分析结果SR、FA、PDA、VOR、A1/A2、AVSV差异无统计学意义(P>0.05).结论 几何学指标对于评价动脉瘤破裂风险具有客观的意义,SR、VOR、A1/A2、AVSV数值越大,动脉瘤越容易破裂;PDA数值越小,动脉瘤越容易破裂.

  14. Coronary spasm as the cause of myocardial ischaemia in a patient with anomalous origin of the left anterior descending artery from the proximal right coronary artery

    OpenAIRE

    Nakazato, Jun; Hirata, Kazuhito; Wake, Minoru

    2014-01-01

    A 49-year-old woman developed angina at rest. A CT of the coronary artery revealed that the left anterior descending artery arose from the right coronary artery, and traversed between the aorta and pulmonary trunk. An exercise stress myocardial scintigraphy did not reproduce myocardial ischaemia or anginal symptoms. A coronary angiography did not show any atherosclerotic changes. Finally, an ergotamine provocation test for vasospasm revealed diffuse severe spasm in the right coronary artery a...

  15. Application of multiple intraoperative monitoring techniques in microsurgery for anterior communicating aneurysms

    OpenAIRE

    Ni, De Wei; CHEN Liang; Xu, Geng; SONG Dong-lei; LEI, YU; Gu, Yu-Xiang

    2012-01-01

    Objective To evaluate the efficacy of combined multiple intraoperative monitoring techniques including transcranial Doppler (TCD), indocyanine green angiography (ICGA) and neuroelectrophysiological monitoring consisting of somatosensory evoked potential (SEP) and motor evoked potential (MEP) in the surgical management of anterior communicating aneurysm. Methods Clinical data were analyzed for the 23 patients who underwent microsurgery for anterior communicating aneurysms with assistance of co...

  16. Spontaneous-idiopathic left anterior descending artery dissection: is watchful waiting better than immediate stenting?

    Science.gov (United States)

    Arrivi, A; Bazzucchi, M; De Paolis, M; Placanica, A; Bock, C; Milici, C; Boschetti, E; Dominici, M

    2013-01-01

    Spontaneous coronary artery dissection (SCAD) is a rare, complex disease, nowadays poorly understood yet. The lack of firm recommendations about this issue is a great limitation which makes any therapeutic decision controversial. The case described is that of a young, otherwise healthy woman, who presented with an ostial dissection of the left anterior descending (LAD) artery. Due to patient's stable clinical and hemodynamic parameters, we used a cautious approach based on watchful waiting and medical therapy, postponing stenting in order to achieve a partial vessel reopening with a more comfortable access to PCI. PMID:24106639

  17. Spontaneous-Idiopathic Left Anterior Descending Artery Dissection: Is Watchful Waiting Better Than Immediate Stenting?

    Science.gov (United States)

    Arrivi, A.; Bazzucchi, M.; De Paolis, M.; Placanica, A.; Bock, C.; Milici, C.; Boschetti, E.; Dominici, M.

    2013-01-01

    Spontaneous coronary artery dissection (SCAD) is a rare, complex disease, nowadays poorly understood yet. The lack of firm recommendations about this issue is a great limitation which makes any therapeutic decision controversial. The case described is that of a young, otherwise healthy woman, who presented with an ostial dissection of the left anterior descending (LAD) artery. Due to patient's stable clinical and hemodynamic parameters, we used a cautious approach based on watchful waiting and medical therapy, postponing stenting in order to achieve a partial vessel reopening with a more comfortable access to PCI. PMID:24106639

  18. Spontaneous resolution of an isolated cervical anterior spinal artery aneurysm after subarachnoid hemorrhage

    Science.gov (United States)

    Pahl, Felix Hendrik; de Oliveira, Matheus Fernandes; Rotta, Marcus Alexandre Cavalcanti; Dias, Guilherme Marcos Soares; Rezende, André Luiz; Rotta, José Marcus

    2014-01-01

    Background: Isolated cervical anterior spinal artery aneurysms are extremely rare. Subarachnoid hemorrhage (SAH) secondary to such lesions have been described only in six cases to the best of our knowledge. Case Description: We describe an unusual clinical picture of SAH due to rupture of anterior spinal artery aneurysm in a patient with previous normal angiogram. Due to the location of the aneurysm and clinical status of the patient, conservative management was proposed, and she was discharged to further follow-up. Monthly routine angiograms revealed resolution of the aneurysm 90 days after bleeding, which was highly suggestive of vascular dissection. Conclusion: We highlight the need to consider these aneurysms in the differential diagnosis of SAH, especially when occurring in the posterior fossa and when angiography findings are inconclusive. PMID:25317354

  19. Anterior Spinal Artery Syndrome: Reversible Paraplegia after Minimally Invasive Spine Surgery

    OpenAIRE

    Bredow, J.; Oppermann, J.; Keller, K.; F. Beyer; Boese, C. K.; Zarghooni, K.; Sobottke, R.; Eysel, P.; Siewe, J.

    2014-01-01

    Background Context. Percutaneous balloon kyphoplasty is an established minimally invasive technique to treat painful vertebral compression fractures, especially in the context of osteoporosis with a minor complication rate. Purpose. To describe the heparin anticoagulation treatment of paraplegia following balloon kyphoplasty. Study Design. We report the first case of an anterior spinal artery syndrome with a postoperative reversible paraplegia following a minimally invasive spine surgery (bal...

  20. Inferior Lateral Genicular Artery Injury during Anterior Cruciate Ligament Reconstruction Surgery

    OpenAIRE

    Lamo-Espinosa, J. M.; R. Llombart Blanco; J. R. Valentí

    2012-01-01

    We report a case of inferior lateral genicular artery (ILG) injury during anterior cruciate ligament (ACL) reconstruction surgery with lateral partial meniscectomy. This is a rare arthroscopy complication. A review of the literature has been made with the aim to define the anatomy of ILG across the lateral articular line and the risk of lesion during knee arthroscopy. We propose embolization as a good treatment option for this type of injuries.

  1. Duplicated middle cerebral artery arising from the origin of the hyperplastic anterior choroidal artery that mimicked aneurysm on routine MR angiography.

    Science.gov (United States)

    Uchino, Akira; Ito, Sayaka; Kurita, Hiroki; Tanaka, Masahiko

    2016-04-01

    We report a case of duplicated right middle cerebral artery that arose from the origin of the right hyperplastic anterior choroidal artery diagnosed by magnetic resonance angiography. To our knowledge, this is the first case of such a variation reported with magnetic resonance angiographic images. The internal carotid artery-hyperplastic anterior choroidal artery-duplicated middle cerebral artery junction was dilated and mimicking aneurysm. Partial maximum intensity projection images and volume-rendering images showed that it was not a saccular aneurysm but an infundibular dilatation. Careful observation of magnetic resonance angiographic images including its source images is important for detecting rare arterial variations. To identify an anomalous artery on magnetic resonance angiography, creation of partial maximum intensity projection images and volume-rendering images is valuable. PMID:26915899

  2. Coronary endarterectomy in left anterior descending artery combined with coronary artery bypass grafting – midterm mortality and morbidity

    Science.gov (United States)

    Domaradzki, Wojciech; Krauze, Jolanta; Kinasz, Leszek; Jankowska-Sanetra, Justyna; Świątkiewicz, Małgorzata; Paradowski, Krzysztof; Cisowski, Marek

    2015-01-01

    Introduction Completeness of myocardial revascularization is essential in surgical treatment of coronary artery disease. The aim of this study is to determine the effectiveness of coronary endarterectomy as an adjunct to coronary artery bypass grafting (CABG) in the most difficult cases. Material and methods Among 1559 patients who had CABG in our department, the cases of 17 who underwent an adjunct left anterior descending endarterectomy were analyzed. All procedures were performed with median sternotomy, extracorporeal circulation and in mild hypothermia (34°C), by the same surgeon. No coronary artery endarterectomy was planned before surgery. Results There was no infarction or cardiac arrest during hospitalization. Only one patient required mechanical circulatory support (intra-aortic balloon counterpulsation). Each patient was contacted and investigation for major adverse cardiac and cerebrovascular events (MACCE) was performed. Eleven patients (65%) already underwent midterm clinical evaluation. There was no death, myocardial infarction or cerebrovascular incident during the entire period (mean follow-up at 15.3 months). One patient required urgent coronarography due to chest pain. No other patient had chest pain or significant deterioration of ventricular function in echocardiography. Conclusions Outcomes and potential indications for performing left anterior descending coronary endarterectomy as an adjunct to CABG are discussed. PMID:26855644

  3. Transcatheter Embolization of a Coronary Fistula Originating from the Left Anterior Descending Artery by Using N-Butyl 2-Cyanoacrylate

    International Nuclear Information System (INIS)

    In this report, we describe a successful percutaneous transcatheter n-butyl 2-cyanoacrylate embolization of a coronary fistula originating from the left anterior descending artery in an adolescent with unexpected recurrent attacks of myocardial ischemia

  4. Graft Flow Unaffected by Full Occlusion of Left Anterior Descending Artery during Coronary Artery Bypass Grafting in a Porcine Model

    DEFF Research Database (Denmark)

    Torstensson, Gustav Nils Johannes; Torp, Thomas Lee; Rasuli-Oskuii, Nader;

    2013-01-01

    Background: We investigated in a porcine model whether measuring both the flow distal to an anastomosis and the graft transit time flow (TTF) gives a more accurate picture of the true blood flow in the left anterior descending artery (LAD) than graft TTF measurement alone.Methods: We performed off-pump...... anastomosis, despite a fully occluded LAD. This result suggests that graft TTF measurement alone is not sufficient when performing CABG, and measurement of flow distal to the anastomosis is also necessary to determine the true blood flow in the LAD....

  5. Spontaneous Anterior Cerebral Artery Dissection Presenting with Simultaneous Subarachnoid Hemorrhage and Cerebral Infarction in a Patient with Multiple Extracranial Arterial Dissections

    OpenAIRE

    Park, Yung Ki; Yi, Hyeong-Joong; Lee, Young Jun; Kim, Young-Seo

    2013-01-01

    Simultaneous subarachnoid hemorrhage and infarction is a quite rare presentation in a patient with a spontaneous dissecting aneurysm of the anterior cerebral artery. Identifying relevant radiographic features and serial angiographic surveillance as well as mode of clinical manifestation, either hemorrhage or infarction, could sufficiently determine appropriate treatment. Enlargement of ruptured aneurysm and progressing arterial stenosis around the aneurysm indicates impending risk of subseque...

  6. Selective treatment of an anterior spinal artery aneurysm with endosaccular coil therapy. Case report.

    Science.gov (United States)

    Lavoie, Pascale; Raymond, Jean; Roy, Daniel; Guilbert, François; Weill, Alain

    2007-05-01

    The authors report the case of a 12-year-old boy with spinal cord arteriovenous malformation (AVM) and an associated anterior spinal artery (ASA) aneurysm treated with selective coil placement in the context of subarachnoid hemorrhage (SAH). The patient presented with headache. Head computed tomography scanning revealed no abnormal findings. The cerebrospinal fluid was sampled and analyzed and a diagnosis of SAH was established. Investigation, including magnetic resonance imaging of the cord as well as cerebral and spinal angiography, revealed a conus medullaris AVM and a saccular aneurysm located on the ASA at the T-11 level. The aneurysm was thought to be responsible for the bleeding. Superselective ASA angiography showed that the aneurysm was at the bifurcation between a large coronal artery supplying the AVM and the ASA. The relation of the aneurysm's neck to the main spinal axis and the aneurysm's morphological features indicated that the lesion was suited for endosaccular coil therapy. The aneurysm was selectively occluded, using electrodetachable bare platinum coils. Follow-up angiography immediately after surgery and at 6 months thereafter demonstrated complete occlusion of the aneurysm and a perfectly patent anterior spinal axis. On clinical follow-up examination, the patient remained neurologically intact. When the morphological features of a spinal aneurysm and its relation with the anterior spinal axis are favorable, selective endosaccular coil placement can successfully be achieved. PMID:17542515

  7. Arteriovenous fistulas of the anterior spinal artery mimicking other types of vascular malformations of the spinal cord

    International Nuclear Information System (INIS)

    Extramedullary direct arteriovenous (AV) fistulas of the anterior spinal artery are a rare type of vascular malformation of the spinal cord. This paper compares the angiographic appearance and flow dynamics of four atypical direct AV fistulas with the findings in 21 with a more classic appearance (I-III). Three of the direct AV fistulas had an angiographic appearance mimicking an intramedullary AV malformation, and one mimicked a dural AV fistula with medullar venous drainage. These four cases demonstrated direct AV fistulas of the anterior spinal artery whose tortuous arterial or venous collaterals observed the true nature of the single fistular type of lesion

  8. Multiple Coronary–Cameral Fistulae in the Left Anterior Descending Coronary Artery Causing Angina Pectoris: A Clinical Case and the State of the Art

    Directory of Open Access Journals (Sweden)

    Musuraca G

    2014-02-01

    Full Text Available CLINICAL CASE A 82-year-old man with hypercholesterolemia, hypertension and glucidic intolerance, presented with angina pectoris upon exertion. The vital signs were normal. Echocardiography showed normal left ventricular (LV ejection fraction, non-critical aortic valvular stenosis and LV diastolic dysfunction. Rest and stress myocardial echocardiography showed a reversible abnormal septal-wall motion. Therefore, an initial diagnosis of possible coronary artery disease was made. Coronary arteriography showed no atherosclerotic lesions in the 3 major coronary arteries; however, in the anterior descending artery a communication with the right ventricle (RV cavity through ve small, di use stulae was detected (Figure 1 and 2, resulting in complete RV contrast opaci cation. The patient was stabilised on medical therapy because he refused any further invasive therapy.

  9. A bypass case due to an acute inferior myocardial infarction caused by vascular occlusion of the left subclavian artery and left anterior descending artery

    Directory of Open Access Journals (Sweden)

    Altas Y

    2016-07-01

    Full Text Available Yakup Altas, Ali Veysel Ulugg Department of Cardiology, Diyarbakir Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey Abstract: ST segment elevation is the most common electrocardiographic finding in acute myocardial infarction. ST elevation in chest leads generally represents left anterior descending artery occlusion, while elevation in DII and III, and aVF represents right coronary and circumflex artery occlusion. A female patient aged 66 years was admitted to our emergency service with ST elevation in leads DIII and aVF. A diagnosis of acute inferior myocardial infarction was made. The patient’s history included coronary artery bypass graft involving the left internal mammary artery to the left anterior descending coronary artery and aorta to the right coronary artery. The patient was taken to the cardiac catheterization laboratory for primary percutaneous coronary intervention and a lesion in the left anterior descending artery was identified. Additionally, the left subclavian artery was totally occluded. Following intervention to the lesion, the patient was discharged on day 4 of admission. Keywords: electrocardiography, myocardial infarction, coronary circulation

  10. Avaliação da artéria etmoidal anterior pela tomografia computadorizada no plano coronal Anterior ethmoidal artery evaluation on coronal CT scans

    Directory of Open Access Journals (Sweden)

    Soraia Ale Souza

    2009-02-01

    Full Text Available O conhecimento da localização da artéria etmoidal anterior (AEA constitui etapa importante na cirurgia do recesso do seio frontal e do etmóide anterior. A tomografia computadorizada (TC, em especial no plano coronal pode fornecer reparos anatômicos que identificam o trajeto da AEA. OBJETIVO: Identificar os reparos anatômicos que caracterizam o trajeto da AEA na parede medial da órbita e na parede lateral da fossa olfatória. Verificar a correlação entre a presença de pneumatização supra-orbitária e a visualização do etmoidal anterior (canal da AEA. CASUÍSTICA E MÉTODOS: Estudo retrospectivo de 198 tomografias computadorizadas dos seios paranasais no plano coronal do período de agosto a dezembro de 2006. RESULTADOS: Pneumatização supra-orbitária foi identificada em 35% (70 exames. O canal da AEA foi caracterizado em 41% (81 exames. O sulco etmoidal anterior foi visualizado em 98% (194 dos exames e o forame etmoidal anterior foi identificado em todos os exames (100%. CONCLUSÃO: O forame etmoidal anterior e o sulco etmoidal anterior foram referências anatômicas presentes em quase 100% dos exames avaliados. Houve correlação entre a presença de pneumatização supra-orbitária e a caracterização do canal da AEA.The anterior ethmoidal artery (AEA is an important point for frontal and ethmoid sinuses surgery. CT scans can identify landmarks to help the surgeon find the AEA. AIM: To identify the landmarks of the AEA on the orbital medial wall and on the lateral wall of the olfactory fossa. and to correlate the presence of supraorbital ethmoidal cells with spotting the anterior ethmoidal artery canal. MATERIALS AND METHODS: Retrospective review of 198 direct coronal paranasal sinuses computed tomography (CT scans from August to December, 2006. RESULTS: Supraorbital pneumatization was seen in 35% (70 scans. The AEA canal was seen in 41% (81 scans. The anterior ethmoidal sulcus was seen in 98% (194 scans and the anterior

  11. Pseudo-aneurysm of anterior tibia artery simulating a soft tissue sarcoma: a case report.

    Directory of Open Access Journals (Sweden)

    Darioush M Barzi

    2014-03-01

    Full Text Available A pseudo aneurysm results from leakage of blood from an artery after trauma or dehiscence or separation of a surgical anastomosis. The reported rate of pseudo aneurysm in access sites range from 0.88% to 8%. It has some cause like penetrating trauma, blunt trauma and endovascular procedure. The differential diagnoses of this lesion are hematoma, AV fistula, lymphadenopathy, lymphocele, DVT, compartment syndrome, soft tissue tumor. A 16 years old male was referred to our clinic with progressive swelling in his right leg for the past three month. In primary survey (MRI, CT, Bone Scan patient was diagnosed with soft tissue tumor, but after biopsy and angiography he was diagnosed with pseudo aneurysm of anterior tibialis artery. Despite easy diagnosis of p aneurysm in most cases, the signs and symptoms are more likely to soft tissue mass in rare cases. So pseudo aneurysm should always be considered as one differential diagnosis for soft tissue tumors.

  12. Pseudo-aneurysm of anterior tibia artery simulating a soft tissue sarcoma: a case report.

    Science.gov (United States)

    Barzi, Darioush M; Sami, Sam H; Fallah, Ehsan

    2014-01-01

    A pseudo aneurysm results from leakage of blood from an artery after trauma or dehiscence or separation of a surgical anastomosis. The reported rate of pseudo aneurysm in access sites range from 0.88% to 8%. It has some cause like penetrating trauma, blunt trauma and endovascular procedure. The differential diagnoses of this lesion are hematoma, AV fistula, lymphadenopathy, lymphocele, DVT, compartment syndrome, soft tissue tumor. A 16 years old male was referred to our clinic with progressive swelling in his right leg for the past three month. In primary survey (MRI, CT, Bone Scan) patient was diagnosed with soft tissue tumor, but after biopsy and angiography he was diagnosed with pseudo aneurysm of anterior tibialis artery. Despite easy diagnosis of p aneurysm in most cases, the signs and symptoms are more likely to soft tissue mass in rare cases. So pseudo aneurysm should always be considered as one differential diagnosis for soft tissue tumors. PMID:24901729

  13. Dissecting Aneurysms of Bilateral Anterior Cerebral Artery Complicated by Subarachnoid Hemorrhage After Cerebral Infarction: A Case Report

    Directory of Open Access Journals (Sweden)

    Akihiro Kurosu

    2008-01-01

    Full Text Available Introduction: Intracranial dissecting aneurysms have been increased due to recent advancements in diagnostic imaging. However there have been little article with subarachnoid hemorrhage and cerebral infarction occurring almost at the same time. We performed the surgical treatment and obtained good result.Case presentation: A 47-year-old male presented to our hospital with chief complaints of sudden headache and mild paralysis of the left lower extremity. Brain imaging at admission revealed cerebral infarction in the right frontal lobe and subarachnoid hemorrhage in the frontal convexy and anterior interhemispheric fissure. The left and right internal carotid angiography showed a bulging cerebral aneurysm at the left A1–A2 junction and stenosis and arterial dissections in the peripheral of the bilateral anterior cerebral artery. Wrapping was performed for the dissecting aneurysm of the left anterior cerebral artery. For the right anterior cerebral artery, trapping was performed at the A2 segment without vascular anastomosis. The patient’s postoperative course was uneventful.Conclusion: A consensus has not been reached on the treatment for intracranial dissecting aneurysms. Proximal trapping without vascular reconstruction was performed for the right anterior cerebral artery without vascular anastomosis to prevent rebleeding. However no symptoms of neurological deficiency were observed. Proximal trapping of dissecting aneurysm seems to be a good option when patient’s functional and life prognosis are taken into account in case that vascular reconstruction will be anticipated difficulty.

  14. [Ruptured distal anterior cerebral artery aneurysm and diagnostic dyspraxia: a case report].

    Science.gov (United States)

    Wada, M; Kajikawa, H; Fujii, S; Yamamura, K; Kajikawa, M

    1995-04-01

    A case of ruptured distal anterior cerebral artery aneurysm presenting with diagnostic dyspraxia is presented. A 54-year-old female was referred to our hospital with the complaint of sudden onset of headache followed by disturbance of consciousness. CT and MRI revealed subarachnoid hemorrhage with hematomas in the interhemispheric fissure and the supracallosal area, and CAG revealed a left-sided callosomarginal artery aneurysm. During and after hospitalization, she showed diagnostic dyspraxia characterized by behavior of both her hands opposite to what might be expected e.g. when she tried to pick up a bowl, both her hands moved forward and held it at once; she wiped her head and face with toilet paper after urination. At times her hands behaved in opposite ways. For example, while folding cloths, her right hand tended to fold them while the left hand tended to unfold them; when she put on a sweater, as the right hand put it on, the left hand took it off; when she put her shirt into her trousers, one hand pushed it in while the other hand pulled it out. This unusual behavior was considered to be caused by the impairment of the corpus callosum due to compression by the hematoma. It disappeared gradually over a period of one year. Involuntary motor behavior of the left hand while the right hand is in voluntary action is known as diagnostic dyspraxia. Although this symptom has rarely been reported so far in cases of ruptured distal anterior cerebral artery, it may become noticed more frequently through careful observation. PMID:7739777

  15. [Medullary venous malformation with azygos anterior cerebral artery aneurysm: a case report].

    Science.gov (United States)

    Harada, K; Kobayashi, S; Sigemori, M; Watanabe, M; Kuramoto, S

    1987-03-01

    A case of medullary venous malformation with azygos anterior cerebral artery aneurysm is reported, which was associated with the leptomenigeal angiomatosis on the cortex of the right frontal lobe. A 62-year-old female was admitted to the Kurume University Hospital on June 21, 1985, because of a convulsive seizure. On admission, neurological and general examinations, except for slightly liver function disorder, was no abnormality. Plain CT scan showed the cortical atrophy and two small high-density areas in the right frontal lobe. Enhanced CT scan showed a high-density area in the genu of the corpus callosum. MRI (magnetic resonance imaging), on T2 weighted image, showed a high signal intensity area in the right paraventricular deep white matter and the right frontal region. A right internal carotid angiogram in the venous phase showed numerous enlarged medullary veins in the deep frontal region, converging into a single large draining vein that empties into the basal vein of Rosenthal. An azygos anterior cerebral artery was visualized on the right and left carotid angiograms. The aneurysm was situated at the distal end of the azygos artery. Twenty eight days after admission, a right frontal cranioplastic craniotomy was performed. During operation, the surface of the right frontal lobe was covered by fine, vascular networks, which was reddish brown. A right frontal lobectomy, including venous malformation and vascular networks, was performed. The aneurysm was clipped via an interhemispheric approach. Histologically, the malformation vessels had spread into the subarachnoid space.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3600991

  16. Brief communication: The distribution of perikymata on Qafzeh anterior teeth.

    Science.gov (United States)

    Guatelli-Steinberg, Debbie; Reid, Donald J

    2010-01-01

    Recent studies have suggested that Neandertals and modern humans differ in the distribution of perikymata (enamel growth increments) over their permanent anterior tooth crowns. In modern humans, perikymata become increasingly more compact toward the cervix than they do in Neandertals. Previous studies have suggested that a more homogeneous distribution of perikymata, like that of Neandertals, characterizes the anterior teeth of Homo heidelbergensis and Homo erectus as well. Here, we investigated whether Qafzeh anterior teeth (N = 14) differ from those of modern southern Africans, northern Europeans, and Alaskans (N = 47-74 depending on tooth type) in the percentage of perikymata present in their cervical halves. Using the normally distributed modern human values for each tooth type, we calculated Z-scores for the 14 Qafzeh teeth. All but two of the 14 Qafzeh teeth had negative Z-scores, meaning that values equal to these would be found in the bottom 50% of the modern human samples. Seven of the 14 would be found in the lowest 5% of the modern human distribution. Qafzeh teeth therefore appear to differ from those of modern humans in the same direction that Neandertals do: with generally lower percentages of perikymata in their cervical regions. The similarity between them appears to represent the retention of a perikymata distribution pattern present in earlier members of the genus Homo, but not generally characteristic of modern humans from diverse regions of the world. PMID:19902531

  17. Far-lateral transcondylar approach for microsurgical trapping of an anterior inferior cerebellar artery aneurysm.

    Science.gov (United States)

    Caplan, Justin M; Jusue-Torres, Ignacio; Kim, Jennifer E; Luksik, Andrew; Liauw, Jason; Gottschalk, Allan; Tamargo, Rafael J

    2015-07-01

    Aneurysms of the posterior circulation remain challenging lesions given their proximity to the brainstem and cranial nerves. Many of these aneurysms may best be approached through a retrosigmoid-suboccipital craniectomy with a far-lateral transcondylar extension. In this narrated video illustration, we present the case of a 37-year-old man with an incidentally discovered right-sided anterior inferior cerebellar artery (AICA) aneurysm. Diagnostic studies included CT angiography and cerebral angiography. A suboccipital craniectomy and far-lateral transcondylar extension were performed for microsurgical trapping and excision of the AICA aneurysm. The techniques of the retrosigmoid craniectomy, C-1 laminectomy, condylectomy and microsurgical trapping of the aneurysm are reviewed. The video can be found here: http://youtu.be/JiM3CXVwXnk. PMID:26132623

  18. Inter-observer variation in delineation of the heart and left anterior descending coronary artery in radiotherapy for breast cancer

    DEFF Research Database (Denmark)

    Lorenzen, Ebbe L.; Taylor, Carolyn W.; Maraldo, Maja;

    2013-01-01

    BACKGROUND AND PURPOSE: To determine the extent of inter-observer variation in delineation of the heart and left anterior descending coronary artery (LADCA) and its impact on estimated doses. METHODS AND MATERIALS: Nine observers from five centres delineated the heart and LADCA on fifteen patient...

  19. Left anterior descending coronary artery myocardial bridging by multislice computed tomography: Correlation with clinical findings

    International Nuclear Information System (INIS)

    Objective: To assess the relationship between left anterior descending (LAD) coronary artery myocardial bridging detected by 64-slice computed tomography (CT) and clinical findings. Methods: 221 consecutive patients were examined with coronary 64-slice CT angiography. 21 patients with coronary stenosis >50% were excluded. The length, depth, and luminal narrowing of LAD myocardial bridges during systole and diastole were measured. CT findings were compared with the treadmill ECG-stress test, and clinical symptoms. Results: Myocardial bridges of the LAD were found in 23% of patients (51/221) (length, 14.9 ± 6.5 mm; depth, 2.6 ± 1.6 mm). A significant difference was noted between the LAD luminal diameter before the intramyocardial course and intramyocardially, for both diastole and systole (p 50% was found in 3/25 (8%). 30/51 (59%) of bridges were 'deep' (>2 mm myocardial depth), 21/51 (41%) were 'superficial'. The prevalence of a positive ECG-stress tests for the anterior myocardial region was significantly higher in patients with LAD myocardial bridges (34/50; 68%) compared to those without (28/144; 19.4%) (p < 0.001). There was no difference between 'superficial' and 'deep' LAD myocardial bridges in regard to a positive treadmill ECG-stress test. Typical angina was rare with 6%. Conclusion: LAD myocardial bridges are common findings and can possibly explain a positive exercise ECG-stress test for anterior myocardial ischemia. Intramyocardial LAD segments show mild-to-moderate luminal narrowing at rest, which is higher during end-systolic phase.

  20. Left anterior descending coronary artery myocardial bridging by multislice computed tomography: Correlation with clinical findings

    Energy Technology Data Exchange (ETDEWEB)

    Jodocy, Daniel; Aglan, Iman [Clinical Department of Radiology II, Innsbruck Medical University, Innsbruck (Austria); Friedrich, Guy [Clinical Department of Cardiology, Innsbruck Medical University, Innsbruck (Austria); Mallouhi, Ammar [Clinical Department of Radiology II, Innsbruck Medical University, Innsbruck (Austria); Pachinger, Otmar [Clinical Department of Radiology II, Innsbruck Medical University, Innsbruck (Austria); Clinical Department of Cardiology, Innsbruck Medical University, Innsbruck (Austria); Jaschke, Werner [Clinical Department of Radiology II, Innsbruck Medical University, Innsbruck (Austria); Feuchtner, Gudrun M. [Clinical Department of Radiology II, Innsbruck Medical University, Innsbruck (Austria)], E-mail: gudrun.feuchtner@i-med.ac.at

    2010-01-15

    Objective: To assess the relationship between left anterior descending (LAD) coronary artery myocardial bridging detected by 64-slice computed tomography (CT) and clinical findings. Methods: 221 consecutive patients were examined with coronary 64-slice CT angiography. 21 patients with coronary stenosis >50% were excluded. The length, depth, and luminal narrowing of LAD myocardial bridges during systole and diastole were measured. CT findings were compared with the treadmill ECG-stress test, and clinical symptoms. Results: Myocardial bridges of the LAD were found in 23% of patients (51/221) (length, 14.9 {+-} 6.5 mm; depth, 2.6 {+-} 1.6 mm). A significant difference was noted between the LAD luminal diameter before the intramyocardial course and intramyocardially, for both diastole and systole (p < 0.001); with a higher diameter reduction of 27% for end-systole compared to end-diastole with 15% (p = 0.006). Systolic LAD intramyocardial luminal narrowing >50% was found in 3/25 (8%). 30/51 (59%) of bridges were 'deep' (>2 mm myocardial depth), 21/51 (41%) were 'superficial'. The prevalence of a positive ECG-stress tests for the anterior myocardial region was significantly higher in patients with LAD myocardial bridges (34/50; 68%) compared to those without (28/144; 19.4%) (p < 0.001). There was no difference between 'superficial' and 'deep' LAD myocardial bridges in regard to a positive treadmill ECG-stress test. Typical angina was rare with 6%. Conclusion: LAD myocardial bridges are common findings and can possibly explain a positive exercise ECG-stress test for anterior myocardial ischemia. Intramyocardial LAD segments show mild-to-moderate luminal narrowing at rest, which is higher during end-systolic phase.

  1. Coil embolization in precommunicating (A1) segment aneurysms of anterior cerebral artery

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Young Dae; Ahn, Jun Hyong; Jung, Seung Chai; Kim, Chang Hun [Seoul National University Hospital, Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Kang, Hyun-Seung; Kim, Jeong Eun [Seoul National University Hospital, Seoul National University College of Medicine, Department of Neurosurgery, 28 Yongon-dong, Jongno-gu, Seoul (Korea, Republic of); Son, Young Je [Seoul National University Boramae Hospital, Seoul National University College of Medicine, Department of Neurosurgery, Seoul (Korea, Republic of); Han, Moon Hee [Seoul National University Hospital, Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Hospital, Seoul National University College of Medicine, Department of Neurosurgery, 28 Yongon-dong, Jongno-gu, Seoul (Korea, Republic of)

    2014-03-15

    Precommunicating (A1) segment aneurysms of the anterior cerebral artery are rare and often pose technical challenges for coil embolization due to their distinctive configurations. Clinical and radiologic outcomes of treating such aneurysms through endovascular coil embolization are presented herein. Data accruing prospectively from May 2002 to August 2013 yielded 48 patients harboring 50 A1 segment aneurysms, each classified as proximal, middle, or distal by location. Clinical outcome of the patients and morphological outcome of the aneurysms were assessed, with emphasis on technical aspects of treatment. The aneurysms studied occupied either proximal (n = 39), middle (n = 6), or distal (n = 5). Proximal aneurysms were largely directed posteriorly (80 %), and most (97 %) were devoid of branches. Middle and distal aneurysms were associated with the medial lenticulostriate artery, cortical branches, or fenestrations. The preshaped ''S'' and steam-shaped ''S'' microcatheters facilitated aneurysm selection in 60 % of lesions. Single-microcatheter technique was most commonly applied for coil embolization (62 %), followed by balloon protection (16 %). Successful aneurysmal occlusion could be achieved in 76 % of the patients, with no procedure-related morbidity and mortality. At final follow-up (mean interval, 29.9 months), stable aneurysmal occlusion was sustained in 93 % of the patients (40/43). A1 segment aneurysms are amenable to safe and efficacious endovascular coil embolization by adjusting procedural strategy to accommodate distinctive anatomic configurations. (orig.)

  2. Anomalous Origin of the Right Coronary Artery from the Left Anterior Descending Coronary Artery in a Patient with Ascending Aortic Aneurysm

    Directory of Open Access Journals (Sweden)

    Ufuk Gürkan

    2012-04-01

    Full Text Available The incidence of coronary artery anomalies has been reported between 0.6 to 1.3% in angiographic series and 0.3% in autopsy series. An isolated single coronary artery (SCA is even a rarer congenital anomaly occurring in approximately 0.02% of the population. The ectopic origin of the right coronary artery (RCA from the left anterior descending (LAD artery is relatively rare and more benign than other types of anomalous origin of the RCAs. We report a case of an adult male patient with SCA anomaly in which the RCA takes off from the mid LAD. To the best of our knowledge, SCA anomaly coinciding with ascending aortic aneurysm which was treated with Bentall operation has never been described before.

  3. Evaluation of false-positive results on Tc myocardial scintigraphy in patients with coronary artery bypass grafting including left internal thoracic artery-left anterior descending artery grafting

    International Nuclear Information System (INIS)

    Stress myocardial scintigraphy in patients who have undergone coronary artery bypass grafting (CABG) frequently shows false-positive results. To investigate the reason for these false-positive results, two different stress tests-adenosine triphosphate (ATP) stress testing and ergometer exercise testing, and Tc-tetrofosmin myocardial scintigraphy were performed with a 1-day stress/rest protocol. The subjects were 6 patients with a history of myocardial infarction (MI) and 14 patients with a history of angina pectoris (AP) who had undergone CABG that included left internal thoracic artery-left anterior descending artery grafting. Graft patency was confirmed with coronary angiography. Short-axis images were reconstructed with single photon emission tomography. The severity of perfusion defects on short-axis images was evaluated quantitatively with a normal database as severity score, and the difference in severity score between stress and rest was defined as fill-in. Fill-in on the ATP stress test was 3.1±7.0 in the AP group and 16.3±13.2 in the MI group (p<0.01). Fill-in on the exercise stress test was 2.7±8.3 in the AP group and 34.8±20.6 in the MI group (p<0.01). In the MI group, fill-in on the exercise stress test was significantly greater than that on the ATP stress test (p<0.05). The exercise time and the amount of exercise stress in patients with MI were significantly greater than those in patients with AP. In conclusion, coronary flow reserve may play a role in false positive-finding on myocardial perfusion scintigraphy in patients who have undergone CABG. (author)

  4. Detection of prominent left anterior descending coronary artery stenosis for patients with stable angina using Doppler tissue echocardiography.

    Science.gov (United States)

    Veyrat, Colette; Larrazet, Fabrice; Cohen, Laurent; Laborde, François; Pellerin, Denis

    2005-08-01

    The midseptum has an elective left anterior descending coronary artery (LAD) supply. Septal peak velocity (PkV) and myocardial velocity gradient (MVG) were studied at rest with M-mode Doppler tissue echocardiography during the cardiac cycle including the septal active relaxation (SAR) outward wall motion preceding isovolumic relaxation. In all, 33 patients had significant multivessel coronary artery disease. Group A (15 patients) had prominent LAD stenosis. Group B (18 patients) had prominent circumflex (15) or right (3) coronary artery stenoses. The goal was to detect a prominent LAD stenosis. During SAR, sensitivity to detect a prominent LAD stenosis was 86% for PkV PkV PkV and 0.80 for MVG during systole. In multivessel coronary artery disease, SAR variables better identified a prominent LAD stenosis than systolic variables. Moreover, SAR PkVs were informative per se, whereas systole required MVG calculation. PMID:16084334

  5. [An infected partially thrombosed giant aneurysm of the azygos anterior cerebral artery].

    Science.gov (United States)

    Mishima, K; Watanabe, T; Sasaki, T; Saito, I; Takakura, K

    1990-05-01

    The authors report a case of partially thrombosed giant aneurysm which was secondarily infected with purulent meningitis. The relationship between the infection of the aneurysm, the rapid growth of the aneurysm and the development of severe cerebral edema was discussed. A 53 year-old man was admitted on September 1, 1986, with a diagnosis of bacterial meningitis. On his admission, his body temperature was 39 degrees C, and he showed mental confusion but no neurological deficits. Laboratory data revealed signs of infection in white blood cell count, CRP, and erythrocyte sedimentation rate. Computerized tomographic (CT) scan and magnetic resonance (MR) imaging showed a massive round mass with perifocal edema measuring 40mm in the maximum diameter in the left paramedian frontal region. T1 weighted MR image also showed the presence of pus accumulation in the left ventricle. Cerebral angiography demonstrated a giant aneurysm at the distal portion of the azygos anterior cerebral artery, and irregular narrowing of both the supraclinoid segment of the carotid artery and its main branches indicating arteritis due to purulent meningitis. The patient was treated with ventricular drainage and administration of antibiotics. Culture of the purulent CSF was negative. The patient's lab data, CSF finding and neurological status improved progressively. However, follow-up CT scan and angiogram a month later showed enlargement of the aneurysm, dilatation of the patent lumen and perifocal edema. On October 8, the patient suddenly became comatose with anisocoria. A CT scan showed massive edema with marked midline shift. Emergency bifrontal craniotomy was carried out, and clipping was completed after removal of the thrombosed portion of the aneurysm, and thromboendarterectomy of the aneurysmal neck.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2385324

  6. Thrombosis of Left Common Iliac Artery Following Anterior Lumbar Interbody Fusion: Case Report and Review of Literatures

    OpenAIRE

    Kim, Jin-Sung; CHOI, KYUNG-CHUL; Jung, Byungjoo; Lee, Sang-Ho

    2009-01-01

    We report on a case of thrombosis of the left common iliac artery following anterior lumbar interbody fusion (ALIF) of L4-5 in a 79-year-old man with no previous medical problems, including peripheral vascular disease. After completing the ALIF procedure, the surgeon could not feel the pulsation of the left dorsalis pedis artery, and the oxygen saturation (SaO2) had fallen below 90% from pulse oxymetry on the left great toe. Thrombectomy was successfully performed after confirming the thrombu...

  7. Systemic thrombolysis in anterior spinal artery syndrome: what has to be considered?

    Science.gov (United States)

    Koch, Mia; Sepp, Dominik; Prothmann, Sascha; Poppert, Holger; Seifert, Christian L

    2016-04-01

    Anterior spinal artery syndrome (ASAS) often leads to complete motor paralysis with poor clinical outcome. There is a lack of controlled clinical trials on acute treatment strategies in ASAS. However, systemic thrombolysis with recombinant tissue-plasminogen activator (rt-PA) might be a useful therapeutic option in ASAS. We report the management of a patient with ASAS below thoracic level 10, who was treated with intravenous thrombolysis. An 81 year old patient presented with flaccid paraplegia. After exclusion of aortal dissection, spinal tumour or haemorrhage, the patient was treated with intravenous rt-PA 3 h 40 min after symptom onset. The follow up magnetic resonance imaging (MRI) showed spinal infarction below thoracic segment 10. In the clinical course, the patient partially recovered lower limb muscle strength and was able to walk with assistance. To the best of our knowledge, this is the first case in the literature of ASAS with MRI-proven spinal ischemia and the application of rt-PA. Systemic thrombolysis seems to be justifiable in patients with ASAS after the rule-out of aortal dissection and spinal bleeding. PMID:26386968

  8. Therapeutic comparison of uterine artery chemoembolization with internal iliac anterior trunk arterial chemotherapy performed before radical hysterectomy in patients with stages I b2-II a cervical cancer

    International Nuclear Information System (INIS)

    Objective: To compare the short-term and long-term therapeutic response of uterine artery chemoembolization with internal iliac anterior trunk arterial chemotherapy performed before radical hysterectomy in patients with stages I b2-II a cervical cancer. Methods: One hundred and fifty-one patients with stages I b2-II a cervical cancer were treated with preoperative intra-arterial chemotherapy before radical hysterectomy was carried out. Patients in study group (n = 113) received uterine artery chemoembolization (UACE), while patients control group(n = 38) received internal iliac anterior trunk arterial chemotherapy. Radical hysterectomy was carried out in all patients within 2-4 weeks after UACE or chemotherapy. The tumor size was measured before and after the procedure,and the survival rate at 2 and 5 years after treatment was calculated. Results: The mean maximum diameter of the tumors was (4.58 ± 0.37) cm before interventional therapy, and it was (2.11 ± 0.24) cm in two weeks after interventional therapy. The complete response rate of study group and control group was 31.9% and 21.1% respectively. The total effective rate of study group and control group was 94.7% (107/113) and 76.3% (29/38) respectively. The effective rate of study group two weeks after therapy was significantly higher than that of control group. No surgical margin infiltration was observed in both groups. Pathological findings in study group included vascular invasion around surgical margin (n = 3), parametrial invasion (n = 5) and pelvic lymph node metastasis (n = 6), while in control group vascular invasion around surgical margin, parametrial invasion and pelvic lymph node metastasis were found in one, two and one cases respectively. The two-year and five-year survival rate in study group were 80.9% (68/84) and 73.4% (47/64) respectively, while the two-year and five-year survival rate in control group were 81.3% (26/32) and 75.0% (18/24) respectively. No significant difference in survival

  9. Pseudoaneurysm of the deep circumflex iliac artery: a rare complication at an anterior iliac bone graft donor site treated by coil embolization.

    Science.gov (United States)

    Chou, Andy Shau-Bin; Hung, Chein-Fu; Tseng, Jeng-Hwei; Pan, Kuang-Tse; Yen, Pao-Sheng

    2002-07-01

    Pseudoaneurysm formation of the deep circumflex iliac artery (DCIA) after harvesting an anterior iliac bone graft for spinal fusion is reported herein. A 76-year-old man with cervical myelopathy underwent anterior cervical decompression and fusion with a left anterior iliac bone graft. A painful left inguinal mass was noted 1 month later. He was admitted to our emergency ward. Angiography of the left external iliac artery was performed which showed a pseudoaneurysm of the DCIA. Selective transarterial coil embolization of the artery was performed, and bleeding was arrested. In a review of the previous literature, only 1 pseudoaneurysm of the DCIA was reported to be associated with anterior iliac bone graft. In conclusion, vascular injury after anterior iliac bone harvesting is rare but can occur. Selective transarterial coil embolization is a prompt and effective solution. PMID:12350036

  10. Acute Ischemic Stroke Involving Both Anterior and Posterior Circulation Treated by Endovascular Revascularization for Acute Basilar Artery Occlusion via Persistent Primitive Trigeminal Artery

    Science.gov (United States)

    Fujita, Atsushi; Hosoda, Kohkichi; Kohmura, Eiji

    2016-01-01

    We report a case of acute ischemic stroke involving both the anterior and posterior circulation associated with a persistent primitive trigeminal artery (PPTA), treated by endovascular revascularization for acute basilar artery (BA) occlusion via the PPTA. An otherwise healthy 67-year-old man experienced sudden loss of consciousness and quadriplegia. Magnetic resonance imaging showed an extensive acute infarction in the right cerebral hemisphere, and magnetic resonance angiography showed occlusion of the right middle cerebral artery (MCA) and BA. Because the volume of infarction in the territory of the right MCA was extensive, we judged the use of intravenous tissue plasminogen activator to be contraindicated. Cerebral angiography revealed hypoplasia of both vertebral arteries and the presence of a PPTA from the right internal carotid artery. A microcatheter was introduced into the BA via the PPTA and revascularization was successfully performed using a Merci Retriever with adjuvant low-dose intraarterial urokinase. After treatment, his consciousness level and right motor weakness improved. Although persistent carotid-vertebrobasilar anastomoses such as a PPTA are relatively rare vascular anomalies, if the persistent primitive artery is present, it can be an access route for mechanical thrombectomy for acute ischemic stroke. PMID:27446523

  11. Acute Ischemic Stroke Involving Both Anterior and Posterior Circulation Treated by Endovascular Revascularization for Acute Basilar Artery Occlusion via Persistent Primitive Trigeminal Artery.

    Science.gov (United States)

    Imahori, Taichiro; Fujita, Atsushi; Hosoda, Kohkichi; Kohmura, Eiji

    2016-07-01

    We report a case of acute ischemic stroke involving both the anterior and posterior circulation associated with a persistent primitive trigeminal artery (PPTA), treated by endovascular revascularization for acute basilar artery (BA) occlusion via the PPTA. An otherwise healthy 67-year-old man experienced sudden loss of consciousness and quadriplegia. Magnetic resonance imaging showed an extensive acute infarction in the right cerebral hemisphere, and magnetic resonance angiography showed occlusion of the right middle cerebral artery (MCA) and BA. Because the volume of infarction in the territory of the right MCA was extensive, we judged the use of intravenous tissue plasminogen activator to be contraindicated. Cerebral angiography revealed hypoplasia of both vertebral arteries and the presence of a PPTA from the right internal carotid artery. A microcatheter was introduced into the BA via the PPTA and revascularization was successfully performed using a Merci Retriever with adjuvant low-dose intraarterial urokinase. After treatment, his consciousness level and right motor weakness improved. Although persistent carotid-vertebrobasilar anastomoses such as a PPTA are relatively rare vascular anomalies, if the persistent primitive artery is present, it can be an access route for mechanical thrombectomy for acute ischemic stroke. PMID:27446523

  12. Pseudoaneurysm of the Deep Circumflex Iliac Artery: A Rare Complication at an Anterior Iliac Bone Graft Donor Site Treated by Coil Embolization

    OpenAIRE

    Andy Shau-Bin Chou; Chein-Fu Hung; Jeng-Hwei Tseng; Kuang-Tse Pan; Pao-Sheng Yen

    2002-01-01

    Pseudoaneurysm formation of the deep circumflex iliac artery (DCIA) after harvestingan anterior iliac bone graft for spinal fusion is reported herein. A 76-year-old man with cervicalmyelopathy underwent anterior cervical decompression and fusion with a left anterioriliac bone graft. A painful left inguinal mass was noted 1 month later. He was admitted toour emergency ward. Angiography of the left external iliac artery was performed whichshowed a pseudoaneurysm of the DCIA. Selective transarte...

  13. Diagnosis of occlusion site in the left anterior descending coronary artery in patients with anterior myocardial infarction. Comparison of thallium-201 myocardial scintigraphy and 12-lead electrocardiography

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Xinchun; Imai, Kamon; Saito, Satoshi; Ozawa, Yukio; Kan-matuse, Katuo [Nihon Univ., Tokyo (Japan). School of Medicine

    1995-03-01

    To evaluate whether the site of occlusion/stenosis in the left anterior descending coronary artery (LAD) could be diagnosed by noninvasive techniques, thallium-201 myocardial scintigraphy (TMS), 12-lead electrocardiography (ECG), and coronary arteriography were performed in 33 patients with anterior acute myocardial infarction (AMI). The subjects were divided into two groups according to the location of stenosis: ie, either proximal to the first diagonal branch (PRO, n=18), or beyond the first diagonal branch (NON-PRO, n=15). The location of the anterior interventricular groove was defined as 0 degrees. The extent of persistent perfusion defect was greater in the PRO group than in the NON-PRO group (0.43{+-}0.12 vs 0.31{+-}0.14, p<0.01). The left margin of the defect in the basal short-axis layer was at 75{+-}30deg in the PRO group and at -19{+-}43deg in the NON-PRO group (p<0.001). A defect with a left margin at >30deg in the basal layer was found in 94% (17/18) of the patients in the PRO group and in 6% (1/15) of the patients in the NON-PRO group (p<0.001). An abnormal Q wave in leads aVL/I was found in 78% (14/18) of the patients in the PRO group and in 20% (3/15) of the patients in the NON-PRO group (p<0.001). The sensitivity, specificity and total predictive accuracy of detection of proximal lesions of the LAD were 94%, 93% and 94% by TMS, and 78%, 80% and 79% by ECG, respectively. A significant difference in accuracy existed between TMS and ECG (p<0.05). These data suggest that it is possible to diagnose the site of occlusion/stenosis of the LAD as either proximal or non-proximal in patients with anterior AMI by TMS and ECG. (author).

  14. A blunt chest trauma causing left anterior descending artery dissection and acute myocardial infarction treated by deferred angioplasty

    Directory of Open Access Journals (Sweden)

    Rafid Fayadh Al-Aqeedi

    2011-01-01

    Full Text Available Traumatic coronary artery dissection is an uncommon cause of acute myocardial infarction (AMI. We report a case of blunt chest trauma resulting from a motorcycle collision causing ostial dissection of the left anterior descending (LAD artery in a 31-year-old previously healthy male. The patient also suffered from compound comminuted fractures of the humerus and ulna and severe liver laceration, which hampered both percutaneous and surgical acute revasularization. After a stormy hospital course, a bare metal stent was implanted to seal the LAD artery dissection. The patient was discharged in a stable condition and was followed-up for rehabilitation. This case report underscores the multidisciplinary approach in facing challenges encountered after rare sequelae of chest trauma.

  15. Aneurysm of the anterior inferior cerebellar artery (AICA) associated with high-flow lesion: report of two cases and review of literature.

    NARCIS (Netherlands)

    Menovsky, T.; Grotenhuis, J.A.; Bartels, R.H.M.A.

    2002-01-01

    OBJECTIVE AND IMPORTANCE: Although aneurysms of the anterior inferior cerebellar artery (AICA) are rare lesions, their occurrence in combination with high-flow lesions in the same arterial territory is even more striking. Two cases of an AICA aneurysm in combination with a high -flow lesion are desc

  16. Simulation of cardiac motion on non-Newtonian, pulsating flow development in the human left anterior descending coronary artery

    Science.gov (United States)

    Theodorakakos, A.; Gavaises, M.; Andriotis, A.; Zifan, A.; Liatsis, P.; Pantos, I.; Efstathopoulos, E. P.; Katritsis, D.

    2008-09-01

    This study aimed at investigating the effect of myocardial motion on pulsating blood flow distribution of the left anterior descending coronary artery in the presence of atheromatous stenosis. The moving 3D arterial tree geometry has been obtained from conventional x-ray angiograms obtained during the heart cycle and includes a number of major branches. The geometry reconstruction model has been validated against projection data from a virtual phantom arterial tree as well as with CT-based reconstruction data for the same patient investigated. Reconstructions have been obtained for a number of temporal points while linear interpolation has been used for all intermediate instances. Blood has been considered as a non-Newtonian fluid. Results have been obtained using the same pulse for the inlet blood flow rate but with fixed arterial tree geometry as well as under steady-state conditions corresponding to the mean flow rate. Predictions indicate that myocardial motion has only a minor effect on flow distribution within the arterial tree relative to the effect of the blood pressure pulse.

  17. Simulation of cardiac motion on non-Newtonian, pulsating flow development in the human left anterior descending coronary artery

    International Nuclear Information System (INIS)

    This study aimed at investigating the effect of myocardial motion on pulsating blood flow distribution of the left anterior descending coronary artery in the presence of atheromatous stenosis. The moving 3D arterial tree geometry has been obtained from conventional x-ray angiograms obtained during the heart cycle and includes a number of major branches. The geometry reconstruction model has been validated against projection data from a virtual phantom arterial tree as well as with CT-based reconstruction data for the same patient investigated. Reconstructions have been obtained for a number of temporal points while linear interpolation has been used for all intermediate instances. Blood has been considered as a non-Newtonian fluid. Results have been obtained using the same pulse for the inlet blood flow rate but with fixed arterial tree geometry as well as under steady-state conditions corresponding to the mean flow rate. Predictions indicate that myocardial motion has only a minor effect on flow distribution within the arterial tree relative to the effect of the blood pressure pulse

  18. Predominant location of coronary artery atherosclerosis in the left anterior descending artery. The impact of septal perforators and the myocardial bridging effect

    Science.gov (United States)

    Wasilewski, Jarosław; Niedziela, Jacek; Osadnik, Tadeusz; Duszańska, Agata; Sraga, Wojciech; Desperak, Piotr; Jackowska, Zuzanna; Nowakowski, Andrzej; Głowacki, Jan

    2015-01-01

    Introduction Coronary artery atherosclerosis presents characteristic patterns of plaque distribution despite systemic exposure to risk factors. We hypothesized that local hemodynamic forces induced by the systolic compression of intramuscular septal perforators could be involved in atherosclerotic processes in the left anterior descending artery (LAD) adjacent to the septal perforators’ origin. Therefore we studied the spatial distribution of atherosclerosis in coronary arteries, especially in relation to the septal perforators’ origin. Material and methods 64-slice computed tomography angiography was performed in 309 consecutive patients (92 male and 217 female) with a mean age of 59.9 years. Spatial plaque distribution in the LAD was analyzed in relation to the septal perforators’ origin. Additionally, plaque distribution throughout the coronary artery tree is discussed. Results The coronary calcium score (CCS) was positive in 164 patients (53.1%). In subjects with a CCS > 0, calcifications were more frequent in the LAD (n = 150, 91.5%) compared with the right coronary artery (RCA) (n = 94, 57.3%), circumflex branch (CX) (n = 76, 46.3%) or the left main stem (n = 42, 25.6%) (p < 0.001). Total CCS was higher in the LAD at 46.1 (IQR: 104.2) and RCA at 34.1 (IQR: 90.7) than in the CX at 16.8 (IQR: 61.3) (p = 0.007). In patients with calcifications restricted to a single vessel (n = 54), the most frequently affected artery was the LAD (n = 42, 77.8%). In patients with lesions limited to the LAD, the plaque was located mostly (n = 37, 88.1%) adjacent to the septal perforators’ origin. Conclusions We demonstrated that coronary calcifications are most frequently located in the LAD in proximity to the septal branch origin. A possible explanation for this phenomenon could be the dynamic compression of the tunneled septal branches, which may result in disturbed blood flow in the adjacent LAD segment (milking effect). PMID:26855661

  19. An electrophysiological study of excitatory purinergic neuromuscular transmission in longitudinal smooth muscle of chicken anterior mesenteric artery

    OpenAIRE

    Khalifa, Maisa; El-Mahmoudy, AbuBakr; SHIINA, Takahiko; Shimizu, Yasutake; NIKAMI, Hideki; El-Sayed, Mossad; Kobayashi, Haruo; TAKEWAKI, Tadashi

    2005-01-01

    The object of the present study was to clarify the neurotransmitters controlling membrane responses to electrical field stimulation (EFS) in the longitudinal smooth muscle cells of the chicken anterior mesenteric artery.EFS (5 pulses at 20 Hz) evoked a depolarization of amplitude 19.7±2.1 mV, total duration 29.6±3.1 s and latency 413.0±67.8 ms. This depolarization was tetrodotoxin (TTX)-sensitive and its amplitude was partially decreased by atropine (0.5 μM); however, its duration was shorten...

  20. Pseudoaneurysm of anterior tibial artery following a diaphyseal fracture of the tibia mimicking a malignant bone tumor.

    Science.gov (United States)

    Sautet, Pierre; Choufani, Elie; Petit, Philippe; Launay, Franck; Jouve, Jean-Luc; Pesenti, Sébastien

    2016-09-01

    Pseudoaneurysms of the lower limb are rare and frequently iatrogenics complications. Closed traumas are likely to generate lesions of the arterial wall, which generally become symptomatic at a later stage. The diagnosis of such vascular lesion is difficult because the symptomatology and the onset can be delayed. We herein report the case of a 15-year-old patient in whom the diagnosis of pseudoaneurysm of the anterior tibial artery was made 5 months after a non-displaced closed fracture of the tibial shaft. The radiographs were evocative of a malignant bone tumor. The study of vessels by a contrast-enhanced CT-scan enabled us to diagnose the pseudoaneurysm. Before the occurrence of late onset swelling, a history of trauma must be sought, even old. PMID:27447879

  1. A RARE CASE OF PERSISTENT TRIGEMINAL ARTERY IN AN ADULT FEMALE WITH PARA POSTERIOR COMMUNICATING ARTERY ANEURYSM

    Directory of Open Access Journals (Sweden)

    Banavathu Daya Bharath Singh

    2015-05-01

    Full Text Available Anastomosis found in the adulthood between the carotid and vertebro - basilar systems, apart from the posterior communicating artery, are extremely infrequent and are due to the persistence of vessels that joined both systems during the fetal period. This carotid - vertebrobasilar anastomosis are the trigeminal, otic, and hypoglossal and proatlantal arteries. P ersistent trigeminal artery is the commonest of the above mentioned four arteries. The reported incidence is about 0.2%. Patients may be asymptomatic or present symptoms due to low flow of posterior circulation or carotid microembolization from posterior circulation. PTA can cause trigemina l neuralgia. We report in this paper a case of a persistant trigeminal artery found in an adult female with a para p com aneurysm who had persistent trigeminal artery which was seen in C T angiogram .

  2. Multislice computed tomographic patterns of muscle bridging of left anterior descending artery and their relation to atheromatous coronary artery disease

    International Nuclear Information System (INIS)

    Objectives: To determine the frequency of atheromatous coronary artery disease in patients with myocardial bridge. Study Design: Descriptive study. Place and Duration of Study: AFIC/NIHD Rawalpindi from September 2010 to November 2010. Patients and Methods: Patients undergoing MSCT angiography for diagnosis of CAD having an abnormal finding were included. Patients with history of prior coronary artery bypass grafting (CABG), coronary stenting and with chronic total occlusions were excluded. Computed Tomographic (CT) examinations were performed with a dual-source CT scanner. Scanning parameters: detector collimation, 2 x 32 x 0.6 mm; slice collimation, 2 x 64 x 0.6 mm; gantry rotation time, 330 milliseconds; tube current-time product, 350 m As per rotation and tube potential 120 kV. Reconstructions done and data transmitted to workstations and analyzed. Myocardial bridge (MB) was diagnosed and evaluated when an intramuscular segment of LAD artery was visualized on axial, volume rendered and multiplanar reformation (MPR) images. Results: Out of 232 patients 32% had MB. Males were three times more likely to have Myocardial bridge (MB). Mid and distal LAD showed 54% and 45% MBs respectively. Fourteen percent had evidence of atherosclerosis proximal to MB segment. Mean length and depth of MB segment was 18mm and 1.8mm respectively. Superficial type was most common (44%), followed by deep type (33%) while RV type was least common (23%). Conclusion: Frequency of patients with myocardial bridge having concomitant atheromatous coronary artery disease was 14%. (author)

  3. Pre-Hospital 12-Lead Electrocardiogram within 60 Minutes Differentiates Proximal versus Nonproximal Left Anterior Descending Artery Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    James J McCarthy

    2011-05-01

    Full Text Available Introduction: Acute anterior myocardial infarctions caused by proximal left anterior descending (LAD artery occlusions are associated with a higher morbidity and mortality. Early identification of high-risk patients via the 12-lead electrocardiogram (ECG could assist physicians and emergency response teams in providing early and aggressive care for patients with anterior ST-elevation myocardial infarctions (STEMI. Approximately 25% of US hospitals have primary percutaneous coronary intervention (PCI capability for the treatment of acute myocardial infarctions. Given the paucity of hospitals capable of PCI, early identification of more severe myocardial infarction may prompt emergency medical service routing of these patients to PCI-capable hospitals. We sought to determine if the 12 lead ECG is capable of predicting proximal LAD artery occlusions. Methods: In a retrospective, post-hoc analysis of the Pre-Hospital Administration of Thrombolytic Therapy with Urgent Culprit Artery Revascularization pilot trial, we compared the ECG findings of proximal and nonproximal LAD occlusions for patients who had undergone an ECG within 180 minutes of symptom onset. Results: In this study, 72 patients had anterior STEMIs, with ECGs performed within 180 minutes of symptom onset. In patients who had undergone ECGs within 60 minutes (n¼35, the mean sum of ST elevation (STE in leads V1 through V6 plus ST depression (STD in leads II, III, and aVF was 19.2 mm for proximal LAD occlusions and 11.7 mm for nonproximal LAD occlusions (P¼0.007. A sum STE in V1 through V6 plus STD in II, III, and aVF of at least 17.5 mm had a sensitivity of 52.3%, specificity of 92.9%, positive predictive value of 91.7%, and negative predictive value of 56.5% for proximal LAD occlusions. When the ECG was performed more than 60 minutes after symptom onset (n¼37, there was no significant difference in ST-segment deviation between the 2 groups. Conclusion: The sum STE (V1-V6 and STD (II

  4. Pseudoaneurysm of the Deep Circumflex Iliac Artery: A Rare Complication at an Anterior Iliac Bone Graft Donor Site Treated by Coil Embolization

    Directory of Open Access Journals (Sweden)

    Andy Shau-Bin Chou

    2002-07-01

    Full Text Available Pseudoaneurysm formation of the deep circumflex iliac artery (DCIA after harvestingan anterior iliac bone graft for spinal fusion is reported herein. A 76-year-old man with cervicalmyelopathy underwent anterior cervical decompression and fusion with a left anterioriliac bone graft. A painful left inguinal mass was noted 1 month later. He was admitted toour emergency ward. Angiography of the left external iliac artery was performed whichshowed a pseudoaneurysm of the DCIA. Selective transarterial coil embolization of theartery was performed, and bleeding was arrested. In a review of the previous literature, only1 pseudoaneurysm of the DCIA was reported to be associated with anterior iliac bone graft.In conclusion, vascular injury after anterior iliac bone harvesting is rare but can occur.Selective transarterial coil embolization is a prompt and effective solution.

  5. Derivation of flow related risk indices for stenosed left anterior descending coronary arteries with the use of computer simulations.

    Science.gov (United States)

    Papadopoulos, Konstantinos P; Gavaises, Manolis; Pantos, Ioannis; Katritsis, Demosthenes G; Mitroglou, Nicholas

    2016-09-01

    The geometry of the coronary vessel network is believed to play a decisive role in the initiation, progression and outcome of coronary artery disease (CAD) and the occurrence of acute coronary syndromes (ACS). It also determines the flow field in the coronary artery which can be linked to CAD evolution. In this work geometric 3D models of left anterior descending (LAD) coronary arteries associated with either myocardial infarction (MI) or stable (STA) CAD were constructed. Transient numerical simulations of the flow for each model showed that specific flow patterns develop in different extent in the different groups examined. Recirculation zones, present distal the stenosis in all models, had larger extent and duration in MI cases. For mild stenosis (up to 50%) areas with low time averaged wall shear stress TAWSS (3Pa) appeared only in MI models; in moderate and severe stenosis (>50%) these areas were present in all models but were significantly larger for MI than STA models. These differentiations were expressed via numerical indices based on TAWSS, oscillating shear index (OSI) and relative residence time (RRT). Additionally we introduced the coagulation activation index (CAI), based on the threshold behaviour of coagulation initiation, which exceeded the suggested threshold only for MI models with intermediate stenosis (up to 50%). These results show that numerical simulations of flow can produce arithmetic indices linked with the risk of CAD complications. PMID:27387905

  6. Age-Specific And Sexual Variability Of Morphological And Biomechanical Parameters Of Anterior Cerebral Artery Of Adults

    Directory of Open Access Journals (Sweden)

    I.V. Kirillova

    2009-12-01

    Full Text Available In the experiment on monoaxonic longitudinal distension by tensile-testing machine Tira Test 28005 (Germany with loading unit - 100 N the general rigidity, breaking point and relative lengthening of anterior cerebral artery (АСА of adult people have been under study. Under the microscope on transverse sections the external diameter of the artery, its wall thickness have been measured and diameter of lumen have been calculated. In total 228 АСА (132 - from corpses of men, 92-from corpses of women have been investigated. They have been received in 16 hours after autopsy of adult people whose cause of death has not been connected with vascular cerebral pathology. It has been revealed that right АСА is longer and narrower than left one. ACA's wall length and thickness predominate in men in comparison with women in average of 5,4 - 13,0%. With years АСА lengthens, its external diameter increases. Biomechanical parameters of ACA's wall do not have any authentic sexual differences, they don't depend on the side of the arterial ring. With years the rigidity of АСА decreases, especially in middle age. In old age its general rigidity increases. It is connected with the increase of ACA's wall thickness. The ability of АСА to lengthening doesn't depend upon age. Experimental findings may be used as criteria of age standard of morphological and biomechanical parameters of АСА

  7. Delayed Ischemic Stroke after Flow Diversion of Large Posterior Communicating Artery Aneurysm.

    Science.gov (United States)

    Kim, Si On; Chung, Yeon Gu; Won, Yu Sam; Rho, Myung Ho

    2016-03-01

    For securing large, giant, and wide-neck aneurysms, conventional coil embolization has substantial limitations, such as incomplete occlusion, recanalization, and a high recurrence rate. To overcome these limitations, a novel paradigm was suggested and, as a result, flow-diverting device was developed. The flow-diverting device is an innovative and effective technique to allow securing of large, giant, and wide-neck aneurysms. In numerous studies, the flow-diverting device has shown better outcomes than coil embolization. However, the flow-diverting device has also some risks, including rupture of aneurysm, intracerebral hemorrhage, and ischemic stroke. In addition, with more experience, unexpected complications are also reported.5)7) In the present case, we experienced a delayed ischemic stroke at 27 days after endovascular treatment. The patient had multiple aneurysms and, among them, we treated a large posterior communicating artery aneurysm using Pipeline™ Embolization Device. The patient was tolerable for 25 days, but then suddenly presented intermittent right hemiparesis. In the initial diffusion magnetic resonance imaging (MRI), there was no acute lesion; however, in the follow-up MRI, an acute ischemic stroke was found in the territory of anterior choroidal artery which was covered by Pipeline Embolization Device. We suspect that neo-intimal overgrowth or a tiny thrombus have led to this delayed complication. Through our case, we learned that the neurosurgeon should be aware of the possibility of delayed ischemic stroke after flow diversion, as well as, long-term close observation and follow-up angiography are necessary even in the event of no acute complications. PMID:27114962

  8. Endovascular Embolization of Ruptured Infundibular Dilation of Posterior Communicating Artery: A Case Report

    Directory of Open Access Journals (Sweden)

    Jinlu Yu

    2010-01-01

    Full Text Available Hemorrhage due to the rupture of the infundibular dilatation of the posterior communicating artery (ID of the PCo-A occurs infrequently. The preferred treatment of such hemorrhages is surgical clipping through craniotomy. There are few reports about endovascular coil embolization in such cases. We report such a case treated by endovascular embolization. A 35-year-old man, who had experienced 2 episodes of subarachnoid hemorrhage (SAH, was found to have a ruptured ID of the PCo-A by head computed tomography angiography (CTA and digital subtraction angiography (DSA. We performed stent-assisted endovascular coil embolization through a combined anterior and posterior circulation approach. Postembolization angiography showed absence of contrast filling of the ID of the PCo-A and nonleakage of the contrast agent. The patient recovered well with no complications. SAH recurrence was not recorded during the 1-year followup. The postoperative angiographic result was good. To our knowledge, this is the first case of hemorrhage due to ruptured ID of the PCo-A that was treated by such a technique.

  9. Endovascular embolization of ruptured infundibular dilation of posterior communicating artery: a case report.

    Science.gov (United States)

    Yu, Jinlu; Wang, Honglei; Xu, Kan; Wang, Bai; Luo, Qi

    2010-01-01

    Hemorrhage due to the rupture of the infundibular dilatation of the posterior communicating artery (ID of the PCo-A) occurs infrequently. The preferred treatment of such hemorrhages is surgical clipping through craniotomy. There are few reports about endovascular coil embolization in such cases. We report such a case treated by endovascular embolization. A 35-year-old man, who had experienced 2 episodes of subarachnoid hemorrhage (SAH), was found to have a ruptured ID of the PCo-A by head computed tomography angiography (CTA) and digital subtraction angiography (DSA). We performed stent-assisted endovascular coil embolization through a combined anterior and posterior circulation approach. Postembolization angiography showed absence of contrast filling of the ID of the PCo-A and nonleakage of the contrast agent. The patient recovered well with no complications. SAH recurrence was not recorded during the 1-year followup. The postoperative angiographic result was good. To our knowledge, this is the first case of hemorrhage due to ruptured ID of the PCo-A that was treated by such a technique. PMID:21209803

  10. The midterm outcome and MACE of robotically enhanced grafting of left anterior descending artery with left internal mammary artery

    OpenAIRE

    Casula, Roberto; Khoshbin, Espeed; Athanasiou, Thanos

    2014-01-01

    Background We assessed the midterm outcome and the incidence of major adverse cardiovascular events in UK’s largest Da Vinci assisted robotic coronary revascularisation cohort. This study was set up at the Imperial College NHS Trust, St. Mary’s Hospital, London, United Kingdom. Method Benchmarking approach through retrospective audit of the regional outcomes against standards in the published literature. Data was collected from the patient’s records, communication with the primary care physic...

  11. Pseudo-aneurysm of anterior tibia artery simulating a soft tissue sarcoma: a case report.

    OpenAIRE

    Darioush M. Barzi; Sami, Sam H.; Ehsan Fallah

    2014-01-01

    A pseudo aneurysm results from leakage of blood from an artery after trauma or dehiscence or separation of a surgical anastomosis. The reported rate of pseudo aneurysm in access sites range from 0.88% to 8%. It has some cause like penetrating trauma, blunt trauma and endovascular procedure. The differential diagnoses of this lesion are hematoma, AV fistula, lymphadenopathy, lymphocele, DVT, compartment syndrome, soft tissue tumor. A 16 years old male was referred to our clinic with progressiv...

  12. Morphological and hemodynamic analysis of mirror posterior communicating artery aneurysms.

    Directory of Open Access Journals (Sweden)

    Jinyu Xu

    Full Text Available BACKGROUND AND PURPOSE: Hemodynamic factors are commonly believed to play an important role in the pathogenesis, progression, and rupture of cerebral aneurysms. In this study, we aimed to identify significant hemodynamic and morphological parameters that discriminate intracranial aneurysm rupture status using 3-dimensional-angiography and computational fluid dynamics technology. MATERIALS AND METHODS: 3D-DSA was performed in 8 patients with mirror posterior communicating artery aneurysms (Pcom-MANs. Each pair was divided into ruptured and unruptured groups. Five morphological and three hemodynamic parameters were evaluated for significance with respect to rupture. RESULTS: The normalized mean wall shear stress (WSS of the aneurysm sac in the ruptured group was significantly lower than that in the unruptured group (0.52±0.20 versus 0.81±0.21, P = .012. The percentage of the low WSS area in the ruptured group was higher than that in the unruptured group (4.11±4.66% versus 0.02±0.06%, P = .018. The AR was 1.04±0.21 in the ruptured group, which was significantly higher than 0.70±0.17 in the unruptured group (P = .012. By contrast, parameters that had no significant differences between the two groups were OSI (P = .674, aneurysm size (P = .327, size ratio (P = .779, vessel angle (P = 1.000 and aneurysm inclination angle (P = 1.000. CONCLUSIONS: Pcom-MANs may be a useful disease model to investigate possible causes of aneurysm rupture. The ruptured aneurysms manifested lower WSS, higher percentage of low WSS area, and higher AR, compared with the unruptured one. And hemodynamics is as important as morphology in discriminating aneurysm rupture status.

  13. Doppler findings in a rare Coronary Artery Fistula

    OpenAIRE

    Jorns Carl; Jung Christian; Huhta James

    2007-01-01

    Abstract One of the primary forms of congenital anomalies of the coronary arteries is coronary artery fistula (CAF). It is defined as a direct communication between the coronary artery and any surrounding cardiac chamber or vascular structure, which bypasses the myocardial capillary bed. We present a newborn baby with a large coronary artery fistula connecting the left anterior descending (LAD) artery to the left ventricular (LV) apex. Associated cardiac abnormalities were found: a ventricula...

  14. An electrophysiological study of excitatory purinergic neuromuscular transmission in longitudinal smooth muscle of chicken anterior mesenteric artery

    Science.gov (United States)

    Khalifa, Maisa; El-Mahmoudy, AbuBakr; Shiina, Takahiko; Shimizu, Yasutake; Nikami, Hideki; El-Sayed, Mossad; Kobayashi, Haruo; Takewaki, Tadashi

    2005-01-01

    The object of the present study was to clarify the neurotransmitters controlling membrane responses to electrical field stimulation (EFS) in the longitudinal smooth muscle cells of the chicken anterior mesenteric artery. EFS (5 pulses at 20 Hz) evoked a depolarization of amplitude 19.7±2.1 mV, total duration 29.6±3.1 s and latency 413.0±67.8 ms. This depolarization was tetrodotoxin (TTX)-sensitive and its amplitude was partially decreased by atropine (0.5 μM); however, its duration was shortened by further addition of prazosin (10 μM). Atropine/prazosin-resistant component was blocked by the nonspecific purinergic antagonist, suramin, in a dose-dependent manner, indicating that this component is mediated by the neurotransmitter adenosine 5′-triphosphate (ATP). Neither desensitization nor blocking of P2X receptor with its putative receptor agonist α,β-methylene ATP (α,β-MeATP, 1 μM) and its antagonist pyridoxalphosphate-6-azophenyl-2′,4′-disulfonic (PPADS, up to 50 μM), had significant effect on the purinergic depolarization. In contrast, either desensitization or blocking of P2Y receptor with its putative agonist 2-methylthioATP (2-MeSATP, 1 μM) and its antagonist Cibacron blue F3GA (CBF3GA, 10 μM) abolished the purinergic depolarization, indicating that this response is mediated through P2Y but not P2X receptor. The purinergic depolarization was inhibited by pertussis toxin (PTX, 600 ng ml−1). Furthermore, it was significantly inhibited by a phospholipase C (PLC) inhibitor, U-73122 (10 μM), indicating that the receptors involved in mediating the purinergic depolarization are linked to a PTX-sensitive G-protein, which is involved in a PLC-mediated signaling pathway. Data of the present study suggest that the EFS-induced excitatory membrane response occurring in the longitudinal smooth muscle of the chicken anterior mesenteric artery is mainly purinergic in nature and is mediated via P2Y purinoceptors. PMID:15685211

  15. Onyx injection by direct puncture for the treatment of hypervascular spinal metastases close to the anterior spinal artery: initial experience.

    Science.gov (United States)

    Clarençon, Frédéric; Di Maria, Federico; Cormier, Evelyne; Sourour, Nader-Antoine; Enkaoua, Eric; Sailhan, Frédéric; Iosif, Christina; Le Jean, Lise; Chiras, Jacques

    2013-06-01

    Presurgical devascularization of hypervascular spinal metastases has been shown to be effective in preventing major blood loss during open surgery. Most often, embolization can be performed using polyvinyl alcohol (PVA) microparticles. However, in some cases, the close relationship between the feeders of the metastases and the feeders of the anterior spinal artery (ASA) poses a risk of spinal cord ischemia when PVA microparticle embolization is performed. The authors present their early experience in the treatment of spinal metastases close to the ASA; in 2 cases they injected Onyx-18, by direct puncture, into hypervascular posterior arch spinal metastases situated close to the ASA. Two women, one 36 and the other 55 years of age, who presented with spinal lesions (at the posterior arch of C-4 and T-6, respectively) from thyroid and a kidney tumors, were sent to the authors' department to undergo presurgical embolization. After having performed a complete spinal digital subtraction angiography study, a regular angiography catheter was positioned at the ostium of the artery that mainly supplied the lesion. Then, with the patient in the left lateral decubitus position, direct puncture with 18-gauge needles of the lesion was performed using roadmap guidance. Onyx-18 was injected through the needles under biplanar fluoroscopy. Satisfactory devascularization of the lesions was obtained; the ASA remained patent in both cases. The metastases were surgically removed in both cases within the 48 hours after the embolization and major blood loss did not occur. Presurgical devascularization of hypervascular spinal metastases close the ASA by direct puncture with Onyx-18 seems to be an effective technique and appears to be safe in terms of the preserving the ASA's patency. PMID:23600580

  16. Myocardial Bridging of the Left Anterior Descending Coronary Artery: Depiction Rate and Morphologic Features by Dual-Source CT Coronary Angiography

    OpenAIRE

    Hwang, Jin Ho; Ko, Sung Min; Roh, Hong Gee; Song, Meong Gun; Shin, Je Kyoun; Chee, Hyun Kun; Kim, Joon Suk

    2010-01-01

    Objective To evaluate the depiction rate and morphologic features of myocardial bridging (MB) of the left anterior descending coronary artery (LAD) using dual-source CT (DSCT). Materials and Methods CT scans from a total of 1,353 patients who underwent DSCT were reviewed retrospectively for LAD-MB. Seventy-eight patients were excluded due to poor image quality or poor enhancement of the coronary artery. The length and depth of the MB were analyzed and classified as superficial or deep with re...

  17. Analysis of Left Anterior Descending Coronary Artery Myocardial Bridging as Detected by Multi-Detector Row Computed Tomography

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Seung Jeong; Koh, Kyung Hun [Chosun University Hospital, Gwangju (Korea, Republic of); Kim, Dong Hun [Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of); Ko, Sung Min [Konkuk University Hospital, Seoul (Korea, Republic of)

    2009-05-15

    We wanted to review the various MDCT findings of myocardial bridging (MB) and we analyzed the correlation of the symptoms with the degree of diastolic compression of the coronary segments with MB. We retrospectively reviewed 1,588 consecutive patients who were referred for coronary MDCT angiography between March 4, 2005, and January 31, 2008. Of the 1,588 patients, 85 patients with MB in the left anterior descending coronary artery (LAD) were included in this study. 16-slice and 64- slice CT scanners were used. Multiplanar reformation, maximal intensity projection, 3-dimensional reconstruction images were used for evaluating MB. We recorded the involved segments, the depth and length of the MB and we compared the CTA findings with the symptoms and those findings of ECG and conventional coronary angiography. Of the 85 patients, myocardial ischemia or infarction was detected in 26 patients, atypical chest pain was detected in 2, and no symptoms were detected in 38. The MB was mostly seen in the LAD mid segment in 92%, 85% and 82% of each symptom group. We found no difference in the prevalence of atypical chest pain when comparing the length of the involved segments (p = 0.08) and the depth of the buried segments (p = 0.59). MBs are mostly seen in the LAD mid segments and the combined chest pain does not correlate with the length and depth of the involved segments.

  18. Analysis of Left Anterior Descending Coronary Artery Myocardial Bridging as Detected by Multi-Detector Row Computed Tomography

    International Nuclear Information System (INIS)

    We wanted to review the various MDCT findings of myocardial bridging (MB) and we analyzed the correlation of the symptoms with the degree of diastolic compression of the coronary segments with MB. We retrospectively reviewed 1,588 consecutive patients who were referred for coronary MDCT angiography between March 4, 2005, and January 31, 2008. Of the 1,588 patients, 85 patients with MB in the left anterior descending coronary artery (LAD) were included in this study. 16-slice and 64- slice CT scanners were used. Multiplanar reformation, maximal intensity projection, 3-dimensional reconstruction images were used for evaluating MB. We recorded the involved segments, the depth and length of the MB and we compared the CTA findings with the symptoms and those findings of ECG and conventional coronary angiography. Of the 85 patients, myocardial ischemia or infarction was detected in 26 patients, atypical chest pain was detected in 2, and no symptoms were detected in 38. The MB was mostly seen in the LAD mid segment in 92%, 85% and 82% of each symptom group. We found no difference in the prevalence of atypical chest pain when comparing the length of the involved segments (p = 0.08) and the depth of the buried segments (p = 0.59). MBs are mostly seen in the LAD mid segments and the combined chest pain does not correlate with the length and depth of the involved segments

  19. A case of primitive persistent hypoglossal artery

    Energy Technology Data Exchange (ETDEWEB)

    Park, C. K.; Koh, B. H.; Kim, Y. S.; Kang, S. R. [Hangyang University College of Medicine, Seoul (Korea, Republic of)

    1979-06-15

    Three kinds of carotid-basilar anastomosis have been found, they were named as persistent primitive trigeminal artery, persistent primitive acoustic (or otic) artery and persistent primitive hypoglossal artery, among them, the persistent primitive hypoglossal artery is by far the least common type of the internal carotid-basilar anastomosis which have been demonstrate in human postembryonic stages. Persistent primitive by hypoglossal artery is usually found incidentally. This vascular anomaly, however,have been reported to be associated with multiple congenital anomalies, such as unilateral or bilateral vertebral artery hypoplasia, absence of the posterior communicating artery, hypoplasia of the proximal portion of the posterior cerebral artery, aneurysm of the circle of Willis, the origin of both pericallosal arteries from a single anterior cerebral artery, retarded mental development dating from infancy, carotid-cavernous fistula formation etc. A case of persistent primitive hypoglossal artery in an young Korean male was reported with brief review of the literature.

  20. Bilateral Carotid and Vertebral Rete Mirabile Presenting with a Prominent Anterior Spinal Artery Mimicking a Spinal Dural AV Fistula at MRI

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Young; Cha, Sang Hoon [Chungbuk National University College of Medicine, Iksan (Korea, Republic of)

    2011-11-15

    Bilateral carotid and vertebral rete mirabile (CVRM) is a very rare condition. We report a new case of CVRM initially detected by magnetic resonance imaging (MRI) of the cervical spine. MRI demonstrated tortuous vascular signal voids limited to the anterior cerebrospinal fluid space mimicking spinal dural arteriovenous fistula. A diagnosis of CVRM was confirmed on the basis of angiographic findings of rete formation associated with bilateral aplasia of the cavernous internal carotid and vertebral arteries without abnormal arteriovenous connection.

  1. Supplementary Motor Complex and Disturbed Motor Control – a Retrospective Clinical and Lesion Analysis of Patients after Anterior Cerebral Artery Stroke

    OpenAIRE

    Brugger, Florian; Galovic, Marian; Weder, Bruno J.; Kägi, Georg

    2015-01-01

    Background Both the supplementary motor complex (SMC), consisting of the supplementary motor area (SMA) proper, the pre-SMA, and the supplementary eye field, and the rostral cingulate cortex are supplied by the anterior cerebral artery (ACA) and are involved in higher motor control. The Bereitschaftspotential (BP) originates from the SMC and reflects cognitive preparation processes before volitional movements. ACA strokes may lead to impaired motor control in the absence of limb weakness a...

  2. Bilateral Carotid and Vertebral Rete Mirabile Presenting with a Prominent Anterior Spinal Artery Mimicking a Spinal Dural AV Fistula at MRI

    International Nuclear Information System (INIS)

    Bilateral carotid and vertebral rete mirabile (CVRM) is a very rare condition. We report a new case of CVRM initially detected by magnetic resonance imaging (MRI) of the cervical spine. MRI demonstrated tortuous vascular signal voids limited to the anterior cerebrospinal fluid space mimicking spinal dural arteriovenous fistula. A diagnosis of CVRM was confirmed on the basis of angiographic findings of rete formation associated with bilateral aplasia of the cavernous internal carotid and vertebral arteries without abnormal arteriovenous connection.

  3. Wall shear stress in intracranial aneurysms and adjacent arteries

    Institute of Scientific and Technical Information of China (English)

    Fuyu Wang; Bainan Xu; Zhenghui Sun; Chen Wu; Xiaojun Zhang

    2013-01-01

    Hemodynamic parameters play an important role in aneurysm formation and growth. However, it is difficult to directly observe a rapidly growing de novo aneurysm in a patient. To investigate possible associations between hemodynamic parameters and the formation and growth of intracranial aneurysms, the present study constructed a computational model of a case with an internal carotid artery aneurysm and an anterior communicating artery aneurysm, based on the CT angiography findings of a patient. To simulate the formation of the anterior communicating artery aneurysm and the growth of the internal carotid artery aneurysm, we then constructed a model that virtually removed the anterior communicating artery aneurysm, and a further two models that also progressively decreased the size of the internal carotid artery aneurysm. Computational simulations of the fluid dynamics of the four models were performed under pulsatile flow conditions, and wall shear stress was compared among the different models. In the three aneurysm growth models, increasing size of the aneurysm was associated with an increased area of low wall shear stress, a significant decrease in wall shear stress at the dome of the aneurysm, and a significant change in the wall shear stress of the parent artery. The wall shear stress of the anterior communicating artery remained low, and was significantly lower than the wall shear stress at the bifurcation of the internal carotid artery or the bifurcation of the middle cerebral artery. After formation of the anterior communicating artery aneurysm, the wall shear stress at the dome of the internal carotid artery aneurysm increased significantly, and the wall shear stress in the upstream arteries also changed significantly. These findings indicate that low wall shear stress may be associated with the initiation and growth of aneurysms, and that aneurysm formation and growth may influence hemodynamic parameters in the local and adjacent arteries.

  4. Avaliação da artéria etmoidal anterior pela tomografia computadorizada no plano coronal Anterior ethmoidal artery evaluation on coronal CT scans

    OpenAIRE

    Soraia Ale Souza; Marcia Maria Ale de Souza; Luís Carlos Gregório; Sergio Ajzen

    2009-01-01

    O conhecimento da localização da artéria etmoidal anterior (AEA) constitui etapa importante na cirurgia do recesso do seio frontal e do etmóide anterior. A tomografia computadorizada (TC), em especial no plano coronal pode fornecer reparos anatômicos que identificam o trajeto da AEA. OBJETIVO: Identificar os reparos anatômicos que caracterizam o trajeto da AEA na parede medial da órbita e na parede lateral da fossa olfatória. Verificar a correlação entre a presença de pneumatização supra-orbi...

  5. Body surface potential maps with low-level exercise in isolated left anterior descending coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Montague, T.J.; Johnstone, D.E.; Spencer, C.A.; Miller, R.M.; Mackenzie, B.R.; Gardner, M.J.; Horacek, B.M.

    1988-02-01

    One hundred and twenty-lead body surface potential maps (BSPMs) were recorded at rest, at immediate cessation of exercise and after 1 (early) and 5 minutes (late) of recovery in 14 patients with isolated, critical, left anterior descending (LAD) coronary artery stenosis. Exercise endpoints, at an average peak rate of 98 +/- 13, were usual pain worsening in 13 LAD patients, and diagnostic ST depression in lead V5 in 1 patient. Twelve patients also had positive thallium scans. BSPMs were also recorded in 8 normal subjects who exercised to peak heart rates similar to those of the LAD subjects. Spatially, there were similar exercise changes in QRS and ST-segment integral patterns over the precordium and inferior torso in both groups. These were transient in the control group but persisted to late recovery in the LAD group, particularly for ST integral. Quantitatively, multivariate analysis revealed significant temporal differences between the 2 groups. However, the only independent BSPM variable was the sum of ST integral decrease, averaging --2323 +/- 1809 microV.s for normal patients between rest and immediate cessation of exercise, compared with -3828 +/- 2329 microV.s for the LAD patients. Late recovery minus rest difference averaged -1264 +/- 1080 microV.s for normal subjects and -2575 +/- 1844 microV.s for LAD patients. To control for the physiologic changes of exercise, the ST integral temporal differential maps of the normal subjects were subtracted from those of the LAD patients and the sum of negative intergroup differences was assumed to reflect only ischemia. Correlation of ST integral ischemia values at immediate cessation of exercise and late recovery was high; however, intertechnique correlations of the BSPM variables with quantitative angiographic scores and thallium perfusion scan scores revealed generally low r values (range 0 to 0.52).

  6. Body surface potential maps with low-level exercise in isolated left anterior descending coronary artery disease

    International Nuclear Information System (INIS)

    One hundred and twenty-lead body surface potential maps (BSPMs) were recorded at rest, at immediate cessation of exercise and after 1 (early) and 5 minutes (late) of recovery in 14 patients with isolated, critical, left anterior descending (LAD) coronary artery stenosis. Exercise endpoints, at an average peak rate of 98 +/- 13, were usual pain worsening in 13 LAD patients, and diagnostic ST depression in lead V5 in 1 patient. Twelve patients also had positive thallium scans. BSPMs were also recorded in 8 normal subjects who exercised to peak heart rates similar to those of the LAD subjects. Spatially, there were similar exercise changes in QRS and ST-segment integral patterns over the precordium and inferior torso in both groups. These were transient in the control group but persisted to late recovery in the LAD group, particularly for ST integral. Quantitatively, multivariate analysis revealed significant temporal differences between the 2 groups. However, the only independent BSPM variable was the sum of ST integral decrease, averaging --2323 +/- 1809 microV.s for normal patients between rest and immediate cessation of exercise, compared with -3828 +/- 2329 microV.s for the LAD patients. Late recovery minus rest difference averaged -1264 +/- 1080 microV.s for normal subjects and -2575 +/- 1844 microV.s for LAD patients. To control for the physiologic changes of exercise, the ST integral temporal differential maps of the normal subjects were subtracted from those of the LAD patients and the sum of negative intergroup differences was assumed to reflect only ischemia. Correlation of ST integral ischemia values at immediate cessation of exercise and late recovery was high; however, intertechnique correlations of the BSPM variables with quantitative angiographic scores and thallium perfusion scan scores revealed generally low r values (range 0 to 0.52)

  7. Pseudo-aneurysm of the anterior tibial artery, a rare cause of ankle swelling following a sports injury

    Directory of Open Access Journals (Sweden)

    McAteer Eamon

    2005-10-01

    Full Text Available Abstract Background Ankle pain and swelling following sports injuries are common presenting complaints to the accident and emergency department. Frequently these are diagnosed as musculoskeletal injuries, even when no definitive cause is found. Vascular injuries following trauma are uncommon and are an extremely rare cause of ankle swelling and pain. These injuries may however be limb threatening and are important to diagnose early, in order that appropriate treatment can be delivered. We highlight the steps to diagnosis of these injuries, and methods of managing these injuries. It is important for clinicians to be aware of the potential for this injury in patients with seemingly innocuous trauma from sports injuries, who have significant ankle pain and swelling. Case presentation A young, professional sportsman presented with a swollen, painful ankle after an innocuous hyper-plantar flexion injury whilst playing football, which was initially diagnosed as a ligamentous injury after no bony injury was revealed on X-Ray. He returned 2 days later with a large ulcer at the lateral malleolus and further investigation by duplex ultrasound and transfemoral arteriogram revealed a Pseudo-Aneurysm of the Anterior Tibial Artery. This was initially managed with percutaneous injection of thrombin, and later open surgery to ligate the feeding vessel. The patient recovered fully and was able to return to recreational sport. Conclusion Vascular injuries remain a rare cause of ankle pain and swelling following sports injuries, however it is important to consider these injuries when no definite musculo-skeletal cause is found. Ultrasound duplex and Transfemoral arteriogram are appropriate, sensitive modalities for investigation, and may allow novel treatment to be directed percutaneously. Early diagnosis and intervention are essential for the successful outcome in these patients.

  8. Guidewires used in first intentional single wiring strategy for chronic total occlusions of the left anterior descending coronary artery

    Directory of Open Access Journals (Sweden)

    Yasser S Nassar

    2013-01-01

    Full Text Available Background: Percutaneous coronary intervention (PCI for chronic total occlusion (CTO of the left anterior descending (LAD specifically is associated with improved long-term 5 year survival as compared to PCI failure.The procedure is associated with usage of different types of dedicated guidewires by simple or complex techniques aiming to reopen the occluded artery. Aim: To describe types and outcome of guidewires used in LAD-CTO utilizing a first intentional single wiring simple strategy. Methods: A single center prospective registry for all consecutive patients with a PCI attempt to a native LAD CTO. The initial strategy for lesion crossing was Single wiring. Results: A total of 30 patients with LAD CTO lesions (100%, were recorded. Mean age was 71.6 + 15 years, 77% were Males, risk factors Hypertension in 63%, Diabetes 27%, Dyslipidemia 57%, smoking 40%, hereditary in 13% of patients. Isolated guidewire (GW success rate was very high 93%. Single wiring was the prevailing technique used in 97% of successfull lesions (83% of total cases while only 3% were by multiple wiring techniques. Successful single antegrade wiring represented 63% with a GW success rate of 92% of cases. Successful single retrograde wiring represented 13% with a GW success rate of 67%. Successful Crossing GW types in our patients were 44% Soft Tapered GWs; fielder XT (44%, 36% were Soft Non Tapered Pilot 50 (28%, whisper (8%, while 16% were Stiff Non tapered GWs; Miracle 12 (8%, Miracle 6 (4%, Miracle 3 (4%, and 4% were Stiff Tapered GWs; Progress 200 (4%. Conclusions: Single wiring as an initial strategy in PCI for LAD-CTO lesions has a high success rate and is associated with a 44% majority of Soft Tapered GWs, 36% Soft Non Tapered, 16% Stiff Non tapered GWs, and 4% Stiff Tapered GWs.

  9. Brain atrophy and neuropsychological outcome after treatment of ruptured anterior cerebral artery aneurysms: a voxel-based morphometric study

    Energy Technology Data Exchange (ETDEWEB)

    Bendel, Paula; Koskenkorva, Paeivi; Vanninen, Ritva [Kuopio University Hospital and University of Kuopio, Department of Clinical Radiology, Kuopio (Finland); Koivisto, Timo; Aeikiae, Marja [Kuopio University Hospital and University of Kuopio, Department of Neurosurgery, Kuopio (Finland); Niskanen, Eini [Kuopio University Hospital and University of Kuopio, Department of Neurology, Kuopio (Finland); Kuopio University Hospital and University of Kuopio, Department of Physics, Kuopio (Finland); Koenoenen, Mervi [Kuopio University Hospital and University of Kuopio, Department of Clinical Radiology, Kuopio (Finland); Kuopio University Hospital and University of Kuopio, Department of Clinical Neurophysiology, Kuopio (Finland); Haenninen, Tuomo [Kuopio University Hospital and University of Kuopio, Department of Neurology, Kuopio (Finland)

    2009-11-15

    Cognitive impairment after aneurysmal subarachnoid hemorrhage (aSAH) is frequently detected. Here, we describe the pattern of cerebral (gray matter) atrophy and its clinical relevance after treatment of aSAH caused by a ruptured anterior cerebral artery (ACA) aneurysm. Thirty-seven aSAH patients with ACA aneurysm (17 surgical, 20 endovascular treatment) and a good or moderate clinical outcome (Glasgow Outcome Scale V or IV) and 30 controls underwent brain MRI. Voxel-based morphometric analysis was applied to compare the patients and controls. Patients also underwent a detailed neuropsychological assessment. The comparisons between controls and either all patients (n=37) or the subgroup of surgically treated patients (n=17) revealed bilateral cortical atrophy in the frontal lobes, mainly in the basal areas. The brainstem, bilateral thalamic and hypothalamic areas, and ipsilateral caudate nucleus were also involved. Small areas of atrophy were detected in temporal lobes. The hippocampus and parahippocampal gyrus showed atrophy ipsilateral to the surgical approach. In the subgroup of endovascularly treated patients (n = 15), small areas of atrophy were detected in the bilateral orbitofrontal cortex and in the thalamic region. Twenty patients (54%) showed cognitive deficits in neuropsychological assessment. Group analysis after aSAH and treatment of the ruptured ACA aneurysm revealed gray matter atrophy, principally involving the frontobasal cortical areas and hippocampus ipsilateral to the surgical approach. Areas of reduced gray matter were more pronounced after surgical than endovascular treatment. Together with possible focal cortical infarctions and brain retraction deficits in individual patients, this finding may explain the neuropsychological disturbances commonly detected after treatment of ruptured ACA aneurysms. (orig.)

  10. Brain atrophy and neuropsychological outcome after treatment of ruptured anterior cerebral artery aneurysms: a voxel-based morphometric study

    International Nuclear Information System (INIS)

    Cognitive impairment after aneurysmal subarachnoid hemorrhage (aSAH) is frequently detected. Here, we describe the pattern of cerebral (gray matter) atrophy and its clinical relevance after treatment of aSAH caused by a ruptured anterior cerebral artery (ACA) aneurysm. Thirty-seven aSAH patients with ACA aneurysm (17 surgical, 20 endovascular treatment) and a good or moderate clinical outcome (Glasgow Outcome Scale V or IV) and 30 controls underwent brain MRI. Voxel-based morphometric analysis was applied to compare the patients and controls. Patients also underwent a detailed neuropsychological assessment. The comparisons between controls and either all patients (n=37) or the subgroup of surgically treated patients (n=17) revealed bilateral cortical atrophy in the frontal lobes, mainly in the basal areas. The brainstem, bilateral thalamic and hypothalamic areas, and ipsilateral caudate nucleus were also involved. Small areas of atrophy were detected in temporal lobes. The hippocampus and parahippocampal gyrus showed atrophy ipsilateral to the surgical approach. In the subgroup of endovascularly treated patients (n = 15), small areas of atrophy were detected in the bilateral orbitofrontal cortex and in the thalamic region. Twenty patients (54%) showed cognitive deficits in neuropsychological assessment. Group analysis after aSAH and treatment of the ruptured ACA aneurysm revealed gray matter atrophy, principally involving the frontobasal cortical areas and hippocampus ipsilateral to the surgical approach. Areas of reduced gray matter were more pronounced after surgical than endovascular treatment. Together with possible focal cortical infarctions and brain retraction deficits in individual patients, this finding may explain the neuropsychological disturbances commonly detected after treatment of ruptured ACA aneurysms. (orig.)

  11. Successful recanalization for internal carotid artery occlusion with persistent primitive trigeminal artery manifesting only as ischemia of the posterior circulation

    OpenAIRE

    Hiramatsu, Ryo; Ohnishi, Hiroyuki; Kawabata, Shinji; Miyachi, Shigeru; KUROIWA, Toshihiko

    2016-01-01

    Background Internal carotid artery (ICA) occlusion mainly manifests as ischemia of the anterior circulation. There are very few reports of ICA occlusion manifesting as only ischemia of the posterior circulation related to a fetal type posterior communicating artery or other arteries. Case presentation The authors experienced a case of ICA occlusion with persistent primitive trigeminal artery (PPTA) manifesting only as ischemia of the posterior circulation. In this case, the initial NIHSS scor...

  12. Intramedullary fixation of proximal humerus fractures: do locking bolts endanger the axillary nerve or the ascending branch of the anterior circumflex artery? A cadaveric study

    Directory of Open Access Journals (Sweden)

    Sermon An

    2008-12-01

    Full Text Available Abstract Background Proximal humerus fractures are one of the most common fractures. Intramedullary locked nailing is becoming a popular alternative treatment, especially for easier fracture patterns. Although axillary nerve injury has been reported, no study has compared the safety of the proximal locking options relative to the axillary nerve and the ascending branch of the anterior circumflex artery. Method Six different commercially available proximal humeral nails were implanted in 30 shoulders of 18 cadavers. After fluoroscopically guided implantation the shoulders were carefully dissected and the distance between the locking screws, the axillary nerve and the ascending branch of the anterior circumflex artery was measured. Results The course of the axillary nerve varies. A mean distance of 55.8 mm (SD = 5.3 between the lateral edge of the acromions and the axillary nerve at the middle of the humerus in a neutrally rotated position was observed. The minimum distance was 43.4 mm, the maximum 63.9 mm. Bent nails with oblique head interlocking bolts appeared to be the most dangerous in relation to the axillary nerve. The two designs featuring such a bend and oblique bolt showed a mean distance of the locking screw to the axillary nerve of 1 mm and 2.7 mm respectively Sirus (Zimmer® and (Stryker® T2 PHN (Proximal Humeral Nail. Regarding the ascending branch of the anterior circumflex artery, there was no difference between the nails which have an anteroposterior locking option. Conclusion It is of great importance for surgeons treating proximal humerus fractures to understand the relative risk of any procedure they perform. Since the designs of different nailing systems risk damaging the axillary nerve and ascending branch, blunt dissection, the use of protection sleeves during drilling and screw insertion, and individual risk evaluation prior to the use of a proximal humeral nail are advocated.

  13. Congenital absence of the internal carotid artery and the basilar artery with persistent trigeminal artery associated with coarctation of the aorta

    Energy Technology Data Exchange (ETDEWEB)

    Jaeger, H.J.; Mehring, U.M.; Gissler, H.M.; Mathias, K.D. [Dept. of Diagnostic Radiology, Staedtische Kliniken Dortmund (Germany); Dept. of Radiology and MicroTherapy, Univ. of Witten/Herdecke (Germany)

    2000-11-01

    We report a case of congenital absence of the cervical and petrous part of the left internal carotid artery, the middle and proximal part of the basilar artery, and the V4 segment of the left vertebral artery associated with a left persistent trigeminal artery and a coarctation of the aorta. The left cerebral vessels are supplied via the anterior communicating artery and the left persistent trigeminal artery. The coexisting coarctation of the aorta led to a subclavian steal phenomenon. The alteration of the cerebral hemodynamics has to be taken in consideration when performing cerebral angiography and surgical correction in such a case. (orig.)

  14. Congenital absence of the internal carotid artery and the basilar artery with persistent trigeminal artery associated with coarctation of the aorta

    International Nuclear Information System (INIS)

    We report a case of congenital absence of the cervical and petrous part of the left internal carotid artery, the middle and proximal part of the basilar artery, and the V4 segment of the left vertebral artery associated with a left persistent trigeminal artery and a coarctation of the aorta. The left cerebral vessels are supplied via the anterior communicating artery and the left persistent trigeminal artery. The coexisting coarctation of the aorta led to a subclavian steal phenomenon. The alteration of the cerebral hemodynamics has to be taken in consideration when performing cerebral angiography and surgical correction in such a case. (orig.)

  15. Development of anterior inferior cerebellar artery pseudoaneurysm after gamma knife surgery for vestibular schwannoma. A case report and review of the literature.

    Science.gov (United States)

    Sunderland, Geraint; Hassan, Faizul; Bhatnagar, Priya; Mitchell, Patrick; Jayakrishnan, Vijayam; Forster, David; Mendelow, Alexander David

    2014-08-01

    Gamma knife surgery (GKS) is a well-established modality for controlling the progression of vestibular schwannomas. Adverse effects of this treatment are extremely rare but include cyst formation and malignant transformation. We report a case of anterior inferior cerebellar artery (AICA) pseudoaneurysm development rupture presenting as a poor WFNS grade subarachnoid haemorrhage. This is only the fourth case of aneurysm development (AICA aneurysm) following GKS reported but due to its serious nature we believe this potential complication warrants awareness in those offering this treatment. PMID:24111706

  16. Congestive myelopathy (Foix-Alajouanine Syndrome due to intradural arteriovenous fistula of the filum terminale fed by anterior spinal artery: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Prasad Krishnan

    2013-01-01

    Full Text Available Spinal arteriovenous fistulas are rare entities. They often present with congestive myelopathy but are infrequently diagnosed as the cause of the patients′ symptoms. Only one such case has been described previously in Indian literature. We describe one such case who presented to us after a gap of 3 years since symptom onset and following a failed laminectomy where the cause was later diagnosed to be an intradural fistula in the filum terminale fed by the anterior spinal artery and review the available literature.

  17. Case of Behçet's disease complicated by oculomotor nerve palsy associated with internal carotid artery-posterior communicating artery aneurysm.

    Science.gov (United States)

    Yamaoka, Toshifumi; Murota, Hiroyuki; Katayama, Ichiro

    2015-03-01

    Behçet's disease (BD) is a relapsing systemic inflammatory disorder of unknown etiology involving systemic vasculitis. Vasculitis in BD results from the involvement of arteries, veins and blood vessels of all sizes, which leads to the three major manifestations of this condition: venous occlusion, arterial occlusion and aneurysm formation. Therefore, whole-body vascular involvement should always be considered in BD patients. Here, we describe the first appearance of an internal carotid-posterior communicating artery aneurysm, resulting in complete oculomotor nerve palsy in a BD patient. A 44-year-old Japanese man suffered from recurrent episodes of erythema nodosum that had presented on the lower extremities for the past 2 years. His condition was diagnosed as an incomplete type of BD based on relapsing oral and genital ulcers, skin eruptions, such as erythema nodosum and folliculitis, a positive pathergy test and systemic arthralgia. Ten years after his initial clinical presentation, he had manifestations of right-sided ptosis and cyclic dull pain in his right temporal region. Magnetic resonance imaging and angiography revealed a right internal carotid artery-posterior communicating artery aneurysm. Although oculomotor nerve palsy associated with internal carotid artery-posterior communicating artery aneurysm in a BD patient has not been reported previously, our report highlights the fact that this abnormal manifestation should be considered in those with vasculo-BD. PMID:25573207

  18. Intra-arterial thrombolysis using rt-PA in patients with acute stroke due to vessel occlusion of anterior and/or posterior cerebral circulation

    International Nuclear Information System (INIS)

    The aim of our study was to evaluate the safety and efficacy of intra-arterial (IA) thrombolysis using recombinant tissue plasminogen activator (rt-PA) in patients with acute stroke due to occlusion in the anterior or posterior circulation. We retrospectively analyzed the clinical and radiological data of 88 consecutive patients with acute ischemic stroke who underwent emergency cerebral angiography for the purpose of subsequent IA thrombolysis. The neurological deficit on admission and discharge was graded using the National Institutes of Health Stroke Scale (NIHSS) score. Baseline computer tomography (CT) scans were examined for any signs indicative of cerebral ischemia. The angiographic findings were classified according to the Thrombolysis in Myocardial Infarction (TIMI) score for myocardial infarction. Follow-up CT scans were examined for hemorrhagic complication. Of the 88 patients who underwent IA thrombolysis, 63 presented with complete or partial arterial occlusion in the suspected perfusion area. In these 63 patients, the median NIHSS score dropped from 15 points on admission to 10 points at discharge. The recanalization rate was 52.6% for partial and complete reperfusion. In-hospital mortality was 20.6% (9.1% for carotid, 44.4% for basilar territory occlusion). Intracerebral bleeding (ICB) occurred in 38.6% of the patients with occlusion in the anterior circulation, resulting in these patients presenting a worse clinical outcome than those without ICB. Only minor extracranial bleedings occurred in 20.6% of patients. Patients with ICB had a significantly higher frequency of ischemic signs on the baseline CT scan. Occlusion of a cerebral artery is present in about 75% of the patients eligible for thrombolytic therapy. Intra-arterial thrombolysis using rt-PA in patients with acute ischemic stroke can achieve re-vascularization, although ICB remains the major risk factor affecting its efficacy. (orig.)

  19. Intra-arterial thrombolysis using rt-PA in patients with acute stroke due to vessel occlusion of anterior and/or posterior cerebral circulation

    Energy Technology Data Exchange (ETDEWEB)

    Tountopoulou, Argyro; Ahl, Bjoern; Weissenborn, Karin [Hannover Medical School, Department of Neurology and Clinical Neurophysiology, Hannover (Germany); Becker, Hartmut; Goetz, Friedrich [Hannover Medical School, Department of Neuroradiology, Hannover (Germany)

    2008-01-15

    The aim of our study was to evaluate the safety and efficacy of intra-arterial (IA) thrombolysis using recombinant tissue plasminogen activator (rt-PA) in patients with acute stroke due to occlusion in the anterior or posterior circulation. We retrospectively analyzed the clinical and radiological data of 88 consecutive patients with acute ischemic stroke who underwent emergency cerebral angiography for the purpose of subsequent IA thrombolysis. The neurological deficit on admission and discharge was graded using the National Institutes of Health Stroke Scale (NIHSS) score. Baseline computer tomography (CT) scans were examined for any signs indicative of cerebral ischemia. The angiographic findings were classified according to the Thrombolysis in Myocardial Infarction (TIMI) score for myocardial infarction. Follow-up CT scans were examined for hemorrhagic complication. Of the 88 patients who underwent IA thrombolysis, 63 presented with complete or partial arterial occlusion in the suspected perfusion area. In these 63 patients, the median NIHSS score dropped from 15 points on admission to 10 points at discharge. The recanalization rate was 52.6% for partial and complete reperfusion. In-hospital mortality was 20.6% (9.1% for carotid, 44.4% for basilar territory occlusion). Intracerebral bleeding (ICB) occurred in 38.6% of the patients with occlusion in the anterior circulation, resulting in these patients presenting a worse clinical outcome than those without ICB. Only minor extracranial bleedings occurred in 20.6% of patients. Patients with ICB had a significantly higher frequency of ischemic signs on the baseline CT scan. Occlusion of a cerebral artery is present in about 75% of the patients eligible for thrombolytic therapy. Intra-arterial thrombolysis using rt-PA in patients with acute ischemic stroke can achieve re-vascularization, although ICB remains the major risk factor affecting its efficacy. (orig.)

  20. Peripheral communications of intercostobrachial nerve Peripheral communications of the intercostobrachial nerve in relation to the alar thoracic artery

    Directory of Open Access Journals (Sweden)

    Shaifaly Madan Rustagi

    2015-01-01

    Full Text Available The intercostobrachial nerve (ICBN is often encountered during axillary dissection for axillary lymph node dissection (ALND for diagnostic and therapeutic surgery for mastectomy. The present report is a case observed in the Department of Anatomy at Vardhman Mahavir Medical College, Delhi during routine dissection of the upper extremity of a male cadaver for first year undergraduate medical students. On the right side , the medial cord of brachial plexus gave two medial cutaneous nerves of arm. Both the nerves were seen communicating with the branches of the ICBN. The ICBN and one of its branches were surrounding the termination of an alar thoracic artery. These peripheral neural connections of the ICBN with the branches of the medial cord can be a cause of sensory impairment during axillary procedures done for mastectomy or exploration of long thoracic nerves. The alar thoracic artery found in relation to the ICBN could further be a cause of vascular complications during such procedures.

  1. Subtemporal approach to basilar tip aneurysm with division of posterior communicating artery: Technical note

    Directory of Open Access Journals (Sweden)

    Shunsuke Kakino

    2008-09-01

    Full Text Available Shunsuke Kakino, Kuniaki Ogasawara, Yoshitaka Kubo, Hideaki Nishimoto, Akira OgawaDepartment of Neurosurgery, Iwate Medical University School of Medicine, Morioka, Iwate, JapanAbstract: The subtemporal approach with division of the posterior communicating artery (PcomA is described for treating aneurysms of the basilar tip. When the ipsilateral posterior cerebral artery (PCA interferes with visibility and manipulation around the aneurysm neck and the artery is tethered by the PcomA and not mobilized, the PcomA can be divided near the junction with the PCA. The procedure permits PCA mobilization and exposes the neck of the aneurysm. We applied this procedure to a patient with a ruptured aneurysm of the basilar tip. The postoperative course was uneventful except for transient left oculomotor nerve palsy. Postoperative cerebral angiography and magnetic resonance imaging confirmed the respective disappearance of the aneurysm and no new ischemic lesions. The subtemporal approach allows safer and easier division of the PcomA near the junction to the PCA compared with the pterional approach, and the present procedure is more suitable for the subtemporal approach.Keywords: basilar tip aneurysm, subtemporal approach, posterior communicating artery

  2. Endovascular Embolization of Ruptured Infundibular Dilation of Posterior Communicating Artery: A Case Report

    OpenAIRE

    Jinlu Yu; Honglei Wang; Kan Xu; Bai Wang; Qi Luo

    2010-01-01

    Hemorrhage due to the rupture of the infundibular dilatation of the posterior communicating artery (ID of the PCo-A) occurs infrequently. The preferred treatment of such hemorrhages is surgical clipping through craniotomy. There are few reports about endovascular coil embolization in such cases. We report such a case treated by endovascular embolization. A 35-year-old man, who had experienced 2 episodes of subarachnoid hemorrhage (SAH), was found to have a ruptured ID of the PCo-A by head com...

  3. Is prophylactic embolization of the hepatic falciform artery needed before radioembolization in patients with {sup 99m}Tc-MAA accumulation in the anterior abdominal wall?

    Energy Technology Data Exchange (ETDEWEB)

    Ahmadzadehfar, Hojjat; Sabet, Amir; Muckle, Marianne; Haslerud, Torjan; Biersack, Hans Juergen; Ezziddin, Samer [University Hospital Bonn, Department of Nuclear Medicine, Bonn (Germany); Moehlenbruch, Markus; Meyer, Carsten; Wilhelm, Kai; Schild, Hans Heinz [University Hospital Bonn, Department of Radiology, Bonn (Germany)

    2011-08-15

    While influx of chemoembolic agents into the hepatic falciform artery (HFA) from the hepatic artery can cause supraumbilical skin rash, epigastric pain and even skin necrosis, the significance of a patent HFA in patients undergoing radioembolization is not completely clear. Furthermore, the presence of tracer in the anterior abdominal wall seen in {sup 99m}Tc-macroaggregated albumin ({sup 99m}Tc-MAA) images, which is generally performed prior to radioembolization, has been described as a sign of a patent HFA. The aim of this retrospective study was to evaluate the incidence and consequences of {sup 99m}Tc-MAA accumulation in the anterior abdominal wall, indicating a patent HFA, in patients undergoing radioembolization of liver tumours. A total of 224 diagnostic hepatic angiograms combined with {sup 99m}Tc-MAA SPECT/CT were acquired in 192 patients with different types of cancer, of whom 142 were treated with a total of 214 radioembolization procedures. All patients received a whole-body scan, and planar and SPECT/CT scans of the abdomen. Only patients with extrahepatic {sup 99m}Tc-MAA accumulation in the anterior abdominal wall were included in this study. Posttreatment bremsstrahlung SPECT/CT and follow-up results for at least 3 months served as reference standards. Tracer accumulation in the anterior abdominal wall was present in pretreatment {sup 99m}Tc-MAA SPECT/CT images of 18 patients (9.3%). The HFA was found and embolized by radiologists before treatment in one patient. In the remaining patients radioembolization was performed without any modification in the treatment plan despite the previously mentioned extrahepatic accumulation. Only one patient experienced abdominal muscle pain above the navel, which started 24 h after treatment and lasted for 48 h without any skin changes. The remaining patients did not experience any relevant side effects during the follow-up period. Side effects after radioembolization in patients with tracer accumulation in the

  4. Morphological, histochemical, and interstitial pressure changes in the tibialis anterior muscle before and after aortofemoral bypass in patients with peripheral arterial occlusive disease

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    Grigoriadis Nikolaos

    2002-02-01

    Full Text Available Abstract Background Morphological and electrophysiological studies of ischemic muscles in peripheral arterial disease disclosed evidence of denervation and fibre atrophy. The purpose of the present study is to describe morphological changes in ischemic muscles before and after reperfusion surgery in patients with peripheral occlusive arterial disease, and to provide an insight into the effect of reperfusion on the histochemistry of the reperfused muscle. Methods Muscle biopsies were obtained from the tibialis anterior of 9 patients with chronic peripheral arterial occlusive disease of the lower extremities, before and after aortofemoral bypass, in order to evaluate the extent and type of muscle fibre changes during ischemia and after revascularization. Fibre type content and muscle fibre areas were quantified using standard histological and histochemical methods and morphometric analysis. Each patient underwent concentric needle electromyography, nerve conduction velocity studies, and interstitial pressure measurements. Results Preoperatively all patients showed muscle fibre atrophy of both types, type II fibre area being more affected. The mean fibre cross sectional area of type I was 3,745 μm2 and of type II 4,654 μm2 . Fibre-type grouping, great variation in fibre size and angular fibres were indicative of chronic dennervation-reinnervation, in the absence of any clinical evidence of a neuropathic process. Seven days after the reperfusion the areas of both fibre types were even more reduced, being 3,086 μm2 for type I and 4,009 μm2 for type II, the proportion of type I fibres, and the interstitial pressure of tibialis anterior were increased. Conclusions The findings suggest that chronic ischemia of the leg muscles causes compensatory histochemical changes in muscle fibres resulting from muscle hypoxia, and chronic dennervation-reinnervation changes, resulting possibly from ischemic neuropathy. Reperfusion seems to bring the oxidative

  5. The blood flow in the posterior communicant artery. Angiographic study by using magnetic resonance

    CERN Document Server

    Portela, L A P

    1995-01-01

    did not change the direction of flow present, in the circumstances of this study. The arterial circle of Willis is the most important collateral pathway for the cerebral vessels when one the afferents is occluded. Its normal function, without vascular compromise, has been considered in conflicting ways in the literature. For centuries after its description by Thomas Willis in 1664 it was considered a flow equalizer, with free admixture of blood within it. Since the beginning of this century the dominant view is one of a potential value only, with null effective flow in the communicating arteries. The premise is included in different experimental models. Alternatively, it was considered that the normal direction of flow is antero-posterior, from carotid to posterior cerebral, since carotid flow is greater. Using phase-contrast magnetic resonance angiography, a non-invasive qualitative method, it was found in 40 patients without morphological brain abnormality and in 10 healthy volunteers that flow can be seen ...

  6. Operative strategy of complex internal carotid artery-posterior communicating artery aneurysms Defensive effect on perioperative nerve injury

    Institute of Scientific and Technical Information of China (English)

    Xinmin Wang; Wende Xiong; Xuqin Li

    2007-01-01

    BACKGROUND: The two problems in treating intracranial aneurysm are the vascular reconstruction and brain protection, especially for complex internal carotid artery-posterior communicating artery (ICA-PComA)aneurysms.OBJECTIVE: To analyze the anatomic features and operative technique of complex ICA-PComA aneurysms, and investigate how to better protect the brain tissue.DESIGN: A retrospective case analysis.SETTING: Department ofNeurosurgery, Dalian Central Hospital.PARTICIPANTS: Totally 154 inpatients with ICA-PComA aneurysms were selected from the Department of Neurosurgery, Dalian Central Hospital from January 1998 to December 2006, including 19 cases (12.3%)of complex ICA-PComA aneurysms, 8 males and 11 females, 38 - 67 years of age. Informed contents for surgery and observation were obtained from all the patients or their relatives.METHODS: The clinical manifestations, including initial symptoms and Hunt&Hess grading, were observed. Corresponding strategies were selected for different types of ICA-PComA aneurysms. The patients were followed up at 3 months postoperatively. According to the results of Glasgow scoring, the curative effects were classified as good (4 - 5 points), bad (2 - 3 points) and dead (1 point). The results at discharge were taken as early results, whereas the follow-up results as late results.MAIN OUTCOME MEASURES: Clinical manifestations and curative effects of the patients.RESULTS: All the 19 patients with ICA-PComA were involved in the analysis of results. For clinical manifestations, the initial symptoms were subarachnoid hemorrhage (n =15), paralysis of oculomotor nerve (n =3), and occasional attack (n =1); The Hunt&Hess grading was grade Ⅰ in 4 cases, grade Ⅱ in 6 cases,grade Ⅲ in 6 cases, grade Ⅳ in 2 cases, and grade Ⅴ in 1 case. The curative effects were that aneurysm breakage and bleeding occurred in 6 cases perioperatively, uncomplete clipping of aneurysm in 2 cases and constriction of parent artery in 1 case. The

  7. Recognizing Wellens’ syndrome, a warning sign of critical proximal LAD artery stenosis and impending anterior myocardial infarction

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    Laura Hollar

    2015-10-01

    Full Text Available Wellens’ syndrome, also known as LAD coronary T-wave syndrome or the ‘widow maker’, is a pre-infarction syndrome with non-classical ischemic ECG changes and unremarkable cardiac biomarkers. This syndrome continues to be a ‘can't miss’ for the clinician as delay in urgent angiography and intervention can result in anterior myocardial infarction, left ventricular dysfunction, arrhythmias, and death. We describe a case followed by a discussion of identification criteria and clinical implications.

  8. Left anterior descending coronary artery blood flow and left ventricular unloading during extracorporeal membrane oxygenation support in a swine model of acute cardiogenic shock.

    Science.gov (United States)

    Brehm, Christoph; Schubert, Sarah; Carney, Elizabeth; Ghodsizad, Ali; Koerner, Michael; McCoach, Robert; El-Banayosy, Aly

    2015-02-01

    The impact of extracorporeal membrane oxygenation (ECMO) support on coronary blood flow and left ventricular unloading is still debated. This study aimed to further characterize the influence of ECMO on coronary artery blood flow and its ability to unload the left ventricle in a short-term model of acute cardiogenic shock. Seven anesthetized pigs were intubated and then underwent median sternotomy and cannulation for venoarterial (VA) ECMO. Flow in the left anterior descending (LAD) artery, left atrial pressure (LAP), left ventricular end-diastolic pressure (LVEDP), and mean arterial pressure (MAP) were measured before and after esmolol-induced cardiac dysfunction and after initiating VA-ECMO support. Induction of acute cardiogenic shock was associated with short-term increases in LAP from 8 ± 4 mm Hg to 18 ± 14 mm Hg (P = 0.9) and LVEDP from 5 ± 2 mm Hg to 13 ± 17 mm Hg (P = 0.9), and a decrease in MAP from 63 ± 16 mm Hg to 50 ± 24 mm Hg (P = 0.3). With VA-ECMO support, blood flow in the LAD increased from 28 ± 25 mL/min during acute unsupported cardiogenic shock to 67 ± 50 mL/min (P = 0.003), and LAP and LVEDP decreased to 8 + 5 mm Hg (P = 0.7) and 5 ± 3 mm Hg (P = 0.5), respectively. In this swine model of acute cardiogenic shock, VA-ECMO improved coronary blood flow and provided some degree of left ventricular unloading for the short duration of the study. PMID:24935151

  9. Achieving highly esthetic anterior restorations with ideal assessment, communication, and technique.

    Science.gov (United States)

    Finlay, Scott; Rego, Nelson

    2014-01-01

    Although all cases should be approached comprehensively, restoring a limited segment in the esthetic zone presents challenges particularly related to microesthetics. Microesthetics are those criteria related to the subtle intricacies of shade, textures, translucencies, and surface effects that make teeth look like teeth. These are the criteria that aid dentists in fooling the eye and allowing restorations to blend invisibly into the smile. Completing a comprehensive assessment of a patient ensures that the restorative foundation will remain biologically and structurally predictable, durable, and above all, esthetically pleasing. Starting esthetic treatment without first doing a comprehensive assessment will result in a compromised result. Within the criteria of microesthetics, the utilization of a common nomenclature and quantitative means of communication between the restorative dentist and the laboratory ceramist are at the core of success. The use of prototypes during the provisionalization phase and progressive techniques in digital photography are invaluable tools. Along with traditional techniques in acquiring proper shade selection, the use of cross-polarization filters has been proven to be an effective way to eliminate spectral artifacts typically found in flash photography. Additionally, the use of a color-corrected master die system provides the ceramist a method to calibrate shades on the lab bench by capturing images--via the cross-polarization filters--that are similar to what is observed clinically. PMID:25369384

  10. Relationship between Willis circle variation and the occurrence of anterior and posterior communicaring artery aneurysms investigated by 64-slice CT angiography%CT血管成像评价颅内Willis环变异与前后交通动脉动脉瘤发生的关系

    Institute of Scientific and Technical Information of China (English)

    王洪生; 徐新文; 王辉; 杨昭伟; 王鹏; 赵佩林; 王阳春

    2011-01-01

    目的 探讨大脑前动脉水平段(A1段)发育异常和胚胎型大脑后动脉与颅内前、后交通动脉动脉瘤形成的关系. 方法 回顾性分析216例64排CT血管成像(CTA)的资料.①将216例中CTA发现有前后交通动脉动脉瘤的126例,分为前交通动脉动脉瘤(ACoAA)组69例和后交通动脉动脉瘤(PCoAA)组57例,其余CTA检查无动脉瘤,但有头痛、头晕的90例患者,作为对照组.②分析动脉瘤的有无,动脉瘤的部位、形态、大小和瘤颈的宽度、瘤顶指向及瘤体与周围结构的关系等.③将判定结果与手术结果进行对照.④同时观察大脑前动脉A1段是否存在发育不良或缺如,是否存在胚胎型大脑后动脉. 结果 ①64排CTA共检出前、后交通动脉动脉瘤126例,其中ACoAA 69例,PCoAA57例,以DSA和手术为判断标准,64排CTA检出动脉瘤的敏感性和特异性均为100%.②ACoAA组中一侧A1段发育不良或缺如达81.7%,明显高于PCoAA组和对照组(P <0.05);PCoAA组中胚胎型大脑后动脉达56.1%,明显高于ACoAA组和对照组(P<0.05).结论 (1)64排CTA检出动脉瘤具有较高的敏感性和特异性;②一侧大脑前动脉Al段发育不良或缺如及胚胎型大脑后动脉与前、后交通动脉动脉瘤的发生密切相关.%Objective To investigate the relationship between the dysplasia of horizontal segment ( A1 segment) of anterior cerebral artery and the formation of anterior and posterior communicating artery aneurysms. Methods The data of 64-slice computed tomography angiography (CTA) of 216 patients were analyzed retrospectively. Of the 216 patients, CTA found 126 patients with aneurysm. They were di-vided into anterior communicating artery aneurysm ( ACoAA) group (n =69) and posterior communicating artery aneurysm (PCoAA)group (re =57). The other patients without aneurysm revealed by CTA but with headache and dizziness (n =90) were used as a control group. The presence or absence of aneurysm

  11. A comparative study of clinical signs, computed tomography, and electroencephalography after direct operation of ruptured anterior communicating aneurysms, 1

    International Nuclear Information System (INIS)

    Eight cases with ruptured anterior communicating aneurysms, who developed mental signs of mild degree lasting more than two weeks following direct operation, were subjected to our study. The following results were obtained. 1) The mental signs of mild degree in 8 cases consisted of memory and emotional disturbances. The main findings of CT scan was low density area in the subcortical and cortical areas of the frontal lobe. There was no close correlation on CT findings between memory and emotional disturbances. 2) Abnormal density areas were detected on CT scan, but EEG showed no localized abnormalities of slow waves. Abnormal density areas were not clearly shown on CT, but EEG showed localized abnormalities. Background activities on EEG were favorable despite lesions detected on CT. Either local or diffuse abnormalities were observed in EEG background activities while no abnormal mental signs were recognized. 3) In cases with no apparent abnormal findings on CT and with favorable background activities on EEG, EEG showed marked build up during hyperventilation. 4) As indicated by the above data, comparative studies of CT and EEG findings revealed differences in sites of abnormalities and degree of abnormalities. This is considered caused by a possible increase in cerebral blood flow and metabolism at initiation of chronic stage following subarachnoid hemorrhage-resulting in the disappearance of abnormalities on EEG. (author)

  12. Fusiform aneurysm of a persistent trigeminal artery associated with rare intracranial arterial variations and subarachnoid hemorrhage.

    Science.gov (United States)

    Kimball, David; Ples, Horia; Kimball, Heather; Miclaus, Gratian D; Matusz, Petru; Loukas, Marios

    2015-01-01

    The trigeminal artery is one of four primitive anastomoses between the internal carotid artery and vertebrobasilar system that regresses in the sixth week of fetal development. A persistent trigeminal artery (PTA) is generally an incidental finding but may also be associated with intracranial vascular pathologies such as aneurysms, arteriovenous malformations, and cranial nerve compression syndromes. We present an extremely rare case of a right PTA with an associated bleeding fusiform aneurysm located in the carotidian (lateral) part of the PTA. In addition, this rare anatomic variation was associated with bilateral absence of the posterior communicating arteries, a left posterior cerebral artery originating from the left internal carotid artery, and agenesis of the A1 segment of the left anterior cerebral artery. PMID:25053265

  13. Myocardial Bridging of the Left Anterior Descending Coronary Artery: Depiction Rate and Morphologic Features by Dual-Source CT Coronary Angiography

    International Nuclear Information System (INIS)

    To evaluate the depiction rate and morphologic features of myocardial bridging (MB) of the left anterior descending coronary artery (LAD) using dual-source CT (DSCT). CT scans from a total of 1,353 patients who underwent DSCT were reviewed retrospectively for LAD-MB. Seventy-eight patients were excluded due to poor image quality or poor enhancement of the coronary artery. The length and depth of the MB were analyzed and classified as superficial or deep with respect to the depth (≤ 1 or > 1 mm) of the LAD tunneled segment. Superficial MB was subdivided into complete or incomplete types according to full or partial encasement of the myocardium. Of the 1,275 patients included in this study, 557 cases of MB were found from 536 patients (42%). Superficial MB was observed in 368 of 557 (66%) cases, and deep MB was seen in 189 of 557 (34%) cases. Superficial MB showed 2 types: complete (128 of 368, 35%) and incomplete (240 of 368, 65%). The mean length of a tunneled segment for superficial MB was 16.4 ± 8.6 mm. The mean length and depth of a tunneled segment for deep MB were 27.6 ± 12.8 mm and 3.0 ± 1.4 mm, respectively. The incidence of atherosclerotic plaques in a 2-cm-long segment proximal to MB was 16%. The depiction rate of LAD-MB using DSCT in a large series of patients was 42%, with two-thirds of MB segments being the superficial type

  14. Myocardial Bridging of the Left Anterior Descending Coronary Artery: Depiction Rate and Morphologic Features by Dual-Source CT Coronary Angiography

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Jin Ho; Ko, Sung Min; Roh, Hong Gee; Song, Meong Gun; Shin, Je Kyoun; Chee, Hyun Kun; Kim, Joon Suk [Konkuk University School of Medicine, Konkuk University Hospital, Seoul (Korea, Republic of)

    2010-10-15

    To evaluate the depiction rate and morphologic features of myocardial bridging (MB) of the left anterior descending coronary artery (LAD) using dual-source CT (DSCT). CT scans from a total of 1,353 patients who underwent DSCT were reviewed retrospectively for LAD-MB. Seventy-eight patients were excluded due to poor image quality or poor enhancement of the coronary artery. The length and depth of the MB were analyzed and classified as superficial or deep with respect to the depth ({<=} 1 or > 1 mm) of the LAD tunneled segment. Superficial MB was subdivided into complete or incomplete types according to full or partial encasement of the myocardium. Of the 1,275 patients included in this study, 557 cases of MB were found from 536 patients (42%). Superficial MB was observed in 368 of 557 (66%) cases, and deep MB was seen in 189 of 557 (34%) cases. Superficial MB showed 2 types: complete (128 of 368, 35%) and incomplete (240 of 368, 65%). The mean length of a tunneled segment for superficial MB was 16.4 {+-} 8.6 mm. The mean length and depth of a tunneled segment for deep MB were 27.6 {+-} 12.8 mm and 3.0 {+-} 1.4 mm, respectively. The incidence of atherosclerotic plaques in a 2-cm-long segment proximal to MB was 16%. The depiction rate of LAD-MB using DSCT in a large series of patients was 42%, with two-thirds of MB segments being the superficial type

  15. Decreases in electrocardiographic R-wave amplitude and QT interval predict myocardial ischemic infarction in Rhesus monkeys with left anterior descending artery ligation.

    Directory of Open Access Journals (Sweden)

    Xiaorong Sun

    Full Text Available Clinical studies have demonstrated the predictive values of changes in electrocardiographic (ECG parameters for the preexisting myocardial ischemic infarction. However, a simple and early predictor for the subsequent development of myocardial infarction during the ischemic phase is of significant value for the identification of ischemic patients at high risk. The present study was undertaken by using non-human primate model of myocardial ischemic infarction to fulfill this gap. Twenty male Rhesus monkeys at age of 2-3 years old were subjected to left anterior descending artery ligation. This ligation was performed at varying position along the artery so that it produced varying sizes of myocardial infarction at the late stage. The ECG recording was undertaken before the surgical procedure, at 2 h after the ligation, and 8 weeks after the surgery for each animal. The correlation of the changes in the ECG waves in the early or the late stage with the myocardial infarction size was analyzed. The R wave depression and the QT shortening in the early ischemic stage were found to have an inverse correlation with the myocardial infarction size. At the late stage, the R wave depression, the QT prolongation, the QRS score, and the ST segment elevation were all closely correlated with the developed infarction size. The poor R wave progression was identified at both the early ischemic and the late infarction stages. Therefore, the present study using non-human primate model of myocardial ischemic infarction identified the decreases in the R wave and the QT interval as early predictors of myocardial infarction. Validation of these parameters in clinical studies would greatly help identifying patients with myocardial ischemia at high risk for the subsequent development of myocardial infarction.

  16. Direction of flow in posterior communicating artery on magnetic resonance angiography in patients with occipital lobe infarcts

    NARCIS (Netherlands)

    Jongen, JCF; Franke, CL; Ramos, LMP; Wilmink, JT; van Gijn, J

    2004-01-01

    Background and Purpose - In some people the blood supply to the posterior cerebral artery occurs partly or even exclusively via the carotid system. This anatomic configuration may influence the risk of occipital lobe infarction. We studied the presence and direction of flow in the posterior communic

  17. Avaliação da anastomose de artéria torácica interna esquerda com artéria interventricular anterior pela ecodopplercardiografia Evaluation of left internal thoracic artery anastomosis with left anterior descending coronary artery by Doppler echocardiography

    Directory of Open Access Journals (Sweden)

    Adelaide Arruda

    1997-12-01

    Full Text Available OBJETIVO: Avaliar o valor do ecocardiograma Doppler(ECO transtorácico na identificação de perviabilidade da anastomose entre artéria torácica interna esquerda (ATIE e interventricular anterior, realizada pela técnica de revascularização miocárdica pela minitoracotomia sem circulação extracorpórea. MÉTODOS: Estudaram-se os primeiros 12 pacientes, consecutivos, no período de pós-operatório intra-hospitalar pelo ECO, utilizando-se transdutores de 5MHz, pela via paraesternal esquerda, preferencialmente. Foram analisadas velocidades máximas e integrais de velocidade dos componentes sistólico e diastólico das curvas espectrais de fluxo Doppler. Todos pacientes foram submetidos à cinecoronariografia, enquanto hospitalizados. RESULTADOS: O ECO foi exeqüível em 93% dos pacientes. Nos com anastomose pérvia (6/7, observou-se ao estudo Doppler amplo componente diastólico (padrão A. Naqueles com anastomose obstruída (4/4 o padrão observado foi de predomínio sistólico (padrão B (p=0,003*. CONCLUSÃO: O ECO da ATIE anastomosada com a artéria interventricular anterior, após cirurgia de revascularização miocárdica pela técnica de minitoracotomia, permitiu caracterizar precocemente, com precisão, a perviabilidade da anastomose.PURPOSE: To study the value of Doppler echocardiography as a tool for the evaluation of left internal thoracic artery graft (LITAG patency in patients who underwent coronary revascularization using minimally invasive bypass surgery without extracorporeal circulation. METHODS: The first 12 consecutive patients were studied after coronary artery bypass surgery using a 5MHz Doppler transducer. Doppler signals for the systolic and diastolic flow velocities were preferably obtained in the second intercostal space. All patients underwent coronary angiography while hospitalized. RESULTS: The exam was feasible in 93% of patients. Doppler flow pattern was predominantly diastolic (pattern A in patients with patent

  18. Major and minor arterial malformations in patients with cutaneous vascular abnormalities.

    Science.gov (United States)

    Pascual-Castroviejo, Ignacio; Pascual-Pascual, Samuel I; Viaño, Juan; López-Gutierrez, Juan C; Palencia, Rafael

    2010-05-01

    The association of persistent embryonic arteries and the absence of 1 carotid or vertebral arteries with facial or neck hemangioma or vascular malformation have been frequently described. The abnormalities can involve major or minor vessels. Of 22 patients of our series with this neurocutaneous syndrome, 20 had the origin of both anterior cerebral arteries from the same internal carotid artery. Thirteen patients showed absence or hypoplasia of 1 carotid artery and 10 of 1 vertebral artery; 10 showed persistence of the trigeminal artery; 3 had persistent proatlantal artery; 6 showed the absence of the posterior communicating artery; and 4 had hypoplastic posterior cerebral artery. Other less frequent abnormalities were found in 7 patients. Intellectual level of most patients was either borderline or below normal. Abnormalities in the vascularization and perfusion of the frontal lobes may contribute to the borderline or lower mental level of these patients. PMID:19808986

  19. Cadaveric study using radio-opaque contrast to determine arterial communication between the two bellies of gastrocnemius muscles

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    Pawan Agarwal

    2016-01-01

    Full Text Available Introduction: Gastrocnemius muscle is a workhorse flap to cover upper third tibial defects but has a limitation in covering middle one-third tibial defects. The inferiorly based hemi gastrocnemius muscle flap can be useful for reconstruction of the middle third of the leg. The arterial communication between the gastrocnemius muscle heads has been demonstrated, the consistent location, however, was not studied in large specimens. Materials and Methods: This study was conducted on sixty specimens of gastrocnemius muscles harvested from thirty fresh cadavers to determine arterial communication between two heads of gastrocnemius muscle using radio-opaque contrast with future application of taking one head of muscle distally based for coverage of middle third defect of tibia. A total of 60 specimens were obtained from thirty fresh cadavers. In thirty specimens, medial sural artery ligated and divided and 20 ml iohexol (350 given through popliteal artery. In remaining thirty specimens lateral sural artery ligated and divided and 20 ml iohexol (350 given through popliteal artery. Digital X-rays of gastrocnemius muscle specimens were taken, and collaterals between two bellies in lower half were noted and the distance of collaterals from the muscles top edge was also noted. Results: We found the communications between both bellies of the gastrocnemius muscle in all specimens in both legs. The mean distance of communications from the upper edge of the medial belly was 15.88 cm and from upper edge of the lateral belly was 14.72 cm in the right leg, respectively. The mean distance of communications from upper edge of the medial belly was 16.01 cm and from upper edge of the lateral belly was 13.78 cm in the left leg. The distal communications between gastrocnemius bellies were not constant in their location, but all the connections were present in distal 3.79 cm of raphe. Conclusion: This study supports the future application of inferior

  20. Cadaveric study using radio-opaque contrast to determine arterial communication between the two bellies of gastrocnemius muscles

    Science.gov (United States)

    Agarwal, Pawan; Gupta, K. L.; Yadav, P.; Sharma, Dhananjaya

    2016-01-01

    Introduction: Gastrocnemius muscle is a workhorse flap to cover upper third tibial defects but has a limitation in covering middle one-third tibial defects. The inferiorly based hemi gastrocnemius muscle flap can be useful for reconstruction of the middle third of the leg. The arterial communication between the gastrocnemius muscle heads has been demonstrated, the consistent location, however, was not studied in large specimens. Materials and Methods: This study was conducted on sixty specimens of gastrocnemius muscles harvested from thirty fresh cadavers to determine arterial communication between two heads of gastrocnemius muscle using radio-opaque contrast with future application of taking one head of muscle distally based for coverage of middle third defect of tibia. A total of 60 specimens were obtained from thirty fresh cadavers. In thirty specimens, medial sural artery ligated and divided and 20 ml iohexol (350) given through popliteal artery. In remaining thirty specimens lateral sural artery ligated and divided and 20 ml iohexol (350) given through popliteal artery. Digital X-rays of gastrocnemius muscle specimens were taken, and collaterals between two bellies in lower half were noted and the distance of collaterals from the muscles top edge was also noted. Results: We found the communications between both bellies of the gastrocnemius muscle in all specimens in both legs. The mean distance of communications from the upper edge of the medial belly was 15.88 cm and from upper edge of the lateral belly was 14.72 cm in the right leg, respectively. The mean distance of communications from upper edge of the medial belly was 16.01 cm and from upper edge of the lateral belly was 13.78 cm in the left leg. The distal communications between gastrocnemius bellies were not constant in their location, but all the connections were present in distal 3.79 cm of raphe. Conclusion: This study supports the future application of inferior-based hemigastrocnemius muscles flap

  1. Comparison of outcomes of percutaneous coronary intervention on proximal versus non-proximal left anterior descending coronary artery, proximal left circumflex, and proximal right coronary artery: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Kassaian Seyed

    2007-03-01

    Full Text Available Abstract Background Previous studies have shown that lesions in proximal left anterior descending coronary artery (LAD may develop more restenosis after balloon angioplasty than lesions in other coronary segments. However, stenting seems to have reduced this gap. In this study, we compared outcomes of percutaneous coronary intervention (PCI on proximal LAD versus proximal left circumflex (LCX or right coronary artery (RCA and proximal versus non-proximal LAD. Methods From 1737 patients undergoing PCI between March 2004 and 2005, those with cardiogenic shock, primary PCI, total occlusions, and multivessel or multi-lesion PCI were excluded. Baseline characteristics and in-hospital outcomes were compared in 408 patients with PCI on proximal LAD versus 133 patients with PCI on proximal LCX/RCA (study I and 244 patients with PCI on non-proximal LAD (study II. From our study populations, 449 patients in study I and 549 patients in study II participated in complete follow-up programs, and long-term PCI outcomes were compared within these groups. The statistical methods included Chi-square or Fisher's exact test, student's t-test, stratification methods, multivariate logistic regression and Cox proportional hazards model. Results In the proximal LAD vs. proximal LCX/RCA groups, smoking and multivessel disease were less frequent and drug-eluting stents were used more often (p = 0.01, p Conclusion Despite the known worse prognosis of proximal LAD lesions, in the era of stenting, our long-term outcomes were similar in patients with PCI on proximal LAD versus proximal LCX/RCA and non-proximal LAD. Furthermore, we had better angiographic success rates in patients with PCI on proximal LAD.

  2. Preoperative evaluation of vertebral and posterior communicating arteries using 3-dimensional CT angiography before cervical posterior instrumentation surgery

    International Nuclear Information System (INIS)

    We preoperatively examined 45 patients to investigate the frequency of an anomalous vertebral artery (VA) and the presence of a posterior communicating artery (PCOM) using 3-dimensional CT angiography (3D-CTA). Asymmetry of the VAs was detected in eight patients (18%). Anomalous VAs in the intra- or extraosseous region, including a high-riding VA, persistent 1st intersegmental artery, and ponticulus posticus, were found in a total of 8 patients (18%). Nineteen patients (42%) did not have a PCOM on either side. When a VA, especially the VA on the dominant side, is injured during cervical instrumentation, catastrophic vascular complications occur in approximately 7% of patients who have asymmetrical VAs without collateral circulation. Preoperative 3D-CTA provides information on anomalous VAs and collateral circulation that is crucial to preventing vascular complications. (author)

  3. 前部缺血性视神经病变并发视网膜分支动脉阻塞1例%A case of branch retinal artery obstruction complicated after anterior ischemic optic neuropathy

    Institute of Scientific and Technical Information of China (English)

    Ungsoo Samuel Kim; Hyoung-Seok Kim; Young Ju Lew

    2011-01-01

    AIM: To report a case of branch retinal artery obstruction (BRAO) complicated after anterior ischemic optic neuropathy (AION).METHODS: A 42-year-old woman who complained of visual disturbance was performed ophthalmological examinations such as fundus photography, fluorescent angiography (FAG) and visual field test. RESULTS: At first visit, disc swelling was noted and arterial circulation was intact, however, 1 week after onset, the inferior branch retinal artery began to shrink and the flame hemorrhage intensified. Sixteen months later, the optic disc evidenced an atrophic change; additionally, a ghost vessel in the inferior branch retinal artery was found.CONCLUSION: We report a case of complications of BRAO arising after AION which caused the mechanical compression on the arterial circulation.%目的:报告1例前部缺血性视神经病变(anterior ischemic optic neuropathy,AION)并发视网膜分支动脉阻塞(branch retinal artery obstruction,BRAO).方法:患者,女,42岁,因视力障碍进行如下眼科检查:眼底照相、荧光血管造影(fluorescent angiography,FAG)和视野测试.结果:第一次就诊时,患者视盘肿胀,动脉循环完整,发病1wk后,视网膜下支动脉开始萎缩并火焰状出血加剧.16mo后,视盘呈萎缩性改变,此外,发现视网膜下分支动脉血管影一条.结论:AION并发BRAO可造成动脉循环的机械性压迫.

  4. Automatic segmentation method which divides a cerebral artery tree in time-of-flight MR-angiography into artery segments

    Science.gov (United States)

    Takemura, Akihiro; Suzuki, Masayuki; Harauchi, Hajime; Okumura, Yusuke; Umeda, Tokuo

    2006-03-01

    To achieve sufficient accuracy and robustness, 2D/3D registration methods between DSA and MRA of the cerebral artery require an automatic extraction method that can isolate wanted segments from the cerebral artery tree. Here, we described an automatic segmentation method that divides the cerebral artery tree in time-of-flight magnetic resonance angiography (TOF-MRA) into each artery. This method requires a 3D dataset of the cerebral artery tree obtained by TOF-MRA. The processes of this method are: 1) every branch in the cerebral artery tree is labeled with a unique index number, 2) the 3D center of the Circle of Willis is determined using 2D and 3D templates, and 3) the labeled branches are classified with reference to the 3D territory map of cerebral arteries centered on the Circle of Willis. This method classifies all branches into internal carotid arteries (ICA), basilar artery (BA), middle cerebral artery (MCA), a1 segment of anterior cerebral artery (ACA(A1)), other segments of the anterior cerebral artery (ACA), posterior communication artery (PcomA), and posterior cerebral artery (PCA). In the eleven cases examined, the numbers of correctly segmented pixels in each branch were counted and the percentages based on the total number of pixels of the artery were calculated. Manually classified arteries of each case were used as references. Mean percentages were: ACA, 87.6%; R-ACA(A1), 44.9%; L-ACA(A1), 30.4%; R-MC, 82.4%; L-MC, 79.0%; R-PcomA, 0.5%; L-PcomA, 0.0%; R-PCA, 77.2%; L-PCA, 80.0%; R-ICA, 78.6%; L-ICA, 93.05; BA, 77.1%; and total arteries, 78.9%.

  5. Cervicoplastia anterior Anterior cervicoplasty

    Directory of Open Access Journals (Sweden)

    Lucas Gomes Patrocínio

    2004-10-01

    Full Text Available Muitos pacientes buscam correção estética da frouxidão da pele do pescoço, depósito de gordura na região submentoneana ou bandas de platisma. Em grande parte dos casos a ação medial, via cervicoplastia anterior é necessária. OBJETIVO: Demonstrar a casuística e avaliar os resultados e complicações com a técnica de cervicoplastia anterior no Serviço de Otorrinolaringologia da Universidade Federal de Uberlândia. FORMA DE ESTUDO: Relato de série. PACIENTES E MÉTODOS: Quarenta e dois pacientes, entre 39 e 65 anos de idade, sendo 40 (95,2% do sexo feminino e 2 (4,8% do masculino, foram submetidos a cervicoplastia anterior. Retrospectivamente foram avaliados resultados e complicações. RESULTADOS: Destes, 34 apresentaram resultados satisfatórios, 4 apresentaram déficit estético notado somente pelo cirurgião, 3 apresentaram déficit estético notado somente pelo paciente e 1 apresentou déficit estético necessitando cirurgia revisional. Ao estudo fotográfico, todos os pacientes apresentaram melhora do perfil cervical, redução das bandas de platisma e da frouxidão da pele, estabilização da musculatura cervical e acentuação do ângulo cervicomental, em graus variados. Houve complicação em 2 casos (discreto serohematoma e cicatriz um pouco alargada. CONCLUSÃO: A cervicoplastia, associada ou não à tração lateral pela ritidoplastia, é uma técnica que produz resultados satisfatórios na grande maioria dos casos.Many patients look for aesthetic correction of the laxity of neck skin, submandibular fat deposit or platisma bands. In a large part of the cases, medial action, through anterior cervicoplasty is necessary. AIM: To demonstrate the casuistic and to evaluate the results and complications with anterior cervicoplasty technique in the Otorhinolaryngology Service of the Federal University of Uberlândia. STUDY DESIGN: Serie report. PATIENTS AND METHODS: Forty-two patients, between 39 and 65 years of age, being 40 (95

  6. Spontaneous Thrombosis in Giant Aneurysm of the Anterior Communicating Artery Complex in Pediatric Age: Five-Year Follow-Up

    OpenAIRE

    Gonçalves, Vítor M.; Cristino, N.; M. Cunha e Sá

    2014-01-01

    Intracranial aneurysms are rare in the pediatric population, especially in infancy, representing less than 1% of all aneurysms. In this age group, they are more frequent at the carotid bifurcation and in the posterior circulation, with a greater number of giant aneurysms and spontaneous aneurysm thrombosis when compared with the adults. They are life-threatening, and, therefore, early investigation, characterization of the lesion, and treatment are essential. The appropriate management depend...

  7. Evaluation of the Effectiveness of Surgical Treatment of Malignant Glaucoma in Pseudophakic Eyes through Partial PPV with Establishment of Communication between the Anterior Chamber and the Vitreous Cavity

    Directory of Open Access Journals (Sweden)

    Marek Rękas

    2015-01-01

    Full Text Available Purpose. Determination of partial posterior vitrectomy (PPV in the proposed modification for treatment of malignant glaucoma. Methods. The prospective, consecutive, single-center case series study involved patients in whom symptoms of malignant glaucoma occurred after combined cataract and glaucoma surgery or after glaucoma surgery in pseudophakic eye. When medical and laser treatment were not successful, partial PPV with establishment of communication between the anterior chamber and the vitreous cavity was performed. Efficacy measures were intraocular pressure (IOP reduction, corrected distance visual acuity (CDVA, AND the number of antiglaucoma medications. Surgical success and occurring complications were also evaluated. Results. The study enrolled 20 eyes of 17 patients. Average IOP was reduced from 30.4 ± 14.2 (SD mmHg to 14.6 ± 3.2 (SD mmHg one year after surgery (P<0.00001. A statistically significant reduction of the number of antiglaucoma medications was obtained from 3.3 ± 1.1 (SD preoperatively to 1.2 ± 1.1 (SD at the end of follow-up. Statistically significant improvement of CDVA was observed 3, 6, and 12 months after surgery. Conclusions. Partial PPV with establishment of communication between the anterior chamber and the vitreous cavity enables effective IOP control over a 12-month observation; however, in most cases, it is necessary to use antiglaucoma medications for IOP control.

  8. Translational informatics approach for identifying the functional molecular communicators linking coronary artery disease, infection and inflammation.

    Science.gov (United States)

    Sharma, Ankit; Ghatge, Madankumar; Mundkur, Lakshmi; Vangala, Rajani Kanth

    2016-05-01

    Translational informatics approaches are required for the integration of diverse and accumulating data to enable the administration of effective translational medicine specifically in complex diseases such as coronary artery disease (CAD). In the current study, a novel approach for elucidating the association between infection, inflammation and CAD was used. Genes for CAD were collected from the CAD‑gene database and those for infection and inflammation were collected from the UniProt database. The cytomegalovirus (CMV)‑induced genes were identified from the literature and the CAD‑associated clinical phenotypes were obtained from the Unified Medical Language System. A total of 55 gene ontologies (GO) termed functional communicator ontologies were identified in the gene sets linking clinical phenotypes in the diseasome network. The network topology analysis suggested that important functions including viral entry, cell adhesion, apoptosis, inflammatory and immune responses networked with clinical phenotypes. Microarray data was extracted from the Gene Expression Omnibus (dataset: GSE48060) for highly networked disease myocardial infarction. Further analysis of differentially expressed genes and their GO terms suggested that CMV infection may trigger a xenobiotic response, oxidative stress, inflammation and immune modulation. Notably, the current study identified γ‑glutamyl transferase (GGT)‑5 as a potential biomarker with an odds ratio of 1.947, which increased to 2.561 following the addition of CMV and CMV‑neutralizing antibody (CMV‑NA) titers. The C‑statistics increased from 0.530 for conventional risk factors (CRFs) to 0.711 for GGT in combination with the above mentioned infections and CRFs. Therefore, the translational informatics approach used in the current study identified a potential molecular mechanism for CMV infection in CAD, and a potential biomarker for risk prediction. PMID:27035874

  9. TU-F-BRF-07: Accuracy of Routine Treatment Planning 4D and DIBH CT Delineation of the Left Anterior Descending Artery in Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    White, B; Lin, L; Freedmen, G; Both, S [University of Pennsylvania, Philadelphia, PA (United States); Vennarini, S [U.O.Protonterapia, Trento (Italy)

    2014-06-15

    Purpose: To assess the feasibility of routine treatment planning 4DCT and deep inspiration breath-hold (DIBH) to accurately contour the left anterior descending artery (LAD), a primary indicator of cardiac toxicity, for radiotherapy treatment planning of breast cancer. Methods: Ten subjects were imaged with a cardiac-gated MRI protocol to determine the displacement of a ROI that included the LAD. The subjects performed a series of breath-hold maneuvers to obtain short-axis and radial views, which were resampled to create a 3D-volume. Tissue motion was determined using a multi-resolution 3D optical flow deformable image registration algorithm. The ROI motion was then used as a spatial boundary to characterize the blurring motion of the LAD in ten patients during clinical 4DCT and DIBH protocols. A radiologist contoured the LAD. Coronary motion-induced blurring artifacts were quantified by applying an unsharp filter to accentuate the LAD despite motion-blurring. The 4DCT maximum inhalation and exhalation respiratory phases were co-registered to determine the LAD displacement during tidal respiration, as visualized in 4DCT. Results: The average 90{sup th} percentile heart motion for the ROI was 0.7±0.1mm(LR), 1.3±0.6mm(SI), 0.6±0.2mm(AP) in the cardiac-gated MRI cohort. The average relative increase in the number of voxels comprising the LAD contour was 69.4±4.5% for the DIBH. During tidal respiration, the average relative increase in the LAD contour was 69.3±5.9% and 67.9±4.6% for inhalation and exhalation respiratory phases respectively. The average 90{sup th} percentile LAD motion was 4.8±1.1mm(LR), 0.9±0.4mm(SI), 1.9±0.6mm(AP) for the 4DCT cohort, in the absence of cardiac-gating. Conclusion: Uncompensated coronary motion was the dominant form of motion blurring present in the CT images due to the high frequency of the cardiac cycle relative to the respiratory cycle. The 4D and DIBH CT contour delineation of the LAD was consistently overestimated without

  10. SU-C-BRF-01: Correlation of DIBH Breath Hold Amplitude with Dosimetric Sparing of Heart and Left Anterior Descending Artery in Left Breast Radiotherapy

    International Nuclear Information System (INIS)

    Purpose: A 7.4% increase in major coronary events per 1 Gy increase in mean heart dose has been reported from the population-based analysis of radiation-induced cardiac toxicity following treatment of left sided breast cancer. Deep inhalation breath-hold (DIBH) is clinically utilized to reduce radiation dose to heart and left anterior descending artery (LAD). We investigated the correlation of dose sparing in heart and LAD with internal DIBH amplitude to develop a quantitative predictive model for expected dose to heart and LAD based on internal breath hold amplitude. Methods: A treatment planning study (Prescription Dose = 50 Gy) was performed on 50 left breast cancer patients underwent DIBH whole breast radiotherapy. Two CT datasets, free breathing (FB) and DIBH, were utilized for treatment planning and for determination of the internal anatomy DIBH amplitude (difference between sternum position at FB and DIBH). The heart and LAD dose between FB and DIBH plans was compared and dose to the heart and LAD as a function of breath hold amplitude was determined. Results: Average DIBH amplitude using internal anatomy was 13.9±4.2 mm. The DIBH amplitude-mean dose reduction correlation is 20%/5mm (0.3 Gy/5mm) for the heart and 18%/5mm (1.1 Gy/5mm) for LAD. The correlation with max dose reduction is 12%/5mm (3.8 Gy/5mm) for the heart and 16%/5mm (3.2 Gy/5mm) for LAD. We found that average dose reductions to LAD from 6.0±6.5 Gy to 2.0±1.6 Gy with DIBH (4.0 Gy reduction: -67%, p < 0.001) and average dose reduction to the heart from 1.3±0.7 Gy to 0.7±0.2 Gy with DIBH (0.6 Gy reduction: -46%, p < 0.001). That suggests using DIBH may reduce the risk of the major coronary event for left sided breast cancer patients. Conclusion: The correlation between breath hold amplitude and dosimetric sparing suggests that dose sparing linearly increases with internal DIBH amplitude

  11. TU-F-BRF-07: Accuracy of Routine Treatment Planning 4D and DIBH CT Delineation of the Left Anterior Descending Artery in Radiotherapy

    International Nuclear Information System (INIS)

    Purpose: To assess the feasibility of routine treatment planning 4DCT and deep inspiration breath-hold (DIBH) to accurately contour the left anterior descending artery (LAD), a primary indicator of cardiac toxicity, for radiotherapy treatment planning of breast cancer. Methods: Ten subjects were imaged with a cardiac-gated MRI protocol to determine the displacement of a ROI that included the LAD. The subjects performed a series of breath-hold maneuvers to obtain short-axis and radial views, which were resampled to create a 3D-volume. Tissue motion was determined using a multi-resolution 3D optical flow deformable image registration algorithm. The ROI motion was then used as a spatial boundary to characterize the blurring motion of the LAD in ten patients during clinical 4DCT and DIBH protocols. A radiologist contoured the LAD. Coronary motion-induced blurring artifacts were quantified by applying an unsharp filter to accentuate the LAD despite motion-blurring. The 4DCT maximum inhalation and exhalation respiratory phases were co-registered to determine the LAD displacement during tidal respiration, as visualized in 4DCT. Results: The average 90th percentile heart motion for the ROI was 0.7±0.1mm(LR), 1.3±0.6mm(SI), 0.6±0.2mm(AP) in the cardiac-gated MRI cohort. The average relative increase in the number of voxels comprising the LAD contour was 69.4±4.5% for the DIBH. During tidal respiration, the average relative increase in the LAD contour was 69.3±5.9% and 67.9±4.6% for inhalation and exhalation respiratory phases respectively. The average 90th percentile LAD motion was 4.8±1.1mm(LR), 0.9±0.4mm(SI), 1.9±0.6mm(AP) for the 4DCT cohort, in the absence of cardiac-gating. Conclusion: Uncompensated coronary motion was the dominant form of motion blurring present in the CT images due to the high frequency of the cardiac cycle relative to the respiratory cycle. The 4D and DIBH CT contour delineation of the LAD was consistently overestimated without cardiac

  12. Arterial circulation of the spinal cord and brain in the Monodontidae (order Cetacea).

    Science.gov (United States)

    Vogl, A W; Fisher, H D

    1981-11-01

    In this paper we document retial supply of the spinal cord and describe the arterial vascular pattern of the brain in the whale family Monodontidae. Observations are based on gross dissections of four brains, two each of Monodon monoceros and Delphinapterus leucas, and one spinal cord from M. monoceros. Vessels of the spinal cord arise from extradural retia in the neural canal. Arteries originating from the retia penetrate the dura between successive spinal roots (mainly ventral) and not in association with them, unlike radicular arteries of other mammals. Also, these vessels are uniformly distributed and contribute equally to a plexus surrounding the cord. An A. radicularis magna is not present, and neither are distinct anterior or posterior spinal arteries. Circulation to the brain is effected by two pairs of arteries originating from intracranial retia. The rostral pair supplies most of the forebrain (prosencephalon), whereas the more caudal pair supplies mainly the midbrain (mesencephalon) and hindbrain (rhombencephalon). The circulatory pattern is characterized by 1) complete independence of anterior cerebral arteries (no anastomoses); 2) extensive cortical supply by the anterior choroidal arteries; 3) absence of subdural communicating vessels between rostral and caudal trunks; 4) union of caudal trunks to form a small basilar artery; and 5) absence of vertebral arteries and hence of a vertebral basilar system. There are some obvious differences between subdural arteries in the Monodontidae and those in other mammals; however, their general patterns of distribution are similar, and we suggest that most of the vessels, at least in the cranium, are homologous. PMID:7299826

  13. Implante de stents farmacológicos na artéria descendente anterior: indicadores de eventos tardios Implante de Stents farmacológicos en la arteria descendente anterior: indicadores de eventos tardíos Pharmacological stent deployment in the left anterior descending artery: late event indicators

    Directory of Open Access Journals (Sweden)

    Marcelo de Freitas Santos

    2009-01-01

    ógicos en las lesiones ateroscleróticas de la arteria descendente anterior e identificar, entre las características clínicas, angiográficas y de ultrasonido intravascular, cuales son las que permiten predecir riesgos de eventos cardiacos MÉTODOS: De mayo de 2002 a agosto de 2005, se trataron a 205 pacientes con implante de 236 stents farmacológicos guiados por ultrasonido intravascular. RESULTADOS: Con un seguimiento promedio de 711 días, la tasa de trombosis del stent fue del 0,48%, la misma que se observó para infarto agudo de miocardio o cirugía de revascularización. La tasa de revascularización de la lesión tratada fue del 7,31% y la tasa global de eventos fue del 10,24%. Los indicadores de eventos, conforme análisis multivariada, fueron el implante de más de un stent en la misma arteria, lesiones concéntricas y área mínima intrastent medida por el ultrasonido intravascular menor que 3,88 mm². CONCLUSIÓN: Tomando como base los datos obtenidos con esta investigación, concluimos que la revascularización de la arteria descendente anterior con implante de stents farmacológicos, elegidos y optimizados por el ultrasonido intravascular, presenta un bajo índice de eventos tardíos. El implante de dos stents farmacológicos para el tratamiento de las lesiones largas fue el principal factor independiente para la ocurrencia de eventos tardíos. El área luminal final mayor que 3,88 mm², obtenida en los segmentos de pequeños diámetros de referencia es un indicador independiente de evolución libre de eventos.BACKGROUND: The efficacy of pharmacological stents in decreasing the incidence of cardiac events is not homogeneous for all lesions or patient subgroups. OBJECTIVE: 1 To evaluate the late clinical evolution of patients submitted to pharmacological stent implantation in atherosclerotic lesions of the left anterior descending artery; 2 to identify, among the clinical, angiographic and intravascular ultrasonographic characteristics, the ones predictive of

  14. Accuracy of Routine Treatment Planning 4-Dimensional and Deep-Inspiration Breath-Hold Computed Tomography Delineation of the Left Anterior Descending Artery in Radiation Therapy

    International Nuclear Information System (INIS)

    Purpose: To assess the feasibility of radiation therapy treatment planning 4-dimensional computed tomography (4DCT) and deep-inspiration breath-hold (DIBH) CT to accurately contour the left anterior descending artery (LAD), a primary indicator of radiation-induced cardiac toxicity for patients undergoing radiation therapy. Methods and Materials: Ten subjects were prospectively imaged with a cardiac-gated MRI protocol to determine cardiac motion effects, including the displacement of a region of interest comprising the LAD. A series of planar views were obtained and resampled to create a 3-dimensional (3D) volume. A 3D optical flow deformable image registration algorithm determined tissue displacement during the cardiac cycle. The measured motion was then used as a spatial boundary to characterize motion blurring of the radiologist-delineated LAD structure for a cohort of 10 consecutive patients enrolled prospectively on a breast study including 4DCT and DIBH scans. Coronary motion–induced blurring artifacts were quantified by applying an unsharp filter to accentuate the LAD structure despite the presence of motion blurring. The 4DCT maximum inhalation and exhalation respiratory phases were coregistered to determine the LAD displacement during tidal respiration, as visualized in 4DCT. Results: The average 90th percentile heart motion for the region of interest was 0.7 ± 0.1 mm (left–right [LR]), 1.3 ± 0.6 mm (superior–inferior [SI]), and 0.6 ± 0.2 mm (anterior–posterior [AP]) in the cardiac-gated MRI cohort. The average relative increase in the number of voxels comprising the LAD contour was 69.4% ± 4.5% for the DIBH. The LAD volume overestimation had the dosimetric impact of decreasing the reported mean LAD dose by 23% ± 9% on average in the DIBH. During tidal respiration the average relative LAD contour increase was 69.3% ± 5.9% and 67.9% ± 4.6% for inhalation and exhalation respiratory phases, respectively. The average 90th

  15. Accuracy of Routine Treatment Planning 4-Dimensional and Deep-Inspiration Breath-Hold Computed Tomography Delineation of the Left Anterior Descending Artery in Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    White, Benjamin M., E-mail: benjamin.white@uphs.upenn.edu [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA (United States); Vennarini, Sabina [L' Unità Operativa di Protonterapia, Azienda Provinciale per i Servizi Sanitari, Trento (Italy); Lin, Lilie; Freedman, Gary [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA (United States); Santhanam, Anand; Low, Daniel A. [Department of Radiation Oncology, University of California, Los Angeles, California (United States); Both, Stefan [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA (United States)

    2015-03-15

    Purpose: To assess the feasibility of radiation therapy treatment planning 4-dimensional computed tomography (4DCT) and deep-inspiration breath-hold (DIBH) CT to accurately contour the left anterior descending artery (LAD), a primary indicator of radiation-induced cardiac toxicity for patients undergoing radiation therapy. Methods and Materials: Ten subjects were prospectively imaged with a cardiac-gated MRI protocol to determine cardiac motion effects, including the displacement of a region of interest comprising the LAD. A series of planar views were obtained and resampled to create a 3-dimensional (3D) volume. A 3D optical flow deformable image registration algorithm determined tissue displacement during the cardiac cycle. The measured motion was then used as a spatial boundary to characterize motion blurring of the radiologist-delineated LAD structure for a cohort of 10 consecutive patients enrolled prospectively on a breast study including 4DCT and DIBH scans. Coronary motion–induced blurring artifacts were quantified by applying an unsharp filter to accentuate the LAD structure despite the presence of motion blurring. The 4DCT maximum inhalation and exhalation respiratory phases were coregistered to determine the LAD displacement during tidal respiration, as visualized in 4DCT. Results: The average 90th percentile heart motion for the region of interest was 0.7 ± 0.1 mm (left–right [LR]), 1.3 ± 0.6 mm (superior–inferior [SI]), and 0.6 ± 0.2 mm (anterior–posterior [AP]) in the cardiac-gated MRI cohort. The average relative increase in the number of voxels comprising the LAD contour was 69.4% ± 4.5% for the DIBH. The LAD volume overestimation had the dosimetric impact of decreasing the reported mean LAD dose by 23% ± 9% on average in the DIBH. During tidal respiration the average relative LAD contour increase was 69.3% ± 5.9% and 67.9% ± 4.6% for inhalation and exhalation respiratory phases, respectively. The average 90th

  16. Reversal of segmental hypokinesis by coronary angioplasty in patients with unstable angina, persistent T wave inversion, and left anterior descending coronary artery stenosis. Additional evidence for myocardial stunning in humans

    International Nuclear Information System (INIS)

    To evaluate the significance of persistent negative T waves during severe ischemia, we prospectively studied 62 patients admitted for unstable angina without evidence of recent or ongoing myocardial infarction. A critical stenosis on the left anterior descending coronary artery (LAD), considered as the culprit lesion, was successfully treated by percutaneous transluminal coronary angioplasty (PTCA). The patients were divided into two groups according to the admission electrocardiogram: T NEG group (n = 32) had persistent negative T waves, and the T POS group (n = 30) had normal positive T waves on precordial leads. The two groups had similar baseline clinical, hemodynamic, and angiographic characteristics. All patients underwent a complete clinical and angiographic evaluation (coronary arteriography and left ventriculography) before undergoing PTCA and 8 +/- 3 months later. Left ventricular anterior wall motion was evaluated by the percent shortening of three areas (S1, S2, and S3) considered as LAD-related segments on left ventriculograms. Before PTCA, there was no significant difference in global ejection fraction between the two groups despite a significant depression in anterior mean percent area shortening in the T NEG compared with the T POS group (S1, 44 versus 54, p less than 0.01; S2, 39 versus 48, p less than 0.01; S3, 44 versus 50, NS). At repeated angiography, the anterior mean percent area shortening improved significantly in the T NEG group (S1, from 44 to 61, p less than 0.001; S2, from 39 to 58, p less than 0.001; S3, from 44 to 61, p less than 0.001)

  17. SHORT COMMUNICATION ON THE INFLUENCE OF POSITION ON ANTERIOR CRUCIATE LIGAMENT INJURY AND RECONSTRUCTION IN RECREATIONAL RUGBY FOOTBALL UNION PARTICIPANTS

    Directory of Open Access Journals (Sweden)

    Helen Dawes

    2003-03-01

    Full Text Available The different player positions in rugby union may place varying demands on a reconstructed anterior cruciate ligament (ACL in regards to 'cutting manoeuvres', this in turn may effect performance. In order to investigate sporting performance post reconstruction, a questionnaire was sent to amateur rugby clubs affiliated to the Oxfordshire Rugby Football Union (R.F.U. From the returned questionnaires player positions were placed into categories based on similar 'cutting manoeuvre' demands. Seventy five percent of Individuals playing in the category 1 (low 'cutting manoeuvre' demands at slow running speeds could play a full game with a damaged ACL and post-reconstruction the majority returned to play at a higher level. Fifty percent of ACL injuries occurred on category 2 (high 'cutting manoeuvre' demands at medium running speeds suggesting they may be more prone to ACL injury than other positions. The majority of individuals playing in category 3 (high 'cutting manoeuvre' demands at fast speeds played at a lower level of rugby post reconstruction. Positional demands may influence ACL injury and post reconstruction sporting performance. However, more research is needed

  18. Doppler findings in a rare Coronary Artery Fistula

    Directory of Open Access Journals (Sweden)

    Jorns Carl

    2007-03-01

    Full Text Available Abstract One of the primary forms of congenital anomalies of the coronary arteries is coronary artery fistula (CAF. It is defined as a direct communication between the coronary artery and any surrounding cardiac chamber or vascular structure, which bypasses the myocardial capillary bed. We present a newborn baby with a large coronary artery fistula connecting the left anterior descending (LAD artery to the left ventricular (LV apex. Associated cardiac abnormalities were found: a ventricular septal defect (diameter 4 mm, a patent foramen ovale as well as trivial tricuspid and mitral regurgitation. Here we demonstrate the echocardiograms of an extremely rare form of CAF diagnosed within the first days of postnatal life.

  19. Caroli's disease: hepatic arterial color doppler signals in the communicating dilated bile ducts

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Moon Gyu; Han, Boo Kyung; Baek, Seong Yon; Cho, Kyoung Sik; Auh, Yong Ho; Kim, Myung Hwan; Yu, Eun Sil [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    1992-01-15

    Three siblings with congenital dilatation of the intrahepatic bile ducts (Caroli's disease) are presented. Bile duct pathology was associated with congenital hepatic fibrosis and polycystic renal disease in all three patients. On color Doppler imaging (CD imaging), multiple small color Doppler signals were observed in or near the vascular radicles within the dilated bile ducts, besides other well-known sonographic findings such as bile duct dilatation, biliary calculi. Doppler frequency spectral analysis confirmed all these color Doppler signals as arterial origin in all patients, showing pulsatile wave pattern. Although portal venous radicles are well known in conventional sonograms or computed tomography(CT), continuous wave patterns were not detected in all patients. In addition to previously reported sonographic findings about Caroli's disease, color Doppler signals showing arterial wave pattern in or around the portal venous radicles within dilated ducts are another helpful diagnostic criteria and those findings are easily depicted on routine sonograms with color mapping.

  20. Caroli's disease: hepatic arterial color doppler signals in the communicating dilated bile ducts

    International Nuclear Information System (INIS)

    Three siblings with congenital dilatation of the intrahepatic bile ducts (Caroli's disease) are presented. Bile duct pathology was associated with congenital hepatic fibrosis and polycystic renal disease in all three patients. On color Doppler imaging (CD imaging), multiple small color Doppler signals were observed in or near the vascular radicles within the dilated bile ducts, besides other well-known sonographic findings such as bile duct dilatation, biliary calculi. Doppler frequency spectral analysis confirmed all these color Doppler signals as arterial origin in all patients, showing pulsatile wave pattern. Although portal venous radicles are well known in conventional sonograms or computed tomography(CT), continuous wave patterns were not detected in all patients. In addition to previously reported sonographic findings about Caroli's disease, color Doppler signals showing arterial wave pattern in or around the portal venous radicles within dilated ducts are another helpful diagnostic criteria and those findings are easily depicted on routine sonograms with color mapping

  1. Retrograde pedal access with a 20-gauge intravenous cannula after failed antegrade recanalization of a tibialis anterior artery in a diabetic patient: a case report

    Directory of Open Access Journals (Sweden)

    Yucel Colkesen

    2015-08-01

    Full Text Available Retrograde tibiopedal approach is being used frequently in below-the-knee vascular interventions. In patients with diabetic foot pathology, complex anatomy often requires a retrograde technique when the distal vascular anatomy and puncture site is suitable. The dorsalis pedis and posterior tibial arteries can be punctured because of their relatively superficial position. We report a retrograde puncturing technique in patients with chronic total occlusions. After failed antegrade recanalization, puncturing and cannulation of a tiny dorsalis pedis artery with a narrow bore [20-gauge (0.8 mm] intravenous cannula is described.

  2. Extremely Rare R-I Subtype Coronary Artery Anomaly and Accompanying Incomplete Myocardial Bridging on the Left Anterior Descending Artery in a Symptomatic Patient: Multidetector Computed Tomography and Coronary Angiography Findings

    International Nuclear Information System (INIS)

    Myocardial bridging and single coronary artery (SCA) may both lead to myocardial ischemia and related secondary complications. We present multidetector computed tomography (MDCT) and catheter coronary angiography (CCA) findings of R-I subtype SCA, which is a distinctively rare congenital coronary anomaly, and accompanying incomplete myocardial bridging in a case with dyspnea and chest burning. In addition, CCA showed a thin milking effect at the tunneled artery

  3. Extremely Rare R-I Subtype Coronary Artery Anomaly and Accompanying Incomplete Myocardial Bridging on the Left Anterior Descending Artery in a Symptomatic Patient: Multidetector Computed Tomography and Coronary Angiography Findings

    Energy Technology Data Exchange (ETDEWEB)

    Koksal, A.; Canyigit, M.; Akgoz, A.; Kaya, D.; Akhan, O. (Dept. of Radiology, Ankara Ataturk Education and Research Hospital, Bilkent, Ankara (Turkey)); Dincer, H. (Dept. of Cardiology, Bayindir Hospital, Sogutozu, Ankara (Turkey))

    2009-08-15

    Myocardial bridging and single coronary artery (SCA) may both lead to myocardial ischemia and related secondary complications. We present multidetector computed tomography (MDCT) and catheter coronary angiography (CCA) findings of R-I subtype SCA, which is a distinctively rare congenital coronary anomaly, and accompanying incomplete myocardial bridging in a case with dyspnea and chest burning. In addition, CCA showed a thin milking effect at the tunneled artery

  4. Intriguing variations of the tibial arteries and their clinical implications

    OpenAIRE

    Jelev L; Georgiev GP; Atanasova M

    2011-01-01

    Unusual course and branching pattern of the tibial arteries were discovered during routine anatomical dissection of the right lower extremity of a 61-year-old female cadaver. The arteries of the crural region arose from the popliteal artery, as usual. However, the anterior tibial artery was hypoplastic and supplying the anterior calf muscles ended above the ankle joint. Instead, the posterior tibial artery gave off a large anterior branch, which crossed the lowest portion of the interosseous ...

  5. Pontine infarction caused by medial branch injury of the basilar artery as a rare complication of cisternal drain placement

    OpenAIRE

    Horiuchi, Tetsuyoshi; Yamamoto, Yasunaga; Kuroiwa, Masafumi; Rahmah, Nunung Nur; Hongo, Kazuhiro

    2012-01-01

    We present a rare complication of cisternal drain placement during aneurysm surgery. A ruptured anterior communicating artery aneurysm was clipped through a right pterional approach. A cisternal drain was inserted from the retro-carotid to the prepontine cistern. Postoperatively, a left-sided paresis of the upper extremity had developed. A CT brain scan revealed that the drain was located between the pons and the basilar artery, resulting in a pontine infarction. Vascular neurosurgeons should...

  6. Anatomia microcirúgica da substâcia perfurada anterior basal humana Microsurgical anatomy of the human basal anterior perforated substance

    Directory of Open Access Journals (Sweden)

    Arlindo Alfredo Silveira D’Ávila

    2006-06-01

    Full Text Available A substância perfurada anterior constitui referencial na base do encéfalo. Localizada acima da bifurcação subaracnóidea da artéria carótida interna em sua porção basal e junto à artéria comunicante anterior na face inter-hemisférica, é transfixada por ramos perfurantes dirigidos aos núcleos telencefálicos corticais, cápsula interna e parte do tálamo. Por injeção intravascular de gelatina carminada, resina de Batson e látex, analisamos 50 hemisférios cerebrais humanos adultos de ambos os sexos, sob o microscópio cirúrgico. Objetivamos contribuir para a determinação da origem, número e topografia dos ramos destinados a essa região, seu curso, anastomoses e territórios de penetração. Propusemo-nos também a analisar a contribuição da artéria comunicante anterior à substância perfurada anterior. Foram encontradas variações anatômicas, incluindo anastomoses, envolvendo principalmente a artéria cerebral média e a artéria coróidea anterior. Estes conhecimentos são de interesse clínico-cirúrgico em razão da freqüência de patologias vasculares e tumorais a ela relacionadas.The anterior perforated substance (APS is a landmark in the basal forebrain. It has a basal face located above the carotid bifurcation in the subarachnoid space, and an interhemispheric one. It is the site of passage of the arteries to the caudate nucleus, putamen, internal capsule, adjacent areas of the globus pallidus and thalamus. Fifty hemispheres from twenty-five adult cadavers were obtained. The arteries were perfused with colored latex, Batson’s resin and gelatin colored with carmine. Using a surgical microscope we have determined the origin, local and number of origin from the parent vessel. The sites of penetration in the mediolateral and anteroposterior direction were also recorded. The anterior communicating artery contribution to the basal APS was reviewed. Significant vascular variations and anastomoses were encountered

  7. A case study of an axillary artery pseudoaneurysm following anterior dislocation of the glenohumeral joint: A rare presentation on plain film radiographs

    International Nuclear Information System (INIS)

    Axillary pseudoaneurysm is a rare but important complication of anterior glenohumeral joint dislocation. Diagnosis of axillary pseudoaneurysm is predominantly undertaken following clinical examination but where diagnosis is uncertain, Doppler ultrasound is the imaging examination of choice to confirm diagnosis. In this case study, the initial clinical signs of axillary pseudoaneurysm were masked by the presenting trauma and, although findings indicative of pseudoaneurysm were present on late plain film images, they were not immediately recognised. Misdiagnosis or delayed diagnosis of axillary pseudoaneurysm may result in upper limb morbidity or patient mortality. Consequently, the prompt and accurate identification of an axillary pseudoaneurysm on plain film radiographs, although rare, is essential. Yet for inexperienced film readers, correctly identifying an axillary pseudoaneurysm can be difficult due to its apparent similarity to other pathologies. This article will highlight the differences in radiological appearances between a pseudoaneurysm and a gleno-humeral joint effusion to raise radiographer awareness of the risks and clinical signs of an axillary pseudoaneurysm post gleno-humeral joint dislocation and discuss the difficulties encountered in its diagnosis. Finally, this review will evaluate current diagnostic practices in comparison with best practice, as identified in the literature [Fitzgerald JF, Keates J. False aneurysm as a late complication of anterior shoulder dislocation. Ann Surg 1975;6:785-6; Drury JK, Scullion JE. Vascular complications of anterior dislocation of the shoulder. Br J Surg 1980;67(8):579-81. Waxman DL, France MP, Douglas T, Harryman I. Late lateral displacement of the humeral head after closed reduction of dislocation: a sign of vascular injury. J Bone Joint Surg 1996;78(6):907-10

  8. Retrograde pedal access with a 20-gauge intravenous cannula after failed antegrade recanalization of a tibialis anterior artery in a diabetic patient: a case report

    OpenAIRE

    Colkesen, Yucel

    2015-01-01

    Retrograde tibiopedal approach is being used frequently in below-the-knee vascular interventions. In patients with diabetic foot pathology, complex anatomy often requires a retrograde technique when the distal vascular anatomy and puncture site is suitable. The dorsalis pedis and posterior tibial arteries can be punctured because of their relatively superficial position. We report a retrograde puncturing technique in patients with chronic total occlusions. After failed antegrade recanalizatio...

  9. TECAB - Totally Endoscopic Coronary Artery Bypass

    Medline Plus

    Full Text Available ... This usually leads us to the fifth intercostal space here on the anterior axillary node. This is ... for the peripheral arteries. Okay. Again, fifth intercostal space, anterior axillary line is where we are with ...

  10. Anterior tarsaltunnelsyndrom

    DEFF Research Database (Denmark)

    Miliam, Palle B; Basse, Peter N

    2009-01-01

    Anterior tarsal tunnel syndrome is a rare entrapment neuropathy of the deep peroneal nerve beneath the extensor retinaculum of the ankle. It may be rare because it is underrecognized clinically.We present a case regarding a 29-year-old man, drummer, who for one and a half year experienced clinical...

  11. 'Doctor' or 'darling'? Decoding the communication partner from ECoG of the anterior temporal lobe during non-experimental, real-life social interaction

    Directory of Open Access Journals (Sweden)

    Johanna eDerix

    2012-09-01

    Full Text Available Human brain processes underlying real-life social interaction in everyday situations have been difficult to study and have, until now, remained largely unknown. Here, we investigated whether electrocorticography (ECoG recorded for pre-neurosurgical diagnostics during the daily hospital life of epilepsy patients could provide a way to elucidate the neural correlates of non-experimental social interaction. We identified time periods in which patients were involved in conversations with either their respective life partners (Condition 1; C1 or attending physicians (Condition 2; C2. These two conditions can be expected to differentially involve subfunctions of social interaction which have been associated with activity in the anterior temporal lobe (ATL, including the temporal poles (TP. Therefore, we specifically focused on ECoG recordings from this brain region and investigated spectral power modulations in the alpha (8-12 Hz and theta (3-5 Hz frequency ranges, which have been previously assumed to play an important role in the processing of social interaction. We hypothesized that brain activity in this region might be sensitive to differences in the two interaction situations and tested whether these differences can be detected by single-trial decoding. Condition-specific effects in both theta and alpha bands were observed: the left and right TP exclusively showed increased power in C1 compared to C2, whereas more posterior parts of the ATL exhibited similar (C1 > C2 and also contrary (C2 > C1 effects. Single-trial decoding accuracies for classification of these effects were highly above chance. Our findings demonstrate that it is possible to study the neural correlates of human social interaction in non-experimental conditions. Decoding the identity of the communication partner and adjusting the speech output accordingly may be useful in the emerging field of brain- machine interfacing for restoration of expressive speech.

  12. Transient Ischemic Attack in the Setting of Carotid Atheromatous Disease with a Persistent Primitive Hypoglossal Artery Successfully Treated with Stenting: A Case Report.

    Science.gov (United States)

    Huang, Meng; Moisi, Marc; Zwillman, Michael E; Volpi, John J; Diaz, Orlando; Klucznik, Richard

    2016-01-01

    Fetal brain perfusion is supplied by the primitive dorsal aorta anteriorly, longitudinal neural arteries posteriorly, and anastomotic transverse segmentals. Most notable of these connections are the primitive trigeminal, otic, hypoglossal, and proatlantal arteries. With cranial-cervical circulatory maturation and development of the posterior communicating segments and vertebro-basilar system, these primitive segmental anastomoses normally regress. Anomalous neurovascular development can result in persistence of these anastomoses. Due to its territory of perfusion, the persistent primitive hypoglossal artery (PPHA) is associated with vertebral artery and posterior communicating artery hypoplasia or aplasia. As a consequence, primary blood supply to the hindbrain comes chiefly from this single artery. Although usually clinically silent, PPHA is susceptible to common cerebrovascular disorders including athero-ischemic disease and saccular aneurysmal dilation to name a few. We present a case of transient ischemic attack in a patient with a PPHA and proximal atherosclerotic disease treated by endovascular stenting. PMID:26929891

  13. Intriguing variations of the tibial arteries and their clinical implications

    Directory of Open Access Journals (Sweden)

    Jelev L

    2011-03-01

    Full Text Available Unusual course and branching pattern of the tibial arteries were discovered during routine anatomical dissection of the right lower extremity of a 61-year-old female cadaver. The arteries of the crural region arose from the popliteal artery, as usual. However, the anterior tibial artery was hypoplastic and supplying the anterior calf muscles ended above the ankle joint. Instead, the posterior tibial artery gave off a large anterior branch, which crossed the lowest portion of the interosseous membrane and prolonged as the most distal continuation of the anterior tibial artery –the dorsalis pedis artery. The rest of the posterior tibial artery continued its course distally and divided into the usual medial and lateral plantar arteries. We briefly review the reported variations of the tibial arteries and discussed their clinical relevance.

  14. 神经电生理联合监测下显微手术治疗前交通动脉瘤的效果观察%Microsurgical treatment of anterior communicating aneurysms under combined neuroelectrophysiologi-cal monitoring

    Institute of Scientific and Technical Information of China (English)

    李家亮; 李岩; 刘文祥; 黄琦; 苗鹏飞; 李想; 牛仁山; 刘寅

    2014-01-01

    Objective To investigate the curative effect of microsurgical treatment of anterior communicating aneurysm via the moeifiee pterional approach uneer combinee neuroelectrophysiological monitoring. Methods The clinical eata of 35 cases of anterior communicating aneurysms were analyzee retrospectively. All the cases were treatee by the microsurgical treatment via moeifiee pterional approach uneer combinee neuroelectrophysiological monitoring. Results All the anterior communicating aneurysms were clippee completely by microsurgical treatment uneer combinee neuroelectrophysiological monitoring. The curative effect was assessee at eischarge accoreing to GOS,inclueing gooe in 29 cases(82. 9% ,29 / 35),moeerate eisability in 4 cases(11. 4% ,4 / 35),severe eisability in 1 case(2. 9% ,1 / 35),eiee in 1 case(2. 9% ,1 / 35). Conclusion Microsurgical treatment of anterior communicating aneurysms via moeifiee pterional approach uneer combinee neuroelectrophysiological monitoring is a safe ane effective methoe,which might be helpful to reeuce the ratio of postoperative eisability ane mortality,ane then improve quality of life for patients.%目的:探讨在神经电生理联合监测下经改良翼点入路显微手术治疗前交通动脉瘤的效果。方法对35例在神经电生理联合监测下经改良翼点入路显微手术治疗的前交通动脉瘤患者的临床资料进行回顾性分析。结果所有患者均在神经电生理联合监测下经显微手术完全夹闭动脉瘤,出院时按 GOS 评定疗效:良好29例(82.9%,29/35),中残4例(11.4%,4/35),重残1例(2.9%,1/35),死亡1例(2.9%,1/35)。结论在神经电生理联合监测下经改良翼点入路显微手术治疗前交通动脉瘤是安全有效的方法,有利于降低术后致残率及病死率,提高患者生活质量。

  15. Cardioembolic occlusion of the internal carotid artery presented with infarction in the posterior cerebral artery territory

    Institute of Scientific and Technical Information of China (English)

    XUE Su-fang; JIA Jian-ping

    2010-01-01

    @@ Posterior circulation stroke may rarely be associated with occlusive disease in the anterior circulation, such as in the context of a direct (fetal) origin of the posterior cerebral artery (PCA) from the internal carotid artery (ICA), or in the presence of a persistent trigeminal artery (PTA) or persistent hypoglossal artery (PHA).1,2

  16. Internal carotid-cerebellar artery anastomosis. So-called persistent trigeminal artery variant

    Energy Technology Data Exchange (ETDEWEB)

    Tanohata, Kazunori; Maehara, Tadayuki; Noda, Masanobu; Katoh, Hiromi

    1987-09-01

    Five cases of internal carotid-cerebellar artery anastomosis are presented. These anomalous vessels are identical to the so-called persistent trigeminal artery variant (PTAV). In our cases, two superior cerebellar arteries (SCAs), two anterior inferior cerebellar arteries (AICAs) and one posterior inferior cerebellar artery (PICA) arose from the precavernous segment of the internal carotid artery. We discuss the embryolgical and neuroradiological aspects of this anomaly.

  17. Typology of the arteries in the human scalenus region, with special reference to the accessory ascending cervical artery.

    OpenAIRE

    Su WD; Ohtsuka A; Taguchi T; Murakami T.

    2000-01-01

    The accessory ascending cervical artery (Murakami et al., 1996), which arises from the subclavian artery and ascends between the scalenus anterior and medius muscles, was studied in 87 Japanese adult cadavers (174 sides), with special attention being given to its origin, distribution, and relationship to other arteries at the cervical or scalenus region. In 154 sides (88.5%), the accessory ascending cervical artery was found to originate from the subclavian artery behind the scalenus anterior...

  18. Digital subtraction angiography of a persistent trigeminal artery variant.

    Science.gov (United States)

    Temizöz, Osman; Genchellac, Hakan; Unlü, Ercüment; Cağli, Bekir; Ozdemir, Hüseyin; Demir, M Kemal

    2010-09-01

    Persistent trigeminal artery variants are described as cerebellar arteries that directly originate from the precavernous segment of the internal carotid artery. This has been observed in 0.18% of cerebral catheter angiograms. On the other hand, a persistent trigeminal artery variant feeding both the anterior inferior cerebellar artery and the posterior inferior cerebellar artery territory is very rare. We present this uncommon anomalous artery along with digital subtraction angiography findings and discuss its clinical significance in light of the literature. PMID:19821254

  19. Successful surgical repair of impending rupture of a pseudoaneurysm of the brachiocephalic artery with prior reconstruction of the carotid artery

    International Nuclear Information System (INIS)

    We report the successful repair of impending rupture of a pseudoaneurysm of the brachiocephalic artery (BCA) in a 70-year-old man. He had undergone a mediastinal tumor resection through a median sternotomy in 1995. Pathological examination revealed non-Hodgkin's lymphoma. Two years later, he underwent radiation therapy of 65 Gray for metastasis to the supraclavicular lymph nodes. On January 18, 2000, plastic surgeons planned to perform a pectoralis major musculocutaneous flap to repair a radiation skin ulcer. During the operation, the BCA was lacerated, possibly in an area of radiation tissue damage. We performed a prosthetic graft (10-mm Gelseal) replacement of the BCA. The right subclavian artery had to be ligated. Postoperative digital subtraction angiography (DSA) showed excellent reconstruction of the artery. Magnetic resonance angiography of the brain showed a deficit in the anterior communicating artery and stenosis of the posterior communicating artery, which indicated that the reconstruction procedure was reasonable. Seven months later, on August 18, 2000, the patient was transferred to our hospital because of swelling of the right neck and oozing from the previous cutaneous wound. CT scan and DSA demonstrated the presence of a pseudoaneurysm of the proximal anastomosis site, which required emergency surgery. Before this third sternotomy, a saphenous vein graft was interposed between both external carotid arteries. Removal of the prosthetic graft and resection of the pseudoaneurysm were performed under mild hypothermia and cardiopulmonary bypass with left common carotid arterial perfusion. Then, the wound was closed completely using a left pectoralis major musculocutaneous flap. The postoperative course was uneventful and DSA showed good patency of the graft and intracranial arteries. The patient was discharged without neurological complications. We conclude that prior reconstruction of the carotid artery is a safe and effective procedure for patients with

  20. Posterior communicating artery cistern and associated arachnoid membrane:the microsurgical anatomy and clinal significance%后交通动脉池及相关蛛网膜的显微解剖研究及临床意义

    Institute of Scientific and Technical Information of China (English)

    宋海民; 漆松涛; 樊俊; 黄广龙; 黄理金; 冯文峰; 李伟光; 陆云涛

    2011-01-01

    Objective To investigate the microsurgical anatomic features and clinical significances of the posterior communicating artery cistern (PComA cisterns) and associated arachnoid membranes. Methods 10 cases (20 sides )of formalin-fixed cadaveric head specimens were microdissected to observe structures of PComA cistern and related arachnoid membranes under the operating microscope. Results The frequency rate of PComA cistern was about 60% (12 sides from all of specimens).The anterior wall of the cistern was the posterior communicating membranes. The carotid cistern directly communicated with the PComA cistern in the absence of the posterior communicating membranes. The posterior wall of the cistern was diencephalic and mesencephalic leaves of liliequist membranes. The medial wall was the carotid membranes and the lateral wall of diencephalic and mesencephalic leaves of liliequist membranes. The anterolateral wall was the lateral carotid membranes or the medial temporal lobe, and the posterlaeral wall the arachnoid trabeculaes arising from mesencephalic leaves of liliequist membranes which attached to the oculomotor nerve and posterior communicating artery. The superior lateral wall was incrual membranes, and the bottom wall the arachnoid membranes of base skull and diencephalic leaves of liliequist membranes. The features of different membranes were distinct. Conclusions This study identifies the features of the PComA cistern and associated arachnoid membrane, which is a valuable reference for clinic application.%目的 对后交通动脉池(PComA池)及相关蛛网膜的显微解剖特点进行描述并探讨其临床意义.方法 在手术显微镜下,对10例(20侧)福尔马林固定的尸头标本进行显微解剖,观察PComA池及相关蛛网膜的膜显微特点.结果 PComA池出现率60%(12侧).组成PComA池前壁为后交通膜,若此膜缺失,则与与颈内动脉池(ICA池)相通;后壁为liliequist膜间脑叶和中脑叶;内侧壁为颈内动脉内侧

  1. Surgical Tutorial of a Robotic-Assisted Anterior Pelvic Exenteration

    Medline Plus

    Full Text Available ... and uterine arteries and opened the recto-vaginal space posteriorly, taken down much of those pelvic side ... anterior extent, coming down in the pre-vesicle space and doing the cystectomy and connecting that cystectomy ...

  2. Aberrant right hepatic artery; A case report

    International Nuclear Information System (INIS)

    We present a rare case of aberrant hepatic artery in a 40-year-old male with a history of chronic cholecystitis. During laparoscopic surgery, the artery found to pass anterior to the body the gallbladder and bifurcating anterior to the gallbladder body. The surgery was un eventful. We present this anomaly of the rare condition of aberrant right hepatic artery which should be in mind during laparoscopic cholecystectomy, because inadverant injury could lead to massive bleeding and increase co morbidities. (author)

  3. Hepatopancreatic arterial ring: bilateral symmetric typology in human celiaco-mesenteric arterial system.

    Directory of Open Access Journals (Sweden)

    Kosaka M

    2002-10-01

    Full Text Available The celiac and mesenteric arterial system including the left gastric, splenic, common hepatic, and superior mesenteric arteries shows various types of origins, courses, ramifications and anastomoses. In order to explain the various expressions of this system, we have proposed a typological model, in which celiacomesenteric arteries develop as paired or bilaterally symmetrical primordial vessels originated from the anterior aspect of the aorta, and these vessels anastomose each other with longitudinal and horizontal pathways. Here, we report 3 unusual cases characterized by arterial rings, formed by the left gastric, left accessory hepatic, proper hepatic, anterior pancreaticoduodenal, and dorsal pancreatic arteries. The dorsal pancreatic and anterior pancreaticoduodenal arteries are located to the right and left of the embryonic pancreas developing in the dorsal mesentery, respectively. Such hepatopancreatic arterial rings simultaneously containing right and left elements can only be explained using our typological model, in which the concept of paired arteries or bilateral symmetry is introduced.

  4. Hepatopancreatic arterial ring: bilateral symmetric typology in human celiaco-mesenteric arterial system.

    Science.gov (United States)

    Kosaka, Motohiro; Horiuchi, Kanji; Nishida, Keiichiro; Taguchi, Takehito; Murakami, Takuro; Ohtsuka, Aiji

    2002-10-01

    The celiac and mesenteric arterial system including the left gastric, splenic, common hepatic, and superior mesenteric arteries shows various types of origins, courses, ramifications and anastomoses. In order to explain the various expressions of this system, we have proposed a typological model, in which celiacomesenteric arteries develop as paired or bilaterally symmetrical primordial vessels originated from the anterior aspect of the aorta, and these vessels anastomose each other with longitudinal and horizontal pathways. Here, we report 3 unusual cases characterized by arterial rings, formed by the left gastric, left accessory hepatic, proper hepatic, anterior pancreaticoduodenal, and dorsal pancreatic arteries. The dorsal pancreatic and anterior pancreaticoduodenal arteries are located to the right and left of the embryonic pancreas developing in the dorsal mesentery, respectively. Such hepatopancreatic arterial rings simultaneously containing right and left elements can only be explained using our typological model, in which the concept of paired arteries or bilateral symmetry is introduced. PMID:12530508

  5. Perfusion scintigraphy (/sup 99m/Tc MAA) during surgery for placement of chemotherapy catheter in hepatic artery: concise communication

    International Nuclear Information System (INIS)

    In 17 patients receiving regional hepatic chemotherapy, /sup 99m/Tc macroaggregated albumin imaging was used to aid arterial catheter placement and to assess perfusion patterns. Intraoperative imaging with a portable gamma camera allowed immediate monitoring of hepatic and extrahepatic perfusion patterns and assisted catheter manipulation when necessary to achieve optimal flow distribution. In all 12 patients with standard hepatic arterial anatomy, complete perfusion of both lobes of the liver was achieved, although three of them required intraoperative catheter manipulation and repeat imaging after initial placement. The remaining five patients had aberrant hepatic arterial anatomy, and complete perfusion was more difficult to achieve; they exemplified the need for dual catheters, ligation of accessory hepatic branches, and repeated imaging

  6. Absence of scalenus anterior muscle.

    OpenAIRE

    Murakami S; Horiuchi K; Yamamoto C; Ohtsuka A; Murakami T.

    2003-01-01

    A rare anomaly of the scalenus muscles is described. In this case, the right scalenus anterior muscle was absent. As a substitute for this muscle, some aberrant muscle slips arose from the lower vertebrae and descended in front of the ventral rami of the lower cervical nerves. These aberrant slips then ran between the ventral rami of the the eighth cervical and first thoracic nerves, and were fused with the right scalenus medius muscle. Thus, the subclavian artery and vein ran in front of the...

  7. Phacoemulsification in anterior megalophthalmos.

    Science.gov (United States)

    Lee, Graham A; Hann, Joshua V; Braga-Mele, Rosa

    2006-07-01

    This case outlines the phacoemulsification technique used to overcome the challenge of the hyperdeep anterior chamber, weak zonules, abnormal anterior capsule, and large capsular bag. Key steps included trypan blue staining of the anterior capsule, a large capsulorhexis, prolapse of the nucleus into the anterior chamber with phacoemulsification anterior to the capsulorhexis, and a posterior chamber-placed iris-clip intraocular lens. Successful visual rehabilitation is achievable in these anatomically challenging eyes. PMID:16857490

  8. 胫前动脉血管内皮功能及血流动力学参数评价2型糖尿病下肢动脉病变%Clinical Evaluation of Peripherial Arterial Diseases with Anterior Tibial Arterial Endothelial Function and Hemodynamic Parameters in Type 2 Diabetic Patients

    Institute of Scientific and Technical Information of China (English)

    马婷; 姚兰辉; 崔凤荣; 康东; 成静

    2012-01-01

    目的:探讨胫前动脉血管内皮舒张功能及血流动力学参数与2型糖尿病下肢疾病的相关性,为2型糖尿病下肢动脉病变的超声诊断提供更多的理论依据.方法:本研究设计经伦理审查委员会批准,所有研究对象在检查前均已签署知情同意书.将159例2型糖尿病患者分为下肢动脉病变(Peripheral Arterial Disease,PAD)症状组(具有间歇性跛行和(或)静息性腿痛)和无PAD症状组,使用高频超声二维时分别测量静息状态下及反应性充血后胫前动脉内径(D0,D1),内-中膜厚度(Intima Media Thickness, IMT),彩色流速流量定量技术测量胫前动脉收缩期峰值血流速度(Peak systolic Velocity,PSV),搏动指数(Pulse Index,PI),血管内压力(Pression,P)及压差(Friqunent,FRQ),比较两组胫前动脉血管内皮舒张功能((D1-D0)/D0),IMT及血流参数的差异,应用多元回归分析血管内皮舒张功能及以上血流动力学参数与下肢PAD症状的相关性.结果:(1)与非PAD症状组相比,PAD症状组血管内皮舒张功能,PSV、PI、P均减低,IMT增加;(2)PAD症状与年龄、病程、糖化血红蛋白、PSV、PI、Sten%、血管内皮舒张功能等有相关性,而与IMT等无相关性.结论:(1)袖带加压法测定血管内皮依赖性舒张功能方法简便且有潜在临床适用性;(2)血管内皮舒张功能作为一项新指标可以和经典的PSV一样反映下肢动脉病变的情况,从而为下肢动脉病变的诊断提供依据.%Objective: To study the anterior tibial arterial endothelial before diastolic function and hemodynamic parameters and type 2 diabetes lower limbs the correlation of disease, type 2 diabetes lower limb artery pathological changes of ultrasound diagnosis for more theoretical basis. Methods: The institutional review board approved the study, and all patients provided signed informed consent. 159 cases of type 2 diabetic patients were divided into peripheral arterial disease (PAD) symptoms group

  9. Unusual hemodynamic stroke related to an accessory middle cerebral artery: The usefulness of fusion images from three-dimensional angiography

    Directory of Open Access Journals (Sweden)

    Kei Noguchi

    2014-01-01

    Full Text Available Background: Ischemic stroke associated with an anomaly of the middle cerebral artery (MCA is a rare occurrence. The diagnosis is very difficult when there are steno-occlusive lesions associated with an accessory middle cerebral artery (AMCA. Case Description: A 77-year-old female with hypertension and hyperlipidemia experienced repeated transient ischemic attacks (TIAs of motor aphasia and dysarthria. Although angiography showed only left intracranial occlusion, the fusion images of three-dimensional digital subtraction angiography (3-D DSA showed complex steno-occlusive lesions and an AMCA related with the TIA. The cerebral blood flow (CBF to the left frontal lobe was supplied by the AMCA, via the anterior communicating artery from the right internal carotid artery. The left temporal and parietal lobes were supplied by the stenotic MCA, via the left posterior communicating artery from the left posterior cerebral artery. Single-photon emission computed tomography showed a marked decrease in CBF to both the left frontal and temporal lobes. A left superficial temporal artery (STA-to-left MCA double anastomosis was performed, in which each branch of the STA supplied branches of the AMCA and MCA. Conclusion: This is the first reported case of ischemic stroke in a patient with an AMCA. The exact diagnosis could be made only by using fusion images of 3-D DSA, which were useful for understanding the complicated CBF pattern and for the choice of recipient artery in bypass surgery.

  10. Vertebral artery injuries in cervical spine surgery

    OpenAIRE

    Schroeder, Gregory D.; Hsu, Wellington K.

    2013-01-01

    Background: Vertebral artery injuries during cervical spine surgery are rare, but potentially fatal. When performing cervical spine surgery, it is imperative that the surgeon has a systematic approach for avoiding, and if necessary, dealing with a vertebral artery injury. Methods: This is a review paper. Results: Upper posterior cervical spine surgeries put the vertebral artery at the highest risk, as opposed to anterior subaxial cervical spine procedures, which put the artery at the least ri...

  11. Basilar Artery Aneurysm at a Persistent Trigeminal Artery Junction

    Science.gov (United States)

    Aguiar, G.B.; Conti, M.L.M.; Veiga, J.C.E.; Jory, M.; Souza, R.B.

    2011-01-01

    Summary The trigeminal artery is an anastomosis between the embryonic precursors of the vertebrobasilar and carotid systems, and may persist into adult life. The association of the persistent primitive trigeminal artery (PTA) with cerebral aneurysm is well documented in the literature and, in general, aneurysms are located in the anterior circulation. We describe a patient who presented with a panencephalic Fisher III subarachnoid hemorrhage due to rupture of an intracranial aneurysm. Digital arteriography showed a saccular aneurysm in the middle third of the basilar artery, adjacent to the junction with a persistent trigeminal artery. She was submitted to endovascular treatment with embolization of the basilar artery aneurysm with coils. Aneurysms at the PTA junction with the basilar artery are rare. This paper describes a case of PTA associated with an aneurysm in the basilar artery at PTA junction and briefly reviews the literature. PMID:22005697

  12. Cerebellar arteries originating from the internal carotid artery: angiographic evaluation and embryologic explanations

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jae Young; Han, Moon Hee; Yu, In Gyu; Chang, Ki Hyun [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of); Kim, Eui Jong [Kyunghee Univ. College of Medicine, Seoul (Korea, Republic of); Kim, Dae Ho [Soonchunhyang Univ. College of Medicine, Asan(Korea, Republic of)

    1997-06-01

    To find and describe the cerebellar arteries arising from the internal carotid artery, explain them embryologically, and evaluate their clinical implication. To determine the point in the internal carotid artery from which the cereballar artery arose anomalously, consecutive angiographic studies performed in the last three years were reviewed. The distribution of such anomalous cerebellar arteries, the point in the internal carotid artery from which the anomalous vessels originated, and associated findings were analyzed. Five anomalous origins of cerebellar arteries arising arising directly from the internal carotid artery were found in five patients. Three anterior inferior cerebellar arteries (AICA) and one common trunk of an AICA and a posterior inferior cerebellar artery (PICA) were found to originate from the internal carotid artery at a point close to the origin of the primitive trigeminal artery. A PICA arose from an artery presenting a course similar to the proatlantal intersegmental artery. Intracranial aneurysms in two patients, Moyamoya disease in one, and facial arteriovenous malformation in one. In our series, AICAs supplied from the arteries considered to be persistent trigeminal artery variants were the most common type. A correlation between type of anomalous cerebellar artery and type of carotid-vertebrobasilar anastomosis may exist. Cerebellar arteries originating anomalously from the internal carotid artery seem to occur as a result of the persistence of carotid-vertebrobasilar anastomoses associated with incomplete fusion of the longitudinal neural arteries. An understanding of these anomalous cerebellar arteries may help prevent accidents during therapeutic embolization and surgical treatment, as well as misinterpretation.

  13. Refining the course of the thoracolumbar nerves: a new understanding of the innervation of the anterior abdominal wall.

    Science.gov (United States)

    Rozen, W M; Tran, T M N; Ashton, M W; Barrington, M J; Ivanusic, J J; Taylor, G I

    2008-05-01

    Previous descriptions of the thoracolumbar spinal nerves innervating the anterior abdominal wall have been inconsistent. With modern surgical and anesthetic techniques that involve or may damage these nerves, an improved understanding of the precise course and variability of this anatomy has become increasingly important. The course of the nerves of the anterior abdominal is described based on a thorough cadaveric study and review of the literature. Twenty human cadaveric hemi-abdominal walls were dissected to map the course of the nerves of the anterior abdominal wall. Dissection included a comprehensive tracing of nerves and their branches from their origins in five specimens. The branching pattern and course of all nerves identified were described. All thoracolumbar nerves that innervate the anterior abdominal wall were found to travel as multiple mixed segmental nerves, which branch and communicate widely within the transversus abdominis plane (TAP). This communication may occur at multiple locations, including large branch communications anterolaterally (intercostal plexus), and in plexuses that run with the deep circumflex iliac artery (DCIA) (TAP plexus) and the deep inferior epigastric artery (DIEA) (rectus sheath plexus). Rectus abdominis muscle is innervated by segments T6-L1, with a constant branch from L1. The umbilicus is always innervated by a branch of T10. As such, identification or damage to individual nerves in the TAP or within rectus sheath is unlikely to involve single segmental nerves. An understanding of this anatomy may contribute to explaining clinical outcomes and preventing complications, following TAP blocks for anesthesia and DIEA perforator flaps for breast reconstruction. PMID:18428988

  14. Phentolamine as a treatment for poor mixing in transposition of the great arteries with adequate intraatrial communication.

    Science.gov (United States)

    Galal, M O; El-Naggar, W I; Sharfi, M H

    2005-01-01

    Patients with transposition of the great arteries often show poor mixing for different reasons, even after adequate balloon atrial septostomy. We present a patient with such a lesion whose clinical status improved dramatically after phentolamine was applied. We believe this improvement is due to reduction in afterload caused by the alpha(2) blocker and also possibly as a response to a presumptive effect of the drug on the diastolic function of the right ventricle, allowing more left-to-right shunt across the atrial septal defect. Both phenomena can improve cardiac output in such a situation. PMID:16374695

  15. Communications

    Science.gov (United States)

    Bailenson, Jeremy; Buzzanell, Patrice; Deetz, Stanley; Tewksbury, David; Thompson, Robert J.; Turow, Joseph; Bichelmeyer, Barbara; Bishop, M. J.; Gayeski, Diane

    2013-01-01

    Scholars representing the field of communications were asked to identify what they considered to be the most exciting and imaginative work currently being done in their field, as well as how that work might change our understanding. The scholars included Jeremy Bailenson, Patrice Buzzanell, Stanley Deetz, David Tewksbury, Robert J. Thompson, and…

  16. Proposal of anatomical terminology to call the arteries of the base of the encephalon in the monkey (Cebus paella L., 1766 Nomenclatura proposta para denominar as artérias da base do encéfalo do macaco-prego (Cebus apella L., 1766

    Directory of Open Access Journals (Sweden)

    Jussara Rocha Ferreira

    2001-05-01

    Full Text Available Arteries of the encephalon basis of 30 monkeys (Cebus paella were studied. Arteries were injected with colored latex, fixed in formaldehyde solution at 10% and dissected under magnifying lenses. Since the animals died from natural causes they had been previously used in other experiments. Human and veterinary anatomical terminology and literature were used as a reference for the determination of vessels studied in the primates. Arteries of the encephalon base represent division branches of three vascular pedicules: the right and left internal carotid arteries and the basilar system. Vessels in the basilar system of the animal were called vertebral arteries; anterior spinal artery; anterior and posterior cerebelar arteries; pontine arteries; satellite cerebelar arteries; caudal and cranial cerebelar arteries. The basilar artery bifurcates into two posterior cerebral arteries (100%. The caudal area of the encephalon’s arterial circuit is thus constituted. Linking between the vertebro-basilar and the carotid segments is done by the posterior communicating artery, that caudally anastomizes (100% with the posterior cerebral artery. The internal carotid artery gives origin to the posterior communicating artery. The right and left internal carotid artery (intracranial portion compounds the carotid system. The following vessels were identified: middle cerebral artery; anterior cerebral artery; interhemispheric artery; olfactory arteries. Results report that Cebus paella presents an arterial pattern of relative morphological stabilityEstudaram-se as artérias da base do encéfalo do Cebus apella em 30 animais, vindos a óbito por morte natural no Zoológico de São Paulo e coletados durante 10 anos. O material recebeu injeção de látex corado, fixado em formol a 10%, e foi dissecado sob lupa. Encontramos dificuldade e denominar estes vasos. As terminologias anatômicas humana e veterinária e a recuperação da literatura nos serviram de base para

  17. Anterior Myocardial Infarction Associated with Myocardial Bridging in a Young Man

    OpenAIRE

    Ngow, HA; Wan Khairina, WMN

    2010-01-01

    A 43-year-old man presented with acute extensive anterior ST-segment elevation myocardial infarction. During coronary angiogram, a segment of myocardial bridging was noted in the mid-segment of left anteriordescending artery. The association of myocardial bridging and an anterior ST segment elevation is rarely reported in the medical literature. Myocardial bridging is caused by systolic compression of a coronary artery by overlying myocardium tissue. It is a rare coronary artery anomaly, whic...

  18. Typology of the arteries in the human scalenus region, with special reference to the accessory ascending cervical artery.

    Directory of Open Access Journals (Sweden)

    Su WD

    2000-12-01

    Full Text Available The accessory ascending cervical artery (Murakami et al., 1996, which arises from the subclavian artery and ascends between the scalenus anterior and medius muscles, was studied in 87 Japanese adult cadavers (174 sides, with special attention being given to its origin, distribution, and relationship to other arteries at the cervical or scalenus region. In 154 sides (88.5%, the accessory ascending cervical artery was found to originate from the subclavian artery behind the scalenus anterior muscle, and to branch out to the scalenus anterior and medius muscles as well as those entering the 5th and 6th intervertebral foramens along the 6th and 7th cervical nerves. This artery arose independently in 105 sides. The accessory ascending cervical artery issued off or formed a common trunk with the transverse cervical artery and/or costocervical trunk in 49 sides. In cases lacking the accessory ascending cervical artery, it was usually compensated for by the costocervial trunk and/or transverse cervical artery (18 sides. Common trunk formation with the vertebral, internal thoracic, or suprascapular arteries was not observed. The authors suggest that the accessory ascending cervical artery, the transverse cervical artery, and the costocervical trunk should be grouped into one arterial system, a system that may be a remnant of the precostal longitudinal anastomoses of intersegmental arteries of the dorsal aorta behind the scalenus anterior muscle.

  19. Carotid artery occlusion and collateral circulation in C57Black/6J mice detected by synchrotron radiation microangiography

    International Nuclear Information System (INIS)

    Using monochromatic synchrotron radiation, we performed microangiography in C57BL/6J mice and investigated their vasculature after unilateral and bilateral carotid artery occlusion. Bilateral occlusion of the carotid artery was made by a ligation of the left common carotid artery followed by a ligation of the right internal carotid artery (ICA) two days later (n=12). Five days after the second surgery, angiography was performed. Unilateral occlusion was made by clipping the right ICA and then angiography was performed immediately (n=5). The control mice did not undergo any occlusion (n=5). We removed the brain of the bilateral occlusion mice after angiography and examined the infarction area. The cerebral microvessels in all animals were clearly visualized. In the control mice, the posterior communicating artery (Pcom) was not visualized. In the unilateral occlusion mice, the anastomosis of the pterygopalatine artery (PPA) and the external carotid artery (ECA) were recognized. The PPA is thus considered to play a role in the collateral vessel between the ICA and the ECA. The Pcom was not visualized. In the bilateral occlusion mice, the Pcom was observed either unilateraly (n=5) or bilateraly (n=5). The Pcom supplied blood flow to the anterior circulation from the vertebrobasilar arteries. The bilateral occlusion mice that had at least one visualized Pcom did not have any infarction. We could successfully visualize the cerebral vasculature of normal mice and carotid artery occluded mice in an in vivo study. Microangiography can demonstrate the development of vasculature and the blood flow dynamics in mice. (author)

  20. Arterial Catheterization

    Science.gov (United States)

    ... version AMERICAN THORACIC SOCIETY Patient Information Series Arterial Catheterization An arterial catheter is a thin, hollow tube ... PHYSICIANS: AND COPY Why Do I Need Arterial Catheterization? Common reasons an arterial catheterization is done include: ■ ...

  1. Feasibility evaluation on preservation of left colonic artery in dealing with inferior mesenteric artery in laparoscopic anterior resection of rectal carcinoma%腹腔镜直肠癌前切除术中处理肠系膜下动脉时保留左结肠动脉的可行性评价

    Institute of Scientific and Technical Information of China (English)

    袁志林; 王博; 杨雁灵; 李强

    2014-01-01

    目的 探讨腹腔镜直肠癌前切除术中处理肠系膜下动脉(IMA)时保留左结肠动脉(LCA)的可行性与应用价值.方法 回顾性分析2010年4月至2013年10月72例腹腔镜直肠癌前切除术患者的临床资料,患者按随机数字表法分为两组,其中保留LCA 32例(观察组),不保留LCA40例(对照组),比较两组术中出血量、手术时间、术后排气时间、末端回肠造口情况、IMA根部淋巴结清扫数目、IMA根部淋巴结转移及预后情况.结果 观察组和对照组术中出血量、手术时间、术后排气时间、IMA根部淋巴结清扫数目、IMA根部淋巴结转移率比较差异均无统计学意义(P>0.05).观察组均无需游离结肠脾区及做末端回肠造口;而对照组3例因近端肠管血运障碍需游离结肠脾曲(P=0.046),4例吻合后加做末端回肠造口(P=0.042).观察组术后无吻合口漏,而对照组术后有2例吻合口漏(P=0.090).两组术后随访6~48个月,局部复发率及肝转移率比较差异无统计学意义(P>0.05).结论 腹腔镜直肠癌前切除术中处理IMA时保留LCA可以有效保障近端肠管血运.%Objective To explore the feasibility and value of preservation of left colonic artery (LCA) in dealing with inferior mesenteric artery (IMA) in laparoscopic anterior resection of rectal carcinoma.Methods The clinical data of 72 cases of laparoscopic anterior resection of rectal carcinoma from April 2010 to October 2013 were retrospectively analyzed including 32 cases with preservation of LCA (observation group) and 40 cases without preservation of LCA (control group).The blood loss,operative time,postoperative exhaust time,terminal ileum stoma,the number of lymph nodes removed around the root of IMA,the rate of lymph node metastasis around the root of IMA and prognosis were compared between two groups.Results There was no significant difference in the blood loss,operative time,postoperative exhaust time,terminal ileum stoma,the number

  2. Parasellar arachnoid cyst presenting with a nonpupil sparing third nerve palsy mimicking a posterior communicating artery aneurysm in an adult

    OpenAIRE

    Tempel, Zachary J.; Johnson, Stephen A.; Richard, Paul S.; Friedlander, Robert M.; Rothfus, William E.; Hamilton, Ronald L.

    2013-01-01

    Background: Arachnoid cysts are congenital lesions that contain fluid identical to cerebrospinal fluid (CSF). They usually do not communicate with CSF spaces. The vast majority of arachnoid cysts are congenital asymptomatic lesions that are discovered incidentally. Those lesions that do become symptomatic typically present in childhood with signs and symptoms of intracranial hypertension, seizures, and focal neurologic deficits specific to cyst location. Case Description: A rare case of a par...

  3. Dural AVM supplied by the ophthalmic artery.

    LENUS (Irish Health Repository)

    Flynn, T H

    2012-02-03

    Dural arteriovenous malformations in the anterior cranial fossa are rare and are especially prone to haemorrhage. These lesions are usually treated by surgical excision. We report the embolization of an anterior cranial fossa DAVM using an endovascular approach via the ophthalmic artery.

  4. COMMUNICATIONS

    CERN Multimedia

    L. Taylor and D. Barney

    2010-01-01

    CMS Centres, Outreach and the 7 TeV Media Event The new CMS Communications group is now established and is addressing three areas that are critical to CMS as it enters the physics operations phase: - Communications Infrastructure, including almost 50 CMS Centres Worldwide, videoconferencing systems, and CERN meeting rooms - Information systems, including the internal and external Web sites as well as the document preparation and management systems - Outreach and Education activities, including working with print, radio and TV media, visits to CMS, and exhibitions. The group has been active in many areas, with the highest priority being accorded to needs of CMS operations and preparations for the major media event planned for 7 TeV collisions. Unfortunately the CMS Centre@CERN suffered a major setback when, on 21st December, a cooling water pipe froze and burst on the floor above the CMS Centre main room. Water poured through the ceiling, flooding the floor and soaking some of the consoles, before e...

  5. COMMUNICATIONS

    CERN Multimedia

    A. Petrilli

    2013-01-01

    The organisation of the Open Days at the end of September was the single biggest effort of the CMS Communications Group this year. We would like to thank all volunteers for their hard work to show our Point 5 facilities and explain science and technology to the general public. During two days more than 5,000 people visited the CMS detector underground and profited from the surface activities, which included an exhibition on CMS, a workshop on superconductivity, and an activity for our younger visitors involving wooden Kapla blocks. The Communications Group took advantage of the preparations to produce new CMS posters that can be reused at other venues. Event display images have been produced not just for this occasion but also for other exhibits, education purposes, publications etc. During the Open Days, Gilles Jobin, 2012 winner of CERN Collide@CERN prize, performed his Quantum show in Point 5, with the light installation of German artist Julius von Bismarck. Image 3: CERN Open Days at CMS wel...

  6. Variant Branching Pattern of Axillary Artery: A Case Report

    OpenAIRE

    Swamy Ravindra Shantakumar; Mohandas Rao, K. G.

    2012-01-01

    During routine dissection of an approximately 50-year-old male cadaver for the undergraduate medical students at Melaka Manipal Medical College, Manipal University, Manipal, we came across a variation in branching pattern of right axillary artery. The second part of axillary artery gave rise to a common trunk which divided into the subscapular and lateral thoracic arteries. The third part of right axillary artery gave rise to anterior and posterior circumflex humeral arteries. Variations in t...

  7. Superficial Ulnar Artery Associated with Anomalous Origin of the Common Interosseous and Ulnar Recurrent Arteries

    Science.gov (United States)

    Pamidi, Narendra; Nayak, Satheesha B; Jetti, Raghu; Thangarajan, Rajesh

    2016-01-01

    Occurrence of vascular variations in the upper limb is not uncommon and is well described in the medical literature. However, occurrence of superficial ulnar artery associated with unusual origin of the common interosseous and ulnar recurrent arteries is seldom reported in the literature. In the present case, we report the anomalous origin of common trunk of common interosseous, anterior and posterior ulnar recurrent arteries from the radial artery, in a male cadaver. Further, ulnar artery had presented superficial course. Knowledge of anomalous arterial pattern in the cubital fossa reported here is clinically important during the angiographic procedures and plastic surgeries. PMID:27437201

  8. Bilateral anterior shoulder dislocation

    OpenAIRE

    Meena, Sanjay; Saini, Pramod; Singh, Vivek; Kumar, Ramakant; Trikha, Vivek

    2013-01-01

    Shoulder dislocations are the most common major joint dislocations encountered in the emergency departments. Bilateral shoulder dislocations are rare and of these, bilateral posterior shoulder dislocations are more prevalent than bilateral anterior shoulder dislocations. Bilateral anterior shoulder dislocation is very rare. We present a case of 24-year-old male who sustained bilateral anterior shoulder dislocation following minor trauma, with associated greater tuberosity fracture on one side...

  9. Minimal Invasive Coronary Artery Fistula Ligation

    OpenAIRE

    Mitropoulos, Fotios A.; Kanakis, Meletios A.; Chatzis, Andrew; Contrafouris, Constantinos; Sofianidou, Ioanna A.; Lioulias, Achilleas G.

    2014-01-01

    A coronary artery fistula was surgically ligated in a 38-year-old woman via a left anterior mini-thoracotomy without the use of cardiopulmonary bypass. In selected cases, this surgical approach can provide an excellent surgical exposure for coronary artery fistula ligation. It also offers an excellent cosmetic result and shorter hospital stay.

  10. Absence of scalenus anterior muscle.

    Directory of Open Access Journals (Sweden)

    Murakami S

    2003-06-01

    Full Text Available A rare anomaly of the scalenus muscles is described. In this case, the right scalenus anterior muscle was absent. As a substitute for this muscle, some aberrant muscle slips arose from the lower vertebrae and descended in front of the ventral rami of the lower cervical nerves. These aberrant slips then ran between the ventral rami of the the eighth cervical and first thoracic nerves, and were fused with the right scalenus medius muscle. Thus, the subclavian artery and vein ran in front of the aberrant slips, together with the ventral ramus of the first thoracic nerve. The aberrant muscle slips issued 2 accessory bundles. One bundle ran between the ventral rami of the fourth and fifth cervical nerves and was fused with the scalenus medius muscle; the other bundle ran between the ventral rami of the fifth and sixth cervical nerves and was fused with the scalenus medius muscle.

  11. Comparison of target images obtained by MR angiography and 3D-CT angiography in the region of internal carotid-posterior communicating artery

    International Nuclear Information System (INIS)

    With the progress of diagnostic imaging equipment, allows us to obtain cerebral angiogram by Computed tomography (CT) and Magnetic resonance imaging (MRI). They are less invasive than conventional angiography and have its own modality-dependent information on the images. Therefore, to determine the indications of CT and MRI for neurovascular disease, we compared the target MIP images by MRI with target SSD images by CT and examined those characteristics in the particular region of internal carotid-posterior communicating (IC-PC) artery. MRA demonstrated blood flow non-invasively without influence of the surrounding bones posterior fossa. But it required several minutes of head fixation. Also, head movement yielded blurring of the images in a few cases. CTA gave us more stereographic informations than MRA so that we could easily differentiate the vascular lesion from normal vascular structure through the threshold processing. However, it is experienced that the dense bones surrounding the IC-PC region interfered reconstruction of vascular images. And high intravenous injection of contrast medium caused a few patients heat sensation or other side effect. Accordingly, both examinations should be used supplementarily, MRA selected for screening of the IC-PC region and the role of CTA is definition and evaluation of vascular lesion after MRA had pointed out the abnormality. (author)

  12. Arterial stick

    Science.gov (United States)

    ... the main arteries in the forearm (radial and ulnar arteries). The procedure is done as follows: The ... Arteries also have thicker walls and have more nerves. When the needle is inserted, there may be ...

  13. A checklist for endonasal transsphenoidal anterior skull base surgery.

    Science.gov (United States)

    Laws, Edward R; Wong, Judith M; Smith, Timothy R; de Los Reyes, Kenneth; Aglio, Linda S; Thorne, Alison J; Cote, David J; Esposito, Felice; Cappabianca, Paolo; Gawande, Atul

    2016-06-01

    OBJECT Approximately 250 million surgical procedures are performed annually worldwide, and data suggest that major complications occur in 3%-17% of them. Many of these complications can be classified as avoidable, and previous studies have demonstrated that preoperative checklists improve operating room teamwork and decrease complication rates. Although the authors' institution has instituted a general preoperative "time-out" designed to streamline communication, flatten vertical authority gradients, and decrease procedural errors, there is no specific checklist for transnasal transsphenoidal anterior skull base surgery, with or without endoscopy. Such minimally invasive cranial surgery uses a completely different conceptual approach, set-up, instrumentation, and operative procedure. Therefore, it can be associated with different types of complications as compared with open cranial surgery. The authors hypothesized that a detailed, procedure-specific, preoperative checklist would be useful to reduce errors, improve outcomes, decrease delays, and maximize both teambuilding and operational efficiency. Thus, the object of this study was to develop such a checklist for endonasal transsphenoidal anterior skull base surgery. METHODS An expert panel was convened that consisted of all members of the typical surgical team for transsphenoidal endoscopic cases: neurosurgeons, anesthesiologists, circulating nurses, scrub technicians, surgical operations managers, and technical assistants. Beginning with a general checklist, procedure-specific items were added and categorized into 4 pauses: Anesthesia Pause, Surgical Pause, Equipment Pause, and Closure Pause. RESULTS The final endonasal transsphenoidal anterior skull base surgery checklist is composed of the following 4 pauses. The Anesthesia Pause consists of patient identification, diagnosis, pertinent laboratory studies, medications, surgical preparation, patient positioning, intravenous/arterial access, fluid management

  14. Anterior Cruciate Ligament (ACL) Injuries

    Science.gov (United States)

    ... Help a Friend Who Cuts? Anterior Cruciate Ligament (ACL) Injuries KidsHealth > For Teens > Anterior Cruciate Ligament (ACL) ... and Recovery Coping With an ACL Injury About ACL Injuries A torn anterior cruciate ligament (ACL) is ...

  15. Coexistence of rare arteries in the human celiaco-mesenteric system.

    Science.gov (United States)

    Murakami, T; Mabuchi, M; Giuvarasteanu, I; Kikuta, A; Ohtsuka, A

    1998-10-01

    Some rare anomalies of the celiaco-mesenteric system were observed postmortem in a Japanese adult male: a) The left gastric, common hepatic, splenic and superior mesenteric arteries arose independently from the abdominal aorta. b) The anterior inferior pancreaticoduodenal artery of the superior mesenteric artery issued a hepatic artery which ascended along the anterior surface of the pancreas and gave off the right gastroepiploic, right gastric and cystic arteries. c) The common hepatic artery gave off an anastomosing branch to the superior mesenteric artery. d) The left gastric artery gave off the left accessory hepatic artery. e) The splenic artery issued the accessory middle colic artery. f) The left inferior phrenic artery gave off the esophageal branch. These anomalies are discussed in light of a typological system which we proposed in a previous paper for the celiaco-mesenteric system. PMID:9810433

  16. A case of myocardial bridging over the right coronary artery diagnosed by coronary angiography

    OpenAIRE

    Karapınar, Hekim; Küçükdurmaz, Zekeriya; GÜL, İbrahim; Hasan Ali GÜMRÜKÇÜOĞLU; Yılmaz, Ahmet

    2012-01-01

    Abstract Angiographically evident myocardial bridges confined to the other arteries rather than the left anterior descending artery is very rare in the literature. Also cardiac computerized tomography studies and postmortem studies demonstrated that myocardial bridges are not as rare as the angiographic series and may be confined to the other arteries rather than the left anterior descending. We reported a very rare case with myocardial bridge on right coronary artery diagnosed by coronary an...

  17. Circle of Willis variant analogous to fetal type primitive trigeminal artery

    International Nuclear Information System (INIS)

    Primitive caroticobasilar anastomoses are uncommon embryonic arterial connections between the carotid (anterior) and vertebrobasilar (posterior) circulations. With the exception of extracranial proatlantal intersegmental arteries, these embryonic arterial anastomoses are named according to the cranial nerves which they parallel. In this report, a previously undescribed variant circle of Willis with supraclinoid caroticobasilar anastomosis, functionally equivalent to a fetal type primitive trigeminal artery, is presented. (orig.)

  18. Higher division of popliteal artery: a case report

    Directory of Open Access Journals (Sweden)

    Prakash Babu Billakanti

    2014-08-01

    Full Text Available During the routine dissection of anatomy in an adult male cadaver at the department of anatomy, Manipal University, Manipal, higher division of popliteal artery was observed on the right side. This artery divided proximal to upper border of popliteus muscle into anterior and posterior tibial arteries. Inferomedial genicular artery which is usually a branch of popliteal artery was found to be arising from anterior tibial artery. However arterial branching pattern and point of bifurcation of popliteal artery on the left side were usual. The knowledge of these variations will be useful for angiography or various surgical approaches during knee joint surgery. [Int J Res Med Sci 2014; 2(4.000: 1723-1725

  19. Anterior cervical plating

    Directory of Open Access Journals (Sweden)

    Gonugunta V

    2005-01-01

    Full Text Available Although anterior cervical instrumentation was initially used in cervical trauma, because of obvious benefits, indications for its use have been expanded over time to degenerative cases as well as tumor and infection of the cervical spine. Along with a threefold increase in incidence of cervical fusion surgery, implant designs have evolved over the last three decades. Observation of graft subsidence and phenomenon of stress shielding led to the development of the new generation dynamic anterior cervical plating systems. Anterior cervical plating does not conclusively improve clinical outcome of the patients, but certainly enhances the efficacy of autograft and allograft fusion and lessens the rate of pseudoarthrosis and kyphosis after multilevel discectomy and fusions. A review of biomechanics, surgical technique, indications, complications and results of various anterior cervical plating systems is presented here to enable clinicians to select the appropriate construct design.

  20. Anterior knee pain

    Science.gov (United States)

    Patellofemoral syndrome; Chondromalacia patella; Runner's knee; Patellar tendinitis; Jumper's knee ... or playing soccer). You have flat feet. Anterior knee pain is more ... skiers, bicyclists, and soccer players who exercise often ...

  1. Anterior knee pain

    Science.gov (United States)

    ... or playing soccer). You have flat feet. Anterior knee pain is more common in: People who are overweight People who have had a dislocation, fracture, or other injury to the kneecap Runners, jumpers, ...

  2. Anomalous Right Coronary Artery Originating from the Left Main Coronary Artery

    Directory of Open Access Journals (Sweden)

    Y Mahmmody

    2009-12-01

    Full Text Available A 50–year–old woman presented to our center with effort angina. Angiography showed normal left main coronary artery, normal left circumflex (LCX artery and critical discrete lesion (99% stenosis in mid part of left anterior descending (LAD artery with good distal flow. However, the right coronary artery (RCA originated from the left main coronary artery. There was no evidence of external compression of the proximal portion of the RCA during systole or diastole. Consult with cardiac surgeon was done but the patient refused from the operation.

  3. Location of foot arteries using infrared images

    Science.gov (United States)

    Villasenor-Mora, Carlos; González-Vega, Arturo; Martín Osmany Falcón, Antonio; Benítez Ferro, Jesús Francisco Guillemo; Córdova Fraga, Teodoro

    2014-11-01

    In this work are presented the results of localization of foot arteries, in a young group of participants by using infrared thermal images, these are the dorsal, posterior tibial and anterior tibial arteries. No inclusion criteria were considered, that causes that no strong statistical data about the influence of the age in the arterial localization. It was achieved to solve the confusion when veins present a heat distribution similar to the artery and in the position of this. it contributes to enhance the rate of location of arteries. In general it is possible to say that the use of infrared thermal images is a good technique to find the foot arteries and can be applied in its characterization in a future. The procedure proposed is a non-invasive technique, and in certain fashion does not requires specialized personnel to achieve locate the arteries. It is portable, safe, and relatively economical.

  4. MDCTA diagnosis of cerebral vessel disease among patients with arterial hypertension

    International Nuclear Information System (INIS)

    to study changes involving cerebral vessels in patients with hypertension and various levels of total cardiovascular risk. One hundred and thirty-four patients underwent CT-angiography of intracranial vessels. Ninety-eight of them were diagnosed with hypertension. Taking into consideration high blood pressure, presence of risk factors and target organ damage subjects were divided into 4 groups: with low, medium, high and very high total cardiovascular risk. Control group included 36 patients. They were not diagnosed with hypertension at the time of examination. One hundred and five patients were examined using a 4-slice CT scanner (Toshiba Asteion 4, Toshiba Medical System, Japan), and 29 patients were examined using a 128-slice scanner (Siemens Definition AS+, Siemens Healthcare, Germany) with an injection system. We used iodine-containing contrast agents such as iodixanol and iopromide for angiography. Anatomical and topographic changes of cerebral vessels were most frequently found in hypertensive patients with high and very high total cardiovascular risk. Narrowing of vertebral vessels was the most common change (27 patients (27.55%), 21 patients (21.43%) had narrowing of the right artery, and 6 (6.12%) subjects – of the left one). Tortuous course of internal carotid arteries at the neck level was visualized in 11 patients (11.22%). Narrowing of A1 segment of anterior cerebral artery was noted in 9 patients (9.18%), of the right one – in 8 patients (8.16%), of the left one – in 1 patient (1.02%). Aneurysmal dilation of intracranial vessels was visualized in 6 patients (6.12%). Saccular aneurysm of left internal carotid artery was diagnosed in 2 patients (2.04%), one patient (1.02%) had right internal carotid artery aneurysm and one patient (1.02%) had an aneurysm of the basilar artery. the most common changes of cerebral vessels diagnosed in MDCTA among patients with hypertension included various degrees of narrowing of vertebral vessels, anterior

  5. Robot-Assisted Minimally Invasive Coronary Artery Bypass Surgery Operation

    Medline Plus

    Full Text Available ... distributing blood supply to. He the went for heart catheterization, which revealed him to have 100 percent ... the artery on the front surface of the heart. And his left anterior descending, which is really ...

  6. Adjustable muscle plication: a new surgical technique for strabismic patients with high risk for anterior segment ischemia

    Institute of Scientific and Technical Information of China (English)

    Carlos; Laria; David; P.Pi?ero

    2015-01-01

    <正>INTRODUCTION Anterior ciliary arteries provide 70%of the vascular supply of the anterior segment.A significant interruption of the vascular flow of these arteries increases the risk for anterior ischemia.Although the frequency of this special condition is low after strabismus surgery(1:13 000)[1],its effects may involve substantial visual problems[2].We report the successful outcome of a new surgical approach for strabismus management in a case of high risk for anterior ischemia.Specifically,we show the correction of the horizontal ocular deviation by means of an adjustable muscle

  7. Arterial Ageing

    OpenAIRE

    Lee, Seung-Jun; Park, Sung-Ha

    2013-01-01

    Arterial ageing is characterized by age associated degeneration and sclerosis of the media layer of the large arteries. However, besides ageing, clinical conditions, which enhance oxidative stress and inflammation act to accelerate the degree of arterial ageing. In this review, we summarized the pathophysiology and contributing factors that accelerate arterial ageing. Among them, we focused on hypertension, the renin-angiotensin-aldosterone system and vascular inflammation which are modifiabl...

  8. Congenital anterior urethral diverticulum.

    Science.gov (United States)

    Singh, Sanjeet Kumar; Ansari, Ms

    2014-09-01

    Congenital anterior urethral diverticulum (CAUD) may be found all along the anterior urethra and may present itself at any age, from infant to adult. Most children with this condition present with difficulty in initiating micturition, dribbling of urine, poor urinary stream, or urinary tract infection. A careful history will reveal that these children never had a good urinary stream since birth, and the telltale sign is a cystic swelling of the penile urethra. In this paper, we present two cases of CAUD that were managed by excision of the diverticulum with primary repair. PMID:26328174

  9. Unusual origin of the artery of Adamkiewicz from the fourth lumbar artery

    International Nuclear Information System (INIS)

    The main arterial supply of the dorso-lumbar spinal cord is usually derived from a single anterior radiculo-medullary artery called the artery of Adamkiewicz and referred to as having a middle or low location. In some cases, the artery origin is higher, and a vessel which arises in the lower part of the region supplements the supply of the anterior spinal artery. In the literature, those arteries have been described as arising from L3 upwards, and have never been previously described angiographically, to our knowledge, below this level, although Suh and Alexander and Gililan have mentioned this eventuality. Of the 4,000 spinal cord angiographies performed in our institution, we report three cases in which the fourth lumbar artery flows into the anterior spinal artery of the conus medullaris. This anatomical variant may explain the sometimes devastating post-operative neurological complications from a spinal cord infarction on surgery of the lumbar spine or the abdominal aorta below L3. (orig.)

  10. Unusual origin of the artery of Adamkiewicz from the fourth lumbar artery

    Energy Technology Data Exchange (ETDEWEB)

    Lo, D.; Vallee, J.N.; Spelle, L.; Cormier, E.; Chiras, J. [Service de Neuroradiologie Charcot, Hopital de la Salpetriere, Paris (France); Saillant, G. [Service de Chirurgie Orthopedique et de Traumatologie, Hopital de la Salpetriere, Paris (France); Rancurel, G. [Service D' urgences Cerebro-Vasculaires, Hopital de la Salpetriere, Paris (France)

    2002-02-01

    The main arterial supply of the dorso-lumbar spinal cord is usually derived from a single anterior radiculo-medullary artery called the artery of Adamkiewicz and referred to as having a middle or low location. In some cases, the artery origin is higher, and a vessel which arises in the lower part of the region supplements the supply of the anterior spinal artery. In the literature, those arteries have been described as arising from L3 upwards, and have never been previously described angiographically, to our knowledge, below this level, although Suh and Alexander and Gililan have mentioned this eventuality. Of the 4,000 spinal cord angiographies performed in our institution, we report three cases in which the fourth lumbar artery flows into the anterior spinal artery of the conus medullaris. This anatomical variant may explain the sometimes devastating post-operative neurological complications from a spinal cord infarction on surgery of the lumbar spine or the abdominal aorta below L3. (orig.)

  11. Isolated intermittent vertigo: A presenting feature of persistent trigeminal artery

    Directory of Open Access Journals (Sweden)

    Rajsrinivas Parthasarathy

    2016-01-01

    Full Text Available Embryonic carotid – basilar anastomosis when persistent in adult life can present with a variety of neurological symptoms. We present a patient with isolated intermittent vertigo attributable to the embryonic anastomosis and describe the different types of persistent trigeminal artery. A 76-year-old Caucasian man presented with isolated intermittent vertigo and symptoms suggestive of anterior and posterior circulation strokes. Impaired vasomotor reactivity was demonstrated on insonation of the anterior and posterior cerebral arteries in this patient with a persistent left trigeminal artery and 75% stenosis of the left internal carotid artery (ICA. The symptom of intermittent vertigo resolved with carotid endarterectomy. Decreased flow across the stenotic segment of the ICA which subserved the posterior circulation resulted in basilar insufficiency. Hypoperfusion to the flocculonodular lobe supplied by the anterior inferior cerebellar artery is a likely cause for the intermittent vertigo.

  12. Isolated intermittent vertigo: A presenting feature of persistent trigeminal artery

    Science.gov (United States)

    Parthasarathy, Rajsrinivas; Derksen, Carol; Saqqur, Maher; Khan, Khurshid

    2016-01-01

    Embryonic carotid – basilar anastomosis when persistent in adult life can present with a variety of neurological symptoms. We present a patient with isolated intermittent vertigo attributable to the embryonic anastomosis and describe the different types of persistent trigeminal artery. A 76-year-old Caucasian man presented with isolated intermittent vertigo and symptoms suggestive of anterior and posterior circulation strokes. Impaired vasomotor reactivity was demonstrated on insonation of the anterior and posterior cerebral arteries in this patient with a persistent left trigeminal artery and 75% stenosis of the left internal carotid artery (ICA). The symptom of intermittent vertigo resolved with carotid endarterectomy. Decreased flow across the stenotic segment of the ICA which subserved the posterior circulation resulted in basilar insufficiency. Hypoperfusion to the flocculonodular lobe supplied by the anterior inferior cerebellar artery is a likely cause for the intermittent vertigo. PMID:26933370

  13. Isolated intermittent vertigo: A presenting feature of persistent trigeminal artery.

    Science.gov (United States)

    Parthasarathy, Rajsrinivas; Derksen, Carol; Saqqur, Maher; Khan, Khurshid

    2016-01-01

    Embryonic carotid - basilar anastomosis when persistent in adult life can present with a variety of neurological symptoms. We present a patient with isolated intermittent vertigo attributable to the embryonic anastomosis and describe the different types of persistent trigeminal artery. A 76-year-old Caucasian man presented with isolated intermittent vertigo and symptoms suggestive of anterior and posterior circulation strokes. Impaired vasomotor reactivity was demonstrated on insonation of the anterior and posterior cerebral arteries in this patient with a persistent left trigeminal artery and 75% stenosis of the left internal carotid artery (ICA). The symptom of intermittent vertigo resolved with carotid endarterectomy. Decreased flow across the stenotic segment of the ICA which subserved the posterior circulation resulted in basilar insufficiency. Hypoperfusion to the flocculonodular lobe supplied by the anterior inferior cerebellar artery is a likely cause for the intermittent vertigo. PMID:26933370

  14. Anterior vaginal wall repair

    Science.gov (United States)

    ... symptoms will go away. This improvement will often last for years. Alternative Names A/P repair; Vaginal wall repair; Anterior and/ ... writing by ADAM Health Solutions. About MedlinePlus Site Map FAQs Contact ... Institutes of Health Page last updated: 23 August 2016

  15. [Toxic anterior segment syndrome].

    Science.gov (United States)

    Cornut, P-L; Chiquet, C

    2011-01-01

    Toxic anterior segment syndrome (TASS) is a general term used to describe acute, sterile postoperative inflammation due to a non-infectious substance that accidentally enters the anterior segment at the time of surgery and mimics infectious endophthalmitis. TASS most commonly occurs acutely following anterior segment surgery, typically 12-72h after cataract extraction. Anterior segment inflammation is usually quite severe with hypopyon. Endothelial cell damage is common, resulting in diffuse corneal edema. No bacterium is isolated from ocular samples. The causes of TASS are numerous and difficult to isolate. Any device or substance used during the surgery or in the immediate postoperative period may be implicated. The major known causes include: preservatives in ophthalmic solutions, denatured ophthalmic viscosurgical devices, bacterial endotoxin, and intraocular lens-induced inflammation. Clinical features of infectious and non-infectious inflammation are initially indistinguishable and TASS is usually diagnosed and treated as acute endophthalmitis. It usually improves with local steroid treatment but may result in chronic elevation of intraocular pressure or irreversible corneal edema due to permanent damage of trabecular meshwork or endothelial cells. PMID:21176994

  16. A STUDY OF ARTERIAL SUPPLY OF CAECUM IN HUMANS.

    Directory of Open Access Journals (Sweden)

    Hosmani

    2012-11-01

    Full Text Available ABSTRACT : The surgical procedures on the caecum demand a prec ise knowledge of vascular anatomy of ileocolic region. The aim of this study is to study the arterial supply of the caecum, findings of which may reveal more anatomical facts about the arteries of caecum and their variations. Total 52 specimens of caecum and appendix with their arteries intact were collected, cleaned and dissected. The ileocolic artery and its branches to the caecum, and ileum were traced carefully and observations were recorded. Th e ileocolic artery arises independently from superior mesenteric artery in 96.88% of cases and en ds by dividing into superior and inferior division in 93.76% of cases. The anterior and poster ior caecal arteries arise by a common trunk in 56.25%. The ileocolic artery arises from the supe rior mesenteric artery independently in 96.88% and terminates into superior and inferior div ision in 93.76% of cases. Common caecal artery seen in 56.25% of cases, arises from inferio r division (43.75%, superior division (9.38% and ileocolic artery (3.12%.Anterior caeca l artery arises from superior division (12.5%, inferior division (15.63%, ileocolic arte ry (3.12%, ileal branch (6.25% and arterial arcade (6.25%.The posterior caecal artery arises fr om superior division (18.76%, inferior division (9.38%, ileal branch (3.12%, ileocolic a rtery (3.12%, arterial arcade (6.25% and from ascending colic branch of inferior division (3 .12%. 21.87% of cases showed additional anterior and posterior caecal arteries.

  17. Basilar artery aneurysm at a persistent trigeminal artery junction. A case report and literature review.

    Science.gov (United States)

    Aguiar, G B; Conti, M L M; Veiga, J C E; Jory, M; Souza, R B

    2011-09-01

    The trigeminal artery is an anastomosis between the embryonic precursors of the vertebrobasilar and carotid systems, and may persist into adult life. The association of the persistent primitive trigeminal artery (PTA) with cerebral aneurysm is well documented in the literature and, in general, aneurysms are located in the anterior circulation. We describe a patient who presented with a panencephalic Fisher III subarachnoid hemorrhage due to rupture of an intracranial aneurysm. Digital arteriography showed a saccular aneurysm in the middle third of the basilar artery, adjacent to the junction with a persistent trigeminal artery. She was submitted to endovascular treatment with embolization of the basilar artery aneurysm with coils. Aneurysms at the PTA junction with the basilar artery are rare. This paper describes a case of PTA associated with an aneurysm in the basilar artery at PTA junction and briefly reviews the literature. PMID:22005697

  18. Acute arterial occlusion - kidney

    Science.gov (United States)

    ... arterial thrombosis; Renal artery embolism; Acute renal artery occlusion; Embolism - renal artery ... often result in permanent kidney failure. Acute arterial occlusion of the renal artery can occur after injury ...

  19. Anterior cruciate ligament (ACL) injury

    Science.gov (United States)

    Cruciate ligament injury - anterior; ACL injury; Knee injury - anterior cruciate ligament (ACL) ... confirm the diagnosis. It may also show other knee injuries. First aid for an ACL injury may include: ...

  20. Riscos e consequências do uso da técnica transportal na reconstrução do ligamento cruzado anterior: relação entre o túnel femoral, a artéria genicular lateral superior e o epicôndilo lateral do côndilo femoral Risks and consequences of using the transportal technique in reconstructing the anterior cruciate ligament: relationships between the femoral tunnel, lateral superior genicular artery and lateral epicondyle of the femoral condyle

    Directory of Open Access Journals (Sweden)

    Diego Costa Astur

    2012-10-01

    Full Text Available OBJETIVO: Definir zona de segurança para evitar possíveis complicações vasculares e ligamentares durante a reconstrução do ligamento cruzado anterior. MÉTODOS: Reconstrução artroscópica com uso de técnica transportal e transtibial em joelhos de cadáver foi realizada seguida de dissecção e mensuração da distância entre o túnel femoral e a inserção proximal do ligamento colateral lateral e o túnel femoral e a artéria genicular lateral superior. RESULTADOS: A mensuração das distâncias analisadas mostra uma aproximação maior do principal ramo da artéria genicular lateral superior e da inserção proximal do ligamento colateral lateral com o túnel femoral, realizado com a técnica transportal. CONCLUSÃO: Percebemos que o uso da técnica transportal para reconstrução artroscópica do LCA apresenta maior probabilidade de lesão da artéria genicular lateral e da inserção do ligamento colateral lateral, favorecendo complicações pós-cirúrgicas como instabilidade do joelho, osteonecrose do côndilo femoral lateral e ligamentização do enxerto.OBJECTIVE: Define a security zone to avoid possibles vascular and ligamentar complications during anterior cruciate ligament reconstruction. METHODS: Arthroscopic reconstruction using the transtibial and transportal technique in cadaver knees was performed followed by dissection and measurement of the distance between the femoral tunnel and the proximal attachment of the lateral collateral ligament and the femoral tunnel and the lateral superior genicular artery. RESULTS: The measure of the analysed distances show us an aproximation between the major branch of the lateral superior genicular artery and the femoral insertion of the colateral lateral ligament and the femoral tunnel during the transportal technique. CONCLUSION: We realize that the use of technical ship it to arthroscopic ACL reconstruction has a higher probability of injury to the lateral geniculate artery and

  1. Analyses of risk factors for posterior communicating artery aneurysm rupture%后交通动脉动脉瘤破裂的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    崔岩; 张明铭; 蒋宇钢

    2015-01-01

    Objective To analyze the risk factors for posterior communicating artery (PCoA) aneurysm rupture from the clinical and morphological aspects.Methods Consecutive patients with single PCoA aneurysm admitted to hospital from January 2011 to December 2013 were analyzed retrospectively.The clinical data and imaging characteristics were analyzed with univariate analysis and multivariate logistic regression analysis.Results Univariate analysis indicated that there were significant differences in the rupture rate of PCoA aneurysms in the history of hypertension (x2 =23.013,P =0.000),aspect ratio (AR) ≥ 1.5 (x2 =8.492,P =0.004),directions of different aneurysm tops (x2 =15.057,P =0.002),and aneurysm blebs (x2 =18.952,P =0.000) between the two groups.The results of multivariate logistic regression analysis were the history of hypertension (OR,13.240,P =0.000),presence of aneurysm blebs (OR,12.933,P =0.001),age less than 60 years (OR,3.766,P =0.010),AR ≥ 1.5 (OR =4.997,P =0.001),and posterior-inferior-lateral directions of aneurysm tops (OR,7.584,P =0.038).Conclusion The history of hypertension,presence of aneurysm blebs,age less than 60 years,AR ≥ 1.5 and posterior-inferior-lateral directions of aneurysm tops were the risk factors for PCoA aneurysm rupture.%目的 从临床与形态学方面分析后交通动脉动脉瘤破裂出血的危险因素.方法 回顾性分析2011年1月至2013年12月连续收治的单发后交通动脉动脉瘤病例(185例),并针临床资料和影像学特征行单因素分析与多元Logistic回归分析.结果 单因素分析提示后交通动脉动脉瘤破裂率在高血压病史(x2=23.013,P=0.000)、瘤体长径/瘤颈宽度(aspect ratio,AR)≥1.5(x2=8.492,P =0.004)、不同瘤顶指向(x2=15.057,P =0.020)、子瘤(x2=18.952,P=0.000)的区组间差异有统计学意义.多因素Logistic回归分析结果为高血压病史(OR=13.240,P=0.000)、存在子瘤(OR=12.933,P=0.001)、年龄低于60岁(OR=3.766,P=0.010)以及AR值≥1.5(OR=4

  2. The normal distribution of thoracoabdominal aorta small branch artery ostia

    International Nuclear Information System (INIS)

    The purpose of this study was to determine the normal distribution of aortic branch artery ostia. CT scans of 100 subjects were retrospectively reviewed. The angular distributions of the aorta with respect to the center of the T3 to L4 vertebral bodies, and of branch artery origins with respect to the center of the aorta were measured. At each vertebral body level the distribution of intercostal/lumbar arteries and other branch arteries were calculated. The proximal descending aorta is posteriorly placed becoming a midline structure, at the thoracolumbar junction, and remains anterior to the vertebral bodies within the abdomen. The intercostal and lumbar artery ostia have a distinct distribution. At each vertebral level from T3 caudally, one intercostal artery originates from the posterior wall of the aorta throughout the thoracic aorta, while the other intercostal artery originates from the medial wall of the descending thoracic aorta high in the chest, posteromedially from the mid-thoracic aorta, and from the posterior wall of the aorta low in the chest. Mediastinal branches of the thoracic aorta originate from the medial and anterior wall. Lumbar branches originate only from the posterior wall of the abdominal aorta. Aortic branch artery origins arise with a bimodal distribution and have a characteristic location. Mediastinal branches of the thoracic aorta originate from the medial and anterior wall. Knowing the location of aortic branch artery ostia may help distinguish branch artery pseudoaneurysms from penetrating ulcers.

  3. Deep Circumflex Iliac Artery Pseudoaneurysm as a Complication of Paracentesis

    OpenAIRE

    Bhawna Satija; Sanyal Kumar; Duggal, Ramnik K.; Supreethi Kohli

    2012-01-01

    We report a case of a pseudoaneurysm arising from the deep circumflex iliac artery, in an end-stage renal disease patient with gross ascitis, presenting with an anterior abdominal wall hematoma following paracentesis. Duplex Doppler sonography confirmed the presence of the pseudoaneurysm and multidetector computed tomography angiography delineated the detailed arterial anatomy.

  4. Dynamic exercise enhances regional cerebral artery mean flow velocity

    DEFF Research Database (Denmark)

    Linkis, P; Jørgensen, L G; Olesen, H L;

    1995-01-01

    Dynamic exercise enhances regional cerebral artery mean flow velocity. J. Appl. Physiol. 78(1): 12-16, 1995.--Anterior (ACA) and middle (MCA) cerebral artery mean flow velocities (Vmean) and pulsatility indexes were determined using transcranial Doppler in 14 subjects during dynamic exercise afte...

  5. [A typical syndrome of the sulco-commissural arteries].

    Science.gov (United States)

    Szyrocka-Szwed, K; Maliszewski, M; Syc, B; Macyszyn, G

    1988-01-01

    Flaccid tetraparesis was observed in a young woman which was caused by embolism of the anterior medullary artery. Topographic investigations of the spinal arteries were carried out, and pathological examination was done confirming the presence of embolic material which was the cause of medullary ischaemia. PMID:3226481

  6. Anterior Cruciate Ligament Injury

    OpenAIRE

    Vilaseca, Tomas; Chahla, Jorge; Rodriguez, Gustavo Gomez; Arroquy, Damián; Herrera, Gonzalo Perez; Orlowski, Belen; Carboni, Martín

    2015-01-01

    Objectives: The objective of this study was to analyze whether it is more frequent the presence of a decreased range of motion in the hips of recreational athletes with primary injury of the anterior cruciate ligament (ACL) than in a control group of volunteers without knee pathology. Methods: We included prospectively recreational athletes between 18 and 40 years with an acute ACL injury between January 2011 and January 2013. They were compared with a control group of volunteers recreational...

  7. Split Right Coronary Artery Its Definition and Its Territory

    OpenAIRE

    Sawaya, Fadi J.; Sawaya, Jaber I.; Angelini, Paolo

    2008-01-01

    We report here, for perhaps the 1st time in the English-language literature, the extent of the territory fed by the anterior bifurcation of the (anomalous) split right coronary artery (RCA). A 64-year-old man presented with an occlusion of the anterior bifurcation of a split RCA—which resulted in an infarct that involved both the inferoseptal left ventricular wall and the anterior right ventricular free wall. Split RCA is the same anomaly as the improperly named “double right coronary artery....

  8. Acute multivessel coronary artery occlusion: a case report

    Directory of Open Access Journals (Sweden)

    Gan Feng

    2012-09-01

    Full Text Available Abstract Background In terms of clinical and angiographic findings, multiple simultaneous coronary occlusions in acute myocardial infarction are infrequent, and the mechanism of the occlusions is unclear. Case presentation We herein report a rare case of two simultaneously occluded coronary arteries, one of which subsequently underwent spontaneous lysis. An 88-year-old man had a 3-hour attack of acute crushing retrosternal chest pain. His first electrocardiogram showed ST-segment elevation in the inferior (II, III, and aVF and anterior (V3–V6 leads. His second electrocardiogram in the cardiac care unit showed ST-segment elevation in the inferior leads but ST-segment depression in the anterior leads. Emergency coronary angiography revealed that the right coronary artery was acutely and totally occluded at the midportion and that the proximal and midportion of the left anterior descending coronary artery had an acute thrombus. According to his electrocardiogram and coronary angiography findings, we inferred that the right coronary artery and left anterior descending coronary artery first totally occluded simultaneously, and then the thrombus in the left anterior descending coronary artery spontaneously underwent partial lysis. Therefore, intervention of the right coronary artery was performed followed by injection of glycoprotein IIB-IIIA inhibitor into the left anterior descending coronary artery. He had an uneventful hospital course and was discharged home 10 days later. Conclusion Because patients with multivessel coronary artery occlusion are often in serious condition, abnormal electrocardiographic results must be identified and affected vessel should be opened timely and efficiently to save the myocardium and reduce complications such as congestive heart failure.

  9. Persistent primitive trigeminal artery: a review.

    Science.gov (United States)

    Azab, Waleed; Delashaw, Johnny; Mohammed, Mohammed

    2012-01-01

    The trigeminal artery is the largest of the fetal carotid-basilar anastomotic arteries, and it persists for the longest embryonic period. The artery usually involutes after the development of the posterior communicating artery. The exact causes of persistence of this primitive vessel into adulthood are not completely clear. Angiographic and anatomical descriptions of the various persistent trigeminal artery (PTA) configurations and their relation to the remainder of the cerebrovascular tree and the other surrounding structures have been reported. Persistent trigeminal artery can be associated with many other vascular anomalies and disorders including aneurysms, arteriovenous malformations and carotid-cavernous fistulae. A thorough understanding of the anatomical and angiographic features of this persistent embryonic arterial channel is of utmost importance when making therapeutic decisions and embarking on surgical or endovascular intervention for any pertinent pathological condition. We review the embryology, angiographic features, microsurgical anatomy and associated vascular anomalies and disorders of the persistent trigeminal artery. PMID:22843453

  10. Willis环变异与颅内动脉瘤关系的临床探讨%Clinical study of the relationship between Willis arterial loop variation and intracranial aneurysms

    Institute of Scientific and Technical Information of China (English)

    杨帆

    2016-01-01

    目的 探究CT血管成像技术显示Willis环的变异情况与颅内动脉瘤发生的关系.方法 分析2014年1月至2014年12月四川医科大学附属第一医院收治的144例颅内动脉瘤患者的数字血管造影资料,根据所有患者动脉瘤所在部位,将患者分为前交通动脉瘤组和后交通动脉瘤组,比较两组患者的性别、年龄、颅内动脉瘤瘤体的长径情况,探讨颅内动脉瘤与Willis环分型的关系.并与手术结果比较,分析其敏感性与特异性.结果 通过CT血管成像共检出144例颅内动脉瘤患者,其中前交通动脉瘤患者68例,后交通动脉瘤患者76例,两组患者在性别分布、年龄分布、瘤体长径差异无统计学意义(P>0.05);前交通动脉瘤组中,A1段纤细或缺如率达79.41%,而后交通动脉瘤组中A1段纤细或缺如率仅为52.63%,两组比较差异有统计学意义(P<0.05);前交通动脉瘤组中双侧胚胎型大脑后动脉率63.24%,后交通动脉瘤组中右侧或左侧(单侧)胚胎型大脑后动脉率59.21%.两组患者CT血管显像(CTA)检查结果敏感性与特异性差异无统计学意义(P>0.05).结论 CT血管成像能够较为准确的诊断出颅内动脉瘤;前交通动脉瘤的发生与A1段纤细、缺如以及双侧胚胎型大脑后动脉关系较为紧密,而后交通动脉瘤的发生与单侧胚胎型大脑后动脉的关系更为密切.%Objective To explore the relationship between the changes of the cerebral arterial circle of Willis and the occurrence of intracranial aneurysms in the diagnosis of digital angiography.Methods From December 2014 to January 2014,144 cases of intracranial aneurysms were treated in the First Affiliated Hospital of Luzhou Medical University.According to the location of the aneurysm of all patients,the patients were divided into the anterior communicating artery and the posterior communicating artery aneurysms.The relationship between two groups of patients was compared by the

  11. Tracheal compression due to anomalous innominate artery in an adult

    OpenAIRE

    Krishna B Gupta; Diksha Tyagi; Deepak Prajapat; Vipul Kumar

    2014-01-01

    A 47-year-old-female presented with dyspnea and unproductive cough for 4 months. General examination revealed pulsatile swelling in the midline below the thyroid cartilage present since childhood. Computed tomography-angiography of the neck showed right innominate artery dilated, elongated and coursing above downward, anterior to the trachea below the thyroid, compressing the trachea and origin of the right subclavian artery higher up. A case of anomalous innominate artery causing symptomatic...

  12. Hydronephrosis by an Aberrant Renal Artery: A Case Report

    OpenAIRE

    Park, Byoung Seok; Jeong, Taek Kyun; Ma, Seong Kwon; Kim, Soo Wan; Kim, Nam Ho; Choi, Ki Chul; Jeong, Yong Yeon

    2003-01-01

    Ureteropelvic junction obstruction is usually intrinsic and is most common in children. Aberrant renal arteries are present in about 30% of individuals. Aberrant renal arteries to the inferior pole cross anteriorly to the ureter and may cause hydronephrosis. To the best of our knowledge, although there are some papers about aberrant renal arteries producing ureteropelvic junction obstruction, there is no report of a case which is diagnosed by the new modalities, such as computed tomography an...

  13. Angle change of the parent arteries after stent-assisted coil embolization of wide-necked intracranial bifurcation aneurysms

    International Nuclear Information System (INIS)

    Aim: To investigate the angle changes of the parent arteries after stent-assisted coil embolization of wide-necked intracranial bifurcation aneurysms. Materials and methods: The adjacent parent arterial angles before and after stent-assisted coil embolization were measured in 38 patients with aneurysms of the anterior communicating artery (ACoAA) and 41 patients with bifurcation aneurysms of the middle cerebral artery (MCABA). Variables were analysed in relation to the angle changes. Results: Vascular angles of the parent arteries significantly increased by 27.8° (±18.5°) immediately after stent-assisted coil embolization in 79 cases (p < 0.001), with 25.7° (±14.8°) in ACoAA and 29.7° (±21.4°) in MCABA, respectively. In 51 (64.6%) cases with follow-up angiography (mean interval 13.5 ± 4.1 months), vascular angles increased by 27.2° (±17.1°) immediately after treatment and further increased by 20.7° (±14.3°) at the last follow-up (all p < 0.001). More acute pre-stent angles of the parent arteries correlated with greater post-stent angle changes (p = 0.006). Younger age tended to be inversely related to post-stent angle changes (p = 0.091). Conclusion: Stent placement during coil embolization induced significant changes in the aneurysm–parent artery relationship. Further study is needed to elicit the association between angle change of the parent arteries and aneurysmal stability after coil embolization

  14. Coronary artery fistulas as a cause of angina: How to manage these patients?

    International Nuclear Information System (INIS)

    Coronary artery fistulas represent the most common hemodynamically significant congenital defect of the coronary arteries and the clinical presentation is mainly dependent on the severity of the left-to-right shunt. We describe a case of a 55-year-old man with history of chest pain and without history of previous significant chest wall trauma or any invasive cardiac procedures. A coronary multislice computed tomography showed two large coronary fistulas arising from the left anterior descending coronary artery and ending in an angiomatous plexus draining into the common pulmonary trunk. Coronary angiography confirmed the CT finding and showed a third fistulous communication arising from the sinus node artery. Although coronary fistulas are infrequent, they are becoming increasingly important because their management and treatment could prevent serious complications. The latest guidelines of the American College of Cardiology/American Heart Association indicate as Class I recommendation the percutaneous or surgical closure for large fistulas regardless of symptoms. In this manuscript, we provide a detailed review of the literature on this topic, focusing on the clinical management of these patients

  15. Coronary artery fistulas as a cause of angina: How to manage these patients?

    Energy Technology Data Exchange (ETDEWEB)

    Buccheri, Dario; Dendramis, Gregory, E-mail: gregorydendramis@libero.it; Piraino, Davide; Chirco, Paola Rosa; Carità, Patrizia; Paleologo, Claudia; Andolina, Giuseppe; Assennato, Pasquale; Novo, Salvatore

    2015-07-15

    Coronary artery fistulas represent the most common hemodynamically significant congenital defect of the coronary arteries and the clinical presentation is mainly dependent on the severity of the left-to-right shunt. We describe a case of a 55-year-old man with history of chest pain and without history of previous significant chest wall trauma or any invasive cardiac procedures. A coronary multislice computed tomography showed two large coronary fistulas arising from the left anterior descending coronary artery and ending in an angiomatous plexus draining into the common pulmonary trunk. Coronary angiography confirmed the CT finding and showed a third fistulous communication arising from the sinus node artery. Although coronary fistulas are infrequent, they are becoming increasingly important because their management and treatment could prevent serious complications. The latest guidelines of the American College of Cardiology/American Heart Association indicate as Class I recommendation the percutaneous or surgical closure for large fistulas regardless of symptoms. In this manuscript, we provide a detailed review of the literature on this topic, focusing on the clinical management of these patients.

  16. Anterior knee pain

    International Nuclear Information System (INIS)

    Anterior knee pain is a common complain in all ages athletes. It may be caused by a large variety of injuries. There is a continuum of diagnoses and most of the disorders are closely related. Repeated minor trauma and overuse play an important role for the development of lesions in Hoffa's pad, extensor mechanism, lateral and medial restrain structures or cartilage surface, however usually an increase or change of activity is referred. Although the direct relation of cartilage lesions, especially chondral, and pain is a subject of debate these lesions may be responsible of early osteoarthrosis and can determine athlete's prognosis. The anatomy and biomechanics of patellofemoral joint is complex and symptoms are often unspecific. Transient patellar dislocation has MR distinct features that provide evidence of prior dislocation and rules our complication. However, anterior knee pain more often is related to overuse and repeated minor trauma. Patella and quadriceps tendon have been also implicated in anterior knee pain, as well as lateral or medial restraint structures and Hoffa's pad. US and MR are excellent tools for the diagnosis of superficial tendons, the advantage of MR is that permits to rule out other sources of intraarticular derangements. Due to the complex anatomy and biomechanic of patellofemoral joint maltracking is not fully understood; plain films and CT allow the study of malalignment, new CT and MR kinematic studies have promising results but further studies are needed. Our purpose here is to describe how imaging techniques can be helpful in precisely defining the origin of the patient's complaint and thus improve understanding and management of these injuries

  17. The anterior cingulate cortex

    Directory of Open Access Journals (Sweden)

    Pavlović D.M.

    2009-01-01

    Full Text Available The anterior cingulate cortex (ACC has a role in attention, analysis of sensory information, error recognition, problem solving, detection of novelty, behavior, emotions, social relations, cognitive control, and regulation of visceral functions. This area is active whenever the individual feels some emotions, solves a problem, or analyzes the pros and cons of an action (if it is a right decision. Analogous areas are also found in higher mammals, especially whales, and they contain spindle neurons that enable complex social interactions. Disturbance of ACC activity is found in dementias, schizophrenia, depression, the obsessive-compulsive syndrome, and other neuropsychiatric diseases.

  18. UNILATERAL VARIATION IN THE BRANCHING PATTERN OF RIGHT AXILLARY ARTERY: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    A.K.Manicka Vasuki

    2015-09-01

    Full Text Available Axillary artery and its branches are prone to have variations in their course. Knowledge about such variations are important for Radiologists in imaging techniques, Surgeons,Orthopedicians and Anesthetists in performing surgeries in the axilla and giving regional nerve blocks in the axilla.During dissection of a cadaver in the department of Anatomy, PSG IMS &R, Coimbatore, We observed a variation in the third part of right Axillary artery. From the common trunk, Subscapular artery, Anterior and Posterior circumflex humeral arteries and Profunda brachii artery arose. Third part of Axillary artery continued down as brachial artery. We are highlighting the variation in this study.

  19. Case report: Varicosity of the communicating vein between the left renal vein and the left ascending lumbar vein mimicking a renal artery aneurysm: Report of an unusual site of varicose veins and a novel hypothesis to explain its association with abdominal pain

    Directory of Open Access Journals (Sweden)

    Sandeep G Jakhere

    2011-01-01

    Full Text Available A communicating vein between the left renal vein and the left ascending lumbar vein has only rarely been reported in the imaging literature. There are very few reports of varicosity of this communicating vein. Nonetheless, awareness about this communicating vein is of utmost importance for surgeons performing aortoiliac surgeries and nephrectomies as it may pose technical difficulties during surgery or cause life-threatening retroperitoneal hemorrhage. Varicosity of this venous channel may be mistaken for paraaortic lymphadenopathy, adrenal pseudo-mass, or renal artery aneurysm. We report a case of a patient with varicosity of this communicating vein, which mimicked a left renal artery aneurysm. A novel hypothesis is also proposed to explain the relationship with abdominal pain.

  20. Ectopic Origin of Coronary Arteries Diagnozed by Coronary Angiography

    Science.gov (United States)

    Krasniqi, Xhevdet; Gorani, Daut; Sejdiu, Basri; Citaku, Hajdin

    2016-01-01

    Introduction: Anomalous origin of coronary arteries from opposite sinus of Valsalva is rare finding. The incidence of anomalous origination of the left coronary artery from right sinus is 0.15% and the right coronary artery from the left sinus is 0.92%. The ectopic origin of left coronary artery or right coronary artery from opposite sinus depending on pathways and considering atherosclerotic changes are manifested with different clinical significance. Case report: We report two cases, the first case the coronary angiography showed the left coronary artery arising from the right coronary sinus, presenting with proximally and distally stenosed left anterior descending artery (LAD), associated with medial and distal stenosed right coronary artery (RCA). The second case the coronary angiography revealed the right coronary artery arising from the left coronary sinus, associated with tortuous medial and distal segments of left anterior descending artery (LAD), without atherosclerotic changes. The first case successfully underwent treatment procedures based on guidelines for revascularization. Conclusion: The coronary angiography of patients with coronary ischemia determines atherosclerotic disease with possibility of the presence of coronary artery anomalies that in cases with ectopic origin from opposite sinus continues to exist as a challenge during treatment in interventional cardiology. PMID:27482140

  1. STUDY ON VARIATIONS OF INFERIOR SEGMENTAL BRANCH OF RENAL ARTERY

    Directory of Open Access Journals (Sweden)

    Chandragirish S

    2014-11-01

    Full Text Available Background: The segmental arteries of the kidney supply the organ in such a way that, each renal pole receives its own artery while, the anterior portion between the poles is supplied by an upper and lower segmental vessel. These two arteries also include in their territory the lateral edge of the kidney and adjacent to the strip of parenchyma on the dorsal or posterior aspect of the organ. The knowledge of inferior segmental branch of renal artery is very important for surgeries in its distribution area in kidney. Materials and Methods: 100 kidneys (Fifty pairs intact with abdominal aorta were collected from department of Forensic medicine, JSS Medical College and Mysore Medical College. For study of segmental variation Corrosion cast technique method was used. The variations of inferior segmental branch of renal artery were observed and recorded. Results: In present study type I inferior segmental branch of renal artery were found in - 59% cases, type II in - 6% cases, type III in - 28% cases, type IV in - 2% cases. Conclusion: The inferior segmental artery from the anterior division of the renal artery is the commonest event –arising in 59%. This is Type I, the normal type. It arises from the renal artery (28% or from the posterior division (6% or from the aorta (2%. The knowledge of inferior segmental branch of renal artery helpful in kidney transplantation and renal surgery because these type of surgeries success mainly depends on arterial ligations.

  2. Clinical significance of hepatic artery variations originating from the superior mesenteric artery in abdominal tumor surgery

    Institute of Scientific and Technical Information of China (English)

    HUANG Yuan; LIU Chao; LIN Jin-ling

    2013-01-01

    Background Hepatic artery variations are frequent clinical occurrences.The aim of this study was to investigate the characteristic course of variant hepatic arteries originating from the superior mesenteric artery for the purpose of providing instructions for abdominal tumor surgery.Methods The course of variant hepatic arteries originating from the superior mesenteric artery was studied in 400 patients with liver cancer confirmed by digital subtraction angiography (DSA) and multi-slice spiral computed tomography angiography (MSCTA),and 86 patients with gastric cancer confirmed by preoperative MSCTA between June 2008 and June 2010 in the First Affiliated Hospital of Guangxi Medical University.Results Hepatic artery variations originating from the superior mesenteric artery were noticed in 49 liver cancer patients and 14 gastric cancer patients (total 63 cases),with a variation rate of 12.96%,including two cases (3.17%) where the hepatic arteries ran along the anterior pancreas,and 61 cases (96.83%) where the hepatic arteries ran along the posterior pancreas.Conclusions Hepatic artery variations originating from the superior mesenteric artery present as two types:the pre-pancreas type and the post-pancreas type with the latter predominating.This finding is of clinical significance in abdominal tumor surgeries where clearance of portal lymph nodes is needed.

  3. Diameter measurements of cerebral arteries on three-dimensional time-of-flight MR angiograms

    International Nuclear Information System (INIS)

    Objective: To measure and establish the normal values of diameters of Chinese cerebral arteries on MRA. Methods: The diameters of the cerebral arteries in 100 persons with normal findings on 3D TOF MRA were measured with projector. There were 53 males and 47 females with the mean age of 45.8 years. 12 subjects were younger than 14 years and 88 were older than 14 years. The diameter differences between the left and the right, in gender and in ages were analyzed statistically. Results: The measurements of each arterial diameter were as follows: Ophthalmic artery: (0.8 ±0.2) mm in male, (0.9±0.2) mm in female. C2 segment of internal carotid artery (ICA-C2): (3.0±0.3) mm (≤14 years) and (3.5±0.6) mm (>14 years) in male, (2.8±0.6) mm (≤14 years) and (3.1±0.5) mm (>14 years) in female. ICA-C4: (4.3±0.6) mm in male, (3.9±0.6) mm in female. A1 segment of anterior cerebral artery (ACA-A1): (2.1±0.4) mm in male, (2.1±0.4) mm in female. Anterior communicating artery (ACoA) : (1.4±0.4) mm in male, (1.3±0.4) mm in female. M1 segment of middle cerebral artery (MCA-M1) : (2.7±0.4) mm in male, (2.6±0.4) mm in female. Basilar artery (BA) : (2.9±0.5) mm in male, (2.8±0.4) mm in female. P1 segment of posterior cerebral artery (PCA-P1) : (2.1±0.5) mm on the left and (2.0±0.5) mm on the right in male, (2.0±0.3) mm on the left and (1.9±0.3) mm on the right in female. PCA-P2: (1.8±0.4) mm in male, (1.7±0.3) mm in female. Posterior communicating artery (PCoA): (1.1±0.3) mm in male, (1.2±0.4) mm in female. Among various diameters, only PCA-P1 had significant difference between the left and the right ( P=0.003); only MCA-M1 (P =0.048), PCA-P1 (P=0.012), ICA-C2 (P=0.000) and C4 segments (P=0.000) had significant differences in gender, respectively; and only ICA-C2 had significant difference in age (P=0.001). Of these significantly different diameters, the diameters in male were larger than those in female. There were significant correlation between PCA-P1 and PCA

  4. Multidisciplinary management of anterior diastemata

    DEFF Research Database (Denmark)

    Furuse, Adilson Yoshio; Herkrath, Fernando José; Franco, Eduardo Jacomino;

    2007-01-01

    Anterior diastemata may compromise the harmony of a patient's smile. Consideration of etiologic factors, previous gingival conditioning, and individual treatment planning are essential in the proper management of anterior diastemata. An integrated orthodontic-restorative approach may enhance the...... aesthetic results when orthodontic therapy itself is not feasible. This article presents integrated orthodonticrestorative solutions of anterior diastemata, associated with the conditioning of the gingival tissue with composite resin, and discusses the most relevant aspects related to their etiology and...

  5. Neurological complications of anterior spinal surgery for kyphosis with normal somatosensory evoked potentials (SEPs)

    OpenAIRE

    Pelosi, L.; A. Jardine; Webb, J

    1999-01-01

    We report a case of neurological complications of anterior release for correction of kyphosis. After the operation, the patient had pyramidal weakness and decreased pain sensation below T5, whereas light touch, proprioception and vibration sensation were intact. Clinical and neurophysiological findings in this patient suggested a partial lesion of the spinal cord probably due to ischaemia in the territory of the anterior spinal artery. Intraoperative and postoperative tibial...

  6. An anatomical study of double brachial arteries – a case report

    Directory of Open Access Journals (Sweden)

    Krstonosic B

    2010-02-01

    Full Text Available Superficial brachial artery is one of the major variations of the arterial pattern in the upper limb. During routine anatomical dissection in our department, we observed a case of unilateral double brachial artery in a formalin-fixed female cadaver.Left axillary artery entered into the anterior region of the arm, where it branched into two brachial arteries – the superficial brachial artery (SBA, which was longer, tortuous and with a smaller caliber, and the brachial artery (BA, which was placed deep and medially. In the cubital fossa, covered with an aponeurosis of the biceps brachii muscle, both brachial arteries were connected with an anastomotic vessel. Under this anastomotic branch, in the forearm, SBA continued as the radial artery, whereas BA continued as the ulnar artery.Variations of the arterial pattern in the upper limb are undoubtedly of interest to the anatomists as well as to the clinicians.

  7. Anterior cruciate ligament reconstruction

    International Nuclear Information System (INIS)

    This paper determines the efficacy of MR imaging in evaluation of the anterior cruciate ligament (ACL) following reconstructive surgery. Forty-three MR examinations were performed in 33 patients who had undergone previous arthroscopic ACL reconstruction with patellar bone-tendon- bone autografts (postoperative period, 1-24 months; mean, 5.2 months). Of the 40 studies performed in clinically stable knees (30 patients), MR demonstrated a well-defined, signal void ACL graft in 36. Of the three studies performed in three patients with clinical ACL laxity or suspected tear, the neoligament was of intermediate definition in one and nondiscernible in the other two. As in the native knee, buckling of the PCL was suggestive of ACL insufficiency. Bone tunnel placement, patellar tendon changes, and joint effusions were also evaluated

  8. Anterior hip pain.

    Science.gov (United States)

    O'Kane, J W

    1999-10-15

    Anterior hip pain is a common complaint with many possible causes. Apophyseal avulsion and slipped capital femoral epiphysis should not be overlooked in adolescents. Muscle and tendon strains are common in adults. Subsequent to accurate diagnosis, strains should improve with rest and directed conservative treatment. Osteoarthritis, which is diagnosed radiographically, generally occurs in middle-aged and older adults. Arthritis in younger adults should prompt consideration of an inflammatory cause. A possible femoral neck stress fracture should be evaluated urgently to prevent the potentially significant complications associated with displacement. Patients with osteitis pubis should be educated about the natural history of the condition and should undergo physical therapy to correct abnormal pelvic mechanics. "Sports hernias," nerve entrapments and labral pathologic conditions should be considered in athletic adults with characteristic presentations and chronic symptoms. Surgical intervention may allow resumption of pain-free athletic activity. PMID:10537384

  9. Subacute anterior spinal cord ischemia with lower limb monoplegia: a clinical dilemma and challenging scenario.

    LENUS (Irish Health Repository)

    Waters, Peadar S

    2012-12-01

    A 70-year-old woman presented with crescendo right lower limb monoplegia. Magnetic resonance imaging depicted anterior spinal artery syndrome with an 8.5 cm Crawford type II thoracoabdominal aortic aneurysm (TAAA). A staged hybrid procedure was performed, following which she had total exclusion of her TAAA and full resolution of her monoplegia. Clinical presentations of TAAAs can be diverse and require detailed clinical knowledge and lateral thinking to unearth unorthodox presentations. This erratic presentation of a TAAA with anterior spinal artery syndrome outlines particular challenges with management and portrays the need for tailored utilization of contemporary techniques to deal with the growing complexity of TAAAs.

  10. Agenesis of the internal carotid artery with a large hemangioma of the tongue

    International Nuclear Information System (INIS)

    Total developmental absence of the internal carotid artery is relatively rare, with only 54 cases previously reported. Most, being without neurological symptoms, were found by chance. For this patient with cavernous hemangiomas in the facial, oral and cervical regions, conventional treatment would be embolization of the feeding vessels, combined with ligation of the external carotid artery. Angiography, however, revealed agenesis of the left internal carotid artery, abnormal origin of the aortic arch and azygos anterior cerebral artery. (orig./MG)

  11. An autopsy case of superficial siderosis of the central nervous system accompanied by anterior sacral polycystic meningocele in neurofibromatosis type 1.

    Science.gov (United States)

    Matsumoto, Arifumi; Suzuki, Hiroyoshi; Tobita, Muneshige; Hisanaga, Kinya

    2016-07-28

    A 74-year-old female patient, who was diagnosed with neurofibromatosis type 1 (NF1) at the age of 40, was admitted with complaints of flickering vision and gait disturbance for the last 2 years. On admission, neurological examination revealed mild bilateral hearing loss and ataxia in the limb and trunk. Laboratory tests revealed anti-hepatitis C virus (HCV) antibody positivity and elevated HCV RNA by real-time polymerase chain reaction. The cerebrospinal fluid examination revealed a slightly yellowish appearance with elevated total protein levels. Gradient echo T2*-weighted brain magnetic resonance imaging (MRI) demonstrated a rim of hypointense lesions surrounding the surface of the cerebellum, brainstem, frontal and temporal lobes, and thalamus, which was considered as hemosiderin depositions. From these MRI findings, she was diagnosed as having superficial siderosis of the central nervous system. Cerebral angiography revealed an aneurysm-like dilatation at the bifurcation of the right internal carotid-posterior communicating artery. (99m)Tc-ethyl cysteinate dimer single-photon emission computed tomography revealed hypoperfusion in the bilateral frontal and temporal lobes. Pelvic plain X-ray, pelvic computed tomography, and lumbosacral MRI revealed a sacral defect and an anterior sacral polycystic meningocele communicating with the spinal subarachnoid space. The patient's symptoms gradually worsened, and she died of septic shock because of pyelonephritis at the age of 77. An autopsy was performed; on pathological examination, we did not observe any findings associated with rupture of the aneurysm-like dilatation in the bifurcation of the right internal carotid-posterior communicating artery and cerebral amyloid angiopathy. Because duropathies-a new neurological disease concept-have been implicated as a cause of bleeding in the superficial siderosis, the anterior sacral polycystic meningocele, a type of duropathies, was presumed to be the most probable bleeding

  12. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... and E-poly antioxidant-infused technology during a hip replacement through the anterior supine intramuscular approach. “OR- ... Dr. Keith Berend perform an anterior approach total hip replacement with the patient on a regular OR ...

  13. Robotically assisted multivessel minimally invasive direct coronary artery bypass grafting with the use of bilateral internal thoracic arteries.

    Science.gov (United States)

    Nishida, Satoru; Yasuda, Tamotsu; Watanabe, Go; Kikuchi, Yujiro; Shintani, Yoshiko; Ito, Shigeki; Tabata, Shigeki; Kawachi, Kenji

    2007-09-01

    This case report presents the robotically assisted multivessel minimally invasive direct coronary artery bypass grafting (MIDCAB) technique using the bilateral internal thoracic arteries. A 54-year-old man with multivessel coronary artery disease was considered eligible for a robotically assisted myocardial revascularization. The bilateral internal thoracic arteries were harvested completely in a totally skeletonized fashion through three 1-2-cm-long incisions on the left thoracic wall. A small left anterior thoracotomy was then performed. The left internal thoracic artery was anastomosed to the left anterior descending coronary artery, and the composite radial artery graft from the right internal thoracic artery was sequentially anastomosed to the first diagonal branch, the obtuse marginal branch, and the distal right coronary artery on the beating heart without cardiopulmonary bypass. The harvesting time of the grafts was 66 min, and the total operative time was 5 h 58 min. Postoperative angiography revealed that all grafts were widely patent. The postoperative course was uneventful, and the patient was discharged 10 days after the operation. Robotically assisted MIDCAB using the bilateral thoracic arteries is a safe and effective means of myocardial revascularization for patients with multivesssel disease. PMID:17721036

  14. Otic artery: a review of normal and pathological features.

    Science.gov (United States)

    Vasović, Ljiljana; Arsić, Stojanka; Vlajković, Slobodan; Jovanović, Ivan; Jovanović, Predrag; Ugrenović, Sladjana; Andjelković, Zlatibor

    2010-05-01

    Three primitive arteries - the trigeminal, otic and hypoglossal take the names according to their close relation with the V, VIII and XII cranial nerves, while at the cervical level, the first segmental artery is named the primitive proatlantal intersegmental artery. When the human embryo is 4 mm long, these arteries serve as transitory anastomoses between primitive internal carotid arteries and bilateral longitudinal neural arterial plexus, which is the precursor of future basilar artery. Normal and/or abnormal morphofunctional aspects of the prenatal and postnatal forms of the otic artery are described according to the personal and literature data. Many (ab) normal arteries are also noted in differential diagnosis of the otic artery. Postnatally, individual incidence rates of the carotid-vertebrobasilar anastomoses have been found to be inversely related to their order of disappearance. The persistent trigeminal artery has a reported incidence from 0.06-0.6%, whereas the persistent primitive otic artery has been convincingly documented only in minor rates. Persistent carotid-vertebrobasilar anastomoses between the anterior and posterior cranial circulation are important to recognize during angiography for endovascular and surgical planning. Most frequently, the otic artery was an incidental finding. PMID:20424561

  15. Pathologic features of lower extremity arterial lesions in diabetes mellitus:an analysis of 162 patients

    International Nuclear Information System (INIS)

    Objective: To investigate the angiographic manifestations of lower extremity atherosclerotic occlusion in patients with diabetes mellitus. Methods: The angiographic findings of lower extremity in 162 patients with diabetes mellitus were retrospectively analyzed. (1) The arteries of lower extremity were divided into the following four segments: iliac, femoral, popliteal and crural artery. The involvements of these arteries were documented. (2) Based on the lesion's number, location, nature (stricture or occlusion) and length ( 5 cm), the diabetic arterial diseases were categorized. Results: (1) Of 162 diabetic lower limbs, multiple segmental lesions were seen in 131, superficial femoral arterial lesions in 130, and crural arterial lesions in 139, of which 130 arterial lesions had at least two below-the-knee arteries being involved. (2) Based on segmental angiographic classification, a total of 660 vascular lesions were detected, including stricture lesions (33.8%) and occlusive lesions (66.2%). Of the 437 occlusions, 70.5% were located in below-the-knee arteries, and most of which were longer than 10 cm and located in anterior and posterior tibial arteries, while only a few peroneal arteries were involved (P < 0.0001). One hundred and fifty-two lesions were detected in superficial femoral arteries, of which 49 (31.2%) were located at the origin of the superficial femoral artery and 56 (35.7) were in the adductor canal hiatus. Conclusion: The main feature of peripheral arterial disease of lower extremity caused by diabetes mellitus is multi-level atherosclerotic occlusion, the superficial femoral and the crural arteries are most likely to be involved. The lesions of superficial femoral artery are often located at the arterial origin and in the adductor canal hiatus, while the deep femoral artery and the femoral artery are less involved. Long occlusive lesions are more prevalent in crural arteries, especially in anterior and posterior tibial arteries. (J Intervent

  16. Myocardial perfusion SPECT in a case of retropulmonary looping of left coronary artery in a baby after arterial switch surgery

    International Nuclear Information System (INIS)

    Pediatric myocardial perfusion imaging (MPI) is not a routine investigation in an Indian setting due to under referrals and logistic problems. However, MPI is a frequently performed and established modality of investigation in adults for the identification of myocardial ischemia and viability. We report myocardial perfusion scintigraphy in a case of retropulmonary looping of left coronary artery in a baby after arterial switch surgery. Adenosine stress MPI revealed a large infarct involving anterior segment with moderate reversible ischemia of the lateral left ventricular segment. Coronary angiogram later confirmed left main coronary artery ostial occlusion with retrograde collateral supply from dilated right coronary artery

  17. Morphologic expression of the left coronary artery in pigs. An approach in relation to human heart

    Directory of Open Access Journals (Sweden)

    Fabian Alejandro Gómez

    2014-04-01

    Full Text Available Introduction: In spite of its importance as an experimental model, the information on the left coronary artery in pigs is sparse. Objective: To determine the morphologic features of the left coronary artery in pigs. Methods: We evaluated 158 pig hearts. The left coronary artery was perfused with synthetic resin after their ostia had been catheterized. Diameters and courses of the vascular beds were measured with an electronic caliper (Mitutoyo(r. Results: The diameter of left coronary artery was 6.98 ± 1.56 mm and its length was 3.51±0.99 mm. It was found to end up by bifurcating itself into the anterior interventricular artery and the circumflex artery in 79% of the cases, and by trifurcating in 21% of the cases, with the presence of the diagonal artery. The anterior interventricular artery ended up at the apex in 79.7% of the cases, and the circumflex artery at the posterior aspect of the left ventricle in 64% of the case, this artery never reached the posterior interventricular sulcus. An anastomosis between the terminal branches of the anterior interventricular artery and the posterior interventricular artery was found in 7.6% of the specimens. The antero-superior branch of the anterior interventricular artery occurred in 89.9% of the hearts. A left marginal branch was observed in 87.9% of the cases with a diameter of 2.25±0.55 mm. Conclusion: Compared with humans, pigs have shorter left coronary artery trunks and branches; even the circumflex artery never reaches the posterior interventricular sulcus. Our findings are useful for the design of experimental hemodynamic and procedural models.

  18. Carotid Artery Screening

    Science.gov (United States)

    ... Resources Professions Site Index A-Z Carotid Artery Screening What is carotid artery screening? Who should consider ... about carotid artery screening? What is carotid artery screening? Screening examinations are tests performed to find disease ...

  19. Intra-arterial tirofiban infusion for thromboembolic complication during coil embolization of ruptured intracranial aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Young Dae, E-mail: aronnn@naver.com [Department of Radiology, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, 425 Sindaebang-dong, Dongjak-gu, Seoul 156-707 (Korea, Republic of); Lee, Jong Young, E-mail: gen78@naver.com [Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of); Seo, Jung Hwa, E-mail: jhseo34@gmail.com [Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of); Kang, Hyun-Seung, E-mail: hsk4428@yahoo.com [Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of); Kim, Jeong Eun, E-mail: eunkim@snu.ac.kr [Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of); Jung, Keun Hwa, E-mail: jungkh@gmail.com [Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of); Han, Moon Hee, E-mail: hanmh@snuh.org [Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of); Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of)

    2012-10-15

    Introduction: Intra-arterial (IA) thrombolytic intervention for acute thrombosis has been challenged due to the risk of bleeding during the endovascular treatment of ruptured aneurysms. We present the results of IA tirofiban infusion for thromboembolic complications during coil embolization in patients with ruptured intracranial aneurysms. Methods: Thromboembolic events requiring thrombolytic intervention occurred in 39 (10.5%) cases during coil embolization of 372 consecutive ruptured intracranial aneurysms. Maximal aneurysm diameters of 39 patients (mean age, 54.7 ± 13.2 years; 23 female, 16 male) ranged from 2.1 to 13.1 mm (mean, 6.6 ± 3.0 mm). The anterior communicating artery was the most common site (n = 13), followed by the middle cerebral artery (n = 9) and the posterior communicating artery (n = 7). In this series, we used intracranial stents in 10 patients during the procedure. Superselective IA tirofiban infusion through a microcatheter was performed to resolve thrombi and emboli. We assessed the efficacy and safety of IA tirofiban infusion in patients with ruptured aneurysms. Results: Intraarterially administered tirofiban doses ranged from 0.25 to 1.25 mg (mean, 0.71 ± 0.26 mg). Effective thrombolysis or recanalization was achieved in 34 patients (87.2%), and three patients (7.7%) suffered distal migration of clots with partial recanalization. The rest (5.1%) had no recanalization. Nonconsequent intracerebral hemorrhage occurred in two patients (5.1%) after the procedure. Thromboemboli-related cerebral infarction developed in eight patients, and only two patients remained infarction related disabilities. Conclusion: IA tirofiban infusion seems to be efficacious and safe for thrombolysis during coil embolization in patients with ruptured intracranial aneurysms.

  20. Intra-arterial tirofiban infusion for thromboembolic complication during coil embolization of ruptured intracranial aneurysms

    International Nuclear Information System (INIS)

    Introduction: Intra-arterial (IA) thrombolytic intervention for acute thrombosis has been challenged due to the risk of bleeding during the endovascular treatment of ruptured aneurysms. We present the results of IA tirofiban infusion for thromboembolic complications during coil embolization in patients with ruptured intracranial aneurysms. Methods: Thromboembolic events requiring thrombolytic intervention occurred in 39 (10.5%) cases during coil embolization of 372 consecutive ruptured intracranial aneurysms. Maximal aneurysm diameters of 39 patients (mean age, 54.7 ± 13.2 years; 23 female, 16 male) ranged from 2.1 to 13.1 mm (mean, 6.6 ± 3.0 mm). The anterior communicating artery was the most common site (n = 13), followed by the middle cerebral artery (n = 9) and the posterior communicating artery (n = 7). In this series, we used intracranial stents in 10 patients during the procedure. Superselective IA tirofiban infusion through a microcatheter was performed to resolve thrombi and emboli. We assessed the efficacy and safety of IA tirofiban infusion in patients with ruptured aneurysms. Results: Intraarterially administered tirofiban doses ranged from 0.25 to 1.25 mg (mean, 0.71 ± 0.26 mg). Effective thrombolysis or recanalization was achieved in 34 patients (87.2%), and three patients (7.7%) suffered distal migration of clots with partial recanalization. The rest (5.1%) had no recanalization. Nonconsequent intracerebral hemorrhage occurred in two patients (5.1%) after the procedure. Thromboemboli-related cerebral infarction developed in eight patients, and only two patients remained infarction related disabilities. Conclusion: IA tirofiban infusion seems to be efficacious and safe for thrombolysis during coil embolization in patients with ruptured intracranial aneurysms

  1. Successful management of a giant spinal arteriovenous malformation with multiple communications between primitive arterial and venous structures by embolization: report of a case.

    Science.gov (United States)

    Kuga, T; Esato, K; Zempo, N; Fujioka, K; Harada, M; Furutani, A; Akiyama, N; Toyota, S; Fujita, Y

    1996-01-01

    A 47-year-old woman was admitted to our hospital with a giant spinal arteriovenous malformation (AVM) causing heart failure and thoracic myelopathy. Angiography revealed that the spinal AVM had multiple feeding vessels branching from the 5th through 12th intercostal arteries. The drainage vein flowed to the azygos vein and superior vena cava. The AVM destroyed the 7th thoracic vertebra. The cardiac output was 16.7l/min and the shunt ratio was 64% before treatment. Embolization with cyanoacrylate was performed because the operation was considered to be associated with a significant risk of paraplegia and organ ischemia. The cardiac output decreased to 11.6l/min and the shunt ratio was reduced to 32%. After embolization the patient demonstrated no symptoms of either heart failure or sensory deficits. During embolization, provocative tests using sodium amytal and lidocaine with magnetic stimulation were also performed. The above findings suggest that provocative tests and magnetic stimulation are useful to predict paraplegia, which could result from embolization while, in addition, embolization is considered to be a useful treatment for multiple shunt and nidus in this region. PMID:8883257

  2. Types of the cerebral arterial circle (circle of Willis in a Sri Lankan Population

    Directory of Open Access Journals (Sweden)

    Gunasekera WSL

    2011-01-01

    Full Text Available Abstract Background The variations of the circle of Willis (CW are clinically important as patients with effective collateral circulations have a lower risk of transient ischemic attack and stroke than those with ineffective collaterals. The aim of the present cadaveric study was to investigate the anatomical variations of the CW and to compare the frequency of prevalence of the different variations with previous autopsy studies as variations in the anatomy of the CW as a whole have not been studied in the Indian subcontinent. Methods The external diameter of all the arteries forming the CW in 225 normal Sri Lankan adult cadaver brains was measured using a calibrated grid to determine the prevalence in the variation in CW. Chisquared tests and a correspondence analysis were performed to compare the relative frequencies of prevalence of anatomical variations in the CW across 6 studies of diverse ethnic populations. Results We report 15 types of variations of CW out of 22 types previously described and one additional type: hypoplastic precommunicating part of the anterior cerebral arteries (A1 and contralateral posterior communicating arteries (PcoA 5(2%. Statistically significant differences (p Conclusion The present study reveals that there are significant variations in the CW among intra and inter ethnic groups (Caucasian, African and Asian: Iran and Sri Lanka dominant populations, and warrants further studies keeping the methods of measurements, data assessment, and the definitions of hypoplasia the same.

  3. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... Taperloc Microplasty stem and E-poly antioxidant-infused technology during a hip replacement through the anterior supine ... renewed interest at this time due to several advantages that it brings. The approach that is performed ...

  4. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... an anterior approach total hip replacement with the patient on a regular OR table supine. My name ... less invasive without being small incision surgery. Obese patients can be easier due to less distribution of ...

  5. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... it to have any real negative or deleterious effect by removing the anterior capsule. Now I would ... is what happens with one of the competitive designs. Like I told you, I just take a ...

  6. Anterior approach for knee arthrography

    International Nuclear Information System (INIS)

    Objective. To develop a new method of magnetic resonance arthrography (MRA) of the knee using an anterior approach analogous to the portals used for knee arthroscopy.Design. An anterior approach to the knee joint was devised mimicking anterior portals used for knee arthroscopy. Seven patients scheduled for routine knee MRA were placed in a decubitus position and under fluoroscopic guidance a needle was advanced from a position adjacent to the patellar tendon into the knee joint. After confirmation of the needle tip location, a dilute gadolinium solution was injected.Results and conclusion. All the arthrograms were technically successful. The anterior approach to knee MRA has greater technical ease than the traditional approach with little patient discomfort. (orig.)

  7. Travoprost Induced Granulomatous Anterior Uveitis

    OpenAIRE

    Patrick Chiam

    2011-01-01

    Purpose. To report a case of granulomatous anterior uveitis caused by travoprost. Methods. Single observational case report. Results. A 71-year-old who was fit and healthy presented with bilateral granulomatous anterior uveitis 2 months after he was started on travoprost in both eyes. There was no past history of uveitis. Blood test and radiological investigation were unremarkable. Travoprost was stopped. The uveitis resolved on topical steroid treatment. A rechallenge with travoprost was att...

  8. Update on anterior ankle impingement

    OpenAIRE

    Vaseenon, Tanawat; Amendola, Annunziato

    2012-01-01

    Anterior ankle impingement results from an impingement of the ankle joint by a soft tissue or osteophyte formation at the anterior aspect of the distal tibia and talar neck. It often occurs secondary to direct trauma (impaction force) or repetitive ankle dorsiflexion (repetitive impaction and traction force). Chronic ankle pain, swelling, and limitation of ankle dorsiflexion are common complaints. Imaging is valuable for diagnosis of the bony impingement but not for the soft tissue impingemen...

  9. Comunicação da equipe multiprofissional e indivíduos portadores de hipertensão arterial Comunicación entre los profesionales de la salud y los portadores de hipertensión arterial Communication between the health staff and hypertensive patients

    Directory of Open Access Journals (Sweden)

    Magda Cristina Queiroz Dell'Acqua

    1997-07-01

    Full Text Available O presente estudo tem como objetivos levantar dados sobre o que os indivíduos portadores de hipertensão arterial pensam sobre a sua doença e verificar a ocorrência do processo de comunicação entre estes e os profissionais que atuam junto aos mesmos. Foram entrevistados 66 clientes, obtendo-se 73 narrativas, constatando-se que a maioria (69 narrativas dos participantes da pesquisa faz correlação com o conceito de hipertensão arterial, ainda que de maneira pouco elaborada. Apesar de 95% dos clientes fazerem alguma referência à doença, não significa que as orientações recebidas anteriormente foram aprendidas. Espera-se que o enfermeiro por desempenhar um importante papel dentro da equipe multiprofissional, identifique as possíveis barreiras relativas ao processo de comunicação, havendo daí a intervenção junto aos elementos que podem estar dificultando ou impedindo a compreensão necessária para que o cliente assuma seu autocuidado.Este trabajo tiene como objetivo coger datos sobre lo que piensan los portadores de hipertensión arterial sobre su enfermedad y verificar el proceso de comunicación entre los mismos y con los profesionales de la salud que actuan junto a ellos. Fueron entrevistados 66 clientes, obteniendo 73 narrativas, de las cuales se constató que la mayoría (69 narrativas de los sujetos hicieron referencia al concepto de hipertensión arterial, aunque de forma pocoelaborada. A pesar de que el 95% de los clientes hacieron alguna referencia a la enfermedad, no significa que las orientaciones recibidas anteriormente fueron aprehendidas. Se espera que el enfermero, por desempenãr un importante papel dentro del equipo multiprofesional, identifique las barreras posibles del proceso de comunicación, obteniendo al mismo que interviene en las etapas que pueden estar dificultando o impidiendo la comprensión necesaria para que cliente asuma su autocuidado.This study aims to analyse data on hypertensive individuals and

  10. Neuroanatomy of a neurobehavioral disturbance in the left anterior thalamic infarction

    OpenAIRE

    Nishio, Yoshiyuki; Hashimoto, Mamoru; Ishii, Kazunari; Mori, Etsuro

    2011-01-01

    Background and purpose Cognitive and behavioural symptoms represent primary clinical manifestations of anterior thalamic infarcts (ATIs) in the tuberothalamic artery territory. The aim of the study is to understand the pathomechanism of cognitive and behavioural disturbances in left ATI (LATI). Methods 6 patients with isolated LATIs were investigated using neuropsychological assessments, MRI stereotactic lesion localisation and positron emission tomography. Results The patients were character...

  11. Anterior chamber depth during hemodialysis

    Directory of Open Access Journals (Sweden)

    Gracitelli CPB

    2013-08-01

    Full Text Available Carolina Pelegrini Barbosa Gracitelli,1 Francisco Rosa Stefanini,1 Fernando Penha,1 Miguel Ângelo Góes,2 Sérgio Antonio Draibe,2 Maria Eugênia Canziani,2 Augusto Paranhos Junior1 1Ophthalmology Department, 2Division of Nephrology, Federal University of São Paulo – UNIFESP, São Paulo, Brazil Background: Exacerbation of chronic glaucoma or acute glaucoma is occasionally observed in patients undergoing hemodialysis (HD because of anterior chamber depth changes during this therapy. Purpose: To evaluate anterior chamber depth and axial length in patients during HD sessions. Methods: A total of 67 eyes of 35 patients were prospectively enrolled. Axial length and anterior chamber depth were measured using ultrasonic biometry, and these measures were evaluated at three different times during HD sessions. Body weight and blood pressure pre- and post-HD were also measured. Results: There was no difference in the axial length between the three measurements (P = 0.241. We observed a significantly decreased anterior chamber depth (P = 0.002 during HD sessions. Conclusion: Our results support the idea that there is a change in anterior chamber depth in HD sessions. Keywords: anterior chamber, hemodialysis, axial length, acute angle-closure glaucoma

  12. Normal variations of coronary arteries in Korean by coronary angiography

    International Nuclear Information System (INIS)

    To diagnosis the coronary artery disease, it is necessary to have a thorough knowledge on coronary anatomy and normal variations. We performed a morphological study on normal variations of coronary artery in Korean adults. 1012 cases of coronary angiography were analyzed with particular emphasis on the normal variation of three coronary arteries and their major branches, including origin of conus artery, sinus node artery and atrioventricular node artery and the variation in posterior descending artery and ramus medianus. We found right dominance in 895 cases(88.4%), left dominance in 44 cases(4.3%) and balanced dominance in 73 cases(7.2%). Conus artery branched from right coronary artery in 468 cases(47.6%) and originated in right coronary sinus close to the os of right coronary artery in 515 cases(52.4%). Sinus node artery originated from left circumflex artery in 551 cases(54.4%), from right coronary artery in 442 cases(43.7%), and from both coronary arteries in 19 cases(1.9%). Atrioventricular node artery originated from right coronary artery in 943 cases(93.4%), from left circumflex artery in 59 cases(5.8%), and two atriovenricular node arteries from both arteries in 8 cases(0.8%). Posterior descending artery had the normal pattern in 505 cases(58.6%) and some variation in 357 cases(41.4%). We found short left main coronary artery, less than 2-3 mm, making it hard to cannulate in 172 cases(17.0%). Ramus medianus was found in 165 cases(16.5%) with marginal distribution in 84 cases(8.4%) diagonal distribution in 80 cases(8.0%) and coursing interventriclar sulcus as double left anterior descending artery in 1 case(0.1%). Left main coronary artery gave off 4 branches in 8 cases(0.8%). Myocardial bridging was found in only 3 cases(0.3%). This study could provide basic morphological data on anatomy and normal variations of coronary arteries in Korean adults

  13. Endovascular treatment of anterior cranial fossa dural arteriovenous fistula

    Energy Technology Data Exchange (ETDEWEB)

    Lv, Xianli; Li, Youxiang; Wu, Zhongxue [Beijing Neurosurgical Institute, Beijing (China); Capital Medical University, Beijing Tiantan Hospital, Beijing (China)

    2008-05-15

    We describe the technique and results of the endovascular treatment of anterior cranial fossa dural arteriovenous fistulas (DAVF) in four symptomatic patients. Catheterization was via the superior sagittal sinus in two patients and via the ophthalmic artery in two patients. Embolization was performed using detachable platinum coils in the former two patients and a liquid embolic system (Onyx-18, MTI) in the latter. We were able to reach the fistula site and to embolize the arteriovenous shunting zone in all of the patients. The final angiogram showed complete occlusion of the DAVFs, and all patients recovered completely. No complications related to either approach were observed. Endovascular treatment of anterior cranial fossa DAVFs is feasible by either transvenous or transarterial access. (orig.)

  14. Endovascular treatment of anterior cranial fossa dural arteriovenous fistula

    International Nuclear Information System (INIS)

    We describe the technique and results of the endovascular treatment of anterior cranial fossa dural arteriovenous fistulas (DAVF) in four symptomatic patients. Catheterization was via the superior sagittal sinus in two patients and via the ophthalmic artery in two patients. Embolization was performed using detachable platinum coils in the former two patients and a liquid embolic system (Onyx-18, MTI) in the latter. We were able to reach the fistula site and to embolize the arteriovenous shunting zone in all of the patients. The final angiogram showed complete occlusion of the DAVFs, and all patients recovered completely. No complications related to either approach were observed. Endovascular treatment of anterior cranial fossa DAVFs is feasible by either transvenous or transarterial access. (orig.)

  15. Anomalous origin of the left circumflex coronary artery from the pulmonary artery. A very rare congenital anomaly in an adult patient diagnosed by cardiovascular magnetic resonance

    OpenAIRE

    Giannitsis Evangelos; Ringwald Gerd; Korosoglou Grigorios; Katus Hugo A

    2008-01-01

    Abstract Here we report for the first time on the diagnostic potential of cardiovascular magnetic resonance (CMR) to delineate the proximal course of an anomalous left circumflex coronary artery (LCX) originating from the right pulmonary artery in an adult patient with no other form of congenital heart disease. The patient was referred to our institution due to exertional chest discomfort. X-Ray coronary angiography showed a normal left anterior descending coronary artery (LAD) and right coro...

  16. Uncontrolled Epistaxis Secondary to Traumatic Pseudoaneurysm of the Maxillary Artery

    OpenAIRE

    Eelam Adil; Dhave Setabutr; Michele M. Carr

    2011-01-01

    We describe a rare case of traumatic pseudoaneurysm of the maxillary artery following a fall. The patient presented with epistaxis that could not be controlled with anterior and posterior nasal packing. She was urgently taken to the angiography suite for evaluation and ultimately underwent embolization of a left maxillary artery pseudoaneurysm with 500–700 micron Contour PVA followed by coiling with two 3 mm Tornado coils. Bleeding subsided after embolization, and the patient suffered no neur...

  17. Novel treatment of coronary artery fistulae concealing severe coronary artery lesion: using thrombus aspiration catheter as a delivery guide

    OpenAIRE

    Korkmaz, Levent; Acar, Zeydin; Dursun, İhsan; Akyüz, Ali Rıza; Korkmaz, Ayca Ata

    2014-01-01

    In this case report, we present the occlusion of multiple coronary artery fistulae originating from proximal left anterior descending (LAD) and right sinus valsavla and empting to the pulmonary artery at the same place. We occluded LAD fistulae by using thrombus aspiration catheter as a delivery guide. To the best of our knowlege, this is the first case of occlusion of coronary fistulae with the help of thrombus aspiration catheter. Our experience may suggest that thrombus aspiration catheter...

  18. Chemoembolization for Hepatocellular Carcinoma Supplied by a Lumbar Artery

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Han Myun, E-mail: seoul49@naver.com [Hallym University College of Medicine, Department of Radiology, Kangnam Sacred Heart Hospital (Korea, Republic of); Kim, Hyo-Cheol, E-mail: angiointervention@gmail.com; Woo, Sungmin, E-mail: j-crew7@hotmail.com [Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, and Clinical Research Institute, Seoul National University Hospital, Department of Radiology (Korea, Republic of); Son, Kyu Ri, E-mail: kyurad@gmail.com [Korea University College of Medicine, Department of Radiology, Korea University Medical Center (Korea, Republic of); Cho, Seong Whi, E-mail: chosw@kangwon.ac.kr [Kangwon National University College of Medicine, Department of Radiology, Kangwon National University Hospital (Korea, Republic of); Chung, Jin Wook, E-mail: chungjw@snu.ac.kr [Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, and Clinical Research Institute, Seoul National University Hospital, Department of Radiology (Korea, Republic of)

    2015-02-15

    PurposeTo describe the radiologic findings and imaging response of hepatocellular carcinoma (HCC) supplied by the lumbar artery.MethodsBetween April 2004 and December 2012, we encountered HCC supplied by a lumbar artery in 21 patients. Two investigators retrospectively reviewed clinical and radiological findings of HCC supplied by the lumbar artery using computed tomography (CT) scans and digital subtraction angiograms.ResultsPatients had received 1–27 sessions of previous chemoembolization procedures (mean 7.7 sessions, median 4 sessions). Mean tumor size was 5.3 cm. The locations of HCC supplied by lumbar artery were the bare area (n = 14, 67 %) and segment VI (n = 7, 33 %). Tumor-feeding arteries arose from the main lumbar artery (n = 7), proximal anterior division (n = 4), and distal anterior division (n = 14). In 20 patients, selective chemoembolization through the tumor-feeding arteries of the lumbar artery was achieved. In 1 patient, nonselective embolization at the main lumbar artery was performed. There was no complication such as skin necrosis or paralysis. On the first follow-up enhanced CT scan, target tumors fed by the lumbar artery showed complete response (n = 6), partial response (n = 4), stable disease (n = 3), and progressive disease (n = 8), but overall tumor response was partial response (n = 1) and progressive disease (n = 20).ConclusionWhen HCC is located in the inferior tip or bare area of the liver, a lumbar artery may supply the tumor. Although selective chemoembolization via the tumor-feeding vessel of the lumbar artery can be achieved in most cases, overall tumor response is commonly unfavorable.

  19. Bilateral persistent primitive trigeminal arteries associated with trigeminal neuralgia.

    Science.gov (United States)

    Son, B; Yang, S; Sung, J; Lee, S

    2013-03-01

    Persistent carotid-vertebrobasilar anastomoses (PCVBA) include the primitive trigeminal artery (PTA), the primitive otic artery (POA), the primitive hypoglossal artery and proatlantal arteries (ProAs). The PTA is the most commonly seen of these accounting for approximately 80-85% of PCVBAs. The PTA which connects the internal carotid artery (ICA) to the basilar artery (BA) may occasionally connect to the superior or posterior inferior cerebellar arteries without interposition to the BA. It is then referred to as a persistent trigeminal artery variant (PTAV), an anomalous carotid-cerebellar anastomosis. Bilateral occurrence of PTA is extremely rare. During vertebral artery (VA) development the anterior radicular artery of segment C1 from the proatlantal artery of Padget evolves into the intradural component of the VA (V4 segment) plus a short extradural segment (distal V3 segment). Agenesis of a single anterior radicular artery of ProA results in the absence of one distal VA associated with an unremarkable contralateral VA and the BA. Absence or hypoplasia of the terminal portion of one VA is a commonly observed anatomic variant. However, absence of the terminal portions of both VAs is exceptional. A rare case of bilateral PTAs is presented with unilateral PTA and a contralateral PTAV causing trigeminal neuralgia. Furthermore, the bilateral PTAs were associated with the absence of the proximal portion of the BA in addition to the bilateral lack of a distal VA. This finding comes as a logical consequence of the developmental anatomy of the vertebrobasilar junction and is consistent with the assumed congenital nature of the anatomic variant. PMID:22113402

  20. The Role of Septal Perforators and “Myocardial Bridging Effect” in Atherosclerotic Plaque Distribution in the Coronary Artery Disease

    OpenAIRE

    Wasilewski, Jarosław; Roleder, Marcin; Niedziela, Jacek; Nowakowski, Andrzej; Osadnik, Tadeusz; Głowacki, Jan; Mirota, Kryspin; Poloński, Lech

    2015-01-01

    Summary The distribution of atherosclerotic plaque burden in the human coronary arteries is not uniform. Plaques are located mostly in the left anterior descending artery (LAD), then in the right coronary artery (RCA), circumflex branch (LCx) and the left main coronary artery (LM) in a decreasing order of frequency. In the LAD and LCx, plaques tend to cluster within the proximal segment, while in the RCA their distribution is more uniform. Several factors have been involved in this phenomenon...

  1. Congenital Circumflex Coronary Arteriovenous Fistula with Aneurysmal Termination in the Pulmonary Artery

    OpenAIRE

    Darwazah, Ahmad K.; Hussein, Izzedein H.; Hawari, Mohammad H.

    2005-01-01

    Coronary arteriovenous fistula is a rare congenital anomaly that is seen in 0.1% to 0.2% of coronary angiograms. Aneurysmal formation in the fistula is even rarer. We report a case of congenital circumflex arteriovenous fistula with aneurysmal formation just near its termination in the pulmonary artery, associated with atherosclerotic left anterior descending coronary artery. The anomaly was successfully repaired.

  2. Travoprost Induced Granulomatous Anterior Uveitis

    Science.gov (United States)

    Chiam, Patrick

    2011-01-01

    Purpose. To report a case of granulomatous anterior uveitis caused by travoprost. Methods. Single observational case report. Results. A 71-year-old who was fit and healthy presented with bilateral granulomatous anterior uveitis 2 months after he was started on travoprost in both eyes. There was no past history of uveitis. Blood test and radiological investigation were unremarkable. Travoprost was stopped. The uveitis resolved on topical steroid treatment. A rechallenge with travoprost was attempted in one eye. The inflammation recurred in this eye only. This subsided with the cessation of travoprost alone without topical steroid. Conclusion. This is the first case report of travoprost causing granulomatous anterior uveitis. The uveitis recurred with a rechallenge. Changing the prostaglandin analogue to another topical treatment may be adequate to cease the inflammation. PMID:22606464

  3. Unilateral Acute Anterior Ischemic Optic Neuropathy in a Patient with an Already Established Diagnosis of Bilateral Optic Disc Drusen

    OpenAIRE

    Ziya Ayhan; Aylin Yaman; Meltem Söylev Bajin; Osman Saatci, A

    2015-01-01

    Optic disc drusen (ODD) are calcific deposits that form in the optic nerve head secondary to abnormalities in axonal metabolism and degeneration. Anterior ischemic optic neuropathy, central retinal artery, and vein occlusion are among the rare vascular complications of disc drusen. We reported the clinical course of a 51-year-old patient with a unilateral acute nonarteritic anterior ischemic optic neuropathy (NAION) who received the diagnosis of bilateral optic disc drusen five years earlier ...

  4. A fusiform aneurysm of a persistent trigeminal artery variant: case report and literature review.

    Science.gov (United States)

    Yang, Zhigang; Liu, Jianmin; Zhao, Wenyuan; Xu, Yi; Hong, Bo; Huang, Qinghai; He, Shike

    2010-04-01

    A 48-year-old man suffered from spontaneous subarachnoid hemorrhage. Emergent right internal carotid angiography showed the presence of a persistent trigeminal artery (PTA) variant with a fusiform aneurysm on its proximal segment where it branched from the internal carotid artery. This artery supplied the territory of the anterior inferior cerebellar artery. After consideration of the adequacy of the cerebellar circulation without this anomalous artery, intraluminal occlusion of the aneurysm together with the PTA variant was performed using detachable coils. The patient recovered uneventfully without any neurologic deficits. PMID:19690795

  5. Analysis of Arterial Mechanics During Head-Down-Tilt Bed Rest

    Science.gov (United States)

    Elliott, Morgan B.; Martin, David S.; Westby, Christian M.; Stenger, Michael B.; Platts, Steven H.

    2014-01-01

    Carotid, brachial, and tibial arteries reacted differently to HDTBR. Previous studies have not analyzed the mechanical properties of the human brachial or anterior tibial arteries. After slight variations during bed-rest, arterial mechanical properties and IMT returned to pre-bed rest values, with the exception of tibial stiffness and PSE, which continued to be reduced post-bed rest while the DC remained elevated. The tibial artery remodeling was probably due to decreased pressure and volume. Resulting implications for longer duration spaceflight are unclear. Arterial health may be affected by microgravity, as shown by increased thoracic aorta stiffness in other ground based simulations (Aubert).

  6. Usefulness of multidetector-row CT (MD-CT) for assessment of coronary artery stenosis

    International Nuclear Information System (INIS)

    Coronary arteries stenosis were evaluated in 49 cases by volume rendering (VR) and partial maximum intensity projection (partial MIP) using multidetector-row CT (MD-CT). Left main trunk (LMT) and left anterior descending artery (LAD) were less affected by cardiac pulsation artifact and presented good images. Right coronary artery (RCA) was affected by cardiac pulsation artifact and image quality was inferior as compared to left coronary artery (LCA). It is suggested that MD-CT is useful for assessment of coronary artery stenosis, especially LCA. (author)

  7. Comparing angiography features of inferior versus anterior myocardial infarction regarding severity and extension in a cohort of Iranian patients

    Directory of Open Access Journals (Sweden)

    Elham Hakki Kazazi

    2011-01-01

    Full Text Available Background: The location of acute myocardial infarction (MI is an important prognostic factor for risk stratification of patients with first ST-segment elevation MI (STEMI. The main goal of this study was to compare the severity and extension of coronary involvement in inferior and anterior MI. Methods: This study reviewed angiographic reports of 579 patients with a first anterior wall STEMI and 690 with a first inferior STEMI that were referred to Tehran Heart Center between March 2004 and September 2007. The number of coronary vessels involvement and the presence of left main lesion were determined based on angiography reports. The Gensini score was also calculated for each patient from the coronary arteriogram. Results: Incidence of left main lesion was similar between the two groups. Although coronary arteries involvement according to Gensini score was more severe in anterior wall MI group compared with inferior wall MI group, the number of involved coronary arteries was significantly higher in the inferior MI patients. Recommendation of coronary artery bypass grafting, percutaneous coronary intervention (PCI or medical treatment were the same for both groups; however, patients with anterior MI were treated more with primary PCI. Conclusions: According to our angiography database, despite anterior wall MI is associated with more severity of coronary artery disease; inferior wall MI is more extent with regard to the number of involved coronary vessels. Location of MI can predict the severity and extension of infarction.

  8. RIGHT SUPERIOR POLAR ARTERY ARISING FROM AORTA

    Directory of Open Access Journals (Sweden)

    Sreekanth

    2013-05-01

    Full Text Available ABSTRACT: The renal vasculature was always a subject of varia tions both in the number and pattern of portal of entry into kidney and Perihilar placement of the artery, vein and pelvis. Good anatomical insight is an essential prerequisite besides the surgical expertise. The cadaveric dissection at Shadan Institute of Medical Sciences, Teaching Hospital and Research Centre, revealed superior / upper polar artery arising from the lateral aspect of the aorta just proximal to the origin of Main Renal Artery (MRA. T he main renal artery and the accessory renal artery had almost a common point of origin. Th e peri-hilar segmentation of the main renal artery was a fork like pattern. One of the segmental arteries was long and had its portal of entry into the kidney by perforating the capsule of the ant erior substance of the kidney. The remaining segmental branches had their portal of ent ry through the hilum. The lower two segmental branches were placed anterior to the main renal vein causing altered hilar anatomy. A thorough knowledge of the frequently to the rarel y occurring wide range of variations of renal vasculature has significance in exploration and trea tment of renal trauma, renal transplantation, renal artery embolization, surgery for abdominal ao rtic aneurysm and conservative or radical renal surgery. Such a rare variation including the combination of extra renal peri-hilar segmentation of MRA with superior polar artery is wor thy of concern to the urologists harvesting kidneys from the live donors for performi ng transplantation procedures, partial nephrectomies for the hilar tumors and for Radiologi sts during interpretation of the angiograms

  9. Bilateral Anterior Opercular Syndrome With Partial Kluver-Bucy Syndrome in a Stroke Patient: A Case Report.

    Science.gov (United States)

    Cho, Ah-Ra; Lim, Young-Ho; Chung, Sae-Hoon; Choi, Eun-Hi; Lim, Jong Youb

    2016-06-01

    Bilateral anterior opercular syndrome and partial Kluver-Bucy syndrome are associated with bilateral middle cerebral artery lesions. The combination of these two syndromes has only been reported in a child with limbic encephalitis. In this case, a 44-year-old woman with bilateral middle cerebral artery infarction, which occurred 2 years prior, could walk independently. However, she showed automatic-voluntary dissociation and anarthria with preserved writing skills. She also presented hypersexuality, hypermetamorphosis, and memory disturbances. Here, we report a case of an adult stroke patient who suffered from bilateral anterior opercular syndrome accompanied by partial Kluver-Bucy syndrome. PMID:27446793

  10. An Incidental Finding of the Thyroidea Ima Artery:-A Case Report Study

    Directory of Open Access Journals (Sweden)

    Lalit C. Ratanpara

    2015-12-01

    Full Text Available We are here reporting a case of an incidental finding of the thyroidea ima artery emerging from the brachiocephalic trunk with a typical inferior thyroid vessels on both sides emerging from the thyrocervical trunk. The thyroidea ima artery entered the thyroid gland near to anterior surface of right lobe of thyroid gland. It arose from the brachiocephalic artery proximal to its bifurcation.

  11. Transcatheter closure of a congenital coronary artery to right ventricle fistula: a case report

    OpenAIRE

    Gribaa, Rym; Slim, Mehdi; Ouali, Sana; Neffati, Elies; Boughzela, Essia

    2014-01-01

    Introduction Congenital coronary artery fistula is a rare anomaly that may cause angina, atrial fibrillation, endocarditis, aneurysmal dilation and myocardial infarction. Both spontaneous regression and life-threatening complications have been described. Treatment can be conservative, surgical or more recently through transcatheter closure. Case presentation We report the case of a 27-year-old Tunisian man with a large coronary artery fistula from the left anterior descending artery to the ri...

  12. Cortex-sparing infarction in triple cervical artery dissection following chiropractic neck manipulation

    OpenAIRE

    Melikyan, Gayane; Kamran, Saadat; Akhtar, Naveed; Deleu, Dirk; Miyares, Francisco Ruiz

    2016-01-01

    Background: Multivessel cervical dissection with cortical sparing is exceptional in clinical practice. Case presentation: A 55-year-old man presented with acute-onset neck pain with associated sudden onset right-sided hemiparesis and dysphasia after chiropractic manipulation for chronic neck pain. Results and Discussion: Magnetic resonance imaging revealed bilateral internal carotid artery dissection and left extracranial vertebral artery dissection with bilateral anterior cerebral artery ter...

  13. Effect of stenosed and occluded coronary arteries on immediate and late myocardial uptake of thallium-201.

    OpenAIRE

    Clitsakis, D; Layton, C A; Battersby, W; Johns, M; Stockley, A V

    1981-01-01

    Exercise and redistribution myocardial scintigraphy using thallium-201 was compared with the left ventricular angiogram and with the presence of stenosis or occlusion of coronary arteries on angiography. Irreversible scintigraphic defects representing areas of myocardial infarction were found in all patients with occlusion of the left anterior descending artery but nearly one-third of patients with stenosis of that artery also showed evidence of infarction. For the right coronary or circumfle...

  14. VARIABILITY OF ORIGIN OF OBTURATOR ARTERY AND ITS CLINICAL SIGNIFICANCE

    Directory of Open Access Journals (Sweden)

    Sakthivel

    2015-12-01

    Full Text Available Background: Obturator artery is a branch of anterior division of internal iliac artery. It normally runs anteroinferiorly on the lateral wall of pelvis to the upper part of the obturator foramen and leaves the pelvis by passing through the obturator canal. On its course, the artery is accompanied by the obturator nerve and vein. It supplies the muscles of the medial compartment of the thigh. A severe and potentially lethal complication in pelvic injuries is arterial bleeding commonly involving the branches of the internal iliac artery, namely the lateral sacral, iliolumbar, obturator, vesical and inferior gluteal arteries. A sound knowledge of retro-pubic pelvic vascular anatomy is pivotal for successful performance of endoscopic procedures such as total extra-peritoneal inguinal hernioplasty or laparoscopic herniorraphy. The context and purpose of the study: This study is an attempt to analyse the origin, course, distribution of obturator artery in pelvis and their clinical implication. Result: out of 60 formalin fixed pelvic halves 36.6% of the specimens, (26.67% in males and 10% in females the origin of obturator artery was found to be normal from anterior division of internal iliac artery. About 63.63% from various other sources. Conclusion: This knowledge of variation in the origin of obturator artery is important while doing pelvic and groin surgeries requiring appropriate ligation. Such aberrant origins may be a significant source for persistent bleeding in the setting of acute trauma. Knowledge regarding the variations of obturator artery is useful during surgeries of fracture and direct or indirect inguinal, femoral and obturator hernias.

  15. Microsurgical anatomy of the middle cerebral artery

    Directory of Open Access Journals (Sweden)

    Pai S

    2005-01-01

    Full Text Available Background: The microsurgical anatomy of the middle cerebral artery (MCA is of particular interest to the cerebrovascular surgeon. The purpose of this study was to define the microsurgical anatomy of the MCA and its various branches in the Indian population. Methods: Ten MCAs were studied from five cadaveric brain specimens. The authors studied the outer diameter, length, branches, perforators and site of these on the main trunk (M1, the division of the main trunk, the secondary trunks and their various cortical branches using the operating microscope under 5-20x magnification. Results: The outer diameter of the MCA main trunk ranges from 2.5 to 4 mm with a mean of 3.35 mm. The superolateral branches consisted of polar temporal artery and anterior temporal artery that had a common origin and sometimes the uncal artery or the accessory uncal artery. Perforators or lenticulostriate arteries were seen in the inferomedial surface all along the length of M1. Eight bifurcations and two trifurcations were noted. Cortical branches and their origin are discussed. Conclusion: Although the microsurgical anatomy of the MCA in Indian population correlated with the findings in the western literature, some structural and statistical variations were noted.

  16. Carotid Artery Disease

    Science.gov (United States)

    ... brain with blood. If you have carotid artery disease, the arteries become narrow, usually because of atherosclerosis. ... one of the causes of stroke. Carotid artery disease often does not cause symptoms, but there are ...

  17. Mesenteric artery ischemia

    Science.gov (United States)

    Mesenteric artery ischemia occurs when there is a narrowing or blockage of one or more of the three major arteries that ... that supply blood to the intestine causes mesenteric ischemia. The arteries that supply blood to the intestines ...

  18. A Case of Double Right Coronary Artery with Separate Ostium

    Directory of Open Access Journals (Sweden)

    Jalal Kheirkhah

    2015-10-01

    Full Text Available Coronary artery anomalies are rare, with their incidence varying from 1 to 5%. Angiography is a commonly used modality for the assessment of coronary artery anomalies. Based on previous reports, a majority of coronary artery anomalies are of origin or distribution, with separate ostia of the left anterior descending artery and left circumflex artery. Coronary artery anomalies may cause myocardial ischemia secondary to atherosclerosis in the same artery. We present a rare case of duplicated right coronary artery with a separate ostium, which caused myocardial ischemia. Our patient was a 51-year-old diabetic woman with typical chest pain and dyspnea on exertion. Electrocardiography showed left axis deviation, poor R progression, and biphasic T wave in the precordial leads. Echocardiography revealed left ventricular ejection fraction of 30-35% and global hypokinesia. Coronary angiography demonstrated three-vessel disease and a double ostial right coronary artery. We recommended coronary artery bypass graft surgery, but the patient refused it and we continued her treatment with anti-ischemic drugs.

  19. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... during a hip replacement through the anterior supine intramuscular approach. “OR-Live,” the vision of improving health. ... the approach are operating through an internervous and intramuscular anatomic interval. It’s not necessary to detach any ...

  20. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... got coming out in “JBJS,” the early six-week recovery is dramatically different between a direct lateral abductor splitting approach and this anterior supine approach. Let me get this head on. My experience, these patients have full leg control in about 24 hours. Yeah. They can get out of bed and ...

  1. Anterior Approach Total Hip Replacement

    Medline Plus

    Full Text Available ... the anterior supine intramuscular approach. “OR-Live,” the vision of improving health. Good evening and welcome to ... should know that this is done under direct vision. Yeah. You are seeing everything you’re doing. ...

  2. MR imaging of persistent primitive trigeminal artery

    Energy Technology Data Exchange (ETDEWEB)

    Ashikaga, Ryuichiro; Araki, Yutaka; Ono, Yukihiko; Ishida, Osamu [Kinki Univ., Higashi-Osaka, Osaka (Japan); Mabuchi, Nobuhisa

    1997-02-01

    The persistent trigeminal artery is the most common anomaly of the primitive carotid-vertebrobasilar anastomoses. We reviewed MR images and MR angiographies of 11 patients with primitive trigeminal artery. In 8 of the 11 cases, PTA were identified with conventional long TR spin-echo images. In 8 of 11 cases, a hypoplastic basilar trunk associated with PTA was seen on both MR images and MR angiographies. In 7 of 11 cases, a hypoplasia or agenesis of the ipsilateral posterior communicating artery was seen on MR angiographies. (author)

  3. MR imaging of persistent primitive trigeminal artery

    International Nuclear Information System (INIS)

    The persistent trigeminal artery is the most common anomaly of the primitive carotid-vertebrobasilar anastomoses. We reviewed MR images and MR angiographies of 11 patients with primitive trigeminal artery. In 8 of the 11 cases, PTA were identified with conventional long TR spin-echo images. In 8 of 11 cases, a hypoplastic basilar trunk associated with PTA was seen on both MR images and MR angiographies. In 7 of 11 cases, a hypoplasia or agenesis of the ipsilateral posterior communicating artery was seen on MR angiographies. (author)

  4. Novel treatment of coronary artery fistulae concealing severe coronary artery lesion: using thrombus aspiration catheter as a delivery guide.

    Science.gov (United States)

    Korkmaz, Levent; Acar, Zeydin; Dursun, Ihsan; Akyüz, Ali Rıza; Korkmaz, Ayca Ata

    2014-03-01

    In this case report, we present the occlusion of multiple coronary artery fistulae originating from proximal left anterior descending (LAD) and right sinus valsavla and empting to the pulmonary artery at the same place. We occluded LAD fistulae by using thrombus aspiration catheter as a delivery guide. To the best of our knowlege, this is the first case of occlusion of coronary fistulae with the help of thrombus aspiration catheter. Our experience may suggest that thrombus aspiration catheters can be used in treating coronary artery fistulae with difficult anotomy. PMID:24748888

  5. Unusual bilateral origins of the deep artery of thigh and associated variations

    Directory of Open Access Journals (Sweden)

    Shankar N

    2009-08-01

    Full Text Available During routine dissection of a middle aged male cadaver, an unusual origin of the deep artery of thigh was observed bilaterally. It arose from the femoral artery less than 1 cm distal to the inguinal ligament. On both sides, its diameter was greater than that of the femoral artery. An unusually distal origin of the lateral circumflex femoral artery was observed bilaterally. An unnamed branch from the deep artery of thigh on the left side was seen coursing superolaterally towards the anterior superior iliac spine. The deep external pudendal artery arose from the medial circumflex femoral artery on either side. On the right side, the femoral nerve emerged in the femoral triangle by piercing the iliacus muscle. As the deep artery of thigh is often used in vascular reconstructive procedures and is frequently visualized by various radiological imaging techniques, anatomical variations of itself as well as its branches have significant clinical implications.

  6. MRI and MR angiography of persistent trigeminal artery

    Energy Technology Data Exchange (ETDEWEB)

    Piotin, M. [Departments of Neuroradiology, Jean Minjoz University Hospital, Besancon (France); Miralbes, S. [Departments of Neuroradiology, Jean Minjoz University Hospital, Besancon (France); Cattin, F. [Departments of Neuroradiology, Jean Minjoz University Hospital, Besancon (France); Marchal, H. [Departments of Neuroradiology, Jean Minjoz University Hospital, Besancon (France); Amor-Sahli, M. [Departments of Neuroradiology, Jean Minjoz University Hospital, Besancon (France); Moulin, T. [Department of Neurology, University Hospital, Besancon (France); Bonneville, J.F. [Departments of Neuroradiology, Jean Minjoz University Hospital, Besancon (France)

    1996-11-01

    We describe the MRA and MR angiography (MRA) features of persistent trigeminal artery (PTA) found incidentally in eight patients, with special attention to its origin, site and course. The different patterns of posterior communicating arteries were also noted. The PTA were shown on sagittal, coronal and axial MRI and on MRA. In four cases, the PTA arose from the lateral aspect of the intracavernous internal carotid artery, ran caudally, passing round the bottom of the dorsum sellae to join the basilar artery. In the other four cases, it arose from the medial aspect, ran caudally through the sella turcica and pierced the dorsum sellae to join the basilar artery. The posterior communicating arteries were present unilaterally in five cases and bilaterally in one, and absent bilaterally in two. Identification of a PTA with a trans-sellar course is crucial if a trans-sphenoidal surgery is planned. (orig.). With 3 figs.

  7. Anterior spinal cord syndrome after initiation of treatment with atenolol.

    Science.gov (United States)

    Schneider, Gregory S

    2010-06-01

    Anterior spinal cord syndrome is a rare condition with a variety of precipitating factors. Patients typically complain of weakness or paralysis of the extremities, often accompanied by pain, but frequently without a history of trauma. A 48-year-old man presented to the emergency department complaining of neck pain and inability to move his legs in the absence of trauma. Several hours prior he had seen his private physician and was given a dose of atenolol for elevated blood pressure. He had not previously been on medications for hypertension. His neurological examination revealed bilateral paralysis of the lower extremities. In the upper extremities he had weakness and sensory loss at the level of C6. Rectal tone was decreased and without sensation. Cervical and thoracic spine magnetic resonance imaging showed spondylotic disc disease, with disc herniation at C6-7 causing severe spinal canal stenosis. Despite i.v. methylprednisolone, pressors, and a prolonged intensive care unit course, the patient was discharged 5 weeks later with continued neurological deficits. Anterior spinal cord syndrome results from compression of the anterior spinal artery and often occurs in the absence of traumatic injury. The recognition, management, and prognosis of this condition are discussed. PMID:18597977

  8. Anomalous origin of the left circumflex coronary artery from the pulmonary artery. A very rare congenital anomaly in an adult patient diagnosed by cardiovascular magnetic resonance

    Directory of Open Access Journals (Sweden)

    Giannitsis Evangelos

    2008-01-01

    Full Text Available Abstract Here we report for the first time on the diagnostic potential of cardiovascular magnetic resonance (CMR to delineate the proximal course of an anomalous left circumflex coronary artery (LCX originating from the right pulmonary artery in an adult patient with no other form of congenital heart disease. The patient was referred to our institution due to exertional chest discomfort. X-Ray coronary angiography showed a normal left anterior descending coronary artery (LAD and right coronary artery (RCA, while the LCX was filled retrograde by collateral flow through the LAD and the RCA. The origin of the LCX was postulated to be the pulmonary artery, but the exact origin of the anomalous artery could not be depicted on conventional angiograms. CMR provided the unambiguous depiction of the origin of the anomalous LCX from the right pulmonary artery and the delineation of its proximal course in this case of a very rare coronary anomaly in adults.

  9. 38 CFR 3.379 - Anterior poliomyelitis.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Anterior poliomyelitis. 3... Specific Diseases § 3.379 Anterior poliomyelitis. If the first manifestations of acute anterior poliomyelitis present themselves in a veteran within 35 days of termination of active military service, it...

  10. The arterial blood supply of the temporomandibular joint: an anatomical study and clinical implications

    International Nuclear Information System (INIS)

    The aim of this study was to analyze three-dimensional images of the arterial supply to the temporomandibular joint. Ten patients (five men and five women, mean age 36 years) without signs or symptoms of temporomandibular disorders, who underwent contrast-enhanced computed tomographic (CT) scanning with intravenous contrast, were studied. The direct volume rendering technique of CT images was used, and a data set of images to visualize the vasculature of the human temporomandibular joint in three dimensions was created. After elaboration of the data through post-processing, the arterial supply of the temporomandibular joint was studied. The analysis revealed the superficial temporal artery, the anterior tympanic artery, the deep temporal artery, the auricular posterior artery, the transverse facial artery, the middle meningeal artery, and the maxillary artery with their branches as the main arterial sources for the lateral and medial temporomandibular joint. The direct volume rendering technique was found to be successful in the assessment of the arterial supply to the temporomandibular joint. The superficial temporal artery and maxillary artery ran along the lateral and medial sides of the condylar neck, suggesting that these arteries are at increased risk during soft-tissue procedures such as an elective arthroplasty of the temporomandibular joint.

  11. Fifty-eight cases of ocular ischemic diseases caused by carotid artery stenosis

    Institute of Scientific and Technical Information of China (English)

    LUO Rong-jiang; LIU Shao-rui; LI Xiao-min; ZHUO Ye-hong; TIAN Zhen

    2010-01-01

    Background The blood supply to the eye comes from the retinal central vascular system of the ophthalmic artery and the ciliary vascular system. The ophthalmic artery stems from the ipsilateral internal carotid artery. If occlusion or stenosis occurs in the carotid artery, the blood perfusion to the ophthalmic artery becomes insufficient, leading to signs and symptoms of anterior and posterior ocular ischemia. The objective of this study was to evaluate the clinical characteristics and risk factors of ocular ischemic diseases caused by carotid artery stenosis.Methods This study was a retrospective review of 145 patients with carotid artery stenosis. Fifty-eight patients who had symptoms of ocular ischemic disease caused by carotid artery stenosis formed group A and the other 87 patients who only had carotid artery stenosis formed group B. We analyzed the causes and course of disease, and relative risk factors,by comparing the two groups.Results The degree of carotid artery stenosis in group A was higher than that in group B. And group A had a greater decrease of ophthalmic artery flow. Male, hypertension, hyperlipidemia, and smoking were significantly related to carotid artery stenosis. Amaurosis fugax was the most common ocular symptom in group A. The ocular ischemic diseases mainly included ischemic optic neuropathy, central/branch retinal artery occlusion, ophthalmoplegia externa, and ocular ischemic syndrome.Conclusions Carotid artery stenosis correlates with ocular ischemic diseases. Ophthalmologists must observe for ocular symptoms, which were the onset symptoms in some patients.

  12. The arterial blood supply of the temporomandibular joint: an anatomical study and clinical implications

    Energy Technology Data Exchange (ETDEWEB)

    Cuccia, Antonino Marco; Caradonna, Carola; Caradonna, Domenico [Dept. of Surgical and Oncological Disciplines, University of Palermo, Palermo (Italy); Anastasi, Giuseppe; Milardi, Demetrio; Favaloro, Angelo; Caradonna, Luigi; Cutroneo, Giuseppina [Biomorphology and Biotechnologies, University of Messina, Messina (Italy); De Pietro, Anita; Angileri, Tommaso Maurizio [Villa Santa Teresa, Diagnostica per Immagini, Palermo (Italy)

    2013-03-15

    The aim of this study was to analyze three-dimensional images of the arterial supply to the temporomandibular joint. Ten patients (five men and five women, mean age 36 years) without signs or symptoms of temporomandibular disorders, who underwent contrast-enhanced computed tomographic (CT) scanning with intravenous contrast, were studied. The direct volume rendering technique of CT images was used, and a data set of images to visualize the vasculature of the human temporomandibular joint in three dimensions was created. After elaboration of the data through post-processing, the arterial supply of the temporomandibular joint was studied. The analysis revealed the superficial temporal artery, the anterior tympanic artery, the deep temporal artery, the auricular posterior artery, the transverse facial artery, the middle meningeal artery, and the maxillary artery with their branches as the main arterial sources for the lateral and medial temporomandibular joint. The direct volume rendering technique was found to be successful in the assessment of the arterial supply to the temporomandibular joint. The superficial temporal artery and maxillary artery ran along the lateral and medial sides of the condylar neck, suggesting that these arteries are at increased risk during soft-tissue procedures such as an elective arthroplasty of the temporomandibular joint.

  13. ANGIOGRAPHIC PROFILE OF LEFT MAIN CORONARY ARTERY (LMCA STENOSIS

    Directory of Open Access Journals (Sweden)

    Malladi Srinivasa

    2015-02-01

    Full Text Available Among patients with coronary artery disease, left coronary artery (LMCA stenosis is the dangerous form of coronary arterial involvement, associated with increased mortality and morbidity unless immediate intervention is done. The gold standard treatment for left main coronary artery (LMCA stenosis is the emergency coronary artery bypass grafting to its branches, left anterior descending artery (LAD, and left circumflex artery (LCX. Of percutaneous intervention in the form of angioplasty and stenting of left main coronary artery are increasingly done. The anatomy and the site of stenosi s in the left main coronary artery determine the management option. In this context, the involvement of left main coronary artery and its anatomical pattern are important in deciding management options. AIM: To study the angiographic profile of significant Left main coronary artery (LMCA stenosis among the patients who underwent coronary angiography. METHODS: A total of 1911 cases of significant coronary arterial disease, who underwent coronary angiography a t King George Hospital, Visakhapatnam were studied in the present study and their coronary angiograms were analysed with respect to the pattern of involvement. RESULTS: of the 1911 cases of coronary artery disease, 118 patients have left main coronary arte ry disease. M/F ratio is 93/25. Of them 68.4% are hypertensive, 41.5 % are diabetics, 34.7% are smokers. Mean age of presentation was 59 yrs. Isolated LMCA involvement is seen in 5, associated with single vessel disease in 9, double vessel disease in 12 an d triple vessel diseases in 93. Ostio - proximal involvement is seen in 21, mid segment involvement in 13, distal – bifurcation involvement in 93 and total occlusion of LMCA in 1 case. CONCLUSION: Significant LMCA involvement is seen in 6.1%. In majority of c ases, it is associated with triple vessel disease and distal bifurcation is the commonest site involved.

  14. Pediatric anterior cruciate ligament reconstruction

    OpenAIRE

    McConkey, Mark O.; Bonasia, Davide Edoardo; Amendola, Annunziato

    2011-01-01

    An increasing number of anterior cruciate ligament (ACL) injuries are seen in children now than in the past due to increased sports participation. The natural history of ACL deficient knees in active individuals, particularly in children is poor. Surgical management of ACL deficiency in children is complex due to the potential risk of injury to the physis and growth disturbance. Delaying ACL reconstruction until maturity is possible but risks instability episodes and intra-articular damage. S...

  15. Anterior impingement syndrome in dancers

    OpenAIRE

    O’Kane, John William; Kadel, Nancy

    2007-01-01

    Anterior impingement is a common problem in dancers occurring primarily secondary to the repetitive forced ankle dorsiflexion inherent in ballet. Symptoms generally occur progressively and may respond to conservative treatment including addressing biomechanical faults that contribute to the problem. As impingement progresses, movements essential to ballet may become impossible and arthroscopic ankle surgery is often effective for both diagnosis and treatment, allowing athletes to return to da...

  16. Arterial blood supply to the basal ganglionic region on CT sections, (1)

    International Nuclear Information System (INIS)

    The selective injection of dyestuff to the perforators from the anterior and middle cerebral arteries, using six normal post-mortem brains, was performed. After fixation, sections parallel with the orbitomeatal line were obtained. The area supplied by perforators of ACA, including the recurrent artery of Heubner, was visualized in the anterior commissure, the inferior and anterior parts of the caudate nucleus and putamen, the anterior part of the globus pallidus, and the anterior limb of the internal capsule below the slice which showed the anterior horn. The area supplied by the so-called lateral lenticulostriate arteries, which originates from the horizontal segment of MCA, was visualized in the lateral part of the anterior perforated substance, the posterior part of the putamen and the globus pallidus, the genu and posterior limb of the internal capsule, and the external capsule and claustrum below the slice which showed the anterior horn. The border between areas was considered as the anterior limb of the internal capsule and the lateral part of the head of the caudate nucleus on the slice which showed the anterior horn. On slices showing the anterior horn and upward, the area supplied by perforators derived from MCA demonstrated a distribution that was visualized in the lateral part of the caudate nucleus, most of the putamen, the internal and external capsules, the claustrum, and the white matter above the putamen. The identification of the area supplied by perforators in the basal ganglionic region on CT sections will be useful in the CT diagnosis of cerebrovascular disorders which involve the basal ganglion. (author)

  17. Single coronary artery; extremely rare coronary anomaly successfully treated surgically in young adult male.

    LENUS (Irish Health Repository)

    Shah, A R

    2010-05-01

    Single coronary artery arising from aortic root, is a rare congenital anomaly. A 30-year-old male presented with acute myocardial infarction (MI) complaining of chest pain and raised troponin levels. Emergency angiography showed no coronary lesions but both left and right coronary arteries arising from single ostium. Patient was operated electively and perioperative findings confirmed the diagnosis of single coronary artery, as left coronary artery after taking origin from right sinus of valsalva runs through the septum, before dividing into left anterior descending and circumflex branches. The single coronary ostium opened with a slit like incision over the course of left main coronary, making the size of ostium three to four times bigger than the native one. In addition left internal mammary artery was harvested and grafted to the left anterior descending branch distally. Patient made successful recovery. Four months follow up dobutamine stress echo showed no inducible ischemia.

  18. Ischemia induced by coronary steal through a patent mammary artery side branch: a role for embolization.

    Science.gov (United States)

    Moreno, Nuno; da Silva Castro, Alexandra; Pereira, Adriana; Silva, João Carlos; Almeida, Pedro Bernardo; Andrade, Aurora; Maciel, Maria Júlia; Pinto, Paula

    2013-06-01

    Non-occlusion of the internal mammary artery side branches may cause ischemia due to flow diversion after coronary artery bypass grafting. The authors present the case of a 67-year-old man with recurrent angina after undergoing myocardial revascularization with a left internal mammary artery to left anterior descending bypass. He presented with impaired anterior wall myocardial perfusion in the setting of a patent left internal mammary artery side branch. Effective percutaneous treatment was carried out through coil embolization, with improved flow and clinical symptoms, confirmed through ischemia testing. Coronary steal through a patent mammary artery side branch is a controversial phenomenon and this type of intervention should be considered only in carefully selected patients. PMID:23809629

  19. [Coverage of anterior knee defect by reverse flow anterolateral thigh flap: About two cases].

    Science.gov (United States)

    Montoya-Faivre, D; Pineau, V; Colson, T; Brix, M; Simon, E

    2016-08-01

    The coverage of soft-tissue defects concerning the front of the knee and the proximal lower leg is a complex procedure. The reverse flow anterolateral thigh flap represents a good solution for this defects, especially when the coverage surface is large-sized and a free flap is not appropriate regarding the difficulty of the process. Flap retrograde vascularization is based on the anastomosis between the descending branch of the circumflex femoral artery and lateral superior genicular artery. It is an easy solution with low morbidity. The authors have chosen this flap to cover soft-tissue defect of anterior knee from two patients with total knee prothesis. PMID:26169962

  20. Imaging of Dual Ophthalmic Arteries: Identification of the Central Retinal Artery

    Directory of Open Access Journals (Sweden)

    Louise Louw

    2014-01-01

    Full Text Available Identification of the origin of the central retinal artery (CRA is imperative in tailoring angiographic studies to resolve a given clinical problem. A case with dual ophthalmic arteries (OAs, characterized by different origins and distinct branching patterns, is documented for training purposes. Pre-clinical diagnosis of a 9-year-old child who presented with a sharp wire in the left-side eyeball was primarily corneal laceration. For imaging, a selected six-vessel angiographic study with the transfemoral approach was performed. Embolization was not required and the wire could be successfully removed. Right-side OA anatomy was normal, while left-side dual OAs with external carotid artery (ECA and internal carotid artery (ICA origins were seen. The case presented with a left-side meningo-ophthalmic artery (M-OA anomaly via the ECA, marked by a middle meningeal artery (MMA (origin: Maxillary artery; course: Through foramen spinosum with normal branches (i.e. anterior and posterior branches, and an OA variant (course: Through superior orbital fissure with a distinct orbital branching pattern. A smaller OA (origin: ICA; course: Through optic foramen with a distinct ocular branching pattern presented with the central retinal artery (CRA. The presence of the dual OAs and the M-OA anomaly can be explained by disturbed evolutionary changes of the primitive OA and stapedial artery during development. The surgical interventionist must be aware of dual OAs and M-OA anomalies with branching pattern variations on retinal supply, because of dangerous extracranial-intracranial anastomotic connections. It is of clinical significance that the origin of the CRA from the ICA or ECA must be determined to avoid complications to the vision.

  1. Traumatic Persistent Trigeminal Artery - Cavernous Sinus Fistula Treated by Transcatheter Arterial Embolization

    Science.gov (United States)

    Asai, K.; Hasuo, K.; Hara, T.; Miyagishima, T.; Terano, N.

    2010-01-01

    Summary We describe a rare case of traumatic persistent trigeminal artery (PTA) - cavernous sinus fistula. Cerebral angiography showed direct communication between the right PTA and the cavernous sinus which was treated by transcathether arterial embolization. Although previous reports have indicated the use of more coils to treat this condition, we successfully treated the patient with only two coils placed near the orifice of the fistula after sufficient anatomical evaluation. PMID:20377986

  2. Traumatic persistent trigeminal artery--cavernous sinus fistula treated by transcatheter arterial embolization. A case report.

    Science.gov (United States)

    Asai, K; Hasuo, K; Hara, T; Miyagishima, T; Terano, N

    2010-03-01

    We describe a rare case of traumatic persistent trigeminal artery (PTA) - cavernous sinus fistula. Cerebral angiography showed direct communication between the right PTA and the cavernous sinus which was treated by transcathether arterial embolization. Although previous reports have indicated the use of more coils to treat this condition, we successfully treated the patient with only two coils placed near the orifice of the fistula after sufficient anatomical evaluation. PMID:20377986

  3. Traumatic Persistent Trigeminal Artery - Cavernous Sinus Fistula Treated by Transcatheter Arterial Embolization: A Case Report

    OpenAIRE

    Asai, K.; Hasuo, K; Hara, T.; Miyagishima, T.; Terano, N.

    2010-01-01

    We describe a rare case of traumatic persistent trigeminal artery (PTA) - cavernous sinus fistula. Cerebral angiography showed direct communication between the right PTA and the cavernous sinus which was treated by transcathether arterial embolization. Although previous reports have indicated the use of more coils to treat this condition, we successfully treated the patient with only two coils placed near the orifice of the fistula after sufficient anatomical evaluation.

  4. Anterior insular cortex regulation in autism spectrum disorders

    Directory of Open Access Journals (Sweden)

    Andrea Caria

    2015-03-01

    Full Text Available Autism spectrum disorders (ASDs comprise a heterogeneous set of neurodevelopmental disorders characterized by dramatic impairments of interpersonal behavior, communication, and empathy. Recent neuroimaging studies suggested that ASD are disorders characterized by widespread abnormalities involving distributed brain network, though clear evidence of differences in large-scale brain network interactions underlying the cognitive and behavioral symptoms of ASD are still lacking. Consistent findings of anterior insula cortex hypoactivation and dysconnectivity during tasks related to emotional and social processing indicates its dysfunctional role in ASD. In parallel, increasing evidence showed that successful control of anterior insula activity can be attained using real-time fMRI paradigms. More importantly, successful regulation of this region was associated with changes in behavior and brain connectivity in both healthy individuals and psychiatric patients. Building on these results we here propose and discuss the use of real-time fMRI neurofeedback in ASD aiming at improving emotional and social behavior.

  5. Anterior insular cortex regulation in autism spectrum disorders.

    Science.gov (United States)

    Caria, Andrea; de Falco, Simona

    2015-01-01

    Autism spectrum disorders (ASDs) comprise a heterogeneous set of neurodevelopmental disorders characterized by dramatic impairments of interpersonal behavior, communication, and empathy. Recent neuroimaging studies suggested that ASD are disorders characterized by widespread abnormalities involving distributed brain network, though clear evidence of differences in large-scale brain network interactions underlying the cognitive and behavioral symptoms of ASD are still lacking. Consistent findings of anterior insula cortex hypoactivation and dysconnectivity during tasks related to emotional and social processing indicates its dysfunctional role in ASD. In parallel, increasing evidence showed that successful control of anterior insula activity can be attained using real-time fMRI paradigms. More importantly, successful regulation of this region was associated with changes in behavior and brain connectivity in both healthy individuals and psychiatric patients. Building on these results we here propose and discuss the use of real-time fMRI neurofeedback in ASD aiming at improving emotional and social behavior. PMID:25798096

  6. 左主干与左前降支病变患者活动平板运动试验的对比分析%Analysis of treadmill exercise test on patients with left main coronary artery or proximal anterior descending obstruction

    Institute of Scientific and Technical Information of China (English)

    李敬涛; 张姝兰; 乔洁; 夏振伟

    2015-01-01

    Objective To explore the significance of treadmill exercise test (TET) in identifying left main coronary artery(LMD) obstruction from proximal left anterior descending(LAD) obstruction.Methods Patients with positive in the TET of the Central Hospital of Dalian from Jan.2008 to Dec.2013 were enrolled in this study and they were divided into LMD group with 21 cases and LAD group with 35 cases according to the results of coronary angiography.Retrospectively study was conducted to analyze the exercise time,the start time of ST segment change,the lead of ST segment between groups.Results Lead aVR ST segment elevation(≥0.10 mV) was 85.7% (18/21) in the LMD group and 62.9% (22/35) in the LAD group.Lead aVR ST segment elevation in the LM group was ((0.16 ± 0.07) mV,higher than in the LAD group ((0.11 ± 0.07) mV ; t =2.614,P < 0.05).Accompany ST segment depression of leads and cumulative ST segment depression were (5.7 ±1.7) pcs and (1.13 ±0.42) mV in LMD group,significantly higher than those of LAD group((4.6 ± ± 1.8) pcs and (0.87 ± 0.32) mV ; t =2.314,2.634,P < 0.05).The occurrence rate of ST segment depression (≥0.10 mV) in leads V2 and V6 were 33.3% (7/21) and 90.5% (19/21) in LM group,significantly higher than that in LAD group (11.4% (4/35) and 62.9 % (22/35) ; x2 =3.990,5.105 ;P < 0..05).The start time of ST segment deviation of LM group was significantly earlier than that of LAD group ((199.8 ± 70.8) s vs.(273.7 ± 127.3) s;t =-2.787,P < 0.01).The differences were not statistically significant in terms of the exercise time between groups ((315.0 ± 120.0) s vs.(376.1 ± 110.0) s;t =-1.948;P > 0.05),the rate for achieving target heart rate(33.3% (7/21) vs.48.6% (17/35) ; x2 =1.244 ; P > 0.05) and the Duke score ((-11.8 ±7.2) vs.(-8.4 ±6.8) ;t =-1:772;P>0.05).Conclusion Compare with patients with the LAD disease,ST segment elevation of lead aVR is significantly higher induced by treadmill exercise test in patients with left

  7. Congenital coronary-pulmonary artery fistula originating from right and left coronary artery

    Directory of Open Access Journals (Sweden)

    Ali Kemal Gür

    2013-12-01

    Full Text Available Coronary artery fistula (CAF is a rare congenital anomalywith an incidence of 1 in 50 000 live births. The fistula wasobserved at the right coronary artery in 53%, the left coronaryartery in 42% and both coronary artery in 5% of thecases. Echocardiography examination in a 46 year-oldwoman with the symptoms of chest pain, palpitation anddyspnea revealed a severe mitral valve insufficiency anda moderate to severe tricuspid valve insufficiency. A CAForiginating from the proximal part of the left anterior descendingartery (LAD and another fistula originating fromosteal part of the right coronary artery (RCA were detectedby coronary angiography. Both fistulas were draininginto the main pulmonary artery. The coronary artery fistulaclosed under cardiopulmonary by-pass. Mitral insufficiencyoriginated from the posterior leaflet was diagnosedintra-operative exploration, and thereafter it was repairedwith mitral annuloplasty including a quadrangular resectionand use of a 32 No St Jude mitral ring. Tricuspid valvewas repaired with Calangos Ring annuloplasty. Followingsix day hospital stay, the woman was discharged free ofany symptom.Key words: Dyspnea, double arteriovenous fistula, mitral and tricuspid insufficiency

  8. Spontaneous resolution of a flow-related ophthalmic-segment aneurysm after treatment of anterior cranial fossa dural arteriovenous fistula

    Directory of Open Access Journals (Sweden)

    Kevin Reinard

    2014-01-01

    Full Text Available Background: The natural history of proximal, feeding-artery aneurysms after successful obliteration of high-grade, anterior cranial fossa dural arteriovenous fistulas (dAVFs has not been well documented. Case Description: A 52-year-old Caucasian male presented with an unruptured anterior cranial fossa (dAVF and an associated aneurysm. Cerebral angiography revealed a large, contralateral, carotid-ophthalmic segment aneurysm, enlarged feeding ophthalmic arteries, as well as cortical venous drainage. Successful surgical obliteration of the dAVF was undertaken to eliminate the risk of hemorrhage. Conclusion: The carotid-ophthalmic aneurysm regressed significantly after surgical obliteration of the dAVF and a follow-up, planned coiling procedure to address the carotid-ophthalmic aneurysm was abandoned. This represents the first reported case of a near complete, spontaneous resolution of an unruptured carotid-ophthalmic aneurysm associated with a high-grade anterior cranial fossa dAVF.

  9. MORPHOLOGICAL STUDY OF THE BASILAR ARTERY IN ADULT HUMAN CADAVERS

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    Harish A. Wankhede

    2014-09-01

    Full Text Available Background: The basilar artery is the large median and major artery of the posterior circulation of the brain. Many variations are seen in the basilar artery, majority of them in position, origin and shape of the artery. Many authors have documented various anomalies as well as differences of the anatomy in this area in the Indian population as compared to the Western literature. Context and purpose of study: Many studies are available on the anterior circulation of the brain i.e. on vessels of the circle of Willis but studies on the posterior circulation are very few. And such studies so far had been done mostly in the American and European races and are mostly based on imaging techniques. Studies in the Indian population have been few. Hence the present study is concentrated on the morphological study of the basilar artery of human adult brain, to show the frequency and type of variations in the morphology of the basilar artery. Results: The basilar artery most commonly takes origin from the vertebral artery where left vertebral artery is greater in size than the right vertebral artery (72.5%. Level of formation of the basilar artery is most commonly observed at the ponto-medullary junction (62.5%. Length of the basilar artery varied from minimum 2.4cm to maximum 3.6cm. More commonly artery lies in the range of 2.6-3.0cm (57.5%. Diameter of the basilar artery at origin ranges from 3.2-4.2mm, at mid level from 3-4mm and at termination 3.1-4mm. Level of termination of the basilar artery is more commonly at the mid brain-pons junction (50%. Most of the basilar arteries are of straight type (55% and next common is bent or curved type (37.5%. Fenestration of 4mm is seen in proximal part of the one basilar artery (2.5%. Conclusion: Variations of the basilar artery are common. Neurosurgical importance of this study lies during the exposure of the region for different purposes. Knowledge of the vascular variations will increase the success of the

  10. Buerger's disease associated with visceral artery occlusions: computed tomography angiography findings of a case

    International Nuclear Information System (INIS)

    Full text: Introduction: Thromboangiitis obliterans or Buerger's Disease (BD) is characterized by occlusive segmental and often multiple inflammatory lesions of medium and small-sized arteries and superficial veins.This disease rarely effects the visceral arteries. Objectives and tasks: In this report, we present the computed tomography angiography (CTA) findings of a BD case associated with inferior mesenteric and splenic artery occlusions. Materials and methods: A 35-year-old man with BD is referred to our department for aorta and bilateral lower extremity arterial CTA examination. Results: On CTA, abdominal aorta and bilateral iliac arteries were normal. The distal 2/3 of the anterior tibial artery was thin and there were multisegmented stenoses at proximal 1/3 part. Right posterior tibial artery was occluded. In addition to the stenoses of the extremity arteries, splenic artery was occluded and the spleen was feeding by collateral vessels. The proximal part of the inferior mesenteric artery was occluded, as well and the distal segment was filling retrogradely via collaterals. Conclusion: BD rarely effects the visceral arteries. CTA which is used commonly in daily radiology practice, is a reliable imaging modality for the detection of the visceral artery occlusions in addition to the pathologies of the extremity arteries in BD patients

  11. Approaches to anterior and anterolateral foramen magnum lesions: A critical review

    OpenAIRE

    Komotar, Ricardo J.; Zacharia, Brad E.; McGovern, Robert A.; Sisti, Michael B.; Bruce, Jeffrey N.; Anthony L D′Ambrosio

    2010-01-01

    Foramen magnum (FM) lesions represent some of the most complex cases for the modern neurosurgeon because of their location near vital brainstem structures, the vertebral arteries, and lower cranial nerves. In particular, anterior or anterolaterally located FM tumors have traditionally been most difficult to resect with high morbidity and mortality resulting from approaches through the posterior midline or transorally. For many neurosurgeons, the far lateral, extreme lateral approach, and more...

  12. Use of a Galeopericranial Flap for the Reconstruction of Anterior Cranial Base Defects

    OpenAIRE

    Chia-Hsiang Fu; Sheng-Po Hao; Yung-Shin Hsu

    2005-01-01

    Background: To evaluate the efficacy of using a galeopericranial flap for reconstruction ofanterior cranial base defects.Methods: In Linkou Chang Gung Memorial Hospital from February 1994 to November2003, 25 patients who had tumors of the skull base underwent craniofacialresection, and a galeopericranial flap was used to reconstruct the anterior cranialbase defect. The galeopericranial flap was developed and based on atleast 1 side of the supraorbital or supratrochlear arteries and veins; it ...

  13. Usefulness of anterior uveitis as an additional tool for diagnosing incomplete Kawasaki disease

    OpenAIRE

    Lee, Kyu Jin; Kim, Hyo Jin; Kim, Min Jae; Yoon, Ji Hong; Lee, Eun Jung; Lee, Jae Young; Oh, Jin Hee; Lee, Soon Ju; Lee, Kyung Yil; Han, Ji Whan

    2016-01-01

    Purpose There are no specific tests for diagnosing Kawasaki disease (KD). Additional diagnostic criteria are needed to prevent the delayed diagnosis of incomplete Kawasaki disease (IKD). This study compared the frequency of coronary artery lesions (CALs) in IKD patients with and without anterior uveitis (AU) and elucidated whether the finding of AU supported the diagnosis of IKD. Methods This study enrolled patients diagnosed with IKD at The Catholic University of Korea, Uijeongbu St. Mary's ...

  14. Left main coronary artery atresia and associated cardiac defects: report on concomitant surgical treatment.

    Science.gov (United States)

    Jatene, Marcelo; Juaneda, Ignacio; Miranda, Rogerio Dos Anjos; Gato, Rafaella; Marcial, Miguel Lorenzo Barbero

    2011-10-01

    A 9-year-old boy with congenital atresia of the left main coronary artery underwent myocardial revascularization. Coarctation of the aorta and ventricular septal defect were diagnosed at the age of 1 year. At age 7 years, the child presented with syncope while exercising. Preoperative evaluation included cardiac catheterization which revealed the unexpected finding of congenital atresia of the left main coronary artery with origin of the circumflex artery from the right coronary artery. Surgical correction included myocardial revascularization by means of left internal mammary artery graft to the anterior descending coronary artery, coarctation resection, and ventricular septal defect repair. The patient recovered uneventfully. We report the details of this extremely rare case with successful concomitant surgical management of the congenital coronary artery anomaly and the associated structural heart disease. PMID:23804483

  15. Lesiones del ligamento cruzado anterior

    OpenAIRE

    Alejandro Álvarez López; Yenima García Lorenzo

    2015-01-01

    Fundamento: el ligamento cruzado anterior desempeña un papel muy importante en la estabili-dad de la rodilla. La incidencia de esta afección es alta en pacientes que practican deportes de contacto y de no ser tratados de forma adecuada, los resultados son desfavorables. Objetivo: profundizar en los factores necesarios para el tratamiento adecuado de enfermos con esta lesión y evitar las complicaciones. Método: se realizó una revisión bibliográfica de un total de 300 artículos publicados en Pu...

  16. Rare anatomical variations of persistent trigeminal artery in two patients with non-aneurysmal subarachnoid hemorrhage.

    Science.gov (United States)

    Samaniego, Edgar A; Dabus, Guilherme; Andreone, Vincenzo; Linfante, Italo

    2011-09-01

    Carotid-basilar anastomoses are remnants of the fetal circulation and although rare, they may become symptomatic and should be recognized during cerebral angiography. Two patients are described with non-aneurysmal subarachnoid hemorrhage and persistent trigeminal arteries (PTA) found on cerebral angiography. In the first patient, the PTA ended in the anterior inferior cerebellar artery (AICA) and posterior inferior cerebellar artery. The second patient had a PTA terminating in the AICA and superior cerebellar artery. These rare anatomical PTA variants should be recognized on cerebral angiography. PMID:21990842

  17. Computed tomography in the evaluation of the supraclinoid arteries in suprasellar pituitary gland tumors

    International Nuclear Information System (INIS)

    The demonstration of the supraclinoid arteries at CT in 38 patients with suprasellar lesions was evaluated. The anterior cerebral artery was visible in 8 per cent, the other supraclinoid arteries in about 80 per cent. In one patient cerebral angiography revealed a giant aneurysm which was erroneously considered as a suprasellar neoplasm at CT and encephalography. The demonstration of the supraclinoid arteries was often inadequate in large suprasellar tumors. Therefore, cerebral angiography is still necessary preoperatively in suprasellar pituitary lesions-at least at the state of technology represented by the Delta 25 Head Scanner. (Auth.)

  18. Endovascular Treatment of Persistent Epistaxis due to Pseudoaneurysm Formation of the Ophthalmic Artery Secondary to Nasogastric Tube

    International Nuclear Information System (INIS)

    We present the case of a 60-year-old man with persistent epistaxis for 20 days that had started 2 weeks after removal of a nasogastric tube placed for an abdominal operation. There was no pathologic finding at selective facial and internal maxillary artery injections. An injury to the ethmoidal branches of the ophthalmic arteries or other arterial origins of bleeding was suspected. The internal carotid artery angiography revealed a pseudoaneurysm of an anterior ethmoidal branch of the left ophthalmic artery. The pseudoaneurysm was occluded with NBCA-histoacryl (25%) injection

  19. The prevalence of coronary artery variations on coronary computed tomography angiography

    International Nuclear Information System (INIS)

    Background: Coronary computed tomography angiography (CCTA) can delineate the coronary artery anatomy precisely. Basic knowledge of the normal coronary artery anatomy and familiarity with its common variations are essential in order to assess CCTA accurately. Purpose: To determine the prevalence of coronary artery variations detected by 64-slice multidetector CT. Material and Methods: CCTA images of 2096 patients were evaluated retrospectively. Relatively unusual coronary artery morphological features that were seen in greater than 1% of the study population were classified as variations. Results: Coronary artery circulation was right dominant in 86.6%, left dominant in 9.6%, and balanced in 3.8% of patients. The conus artery arose from the right coronary artery in 83%, or directly from the aorta with a separate ostium in 17% of cases which was much more common in men than women. The sinoatrial node artery originated from the right coronary artery (65.6%) or the circumflex artery (33.7%). The atrioventricular node artery originated from the right coronary artery in 86.4% or the circumflex artery in 13.6% of cases. The left main coronary artery was shorter than 0.5 cm in 4.7% of cases and trifurcated into the intermediate artery in 31.3% of cases. A myocardial bridge was observed in 21.6%, coronary ectasia-aneurysm in 2%, dual left anterior descending artery (LAD) type 1 in 1.38%, and a variant of type 1 in 0.1% of cases. The presence of coronary atherosclerosis was higher in patients with coronary ectasia-aneurysm than the patients who did not have coronary ectasia-aneurysm (90.5% vs. 72.2%, P = 0.000). Conclusion: CCTA is a non-invasive imaging modality for the depiction of variations of the coronary arteries. The incidence of coronary artery variations is high and various, and readers should be familiar and looking for these conditions during interpretation of CCTA examinations

  20. Short-term clinical outcomes after hybrid coronary revascularization versus off-pump coronary artery bypass for the treatment of multivessel or left main coronary artery disease: a meta-analysis

    OpenAIRE

    Hu, Fang-Bin; Cui, Lian-Qun

    2015-01-01

    Background Hybrid coronary revascularization (HCR) and off-pump coronary artery bypass grafting (OPCABG) are both feasible, less invasive techniques for coronary revascularization. Although both techniques utilize the left internal mammary artery to left anterior descending artery graft, HCR uses drug-eluting stents instead of saphenous vein bypass. It remains unclear whether HCR is equal to, better or worse than OPCABG. Methods and results A meta-analysis was carried out using a random-effec...

  1. Anterior chest wall examination reviewed

    Directory of Open Access Journals (Sweden)

    F. Trotta

    2011-09-01

    Full Text Available Anterior chest wall involvement is not infrequently observed within inflammatory arthropaties, particularly if one considers seronegative spondiloarthritides and SAPHO syndrome. Physical examination is unreliable and conventional X-rays analysis is an unsatisfactory tool during diagnostic work-up of this region. Scintigraphic techniques yield informations both on the activity and on the anatomical extent of the disease while computerized tomography visualize the elementary lesions, such as erosions, which characterize the process. Moreover, when available, magnetic resonance imaging couple the ability to finely visualize such lesions with the possibility to show early alterations and to characterize the “activity” of the disease, presenting itself as a powerful tool both for diagnosis and follow-up. This review briefly shows the applications of imaging techniques for the evaluation of the anterior chest wall focusing on what has been done in the SAPHO syndrome which can be considered prototypical for this regional involvement since it is the osteo-articular target mainly affected by the disease.

  2. Dolor anterior de la rodilla

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    Alejandro Álvarez López

    2010-01-01

    Full Text Available Introducción:el dolor anterior de la rodilla constituye una importante causa de consulta en la especialidad de Ortopedia y Traumatología. La incidencia de otras enfermedades relacionadas con este síntoma es cada vez mayor, ejemplo de ello es la condromalacia de rótula, tendinitis patelar, osteoartritis patelofemoral entre otras, el diagnóstico de estas enfermedades se debe al cúmulo de experiencia y a la introducción de técnicas y equipos imagenológicos de avanzada. Desarrollo: se realizó una revisión bibliográfica sobre el dolor anterior de la rodilla, con especial énfasis en las teorías involucradas en su fisiopatología, entre las que se encuentran la mala-alineación patelo-femoral, equilibrio de la homeostasis tisular y aumento de la presión intra-ósea, además de brindar brevemente el cuadro clínico de la enfermedad. Para finalizar se expone el enfoque terapéutico que se basa fundamentalmente en el tratamiento conservador, se mencionan además las modalidades de tratamiento quirúrgico.

  3. Positioning of anterior teeth in removable dentures

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    Strajnić Ljiljana

    2002-01-01

    Full Text Available Introduction The aim of this paper was to present methods of placement of artificial anterior teeth in edentulous individuals. The following review takes account of the majority of papers published during the last 100 years. The review has been divided into sections regarding the method used to determine the position of artificial anterior teeth. Geometric aspect Gysi (1895-1920 produced the first scientific theory about the position of artificial anterior teeth. Physiognomic theory The aim of this theory is to find the most natural position for artificial anterior teeth for each individual. Camper's "face angle" as a physiognomic criterion, has been introduced in papers of Wehrli (1961, Marxhors (1966, Tanzer (1968, Lombardi (1973. Esthetic aspect Important names in the field of dental esthetics are: Schön and Singer (1961, Arnheim (1965, Krajiček (1969, Tanzer (1968, Lombardi (1973, Goldstein (1976. They have introduced principles of visual aspects for selection of contours, dimension and position of artificial anterior teeth. Constitution aspect Flagg (1880, Williams (1913 and Hrauf (1957, 1958, have considered body constitution and individual characteristics regarding position of artificial anterior teeth. Physiological theory In 1971, Marxhors pointed to the fact that the position of artificial teeth corresponds with the function of the surrounding soft tissue and from the aspect of physiognomy as well. Phonetic aspect According to Silverman (1962 artificial anterior teeth are nearest when we pronounce the sound "S". Cephalometrical research Rayson (1970, Watson (1989, Strajnić Lj. (1999, Bassi F. (2001 have presented cephalometric radiographic analyses of natural anterior teeth compared with cephalometric radiographic analyses of artificial anterior teeth. A review of dental literature shows several factors suggesting modalities which should determine the position of artificial anterior teeth. Numerous methods have been designed for

  4. Pharyngocutaneous fistula after anterior cervical spine surgery

    OpenAIRE

    Sansur, Charles A.; Early, Stephen; Reibel, James; Arlet, Vincent

    2009-01-01

    Pharyngocutaneous fistulae are rare complications of anterior spine surgery occurring in less than 0.1% of all anterior surgery cases. We report a case of a 19 year old female who sustained a C6 burst fracture with complete quadriplegia. She was treated urgently with a C6 corpectomy with anterior cage and plating followed by posterior cervical stabilization at another institution. Post operatively she developed a pharyngocutaneous fistula that failed to heal despite several attempts of closu...

  5. Unilateral and bilateral internal carotid artery stenosis or occlusion: a study of the secondary collateral circulation

    International Nuclear Information System (INIS)

    Objective: It's a study of the collateral circulation secondary to unilateral and bilateral internal carotid artery (ICA) severe stenosis or occlusion using digital subtract angiography (DSA) and magnetic resonance angiography (MRA). Methods: Ninty-five patients with ICA stenosis or occlusion were diagnosed by DSA or MRA. Forty-four patients were assessed by DSA, and fifty-one patients were evaluated by MRA, who were divided into two groups of the unilateral and bilateral involvement. DSA, MRA findings were analyzed, by which the patterns of the collateral circulation were comparatively studied. Results: The presence rate of anterior communicating artery (AcoA) in the unilateral group on DSA and MRA was significantly higher than that in the bilateral group (P0.05). On DSA, the presence rate of ophthalmic artery (OphA) in the unilateral and bilateral groups had no significant difference between the two groups. The augmentation rate of the OphA in the bilateral group was significantly higher than that in the unilateral group (P<0.05). The presence rate of leptomeningeal anastomosis in the bilateral group was significantly higher than that in the unilateral group on DSA and MRA (P<0.01). Conclusion: In patients with the unilateral and bilateral ICA stenosis or occlusion, the collateral circulation formats in different patterns. The major collateral pathways secondary to the unilateral ICA stenosis or occlusion are AcoA and ispilateral PCoA, while to the bilateral ICA stenosis or' occlusion are PCoA, OPhA, and leptomeningeal anastomosis. (authors)

  6. Emergency Thoracotomy- Isolated Internal Thoracic Artery Injury

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    Islam S

    2014-09-01

    Full Text Available Aim: A tension haemothorax is an uncommon injury after penetrating chest trauma. Presentation of a Case: We present a case in which a 55 year old man sustained multiple thoracic stab wounds. He had emergency right antero-lateral thoracotomy and laparotomy. A massive haemothorax secondary to complete disruption of right internal mammary artery and a laceration to middle lobe of right lung was noticed. Conclusion: Penetrating thoracic injury with isolated internal mammary injury is a very rare cause of massive haemothorax and associated with high mortality. Emergent thoracotomy can be life-saving for these patients. Introduction: Anterior thoracic penetrating injuries may result in life-threatening complications. One of these is massive tension haemothorax with pericardial tamponade as a result of stab wounds to the internal mammary artery.

  7. Clinical usefulness of multi-planar reconstruction images of three-dimensional computed tomographic angiography for internal carotid artery aneurysms

    International Nuclear Information System (INIS)

    The usefulness of multi-planar reconstruction (MPR) images of three-dimensional computed tomographic angiography (3D-CTA) for the diagnosis of internal carotid artery (ICA) aneurysms is described. Eleven unruptured ICA aneurysms including six cases of IC-cavernous aneurysm, two cases of IC-ophthalmic artery aneurysm, two cases of IC-posterior communicating artery aneurysm and one cases of IC-anterior choroidal artery aneurysm, were examined by magnetic resonance angiography (MRA), digital subtraction angiography (DSA), 3D-CTA and its MPR images. 3D-CTA and DSA were useful to identify the aneurysmal neck in small aneurysms, but it was difficult to identify the aneurysmal neck in small aneurysms by 3D-CTA-MPR images. DSA and MRA were not useful for identifying the aneurysmal neck in aneurysms more than 10 mm in diameter, as a precise viewing of the neck could not be found due to their large size. For large aneurysms, neither was 3D-CTA useful for identifying the aneurysmal neck when their large size and surrounding bony structures overlapped the aneurysmal neck. On the other hand, 3D-CTA-MPR was very useful for identifying the aneurysmal neck without overlapping by surrounding bony structures. 3D-CTA-MPR images clearly visualized the calcification of the wall. 3D-CTA-MPR images are obtained from 3D-CTA source images without any additional stress to the patients, and they are more useful for the diagnosis as well as demonstration of the aneurysmal neck particularly in more than large aneurysms. (author)

  8. Clinical usefulness of multi-planar reconstruction images of three-dimensional computed tomographic angiography for internal carotid artery aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Nishio, Akimasa; Hara, Mitsuhiro; Nakamura, Kazuhito; Yamauchi, Shigeru; Tsuchida, Kazuyuki; Inoue, Yuichi; Daikokuya, Hideo [Osaka City Univ. (Japan). Medical School

    2002-03-01

    The usefulness of multi-planar reconstruction (MPR) images of three-dimensional computed tomographic angiography (3D-CTA) for the diagnosis of internal carotid artery (ICA) aneurysms is described. Eleven unruptured ICA aneurysms including six cases of IC-cavernous aneurysm, two cases of IC-ophthalmic artery aneurysm, two cases of IC-posterior communicating artery aneurysm and one cases of IC-anterior choroidal artery aneurysm, were examined by magnetic resonance angiography (MRA), digital subtraction angiography (DSA), 3D-CTA and its MPR images. 3D-CTA and DSA were useful to identify the aneurysmal neck in small aneurysms, but it was difficult to identify the aneurysmal neck in small aneurysms by 3D-CTA-MPR images. DSA and MRA were not useful for identifying the aneurysmal neck in aneurysms more than 10 mm in diameter, as a precise viewing of the neck could not be found due to their large size. For large aneurysms, neither was 3D-CTA useful for identifying the aneurysmal neck when their large size and surrounding bony structures overlapped the aneurysmal neck. On the other hand, 3D-CTA-MPR was very useful for identifying the aneurysmal neck without overlapping by surrounding bony structures. 3D-CTA-MPR images clearly visualized the calcification of the wall. 3D-CTA-MPR images are obtained from 3D-CTA source images without any additional stress to the patients, and they are more useful for the diagnosis as well as demonstration of the aneurysmal neck particularly in more than large aneurysms. (author)

  9. Preservation of the superior hemorrhoidal artery in resection of the colon and rectum.

    Science.gov (United States)

    Fegiz, G; Tonelli, F; Rossi, P; Di Paola, M; De Masi, E; Simonetti, G

    1976-12-01

    As an alternative to anterior resection of the rectum requiring ligature of the inferior mesenteric artery at its origin, it is proposed to carry out this procedure preserving the inferior mesenteric artery and freeing it as far as the origin of the superior hemorrhoidal artery and its division into rectal branches to improve the blood supply to the rectal stump. The results of this new procedure were compared with those of anterior resection. Post-operatively, the blood supply of the rectum was studied by means of angiography. The results of 84 anterior resections for neoplastic disease of the colon were studied. In 56 patients, the inferior mesenteric artery was preserved and in 28 the inferior mesenteric artery was ligated. Postoperative complications due to leakage of the colorectal anastomosis rarely occurred in the first group and were frequent in the latter. In patients in whom the inferior mesenteric artery was preserved, arteriograms showed that vascularization of the preserved rectal stump is supplied essentially by the branches of the superior hemorrhoidal artery. PMID:996711

  10. Occlusive Peripheral Arterial Disease

    Science.gov (United States)

    ... erythrocyte sedimentation rate (ESR) and level of C-reactive protein, which is produced only when inflammation is present. ... people with occlusive peripheral arterial disease also have coronary artery disease. Amputation of a limb may be necessary if ...

  11. Herniation of the anterior lens capsule

    Directory of Open Access Journals (Sweden)

    Pereira Nolette

    2007-01-01

    Full Text Available Herniation of the anterior lens capsule is a rare abnormality in which the capsule bulges forward in the pupillary area. This herniation can be mistaken for an anterior lenticonus where both the capsule and the cortex bulge forward. The exact pathology behind this finding is still unclear. We report the clinical, ultrasound biomicroscopy (UBM and histopathological findings of a case of herniation of the anterior lens capsule. UBM helped to differentiate this entity from anterior lenticonus. Light microscopy revealed capsular splitting suggestive of capsular delamination and collection of fluid (aqueous in the area of herniation giving it a characteristic appearance.

  12. Anterior Uveitis as an Initial Manifestation of Polymyalgia Rheumatica

    Directory of Open Access Journals (Sweden)

    Hiromasa Tsuda

    2011-01-01

    Full Text Available A 74-year-old woman without contributory medical history presented with acute iridocyclitis in the right eye. Although the iridocyclitis disappeared within two weeks under topical steroid, she complained of acute progressing bilateral shoulder pain and morning stiffness of upper extremities. She was diagnosed as having polymyalgia rheumatica (PMR, and iridocyclitis was considered as its related manifestation. PMR and giant cell arteritis (GCA are closely related conditions and frequently occur together. GCA with uveitis has been rarely noted. However, ocular symptoms in PMR have not been previously mentioned. This is a first reported case of PMR presented with uveitis, without a complication of GCA. This anterior uveitis might be caused by ischemia of the posterior ciliary arteries and their branches.

  13. Combination of Rare Right Arterial Variation with Anomalous Origins of the Vertebral Artery, Aberrant Subclavian Artery and Persistent Trigeminal Artery

    Science.gov (United States)

    Ishihara, H.; San Millán Ruíz, D.; Abdo, G.; Asakura, F.; Yilmaz, H.; Lovblad, K.O.; Rüfenacht, D.A.

    2011-01-01

    Summary A 32-year-old woman hospitalized for subarachnoid hemorrhage showed rare arterial variation on the right side with anomalous origins of the vertebral artery, aberrant subclavian artery and persistent trigeminal artery. Angiography showed the right vertebral artery to originate from the right common carotid artery, the right subclavian artery to arise separately from the descending aorta, and persistent trigeminal artery on the right side. The possible embryonic mechanism of this previously unreported variant combination is discussed. PMID:22005696

  14. On Renal Artery Stenosis

    OpenAIRE

    Eklöf, Hampus

    2005-01-01

    Renal artery stenosis (RAS) is a potentially curable cause of hypertension and azotemia. Besides intra-arterial renal angiography there are several non-invasive techniques utilized to diagnose patients with suspicion of renal artery stenosis. Removing the stenosis by revascularization to restore unobstructed blood flow to the kidney is known to improve and even cure hypertension/azotemia, but is associated with a significant complication rate. To visualize renal arteries with x-ray technique...

  15. EXERCISE-INDUCED ARTERIAL ADAPTATIONS IN ELITE JUDO ATHLETES

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    Panagiotis Karagounis

    2009-09-01

    Full Text Available The purpose of this study was to examine exercise-induced arterial adaptations in elite Judo male and female athletes. 27 male Judo athletes (age 24.06 ± 2 years, 11 female Judoka (age 24.27 ± 1 years, 27 sedentary healthy men (age 24.01 ± 2 years and 11 women (age 24.21 ± 1 years participated in the current study. The examined vessels included brachial, radial, ulnar, popliteal, anterior and posterior tibial arteries. The experimental parameters were recorded with the use of Duplex ultrasound at rest. Diastolic diameter and blood mean flow velocity of the examined arteries in Judo athletes were found to be both significantly increased (p < 0.05 compared to the findings of the control groups. In male Judo athletes the brachial (p < 0.001, radial (p < 0.001, and anterior tibial artery (p < 0.001 presented the highest difference on the diastolic diameter, compared with the control male group. In female Judo athletes, ulnar (p < 0.001, radial (p < 0.001, and brachial (p < 0.001 arteries illustrated the highest diastolic diameter. The highest blood mean flow velocity was recorded in ulnar (p < 0.001 and popliteal arteries (p < 0.001 of the Judo athletes groups. Recording differences between the two genders, male participants presented larger arteries than females. Conclusively, Judo has been found to be a highly demanding physical sport, involving upper and lower limbs leading to significant arterial adaptations. Obtaining vascular parameters provide a useful tool to the medical team, not only in the direction of enhancement of the efficacy of physical training, but in unknown so far parameters that may influence athletic performance of both male and female elite Judokas

  16. Perawatan Gigitan Terbalik Anterior Dengan Menggunakan Inclined Plane

    OpenAIRE

    Siregar, Wilda A.

    2008-01-01

    Gigitan terbalik anterior adalah suatu anomali posisi gigi anterior atas yang lebih ke lingual dibandingkan gigi anterior bawah. Anomali gigitan terbalik anterior dapat ditemui pada periode gigi sulung, gigi bercampur, dan gigi permanen. Faktor etiologi gigitan terbalik anterior dibedakan atas dental, fungsional atau skeletal. Untuk menentukan etiologi dari anomali gigitan terbalik anterior perlu dilakukan diagnosa yang tepat. Perawatan gigitan terbalik anterior ini dapat dilakukan de...

  17. Safety of Chemotherapeutic Infusion or Chemoembolization for Hepatocellular Carcinoma Supplied Exclusively by the Cystic Artery

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Beomsik, E-mail: kangbs98@gmail.com; Kim, Hyo-Cheol, E-mail: angiointervention@gmail.com; Chung, Jin Wook, E-mail: chungjw@snu.ac.kr; Hur, Saebeom, E-mail: hurz21@gmail.com; Joo, Seung-Moon, E-mail: huchi79@gmail.com; Jae, Hwan Jun, E-mail: jhj@radiol.snu.ac.kr; Park, Jae Hyung, E-mail: parkjh4803@gmail.com [Seoul National University College of Medicine, Department of Radiology (Korea, Republic of)

    2013-10-15

    Purpose: This study was designed to evaluate the safety of chemotherapeutic infusion or chemoembolization by way of the cystic artery in patients with hepatocellular carcinoma (HCC) supplied exclusively by the cystic artery. Methods: Between Jan 2002 and Dec 2011, we performed chemotherapeutic infusion or chemoembolization using iodized oil for the treatment of 27 patients with HCC supplied exclusively by the cystic artery. Computed tomography (CT) scans, digital subtraction angiograms, and medical records were retrospectively reviewed by consensus. Results: The cystic artery originated from the main right hepatic artery in 24 (89 %) patients, from the right anterior hepatic artery in 2 (7 %) patients, and from the left hepatic artery in 1 (4 %) patient. Selective catheterization of the cystic artery was achieved in all patients. Superselection of tumor-feeding vessels from the cystic artery was achieved in 7 patients (26 %). Chemotherapeutic infusion was performed in 18 patients (67 %), and chemoembolization was performed in 9 patients (33 %). There were no major complications and only 2 minor complications, including vasovagal syncope and nausea with vomiting. Individual tumor response supplied exclusively by the cystic artery at the follow-up enhanced CT scan were complete response (n = 16), partial response (n = 3), and stable disease (n = 8). Conclusion: HCC supplied exclusively by the cystic artery can be safely treated without severe complications by chemotherapeutic infusion or chemoembolization using iodized oil through the cystic artery.

  18. Safety of Chemotherapeutic Infusion or Chemoembolization for Hepatocellular Carcinoma Supplied Exclusively by the Cystic Artery

    International Nuclear Information System (INIS)

    Purpose: This study was designed to evaluate the safety of chemotherapeutic infusion or chemoembolization by way of the cystic artery in patients with hepatocellular carcinoma (HCC) supplied exclusively by the cystic artery. Methods: Between Jan 2002 and Dec 2011, we performed chemotherapeutic infusion or chemoembolization using iodized oil for the treatment of 27 patients with HCC supplied exclusively by the cystic artery. Computed tomography (CT) scans, digital subtraction angiograms, and medical records were retrospectively reviewed by consensus. Results: The cystic artery originated from the main right hepatic artery in 24 (89 %) patients, from the right anterior hepatic artery in 2 (7 %) patients, and from the left hepatic artery in 1 (4 %) patient. Selective catheterization of the cystic artery was achieved in all patients. Superselection of tumor-feeding vessels from the cystic artery was achieved in 7 patients (26 %). Chemotherapeutic infusion was performed in 18 patients (67 %), and chemoembolization was performed in 9 patients (33 %). There were no major complications and only 2 minor complications, including vasovagal syncope and nausea with vomiting. Individual tumor response supplied exclusively by the cystic artery at the follow-up enhanced CT scan were complete response (n = 16), partial response (n = 3), and stable disease (n = 8). Conclusion: HCC supplied exclusively by the cystic artery can be safely treated without severe complications by chemotherapeutic infusion or chemoembolization using iodized oil through the cystic artery

  19. Peripheral Artery Disease

    Science.gov (United States)

    ... or atherectomy may be used to help improve blood flow. What is peripheral artery disease (PAD)? How is peripheral artery disease evaluated? How ... PAD are diabetes, smoking, high cholesterol and high blood pressure. Most cases occur in ... is peripheral artery disease evaluated? Several imaging tests can be used to ...

  20. Retinal artery occlusion

    Science.gov (United States)

    ... artery occlusion; Branch retinal artery occlusion; CRAO; BRAO Images Retina References Sanborn GE, Magargal LE. Arterial obstructive disease ... A.M. Editorial team. Related MedlinePlus Health Topics ... audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among ...

  1. Diagnostic accuracy of computed tomographic angiography for the detection of stenotic lesion of the distal segments of main coronary arteries

    International Nuclear Information System (INIS)

    Objective: It was to find out the diagnostic accuracy of CT angiography for the detection of stenotic atherosclerotic lesions in the distal segments of 4 main coronary arteries using invasive angiography as gold standard. Methodology: This observational study was carried out at Department of Cardiology, Hayatabad Medical Complex, Peshawar. It included 50 patients from June to September 2011. CT and invasive angiography was performed for each patient and data was analyzed in SPSS software version 10.0 to analyze the findings of distal segments of the 4 main arteries. Results: The sensitivity for detection of stenotic atherosclerotic lesions in left main stem, left anterior descending, circumflex and right coronary arteries was 87.5%, 100%, 66.67% and 50% respectively. Specificity for detection of stenotic atherosclerotic lesions in left main stem, left anterior descending, circumflex and right coronary artery was 100% for all. Positive predictive value for detection of stenotic atherosclerotic lesions in left main stem, left anterior descending, circumflex and right coronary arteries was also 100% for all and negative predictive value was 97.6%, 100%, 97.91% and 95.83% for the left main stem, left anterior descending, circumflex and right coronary arteries respectively. Conclusion: Invasive angiography is more sensitive than CT angiography but has equal specificity to invasive angiography for the detection of stenotic lesions in the distal segments of 4 main coronary arteries. (author)

  2. Toxic Anterior Segment Syndrome (TASS

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    Özlem Öner

    2011-12-01

    Full Text Available Toxic anterior segment syndrome (TASS is a sterile intraocular inflammation caused by noninfectious substances, resulting in extensive toxic damage to the intraocular tissues. Possible etiologic factors of TASS include surgical trauma, bacterial endotoxin, intraocular solutions with inappropriate pH and osmolality, preservatives, denatured ophthalmic viscosurgical devices (OVD, inadequate sterilization, cleaning and rinsing of surgical devices, intraocular lenses, polishing and sterilizing compounds which are related to intraocular lenses. The characteristic signs and symptoms such as blurred vision, corneal edema, hypopyon and nonreactive pupil usually occur 24 hours after the cataract surgery. The differential diagnosis of TASS from infectious endophthalmitis is important. The main treatment for TASS formation is prevention. TASS is a cataract surgery complication that is more commonly seen nowadays. In this article, the possible underlying causes as well as treatment and prevention methods of TASS are summarized. (Turk J Oph thal mol 2011; 41: 407-13

  3. Recurrent Syncope Attributed to Left Main Coronary Artery Severe Stenosis

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    Min Li

    2015-01-01

    Full Text Available Patients with acute coronary syndrome (ACS rarely manifest as recurrent syncope due to malignant ventricular arrhythmia. We report a case of a 56-year-old Chinese male with complaints of paroxysmal chest burning sensation and distress for 2 weeks as well as loss of consciousness for 3 days. The electrocardiogram (ECG revealed paroxysmal multimorphologic ventricular tachycardia during attack and normal heart rhythm during intervals. Coronary angiograph showed 90% stenosis in left main coronary artery and 80% stenosis in anterior descending artery. Two stents sized 4.0*18 mm and 2.75*18 mm were placed at left main coronary artery and anterior descending artery, respectively, during percutaneous coronary intervention (PCI. The patient was discharged and never had ventricular arrhythmia again during a 3-month follow-up since the PCI. This indicated that ventricular tachycardia was correlated with persistent severe myocardial ischemia. Coronary vasospasm was highly suspected to be the reason of the sudden attack and acute exacerbation. PCI is recommended in patients with both severe coronary artery stenosis and ventricular arrhythmia. Removing myocardial ischemia may stop or relieve ventricular arrhythmia and prevent cardiac arrest.

  4. Superselective pseudo-continuous arterial spin labeling angiography

    International Nuclear Information System (INIS)

    Highlights: • Superselective arterial spin labeling was capable of acquiring angiograms of individually selected arteries. • Image quality was similar compared with a routinely used time-of-flight angiography. • Superselective arterial spin labeling was utilized in patients with arterio-venous malformations and made it possible to visualize individual feeding vessels in a complete non-invasive way - Abstract: Purpose: To evaluate the utility of a novel non-contrast enhanced, vessel-selective magnetic resonance angiography (MRA) approach based on superselective pseudo-continuous arterial spin labeling (ASL) for the morphologic assessment of intracranial arteries when compared to a clinically used time-of-flight (TOF) MRA. Materials and methods: Three sets of selective ASL angiographies (right and left internal carotid artery, basilar artery) as well as one TOF data set were obtained from each of the five volunteers included in this study on a clinical 1.5T system. The depiction of arterial segments as well as their delineation was evaluated and independently analyzed by two radiologists. Additionally, the ASL angiography approach was performed in two patients suffering from arterio-venous malformations (AVM) in order to illustrate potential applications in a clinical setting. Results: In both angiography techniques, intracranial arteries and their segments (distal branches up to A5 segments of the anterior cerebral arteries, M8 segments of the middle cerebral arteries, and P5 segments of the posterior cerebral arteries) were continuously depicted with excellent inter-reader agreement (κ > 0.81). In AVM patients, reconstructed images of the TOF angiography presented similar information about the size and shape of the AVM as did superselective ASL angiography. In addition, the acquired ASL angiograms of selected vessels allowed assessing the blood supply of individually labeled arteries to the AVM which could also be confirmed by digital subtraction angiography

  5. Superselective pseudo-continuous arterial spin labeling angiography

    Energy Technology Data Exchange (ETDEWEB)

    Jensen-Kondering, Ulf [Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Kiel (Germany); Lindner, Thomas, E-mail: thomas.lindner@uksh.de [Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Kiel (Germany); Osch, Matthias J.P. van [C. J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden (Netherlands); Rohr, Axel; Jansen, Olav [Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Kiel (Germany); Helle, Michael [Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Kiel (Germany); Now with Philips GmbH Innovative Technologies, Research Laboratories, Hamburg (Germany)

    2015-09-15

    Highlights: • Superselective arterial spin labeling was capable of acquiring angiograms of individually selected arteries. • Image quality was similar compared with a routinely used time-of-flight angiography. • Superselective arterial spin labeling was utilized in patients with arterio-venous malformations and made it possible to visualize individual feeding vessels in a complete non-invasive way - Abstract: Purpose: To evaluate the utility of a novel non-contrast enhanced, vessel-selective magnetic resonance angiography (MRA) approach based on superselective pseudo-continuous arterial spin labeling (ASL) for the morphologic assessment of intracranial arteries when compared to a clinically used time-of-flight (TOF) MRA. Materials and methods: Three sets of selective ASL angiographies (right and left internal carotid artery, basilar artery) as well as one TOF data set were obtained from each of the five volunteers included in this study on a clinical 1.5T system. The depiction of arterial segments as well as their delineation was evaluated and independently analyzed by two radiologists. Additionally, the ASL angiography approach was performed in two patients suffering from arterio-venous malformations (AVM) in order to illustrate potential applications in a clinical setting. Results: In both angiography techniques, intracranial arteries and their segments (distal branches up to A5 segments of the anterior cerebral arteries, M8 segments of the middle cerebral arteries, and P5 segments of the posterior cerebral arteries) were continuously depicted with excellent inter-reader agreement (κ > 0.81). In AVM patients, reconstructed images of the TOF angiography presented similar information about the size and shape of the AVM as did superselective ASL angiography. In addition, the acquired ASL angiograms of selected vessels allowed assessing the blood supply of individually labeled arteries to the AVM which could also be confirmed by digital subtraction angiography

  6. Mild toxic anterior segment syndrome mimicking delayed onset toxic anterior segment syndrome after cataract surgery

    Directory of Open Access Journals (Sweden)

    Su-Na Lee

    2014-01-01

    Full Text Available Toxic anterior segment syndrome (TASS is an acute sterile postoperative anterior segment inflammation that may occur after anterior segment surgery. I report herein a case that developed mild TASS in one eye after bilateral uneventful cataract surgery, which was masked during early postoperative period under steroid eye drop and mimicking delayed onset TASS after switching to weaker steroid eye drop.

  7. Pelvic Arterial Anatomy Relevant to Prostatic Artery Embolisation and Proposal for Angiographic Classification

    International Nuclear Information System (INIS)

    PurposeTo describe and categorize the angiographic findings regarding prostatic vascularization, propose an anatomic classification, and discuss its implications for the PAE procedure.MethodsAngiographic findings from 143 PAE procedures were reviewed retrospectively, and the origin of the inferior vesical artery (IVA) was classified into five subtypes as follows: type I: IVA originating from the anterior division of the internal iliac artery (IIA), from a common trunk with the superior vesical artery (SVA); type II: IVA originating from the anterior division of the IIA, inferior to the SVA origin; type III: IVA originating from the obturator artery; type IV: IVA originating from the internal pudendal artery; and type V: less common origins of the IVA. Incidences were calculated by percentage.ResultsTwo hundred eighty-six pelvic sides (n = 286) were analyzed, and 267 (93.3 %) were classified into I–IV types. Among them, the most common origin was type IV (n = 89, 31.1 %), followed by type I (n = 82, 28.7 %), type III (n = 54, 18.9 %), and type II (n = 42, 14.7 %). Type V anatomy was seen in 16 cases (5.6 %). Double vascularization, defined as two independent prostatic branches in one pelvic side, was seen in 23 cases (8.0 %).ConclusionsDespite the large number of possible anatomical variations of male pelvis, four main patterns corresponded to almost 95 % of the cases. Evaluation of anatomy in a systematic fashion, following a standard classification, will make PAE a faster, safer, and more effective procedure

  8. Pelvic Arterial Anatomy Relevant to Prostatic Artery Embolisation and Proposal for Angiographic Classification

    Energy Technology Data Exchange (ETDEWEB)

    Assis, André Moreira de, E-mail: andre.maa@gmail.com; Moreira, Airton Mota, E-mail: motamoreira@gmail.com; Paula Rodrigues, Vanessa Cristina de, E-mail: vanessapaular@yahoo.com.br [University of Sao Paulo Medical School, Interventional Radiology and Endovascular Surgery Department, Radiology Institute (Brazil); Harward, Sardis Honoria, E-mail: sardis.harward@merit.com [The Dartmouth Center for Health Care Delivery Science (United States); Antunes, Alberto Azoubel, E-mail: antunesuro@uol.com.br; Srougi, Miguel, E-mail: srougi@usp.br [University of Sao Paulo Medical School, Urology Department (Brazil); Carnevale, Francisco Cesar, E-mail: fcarnevale@uol.com.br [University of Sao Paulo Medical School, Interventional Radiology and Endovascular Surgery Department, Radiology Institute (Brazil)

    2015-08-15

    PurposeTo describe and categorize the angiographic findings regarding prostatic vascularization, propose an anatomic classification, and discuss its implications for the PAE procedure.MethodsAngiographic findings from 143 PAE procedures were reviewed retrospectively, and the origin of the inferior vesical artery (IVA) was classified into five subtypes as follows: type I: IVA originating from the anterior division of the internal iliac artery (IIA), from a common trunk with the superior vesical artery (SVA); type II: IVA originating from the anterior division of the IIA, inferior to the SVA origin; type III: IVA originating from the obturator artery; type IV: IVA originating from the internal pudendal artery; and type V: less common origins of the IVA. Incidences were calculated by percentage.ResultsTwo hundred eighty-six pelvic sides (n = 286) were analyzed, and 267 (93.3 %) were classified into I–IV types. Among them, the most common origin was type IV (n = 89, 31.1 %), followed by type I (n = 82, 28.7 %), type III (n = 54, 18.9 %), and type II (n = 42, 14.7 %). Type V anatomy was seen in 16 cases (5.6 %). Double vascularization, defined as two independent prostatic branches in one pelvic side, was seen in 23 cases (8.0 %).ConclusionsDespite the large number of possible anatomical variations of male pelvis, four main patterns corresponded to almost 95 % of the cases. Evaluation of anatomy in a systematic fashion, following a standard classification, will make PAE a faster, safer, and more effective procedure.

  9. Anterior and posterior tibial anesthetic block in diabetic foot surgery.

    Directory of Open Access Journals (Sweden)

    José Julio Ojeda González

    2004-12-01

    Full Text Available Fundament: Diabetes Mellitus is a disease of high and increasing prevalence and its complications follow a parallel course. Its morbidity is derived from its own complications which are produced at a long or short term and peripheral vascular disease hihglights among them.Objective: to check the usefulness of the anterior and posterior blockade of the tibia for the surgery of the diabetic foot. Method: Prospective study carried out from January to December 2003 at the University Hospital ¨Dr. Gustavo Aldereguía Lima¨ to patients who are carriers of a diabetic foot and who were initially assisted at the service of Angiology and later at the service of Anesthesiology when the surgical procedures were decided. All the patients were applied an anterior and posterior blockade of the tibial nerve . The variables measured were: age, weight, height, surgical time, type of surgery, cardiac frequency medium arterial pressure, and classification of patients according to the American Association of Anesthesiology All the patients were applied a scale for assessing pain in three different moments.Result: There was a predominance of females . The blockade of the posterior tibial nerve with lidocaine 1 % in different points permitted the performance of the surgical techniques proposed. The anesthetic procedure was favorable, and economic since the patients did not requiere of the use of analgesic in the post operatory stage.

  10. Monocortical Deep Circumflex Iliac Artery Flap in Jaw Reconstruction.

    Science.gov (United States)

    Moon, Seong-Yong

    2015-06-01

    Conventionally deep circumflex iliac artery (DCIA) flap had been harvested as bicortical form. However, several complications and adverse effects occurred such as abnormal hip contour, hernia, severe bleeding tendency, gait disturbance, and hypoesthesia. All the 9 patients required reconstruction of the jaw with microvascular free flaps after radical resection. Monocortical bone segment was harvested from the anterior iliac crest, and the amount of bone harvested was from 47 to 90 mm (mean, 63 ± 14.6). Monocortical deep circumflex iliac artery flap has sufficient advantages in donor-site morbidity, which is one of the factors to choose flap. PMID:26080179

  11. Uncontrolled Epistaxis Secondary to Traumatic Pseudoaneurysm of the Maxillary Artery

    Directory of Open Access Journals (Sweden)

    Eelam Adil

    2011-01-01

    Full Text Available We describe a rare case of traumatic pseudoaneurysm of the maxillary artery following a fall. The patient presented with epistaxis that could not be controlled with anterior and posterior nasal packing. She was urgently taken to the angiography suite for evaluation and ultimately underwent embolization of a left maxillary artery pseudoaneurysm with 500–700 micron Contour PVA followed by coiling with two 3 mm Tornado coils. Bleeding subsided after embolization, and the patient suffered no neurologic sequelae.

  12. Spontaneous coronary artery dissection as the first presentation of systemic lupus erythematosus.

    Science.gov (United States)

    Reddy, Sravan; Vaid, Tejasvini; Ganiga Sanjeeva, Naveen Chandra; Shetty, Ranjan K

    2016-01-01

    A 33-year-old woman with no premorbidities presented to us with chest pain and worsening dyspnoea since 1 week. Systemic examination was suggestive of acute pulmonary oedema and preliminary investigations revealed evolved anterior wall myocardial infarction (MI). The patient was stabilised and taken up for angiography which revealed spontaneous coronary artery dissection (SCAD) of the left anterior descending (LAD) artery. She underwent percutaneous coronary intervention (PCI) for the same. Further investigation into the cause for the SCAD came strongly positive for systemic lupus erythematosus (SLE). She had no prior symptoms suggestive of SLE and the SCAD was its very first clinical manifestation. PMID:27558190

  13. Morphology of atherosclerotic coronary arteries

    Science.gov (United States)

    Holme, Margaret N.; Schulz, Georg; Deyhle, Hans; Hieber, Simone Elke; Weitkamp, Timm; Beckmann, Felix; Herzen, Julia; Lobrinus, Johannes A.; Montecucco, Fabrizio; Mach, François; Zumbuehl, Andreas; Saxer, Till; Müller, Bert

    2012-10-01

    Atherosclerosis, the narrowing of vessel diameter and build-up of plaques in coronary arteries, leads to an increase in the shear stresses present, which can be used as a physics-based trigger for targeted drug delivery. In order to develop appropriate nanometer-size containers, one has to know the morphology of the critical stenoses with isotropic micrometer resolution. Micro computed tomography in absorption and phase contrast mode provides the necessary spatial resolution and contrast. The present communication describes the pros and cons of the conventional and synchrotron radiation-based approaches in the visualization of diseased human and murine arteries. Using registered datasets, it also demonstrates that multi-modal imaging, including established histology, is even more powerful. The tomography data were evaluated with respect to cross-section, vessel radius and maximal constriction. The average cross-section of the diseased human artery (2.31 mm2) was almost an order of magnitude larger than the murine one (0.27 mm2), whereas the minimal radius differs only by a factor of two (0.51 mm versus 0.24 mm). The maximal constriction, however, was much larger for the human specimen (85% versus 49%). We could also show that a plastic model used for recent experiments in targeted drug delivery represents a very similar morphology, which is, for example, characterized by a maximal constriction of 82%. The tomography data build a sound basis for flow simulations, which allows for conclusions on shear stress distributions in stenosed blood vessels.

  14. Early results of coronary artery bypass grafting with coronary endarterectomy for severe coronary artery disease

    Directory of Open Access Journals (Sweden)

    Toischer Karl

    2009-09-01

    Full Text Available Abstract Background Despite the existence of controversial debates on the efficiency of coronary endarterectomy (CE, it is still used as an adjunct to coronary artery bypass grafting (CABG. This is particularly true in patients with endstage coronary artery disease. Given the improvements in cardiac surgery and postoperative care, as well as the rising number of elderly patient with numerous co-morbidities, re-evaluating the pros and cons of this technique is needed. Methods Patient demographic information, operative details and outcome data of 104 patients with diffuse calcified coronary artery disease were retrospectively analyzed with respect to functional capacity (NYHA, angina pectoris (CCS and mortality. Actuarial survival was reported using a Kaplan-Meyer analysis. Results Between August 2001 and March 2005, 104 patients underwent coronary artery bypass grafting (CABG with adjunctive coronary endarterectomy (CE in the Department of Thoracic-, Cardiac- and Vascular Surgery, University of Goettingen. Four patients were lost during follow-up. Data were gained from 88 male and 12 female patients; mean age was 65.5 ± 9 years. A total of 396 vessels were bypassed (4 ± 0.9 vessels per patient. In 98% left internal thoracic artery (LITA was used as arterial bypass graft and a total of 114 vessels were endarterectomized. CE was performed on right coronary artery (RCA (n = 55, on left anterior descending artery (LAD (n = 52 and circumflex artery (RCX (n = 7. Ninety-five patients suffered from 3-vessel-disease, 3 from 2-vessel- and 2 from 1-vessel-disease. Closed technique was used in 18%, open technique in 79% and in 3% a combination of both. The most frequent endarterectomized localization was right coronary artery (RCA = 55%. Despite the severity of endstage atherosclerosis, hospital mortality was only 5% (n = 5. During follow-up (24.5 ± 13.4 months, which is 96% complete (4 patients were lost caused by unknown address 8 patients died (cardiac

  15. Anterior capsular rupture following blunt ocular injury

    OpenAIRE

    Gremida, Anas; Kassem, Iris; Traish, Aisha

    2011-01-01

    A 10-year-old boy suffered a large, oblique anterior capsular tear following blunt injury to his right eye. The boy was followed daily for hyphema resolution and progressive traumatic cataract formation. After the hyphema had resolved, the lens was removed using an anterior approach and an intraocular lens was placed with excellent visual outcome.

  16. Dentulous Appliance for Upper Anterior Edentulous Span

    OpenAIRE

    Chalakkal, Paul; Devi, Ramisetty Sabitha; Srinivas, G Vijay; Venkataramana, Pammi

    2013-01-01

    This article discusses about a fixed dentulous appliance that was constructed to replace the primary upper anterior edentulous span in a four year old girl. It constituted a design, whereby the maxillary primary second molars were used to support the appliance through bands and a wire that contained an acrylic flange bearing trimmed acrylic teeth, anteriorly. The appliance was functionally and aesthetically compliant.

  17. Anterior cervical hypertrichosis: a sporadic case.

    Science.gov (United States)

    Bostan, Sezen; Yaşar, Şirin; Serdar, Zehra Aşiran; Gizlenti, Sevda

    2016-03-01

    Anterior cervical hypertrichosis is a very rare form of primary localized hypertrichosis. It consists of a tuft of terminal hair on the anterior neck just above the laryngeal prominence. The etiology is still unknown. In this article, we reported a 15-year-old female patient who presented to our clinic with a complaint of hypertrichosis on the anterior aspect of the neck for the last five years. Her past medical history revealed no pathology except for vesicoureteral reflux. On the basis of clinical presentation, our patient was diagnosed with anterior cervical hypertrichosis and she was considered to be a sporadic case due to lack of other similar cases in familial history. To date, 33 patients with anterior cervical hypertrichosis have been reported. Anterior cervical hypertrichosis can be associated with other abnormalities, but it frequently presents as an isolated defect (70%). The association of vesicoureteral reflux and anterior cervical hypertrichosis which was observed in our patient might be coincidental. So far, no case of anterior cervical hypertrichosis associated with vesicoureteral reflux has been reported in the literature. PMID:27103865

  18. Duplication of hepatic artery

    Directory of Open Access Journals (Sweden)

    Saeed Muhammad

    2001-01-01

    Full Text Available Background: The hepatic arterial anatomy is aberrant in almost 33-41% of individuals. The variant arterial anatomy recognized during routine cadaveric dissection offers great learning potential. Such findings provide an alternative perspective to view common morphology and its structural and functional importance. These impart the concept of patient individuality and subsequent individualization of medical and surgical therapies. Adequate knowledge of normal and abnormal arterial anatomy is essential for peripancreatic surgery and liver transplantation. Aims of the study: To report on hepatic artery variations observed in the dissecting room and to find out the macroscopic pattern of varied human hepatic arterial vascularization by cadaveric dissection. Patients and Methods: Twenty human cadavers of caucasian origin were dissected to study the source and topographic pattern of hepatic arterial supply. Results: Nineteen cadavers exhibited typical hepatic arterial supply from the celiac axis. Only one female body out of twenty cadavers exhibited a dual arterial supply to all parts of liver and gallbladder. One artery originated from the celiac axis whereas the other was given off by the superior mesenteric artery. Conclusion: No doubt, aberrant hepatic vascularization should be assessed preoperatively by invasive and noninvasive techniques to avoid fatal complications, but we favour careful dissection over angiography as a means of defining the arterial anatomy.

  19. Spontaneous coronary artery dissection in a young man - Case report

    Directory of Open Access Journals (Sweden)

    Auer Johann

    2011-03-01

    Full Text Available Abstract A 31 year old man with a 17-year-history of drug abuse (heroine and cannabis was admitted with recurrent chest pain over a period of about three weeks. Chest discomfort severely worsened during the 5 hours before hospital admission. Electrocardiography revealed poor R-wave progression and non specific repolarization abnormalities. Echocardiography showed extensive left ventricular anterior and apical wall motion abnormalities and a ventricular thrombus located at the apex of the left ventricle was present. Subsequently, a diagnosis of acute coronary syndrome was made. Coronary angiography revealed spontaneous coronary artery dissection of the left anterior descending (LAD artery with Thrombolysis In Myocardial Infarction (TIMI flow 2 to 3. We managed the patient conservatively. The clinical course was uneventful and repeated angiography on day 4 demonstrated spontaneous healing of large parts of the dissection with TIMI 3 flow in the LAD.

  20. Acute occlusion of the left subclavian artery with artery dissection

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    @@ Subclavian steal syndrome is cerebral or brain stem ischemia resulting from diversion of blood flow from the basilar artery to the subclavian artery, which is caused by occlusive disease of either the subclavian artery or the innominate artery before they branch off at the vertebral artery. In the patients with subclavian steal syndrome the subclavian artery is fed by retrograde flow from the vertebral artery via the carotids and the circle of Willis.

  1. Isolated single coronary artery presenting as acute coronary syndrome: case report and review.

    Science.gov (United States)

    Mahapatro, Anil K; Patro, A Sarat K; Sujatha, Vipperala; Sinha, Sudhir C

    2014-06-01

    Congenital single coronary artery is commonly associated with complex congenital heart diseases and manifests in infancy or childhood. But isolated single coronary artery is a rare congenital anomaly which can present as acute coronary syndrome in adults. The aim of the work is to discuss on isolated single coronary artery in two adults presenting as acute coronary syndrome. The first case underwent coronary angiography (CAG) through right radial route, but switched over to femoral for confirmation of diagnosis and due to radial spasm. An aortic root angiogram was done to rule out presence of any other coronary ostia. It revealed a single coronary artery originating from right sinus of valsalva. After giving rise to posterior descending artery branch at crux, it continued in the atrioventricular groove to the anterior basal surface of the heart and traversed as anterior descending artery. There was no atheromatous occlusive stenosis. This is R-I type single coronary artery as per Lipton classification. In the second case, angiography was completed through right radial route. It revealed a single coronary artery arising from right aortic sinus. Anterior descending and circumflex branch were originating from proximal common trunk of the single coronary artery and supplying the left side of the heart. The right coronary artery has diffuse atheromatous disease without significant stenosis in any major branch. This is R-III C type as per Lipton classification. A coronary anomaly of both origin and course is very rare. It may be encountered in adults evaluated for atherosclerotic coronary heart disease. Knowledge and understanding of anatomical types of this congenital anomaly will reduce time, anxiety, complications during CAG and cardiac surgery. PMID:25075168

  2. Emergency endovascular revascularization of tandem occlusions: Internal carotid artery dissection and intracranial large artery embolism.

    Science.gov (United States)

    Cohen, José E; Leker, Ronen R; Eichel, Roni; Gomori, Moshe; Itshayek, Eyal

    2016-06-01

    Internal carotid artery dissection (ICAD) with concomitant occlusive intracranial large artery emboli is an infrequent cause of acute stroke, with poor response to intravenous thrombolysis. Reports on the management of this entity are limited. We present our recent experience in the endovascular management of occlusive ICAD and major intracranial occlusion. Consecutive anterior circulation acute stroke patients meeting Medical Center criteria for endovascular management of ICAD from June 2011 to June 2015 were included. Clinical, imaging, and procedure data were collected retrospectively under Institutional Review Board approval. The endovascular procedure for carotid artery revascularization and intracranial stent thrombectomy is described. Six patients met inclusion criteria (National Institutes of Health Stroke Scale score 12-24, time from symptom onset 2-8hours). Revascularization of the extracranial carotid dissection and stent thrombectomy were achieved in 5/6 patients, resulting in complete recanalization (Thrombolysis in Myocardial Infarction flow grade 3 in a mean 2.7hours), and modified Rankin Scale score 0-2 at 90 day follow-up. In one patient, attempts to microcatheterize the true arterial lumen failed and thrombectomy was therefore not feasible. No arterial dissection, arterial rupture or accidental stent detachment occurred, and there was no intracerebral hemorrhage or hemorrhagic transformation. Our preliminary data on this selected subgroup of patients suggest the presented approach is safe, feasible in a significant proportion of patients, and efficacious in achieving arterial recanalization and improving patient outcome. Crossing the dissected segment remains the most important limiting factor in achieving successful ICA recanalization. Further evaluation in larger series is warranted. PMID:26924182

  3. Prevalence of anomalous origin of coronary arteries: a retrospective study in a Portuguese population.

    Science.gov (United States)

    Correia, Emanuel; Ferreira, Pedro; Rodrigues, Bruno; Santos, Luís; Faria, Rita; Nunes, Luís; Pipa, João; Cabral, J Costa; Santos, J Oliveira

    2010-02-01

    The definition, prevalence, classification and clinical relevance of anomalous origin of coronary arteries (AOCA) are still the subject of debate. Most international series estimate its prevalence at 1-2% but we found values ranging from 0.3 to 5.6% in the literature. The prevalence in our population was 0.54%, absence of the left main coronary artery being the most common anomaly (0.38%.). There were two cases involving the circumflex artery, one the anterior descending artery, two of the left main artery originating from the right coronary sinus, and one of the right coronary artery originating from the left coronary sinus. The aim of this retrospective study was to assess the prevalence of AOCA in an unselected population undergoing coronary angiography and to characterize that population. PMID:20545249

  4. Cortex-sparing infarction in triple cervical artery dissection following chiropractic neck manipulation

    Science.gov (United States)

    Melikyan, Gayane; Kamran, Saadat; Akhtar, Naveed; Deleu, Dirk; Miyares, Francisco Ruiz

    2015-01-01

    Background: Multivessel cervical dissection with cortical sparing is exceptional in clinical practice. Case presentation: A 55-year-old man presented with acute-onset neck pain with associated sudden onset right-sided hemiparesis and dysphasia after chiropractic manipulation for chronic neck pain. Results and Discussion: Magnetic resonance imaging revealed bilateral internal carotid artery dissection and left extracranial vertebral artery dissection with bilateral anterior cerebral artery territory infarctions and large cortical-sparing left middle cerebral artery infarction. This suggests the presence of functionally patent and interconnecting leptomeningeal anastomoses between cerebral arteries, which may provide sufficient blood flow to salvage penumbral regions when a supplying artery is occluded. Conclusion: Chiropractic cervical manipulation can result in catastrophic vascular lesions preventable if these practices are limited to highly specialized personnel under very specific situations. PMID:26835412

  5. CMR Assessment of endothelial damage and angiogenesis in porcine coronary arteries using gadofosveset

    OpenAIRE

    Falk Erling; Thim Troels; Paaske William P; Thrysøe Samuel A; Pedersen Steen F; Ringgaard Steffen; Kim Won Y

    2011-01-01

    Abstract Background Endothelial damage and angiogenesis are essential for atherosclerotic plaque development and destabilization. We sought to examine whether contrast enhanced cardiovascular magnetic resonance (CMR) using gadofosveset could show endothelial damage and neovessel formation in balloon injured porcine coronary arteries. Methods and Results Data were obtained from seven pigs that all underwent balloon injury of the left anterior descending coronary artery (LAD) to induce endothel...

  6. A new puncture needle (Seldinger technique) for easy antegrade catheterization of the superficial femoral artery

    International Nuclear Information System (INIS)

    Mainly for anatomical reasons a guide-wire or a catheter has a tendency to turn into the deep femoral artery during antegrade catheterization of the lower limb. To overcome this problem a curved puncture needle has been designed which allows positioning of the guide-wire in an anterior direction. Antegrade catheterization of the superficial femoral artery was achieved in 25 patients without lengthy manipulations or complications. With this technique the rate of complications at antegrade catheterization will probably be reduced. (orig.)

  7. Anterior Shoulder Instability with Concomitant Superior Labrum from Anterior to Posterior (SLAP) Lesion Compared to Anterior Instability without SLAP Lesion

    Science.gov (United States)

    Durban, Claire Marie C.; Kim, Je Kyun; Kim, Sae Hoon

    2016-01-01

    Background The aims of this study were to investigate the clinical characteristics of patients with combined anterior instability and superior labrum from anterior to posterior (SLAP) lesions, and to analyze the effect of concomitant SLAP repair on surgical outcomes. Methods We retrospectively reviewed patients who underwent arthroscopic stabilization for anterior shoulder instability between January 2004 and March 2013. A total of 120 patients were available for at least 1-year follow-up. Forty-four patients with reparable concomitant detached SLAP lesions (group I) underwent combined SLAP and anterior stabilization, and 76 patients without SLAP lesions (group II) underwent anterior stabilization alone. Patient characteristics, preoperative and postoperative pain scores, Rowe scores, and shoulder ranges of motion were compared between the 2 groups. Results Patients in group I had higher incidences of high-energy trauma (p = 0.03), worse preoperative pain visual analogue scale (VAS) (p = 0.02), and Rowe scores (p = 0.04). The postoperative pain VAS and Rowe scores improved equally in both groups without significant differences. Limitation in postoperative range of motion was similar between the groups (all p-value > 0.05). Conclusions Anterior instability with SLAP lesion may not be related to frequent episodes of dislocation but rather to a high-energy trauma. SLAP fixation with anterior stabilization procedures did not lead to poor functional outcomes if appropriate surgical techniques were followed. PMID:27247742

  8. Arterial blood architecture of the maxillary sinus in dentate specimens

    OpenAIRE

    Kqiku, Lumnije; Biblekaj, Robert; Weiglein, Andreas H.; Kqiku, Xhylsime; Städtler, Peter

    2013-01-01

    Aim To describe vascular anatomy of the maxillary sinus in dentate specimens dissected from human cadavers. Methods Twenty dentate maxillary specimens were dissected, anatomically prepared, and injected with liquid latex for a better visualization of the maxillary sinus artery. Results We found an intraosseous anastomosis in 100% and an extraosseous anastomosis in 90% of the cases. The anterior lateral wall of the maxillary sinus was transversed by two anastomoses between the posterior superi...

  9. Isolated intermittent vertigo: A presenting feature of persistent trigeminal artery

    OpenAIRE

    Rajsrinivas Parthasarathy; Carol Derksen; Maher Saqqur; Khurshid Khan

    2016-01-01

    Embryonic carotid – basilar anastomosis when persistent in adult life can present with a variety of neurological symptoms. We present a patient with isolated intermittent vertigo attributable to the embryonic anastomosis and describe the different types of persistent trigeminal artery. A 76-year-old Caucasian man presented with isolated intermittent vertigo and symptoms suggestive of anterior and posterior circulation strokes. Impaired vasomotor reactivity was demonstrated on insonation of th...

  10. Clarifying the anatomy of the fifth arch artery

    Directory of Open Access Journals (Sweden)

    Saurabh Kumar Gupta

    2016-01-01

    Full Text Available The artery allegedly forming in the fifth pharyngeal arch has increasingly been implicated as responsible for various vascular malformations in patients with congenitally malformed hearts. Observations from studies on developing embryos, however, have failed to provide support to substantiate several of these inferences such that the very existence of the fifth arch artery remains debatable. To the best of our knowledge, in only a solitary human embryo has a vascular channel been found that truly resembled the artery of the fifth arch. Despite the meager evidence to support its existence, the fifth arch artery has been invoked to explain the morphogenesis of double-barreled aorta, some unusual forms of aortopulmonary communications, and abnormalities of the brachiocephalic arteries. In most of these instances, the interpretations have proved fallible when examined in the light of existing knowledge of cardiac development. In our opinion, there are more plausible alternative explanations for the majority of these descriptions. Double-barreled aorta is more likely to result from retention of the recently identified dorsal collateral channels while abnormalities of brachiocephalic arteries are better explained on the basis of extensive remodeling of aortic arches during fetal development. Some examples of aortopulmonary communications, nonetheless, may well represent persistence of the developing artery of the fifth pharyngeal arch. We here present one such case - a patient with tetralogy of Fallot and pulmonary atresia, in whom the fifth arch artery provided a necessary communication between the ascending aorta and the pulmonary arteries. In this light, we discuss the features we consider to be essential before attaching the tag of "fifth arch artery" to a candidate vascular channel.

  11. La hemiplejia en el reblandecimiento anterior del bulbo

    Directory of Open Access Journals (Sweden)

    J. O. Trelles

    1971-03-01

    Full Text Available A propósito de un caso de reblandecimiento limitado al territorio arterial anterior y mediano del bulbo que se traducía, clínicamente, por una hemiplejía controlateral con trastornos sensitivos y ausencia de compromiso del facial o de la lengua, y del análisis de 8 casos anatomo-clínicos encontrados en una revisión bibliográfica, los autores discuten el problema de la irrigación arterial del bulbo, el cuadro clínico y el tan debatido asunto de la pretendida flaccidez de estas hemiplejias. Desde el punto de vista de la vascularización arterial del bulbo, se insiste en que ésta es compleja y variable según que se trate del sector oral contiguo a la protuberancia, del sector caudal contiguo a la médula o del sector intermediario a los dos. Desde el punto de vista clínico, en los casos típicos, se trata de una hemiplejia espástica con trastornos sensitivos sin compromiso del facial, ni del hipogloso. De los nueve casos anatomo-clínicos registrados hasta el presente, seis con larga sobrevida, presentaron hemiplejia espástica; dos, con sobrevidas cortas, se encontraban en la etapa de transición hacia la espasticidad; uno con lesiones extensas presentó una flaccidez permanente. En lo que se refiere al problema de la pretendida flaccidez de estas hemiplejias vemos que las hemiplejías bulbares no escapan a la regla de las lesiones del haz piramidal, las que después de una primera etapa de flaccidez evolucionan hacia la espasticidad. Por tanto las conclusiones doctrinarias referentes al haz piramidal basadas en ésta pretendida flaccidez de la hemiplejía bulbar son erróneas y deben revisarse.

  12. Scintigraphic anatomy of coronary artery disease in digital thallium-201 myocardial images

    International Nuclear Information System (INIS)

    One hundred and eight patients with single and multiple vessel coronary artery disease confirmed by arteriography were evaluated by exercise thallium-201 (201Tl) myocardial scintigraphy to determine the scintigraphic appearances of specific coronary stenoses. In general proximal stenoses caused more widespread, but not necessarily more severe, myocardial tracer deficit, than distal stenoses. In particular, proximal dominant right coronary artery disease was specifically associated with extensive inferior wall tracer deficit in the anterior scintigram, whereas proximal left circumflex disease caused similar tracer depletion best visualised in the left lateral scintigram. A triad of uptake defects was caused by left anterior descending coronary artery disease; one of these defects called 'diagonal window tracer deficit' was the most useful scintigraphic sign distinguishing proximal from distal disease in the left anterior descending coronary artery. Certain scintigraphic patterns of 201Tl myocardial accumulation appear invaluable in the noninvasive localisation of stenoses within specific coronary arteries and thus may be useful in predicting life-threatening coronary artery disease which should be confirmed by definitive coronary arteriography. The digital 201Tl myocardial scintigram also provides an independent functional guide to the interpretation of coronary arteriograms and may be helpful in the planning of aortocoronary bypass graft surgery. (author)

  13. Left ventricular diastolic function in patients with coronary artery disease

    International Nuclear Information System (INIS)

    In 302 patients with confirmed coronary disease we determined the left ventricular diastolic function with the Nuclear Stethoscope by the aid of the Peak Filling Rate (PFR) and the Time to Peak Filling Rate (TPFR). Moreover we investigated the ejection fraction (EF). 201 patients had already suffered a myocardial infarction, of these 99 an anterior wall and 102 an inferior wall infarction. The remaining 101 patients had a CAD without a history of myocardial infarction. The PFR was 2.19 ± 0.65 EDV/sec in the 99 patients after anterior wall infarction and 2.62 ± 0.85 EDV/sec in the 102 patients after inferior wall infarction and 2.79 ± 0.85 EDV/sec in 101 patients with coronary artery disease without a history of myocardial infarction. For the PFR there could be found a statistically significant difference between normal patients and patients after anterior wall infarction (p < 0.0001), normal patients and patients after inferior wall infarction (p < 0.0001) and normal patients and patients with coronary artery disease (p < 0.0001). The TPFR was 180 ± 37.5 msec after anterior - and 158 ± 50.7 msec after inferior wall infarction and 156 ± 45.2 msec in the patients with CAD without previous infarction. The left ventricular diastolic function (PFR and/or TPFR) was abnormal in 88% after anterior- and in 82% after inferior wall infarction and in 69% in coronary patients without previous myocardial infarction. In comparison with this the ejection fraction was reduced in 66% in anterior- and in 61% inferior wall infarction at rest. These results indicate that the diastolic function at rest appears to be more informative for evaluation of a left ventricular dysfunction than the systolic function at rest. (orig.)

  14. Left ventricular diastolic function in patients with coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Brugger, P.T.

    1986-08-01

    In 302 patients with confirmed coronary disease we determined the left ventricular diastolic function with the Nuclear Stethoscope by the aid of the Peak Filling Rate (PFR) and the Time to Peak Filling Rate (TPFR). Moreover we investigated the ejection fraction (EF). 201 patients had already suffered a myocardial infarction, of these 99 an anterior wall and 102 an inferior wall infarction. The remaining 101 patients had a CAD without a history of myocardial infarction. The PFR was 2.19 +- 0.65 EDV/sec in the 99 patients after anterior wall infarction and 2.62 +- 0.85 EDV/sec in the 102 patients after inferior wall infarction and 2.79 +- 0.85 EDV/sec in 101 patients with coronary artery disease without a history of myocardial infarction. For the PFR there could be found a statistically significant difference between normal patients and patients after anterior wall infarction (p < 0.0001), normal patients and patients after inferior wall infarction (p < 0.0001) and normal patients and patients with coronary artery disease (p < 0.0001). The TPFR was 180 +- 37.5 msec after anterior - and 158 +- 50.7 msec after inferior wall infarction and 156 +- 45.2 msec in the patients with CAD without previous infarction. The left ventricular diastolic function (PFR and/or TPFR) was abnormal in 88% after anterior- and in 82% after inferior wall infarction and in 69% in coronary patients without previous myocardial infarction. In comparison with this the ejection fraction was reduced in 66% in anterior- and in 61% inferior wall infarction at rest. These results indicate that the diastolic function at rest appears to be more informative for evaluation of a left ventricular dysfunction than the systolic function at rest.

  15. Anterior retropharyngeal approach to the cervical spine.

    OpenAIRE

    Behari S; Banerji D; Trivedi P; Jain V; Chhabra D

    2001-01-01

    The anterior retropharyngeal approach (ARPA) accesses anteriorly situated lesions from the clivus to C3, in patients with a short neck, Klippel Feil anomaly or those in whom the C2-3 and C3-4 disc spaces are situated higher in relation to the hyoid bone and the angle of mandible where it is difficult to approach this region using the conventional anterior approach, due to the superomedial obliquity of the trajectory. The ARPA avoids the potentially contaminated oropharyngeal cavity providing ...

  16. Mini-open anterior lumbar interbody fusion.

    Science.gov (United States)

    Gandhoke, Gurpreet S; Ricks, Christian; Tempel, Zachary; Zuckerbraun, Brian; Hamilton, D Kojo; Okonkwo, David O; Kanter, Adam S

    2016-07-01

    In deformity surgery, anterior lumbar interbody fusion provides excellent biomechanical support, creates a broad surface area for arthrodesis, and induces lordosis in the lower lumbar spine. Preoperative MRI, plain radiographs, and, when available, CT scan should be carefully assessed for sacral slope as it relates to pubic symphysis, position of the great vessels (especially at L4/5), disc space height, or contraindication to an anterior approach. This video demonstrates the steps in an anterior surgical procedure with minimal open exposure. The video can be found here: https://youtu.be/r3bC4_vu1hQ . PMID:27364424

  17. Celiac Artery Compression Syndrome

    Directory of Open Access Journals (Sweden)

    Mohammed Muqeetadnan

    2013-01-01

    Full Text Available Celiac artery compression syndrome is a rare disorder characterized by episodic abdominal pain and weight loss. It is the result of external compression of celiac artery by the median arcuate ligament. We present a case of celiac artery compression syndrome in a 57-year-old male with severe postprandial abdominal pain and 30-pound weight loss. The patient eventually responded well to surgical division of the median arcuate ligament by laparoscopy.

  18. Popliteal artery entrapment syndrome.

    LENUS (Irish Health Repository)

    O'Leary, D P

    2010-01-01

    Popliteal artery entrapment syndrome is a rare abnormality of the anatomical relationship between the popliteal artery and adjacent muscles or fibrous bands in the popliteal fossa. The following is a case report of a 19 year old female, in whom popliteal artery entrapment syndrome was diagnosed, and successfully treated surgically. A review of literature is also presented and provides details on how PAES is classified, diagnosed both clinically and radiologically, and treated surgically.

  19. Coeliac artery compression syndrome

    OpenAIRE

    OKTAY, Özgür; MEMİŞ, Ahmet; Parildar, Mustafa; Oran, İsmail

    2003-01-01

    Celiac artery compression syndrome, also called median arcuate ligament compression syndrome, causes gastrointestinal ischemia secondary to compression of the proximal portion of the celiac artery just beyond its origin by the median arcuate ligament of the diaphragm. This syndrome is frequently demonstrated on aortography performed in patients without complaints of intestinal angina. Isolated stenosis or even occlusion of the celiac artery is always compensated for by collateral circul...

  20. High-Risk Acute Coronary Syndrome in a Patient with Coronary Subclavian Steal Syndrome Secondary to Critical Subclavian Artery Stenosis

    Directory of Open Access Journals (Sweden)

    Zaher Fanari

    2014-01-01

    Full Text Available Patients with multivessel coronary artery disease are more likely to have extensive atherosclerosis that involves other major arteries. Critical subclavian artery (SCA stenosis can result in coronary subclavian steal syndrome that may present as recurrent ischemia and even myocardial infarction in patients with coronary artery bypass graft (CABG. In patients with concomitant severe native coronary disease, occluded saphenous venous grafts (SVG to other arteries, percutaneous intervention on critical subclavian artery (SCA stenosis that will compromise the blood flow to left internal mammary graft (LIMA and left anterior descending (LAD artery will be a high-risk procedure and may be associated with cardiogenic shock, especially in patients with preexisting ischemic cardiomyopathy. The use of percutaneous left ventricular (LV assist device like Impella will offer better hemodynamic support and coronary perfusion and therefore results in decreased myocardial damage, maximized residual cardiac function, and lower incidence of cardiogenic shock.

  1. Intrahepatic branching patterns of the right hepatic artery: analysis of anteroposterior and oblique views of the hepatic arteriography with the help of CT scan

    International Nuclear Information System (INIS)

    With the technical advancement in arterial embolization and subsegmental resection of liver neoplasm, emphasis has been on more detailed knowledge of normal arterial anatomy and its variation. We analysed the patterns of intrahepatic branches of right hepatic artery. We retrospectively analyzed intrahepatic branching patterns of right hepatic artery in 165 cases. All cases had a single right hepatic artery which could be traced up to tertiary branches, and also performed rapid drip infusion CT scan, hepatic arteriography with antero-posterior and oblique views, superior mesenteric arteriorgraphy and indirect portography. Intrahepatic branching patterns of the right hepatic artery had eight types of variation. The most common intrahepatic branching pattern was type I: 107 (64.5%) which represented 5, 8th branch emerging from the anterior segmental artery and 6, 7th branch from the posterior segmental artery. Type VII: 26 (15.8%) was the next common type which represented 6th branch emerging first from the posterior segmental artery and 7th branch emerging secondly from the posterior segmental artery. Type VII, VI, III were branched from the posterior segmental artery. Type IV, II, V were branched from the anterior segmental artery. These result could be helpful to the planning of treatment, such as hepatic subsegmentectomy or transarterial embolization of the hepatic neoplasm

  2. Imaging the vertebral artery

    Energy Technology Data Exchange (ETDEWEB)

    Tay, Keng Yeow; U-King-Im, Jean Marie; Trivedi, Rikin A.; Higgins, Nicholas J.; Cross, Justin J.; Antoun, Nagui M. [Addenbrooke' s Hospital and University of Cambridge, Department of Radiology, Cambridge (United Kingdom); Davies, John R.; Weissberg, Peter L. [Addenbrooke' s Hospital and University of Cambridge, Division of Cardiovascular Medicine, Cambridge (United Kingdom); Gillard, Jonathan H. [Addenbrooke' s Hospital and University of Cambridge, Department of Radiology, Cambridge (United Kingdom); Addenbrooke' s Hospitald, University Department of Radiology, Cambridge (United Kingdom)

    2005-07-01

    Although conventional intraarterial digital subtraction angiography remains the gold standard method for imaging the vertebral artery, noninvasive modalities such as ultrasound, multislice computed tomographic angiography and magnetic resonance angiography are constantly improving and are playing an increasingly important role in diagnosing vertebral artery pathology in clinical practice. This paper reviews the current state of vertebral artery imaging from an evidence-based perspective. Normal anatomy, normal variants and a number of pathological entities such as vertebral atherosclerosis, arterial dissection, arteriovenous fistula, subclavian steal syndrome and vertebrobasilar dolichoectasia are discussed. (orig.)

  3. Peripheral artery disease - legs

    Science.gov (United States)

    ... if they have a history of: Abnormal cholesterol Diabetes Heart disease (coronary artery disease) High blood pressure ( hypertension ) Kidney disease involving hemodialysis Smoking Stroke ( cerebrovascular disease )

  4. Secondary anterior crocodile shagreen of Vogt.

    Science.gov (United States)

    Tripathi, R C; Bron, A J

    1975-01-01

    The clincopathological features and pathogenesis of secondary mosaic degeneration of the cornea (anterior crocodile shagreen of Vogt) are described. The structural basis for the normal anterior corneal mosaic pattern seems to lie in the particular arrangement of many prominent collagen lamellae of the anterior stroma that thake an oblique course to gain insertion into Bowman's layer. Since, at normal intraocular pressure, Bowman's layer is under tension, when viewed from the anterior surface the cornea appears smooth. By releasing the tension, however, a reproducible polygonal ridge pattern becomes manifest. It is suggested that a prolonged phthisical state of the eye is one condition wherein the mosaic pattern may become permanent and that, as a secondary event, this is followed by irregular calcification of Bowman's layer which particularly involves the ridges projecting into the epithelium. Biomicroscopically these ridges corresponded to the branching reticular arrangement of the mosaic opacities. Images PMID:1079137

  5. Anterior Cervical Discectomy and Fusion with Plating

    Medline Plus

    Full Text Available Anterior Cervical Discectomy and Fusion with Plating Broward Health Medical Center Fort Lauderdale, FL November 17, 2011 I'm Dr. Matthew Moore, head of the Spine Care Center here at North Broward Medical Center. And ...

  6. Laser assisted internal mammary artery-coronary artery anastomosis - an experimental study

    Science.gov (United States)

    Zhu, Hong-Sheng; Zhang, Liang-ping; Feng, Lian

    2005-07-01

    Objective: To observe the time required for anastomosis and the reliability for pressure tolerance after internal mammay artery (IMA) -coronary artery anastomosis. Method: Eight sheep underwent thoracotomy and left IMA harvest. In group I (T) the IMA were anastomosed to left anterior descending artery (LAD) with 7-0 prolene suture (n=4) and in group II (LA) IMA were anastomosed to LAD with laser. Result: The time required for laser technique was shorter than that required in suturing technique [117.5+/-39.48min (total) and 38.25+/-6.23 min vs 62.5+/-37.83 min (total) and 20+/-6.53 min respectively ] (pthoracotomy both two groups endured the impact of pharmacologic vasopressor. No leakage at the anastomosed site was observed in both groups. After the closure of thoracotomy, well tolerance for both adrenalin and thoracic negative pressure was observed in the two groups. The peak systolic pressure induced by pharmacologic agent was similar in both groups. Neither stenosis nor thrombus or embolism was observed and immediate patency rate in both groups was 100%. Conclusion: Laser assisted technique seems to be favorable for patency rate and could lead to better result after coronary artery bypass grafting(CABG).

  7. Trypan blue dye for anterior segment surgeries

    OpenAIRE

    Jhanji, V; Chan, E.; Das, S.; Zhang, H; Vajpayee, R B

    2011-01-01

    Use of vital dyes in ophthalmic surgery has gained increased importance in the past few years. Trypan blue (TB) has been a popular choice among anterior segment surgeons mainly due to its safety, ease of availability, and remarkable ability to enable an easy surgery in difficult situations mostly related to visibility of the targeted tissue. It is being used in cataract surgery since nearly a decade and its utilization has been extended to other anterior segment surgeries like trabeculectomy ...

  8. Myocardial Bridging of the Right Coronary Artery inside the Right Atrial Myocardium Identified by ECG-gated 64-slice Multidetector Computed Tomography Angiography

    OpenAIRE

    Yung-Liang Wan; Ming-Shien Wen; Fen-Chiung Lin; Chen-Ju Fu; Huan-Wu Chen; Chien-Cheng Chen; Yuan-Chang Liu

    2010-01-01

    A myocardial bridge (MB) is defined as an intramyocardial course of a major epicardialcoronary artery, and it is mainly confined to the left ventricle and the left anterior descendingcoronary artery. There are rare reports of right coronary MB seen during angiographicexamination. Herein, we present a 49 year-old man with right coronary artery MB withoutluminal narrowing in the diastolic and systolic phases of electrocardiography-gated computedtomography images. The value of multi-detector com...

  9. Functional Outcomes of Primary Anterior Cruciate Ligament Reconstruction with Tibialis Anterior Allograft

    OpenAIRE

    Başar, Selda; Büyükafşar, Enes; Hazar, Zeynep; Ataoğlu, Baybars; Kanatlı, Ulunay

    2014-01-01

    Objectives: Allografts have potential advantages in primary anterior cruciate ligament reconstruction (ACLR), including the absence of donor site morbidity, shorter operative times, improved cosmesis, and easier rehabilitation. There is limited and conflicting outcome data for ACLR with tibialis anterior allograft. The purpose of this study was to evaluate the functional outcomes of ACLR with tibialis anterior allograft. Methods: We retrospectively evaluated patients underwent ACLR using with...

  10. Persistent trigeminal artery variants detected by MR angiography

    Energy Technology Data Exchange (ETDEWEB)

    Uchino, A.; Kato, A.; Takase, Y.; Kudo, S. [Dept. of Radiology, Saga Medical School (Japan)

    2000-11-01

    Persistent trigeminal artery (PTA) variants are cerebellar arteries that originate directly from the precavernous portion of the internal carotid artery (ICA). The goal of our study was to determine the incidence and MR angiographic features of PTA variants. Between April 1996 and September 1999, 523 cranial MR angiographies were performed at our institution. Most of the patients examined had or were suspected of having cerebrovascular disease. We retrospectively reviewed these 523 MR angiograms. A 1.5-T scanner was used in all studies, and maximum intensity projection (MIP) images obtained using the three-dimensional time-of-flight (3D TOF) technique were displayed stereoscopically. Four PTA variants were detected on MR angiograms, at a rate of 0.76 %. At least three of the four PTA variants were anterior inferior cerebellar arteries (AICAs), small tortuous arteries arising from the precavernous portions of the ICAs and taking a posterior course. Although the clinical significance is not great, we found a relatively high incidence of PTA variants on MR angiograms. We stress that knowledge and recognition of these anomalous cerebellar arteries are useful and important in the interpretation of cranial MR angiograms. (orig.)

  11. [Variability of the celiac artery and its branches in sheep].

    Science.gov (United States)

    Karmona, Kh; Kovachev, G

    1985-01-01

    Contrast matter was used with a total of 363 sheep fetuses, newborn lambs, and adult sheep to study the variability of the coeliac artery and its branches. It was found that the artery and some of its branches, such as arteria ruminalis sinistra, arteria reticularis, and arteria lienalis often showed variations, resp., deviations in their branching and distribution. Others, such as arteria ruminalis dextra and arteria hepatica showed no variations whatever. Both the coeliac artery and the anterior intestinal artery in the sheep were most often shown to branch from the aorta alone (in 71.07 per cent of the cases) as against the rarely observed common truncus coeliacomesentericus (in 28.93 per cent of the cases). The most commonly observed form of branching of arteria coeliaca seemed to be tripus coeliacus, while the branching with the formation of a short truncus hepatogastricus was comparatively a rare phenomenon. It was also established that the left ruminal artery was much more frequently the branch of truncus lienoruminalis than the branch of arteria gastrica sinistra. So far as the place in which arteria reticularis arose three variants were observed. Most frequently this artery was shown to be the branch of arteria gastrica sinistra. PMID:4013078

  12. Anterior Eye Imaging with Optical Coherence Tomography

    Science.gov (United States)

    Huang, David; Li, Yan; Tang, Maolong

    The development of corneal and anterior segment optical coherence tomography (OCT) technology has advanced rapidly in recently years. The scan geometry and imaging wavelength are both important choices to make in designing anterior segment OCT systems. Rectangular scan geometry offers the least image distortion and is now used in most anterior OCT systems. The wavelength of OCT light source affects resolution and penetration. An optimal choice of the OCT imaging wavelength (840, 1,050, or 1,310 nm) depends on the application of interest. Newer generation Fourier-domain OCT technology can provide scan speed 100-1000 times faster than the time-domain technology. Various commercial anterior OCT systems are available on the market. A wide spectrum of diagnostic and surgical applications using anterior segment OCT had been investigated, including mapping of corneal and epithelial thicknesses, keratoconus screening, measuring corneal refractive power, corneal surgery planning and evaluation in LASIK, intracorneal ring implantation, assessment of angle closure glaucoma, anterior chamber biometry and intraocular lens implants, intraocular lens power calculation, and eye bank donor cornea screening.

  13. Morphology of the middle rectal arteries. A study of 30 cadaveric dissections.

    Science.gov (United States)

    DiDio, L J; Diaz-Franco, C; Schemainda, R; Bezerra, A J

    1986-01-01

    The middle rectal arteries were studied in 30 cadavers of adult and older individuals (29 Caucasians and one Negro) of both sexes (15 males and 15 females). The middle rectal artery was present in 56.7% of the cases, bilaterally (36.7%) or unilaterally (20%), originating from the internal pudendal (40%), inferior gluteal (26.7%), internal iliac (16.8%), and less frequently from other pelvic branches. The average external diameter of the middle rectal artery was found to be 1.7 mm, its average length about 7 cm, and the point of penetration in the rectal wall about 6 cm (average) superior to the anus. The most frequent sites of the rectal wall pierced by the middle rectal arteries were the anterior (50% of the cases) and posterior (45%) quadrants of the rectum, whether isolated or combined (43.3%). These anatomical features justify, when needed and possible, the preservation of the middle rectal artery in surgical interventions on related organs. The term middle rectal arteries in Nomina Anatomica should be changed to inferior rectal arteries and indented under internal pudendal artery; the current term inferior rectal arteries should be changed to anal arteries to follow the already adopted division of the terminal intestine into rectum and anal canal. PMID:3107146

  14. [Functional-anatomical prerequisites of revascularization of the femoro-popliteal arterial segment].

    Science.gov (United States)

    Losev, R Z; Nikolenko, V N; Mikul'skaia, E G; Eliseev, A A; Burov, Iu A

    2008-01-01

    Improved results of surgical treatment of patients with critical ischemia of lower extremities can be obtained by using the collateral bed. The condition of the profound femoral artery and the popliteal artery, especially in the zone of its trifurcation, is of the greatest significance for the decision on the volume of surgery. The carrying capacity of the collateral bed of the profound femoral artery in occlusion of the femoral artery was on average 284 ml/min. A positive prognostic criterion of recovered circulation in the extremity using the profound femoral artery is preservation of the patent trifurcation of the popliteal artery and/or the anterior tibial artery. The blood flow volume along the profound femoral artery under the given functional-anatomical conditions should be not less than 150 ml/min. Semiclosed loop endarterectomy of the superficial femoral and popliteal arteries with multilevel lesions of the lower extremity arteries allows the main zones of the collateral bed of the femoro-popliteal-tibial segment to be included in the blood flow. PMID:18411661

  15. Upregulation of endothelin ETB receptor-mediated vasoconstriction in rat coronary artery after organ culture

    DEFF Research Database (Denmark)

    Eskesen, Karen; Edvinsson, Lars

    2006-01-01

    The aim of this study was to examine if endothelin ET(B) receptor-mediated contraction occurred in isolated segments of rat coronary arteries during organ culture. Presence of contractile endothelin ET(B) receptors was studied by measuring the change in isometric tension in rings of left anterior...

  16. Lesiones del ligamento cruzado anterior

    Directory of Open Access Journals (Sweden)

    Alejandro Álvarez López

    2015-01-01

    Full Text Available Fundamento: el ligamento cruzado anterior desempeña un papel muy importante en la estabili-dad de la rodilla. La incidencia de esta afección es alta en pacientes que practican deportes de contacto y de no ser tratados de forma adecuada, los resultados son desfavorables. Objetivo: profundizar en los factores necesarios para el tratamiento adecuado de enfermos con esta lesión y evitar las complicaciones. Método: se realizó una revisión bibliográfica de un total de 300 artículos publicados en Pubmed, Hinari y Medline mediante el localizador de información Endnote, de ellos se utilizaron 52 citas selecciona-das para realizar la revisión, 48 de ellas de los últimos cinco años donde se incluyeron seis libros. Desarrollo: se discuten los aspectos relacionados con el diagnóstico clínico e imaginológico. Se aborda la clasificación de esta lesión en cuanto a varios aspectos como: tiempo, lesión de ligamentos u ósea, aislada o combinada y parcial o total. Se mencionan los parámetros para obtener resultados satisfac-torios al considerar factores como la edad del enfermo, lesiones asociadas y tiempo de la lesión. Se relacio-nan los requisitos para la selección del implante y se mostró las ventajas y desventajas de cada tipo de in-jerto. Las complicaciones de esta cirugía están relacionadas con la técnica quirúrgica y médicas. Conclusiones: las lesiones del ligamento son entidades traumáticas que afectan por lo general a pacientes jóvenes. Para lograr un resultado satisfactorio en el tratamiento es necesario el conocimiento de su anatomía, clasificación, tipo de injerto a emplear según sus ventajas y desventajas.

  17. Ligation of the internal maxillary artery for intractable epistaxis. 3D imaging of internal maxillary artery using helical CT scan

    International Nuclear Information System (INIS)

    Sever posterior epistaxis is one of the serious clinical problems. Nasal bleeding usually occurs in the anterior septal region, where it can be seen easily and controlled with topical cautery or localized packing. When the bleeding occurs in the posterior nose, it becomes a more serious problem. Many methods have been used to control posterior epistaxis. Some of these are electrocautery, posterior nasal packing, vascular ligation and therapeutic percutaneous embolization. Between 1997 and 2000, nineteen patients were admitted to our hospital because of intractable epistaxis. There were 16 male and 3 female patients whose average age was 55 years. Ten of 19 patients were hypertensive, and none of these had undergoing treatment. Five of 19 patients received maxillary artery ligation. Clinical applications of 3D imaging of the internal maxillary artery using helical CT scan were done for 5 patients. These images were helpful for planning of ligation of the internal maxillary artery. (author)

  18. Popliteal artery branching patterns-an angiographic study

    Energy Technology Data Exchange (ETDEWEB)

    Day, C.P. [Department of Radiology, Royal Shrewsbury Hospital, Shrewsbury (United Kingdom)]. E-mail: chris.laura2001@ntlworld.com; Orme, R. [Department of Radiology, Royal Shrewsbury Hospital, Shrewsbury (United Kingdom)

    2006-08-15

    AIM: To analyse the variations in branching patterns of the popliteal artery and infrapopliteal vessels using angiography. MATERIALS And METHODS: Femoral angiograms of 1037 lower limbs in 568 patients were examined to assess the popliteal artery branching pattern. Variations of the infrapopliteal vessels supplying the foot were assessed in 662 limbs from the same cohort of patients. RESULTS: Nine hundred and forty-one (90.7%) limbs had the usual branching pattern with anterior tibial artery (AT) arising first followed by the tibial-peroneal trunk (TPT), which then gives rise to the posterior tibial (PT) and peroneal (PR) arteries. Variations in popliteal branching pattern were seen in 96 (9.3%) limbs. The commonest variation is high origin of the AT in 47 (4.5%) limbs or trifurcation of the popliteal artery in 33 (3.2%) limbs with AT, PT and PR arising together with no true TPT. The course of AT with high origin either anterior or posterior to popliteus was almost equal [25 (2.4%) or 22 (2.1%) limbs, respectively]. Eleven limbs (1.1%) had high origin of PT and two (0.2%) had a high origin of the PR. Six hundred and fifty-five (99%) limbs had normal infrapopliteal vessels. Seven (1%) had hypoplasia-aplasia of the infrapopliteal vessels. Five (0.8%) limbs had a hypoplastic PT with the remaining 2 (0.2%) having either a hypoplastic-aplastic AT or hypoplasia-aplasia of both AT and PT. CONCLUSION: Variations in the branching of the popliteal artery occur in about 10% of patients. Knowledge of these variations is important because of the potential consequences for the management of peripheral vascular disease.

  19. Popliteal artery branching patterns-an angiographic study

    International Nuclear Information System (INIS)

    AIM: To analyse the variations in branching patterns of the popliteal artery and infrapopliteal vessels using angiography. MATERIALS And METHODS: Femoral angiograms of 1037 lower limbs in 568 patients were examined to assess the popliteal artery branching pattern. Variations of the infrapopliteal vessels supplying the foot were assessed in 662 limbs from the same cohort of patients. RESULTS: Nine hundred and forty-one (90.7%) limbs had the usual branching pattern with anterior tibial artery (AT) arising first followed by the tibial-peroneal trunk (TPT), which then gives rise to the posterior tibial (PT) and peroneal (PR) arteries. Variations in popliteal branching pattern were seen in 96 (9.3%) limbs. The commonest variation is high origin of the AT in 47 (4.5%) limbs or trifurcation of the popliteal artery in 33 (3.2%) limbs with AT, PT and PR arising together with no true TPT. The course of AT with high origin either anterior or posterior to popliteus was almost equal [25 (2.4%) or 22 (2.1%) limbs, respectively]. Eleven limbs (1.1%) had high origin of PT and two (0.2%) had a high origin of the PR. Six hundred and fifty-five (99%) limbs had normal infrapopliteal vessels. Seven (1%) had hypoplasia-aplasia of the infrapopliteal vessels. Five (0.8%) limbs had a hypoplastic PT with the remaining 2 (0.2%) having either a hypoplastic-aplastic AT or hypoplasia-aplasia of both AT and PT. CONCLUSION: Variations in the branching of the popliteal artery occur in about 10% of patients. Knowledge of these variations is important because of the potential consequences for the management of peripheral vascular disease

  20. Bilateral popliteal arterial dissection.

    Science.gov (United States)

    Chen, Po-Liang; Ko, Shih-Yu; Tan, Ken-Hing

    2012-01-01

    A clinical feature of bilateral popliteal arterial dissection without involving the descending aorta, bilateral iliac, as well as femoral arteries has never been reported in the past literature. We report a 56-year-old man with hypertension and coronary artery disease who presented to our emergency department with complaints of bilateral knee pain after long-distance walking. Physical examination was notable for elevated blood pressure, but there was no palpable pulsation over dorsalis pedis arteries on his feet. Laboratory evaluation revealed a d-dimer level of 35.2 mg/L (FEU) on the day of the test and 1.2 mg/L one and a half months ago (normal level, <0.55). These findings were suggestive of a recent-onset peripheral arterial occlusive disorder. Computed tomography of the aorta showed bilateral popliteal arterial dissection with arterial intimal flap. Abdominal aorta, bilateral iliac, and femoral arteries remained intact with only arteriosclerotic change. Minimally invasive endovascular stent grafting was then performed. The patient had an uneventful recovery. PMID:21106320

  1. Microsurgical anatomy of the arterial basket of the conus medullaris.

    Science.gov (United States)

    Martirosyan, Nikolay L; Kalani, M Yashar S; Lemole, G Michael; Spetzler, Robert F; Preul, Mark C; Theodore, Nicholas

    2015-06-01

    OBJECT The arterial basket of the conus medullaris (ABCM) consists of 1 or 2 arteries arising from the anterior spinal artery (ASA) and circumferentially connecting the ASA and the posterior spinal arteries (PSAs). The arterial basket can be involved in arteriovenous fistulas and arteriovenous malformations of the conus. In this article, the authors describe the microsurgical anatomy of the ABCM with emphasis on its morphometric parameters and important role in the intrinsic blood supply of the conus medullaris. METHODS The authors performed microsurgical dissections on 16 formalin-fixed human spinal cords harvested within 24 hours of death. The course, diameter, and branching angles of the arteries comprising the ABCM were then identified and measured. In addition, histological sections were obtained to identify perforating vessels arising from the ABCM. RESULTS The ASA tapers as it nears the conus medullaris (mean preconus diameter 0.7 ± 0.12 mm vs mean conus diameter 0.38 ± 0.08 mm). The ASA forms an anastomotic basket with the posterior spinal artery (PSA) via anastomotic branches. In most of the specimens (n= 13, 81.3%), bilateral arteries formed connections between the ASA and PSA. However, in the remaining specimens (n= 3, 18.7%), a unilateral right-sided anastomotic artery was identified. The mean diameter of the right ABCM branch was 0.49 ± 0.13 mm, and the mean diameter of the left branch was 0.53 ± 0.14 mm. The mean branching angles of the arteries forming the anastomotic basket were 95.9° ± 36.6° and 90° ± 34.3° for the right- and left-sided arteries, respectively. In cases of bilateral arterial anastomoses between the ASA and PSA, the mean distance between the origins of the arteries was 4.5 ± 3.3 mm. Histological analysis revealed numerous perforating vessels supplying tissue of the conus medullaris. CONCLUSIONS The ABCM is a critical anastomotic connection between the ASA and PSA, which play an important role in the intrinsic blood supply

  2. STUDY OF EXTERNAL DIAMETER OF CRURAL ARTERIES AND THEIR CLINICAL SIGNIFICANCE

    Directory of Open Access Journals (Sweden)

    Deepali D.

    2012-12-01

    Full Text Available ABSTRACT: BACKGROUND: Popliteal artery, continuation of femoral artery situated in popliteal fossa, divides into anterior tibial artery (ATA and posterior ti bial artery (PTA at the lower border of popliteus muscle. The external diameter of these arteries and the peroneal artery (PeA may vary and are inversely proportional to one another. Variations in arterial supply to the leg and foot depends on, hypoplast ic/aplastic conditions of these arteries, resulting in compensatory hypertrophy of other artery. AIMS: The aim of present study is to measure external diameter of crural arteries and correlate these results with the clinical significance. MATERIALS & METHO DS: The study was done by dissection method on 100 lower limbs (50 right, 50 left of embalmed human cadavers, at department of Anatomy, Kempegowda Institute of Medical Sciences, Bangalore and medical colleges in and around Bangalore. In each specimen the external diameter of crural arteries were measured with the help of sliding calipers and findings noted down. Data analyzed by applying statistical method. RESULTS: Diameter of ATA was greater than PeA and PTA in all the specimens studied. The crural arter ies were classified on the basis of their diameters into strong, intermediate & small. The study showed crural arteries with intermediate diameter constituted the major group and 13 different patterns were noticed. CONCLUSION: The results of the present st udy indicate the compensatory mechanism exists with regards to hypoplastic/aplastic conditions of a vessel leading to increase in the diameter of the other artery. This results in variation in the arterial distribution to leg and foot with clinical signifi cance

  3. Anatomical Variations of the Popliteal Artery and its Tibial Branches: Analysis in 1242 Extremities

    International Nuclear Information System (INIS)

    The purpose of this study was to analyze the variations in branching of the popliteal artery by reviewing femoral arteriograms. Between 2004 and 2006, digital subtraction angiographies of both lower extremities were performed in 621 patients. We reviewed these 1242 arteriograms retrospectively in order to analyze the branching pattern of the popliteal artery. Of the 1242 extremities, 1108 extremities (89.2%) had normal branching pattern of the popliteal artery. The remaining 134 extremities (10.8%; 65 right, 69 left) in 105 patients (66 men, 39 women; 76 unilateral, 29 bilateral) showed seven variant branching patterns: hypoplastic or aplastic posterior tibial artery (PT) (n = 63, 5.1%); hypoplastic or aplastic anterior tibial artery (AT) (n = 21, 1.7%); trifurcation (n = 19, 1.5%); high origin of AT (n = 15, 1.2%); hypoplastic or aplastic PT and AT (n = 10, 0.8%); high origin of PT (n = 5, 0.4%); and anterior tibioperoneal trunk (n = 1, 0.1%). When the branching pattern of the popliteal artery is normal in one extremity, there is a 13% probability the other side will be a variant pattern. When the branching pattern is variant in one extremity, there is a 28% probability the opposite side will also contain a variation. Variations in branching of the popliteal artery are not uncommon. Awareness of these variations is important for evaluation of the lower extremity arteriograms and has clinical implications for vascular surgeons and interventional radiologists.

  4. Operative treatment for cervical fracture and dislocation with blunt unilateral vertebral artery injury

    Institute of Scientific and Technical Information of China (English)

    JIANG Tao; REN Xian-jun; WANG Wei-dong; ZHANG Xia; LI Chang-qing; HAO Yong

    2010-01-01

    Objective: To investigate risks and clinical effects of operative treatment for cervical vertebral fracture and dislocation associated with unilateral vertebral artery injury.Methods: This group consisted of 76 cases of closed cervical spine trauma combined with unilateral vertebral artery injury (23 cases of bilateral facet dislocation, 28 unilateral facet dislocation and 25 fracture). All patients underwent prospective examination of cervical spine MRI and vertebral artery two-dimensional time-of-flight (2D TOF)magnetic resonance angiography (MRA), and anterior cervical decompression. The healthy vertebral artery paths were evaluated before the surgery, and were protected during the surgery according to the anatomical signs.Results: There were no acute or chronic clinical damage symptoms in 76 cases after surgery. No neural damage symptoms were observed in patients with normal neural functions. The neural functions of incomplete paralyzed patients were improved in different grades.Conclusions: Reliable anterior operation can produce good results for cervical fracture and dislocation with unilateral vertebral artery injury. Detecting the course of uninjured vertebral artery before operation and locating the anatomical site during operation are effective to avoid damaging vertebral artery of uninjured side.

  5. Approaches to anterior and anterolateral foramen magnum lesions: A critical review

    Directory of Open Access Journals (Sweden)

    Ricardo J Komotar

    2010-01-01

    Full Text Available Foramen magnum (FM lesions represent some of the most complex cases for the modern neurosurgeon because of their location near vital brainstem structures, the vertebral arteries, and lower cranial nerves. In particular, anterior or anterolaterally located FM tumors have traditionally been most difficult to resect with high morbidity and mortality resulting from approaches through the posterior midline or transorally. For many neurosurgeons, the far lateral, extreme lateral approach, and more recently, endoscopic endonasal approaches have become the preferred modern methods for the resection of anterior or anterolateral FM tumors. In this review, we examine both operative and non-operative approaches to FM tumors, including surgical anatomy, surgical technique, and indications for operative intervention in these complex cases. In addition, we compared outcomes from prior series.

  6. Variations of the posterior cerebral artery diagnosed by MR angiography at 3 tesla

    International Nuclear Information System (INIS)

    Fenestration, early bifurcation, and duplication of the posterior cerebral artery (PCA) and the so-called hyperplastic anterior choroidal artery (AChA), considered a variation of the PCA, are rare. We evaluated the prevalence and characteristic features of these PCA variations on magnetic resonance (MR) angiography. We reviewed intracranial MR angiographic images of 2402 patients examined using a 3-tesla scanner. Images from the skull base to the intracranial region were obtained using the standard time-of-flight technique. We excluded images of 52 patients with insufficient image quality or occlusion of the PCA(s) and retrospectively evaluated the images of 2350 patients using a picture archiving and communication system. We observed PCA fenestration in eight (0.34 %) patients, most at the P1 segment and P1-P2 junction and all small in size, early bifurcation at the P1-P2 junction or proximal P2A segment in eight (0.34 %) patients, complete duplication in one patient, and hyperplastic AChA in 13 (0.55 %) patients. Eleven of the 13 hyperplastic AChAs supplied only the territory of the temporal branch of the PCA, and the remaining two supplied the entire territory of the PCA. We observed PCA variations in 30 (1.28 %) patients. We believe the name ''hyperplastic AChA'' inaccurately describes variations of the PCA in which the AChA supplies part of or all of the territory of the PCA and propose ''accessory PCA'' to describe an AChA that supplies part of the territory of the PCA or ''replaced PCA'' to describe that vessel that supplies the territory all branches of the PCA. (orig.)

  7. Variations of the posterior cerebral artery diagnosed by MR angiography at 3 tesla

    Energy Technology Data Exchange (ETDEWEB)

    Uchino, Akira; Saito, Naoko; Takahashi, Masahiro; Okano, Nanami; Tanisaka, Megumi [Saitama Medical University International Medical Center, Department of Diagnostic Radiology, Hidaka, Saitama (Japan)

    2016-02-15

    Fenestration, early bifurcation, and duplication of the posterior cerebral artery (PCA) and the so-called hyperplastic anterior choroidal artery (AChA), considered a variation of the PCA, are rare. We evaluated the prevalence and characteristic features of these PCA variations on magnetic resonance (MR) angiography. We reviewed intracranial MR angiographic images of 2402 patients examined using a 3-tesla scanner. Images from the skull base to the intracranial region were obtained using the standard time-of-flight technique. We excluded images of 52 patients with insufficient image quality or occlusion of the PCA(s) and retrospectively evaluated the images of 2350 patients using a picture archiving and communication system. We observed PCA fenestration in eight (0.34 %) patients, most at the P1 segment and P1-P2 junction and all small in size, early bifurcation at the P1-P2 junction or proximal P2A segment in eight (0.34 %) patients, complete duplication in one patient, and hyperplastic AChA in 13 (0.55 %) patients. Eleven of the 13 hyperplastic AChAs supplied only the territory of the temporal branch of the PCA, and the remaining two supplied the entire territory of the PCA. We observed PCA variations in 30 (1.28 %) patients. We believe the name ''hyperplastic AChA'' inaccurately describes variations of the PCA in which the AChA supplies part of or all of the territory of the PCA and propose ''accessory PCA'' to describe an AChA that supplies part of the territory of the PCA or ''replaced PCA'' to describe that vessel that supplies the territory all branches of the PCA. (orig.)

  8. The 'SAFARI' Technique Using Retrograde Access Via Peroneal Artery Access

    Energy Technology Data Exchange (ETDEWEB)

    Zhuang, Kun Da, E-mail: zkunda@gmail.com [Singapore General Hospital, Interventional Radiology Centre (Singapore); Tan, Seck Guan [Singapore General Hospital, Department of General Surgery (Singapore); Tay, Kiang Hiong [Singapore General Hospital, Interventional Radiology Centre (Singapore)

    2012-08-15

    The 'SAFARI' technique or subintimal arterial flossing with antegrade-retrograde intervention is a method for recanalisation of chronic total occlusions (CTOs) when subintimal angioplasty fails. Retrograde access is usually obtained via the popliteal, distal anterior tibial artery (ATA)/dorsalis pedis (DP), or distal posterior tibial artery (PTA). Distal access via the peroneal artery has not been described and has a risk of continued bleeding, leading to compartment syndrome due to its deep location. We describe our experience in two patients with retrograde access via the peroneal artery and the use of balloon-assisted hemostasis for these retrograde punctures. This approach may potentially give more options for endovascular interventions in lower limb CTOs.

  9. Succesful treatment of spontaneous dissection of the coronary artery by primary percutaneous coronary intervention

    Directory of Open Access Journals (Sweden)

    Yüksel Çavuşoğlu

    2011-09-01

    Full Text Available Spontaneous coronary artery dissection (SCAD is a rare cause of acute myocardial infarction. The disease is usually seen in young-middle aged women and leads to sudden death in the majority of cases. In survived patients, diagnosis of SCAD has been made with coronary anjiography. Involvement of left main coronary artery (LMCA is very unusual. We describe on a case of SCAD involving the LMCA in a young woman presenting with an acute myocardial infarction and cardiogenic shock status. There were no risk factors for coronary artery disease and no evidence of atherosclerosis on angiography. Coronary angiography revealed dissection of the LMCA that extended into the anterior descending and circumflex coronary arteries. The dissection was successfully treated with primary coronary artery stenting. The patient was discharged without complication. There was no problem in the first evaluation at the end of the first of the month. J Clin Exp Invest 2011; 2 (3: 299-303.

  10. Percutaneous Retrograde Recanalization of a Chronic Total Coronary Artery Occlusion in a 7 Year Old

    Energy Technology Data Exchange (ETDEWEB)

    Natal-Hernandez, Luz; Meadows, Jeffery; Shunk, Kendrick A.; Boyle, Andrew J., E-mail: aboyle@medicine.ucsf.edu

    2013-03-15

    The arterial switch operation for correction of transposition of the great arteries can be complicated by late stenosis or occlusion of the coronary arteries that are re-implanted to the new aorta. We report the case of a young boy who underwent this operation as a neonate and was found to have an occluded anomalous left anterior descending artery (LAD) before age 3. Subsequent bypass surgery was complicated by anastomotic stricture and kinking of the left internal mammary artery graft to the LAD. At age 7, the LAD territory showed reversible ischemia on nuclear perfusion testing and he was referred for percutaneous coronary intervention. A combined approach with pediatric and adult interventional cardiologists resulted in successful retrograde PCI to recanalize the chronic total occlusion of the LAD. Important features of this technique in pediatric patients are discussed.

  11. CT angiography diagnosis on the rupture of traumatic pseudoaneurysms of the cavernous of the internal carotid artery into the sphenoid sinus

    International Nuclear Information System (INIS)

    Objective: To investigate diagnostic value of CTA for traumatic pseudoaneurysms (TPA) in the cavernous segment of the internal carotid artery (ICA) when they rupture into the sphenoid sinus. Methods: CTA of 7 patients with TPA in the cavernous segments of ICA verified by DSA were retrospectively analyzed. All the patients were performed CTA scanning. The post-processing techniques included VR, MIP, MPR, and CPR. Results: All the CTA images of 7 patients showed irregular mass in the sphenoid sinus with obviously enhancement in the same phase to ICA, which communicating with ICA in wide base. The peripheral area of the mass showed no enhancement. The size varied from 3 mm × 2 mm × 1 mm to 33 mm × 30 mm × 27 mm. The adjacent lateral wall of sphenoid sinus showed fractures in all cases. TPA located at anterior-knee segments of cavernous ICA in 6 cases, and cavernous free segment in 1 case. All the disruptions were found at medial or anterior medial wall of ICA. Conclusions: Cranial CTA is the effective non-invasive method for diagnosing TPA in the cavernous segment of ICA when they rupture into sphenoid sinus. Combined using of VR, MIP, MPR, and CPR can delineate the location and size of the sphenoid wall fracture and the ICA rupture, which help to clarify the anatomical relationship between them. (authors)

  12. Efficacy of plain radiography and computer tomography in localizing the site of pelvic arterial bleeding in trauma patients

    International Nuclear Information System (INIS)

    Background: Immediate angiography is warranted in pelvic trauma patients with suspected arterial injury (AI) in order to stop ongoing bleeding. Prior to angiography, plain pelvic radiography (PPR) and abdominopelvic computer tomography (CT) are performed to identify fracture and hematoma sites. Purpose: To investigate if PPR and CT can identify the location of AI in trauma patients undergoing angiography. Material and Methods: 95 patients with pelvic fractures on PPR (29 women, 66 men), at a mean age of 44 (9-92) years, underwent pelvic angiography for suspected AI. Fifty-six of them underwent CT additionally. Right and left anterior and posterior fractures on PPR were registered, and fracture displacement was recorded for each quadrant. Arterial blush on CT was registered, and the size of the hematoma in each region was measured in cm2. AIs were registered for anterior and posterior segments of both internal iliac arteries. Presence of fractures, arterial blush, and hematomas were correlated with AI. Results: Presence of fracture in the corresponding skeletal segment on PPR showed sensitivity and specificity of 0.86 and 0.58 posteriorly, and 0.87 and 0.44 anteriorly. The area under the curve (AUC) was 0.77 and 0.69, respectively. Fracture displacement on PPR >0.9 cm posteriorly and >1.9 cm anteriorly revealed specificity of 0.84. Sensitivities of arterial blush and hematoma on CT were 0.38 and 0.82 posteriorly, and 0.24 and 0.82 anteriorly. The specificities were 0.96 and 0.58 posteriorly, and 0.79 and 0.53 anteriorly, respectively. For hematomas, the AUC was 0.79 posteriorly and 0.75 anteriorly. Size of hematoma >22 cm2 posteriorly and >29 cm2 anteriorly revealed specificity of 0.85 and 0.86, respectively. Conclusion: CT findings of arterial blush and hematoma predicted site of arterial bleeding on pelvic angiography. Also, PPR predicted the site of bleeding using location of fracture and size of displacement. In the hemodynamically unstable patient, PPR may

  13. Floating anterior lens capsule: an unusual case of true exfoliation

    OpenAIRE

    Riffle, John

    2010-01-01

    A rare case of delamination and replication of the anterior lens capsule into prominent floating folds in the anterior chamber approximately 55 years after a penetrating injury to the eye and anterior lens capsule is reported. Classically, true exfoliation of the anterior lens capsule has been reported in individuals who have been exposed to intense heat over a prolonged period. However, more recently cases of true exfoliation of the anterior lens capsule have been reported in patients who ha...

  14. Idiopathic aneurysms of distal cerebellar arteries: endovascular treatment after rupture

    International Nuclear Information System (INIS)

    Idiopathic ruptured aneurysms of distal cerebellar arteries (DCAAs) are rare, and their endovascular therapy (EVT) has as yet not been extensively reported. They are usually assumed to result from local arterial wall disruption rather than infection, unlike distal supratentorial artery aneurysms. This study was performed to audit their frequency, potential aetiology and results of EVT. Using strict inclusion criteria and a database of 1715 EVT patients, we identified ten idiopathic ruptured DCAAs (0.6%) over a 13-year period (1993-2006). The series comprised six males and four females with mean age of 64 years and solitary aneurysms located on posterior inferior cerebellar artery (five patients), anterior inferior cerebellar artery (three patients) and superior cerebellar artery (two patients). Nine aneurysms were fusiform and were treated by endovascular parent artery occlusion, and one was saccular and treated by endosaccular packing. Endovascular therapy was performed with coils in seven cases, n-butyl-2-cyanoacrylate (NBCA) in two cases and with both in one case. Primary EVT was successful in eight patients. One patient died following a procedure-related re-bleeding and one patient required re-treatment after failed endosaccular packing. Nine patients made good or excellent clinical recoveries (modified Rankin Scale 2 or less). Focal cerebellar infarctions were seen on computed tomography images after EVT in three patients, only one of whom was symptomatic with transient dysmetria, which resolved completely during follow up. No aneurysm recanalisation was detected on late follow-up imaging up to 24 months. Ruptured DCAAs are rare. The majority are fusiform in shape and their aetiology remains uncertain. Endovascular treatment is feasible and effective. It usually requires parent artery occlusion. (orig.)

  15. Coronary Artery Bypass

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    Kadri Ceberut

    2011-01-01

    Full Text Available Ancient schwannoma is a rare variant of neural tumors though rarely seen in the thorax. The combination with coronary artery diseases is also rare. Here we describe a 66 year-old male who had undergone one-stage combined surgery for thoracic ancient schwannomas removal and coronary artery disease. The masses were, respectively, 13 cm in the middle mediastinum and 5 cm in diameter originating from the intercostal nerve. The tumors were successfully removed using sternotomy, and then a coronary artery bypass grafting was performed. Here we discuss this rare tumor in relation to the relevant literature.

  16. Early Results of Coronary Endarterectomy Combined with Coronary Artery Bypass Grafting in Patients with Diffused Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Li-Qun Chi

    2015-01-01

    Full Text Available Background: It is still a challenge for the cardiac surgeons to achieve adequate revascularization for diffused coronary artery disease (CAD. Coronary endarterectomy (CE offers an alternative choice of coronary artery reconstruction and revascularization. In this study, short-term result of CE combined with coronary artery bypass graft (CABG was discussed in the treatment for the diffused CAD. Methods: From January 2012 to April 2014, 221 cases of CABG were performed by the same surgeon in our unit. Among these cases, 38 cases of CE + CABG were performed, which was about 17.2% (38/221 of the cohort. All these patients were divided into two groups: CE + CABG group (Group A and CABG alone group (Group B. All clinical data were compared between the two groups, and postoperative complications and in-hospital mortality were analyzed. The categorical and continuous variables were analyzed by Chi-square test and Student′s t-test respectively. Results: Diabetes mellitus, hypertension, hyperlipidemia, and peripheral vascular disease were more common in group A. In this cohort, a total of 50 vessels were endarterectomized. Among them, CE was performed on left anterior descending artery in 11 cases, on right coronary artery in 29 cases, on diagonal artery in 3 cases, on intermediate artery in 2 cases, on obtuse marginal artery in 5 cases. There was no hospital mortality in both groups. The intro-aortic balloon pump was required in 3 cases in Group A (3/38, which was more often than that in Group B (3/183. At the time of follow-up, coronary computed tomography angiogram showed all the grafts with CE were patent (50/50. There is no cardio-related mortality in both groups. All these patients were free from coronary re-intervention. Conclusions: Coronary endarterectomy + CABG can offer satisfactory result for patients with diffused CAD in a short-term after the operation.

  17. THYMOLIPOMA: A RARE, LARGE ANTERIOR MEDIASTINAL MASS

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    Premananth

    2015-07-01

    Full Text Available Thymolipoma is a rare benign tumor of anterior mediastinum, described by Lange in 1916. 1 Less than 200 cases have been reported worldwide. 2 It accounts for 2% to 9% of thymic tumours. 3 We report a case of thymolipoma in a 37 year s old male patient, who pre sented with cough, dys p nea, chest pain for 2 months. CT THORAX revealed a large anterior mediastinal mass extending in to right hemithorax arising from thymus gland, with multiple areas of fat density, no significant mediastinal adenopathy, complete collap se of right middle and lower lobe suggestive of thymolipoma. CT guided biopsy suggestive of thymic neoplasm. The tumour was removed enbloc through surgery. Histopathological examination of large mass lesion confirmed thymolipoma. We report this case to emp hasize the importance of considering thymolipoma as a differential diagnosis of anterior mediastinal mass, although rare.

  18. A treatment-refractory spinal dural arteriovenous fistula sharing arterial origin with the Artery of Adamkiewicz: Repeated endovascular treatment after failed microsurgery

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    Johanna Eneling

    2014-01-01

    Full Text Available Background: Effective management of a spinal dural arteriovenous fistula (SDAVF can be accomplished with either microsurgery or endovascular embolization, but there is a consensus that in patients in whom a radiculomedullary artery supplying the anterior spinal artery (ASA originates from the same feeding artery as the SDAVF, the endovascular approach is to be avoided. Case Description: The patient was a 46-year-old woman with progressive lower limb paraparesis, sensory deficit, and sphincter dysfunction. Magnetic resonance imaging (MRI and spinal angiography showed an SDAVF fed by a branch from the left second lumbar segmental artery, and the artery of Adamkiewicz (AA, a major ASA supplier, originating from the same segmental artery just proximal to the SDAVF. Microsurgical disconnection of the SDAVF was attempted, but failed. Embolization with cyanoacrylates was done in two occasions, the first time through a microcatheter placed just distal to the origin of the AA and the second time through another feeder coming from the same segmental artery that could not be visualized in the previous angiographies. All procedures were neurologically uncomplicated. Magnetic resonance imaging (MRI 1 month after the last embolization showed resolution of the spinal cord edema. MRI scan taken 68 months after embolization revealed a slightly atrophic spinal cord with visible central canal and no recurrence of medullary edema. The patient presented good, but incomplete neurological improvement. Conclusion: Microsurgery is the first choice for an SDAVF branching off the same radiculomedullary artery supplying the ASA, but uncomplicated embolization can be feasible after failed surgery.

  19. Anatomic landmarks of fluoroscopy guided puncture of the pulseless femoral artery

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Min Hee; Han, Gi Seok; Kim, Sung Jin; Park, Kil Sun; Cha, Sang Hoon; Bae, Il Hun; Lee, Seung Young [College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju (Korea, Republic of)

    2006-07-15

    We wanted to improve puncturing the pulseless femoral artery by evaluating the anatomic landmarks that suggest the course of the femoral artery on fluoroscopy. We analyzed 37 hemipelvis spot images that were centered on the arterial sheath after puncture of the femoral artery. The inguinal angles were measured between the inguinal line connecting the anterior superior iliac spine and the symphysis pubis, and the line of the arterial sheath. Inguinal ligament ratios were measured as the distance from the symphysis pubis to the arterial sheath to the length of the inguinal ligament on the inguinal line. The femoral head ratios were measured as the distance from the medial margin of the femur head to the arterial sheath to the transverse length of the femur head. The mean inguinal angle was 66.5 and the mean inguinal ligament ratio was 0.42 ({+-} 0.03). The mean femoral head ratio was 0.08 ({+-} 0.18). In comparing the men and women, there was no significant difference in the inguinal angle and the femoral head ratio, but the inguinal distance ratio was larger in women (men: 0.41 {+-} 0.033, women: 0.44 {+-} 0.031, {rho} < 0.05). The femoral artery generally courses just lateral to the medial margin of the femur head (femoral head ratio: 0.08) and the medial 40% of the inguinal ligament (inguinal ligament ratio: 0.42). So, consideration of these relations may be helpful for puncturing the pulseless femoral artery.

  20. Anterior Cervical Discectomy and Fusion with Plating

    Medline Plus

    Full Text Available ... to the front of the spine here. The structure will feel or the carotid artery – her right ... ligament and removing disc against the spinal cord, but now it's the level below. For scale purposes, ...