WorldWideScience

Sample records for artery branch rupture

  1. Coil Embolization Treatment in Pulmonary Artery Branch Rupture During Swan-Ganz Catheterization

    International Nuclear Information System (INIS)

    Gottwalles, Yannick; Wunschel-Joseph, Marie-Eve; Hanssen, Michel

    2000-01-01

    Rupture of the pulmonary artery or one of its branches during Swan-Ganz catheterization is a complication that is rare but remains fatal in almost 50% of cases. The risk factors and mechanisms involved in the pathogenesis of this accident have been widely reported. Management is twofold: resuscitation procedures and specific medical or even surgical treatment. We report a case of pulmonary artery rupture occurring during Swan-Ganz catheterization that was treated by coil embolization. This technique, which is quick and simple to use, would appear to be very promising. This is the first case of successful emergency treatment of pulmonary artery rupture using an endovascular technique

  2. Renal Branch Artery Stenosis

    DEFF Research Database (Denmark)

    Andersson, Zarah; Thisted, Ebbe; Andersen, Ulrik Bjørn

    2017-01-01

    Renovascular hypertension is a common cause of pediatric hypertension. In the fraction of cases that are unrelated to syndromes such as neurofibromatosis, patients with a solitary stenosis on a branch of the renal artery are common and can be diagnostically challenging. Imaging techniques...... that perform well in the diagnosis of main renal artery stenosis may fall short when it comes to branch artery stenosis. We report 2 cases that illustrate these difficulties and show that a branch artery stenosis may be overlooked even by the gold standard method, renal angiography....

  3. Branches of the Facial Artery.

    Science.gov (United States)

    Hwang, Kun; Lee, Geun In; Park, Hye Jin

    2015-06-01

    The aim of this study is to review the name of the branches, to review the classification of the branching pattern, and to clarify a presence percentage of each branch of the facial artery, systematically. In a PubMed search, the search terms "facial," AND "artery," AND "classification OR variant OR pattern" were used. The IBM SPSS Statistics 20 system was used for statistical analysis. Among the 500 titles, 18 articles were selected and reviewed systematically. Most of the articles focused on "classification" according to the "terminal branch." Several authors classified the facial artery according to their terminal branches. Most of them, however, did not describe the definition of "terminal branch." There were confusions within the classifications. When the inferior labial artery was absent, 3 different types were used. The "alar branch" or "nasal branch" was used instead of the "lateral nasal branch." The angular branch was used to refer to several different branches. The presence as a percentage of each branch according to the branches in Gray's Anatomy (premasseteric, inferior labial, superior labial, lateral nasal, and angular) varied. No branch was used with 100% consistency. The superior labial branch was most frequently cited (95.7%, 382 arteries in 399 hemifaces). The angular branch (53.9%, 219 arteries in 406 hemifaces) and the premasseteric branch were least frequently cited (53.8%, 43 arteries in 80 hemifaces). There were significant differences among each of the 5 branches (P < 0.05) except between the angular branch and the premasseteric branch and between the superior labial branch and the inferior labial branch. The authors believe identifying the presence percentage of each branch will be helpful for surgical procedures.

  4. Coiling of ruptured pericallosal artery aneurysms.

    NARCIS (Netherlands)

    Menovsky, T.; Rooij, W.J.J. van; Sluzewski, M.; Wijnalda, D.

    2002-01-01

    OBJECTIVE: To assess the technical feasibility of treating ruptured pericallosal artery aneurysms with detachable coils and to evaluate the anatomic and clinical results. METHODS: Over a period of 27 months, 12 patients with a ruptured pericallosal artery aneurysm were treated with detachable

  5. Ruptured gastroepiploic artery aneurysm: A case report

    Directory of Open Access Journals (Sweden)

    Ahmad S. Ashrafi

    Full Text Available Introduction: Gastroepiploic artery aneurysms are extremely rare, with few reported cases in the literature. The risk of rupture however, is high and thus warrants attention. Presentation of case: Here we present a rare case of a women who presented to the emergency department in shock and was found to have a ruptured gastroepiploic artery aneurysm during surgical exploration. Suture ligation of the aneurysm was completed. Discussion: Although rare, gastroepiploic artery aneurysms have up to a 90% rate of rupture and therefore require intervention. A laparoscopic approach has been described however, in cases where rupture has occurred, urgent laparotomy and control of hemorrhage is needed. Conclusion: We describe a rare case of a ruptured gastroepiploic aneurysm that was successfully managed with urgent laparotomy and aneurysmal resection. Keywords: Gastroepiploic, Aneurysm, Hemorrhage, Case report

  6. Acute Iliac Artery Rupture: Endovascular Treatment

    International Nuclear Information System (INIS)

    Chatziioannou, A.; Mourikis, D.; Katsimilis, J.; Skiadas, V.; Koutoulidis, V.; Katsenis, K.; Vlahos, L.

    2007-01-01

    The authors present 7 patients who suffered iliac artery rupture over a 2 year period. In 5 patients, the rupture was iatrogenic: 4 cases were secondary to balloon angioplasty for iliac artery stenosis and 1 occurred during coronary angioplasty. In the last 2 patients, the rupture was secondary to iliac artery mycotic aneurysm. Direct placement of a stent-graft was performed in all cases, which was dilated until extravasation was controlled. Placement of the stent-graft was successful in all the cases, without any complications. The techniques used, results, and mid-term follow-up are presented. In conclusion, endovascular placement of a stent-graft is a quick, minimally invasive, efficient, and safe method for emergency treatment of acute iliac artery rupture, with satisfactory short- and mid-term results

  7. Splenic artery aneurysm rupture in pregnancy

    International Nuclear Information System (INIS)

    Khan, H.R.; Low, S.; Selinger, M.; Nelson, N.

    2004-01-01

    Rupture of a splenic artery aneurysm, commonly associated with pregnancy is a rare and catastrophic event. We report here a case of a patient in her second pregnancy who presented with a short history of left hypochondriac and epigastric pain, followed by collapse at 32 weeks gestation. Sudden fetal distress lead to emergency caesarean delivery when splenic artery aneurysm rupture was diagnosed. With timely involvement of multidisciplinary personnel both mother and baby survived and had an uneventful recovery. (author)

  8. Endovascular treatment of ruptured splenic artery aneurysm

    DEFF Research Database (Denmark)

    Bjerring, Ole Steen

    2008-01-01

    Splenic artery aneurysms (SAA) are traditionally treated surgically, but endovascular techniques are becoming increasingly popular. A 64 year-old male with chest pain and low blood pressure was admitted under suspicion of AMI. A CT scan showed a 56 mm SAA with signs of rupture. The patient...... was treated with endovascular embolisation of the SAA with coils. Blood pressure and haemoglobin levels were stabilized and the patient was discharged. In the case of rupture the treatment of choice seems to be endovascular....

  9. Ruptured mycotic aneurysm of the superior mesenteric artery secondary to bacterial endocarditis in a 6-year-old-girl

    International Nuclear Information System (INIS)

    Christophe, C.; Spehl, M.; Cogaert, C.; Perlmutter, N.; Burniat, W.; Biarent, D.; Delaet, F.; Amalou, N.

    1985-01-01

    By non-invasive examination we demonstrated as false mycotic aneurysm on a branch of the superior mesenteric artery (SMA). It suddenly ruptured but was managed successfully. The patient had mitral valve disease and probably bacterial endocarditis also. (orig.)

  10. Ruptured mycotic aneurysm of the superior mesenteric artery secondary to bacterial endocarditis in a 6-year-old-girl

    Energy Technology Data Exchange (ETDEWEB)

    Christophe, C; Spehl, M; Cogaert, C; Perlmutter, N; Burniat, W; Biarent, D; Delaet, F; Amalou, N

    1985-02-01

    By non-invasive examination we demonstrated as false mycotic aneurysm on a branch of the superior mesenteric artery (SMA). It suddenly ruptured but was managed successfully. The patient had mitral valve disease and probably bacterial endocarditis also.

  11. Branch retinal artery occlusion in Susac's syndrome

    Directory of Open Access Journals (Sweden)

    Ricardo Evangelista Marrocos de Aragão

    2015-02-01

    Full Text Available Susac's syndrome is a rare disease attribuited to a microangiopathy involving the arterioles of the cochlea, retina and brain. Encefalopathy, hearing loss, and visual deficits are the hallmarks of the disease. Visual loss is due to multiple, recurrent branch arterial retinal occlusions. We report a case of a 20-year-old women with Susac syndrome presented with peripheral vestibular syndrome, hearing loss, ataxia, vertigo, and vision loss due occlusion of the retinal branch artery.

  12. Massive spontaneous hemoperitoneum due to rupture of visceral branches of the abdominal aorta.

    Science.gov (United States)

    Pollak, E W; Michas, C A

    1979-10-01

    Review of 153 cases of massive spontaneous hemoperitoneum following visceral arterial rupture showed that 94% of all young women and 100% of all pregnant women had ruptured congenital splenic artery aneurysms at the time of hemorrhage, whereas young males bled from a variety of sources. Individuals who were 45 years old or older bled either from lesions of the celiac axis or its branches (66%) or from arterial mesenteric system lesions (34%). Only 22% of the older individuals of either sex bled from splenic artery sources. Arterial hypertension was present in 40% and previous or simultaneous intracranial hemorrhage occurred in 9% of the older patients. There were no survivors among those in whom the bleeding source was not operatively controlled. With operation, 79% of the younger patients and 57% of the older ones survived. Results emphasize the high mortality of visceral artery rupture with intraperitoneal bleeding. Prophylactic excision is advised for all complicated aneurysms regardless of age and all uncomplicated aneurysms in healthy individuals, especially in fertile or pregnent women.

  13. Fault Branching and Long-Term Earthquake Rupture Scenario for Strike-Slip Earthquake

    Science.gov (United States)

    Klinger, Y.; CHOI, J. H.; Vallage, A.

    2017-12-01

    Careful examination of surface rupture for large continental strike-slip earthquakes reveals that for the majority of earthquakes, at least one major branch is involved in the rupture pattern. Often, branching might be either related to the location of the epicenter or located toward the end of the rupture, and possibly related to the stopping of the rupture. In this work, we examine large continental earthquakes that show significant branches at different scales and for which ground surface rupture has been mapped in great details. In each case, rupture conditions are described, including dynamic parameters, past earthquakes history, and regional stress orientation, to see if the dynamic stress field would a priori favor branching. In one case we show that rupture propagation and branching are directly impacted by preexisting geological structures. These structures serve as pathways for the rupture attempting to propagate out of its shear plane. At larger scale, we show that in some cases, rupturing a branch might be systematic, hampering possibilities for the development of a larger seismic rupture. Long-term geomorphology hints at the existence of a strong asperity in the zone where the rupture branched off the main fault. There, no evidence of throughgoing rupture could be seen along the main fault, while the branch is well connected to the main fault. This set of observations suggests that for specific configurations, some rupture scenarios involving systematic branching are more likely than others.

  14. Parent artery occlusion for ruptured "true" posterior communicating artery aneurysm.

    Science.gov (United States)

    Mitsuhashi, Takashi; Takeda, Nobuaki; Oishi, Hidenori; Arai, Hajime

    2015-04-01

    A case of a patient with a ruptured true posterior communicating artery (PCoA) aneurysm is reported, who had been managed by early endovascular parent artery occlusion with coils. The small blister aneurysm was located at the proximal PCoA itself and directed superiorly. Postoperative course was uneventful. During 1-month follow-up, the patient recovered well and could care for herself. Aneurysms of the PCoA itself are very rare. As reported to date, surgical procedures would favor microsurgical clipping over endovascular coil embolization. Endovascular treatment may be a good alternative to surgical trapping for true PCoA blister aneurysm. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  15. Endovascular rescue from arterial rupture and thrombosis during middle cerebral artery stenting

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, J.Y.; Chung, Y.S. [Department of Neurosurgery, College of Medicine, Pundang CHA Hospital, 351 Yatap-ding, Pundang-gu, 463-712, Sungnam (Korea); Lee, B.H. [Department of Interventional Neuroradiology, College of Medicine, Pundang CHA Hospital, 351 Yatap-dong, Pundang-gu, 463-712, Sungnam (Korea); Kim, O.J. [Department of Emergency Medicine, College of Medicine, Pundang CHA Hospital, 351 Yatap-dong, Pundang-gu, 463-712, Sungnam (Korea)

    2003-08-01

    Intravascular stents are being used with increasing frequency in interventional neuroradiology. Iatrogenic arterial rupture is an uncommon but serious complication. We present a case of arterial rupture and subarachnoid haemorrhage during middle cerebral artery stenting, treated by emergency additional, overlapping stenting and balloon tamponade of the dissected vessel. Thrombotic occlusion of the artery was managed by intra-arterial abciximab. Normal vessel patency was re-established within 20 min and the patient recovered with no neurological deficit. (orig.)

  16. Emergency endovascular coiling of a ruptured giant splenic artery aneurysm

    DEFF Research Database (Denmark)

    Wernheden, Erika; Brenøe, Anne Sofie; Shahidi, Saeid

    2017-01-01

    Splenic artery aneurysms (SAAs) are the third most common abdominal aneurysm. Endovascular treatment of SAAs is preferred, and coiling is the most commonly used technique. Ruptured giant (>5 cm) SAAs are usually treated with open surgery including splenectomy. We present a rare case of a ruptured...... 15-cm giant SAA in an 84-year-old woman treated successfully with emergency endovascular coiling. To our knowledge, this is one of the few reports of emergency endovascular treatment for ruptured giant SAA....

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

    International Nuclear Information System (INIS)

    Cronin, Paul; Williams, David M.; Vellody, Ranjith; Kelly, Aine Marie; Kazerooni, Ella A.; Carlos, Ruth C.

    2011-01-01

    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.

  18. A Case of Ruptured Splenic Artery Aneurysm in Pregnancy

    Directory of Open Access Journals (Sweden)

    Elizabeth K. Corey

    2014-01-01

    Full Text Available Background. Rupture of a splenic artery aneurysm is rare complication of pregnancy that is associated with a significant maternal and fetal mortality. Case. A multiparous female presented in the third trimester with hypotension, tachycardia, and altered mental status. A ruptured splenic artery aneurysm was discovered at the time of laparotomy and cesarean delivery. The patient made a full recovery following resection of the aneurysm. The neonate survived but suffered severe neurologic impairment. Conclusion. The diagnosis of ruptured splenic artery aneurysm should be considered in a pregnant woman presenting with signs of intra-abdominal hemorrhage. Early intervention by a multidisciplinary surgical team is key to preserving the life of the mother and fetus.

  19. Emergency endovascular coiling of a ruptured giant splenic artery aneurysm

    Directory of Open Access Journals (Sweden)

    Erika Wernheden, MD

    2017-12-01

    Full Text Available Splenic artery aneurysms (SAAs are the third most common abdominal aneurysm. Endovascular treatment of SAAs is preferred, and coiling is the most commonly used technique. Ruptured giant (>5 cm SAAs are usually treated with open surgery including splenectomy. We present a rare case of a ruptured 15-cm giant SAA in an 84-year-old woman treated successfully with emergency endovascular coiling. To our knowledge, this is one of the few reports of emergency endovascular treatment for ruptured giant SAA.

  20. Internal carotid artery rupture caused by carotid shunt insertion.

    Science.gov (United States)

    Illuminati, Giulio; Caliò, Francesco G; Pizzardi, Giulia; Vietri, Francesco

    2015-01-01

    Shunting is a well-accepted method of maintaining cerebral perfusion during carotid endarterectomy (CEA). Nonetheless, shunt insertion may lead to complications including arterial dissection, embolization, and thrombosis. We present a complication of shunt insertion consisting of arterial wall rupture, not reported previously. A 78-year-old woman underwent CEA combined with coronary artery bypass grafting (CABG). At the time of shunt insertion an arterial rupture at the distal tip of the shunt was detected and was repaired via a small saphenous vein patch. Eversion CEA and subsequent CABG completed the procedure whose postoperative course was uneventful. Shunting during combined CEA-CABG may be advisable to assure cerebral protection from possible hypoperfusion due to potential hemodynamic instability of patients with severe coronary artery disease. Awareness and prompt management of possible shunt-related complications, including the newly reported one, may contribute to limiting their harmful effect. Arterial wall rupture is a possible, previously not reported, shunt-related complication to be aware of when performing CEA. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. Spontaneous rupture of the middle colic artery resulting in delayed ...

    African Journals Online (AJOL)

    mission for three days after delivery due to raised blood pressure which was controlled using antihypertensives. The baby weighed 3.8 kg with good Apgar score. ... Osamu C, Hiroshi K, Makoto S, Soichiro Y, Hiroyuki. K, Yasumasa K, Hiroyasu M. Spontaneous rupture of. Dissecting Aneurysm of the Middle colic Artery. Tokai.

  2. Ruptured superior gluteal artery pseudoaneurysm with hemorrhagic shock: Case report

    Directory of Open Access Journals (Sweden)

    Kerem Seref Corbacioglu

    2016-03-01

    Full Text Available Pseudoaneurysm of the superior gluteal artery (SGA is very rare and the most common causes are blunt or penetrating pelvic traumas. Although pseudoaneurysm can be asymptomatic at the time of initial trauma, it can be symptomatic weeks, months, even years after initial trauma. We present a case of a ruptured superior gluteal artery pseudoaneurysm with hemorrhagic shock twenty days after a bomb injury in the Syria civil war. In addition, we review the anatomy of the SGA, clinical presentation and pitfalls of pseudoaneurysm, and imaging and treatment options. Keywords: Pseudoaneurysm, Superior gluteal artery, Pitfall, Angiography

  3. Microballoon Occlusion Test to Predict Colonic Ischemia After Transcatheter Embolization of a Ruptured Aneurysm of the Middle Colic Artery

    International Nuclear Information System (INIS)

    Tajima, Tsuyoshi; Yoshimitsu, Kengo; Inokuchi, Hiroyuki; Irie, Hiroyuki; Nishie, Akihiro; Hirakawa, Masakazu; Ishigami, Kousei; Ushijima, Yasuhiro; Okamoto, Daisuke; Honda, Hiroshi; Itoh, Hiroyuki; Morita, Masaru; Kakeji, Yoshihiro

    2008-01-01

    A 76-year-old woman presented with sudden massive melena, and superior mesenteric arteriography showed an aneurysm in the middle colic artery (MCA). Because she had a history of right hemicolectomy and ligation of the inferior mesenteric artery (IMA) during open abdominal aortic aneurysm repair, embolization of the MCA aneurysm was considered to pose a risk comparable to that of colonic ischemia. A microballoon occlusion test during occlusion of the MCA confirmed retrograde visualization of the IMA branches through the collateral arteries by way of the left internal iliac artery, and embolization was successfully performed using microcoils. No colonic ischemia or aneurysm rupture occurred after embolization.

  4. Cervical hemorrhage due to spontaneous rupture of the superior thyroid artery: Case report and review of the literature.

    Science.gov (United States)

    Stenner, Markus; Helmstaedter, Victor; Spuentrup, Elmar; Quante, Gero; Huettenbrink, Karl-Bernd

    2010-09-01

    Beneath the different reasons for cervical masses, a spontaneous hemorrhage presents a rare and life-threatening condition. We present the rare case of a 62-year-old man who was presented with a dramatically enlarging cervical mass causing respiratory distress because of upper airway compression. An endotracheal intubation was lifesaving and avoided tracheotomy. A CT scan revealed a hematoma in the region of the left external carotid artery. An emergency angiography embolized a ruptured branch of the superior thyroid artery and surgery evacuated the hematoma. We discuss the rarity of the condition, reasons for a spontaneous rupture of the artery, and the diagnostic and treatment strategy. In addition, we review the literature on spontaneous thyroid artery hemorrhages, which, up to now, have been described only for the inferior thyroid artery. We conclude that the optimal management for cases of cervical hematoma is intubation, diagnosis, and angiography before surgery.

  5. Neurofibromatosis Type 1: Transcatheter Arterial Embolization for Ruptured Occipital Arterial Aneurysms

    International Nuclear Information System (INIS)

    Kanematsu, Masayuki; Kato, Hiroki; Kondo, Hiroshi; Goshima, Satoshi; Tsuge, Yusuke; Kojima, Toshiaki; Watanabe, Haruo

    2011-01-01

    Two cases of ruptured aneurysms in the posterior cervical regions associated with type-1 neurofibromatosis treated by transcatheter embolization are reported. Patients presented with acute onset of swelling and pain in the affected areas. Emergently performed contrast-enhanced CT demonstrated aneurysms and large hematomas widespread in the posterior cervical regions. Angiography revealed aneurysms and extravasations of the occipital artery. Patients were successfully treated by percutaneous transcatheter arterial microcoil embolization. Transcatheter arterial embolization therapy was found to be an effective method for treating aneurysmal rupture in the posterior cervical regions occurring in association with type-1 neurofibromatosis. A literature review revealed that rupture of an occipital arterial aneurysm, in the setting of neurofibromatosis type 1, has not been reported previously.

  6. Pelvic injuries in combination with vascular lesions of branches from the iliac artery: Outcome - Incidence - Treatment strategy

    DEFF Research Database (Denmark)

    Schmal, H.; Klemt, C.; Uhrmeister, P.

    2002-01-01

    The acute haemorrhagic shock is one of the leading causes for death following severe pelvic injuries. Typical bleeding sources are fractured spongiosa surfaces, lesions of the major venous plexus or ruptures of branches originating from the iliac artery. This study characterizes the population...... from active hemorrhage because of vascular lacerations of iliac artery branches. Average of ISS, PTS, part of multiple injured patients, prevalence of rotary and vertical unstable fractures as well as mortality of patients with accompanying arterial injury was found to be much higher when compared...

  7. Ruptured superior gluteal artery pseudoaneurysm with hemorrhagic shock: Case report.

    Science.gov (United States)

    Corbacioglu, Kerem Seref; Aksel, Gokhan; Yildiz, Altan

    2016-03-01

    Pseudoaneurysm of the superior gluteal artery (SGA) is very rare and the most common causes are blunt or penetrating pelvic traumas. Although pseudoaneurysm can be asymptomatic at the time of initial trauma, it can be symptomatic weeks, months, even years after initial trauma. We present a case of a ruptured superior gluteal artery pseudoaneurysm with hemorrhagic shock twenty days after a bomb injury in the Syria civil war. In addition, we review the anatomy of the SGA, clinical presentation and pitfalls of pseudoaneurysm, and imaging and treatment options.

  8. Unusually Looped and Muzzled Branches of Right Coronary Artery

    Directory of Open Access Journals (Sweden)

    Anitha Guru

    2017-01-01

    Full Text Available Coronary artery disease (CAD is the major cause of death in developed countries as it accounts on an average for 1 of every 5 deaths. Morphological variations of coronary arterial system is one of the causative factor for CAD. Anatomical knowledge of all possible variant patterns of coronary arterial system is imperative in the diagnostic and therapeutic approach of CAD. We report here a rare branching pattern of right coronary artery (RCA. The origin of RCA was normal but the course and branching pattern of it were atypical. RCA was not occupying its usual position in atrioventricular (coronary sulcus and its course was incomplete. It gave a ventricular branch to right ventricle, which presented an unusual looping pattern. It terminated as right marginal artery following its muzzled appearance within the musculature of the ventricle.

  9. Angiographic imaging of the branching of the popliteal artery into the arteries of the lower leg

    International Nuclear Information System (INIS)

    Prayer, L.; Karnel, F.; Schurawitzki, H.

    1990-01-01

    For the anatomic analysis of the branching of the popliteal artery into the lower leg arteries, 414 intra-arterial DSA images of the lower extremity (obtained in 223 patients) were available. In 90.1% of the material examined, a 'normal' branching was found. If one leg of a patient showed 'normal' branching, there was a probability of 6.9% to find a different branching of the artery in the other leg. In 9.9% of the examined legs deviations from standard branching were observed. If there was a deviation from standard observed in one leg, the probability of finding a variant of branching in the other leg as well was 4.4%. (orig./MG) [de

  10. Autopsy findings in carotid arterial rupture following radiotherapy of head and neck advanced carcinoma

    International Nuclear Information System (INIS)

    Satake, Bunsuke; Matsuura, Shizumu; Sakaino, Kouji; Maehara, Yasunobu

    1989-01-01

    The influence of radiotherapy in advanced head and neck cancer was investigated by autopsy of head and neck patients who had had carotid artery rupture. Twenty-five cases of head and neck cancer revealed carotid artery rupture among the 255 head and neck cases autopsied from 1972 to 1985. The rate of carotid artery rupture in hypopharyngeal cancer was 8/32 (25%); in oral cancer 8/55 (14.5%), and in other cancers 9/165 (5.4%). In localization of ruptured arteries there were 9 cases of common carotid artery, 14 cases of external carotid artery, one case of internal carotid artery, and one unknown. These cases were irradiated using more than 70 Gy. The following reasons for carotid artery rupture were suspected: 1. There was a tumor with deep ulceration and necrosis near the vessel. 2. The wall of the artery had radiation angitis. 3. The artery wall was necrotic because of invasion by the tumor. 4. Thrombosis developed with ensuant rupture of the artery. Radiotherapy for advanced cancer of the head and neck is necessary to control pain and as palliative treatment, but to avoid rupture of the carotid artery, pain clinic techniques and chemotherapy as palliative treatment for this kinds of terminal condition should also be considered. (author)

  11. Life-Threatening Retropharyngeal Hemorrhage Secondary to Rupture of the Inferior Thyroid Artery

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    Cristina G. Calogero

    2015-01-01

    Full Text Available Inferior thyroid artery (ITA rupture is rare and may progress to life-threatening conditions. We present a patient who visited the emergency department after an episode of syncope and dizziness in which he had a mechanical fall that resulted in abrasions and a hematoma to his left forehead. The patient presented with dysphagia and anterior neck swelling that progressed rapidly into airway compromise requiring endotracheal intubation. Emergent computed tomography revealed a large retropharyngeal hematoma, with active arterial extravasation that was thought to be arising from the thyrocervical trunk on the left. The hematoma measured approximately 6.7 cm transversely and 3.2 cm anteroposteriorly and extended from the level of the lower nasopharynx, down the neck into the retropharyngeal and danger space and into the mediastinum posterior to the esophagus, overall approximately 25 cm. The larynx was deviated anteriorly and there was esophageal compression. An emergent arteriogram and catheterization confirmed bleeding from branches of the ITA, and successful embolization was performed. It is important to recognize the ITA rupture as a potential etiology of an acute airway compromise. In emergent situations, while securing an airway is a priority, rapidly initiating diagnostic testing to confirm the diagnosis and arranging for arterial embolization can be life-saving.

  12. Spontaneous Superior Mesenteric Artery Branch Pseudoaneurysm: A Rare Case Report

    Directory of Open Access Journals (Sweden)

    Mina Guirgis

    Full Text Available : Background: Visceral arterial pseudoaneurysms (VAPAs are rare vascular entities with serious consequences. Traditionally, they are associated with trauma, infection, and inflammatory disease, or they can arise as a post-operative complication. Report: An 87 year old man presented with abdominal pain and was found to have a spontaneous VAPA on a computed tomography angiogram. Serial imaging 4 months previously had demonstrated no aneurysm. Between scans, warfarin was changed to apixaban for aortic valve replacement, but he had no other changes to any other medications. He required urgent endovascular coiling of the pseudoaneurysm, with satisfactory recovery and outcome. Discussion: VAPAs are extremely rare, with splenic artery VAPAs the most commonly reported. Regardless, fewer than 250 cases of splenic artery pseudoaneurysm have been reported. Superior mesenteric artery (SMA pseudoaneurysms are the rarest type of VAPAs. Early identification and urgent treatment are warranted because of the associated high mortality risk, with a 50% risk of rupture in any given VAPA. Treatment options range from open operation to endoscopic and endovascular procedures. Apixaban has been proposed to contribute to pseudoaneurysm formation by slow and continuous bleeding that results in the formation of the pseudoaneurysm. Conclusions: Spontaneous VAPAs are extremely rare and this is the first time a VAPA has been associated with the novel oral anticoagulant “apixaban”. Urgent management of any VAPAs is important because of the high risk of rupture and potential life threatening haemorrhage. Keywords: Visceral arterial pseudoaneurysm, Superior mesenteric artery, Apixaban, Coils

  13. Anomalous Medial Branch of Radial Artery: A Rare Variant

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    Surbhi Wadhwa

    2016-10-01

    Full Text Available Radial artery is an important consistent vessel of the upper limb. It is a useful vascular access site for coronary procedures and its reliable anatomy has resulted in an elevation of radial forearm flaps for reconstructive surgeries of head and neck. Technical failures, in both the procedures, are mainly due to anatomical variations, such as radial loops, ectopic radial arteries or tortuosity in the vessel. We present a rare and a unique anomalous medial branch of the radial artery spiraling around the flexor carpi radialis muscle in the forearm with a high rising superficial palmar branch of radial artery. Developmentally it probably is a remanent of the normal pattern of capillary vessel maintenance and regression. Such a case is of importance for reconstructive surgeons and coronary interventionists, especially in view of its unique medial and deep course.

  14. Ruptured internal iliac artery aneurysm presenting as Cullen’s sign

    OpenAIRE

    Choon K. Gan; Srinivasan Ravi; Rachel Archibald; David Hodgson; Fung J. Foo; William Wong

    2010-01-01

    Cullen?s sign or periumbilical ecchymosis, is classically considered as an indicator of acute hemorrhagic pancreatitis or ruptured ectopic pregnancy. Internal iliac artery aneurysms are rare and are usually asymptomatic. We present a case of a contained rupture of the internal iliac artery aneurysm presenting with Cullen?s sign.

  15. Ruptured internal iliac artery aneurysm presenting as Cullen’s sign

    Directory of Open Access Journals (Sweden)

    Choon K. Gan

    2010-11-01

    Full Text Available Cullen’s sign or periumbilical ecchymosis, is classically considered as an indicator of acute hemorrhagic pancreatitis or ruptured ectopic pregnancy. Internal iliac artery aneurysms are rare and are usually asymptomatic. We present a case of a contained rupture of the internal iliac artery aneurysm presenting with Cullen’s sign.

  16. Anterolateral papillary muscle rupture after intervention of the right coronary artery.

    Science.gov (United States)

    Morris, Liam; Desai, Anand; Akkus, Nuri Ilker

    2015-11-01

    Rupture of the anterolateral papillary muscle following a right coronary artery occlusion is extremely rare, and when complicated by a right ventricular infarction, can be fatal. The literature on optimal management of this complication is limited. We present an unusual case of anterolateral papillary muscle rupture following intervention of the right coronary artery. Published by Elsevier España.

  17. CT finding of ruptured splenic artery aneurysm after cesarean section : a case report

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Chang Woo; Kim, Hee Jin [CHA Medical College, Pundang CHA Gerneral Hospital Sungnam, (Korea, Republic of)

    2000-03-01

    Spontaneous rupture of a splenic artery aneurysm during puerperium is rare and is due to the non-specific clinical appearance, diagnosis is difficult. We describe a case of spontaneous rupture of splenic artery aneurysm after a Cesarean section. CT showed high-density ascites localized in the lesser sac and left retroperitoneum.

  18. CT finding of ruptured splenic artery aneurysm after cesarean section : a case report

    International Nuclear Information System (INIS)

    Ryu, Chang Woo; Kim, Hee Jin

    2000-01-01

    Spontaneous rupture of a splenic artery aneurysm during puerperium is rare and is due to the non-specific clinical appearance, diagnosis is difficult. We describe a case of spontaneous rupture of splenic artery aneurysm after a Cesarean section. CT showed high-density ascites localized in the lesser sac and left retroperitoneum

  19. Spontaneous Hepatic Rupture Associated with Preeclampsia: Treatment with Hepatic Artery Embolization

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Seung Boo; Goo, Dong Erk; Chang, Yun Woo; Kim, Yong Jae; Hwang, In Cheol; Han, Hyo Sang; Yoon, Jong Hyun; Lee, Tae Il [Soonchunhyang University Hospital, Gumi (Korea, Republic of)

    2010-02-15

    Spontaneous rupture of the liver due to preeclampsia is a rare condition of pregnant women, and it can be very dangerous if not treated. We report here on a case of successfully treating spontaneous liver rupture associated with preeclampsia by performing transcatheter hepatic arterial embolization. A 41-year-old woman with spontaneous rupture of the liver associated with preeclampsia was treated by hepatic arterial embolization

  20. Spontaneous Hepatic Rupture Associated with Preeclampsia: Treatment with Hepatic Artery Embolization

    International Nuclear Information System (INIS)

    Yang, Seung Boo; Goo, Dong Erk; Chang, Yun Woo; Kim, Yong Jae; Hwang, In Cheol; Han, Hyo Sang; Yoon, Jong Hyun; Lee, Tae Il

    2010-01-01

    Spontaneous rupture of the liver due to preeclampsia is a rare condition of pregnant women, and it can be very dangerous if not treated. We report here on a case of successfully treating spontaneous liver rupture associated with preeclampsia by performing transcatheter hepatic arterial embolization. A 41-year-old woman with spontaneous rupture of the liver associated with preeclampsia was treated by hepatic arterial embolization

  1. Inverse parameter identification for a branching 1 D arterial network

    CSIR Research Space (South Africa)

    Bogaers, Alfred EJ

    2012-07-01

    Full Text Available In this paper we investigate the invertability of a branching 1 D arterial blood flow network. We limit our investigation to a single bifurcating vessel, where the material properties, unloaded areas and variables characterizing the input and output...

  2. Ruptured Retinal Arterial Macroaneurysm Secondary to Toxoplasmic Kyrieleis Arteriolitis: A Case Report

    Directory of Open Access Journals (Sweden)

    Natalie Huang

    2017-07-01

    Full Text Available Purpose: The aim of this report was to describe multimodal ocular imaging findings in a patient who presented with a ruptured retinal arterial macroaneurysm (RAM associated with toxoplasmic Kyrieleis arteriolitis. Methods: We report the case of a 64-year-old man with a history of systemic hypertension and dense amblyopia of the left eye who presented with decreased vision and new floaters in the left eye. Color fundus photography, spectral-domain optical coherence tomography, fluorescein angiography, and indocyanine green angiography were used as diagnostic imaging tools. Results: No signs of hypertensive retinopathy were noted in the right eye. Multiple chorioretinal scars characteristic of previous toxoplasmosis were revealed in the left eye, with one covering most of the macula. Periarterial plaques or Kyrieleis arteriolitis were observed in retinal arteries surrounding the toxoplasmic retinal scars. Multiple RAMs were observed in these vessels, one of which was acutely ruptured. A perivenular plaque associated with a chronic branch retinal vein occlusion (BRVO was noted along the same arcade at the arteriovenous crossing. Conclusion: RAM formation and BRVO can present as possible long-term complications of toxoplasmic Kyrieleis arteriolitis. This is the first reported case demonstrating an association between toxoplasmic Kyrieleis arteriolitis and RAM formation.

  3. Management of a Complicated Ruptured Infected Pseudoaneurysm of the Femoral Artery in a Drug Addict

    Directory of Open Access Journals (Sweden)

    Emmanouil Psathas

    2012-01-01

    Full Text Available Infected pseudoaneurysm of the femoral artery represents a devastating complication of intravenous drug abuse, especially in the event of rupture. Operative strategy depends upon the extent of arterial injury and the coexistence of infection or sepsis. Options range from simple common femoral artery (CFA ligation to complex arterial reconstruction with autologous grafts (arterial, venous, or homografts. We report herein the management of a 29-year-old male patient who was urgently admitted with a ruptured pseudoaneurysm of the right CFA, extending well above the inguinal ligament. Multidisciplinary approach with multiple arterial reconstructions and subsequent coverage of the tissue defect with a rectus abdominis musculocutaneous flap transposition was performed.

  4. Parent artery occlusion for ruptured “true” posterior communicating artery aneurysm

    Science.gov (United States)

    Takeda, Nobuaki; Oishi, Hidenori; Arai, Hajime

    2015-01-01

    A case of a patient with a ruptured true posterior communicating artery (PCoA) aneurysm is reported, who had been managed by early endovascular parent artery occlusion with coils. The small blister aneurysm was located at the proximal PCoA itself and directed superiorly. Postoperative course was uneventful. During 1-month follow-up, the patient recovered well and could care for herself. Aneurysms of the PCoA itself are very rare. As reported to date, surgical procedures would favor microsurgical clipping over endovascular coil embolization. Endovascular treatment may be a good alternative to surgical trapping for true PCoA blister aneurysm. PMID:25953771

  5. Parent artery occlusion for ruptured “true” posterior communicating artery aneurysm

    OpenAIRE

    Mitsuhashi, Takashi; Takeda, Nobuaki; Oishi, Hidenori; Arai, Hajime

    2015-01-01

    A case of a patient with a ruptured true posterior communicating artery (PCoA) aneurysm is reported, who had been managed by early endovascular parent artery occlusion with coils. The small blister aneurysm was located at the proximal PCoA itself and directed superiorly. Postoperative course was uneventful. During 1-month follow-up, the patient recovered well and could care for herself. Aneurysms of the PCoA itself are very rare. As reported to date, surgical procedures would favor microsurgi...

  6. Role and Effectiveness of Percutaneous Arterial Embolization in Hemodynamically Unstable Patients with Ruptured Splanchnic Artery Pseudoaneurysms

    International Nuclear Information System (INIS)

    Dohan, Anthony; Eveno, Clarisse; Dautry, Raphael; Guerrache, Youcef; Camus, Marine; Boudiaf, Mourad; Gayat, Etienne; Dref, Olivier Le; Sirol, Marc; Soyer, Philippe

    2015-01-01

    PurposeTo assess the role and effectiveness of percutaneous arterial embolization (TAE) in patients with hemodynamic instability due to hypovolemic shock secondary to ruptured splanchnic artery pseudoaneurysms (SAPA).Materials and MethodsSeventeen patients (11 men, 6 women; mean age, 53 years) with hemodynamic instability (systolic blood pressure <90 mmHg) due to hypovolemic shock secondary to ruptured SAPA were treated by TAE. Clinical files, multidetector row computed tomography angiography, and angiographic examinations along with procedure details were reviewed.ResultsSeventeen SAPAs were present, predominantly located on gastroduodenal or pancreatic arteries (9/17; 53 %). Angiography showed extravasation of contrast medium from SAPA in 15/17 patients (88 %). Technical success rate of TAE was 100 %. TAE was performed using metallic coils in all patients (100 %), in association with gelatin sponge in 5/17 patients (29 %). TAE allowed controlling the bleeding and returning to normal hemodynamic status in 16/17 patients (94 %). In 1/17 patient (6 %), surgery was needed to definitively control the bleeding. The mortality and morbidity rate of TAE at 30 days were 0 and 12 %, respectively. Morbidity consisted in coil migration in 1/17 patient (6 %) and transient serum liver enzyme elevation in 1/17 patient (6 %).ConclusionTAE is an effective and safe treatment option for ruptured SAPA in hemodynamically unstable patients, with a success rate of 94 %. Our results suggest that TAE should be the favored option in patients with hemodynamic instability due to ruptured SAPA

  7. Role and Effectiveness of Percutaneous Arterial Embolization in Hemodynamically Unstable Patients with Ruptured Splanchnic Artery Pseudoaneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Dohan, Anthony, E-mail: anthony.dohan@lrb.aphp.fr [Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Department of Abdominal and Interventional Imaging (France); Eveno, Clarisse, E-mail: clarisse.eveno@lrb.aphp.fr [Université Paris-Diderot, Sorbonne Paris Cité (France); Dautry, Raphael, E-mail: raphael.dautry@lrb.aphp.fr; Guerrache, Youcef, E-mail: docyoucef05@yahoo.fr [Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Department of Abdominal and Interventional Imaging (France); Camus, Marine, E-mail: marine.camus@lrb.aphp.fr [Université Paris-Diderot, Sorbonne Paris Cité (France); Boudiaf, Mourad, E-mail: mourad.boudiaf@lrb.aphp.fr [Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Department of Abdominal and Interventional Imaging (France); Gayat, Etienne, E-mail: etienne.gayat@lrb.aphp.fr [Université Paris-Diderot, Sorbonne Paris Cité (France); Dref, Olivier Le, E-mail: olivier.ledref@lrb.aphp.fr; Sirol, Marc, E-mail: marc.sirol@lrb.aphp.fr; Soyer, Philippe, E-mail: philippe.soyer@lrb.aphp.fr [Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Department of Abdominal and Interventional Imaging (France)

    2015-08-15

    PurposeTo assess the role and effectiveness of percutaneous arterial embolization (TAE) in patients with hemodynamic instability due to hypovolemic shock secondary to ruptured splanchnic artery pseudoaneurysms (SAPA).Materials and MethodsSeventeen patients (11 men, 6 women; mean age, 53 years) with hemodynamic instability (systolic blood pressure <90 mmHg) due to hypovolemic shock secondary to ruptured SAPA were treated by TAE. Clinical files, multidetector row computed tomography angiography, and angiographic examinations along with procedure details were reviewed.ResultsSeventeen SAPAs were present, predominantly located on gastroduodenal or pancreatic arteries (9/17; 53 %). Angiography showed extravasation of contrast medium from SAPA in 15/17 patients (88 %). Technical success rate of TAE was 100 %. TAE was performed using metallic coils in all patients (100 %), in association with gelatin sponge in 5/17 patients (29 %). TAE allowed controlling the bleeding and returning to normal hemodynamic status in 16/17 patients (94 %). In 1/17 patient (6 %), surgery was needed to definitively control the bleeding. The mortality and morbidity rate of TAE at 30 days were 0 and 12 %, respectively. Morbidity consisted in coil migration in 1/17 patient (6 %) and transient serum liver enzyme elevation in 1/17 patient (6 %).ConclusionTAE is an effective and safe treatment option for ruptured SAPA in hemodynamically unstable patients, with a success rate of 94 %. Our results suggest that TAE should be the favored option in patients with hemodynamic instability due to ruptured SAPA.

  8. Isolated Unilateral Absent Branch Pulmonary Artery with Peripheral Pulmonary Stenosis and Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Sunil Abhishek B

    2017-09-01

    Full Text Available Isolated Unilateral Absent Pulmonary Artery (UAPA is a rare congenital anomaly. It is usually associated with congenital heart defects. A 45 year old male patient presented with complaints of fever with cough and expectoration for 15 days and retrosternal chest discomfort for the previous 2 days. ECG showed diffuse ST segment depression with T wave inversion in the inferior and lateral leads. Coronary Angiogram done through the right femoral approach revealed diffusely diseased Left Anterior Descending (LAD artery that was totally cut off at the mid segment. The Left Circumflex (LCx artery was providing blood supply to the right middle and lower lung areas. There was another collateral arising from the Left Subclavian Artery supplying the right middle and lower lung areas. The left pulmonary artery was normal, but branches supplying the middle and lower lobes of the right lung were absent and the upper lobe branch had pulmonary stenosis. UAPA is a rare clinical entity; collaterals from coronaries are extremely rare in this condition and till now there has not been any case report of unilateral absent branch pulmonary artery with peripheral stenosis of other branches, on the affected side and associated coronary artery disease.

  9. Morphological and Hemodynamic Discriminators for Rupture Status in Posterior Communicating Artery Aneurysms

    OpenAIRE

    Lv, Nan; Wang, Chi; Karmonik, Christof; Fang, Yibin; Xu, Jinyu; Yu, Ying; Cao, Wei; Liu, Jianmin; Huang, Qinghai

    2016-01-01

    Background and Purpose The conflicting findings of previous morphological and hemodynamic studies on intracranial aneurysm rupture may be caused by the relatively small sample sizes and the variation in location of the patient-specific aneurysm models. We aimed to determine the discriminators for aneurysm rupture status by focusing on only posterior communicating artery (PCoA) aneurysms. Materials and Methods In 129 PCoA aneurysms (85 ruptured, 44 unruptured), clinical, morphological and hemo...

  10. Endovascular treatment of ruptured true posterior communicating artery aneurysms.

    Science.gov (United States)

    Yang, Yonglin; Su, Wandong; Meng, Qinghai

    2015-01-01

    Although true posterior communicating artery (PCoA) aneurysms are rare, they are of vital importance. We reviewed 9 patients with this fatal disease, who were treated with endovascular embolization, and discussed the meaning of endovascular embolization for the treatment of true PCoA aneurysms. From September 2006 to May 2012, 9 patients with digital substraction angiography (DSA) confirmed true PCoA aneurysms were treated with endovascular embolization. Patients were followed-up with a minimal duration of 17 months and assessed by Glasgow Outcome Scale (GOS) score. All the patients presented with spontaneous subarachnoid hemorrhage from the ruptured aneurysms. The ratio of males to females was 1:2, and the average age of onset was 59.9 (ranging from 52 to 72) years. The preoperative Hunt-Hess grade scores were I to III. All patients had recovered satisfactorily. No permanent neurological deficits were left. Currently, endovascular embolization can be recommended as the top choice for the treatment of most true PCoA aneurysms, due to its advanced technique, especially the application of the stent-assisted coiling technique, combined with its advantage of mininal invasiveness and quick recovery. However, the choice of treatment methods should be based on the clinical and anatomical characteristics of the aneurysm and the skillfulness of the surgeon.

  11. Ruptured aneurysms of the middle cerebral artery with intracerebral hematoma

    International Nuclear Information System (INIS)

    Inomori, Shigeo; Kim, Ilu; Ueda, Shinsuke; Pak, Shinsa

    1984-01-01

    Twenty-one cases of ruptured middle cerebral artery aneurysm with intracerebral hematoma were studied. The age distribution ranged from 16 to 68, with an average of 48 years. Fifteen were female, 6 male. Computerized tomography (CT) scans were performed within 24 hours after the onset in 19. Diagnosis was established by angiography or surgery. Seventeen patients were operated on, whereas 4 were not because their condition was too poor. CT showed hematoma in the Sylvian fissure and the temporal lobe in a section 30 mm above the orbitomeatal line. Extension of the hematoma was to the frontal lobe anteriorly and/or the temporal lobe posterosuperiorly. The site of hematoma was related to the direction of the aneurysmal projection. Cases were divided into the following three groups: Group I; cases with the temporal lobe hematoma. Group II; cases with hematoma extending to both the frontal and temporal lobes. Group III; cases with hematoma in the frontal lobe. All of the 14 cases in Group I underwent operation. Mortality was 14%. Morbidity was correlated to the size of hematoma. The outcome was good in cases with hematoma less than 40 mm in diameter. Four out of 6 cases of Group II were not operated on and died within 3 days after onset. Uncal herniation was suspected early in their course. Of two operated cases, one died and the other was severely disabled. Outcome in one case of Group III was good. This study suggests that outcome can be anticipated from CT findings. (author)

  12. [Subclavian artery rupture after road crash: many similitaries].

    Science.gov (United States)

    Rulliat, E; Ndiaye, A; David, J-S; Voiglio, E J; Lieutaud, T

    2011-12-01

    Traumatic Subclavian Arterial Ruptures (TSCAR) are rare and with a poor prognosis. The aim of this study was to describe the epidemiological data and the medical charts of the initial care of each patient suffering a TSCAR following a traffic accident. Using the register of the road crash in the Rhone department (France) that records every casualty using the AIS codes, we retrospectively reviewed the prehospital and intrahospital medical, biological and radiological charts of every patient. Follow-up was obtained at day 60 post-trauma. Among the 1181 severe traumatic injuries, five casualties have been recorded in the register with a TSCAR (0.4%). Four of the five patients died in an early dramatic fatal hemorrhagic shock. Similarities between casualties were observed for patients still alive at hospital arrival that associate 1) a two-wheel motorized rider (2-WMR) crashing without antagonist 2) a severe polytraumatism including thoracic and 3) orthopaedic lesions; 4) clinical and biological signs of a severe haemorrhagic shock; 5) radiological signs of scapulothoracic dissociation. TSCAR are rare with a high mortality. We recommend improving the early care by the recognition of the triad associating early severe shock, polytraumatism (thorax and superior limb) and radiological signs evocating scapulothoracic dissociation in a 2-WMR. These signs must lead to the operating theatre as fast as possible in association with early massive transfusions. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  13. Rupture of the Pitáycachi Fault in the 1887 Mw 7.5 Sonora, Mexico earthquake (southern Basin-and-Range Province): Rupture kinematics and epicenter inferred from rupture branching patterns

    Science.gov (United States)

    Suter, Max

    2015-01-01

    During the 3 May 1887 Mw 7.5 Sonora earthquake (surface rupture end-to-end length: 101.8 km), an array of three north-south striking Basin-and-Range Province faults (from north to south Pitáycachi, Teras, and Otates) slipped sequentially along the western margin of the Sierra Madre Occidental Plateau. This detailed field survey of the 1887 earthquake rupture zone along the Pitáycachi fault includes mapping the rupture scarp and measurements of surface deformation. The surface rupture has an endpoint-to-endpoint length of ≥41.0 km, dips 70°W, and is characterized by normal left-lateral extension. The maximum surface offset is 487 cm and the mean offset 260 cm. The rupture trace shows a complex pattern of second-order segmentation. However, this segmentation is not expressed in the 1887 along-rupture surface offset profile, which indicates that the secondary segments are linked at depth into a single coherent fault surface. The Pitáycachi surface rupture shows a well-developed bipolar branching pattern suggesting that the rupture originated in its central part, where the polarity of the rupture bifurcations changes. Most likely the rupture first propagated bilaterally along the Pitáycachi fault. The southern rupture front likely jumped across a step over to the Teras fault and from there across a major relay zone to the Otates fault. Branching probably resulted from the lateral propagation of the rupture after breaching the seismogenic part of the crust, given that the much shorter ruptures of the Otates and Teras segments did not develop branches.

  14. Hemothorax due to Ruptured Mycotic Aneurysm of Intercostal Arteries Associated with Infective Endocarditis

    Directory of Open Access Journals (Sweden)

    Eddie Y. Liu

    2017-01-01

    Full Text Available We present a case of hemothorax due to ruptured mycotic aneurysm in three intercostal arteries in a 40-year-old male with methicillin-resistant Staphylococcus aureus infective endocarditis (IE due to intravenous drug use. Microcoil embolization and thoracotomy successfully achieved hemostasis. Mycotic aneurysm is a rare complication of IE and is usually found in the intracranial vessels. Ruptured mycotic aneurysm in the intercostal arteries can be associated with IE and can present as acute hemothorax.

  15. A Unique Branching Pattern of the Axillary Artery: A Case Report

    OpenAIRE

    Bagoji, Ishwar B.; Hadimani, Gavishiddappa A.; Bannur, Balappa M.; Patil, B.G.; Bharatha, Ambadasu

    2013-01-01

    During routine dissection classes for under graduate students, we found a unique and unusual case regarding the anomalous branching in the third part of the axillary artery was terminated into subscapular arterial trunk, superficial brachial artery and deep brachial artery. The subscapular arterial trunk was origin of several important arteries as the circumflex scapular, thoracodorsal, posterior circumflex humeral, thoraco-acromial and lateral thoracic arteries. The deep brachial artery in t...

  16. Saccular aneurysm of segmental branch of the main renal artery: approach to diagnosis and treatment

    International Nuclear Information System (INIS)

    Karaman, B.; Hamcan, S.; Bozkurt, Y.; Kara, K.; Aslan, A.

    2012-01-01

    Full text: Introduction: Renal artery aneurysms rarely detected clinical situation. Mostly determined by symptoms such as hematuria, hypertension and flank pain. Generally detected during investigation of symptoms or incidentally. Objectives and tasks: We aim to present the findings of CTA and DSA of the 58-year-old male patient with flank pain, hematuria and hypertension complaints. Materials and methods: We performed CTA and selective renal angiography to 58-year-old male patient with complaints of hypertension, flank pain and hematuria. Results: Approximately 11.5x 13.5 mm size of saccular aneurysm at the upper segmental branch of the left renal artery and focal cortical infarct detected in CT abdomen of the patient before treatment. The aneurysm was confirmed with selective renal angiography examination and treated with Cardiatis stent in the same procedure. Conclusion: Primary goal of treatment of renal artery aneurysms is to prevent complications such as rupture and thrombosis. Renal artery aneurysms have been treated with open surgery previously. Parenchyma preventive and minimally invasive treatments such as Cardiatis stent placement successfully uses currently

  17. Morphometry of medial gaps of human brain artery branches.

    Science.gov (United States)

    Canham, Peter B; Finlay, Helen M

    2004-05-01

    The bifurcation regions of the major human cerebral arteries are vulnerable to the formation of saccular aneurysms. A consistent feature of these bifurcations is a discontinuity of the tunica media at the apex of the flow divider. The objective was to measure the 3-dimensional geometry of these medial gaps or "medial defects." Nineteen bifurcations and 2 junctions of human cerebral arteries branches (from 4 male and 2 female subjects) were formalin-fixed at physiological pressure and processed for longitudinal serial sectioning. The apex and adjacent regions were examined and measurements were made from high-magnification photomicrographs, or projection microscope images, of the gap dimensions at multiple levels through the bifurcation. Plots were made of the width of the media as a function of distance from the apex. The media at each edge of the medial gap widened over a short distance, reaching the full width of the media of the contiguous daughter vessel. Medial gap dimensions were compared with the planar angle of the bifurcation, and a strong negative correlation was found, ie, the acute angled branches have the more prominent medial gaps. A discontinuity of the media at the apex was seen in all the bifurcations examined and was also found in the junction regions of brain arteries. We determined that the gap width is continuous with well-defined dimensions throughout its length and average length-to-width ratio of 6.9. The gaps were generally centered on the prominence of the apical ridge.

  18. Ruptured Aneurysms of the Occipital Artery Associated with Congenital Occipital Bone Defect.

    Science.gov (United States)

    Kawasaki, Toshinari; Yoshida, Kazumichi; Kikuchi, Takayuki; Ishii, Akira; Takagi, Yasushi; Miyamoto, Susumu

    2017-01-01

    Traumatic aneurysms of the superficial temporal artery have been frequently reported in the literature, whereas traumatic aneurysms of the occipital artery (OA) are extremely rare. A 30-year-old man had been followed at another hospital for meningoencephalocele associated with his congenital occipital bone defect. He was admitted to our hospital with a chief complaint of neck swelling and pain during a football game. Computed tomography and magnetic resonance imaging showed a hematoma in his right neck along with the meningoencephalocele. In addition, it showed an atrophic cerebellum with a cyst protruding from his occipital bone defect. Digital subtraction angiography of the right OA showed 3 aneurysms responsible for the large hematoma in his neck. Endovascular embolization with 20% N-butyl-2-cyanoacrylate was performed for treatment of the ruptured aneurysms followed by emergent surgical evacuation of the hematoma. An occipital cranioplasty with titanium mesh was performed 10 months after the emergent intervention. In this patient, the congenital occipital bone defect with meningoencephalocele might have been the remote source of risk for traumatic pseudoaneurysms along the muscle branches of the OA. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Rupture of hepatocellular carcinoma following transcatheter arterial chemoembolization: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Hyo Jin; Lee, Byung Hoon; Hwang, Yoon Joon; Kim, Su Young; Lee, Ji Young [Ilsan Paik Hospital/Inje Univ. School of Medicine, Goyang (Korea, Republic of); Han, Yoon Hee [Seonam Hospital/Ewha Womans Univ. School of Medicine, Seoul (Korea, Republic of)

    2012-08-15

    Transcatheter arterial chemoembolization (TACE) is known to be an effective palliative treatment for unresectable hepatocellular carcinoma (HCC). Serious complications, such as neutropenic sepsis and hepatic decompensation, are well known. A HCC rupture following TACE is a rare complication; however, it can be life threatening if it occurs. In a 75 year old male patient who subsequently developed capsular rupture of the lipiodol laden mass and several free intraperitoneal chemoembolization agents with hemoperitoneum, we report a case of a ruptured HCC that superficially located arterial enhancing and early wash out mass in the right hepatic dome following TACE.

  20. Rupture of popliteal arterial aneurysm due to salmonella infection

    International Nuclear Information System (INIS)

    Kim, Dong Hun; Oh, Hyung Woo; Kim, Dong Hyun; Byun, Joo Nam

    2006-01-01

    We report here on a case of popliteal aneurysm and rupture that occurred over a 10-day period and this was all secondary to salmonella infection. Computed tomography (CT) angiography of the extremity that was performed before and after aneurysmal rupture showed the aneurysm's rapid evolution to rupture over a short period of time. We also review the pathogenesis, clinical presentation, diagnostic approach and management of salmonella aneurysms

  1. Balloon Tamponade Treatment of a Stent-graft Related Rupture with a Splenic Artery Pseudoaneurysm: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, See Hyung; Kim, Young Hwan [Dongsan Medical Center, Keimyung University College of Medicine, Daegu (Korea, Republic of)

    2009-09-15

    An arterial rupture resulting from stent-graft placement of a splenic artery pseudoaneurysm is a life-threatening complication and immediate endovascular or surgical treatment is indicated. We report a case of a stentgraft related splenic artery rupture treated solely with a prolonged balloon catheter tamponade, which resulted in preservation of vessel patency

  2. Variant Branching of the Common Femoral Artery in a Black Kenyan ...

    African Journals Online (AJOL)

    Branching pattern of common femoral artery is important during artery catheterization, orthopaedic, plastic and general surgery in the proximal thigh. Frequency of variant branching shows ethnic variation but there are no data for black African populations. Since atherosclerotic diseases are increasing and femoral artery ...

  3. Indocyanine Green Videoangiography for Surgery of a Ruptured Dissecting Aneurysm in the Precommunicating Anterior Cerebral Artery: A Technical Case Report.

    Science.gov (United States)

    Nagai, Yasunori; Goto, Masanori; Toda, Hiroki; Nishida, Namiko; Yoshimoto, Naoya; Iwasaki, Koichi

    2017-08-01

    Indocyanine green videoangiography (ICG-VA) is an important intraoperative adjunct for saccular aneurysm surgery, but its efficacy in surgery for dissecting aneurysms has rarely been reported. The authors describe the usefulness of preclipping ICG-VA in a rare case of a ruptured dissecting aneurysm located at the precommunicating (A1) segment of the anterior cerebral artery. A 52-year-old woman, with no history of connective tissue diseases or vascular disorders, presented with sudden headache and convulsion. The CT scan showed that the patient had subarachnoid hemorrhage. Angiography showed a dissecting aneurysm in the left A1 segment of the anterior cerebral artery. Thus, the patient underwent trapping of the dissecting aneurysm. ICG-VA was used as an intraoperative adjunct before and after clipping. The preclipping ICG-VA showed the heterogeneously bright dissecting aneurysm and branching arteries even in the presence of hematoma. Preclipping ICG-VA may enhance the advantage of direct surgery for dissecting aneurysm by allowing visualization of the extent of the dissected vascular wall and the related branching arteries. ICG-VA can be an indispensable adjunct to minimize the compromise from the surgical treatment for intracranial dissecting aneurysms. Copyright © 2017 by the Congress of Neurological Surgeons

  4. Successful flow reduction surgery for a ruptured true posterior communicating artery aneurysm caused by the common carotid artery ligation for epistaxis.

    Science.gov (United States)

    Yamao, Yukihiro; Takahashi, Jun C; Satow, Tetsu; Iihara, Koji; Miyamoto, Susumu

    2014-01-01

    Carotid artery occlusion can lead to the development of rare true posterior communicating artery (PCoA) aneurysms because of hemodynamic stress on the PCoA. Surgical treatment of these lesions is challenging. The authors report a case of a true PCoA aneurysm that developed and ruptured 37 years after ligation of the ipsilateral common carotid artery for epistaxis. The lesion was successfully treated with clipping of the distal M1 segment of the middle cerebral artery (MCA) after the occipital artery-radial artery free graft-MCA bypass, which led to extreme reduction in collateral flow through the PCoA. A cortical branch, located just proximal to the obliteration site, functioned as a sufficient flow outlet. The aneurysm shrank, and the patient has been doing well without any symptoms for 5 years after surgery. M1 obliteration combined with high-flow extra-intracranial bypass might be a promising option for a true PCoA aneurysm, and therapeutic design that leaves a sufficient flow outlet on the M1 is mandatory to avoid unexpected occlusion of the M1 and its perforators.

  5. Morphological and clinical risk factors for posterior communicating artery aneurysm rupture.

    Science.gov (United States)

    Matsukawa, Hidetoshi; Fujii, Motoharu; Akaike, Gensuke; Uemura, Akihiro; Takahashi, Osamu; Niimi, Yasunari; Shinoda, Masaki

    2014-01-01

    Recent studies have shown that posterior circulation aneurysms, specifically posterior communicating artery (PCoA) aneurysms, are more likely to rupture than other aneurysms. To date, few studies have investigated the factors contributing to PCoA aneurysm rupture. The authors aimed to identify morphological and clinical characteristics predisposing to PCoA aneurysm rupture. The authors retrospectively reviewed 134 consecutive patients with PCoA aneurysms managed at their facility between July 2003 and December 2012. The authors divided patients into groups of those with aneurysmal rupture (n = 39) and without aneurysmal rupture (n = 95) and compared morphological and clinical characteristics. Morphological characteristics were mainly evaluated by 3D CT angiography and included diameter of arteries (anterior cerebral artery, middle cerebral artery, and internal carotid artery), size of the aneurysm, dome-to-neck ratio, neck direction of the aneurysmal dome around the PCoA (medial, lateral, superior, inferior, and posterior), aneurysm bleb formation, whether the PCoA was fetal type, and the existence of other intracranial unruptured aneurysm(s). Patients with ruptured PCoA aneurysms were significantly younger (a higher proportion were PCoA aneurysms showed a lateral direction of the aneurysmal dome around the PCoA, had bleb formation, and the aneurysm was > 7 mm in diameter and/or the dome-to-neck ratio was > 2.0. Multivariate logistic regression analysis showed age PCoA (OR 6.7, p = 0.0001), and bleb formation (OR 11, p PCoA aneurysm rupture. The present results demonstrated that lateral projection of a PCoA aneurysm may be related to rupture.

  6. Rupture-control via T-Branches - now with precise indication of the rupture; Abrissueberwachung ueber T-Weichen mit Lokalisierung des Abrisses

    Energy Technology Data Exchange (ETDEWEB)

    Lentz, S. [Roetter Industrieelektronik GmbH, Kaiserslautern (Germany)

    2000-05-01

    In hierarchical monitoring systems, normally only the main line can be checked automatically for rupture of the sensor wire. During the AGFW lecture conference in 1998 in Essen, a solution was introduced, where through closing the branch lines with endpieces by the Roetter Industrieelektronik GmbH, the branch lines could be also monitored for ruptures automatically. This process has been further developed since then and now offers the possibility to directly indicate the ruptured branch and if there is more than one rupture, this can be indicated separately as well. (orig.) [German] In hierarchischen Ueberwachungssystemen kann ueblicherweise nur die Hauptleitung automatisch auf Abriss des Sensordrahtes geprueft werden. Bereits auf der AGFW Vortragstagung 1998 in Essen wurde eine Loesung vorgestellt, durch Abschluss der Abzweigleitungen mit Endstuecken von Roetter Industrieelektronik GmbH auch die Abzweigleitungen automatisch auf Abriss zu ueberwachen. Dieses Verfahren wurde praxisgerecht weiterentwickelt und bietet nun die Moeglichkeit, den vom Abriss betroffenen Abzweig direkt anzuzeigen, bei mehreren Abrissen ist jeder einzelne zuzuordnen. (orig.)

  7. Why the 2002 Denali fault rupture propagated onto the Totschunda fault: implications for fault branching and seismic hazards

    Science.gov (United States)

    Schwartz, David P.; Haeussler, Peter J.; Seitz, Gordon G.; Dawson, Timothy E.

    2012-01-01

    The propagation of the rupture of the Mw7.9 Denali fault earthquake from the central Denali fault onto the Totschunda fault has provided a basis for dynamic models of fault branching in which the angle of the regional or local prestress relative to the orientation of the main fault and branch plays a principal role in determining which fault branch is taken. GeoEarthScope LiDAR and paleoseismic data allow us to map the structure of the Denali-Totschunda fault intersection and evaluate controls of fault branching from a geological perspective. LiDAR data reveal the Denali-Totschunda fault intersection is structurally simple with the two faults directly connected. At the branch point, 227.2 km east of the 2002 epicenter, the 2002 rupture diverges southeast to become the Totschunda fault. We use paleoseismic data to propose that differences in the accumulated strain on each fault segment, which express differences in the elapsed time since the most recent event, was one important control of the branching direction. We suggest that data on event history, slip rate, paleo offsets, fault geometry and structure, and connectivity, especially on high slip rate-short recurrence interval faults, can be used to assess the likelihood of branching and its direction. Analysis of the Denali-Totschunda fault intersection has implications for evaluating the potential for a rupture to propagate across other types of fault intersections and for characterizing sources of future large earthquakes.

  8. Long term outcome of ruptured vertebrobasilar artery dissection treated non-surgically

    International Nuclear Information System (INIS)

    Nakano, Takahiro; Ohkuma, Hiroki; Shimamura, Norihito; Munakata, Akira; Kikkawa, Tomoshige

    2010-01-01

    Vertebrobasilar artery dissection began to attract attention as a cause of subarachnoid hemorrhage (SAH) in the late 1970s. Although reports on this disease have gradually increased, the natural history of vertebrobasilar artery dissection remains obscure, and long-term follow-up of patients without surgical treatment is necessary to determine appropriate treatment. We describe the long-term clinical course of ruptured vertebrobasilar artery dissection treated non-surgically. Fourteen subjects with ruptured vertebrobasilar artery dissection were treated conservatively in 7 neurosurgical departments. We reviewed their clinical outcomes, image findings and the chronological changes at the dissection site from their charts. The modified Rankin Scale was Grade 0 in 13 of 14 cases, and Grade 2 in 1 case. The configuration of dissection did not change during the follow-up period in 12 of 14 cases, but occlusion and restoration were recognized in a single case each. Good prognosis was common in the patients with ruptured vertebrobasilar artery dissection who were treated non-surgically. It is essential to accumulate more data on the clinical course and changes in image findings of long-term survival cases to establish a definite strategy for ruptured vertebrobasilar artery dissection. (author)

  9. Isolated Common Hepatic Artery Branch Thrombosis: Results and Risk Factors

    Directory of Open Access Journals (Sweden)

    Abdoulhossein Davoodabadi

    2016-10-01

    Full Text Available Isolated common hepatic artery branch thrombosis with severe gastric ischemia and duodenojejunal infarction is a rare condition; it usually presents with acute abdomen and may be associated with underlying thrombotic risk factors. We present a 35-year-old man admitted to our hospital with five days history of sudden abdominal pain and deteriorating epigastric pain. He was a driver and had no any past medical history. Explorative laparotomy showed: distal 2/3 gastric, duodenojejunal and papilla vater was sloughed. The stomach subtotal and sloughed duodenum and first 20 cm of jejunum were resected, continuity of the gastrointestinal was preserved with anastomosis of the proximal part of jejunum to gastric stump, pancreatic duct, and CBD repaired to the lateral side of jejunum on the guide of two 18 French feeding tube as an external drain. The patient had a good immediate postoperative recovery. Coagulation checkup after operation revealed isolated Hyperhomocysteinemia.

  10. Variant Branching Pattern of Dorsalis Pedis Artery Accompanied with Anomalous Presence of Extensor Hallucis Brevis Muscle

    Directory of Open Access Journals (Sweden)

    Ashwini Aithal Padur

    2017-10-01

    Full Text Available During routine dissection, we came across multiple variations in the dorsum of the right foot. Dorsalis pedis artery (DPA presented with an unusual branching pattern. The arcuate artery was completely absent, and hence three tarsal branches arose from lateral side of DPA. The first branch continued as first dorsal metatarsal artery, the second branch continued as the second dorsal metatarsal artery, and the third branch continued as third dorsal metatarsal artery which also provided a small twig to the fourth intermetatarsal space as the fourth dorsal metatarsal artery. We also observed the unique presence of extensor hallucis brevis muscle with the origin from the medial part of superior surface of the calcaneus and inserted to proximal phalanx of great toe. Since the DPA was just beneath this muscle, anomalous presence of the muscle may lead to compression of DPA. Awareness regarding such variations is critical for angiographers, vascular surgeons, reconstructive and plastic surgeons.

  11. Successful management with glue injection of arterial rupture seen during embolization of an arteriovenous malformation using a flow-directed catheter: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Jong Won; Baik, Seung Kug; Shin, Mi Jung; Choi, Han Yong; Kim, Bong Gi [Wallace Memorial Baptist Hospital, Pusan (Korea, Republic of)

    2000-12-01

    We present a case in which an arterial rupture occurring during embolization of an arteriovenous malformation of the left occipital lobe with a flow-directed micro-catheter, was successfully sealed with a small amount of glue. We navigated a 1.8-Fr Magic catheter through the posterior cerebral artery, and during superselective test injection, extravasation was observed at the parieto-occipital branch. The catheter was not removed and the perforation site was successfully sealed with a small amount of glue injected through the same catheter. Prompt recognition and closure of the perforation site is essential for good prognosis. (author)

  12. Branch Retinal Artery Occlusion Caused by Toxoplasmosis in an Adolescent

    Directory of Open Access Journals (Sweden)

    Elizabeth Chiang

    2012-10-01

    Full Text Available Purpose: Branch retinal artery occlusion (BRAO, while not uncommon in elderly patient populations, is rare in children and adolescents. We report a case of a BRAO secondary to toxoplasmosis in this demographic. Case: A previously healthy 17-year-old male developed a unilateral BRAO in conjunction with inflammation and increased intraocular pressure. Family history was positive for cerebrovascular accidents in multiple family members at relatively young ages. The patient had a hypercoagulable workup as well as a cardiovascular workup which were both normal. A rheumatologic workup was unremarkable. By 3 weeks, a patch of retinitis was more easily distinguished from the BRAO and the diagnosis of ocular toxoplasmosis was made. Treatment was started with prednisone and azithromycin with subsequent improvement in vision. Toxoplasma antibody levels were elevated for IgG and negative for IgM, IgA, and IgE. The etiology of the BRAO was attributed to ocular toxoplasmosis. Conclusions: Vascular occlusions are rare in toxoplasmosis. This is the third case report of a BRAO in a patient in the pediatric population. The diagnosis of ocular toxoplasmosis should be considered in young patients with retinal artery occlusions associated with inflammation.

  13. [Risk factors of rupture of internal carotid artery during surgical resection of carotid body tumor].

    Science.gov (United States)

    Li, Y H; Wang, J S; Yao, C; Chang, G Q; Yin, H H; Li, S Q; Lü, W M; Hu, Z J; Wang, S M

    2017-06-13

    Objective: To investigate risk factors of rupture of internal carotid artery resection during carotid body tumor resection and to summarize our treatment experience. Methods: During the period from 1991 to 2016, rupture of internal carotid artery occurred in 27 patients (28 tumors) during surgical resection of carotid body tumor in the First Affiliated Hospital of Sun Yat-sen University. Their clinical and follow-up data were retrospectively collected and analyzed. For all patients underwent surgical resection during this period, Logistic regression analysis was used to investigate the risk factors of intraoperative rupture of internal carotid artery. Results: Of these 28 tumors, there were 15 (53.6%) tumors with diameter≥5 cm and 20 (71.4%) Shamblin Ⅲ tumors. Intraoperatively, shunt was applied for 8 (28.6%) cases. Thirteen (46.4%) patients underwent ligation of external carotid artery, while 2 (7.1%) patients accepted resection of cranial nerves. Direct closure/patchplasty, autologous vessels or graft reconstruction was used in 16, 10 and 2 cases, respectively. Postoperatively, stroke occurred in 4(14.3%) cases and cranial nerve deficit in 15 (53.6%) cases. During a median length of 36 (14-125) months, cranial nerve deficit persisted in 5 cases. Follow-up radiologic examination indicated 3 (10.7%) cases of targeted vessel occlusion. However, no new-onset stroke was identified. Among all patients underwent surgical resection of carotid body tumor, female ( OR =3.650, P =0.012), age≤25 years old ( OR =3.710, P =0.013) and Shamblin Ⅲ tumor ( OR =4.631, P =0.008) increase the risks of intraoperative carotid artery rupture. Conclusions: Shamblin Ⅲ tumor is the predictor of rupture of internal carotid artery. Intraoperative, properly increased blood pressure, intraoperative heparinization and use of shunt for those cases without well-compensated cranial collateral arteries are likely to decreasing the incidence of stroke.

  14. Percutaneous and Endovascular Embolization of Ruptured Hepatic Artery Aneurysm

    International Nuclear Information System (INIS)

    Little, Andrew F.; Lee, Wai Kit

    2002-01-01

    A 72-year-old woman presented with an intraperitoneal hemorrhage from a ruptured intrahepatic arteryaneurysm, with an associated pseudoaneurysm developing a high-flow arteriovenous fistula. Persistent coagulopathy and a median arcuate ligament stenosis of the celiac axis further complicated endovascular management. Aneurysm thrombosis required percutaneous embolization with coils, a removable core guidewire and polyvinyl alcohol particles

  15. Morphological and Hemodynamic Discriminators for Rupture Status in Posterior Communicating Artery Aneurysms.

    Directory of Open Access Journals (Sweden)

    Nan Lv

    Full Text Available The conflicting findings of previous morphological and hemodynamic studies on intracranial aneurysm rupture may be caused by the relatively small sample sizes and the variation in location of the patient-specific aneurysm models. We aimed to determine the discriminators for aneurysm rupture status by focusing on only posterior communicating artery (PCoA aneurysms.In 129 PCoA aneurysms (85 ruptured, 44 unruptured, clinical, morphological and hemodynamic characteristics were compared between the ruptured and unruptured cases. Multivariate logistic regression analysis was performed to determine the discriminators for rupture status of PCoA aneurysms.While univariate analyses showed that the size of aneurysm dome, aspect ratio (AR, size ratio (SR, dome-to-neck ratio (DN, inflow angle (IA, normalized wall shear stress (NWSS and percentage of low wall shear stress area (LSA were significantly associated with PCoA aneurysm rupture status. With multivariate analyses, significance was only retained for higher IA (OR = 1.539, p < 0.001 and LSA (OR = 1.393, p = 0.041.Hemodynamics and morphology were related to rupture status of intracranial aneurysms. Higher IA and LSA were identified as discriminators for rupture status of PCoA aneurysms.

  16. Regional blood flow analysis and its relationship with arterial branch lengths and lumen volume in the coronary arterial tree

    International Nuclear Information System (INIS)

    Molloi, Sabee; Wong, Jerry T

    2007-01-01

    The limitations of visually assessing coronary artery disease are well known. These limitations are particularly important in intermediate coronary lesions (30-70% diameter stenosis) where it is difficult to determine whether a particular lesion is the cause of ischaemia. Therefore, a functional measure of stenosis severity is needed. The purpose of this study is to determine whether the expected maximum coronary blood flow in an arterial tree is predictable from its sum of arterial branch lengths or lumen volume. Using a computer model of a porcine coronary artery tree, an analysis of blood flow distribution was conducted through a network of millions of vessels that included the entire coronary artery tree down to the first capillary branch. The flow simulation results show that there is a linear relationship between coronary blood flow and the sum of its arterial branch lengths. This relationship holds over the entire arterial tree. The flow simulation results also indicate that there is a 3/4 er relation between coronary blood flow (Q) and the sum of its arterial lumen volume (V). Moreover, there is a linear relationship between normalized Q and normalized V raised to a power of 3/4 over the entire arterial tree. These results indicate that measured arterial branch lengths or lumen volumes can be used to predict the expected maximum blood flow in an arterial tree. This theoretical maximum blood flow, in conjunction with an angiographically measured blood flow, can potentially be used to calculate fractional flow reserve based entirely on angiographic data

  17. Percutaneous treatment of a ruptured superior mesenteric artery aneurysm in a child

    International Nuclear Information System (INIS)

    Oechsle, Susanne; Vollert, Kurt; Buecklein, Wolfgang; Michl, Wolfgang; Roemer, Frank W.

    2006-01-01

    Splanchnic artery aneurysms are very rare in children. We report a 10-year-old girl with a large atraumatic ruptured superior mesenteric artery aneurysm that was considered inoperable. She was ultimately treated with two percutaneous US-guided thrombin injections, which led to complete occlusion of the aneurysm. The aetiology of the aneurysm remained unclear, but a family history was suggestive of a congenital connective tissue disease such as Ehlers-Danlos syndrome subtype IV. (orig.)

  18. Percutaneous treatment of a ruptured superior mesenteric artery aneurysm in a child

    Energy Technology Data Exchange (ETDEWEB)

    Oechsle, Susanne; Vollert, Kurt; Buecklein, Wolfgang; Michl, Wolfgang; Roemer, Frank W. [Klinikum Augsburg, Department of Radiology, Augsburg (Germany)

    2006-03-15

    Splanchnic artery aneurysms are very rare in children. We report a 10-year-old girl with a large atraumatic ruptured superior mesenteric artery aneurysm that was considered inoperable. She was ultimately treated with two percutaneous US-guided thrombin injections, which led to complete occlusion of the aneurysm. The aetiology of the aneurysm remained unclear, but a family history was suggestive of a congenital connective tissue disease such as Ehlers-Danlos syndrome subtype IV. (orig.)

  19. [Successful correction with stent-graft of coronary artery rupture after angioplasty].

    Science.gov (United States)

    Demin, V V

    2003-01-01

    Rupture and perforation of coronary arteries complicate in average 0.5% of radiosurgical coronary interventions and often are accompanied by serious consequences and high mortality. According to-type of coronary perforation different methods of correction are used, ranging from conservative measures to urgent cardiosurgical interventions. Coronary stent-grafts with 'sandwich' type of construction ore composed from two metal stents and PTFE layer between them. Development of such stents enabled effective radioguided endovascular repair of coronary ruptures. The paper presents the first Russian experience of stout-graft implantation for coronary artery rupture occurred during direct stenting of proximal anterior descending artery and balloon angioplasty in distal segment. The rupture occurred probably because of wall fragility between affected segment and muscular bridge. Stent-graft JoStent 16 mm in length connected with 3-mm balloon was implanted with subsequent complete restitution of blood flow, resolution of pain syndrome and ECG normalization. Echocardiography in operative theatre and one day after surgery showed no intrapericardial fluid. Stent-graft devices for urgent implantation in cases of coronary rupture must be included into obligatory equipment of radiosurgical facilities.

  20. Computer-assisted 3D reconstruction of the terminal branches of th cerebral arteries. Pt. 2. Middle cerebral artery

    International Nuclear Information System (INIS)

    Gloger, S.; Gloger, A.; Vogt, H.; Kretschmann, H.J.

    1994-01-01

    We present a three-dimensional anatomical computer model of the terminal branches of the middle cerebral artery, acquired from equidistant serial anatomical slices of three brains. The reconstructions provide a clear picture from all angles of the complicated course of the terminal branches of the cerebral arteries, which can help to identify them on conventional angiography and magnetic resonance angiography. The arteries can also be matched with CT, MR or PET images to indicate the areas of extension of individual branches, allowing neuromorphological and functional correlations. (orig.)

  1. Computer-assisted 3D reconstruction of the terminal branches of the cerebral arteries. Pt. 1. Anterior cerebral artery

    International Nuclear Information System (INIS)

    Gloger, S.; Gloger, A.; Vogt, H.; Kretschmann, H.J.

    1994-01-01

    We present a three-dimensional anatomical computer model of the terminal branches of the anterior cerebral artery, acquired from equidistant serial anatomical slices of three brains. The reconstructions provide a clear picture from all angles of the complicated course of the terminal branches of the cerebral arteries, which can help to identify them on conventional and magnetic resonance angiography. Our rendition of the cerebral arteries can also be matched with CT, MR or PET images to indicate the areas of extension of individual branches, allowing neuromorphological and functional correlation. (orig.)

  2. Computer-assisted 3D reconstruction of the terminal branches of th cerebral arteries. Pt. 2. Middle cerebral artery

    Energy Technology Data Exchange (ETDEWEB)

    Gloger, S. (Dept. of Neuroanatomy, Hannover Medical School (Germany)); Gloger, A. (Dept. of Neuroanatomy, Hannover Medical School (Germany)); Vogt, H. (Dept. of Neuroanatomy, Hannover Medical School (Germany)); Kretschmann, H.J. (Dept. of Neuroanatomy, Hannover Medical School (Germany))

    1994-04-01

    We present a three-dimensional anatomical computer model of the terminal branches of the middle cerebral artery, acquired from equidistant serial anatomical slices of three brains. The reconstructions provide a clear picture from all angles of the complicated course of the terminal branches of the cerebral arteries, which can help to identify them on conventional angiography and magnetic resonance angiography. The arteries can also be matched with CT, MR or PET images to indicate the areas of extension of individual branches, allowing neuromorphological and functional correlations. (orig.)

  3. Computer-assisted 3D reconstruction of the terminal branches of the cerebral arteries. Pt. 1. Anterior cerebral artery

    Energy Technology Data Exchange (ETDEWEB)

    Gloger, S. (Dept. of Neuroanatomy, Hannover Medical School (Germany)); Gloger, A. (Dept. of Neuroanatomy, Hannover Medical School (Germany)); Vogt, H. (Dept. of Neuroanatomy, Hannover Medical School (Germany)); Kretschmann, H.J. (Dept. of Neuroanatomy, Hannover Medical School (Germany))

    1994-04-01

    We present a three-dimensional anatomical computer model of the terminal branches of the anterior cerebral artery, acquired from equidistant serial anatomical slices of three brains. The reconstructions provide a clear picture from all angles of the complicated course of the terminal branches of the cerebral arteries, which can help to identify them on conventional and magnetic resonance angiography. Our rendition of the cerebral arteries can also be matched with CT, MR or PET images to indicate the areas of extension of individual branches, allowing neuromorphological and functional correlation. (orig.)

  4. Rupture of true profunda femoris artery aneurysms. Two new cases

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Schroeder, T V

    1996-01-01

    Atherosclerotic aneurysms of the deep femoral artery are very rare. We report the first 2 published Scandinavian cases. Both were present in elderly smoking men. They presented with acute local pain, swelling and circulatory collapse. Ultrasonography and angiography demonstrated femoral aneurysm ...... but it was only at operation that the relation to the deep femoral artery was established. Simple ligation of the deep femoral artery was performed in one case. The other patient had a 6 mm PTFE graft interpositioned. Both made an uneventful recovery....

  5. Spontaneous rupture of a left gastroepiploic artery aneurysm.

    Directory of Open Access Journals (Sweden)

    Rohatgi A

    2002-10-01

    Full Text Available Gastroepiploic aneurysms are extremely rare. They occur mainly in elderly men and in 90% of cases are ruptured at presentation. Visceral aneurysms though rare should be borne in mind in cases of unexplained haemorrhagic shock. We present a case of a 79-year-old man who presented with abdominal pain, hypotension and anaemia but no obvious source of bleeding. He had undergone a prior aorto-bifemoral graft. The patient refused an operation and died the following day.

  6. Chemoembolization Via Branches from the Splenic Artery in Patients with Hepatocellular Carcinoma

    International Nuclear Information System (INIS)

    Choi, Jin Woo; Kim, Hyo-Cheol; Chung, Jin Wook; Kim, Ji Dae; Kim, Gyoung Min; Lee, In Joon; Jae, Hwan Jun; Park, Jae Hyung

    2012-01-01

    Purpose: This study was designed to evaluate the radiologic findings and imaging response of chemoembolization via branches of the splenic artery in patients with hepatocellular carcinoma (HCC). Methods: From January 2001 to July 2010, we observed tumor staining supplied by branches of the splenic artery in 34 (0.6%) of 5,413 patients with HCC. Computed tomography (CT) scans and digital subtraction angiograms of these patients were retrospectively reviewed in consensus by two investigators. Results: A total of 39 tumor feeding-vessels in 34 patients were identified: omental branches from the left gastroepiploic artery (n = 5), branches from the short gastric artery (n = 9), and omental branches directly from the splenic artery (n = 25). Branches of the splenic artery that supplied tumors were revealed on the celiac angiogram in 29 (85%) of 34 patients and were detected on pre-procedure CT images in 27 (79%) of 34 patients. Selective chemoembolization was achieved in 38 of 39 tumor-feeding vessels. Complete or partial response of the tumor fed by branches of the splenic artery, as depicted on follow-up CT scans, was achieved in 21 (62%) patients. No patient developed severe complications directly related to chemoembolization via branches of the splenic artery. Conclusions: Omental branches directly from the splenic artery are common tumor-feeding vessels of the splenic artery in cases of advanced HCC with multiple previous chemoembolizations. Tumor-feeding vessels of the splenic artery are usually visualized on the celiac angiogram or CT scan, and chemoembolization through them can be safely performed in most patients.

  7. Endovascular management of renal artery aneurysm rupture in pregnancy – A case report

    Directory of Open Access Journals (Sweden)

    E. Maughan

    2015-01-01

    Conclusion: In the shocked pregnant patient with an acute abdominal presentation, visceral artery aneurysm rupture may be comparatively more common, and should be considered in the absence of other localizing symptoms. Prompt interventional radiological treatment may be lifesaving in such cases.

  8. Embolization of Life-Threatening Arterial Rupture in Patients with Vascular Ehlers–Danlos Syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Okada, Takuya, E-mail: okabone@gmail.com [Assistance Publique des Hôpitaux de Paris, Georges Pompidou European Hospital, Interventional Radiology Department (France); Frank, Michael, E-mail: michael.frank@egp.aphp.fr [Assistance Publique des Hôpitaux de Paris, Georges Pompidou European Hospital, Rare Vascular Diseases Reference Center (France); Pellerin, Olivier, E-mail: olivier@pellerin.as; Primio, Massimiliano Di, E-mail: massimiliano.di.primio@gmail.com; Angelopoulos, Georgios, E-mail: giorginos78@msn.com [Assistance Publique des Hôpitaux de Paris, Georges Pompidou European Hospital, Interventional Radiology Department (France); Boughenou, Marie-Fazia, E-mail: marie-fazia.boughenou@egp.aphp.fr [Assistance Publique des Hôpitaux de Paris, Georges Pompidou European Hospital, Anesthesia and Surgical Intensive Care Unit (France); Pagny, Jean-Yves, E-mail: jean-yves.pagny@egp.aphp.fr [Assistance Publique des Hôpitaux de Paris, Georges Pompidou European Hospital, Interventional Radiology Department (France); Messas, Emmanuel, E-mail: emmanuel.messas@egp.aphp.fr [Assistance Publique des Hôpitaux de Paris, Georges Pompidou European Hospital, Rare Vascular Diseases Reference Center (France); Sapoval, Marc, E-mail: marc.sapoval2@egp.aphp.fr [Assistance Publique des Hôpitaux de Paris, Georges Pompidou European Hospital, Interventional Radiology Department (France)

    2013-05-09

    PurposeTo evaluate the safety and efficacy of transarterial embolization of life-threatening arterial rupture in patients with vascular Ehlers–Danlos syndrome (vEDS) in a single tertiary referral center.MethodsWe retrospectively analyzed transarterial embolization for vEDS performed at our institution from 2000 to 2012. The indication of embolization was spontaneous arterial rupture or pseudoaneurysm with acute bleeding. All interventions used a percutaneous approach through a 5F or less introducer sheath. Embolic agents were microcoils and glue in 3 procedures, glue alone in 2, and microcoils alone in 2.ResultsFive consecutive vEDS patients were treated by 7 embolization procedures (4 women, mean age 29.8 years). All procedures were successfully performed. Two patients required a second procedure for newly arterial lesions at a different site from the first procedure. Four of the five patients were still alive after a mean follow-up of 19.4 (range 1–74.7) months. One patient died of multiple organ failure 2 days after procedure. Minor procedural complications were observed in 3 procedures (43 %), all directly managed during the same session. Remote arterial lesions occurred after 3 procedures (43 %); one underwent a second embolization, and the other 2 were observed conservatively. Puncture site complication was observed in only one procedure (14 %).ConclusionEmbolization for vEDS is a safe and effective method to manage life-threatening arterial rupture.

  9. Embolization of Life-Threatening Arterial Rupture in Patients with Vascular Ehlers–Danlos Syndrome

    International Nuclear Information System (INIS)

    Okada, Takuya; Frank, Michael; Pellerin, Olivier; Primio, Massimiliano Di; Angelopoulos, Georgios; Boughenou, Marie-Fazia; Pagny, Jean-Yves; Messas, Emmanuel; Sapoval, Marc

    2014-01-01

    PurposeTo evaluate the safety and efficacy of transarterial embolization of life-threatening arterial rupture in patients with vascular Ehlers–Danlos syndrome (vEDS) in a single tertiary referral center.MethodsWe retrospectively analyzed transarterial embolization for vEDS performed at our institution from 2000 to 2012. The indication of embolization was spontaneous arterial rupture or pseudoaneurysm with acute bleeding. All interventions used a percutaneous approach through a 5F or less introducer sheath. Embolic agents were microcoils and glue in 3 procedures, glue alone in 2, and microcoils alone in 2.ResultsFive consecutive vEDS patients were treated by 7 embolization procedures (4 women, mean age 29.8 years). All procedures were successfully performed. Two patients required a second procedure for newly arterial lesions at a different site from the first procedure. Four of the five patients were still alive after a mean follow-up of 19.4 (range 1–74.7) months. One patient died of multiple organ failure 2 days after procedure. Minor procedural complications were observed in 3 procedures (43 %), all directly managed during the same session. Remote arterial lesions occurred after 3 procedures (43 %); one underwent a second embolization, and the other 2 were observed conservatively. Puncture site complication was observed in only one procedure (14 %).ConclusionEmbolization for vEDS is a safe and effective method to manage life-threatening arterial rupture

  10. Severe postpartum haemorrhage from ruptured pseudoaneurysm: successful treatment with transcatheter arterial embolization

    Energy Technology Data Exchange (ETDEWEB)

    Soyer, Philippe; Fargeaudou, Yann; Boudiaf, Mourad; Le Dref, Olivier; Rymer, Roland [Hopital Lariboisiere-AP-HP Universite Paris 7, Department of Abdominal Imaging, Paris cedex 10 (France); Morel, Olivier [Hopital Lariboisiere-AP-HP Universite Paris 7, Department of Obstetrics, Paris cedex 10 (France)

    2008-06-15

    The purpose of this retrospective study was to evaluate the role of transcatheter arterial embolization in the management of severe postpartum haemorrhage due to a ruptured pseudoaneurysm and to analyse the clinical symptoms that may suggest a pseudoaneurysm as a cause of postpartum haemorrhage. A retrospective search of our database disclosed seven women with severe postpartum haemorrhage in whom angiography revealed the presence of a uterine or vaginal artery pseudoaneurysm and who were treated using transcatheter arterial embolization. Clinical files were reviewed for possible clinical findings that could suggest pseudoaneurysm as a cause of bleeding. Angiography revealed extravasation of contrast material in five out of seven patients. Transcatheter arterial embolization allowed to control the bleeding in all patients and subsequently achieve vaginal suture in four patients with vaginal laceration. No complications related to transcatheter arterial embolization were noted. Only two patients had uterine atony, and inefficiency of sulprostone was observed in all patients. Transcatheter arterial embolization is an effective and secure technique for the treatment of severe postpartum haemorrhage due to uterine or vaginal artery pseudoaneurysm. Ineffectiveness of suprostone and absence of uterine atony should raise the possibility of a ruptured pseudoaneurysm. (orig.)

  11. Severe postpartum haemorrhage from ruptured pseudoaneurysm: successful treatment with transcatheter arterial embolization

    International Nuclear Information System (INIS)

    Soyer, Philippe; Fargeaudou, Yann; Boudiaf, Mourad; Le Dref, Olivier; Rymer, Roland; Morel, Olivier

    2008-01-01

    The purpose of this retrospective study was to evaluate the role of transcatheter arterial embolization in the management of severe postpartum haemorrhage due to a ruptured pseudoaneurysm and to analyse the clinical symptoms that may suggest a pseudoaneurysm as a cause of postpartum haemorrhage. A retrospective search of our database disclosed seven women with severe postpartum haemorrhage in whom angiography revealed the presence of a uterine or vaginal artery pseudoaneurysm and who were treated using transcatheter arterial embolization. Clinical files were reviewed for possible clinical findings that could suggest pseudoaneurysm as a cause of bleeding. Angiography revealed extravasation of contrast material in five out of seven patients. Transcatheter arterial embolization allowed to control the bleeding in all patients and subsequently achieve vaginal suture in four patients with vaginal laceration. No complications related to transcatheter arterial embolization were noted. Only two patients had uterine atony, and inefficiency of sulprostone was observed in all patients. Transcatheter arterial embolization is an effective and secure technique for the treatment of severe postpartum haemorrhage due to uterine or vaginal artery pseudoaneurysm. Ineffectiveness of suprostone and absence of uterine atony should raise the possibility of a ruptured pseudoaneurysm. (orig.)

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

    Science.gov (United States)

    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.

  13. Management of ruptured anterior communicating artery aneurysms presenting with sudden paraplegia

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    Jiu-hong MA

    2016-10-01

    Full Text Available Objective  To explore the causes of ruptured anterior communicating artery aneurysms presenting with paraplegia, and summarize the key points of diagnosis and treatment methods. Methods  A total of 260 patients with ruptured anterior communicating artery aneurysms were received medical treatment in the Department of Neurosurgery, Shanxi Provincial People's Hospital from Jan. 2012 to Mar. 2015. Of which 6 patients were clinically presented with paraplegia, their clinical data including CT/MR/DSA were retrospectively analyzed, and based on the analysis, aneurysm embolization and anti-vasospasm treatment were performed. Results  Besides headache and discomfort in the neck, 5 of the 6 patients were with double lower limbs paraplegia, and the another one presented quadriplegia. By symptomatic treatment of aneurysm embolization and anti vasospasm, the myodynamia of the paraplegic limbs recovered from 0-Ⅰto Ⅳ-Ⅴgrade, and 2 of the 6 patients spent a shorter recovery time (about 2 weeks, the other 4 recovered in 3 months. The limbs myodynamia of the 6 patients recovered completely in half-and one year follow up. Conclusions  The mechanism of ruptured anterior communicating artery aneurysms presenting with paraplegia may be the insufficient blood supply to the primary motor area and supplementary motor area (SMA of brain cortex caused by aneurysms rupture. Aneurysm embolization should be performed in clinical treatment, supplemented with anti vasospasm and symptomatic treatment of improving neurological function. DOI: 10.11855/j.issn.0577-7402.2016.09.14

  14. Morphological and Hemodynamic Discriminators for Rupture Status in Posterior Communicating Artery Aneurysms.

    Science.gov (United States)

    Lv, Nan; Wang, Chi; Karmonik, Christof; Fang, Yibin; Xu, Jinyu; Yu, Ying; Cao, Wei; Liu, Jianmin; Huang, Qinghai

    2016-01-01

    The conflicting findings of previous morphological and hemodynamic studies on intracranial aneurysm rupture may be caused by the relatively small sample sizes and the variation in location of the patient-specific aneurysm models. We aimed to determine the discriminators for aneurysm rupture status by focusing on only posterior communicating artery (PCoA) aneurysms. In 129 PCoA aneurysms (85 ruptured, 44 unruptured), clinical, morphological and hemodynamic characteristics were compared between the ruptured and unruptured cases. Multivariate logistic regression analysis was performed to determine the discriminators for rupture status of PCoA aneurysms. While univariate analyses showed that the size of aneurysm dome, aspect ratio (AR), size ratio (SR), dome-to-neck ratio (DN), inflow angle (IA), normalized wall shear stress (NWSS) and percentage of low wall shear stress area (LSA) were significantly associated with PCoA aneurysm rupture status. With multivariate analyses, significance was only retained for higher IA (OR = 1.539, p PCoA aneurysms.

  15. Rupture of the Renal Artery After Cutting Balloon Angioplasty in a Young Woman With Fibromuscular Dysplasia

    International Nuclear Information System (INIS)

    Oguzkurt, Levent; Tercan, Fahri; Gulcan, Oner; Turkoz, Riza

    2005-01-01

    A 24-year-old woman with uncontrollable high blood pressure for 3 months had significant stenosis of the left renal artery caused by fibromuscular dysplasia (FMD). The lesion was resistant to percutaneous transluminal angioplasty at 18 atm with a semicompliant balloon. Angioplasy with a 6 x 10 mm cutting balloon (CB) caused rupture of the artery. Low-pressure balloon inflation decreased but did not stop the leak. An attempt to place a stent-graft (Jostent; Jomed, Rangendingen, Germany) failed, and a bare, 6-mm balloon-expandable stent (Express SD; Boston Scientific, MN) was deployed to seal the leak, which had decreased considerably after long-duration balloon inflation. The bleeding continued, and the patient underwent emergent surgical revascularization of the renal artery with successful placement of a 6-mm polytetrafluoroethylene bypass graft. CBs should be used very carefully in the treatment of renal artery stenosis, particularly in patients with FMD

  16. Miscellaneous Endovascular Treatment of Ruptured Hepatic Artery Pseudoaneurysms after Pylorus Preserving Pancreaticoduodenectomy

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Ung Rae; Lee, Young Hwan [Dept. of Radiology, Daegu Catholic University Medical Center, Catholic of Daegu University School of Medicine, Daegu (Korea, Republic of); Ahn, Eun Joung; Kim, See Hyung; Kim, Young Hwan [Dept. of Radiology, Keimyung University Dongsan Medical Center, Keimyung University College of Medicine, Daegu (Korea, Republic of)

    2012-03-15

    To assess the feasibility and safety of the endovascular treatment of ruptured hepatic artery pseudoaneurysms after pylorus preserving pancreaticoduodenectomy (PPPD). Thirteen patients with hepatic artery pseudoaneurysm after PPPD were enrolled. Various endovascular techniques were used depending on the sites and morphologies of the pseudoaneurysms. Five cases were treated by coil embolization, five with stent-graft, one by thrombin injection and coil embolization, one with stent-graft and coil embolization, and one with N-butyl cyanoacrylate (NBCA) injection. Computed tomography scans and liver function test were performed after the procedures. Pseudoaneurysm exclusion and bleeding cessation was achieved in all patients. In four patients that underwent coil or NBCA embolization of the hepatic artery, aspartate transaminase (AST) and alanine transaminase (ALT) were markedly elevated. Two of these four patients with narrowing of the portal vein due to surrounding hematoma died of hepatic infarction or hepatic abscess. In other nine patients, AST and ALT were unchanged. In the 11 surviving patients, normal hepatic function and complete pseudoaneurysm disappearance were achieved during follow-up. Endovascular treatment of ruptured hepatic artery pseudoaneurysms can be considered as a feasible and safe method. However, complete occlusion of the hepatic artery with coils should be avoided in patients with inadequate portal flow.

  17. Clinical, morphological, and hemodynamic independent characteristic factors for rupture of posterior communicating artery aneurysms.

    Science.gov (United States)

    Zhang, Ying; Jing, Linkai; Liu, Jian; Li, Chuanhui; Fan, Jixing; Wang, Shengzhang; Li, Haiyun; Yang, Xinjian

    2016-08-01

    To identify clinical, morphological, and hemodynamic independent characteristic factors that discriminate posterior communicating artery (PCoA) aneurysm rupture status. 173 patients with single PCoA aneurysms (108 ruptured, 65 unruptured) between January 2012 and June 2014 were retrospectively collected. Patient-specific models based on their three-dimensional digital subtraction angiography images were constructed and analyzed by a computational fluid dynamic method. All variables were analyzed by univariate analysis and multivariate logistic regression analysis. Two clinical factors (younger age and atherosclerosis), three morphological factors (higher aspect ratio, bifurcation type, and irregular shape), and six hemodynamic factors (lower mean and minimum wall shear stress, higher oscillatory shear index, a greater portion of area under low wall shear stress, unstable and complex flow pattern) were significantly associated with PCoA aneurysm rupture. Independent factors characterizing the rupture status were identified as age (OR 0.956, p=0.015), irregular shape (OR 6.709, pPCoA aneurysm rupture were younger age, irregular shape, and low minimum wall shear stress. This may be useful for guiding risk assessments and subsequent treatment decisions for PCoA aneurysms. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  18. A unique branching pattern of the axillary artery: a case report.

    Science.gov (United States)

    Bagoji, Ishwar B; Hadimani, Gavishiddappa A; Bannur, Balappa M; Patil, B G; Bharatha, Ambadasu

    2013-12-01

    During routine dissection classes for under graduate students, we found a unique and unusual case regarding the anomalous branching in the third part of the axillary artery was terminated into subscapular arterial trunk, superficial brachial artery and deep brachial artery. The subscapular arterial trunk was origin of several important arteries as the circumflex scapular, thoracodorsal, posterior circumflex humeral, thoraco-acromial and lateral thoracic arteries. The deep brachial artery in the arm gave anterior circumflex humeral artery at the surgical neck of humerus, which terminated in the cubital fossa by dividing into radial and ulnar arteries. The superficial brachial artery gave two profunda brachii arteries, both of which passed through spiral groove, along with radial nerve and three muscular branches, to brachialis muscle. This variation is very rare. As per our knowledge, we did not find any literature which explained variations which were similar to this. The normal and abnormal anatomy of the axillary region has practical importance among vascular radiologists and surgeons and it should be known for making an accurate diagnostic interpretation.

  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)

    Miyahara, Ken; Maeda, Masanobu; Sakai, Yoshimasa; Sakurai, Hajime; Murayama, Hiroomi; Hasegawa, Hiroki

    2003-01-01

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

    Energy Technology Data Exchange (ETDEWEB)

    Miyahara, Ken; Maeda, Masanobu; Sakai, Yoshimasa; Sakurai, Hajime; Murayama, Hiroomi; Hasegawa, Hiroki [Social Insurance Chukyo Hospital, Nagoya (Japan)

    2003-01-01

    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

  1. Myocardial Bridges and their Relationship to the Anterior Interventricular Branch of the Left Coronary Artery

    Directory of Open Access Journals (Sweden)

    Lima Vanildo Júnior de Melo

    2002-01-01

    Full Text Available OBJECTIVE: To analyze the relationship between myocardial bridges and the anterior interventricular branch (anterior descending of the left coronary artery. METHODS: The study was carried out with postmortem material, and methods of dissection and observation were used. We assessed the perimeter of the anterior interventricular branch of the left coronary artery using a pachymeter, calculated its proximal and distal diameters in relation to the myocardial bridge, and also its diameter under the myocardial bridge in 30 hearts. We also observed the position of the myocardial bridge in relation to the origin of the anterior interventricular branch. RESULTS: The diameters of the anterior interventricular branch were as follows: the mean proximal diameter was 2.76±0.76 mm; the mean diameter under the myocardial bridge was 2.08±0.54 mm; and the mean distal diameter was 1.98±0.59 mm. In 33.33% (10/30 of the cases, the diameter of the anterior interventricular branch under the myocardial bridge was lower than the diameter of the anterior interventricular branch distal to the myocardial bridge. In 3.33% (1/30 of the cases, an atherosclerotic plaque was found in the segment under the myocardial bridge. The myocardial bridge was located in the middle third of the anterior interventricular branch in 86.66% (26/30 of the cases. CONCLUSION: Myocardial bridges are more frequently found in the middle third of the anterior interventricular branch of the left coronary artery. The diameter of the anterior interventricular branch of the left coronary artery under the myocardial bridge may be smaller than after the bridge. Myocardial bridges may not provide protection against the formation of atherosclerotic plaque inside the anterior interventricular branch of the left coronary artery.

  2. A Case of Ruptured Aneurysm of the Proper Esophageal Artery with Symptomatic Mediastinal Hematoma

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Jiajia; Sato, Yusuke, E-mail: yusuke@doc.med.akita-u.ac.jp [Akita University Graduate School of Medicine, Department of Thoracic Surgery (Japan); Takahashi, Satoshi [Akita University Graduate School of Medicine, Department of Radiology (Japan); Motoyama, Satoru; Yoshino, Kei; Sasaki, Tomohiko; Imai, Kazuhiro; Saito, Hajime; Minamiya, Yoshihiro [Akita University Graduate School of Medicine, Department of Thoracic Surgery (Japan)

    2016-08-15

    Mediastinal aneurysms are rare but potentially life-threatening. Among these, bronchial artery aneurysms are most frequently reported, whereas up to now aneurysms of the proper esophageal artery had never been reported. A 69-year-old woman was referred to our hospital for treatment of a massive mediastinal hematoma. Enhanced computed tomography and selective proper esophageal arteriography revealed a 5-mm aneurysm in the proper esophageal artery that arises from the thoracic aorta at the Th8 level and has an anastomotic branch with the bronchial artery peripherally. Transcatheter arterial embolization was successfully performed using a mixture of N-butyl cyanoacrylate and lipiodol (1:3 ratio, 0.3 ml). Post-embolization angiography showed no filling into the aneurysm. The patient recovered with no complications and was discharged on the 25th post-procedure day.

  3. Microneurosurgical management of aneurysms at A4 and A5 segments and distal cortical branches of anterior cerebral artery.

    Science.gov (United States)

    Lehecka, Martin; Dashti, Reza; Hernesniemi, Juha; Niemelä, Mika; Koivisto, Timo; Ronkainen, Antti; Rinne, Jaakko; Jääskeläinen, Juha

    2008-10-01

    Aneurysms originating distal to the A3 segment of the ACA, located on the A4 and the A5 segments or the distal cortical branches of the ACA (AdistAs) are rare, forming about 0.5% of all IAs. There are only few reports on management of AdistAs. In this article, we review the practical anatomy, preoperative planning, and avoidance of complications in the microsurgical dissection and clipping of AdistAs. This review, and the whole series on IAs, is mainly based on the personal microneurosurgical experience of the senior author (J. H.) in 2 Finnish centers (Helsinki and Kuopio), which serve without patient selection the catchment area in Southern and Eastern Finland. These 2 centers have treated more than 10000 patients with IAs since 1951. In the Kuopio Cerebral Aneurysm Database of 3005 patients and 4253 IAs, there were 26 patients carrying 26 AdistAs, forming 0.9% of all patients with IAs, 0.6% of all IAs, and 2% of all ACA aneurysms. A total of 10 (38%) patients presented with ruptured AdistAs, with ICH in 4 (40%) and IVH in 2 (20%); 16 patients (62%) had multiple aneurysms. AdistAs are small, even when ruptured, with relatively wide base, and they are frequently associated with ICHs. Our data suggest that AdistAs rupture at smaller size than IAs in general. The challenge is to locate the aneurysm inside the interhemispheric fissure and to clip the neck adequately without obstructing branching arteries at the base. Unruptured AdistAs also need microneurosurgical clipping even when they are small.

  4. Endovascular repair of an innominate artery pseudoaneurysm using the Valiant Mona LSA branched graft device

    Directory of Open Access Journals (Sweden)

    Josh A. Sibille, MD

    2017-03-01

    Full Text Available A 60-year-old woman involved in a motor vehicle collision presented with a traumatic pseudoaneurysm of the innominate artery origin in addition to multiple concomitant injuries. She was classified as a high-risk candidate for open repair. An experimental thoracic branched graft device was used for coverage of the injury with the addition of a right carotid-to-left carotid-to-left subclavian artery bypass. Follow-up imaging showed resolution of the pseudoaneurysm and patency of her bypass grafts. This is the first described use of the Mona LSA Branch Thoracic Stent Graft System (Medtronic, Minneapolis, Minn in the innominate artery.

  5. Impact of Aneurysm Projection on Intraoperative Complications During Surgical Clipping of Ruptured Posterior Communicating Artery Aneurysms.

    Science.gov (United States)

    Fukuda, Hitoshi; Hayashi, Kosuke; Yoshino, Kumiko; Koyama, Takashi; Lo, Benjamin; Kurosaki, Yoshitaka; Yamagata, Sen

    2016-03-01

    Surgical clipping of ruptured posterior communicating artery (PCoA) aneurysms is a well-established procedure to date. However, preoperative factors associated with procedure-related risk require further elucidation. To investigate the impact of the direction of aneurysm projection on the incidence of procedure-related complications during surgical clipping of ruptured PCoA aneurysms. A total of 65 patients with ruptured PCoA aneurysms who underwent surgical clipping were retrospectively analyzed from a single-center, prospective, observational cohort database in this study. The aneurysms were categorized into lateral and posterior projection groups, depending on direction of the dome. Characteristics and operative findings of each projection group were identified. We also evaluated any correlation of aneurysm projection with the incidence of procedure-related complications. Patients with ruptured PCoA aneurysms with posterior projection more likely presented with good-admission-grade subarachnoid hemorrhage (P = .01, χ test) and were less to also have intracerebral hematoma (P = .01). These aneurysms were found to be associated with higher incidence of intraoperative rupture (P = .02), complex clipping with fenestrated clips (P = .02), and dense adherence to PCoA or its perforators (P = .04) by univariate analysis. Aneurysms with posterior projection were also correlated with procedure-related complications, including postoperative cerebral infarction or hematoma formation (odds ratio, 5.87; 95% confidence interval, 1.11-31.1; P = .04) by multivariable analysis. Ruptured PCoA aneurysms with posterior projection carried a higher risk of procedure-related complications of surgical clipping than those with lateral projection.

  6. Endovascular Treatment of a Gastroduodenal Artery Pseudoaneurysm Rupture after a Car Accident

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    Sofia Dutra

    2017-09-01

    Full Text Available The authors present a case of a 39-year-old man with alcoholic chronic pancreatitis that was admitted in the emergency department after a car accident, complaining of abdominal pain and looking pale. The patient was hemodinamically unstable, requiring blood transfusions. He underwent computed tomography angiogram of the abdomen and pelvis, showing a pseudoaneurysm of the gastroduodenal artery and a hemoperitoneum. He was referred to our interventional radiology unit and submitted to endovascular treatment, consisting of ‘backdoor’ and ‘frontdoor’ embolization of the gastroduodenal artery and pseudoaneurysm neck with coils, with total exclusion in control angiography. With this case description we intend to highlight the rarity of the pseudoaneurysm rupture of the gastroduodenal artery and to emphasize the importance of an interventional radiology response that had a fundamental role in the endovascular treatment, in an emergency context.

  7. Extracranial Internal Carotid Artery Aneurysms: Report of a Ruptured Case and Review of the Literature

    International Nuclear Information System (INIS)

    Siablis, Dimitrios; Karnabatidis, Dimitrios; Katsanos, Konstantinos; Mastronikolis, Nikos; Zabakis, Peter; Kraniotis, Pantelis

    2004-01-01

    Aneurysms of the extracranial carotid arteries (ECAA) are extremely rare. Schechter et al. documented 835 cases in the literature up to 1977. One hundred and sixteen cases of ECAA have been documented in the Chinese literature since 1981, suggesting a higher prevalence of carotid aneurysmal disease in China than in the West. Four percent of all peripheral artery aneurysms are reported to be ECAA. Those arising from the internal carotid artery (EICAA) are even more rare. Two recent reviews reported 24 and 25 cases of EICAA during 21 and 17 years, respectively, the majority of them is treated surgically. Our literature review revealed only a few true EICAA managed endovascularly, but none of them with a covered stent. We describe a rare such case of ruptured atherosclerotic EICAA which was treated percutaneously

  8. Acute gluteal compartment syndrome: superior gluteal artery rupture following a low energy injury.

    Science.gov (United States)

    Smith, Aubrey; Chitre, Vivek; Deo, Hersh

    2012-12-17

    Acute compartment syndrome affecting the gluteal region is rare when compared to the same condition in the forearm or calf. When it does occur, it is usually due to prolonged immobilisation in those with altered consciousness. Gluteal compartment syndrome resulting from injury to the superior gluteal artery is extremely rare and to our knowledge has been described only twice--both after high-energy road traffic accidents (RTA). Other cases have described profound hypotension with superior gluteal artery injury after an RTA and falling off a horse, without acute gluteal compartment syndrome. We present a case of gluteal compartment syndrome due to rupture of the superior gluteal artery following a relatively minor fall. The patient required an emergency fasciotomy, which was performed within 4 h of the injury. This case highlights the importance of early diagnosis and treatment of this rare condition.

  9. Endovascular Management of Ruptured Pancreaticoduodenal Artery Aneurysms Associated with Celiac Axis Stenosis

    International Nuclear Information System (INIS)

    Suzuki, Kojiro; Tachi, Yasushi; Ito, Shinji; Maruyama, Kunihiro; Mori, Yoshine; Komada, Tomohiro; Matsushima, Masaya; Ota, Toyohiro; Naganawa, Shinji

    2008-01-01

    The purpose of this study was to assess the efficacy of transcatheter arterial embolization for ruptured pancreaticoduodenal artery (PDA) aneurysms associated with celiac axis stenosis (CS). Seven patients (four men and three women; mean age, 64; range, 43-84) were treated with transcatheter arterial embolization between 2002 and 2007. They were analyzed with regard to the clinical presentation, radiological finding, procedure, and outcome. All patients presented with sudden epigastric pain or abdominal discomfort. Contrast-enhanced CT showed a small aneurysm and retroperitoneal hematoma around the pancreatic head in all patients. The aneurysms ranged from 0.3 to 0.9 cm in size. In one patient, two aneurysms were detected. The aneurysms were located in the pancreaticoduodenal artery (n = 5) and the dorsal pancreatic artery (n = 3). Embolization was performed with microcoils in all aneurysms (n = 8). N-Butyl 2-cyanoacrylate (n = 1) and gelatine particle (n = 1) were also used. Complete occlusion was achieved in four patients. In the other three patients, a significantly reduced flow to the aneurysm remained at final angiography. However, these aneurysms were thrombosed on follow-up CT within 2 weeks. And there was no recurrence of the symptoms and bleeding during follow-up (mean, 28 months; range, 5-65 months) in all patients. In conclusion, transcatheter arterial embolization for PDA aneurysms associated with CS is effective. Significant reduction of the flow to the aneurysm at final angiography may be predictive of future thrombosis.

  10. Interventional and surgical treatment of a hemothorax caused by a ruptured vertebral artery in a patient with neurofibromatosis type I

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ji Hoon; Kim, Dong Hun; Kim, Dong Hyun; Seo, Hong Joo [Chosun University College of Medicine, Gwangju (Korea, Republic of)

    2014-04-15

    We report a case of a massive hemothorax arising from a ruptured vertebral artery aneurysm in a patient with neurofibromatosis type 1 suffering from sudden onset of dyspnea. The vertebral artery aneurysm was treated with endovascular coil embolization. Then, an open thoracotomy was performed to evacuate the hematoma.

  11. True posterior communicating artery aneurysms: are they more prone to rupture? A biomorphometric analysis.

    Science.gov (United States)

    He, Wenzhuan; Hauptman, Jason; Pasupuleti, Latha; Setton, Avi; Farrow, Maria G; Kasper, Lydia; Karimi, Reza; Gandhi, Chirag D; Catrambone, Jeffrey E; Prestigiacomo, Charles J

    2010-03-01

    Posterior communicating artery (PCoA) aneurysms can occur at the junction with the internal carotid artery, posterior cerebral artery (PCA), or the proximal PCoA itself. Hemodynamic stressors contribute to aneurysm formation and may be associated with parent vessel size and aneurysm location. This study evaluates the correlation of various biomorphometric characteristics in 2 of the aforementioned types of PCoA aneurysms. Patients with PCoA aneurysms were analyzed using CT angiography. Source images and reconstructions were used to determine which aneurysms originated purely from the PCoA and those that originated from the internal carotid artery/PCoA junction. Morphometric analysis was performed on the aneurysm, the precommunicating segment of the PCA (P(1)), the ambient segment of the PCA (P(2)), and both PCoA arteries and were correlated to clinical presentation. Parametric and nonparametric analyses were performed to test for significance. A total of 77 PCoA aneurysms were analyzed, and 10 were found to be true PCoA aneurysms (13.0%). The ipsilateral PCoA/P(1) ratio (1.77 +/- 0.44 vs 0.82 +/- 0.46, p = 0.0001) and ipsilateral P(2)/P(1) ratio (1.73 +/- 0.40 vs 1.22 +/- 0.41, p = 0.0003) were significantly larger in true PCoA aneurysms. Interestingly, aneurysm size was statistically larger in the junctional aneurysms (0.14 +/- 0.1 vs 0.072 +/- 0.04 cm(3), p = 0.03). The prevalence of ruptured aneurysms was similar in both groups (approximately 80%, p value not significant). These data suggest that true PCoA aneurysms have a larger PCoA relative to the ipsilateral P(1) segment. To the authors' knowledge, this represents the first such biomorphometric comparison of these different types of PCoA aneurysms. Although statistically smaller in size, true PCoA aneurysms also have a similar prevalence of presenting as a ruptured aneurysm, suggesting that they might be more prone to rupture than a junctional aneurysms of similar size. Further analysis will be required to

  12. Delayed rupture of common carotid artery following rugby tackle injury: a case report

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    Abbas Saleh

    2008-03-01

    Full Text Available Abstract Background Common Carotid Artery (CCA is an uncommon site of injury following a blunt trauma, its presentation with spontaneous delayed rupture is even more uncommon and a rugby tackle leading to CCA injury is a rare event. What makes this case unique and very rare is combination of all of the above. Case presentation Mr H. presented to the Emergency Department with an expanding neck haematoma and shortness of breath. He was promptly intubated and had contrast CT angiography of neck vessels which localized the bleeding spot on posteromedial aspect of his Right CCA. He underwent emergency surgery with repair of the defect and made an uneventful recovery post operatively. Conclusion Delayed post traumatic rupture of the CCA is an uncommon yet potentially life threatening condition which can be caused by unusual blunt injury mechanism. A high index of suspicion and low threshold for investigating carotid injuries in the setting of blunt trauma is likely to be beneficial.

  13. Idiopathic Splenic Artery Pseudoaneurysm Rupture as an Uncommon Cause of Hemorrhagic Shock

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    Richard A. Schatz MD

    2015-04-01

    Full Text Available Splenic artery pseudoaneurysms are infrequently encountered but critical to recognize. Limited literature to date describes associations with pancreatitis, trauma, and rarely peptic ulcer disease. Hemorrhage and abdominal pain are the most common manifestations. There is typically overt gastrointestinal blood loss but bleeding can also extend into the peritoneum, retroperitoneum, adjacent organs, or even a pseudocyst. Most patients with ruptured splenic artery pseudoaneurysms present with hemodynamic instability. Here, we describe a patient recovering from acute illness in the intensive care unit but with otherwise no obvious risk factors or precipitants for visceral pseudoaneurysm. He presented with acute onset altered mental status, nausea, and worsening back and abdominal pain and was found to be in hypovolemic shock. The patient was urgently stabilized until more detailed imaging could be performed, which ultimately revealed the source of blood loss and explained his rapid decompensation. He was successfully treated with arterial coiling and embolization. Thus, we herein emphasize the importance of prompt recognition of hemorrhagic shock and of aggressive hemodynamic stabilization, as well as a focused diagnostic approach to this problem with specific treatment for splenic artery pseudoaneurysm. Finally, we recommend that multidisciplinary management should be the standard approach in all patients with splenic artery pseudoaneurysm.

  14. Rupture

    CERN Multimedia

    Association du personnel

    2006-01-01

    Our Director-General is indifferent to the tradition of concertation foreseen in our statutes and is "culturally" unable to associate the Staff Association with problem-solving in staff matters. He drags his heels as long as possible before entering into negotiations, presents "often misleading" solutions at the last minute which he only accepts to change once a power struggle has been established. Faced with this rupture and despite its commitment to concertation between gentlemen. The results of the poll in which the staff is invited to participate this week. We therefore need your support to state our claims to the Governing Bodies. The Staff Association proposes a new medium of communication and thus hopes to show that it is ready for future negotiations. The pages devoted to the Staff Association are presented in a more informative, reactive and factual manner and in line with the evolution of the social situation at CERN. We want to establish strong and continuous ties between the members of CERN and ou...

  15. Left atrial myxoma, ruptured chordae tendinae causing mitral regurgitation and coronary artery disease

    Directory of Open Access Journals (Sweden)

    Bhupesh Kumar

    2014-01-01

    Full Text Available Mitral regurgitation is uncommon with left atrial myxoma. The echocardiographic assessment of presence of mitral regurgitation and its severity are impaired by the presence of left atrial myxoma. We describe an uncommon association of left atrial myxoma with coronary artery disease and mitral regurgitation. MR was reported as mild on pre-operative transthoracic echocardiography but found to be severe due to ruptured chordae tendinae during intra-operative transesophageal echocardiography, which lead to change in the surgical plan to mitral valve replacement in addition to excision of myxoma.

  16. Automatic detection of coronary arterial branches from X-ray angiograms

    International Nuclear Information System (INIS)

    Lu, Shan; Eiho, Shigeru

    1992-01-01

    This paper describes a method to trace the coronary arterial boundaries automatically from x-ray angiograms. We developed an automatic procedure to detect the edges of an artery with its branches. The edge point is evaluated by a function based on smoothing differential operator on a searching line which is obtained by using the continuous properties of the arterial edges. Thus the boundary points along the artery are detected automatically. If there exists a branch on the boundary, it can be detected automatically. This information about the branch is stored on the stack of the search information and will be used to detect the branch artery. In our edge detection process, the required user interaction is only the manual definition of a starting point for the search, the direction of the search and the range for search. We tested this method on some images generated by a computer with different stenoses and on a coronary angiogram. These results show that this method is useful for analyzing coronary angiograms. (author)

  17. Anatomical Arrangement of the Subclavian Artery Branches in the Rabbit and European Hare

    Directory of Open Access Journals (Sweden)

    Maženský D.

    2017-12-01

    Full Text Available The aim of this study was to compare the anatomical arrangements of the branches arising from the subclavian arteries in the domesticated rabbit and hare. The study was carried out on ten adult rabbits and ten adult European hares using the corrosion cast technique. After the euthanasia, the vascular network was perfused with saline. The arterial system of the entire body was injected by Batson’s corrosion casting kit No. 17. After polymerization of the medium, the maceration was carried out in KOH solution. The arrangement of the origins of the branches of the bilateral subclavian arteries were more variable in the hare. The number of branches arising from the subclavian artery were more regular in the rabbit on the right side and in the hare on the left side. In the rabbit, we found in two cases, the origins of the branches of the left subclavian artery from the aortic arch. The anatomical found between the rabbit and the hare may possibly be associated with their different ways of life.

  18. Rupture of an internal carotid artery pseudoaneurysm after irradiation for a nasopharyngeal carcinoma. Case report

    International Nuclear Information System (INIS)

    Hanada, Yukiko; Nakamura, Megumi; Sasai, Hisanori; Kamakura, Aya; Sakata, Yoshiharu; Miyahara, Hiroshi

    2013-01-01

    The primary treatment of nasopharyngeal carcinoma (NPC) has been external radiotherapy. Rupture of an internal carotid artery (ICA) pseudoaneurysm is a rare complication of irradiation therapy for a nasopharyngeal carcinoma. A 78 years old man had a history of NPC treated with radiotherapy in 1993. He was admitted to the hospital because of epistaxis. Angiography showed an ICA pseudoaneurysm pointing medially to the nasopharynx. Coil embolization of the ICA was performed, but cerebral infarction occurred. Internal carotid artery (ICA) pseudoaneurysms are an uncommon but potentially lethal condition. Angiography is the mainstay of diagnosis of the aneurysm and planning the embolization of the ICA. We should be more aware of this complication in NPC patients. (author)

  19. Analysis of branching patterns of middle hepatic artery using A-P and oblique view hepatic angiography

    International Nuclear Information System (INIS)

    Han, Kun Soo; Chang, Jae Chun; Park, Bok Hwan

    1992-01-01

    A study on branching patterns of middle hepatic artery was performed in 109 patients with A-P and oblique view hepatic angiogram, which refereed to size and location of quadrate lobe in CT and SMA photography. We could analyze the branching patterns of middle hepatic artery (MHA) in 100 among 109 patients. MHA arising as a first branch of left hepatic artery was the most common pattern (50%), and MHA arising from proper hepatic artery separately on from left hepatic artery was the next common pattern (35%). MHA originating from left gastric artery, or from anterior or posterior of the right hepatic artery was not seen. MHA was not found as an accessory or replaced artery except as replaced common hepatic artery

  20. Spontaneous splenic artery aneurysm rupture in a 38-year old female: a case report.

    Science.gov (United States)

    Koutserimpas, C; Papachristou, E; Nikitakis, N; Zannes, N; Tellos, A; Velimezis, G

    2017-01-01

    Splenic artery aneurysm (SAA) is a rare and extremely difficult diagnosis. A rare case of a ruptured SAA in a 38-year old female, firstly treated with endovascular embolization and then with splenectomy, is presented. A 38-year old female presented to the emergency department with epigastric pain and fainting episodes. Direct catheter angiography revealed a ruptured SAA and distal, as well as proximal coil embolization was performed. Due to abdominal compartment syndrome the patient underwent open surgery with splenic artery ligation and splenectomy. Postoperative she showed signs of sepsis and was treated with i.v. fluids, steroids, packed red blood cells, platelets, fresh frozen plasma and antimicrobial treatment. Additionally, a multidrug resistant Acinetobacter baumanni was yielded from the urine culture. She had a satisfactory recovery. She is followed up a total of 5 years with no signs of overwhelming post-splenectomy infection syndrome. Direct catheter angiography is a very helpful option in diagnosis, as well as treatment, but a close monitoring after embolization is essential. Furthermore, post-splenectomy sepsis is a severe disease with high mortality rates that requires immediate appropriate treatment.

  1. Renal Artery Variations, Hilar Arrangement and Its Distances to Ventral Branches of Abdominal Aorta: A Morphometric Study

    Directory of Open Access Journals (Sweden)

    D'Souza A

    2015-10-01

    Full Text Available Purpose: To measure the distance of origin of renal artery in relation to the ventral branches of abdominal aorta and also to study the variations in the number and the hilar branching pattern of renal arteries. Materials and methods: The present study was carried out using ten embalmed adult cadavers. The distances were measured bilaterally from the origin of renal artery to the origin of superior and inferior mesenteric artery and the bifurcation of abdominal aorta. Results: Out of ten cadavers studied, bilateral accessory renal artery was observed in two cases. The hilar branching pattern varied from a single artery to maximum of six branches. The mean and standard deviations of the measured parameters were calculated. Conclusion: Knowledge of variations of renal artery is important for surgeons in performing many procedures and may help to avoid clinical complications in the abdominal region.

  2. Variations in Branching Pattern of Renal Artery in Kidney Donors Using CT Angiography.

    Science.gov (United States)

    Munnusamy, Kumaresan; Kasirajan, Sankaran Ponnusamy; Gurusamy, Karthikeyan; Raghunath, Gunapriya; Bolshetty, Shilpakala Leshappa; Chakrabarti, Sudakshina; Annadurai, Priyadarshini; Miyajan, Zareena Begum

    2016-03-01

    Each kidney is supplied by a single renal artery originating from abdominal aorta. Since there are lots of renal surgeries happening now-a-days, it becomes mandatory for the surgeons to understand the abnormality and variations in the renal vasculature. To study the variations in the branching pattern of renal artery for the presence of early division and accessory renal artery in Indian kidney donors using CT angiography. The CT angiogram images of 100 normal individuals willing for kidney donation were analysed for early divisions and occurrence of accessory renal artery. A 51% of kidney donors showed variation in the renal artery. Out of 51% variations 38 individuals had accessory renal artery and 13 individuals had early division of renal artery. The distribution of accessory renal artery was equal on both sides (13% on right and left) and 12% of individuals had accessory renal artery on both sides. Out of 13% earlier divisions, 5% was on right side, 7% was on left side and 1% was on both sides. This study concludes that 51% of kidney donors had renal artery variations. Hence, awareness of variations by evaluating the donors is a must before renal transplantation, urological procedures and angiographic interventions.

  3. Epistaxis and pituitary apoplexy due to ruptured internal carotid artery aneurysm embedded within pituitary adenoma.

    Science.gov (United States)

    Peng, Zesheng; Tian, Daofeng; Wang, Hongliu; Kong, Derek Kai; Zhang, Shenqi; Liu, Baohui; Deng, Gang; Xu, Zhou; Wu, Liquan; Ji, Baowei; Wang, Long; Cai, Qiang; Li, Mingchang; Wang, Junmin; Zhang, Aimin; Chen, Qianxue

    2015-01-01

    Epistaxis due to ruptured internal carotid artery (ICA) aneurysm embedded within a pituitary adenoma (PA) has seldom been reported in the literature. Here we want to elaborate the incidence, mechanisms, clinical manifestations, and treatment strategy for this condition. The first survived case of a patient with epistaxis and pituitary apoplexy due to ruptured aneurysm embedded within PA was reported and the literature was reviewed. A 53-year-old male patient presented to our institution with sudden onset epistaxis and progressive vision loss. Neurological examination revealed bilateral ptosis and dilated unresponsive pupils. A CT scan showed a large mass in the pituitary fossa with bony erosion. MRI revealed a large pituitary tumor and abnormal signal intensity in the tumor. No aneurysm was noted during the pre-operative MR angiography. Abundant arterial bleeding suddenly occurred during urgent transsphenoidal surgery. Digital subtraction angiography confirmed the presence of a 14 mm unexpected saccular aneurysm of right ICA in the cavernous sinus with the dome protruding into the sella turcica. Balloon test occlusion of the right ICA was undertaken and permanent occlusion was performed. The patient recovered well and received bromocriptine and thyroid hormone replacement therapy during the follow-up period. At 14-month followup, the patient had no neurological deficits, no features of ischaemia relating to the right ICA therapeutic occlusion. Our case indicated that epistaxis and pituitary apoplexy could be due to the rupture of an ICA aneurysm embedded in a PA. Clinical suspicion should remain high when evaluating any case of epistaxis and pituitary apoplexy. Optimal treatment should take into consideration individual features of the tumor, aneurysm, and patient. Making the correct diagnosis as well as identifying an appropriate management strategy is critical in the care of such patients.

  4. Computer-assisted 3D reconstruction of the terminal branches of the cerebral arteries. Pt. 3. Posterior cerebral artery and circle of Willis

    International Nuclear Information System (INIS)

    Gloger, S.; Gloger, A.; Vogt, H.; Kretschmann, H.J.

    1994-01-01

    We present a three-dimensional anatomical computer model of the terminal branches of the posterior cerebral artery and circle of Willis, acquired from equidistant serial anatomical slices of three brains. The reconstructions provide a clear picture from all angles of the complicated course of the terminal branches of the cerebral arteries. This can help to identify the arteries in conventional and magnetic resonance angiography. Our rendition of the cerebral arteries can be matched with CT, MR and PET images to indicate the areas of extension of the individual branches, allowing neuromorphological and functional correlations. (orig.)

  5. Computer-assisted 3D reconstruction of the terminal branches of the cerebral arteries. Pt. 3. Posterior cerebral artery and circle of Willis

    Energy Technology Data Exchange (ETDEWEB)

    Gloger, S. (Dept. of Neuroanatomy, Hannover Medical School (Germany)); Gloger, A. (Dept. of Neuroanatomy, Hannover Medical School (Germany)); Vogt, H. (Dept. of Neuroanatomy, Hannover Medical School (Germany)); Kretschmann, H.J. (Dept. of Neuroanatomy, Hannover Medical School (Germany))

    1994-05-01

    We present a three-dimensional anatomical computer model of the terminal branches of the posterior cerebral artery and circle of Willis, acquired from equidistant serial anatomical slices of three brains. The reconstructions provide a clear picture from all angles of the complicated course of the terminal branches of the cerebral arteries. This can help to identify the arteries in conventional and magnetic resonance angiography. Our rendition of the cerebral arteries can be matched with CT, MR and PET images to indicate the areas of extension of the individual branches, allowing neuromorphological and functional correlations. (orig.)

  6. A flap based on the plantar digital artery arch branch to improve appearance of reconstructed fingers: Anatomical and clinical application.

    Science.gov (United States)

    Tang, Lin-Feng; Ju, Ji-Hui; Liu, Yue-Fei; Lan, Bo; Hou, Rui-Xing

    2018-02-01

    To investigate blood supply features of the flap based on the plantar digital artery arch and arch branch artery, and the treatment of outcomes of reconstructed fingers by the plantar digital artery arch branch island flap. Eight fresh foot specimens were employed with red emulsion infusion and microdissection. The vascular organization was observed in the second toe, such as initiation site, the course, and the number of the plantar digital artery arch branch. There were 15 fingers of 13 patients (8 males and 5 females) with finger defects accompanied by toe transfer, using the plantar digital artery arch branch flap inserted in the neck of the second toe to correct the appearance defect caused by a narrow "neck" and a bulbous tip. The intact plantar digital arches were identified in all specimens. The plantar digital artery arch had 5 branches. The range of external diameter of the arch branch was 0.4-0.6 mm. All the plantar digital artery arch branch island flaps and the reconstructed fingers survived. These cases were conducted with a follow-up period for 3-18 months (average, 9 months). All the plantar digital artery arch branch island flaps and reconstructed fingers demonstrated a satisfactory appearance and favorable sense function. The reconstructed finger-tip characteristic was good, with no obvious scar hyperplasia. The range of flexion and extension of reconstructed fingers was favorable as well. The plantar digital artery arch and arch branch artery possess regular vasa vasorum and abundant vascularity. A flap based on the plantar digital artery arch branch is an ideal selection for plastic surgery of reconstructed fingers. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  7. Multidetector-row computed tomography for evaluating the branching angle of the celiac artery: a descriptive study

    International Nuclear Information System (INIS)

    Tokue, Hiroyuki; Tokue, Azusa; Tsushima, Yoshito

    2012-01-01

    We performed this study in order to investigate the shape of the origin of the celiac artery in maximum intensity projection (MIP) using routine 64 multidetector-row computed tomography (MDCT) data in order to plan for the implantation of an intra-arterial hepatic port system. A total of 1,104 patients with hepatocellular carcinoma were assessed with MDCT. In the definition of the branching angle, the anterior side of the abdominal aorta was considered the baseline, and the cranial and caudal sides were designated as 0 and 180 degrees, respectively. The angles between 0 and 90 degrees and between 90 and 180 degrees from the cranial side were considered upward and downward, respectively, and the branching angle of the celiac artery was classified every 30 degrees. The subclavian arterial route was used for the implantation of an intra-arterial hepatic port system in patients with branching angles of 150 degrees or more (sharp downward). The median branching angle was (median ± standard deviation) 135 ± 23 (range, 51–174) degrees. The branching was upward in 77 patients (7%) and downward in 1,027 patients (93%). The branching was downward with an angle of 120 to150 degrees in most patients (n = 613). The branching was sharply downward with an angle of 150 degrees or more in 177 patients (16%). A total of 10 patients were referred for interventional placement of an intra-arterial hepatic port system. The subclavian arterial route was used for implantation of an intra-arterial hepatic port system in 2 patients with sharp downward branching. The branching angle of the celiac artery can be easily determined by the preparation of MIP images from routine MDCT data. MIP may provide useful information for the selection of the catheter insertion route in order to avoid a sharp branching angle of the celiac artery

  8. Multidetector-row computed tomography for evaluating the branching angle of the celiac artery: a descriptive study

    Directory of Open Access Journals (Sweden)

    Tokue Hiroyuki

    2012-12-01

    Full Text Available Abstract Background We performed this study in order to investigate the shape of the origin of the celiac artery in maximum intensity projection (MIP using routine 64 multidetector-row computed tomography (MDCT data in order to plan for the implantation of an intra-arterial hepatic port system. Methods A total of 1,104 patients with hepatocellular carcinoma were assessed with MDCT. In the definition of the branching angle, the anterior side of the abdominal aorta was considered the baseline, and the cranial and caudal sides were designated as 0 and 180 degrees, respectively. The angles between 0 and 90 degrees and between 90 and 180 degrees from the cranial side were considered upward and downward, respectively, and the branching angle of the celiac artery was classified every 30 degrees. The subclavian arterial route was used for the implantation of an intra-arterial hepatic port system in patients with branching angles of 150 degrees or more (sharp downward. Results The median branching angle was (median ± standard deviation 135 ± 23 (range, 51–174 degrees. The branching was upward in 77 patients (7% and downward in 1,027 patients (93%. The branching was downward with an angle of 120 to150 degrees in most patients (n = 613. The branching was sharply downward with an angle of 150 degrees or more in 177 patients (16%. A total of 10 patients were referred for interventional placement of an intra-arterial hepatic port system. The subclavian arterial route was used for implantation of an intra-arterial hepatic port system in 2 patients with sharp downward branching. Conclusions The branching angle of the celiac artery can be easily determined by the preparation of MIP images from routine MDCT data. MIP may provide useful information for the selection of the catheter insertion route in order to avoid a sharp branching angle of the celiac artery.

  9. Dynamic Models of Earthquake Rupture along branch faults of the Eastern San Gorgonio Pass Region in CA using Complex Fault Structure

    Science.gov (United States)

    Douilly, R.; Oglesby, D. D.; Cooke, M. L.; Beyer, J. L.

    2017-12-01

    Compilation of geomorphic and paleoseismic data have illustrated that the right-lateral Coachella segment of the southern San Andreas Fault is past its average recurrence time period. On its western edge, this fault segment is split into two branches: the Mission Creek strand, and the Banning fault strand, of the San Andreas. Depending on how rupture propagates through this region, there is the possibility of a through-going rupture that could lead to the channeling of damaging seismic energy into the Los Angeles Basin. The fault structures and rupture scenarios on these two strands are potentially very different, so it is important to determine which strand is a more likely rupture path, and under which circumstances rupture will take either one. In this study, we focus on the effect of different assumptions about fault geometry and stress pattern on the rupture process to test those scenarios and thus investigate the most likely path of a rupture that starts on the Coachella segment. We consider two types of fault geometry based on the SCEC Community Fault Model and create a 3D finite element mesh. These two meshes are then incorporated into the finite element method code FaultMod to compute a physical model for the rupture dynamics. We use the slip-weakening friction law, and we consider different assumptions of background stress such as constant tractions, regional stress regimes of different orientations, heterogeneous off-fault stresses and the results of long-term stressing rates from quasi-static crustal deformation models that consider time since last event on each fault segment. Both the constant and regional stress distribution show that it is more likely for the rupture to branch from the Coachella segment to the Mission Creek compared to the Banning fault segment. For the regional stress distribution, we encounter cases of super-shear rupture for one type of fault geometry and sub-shear rupture for the other one. The fault connectivity at this branch

  10. Interventional Radiology Management of a Ruptured Lumbar Artery Pseudoaneurysm after Cryoablation and Vertebroplasty of a Lumbar Metastasis

    Energy Technology Data Exchange (ETDEWEB)

    Giordano, Aldo Victor; Arrigoni, Francesco, E-mail: arrigoni.francesco@gmail.com [Ospedale San Salvatore, Department of Radiology (Italy); Bruno, Federico [University of L’Aquila, Department of Biotechnological and Applied Clinical Sciences (Italy); Carducci, Sergio; Varrassi, Marco; Zugaro, Luigi [Ospedale San Salvatore, Department of Radiology (Italy); Barile, Antonio; Masciocchi, Carlo [University of L’Aquila, Department of Biotechnological and Applied Clinical Sciences (Italy)

    2017-05-15

    We describe the management of a complication (a lumbar artery pseudoaneurysm and its rupture) after combined procedure (cryoablation and vertebroplasty) on a lumbar (L2) metastasis from renal cell carcinoma. Review of the literature is also presented with discussion about the measures to be taken to prevent these types of complications.

  11. Branching pattern of lenticulostriate arteries observed by MR angiography at 3.0 T

    International Nuclear Information System (INIS)

    Akashi, Toshiaki; Taoka, Toshiaki; Ochi, Tomoko; Miyasaka, Toshiteru; Wada, Takeshi; Sakamoto, Masahiko; Kichikawa, Kimihiko; Takewa, Megumi

    2012-01-01

    We hypothesized that the pattern of branching of the lenticulostriate arteries (LSAs) is involved in the variation of the distribution of the infarction within the LSA region. Our purpose was to evaluate the visibility of LSAs in 3D time-of-flight (TOF) MR angiography (MRA) with a 3.0 T scanner and to investigate the branching patterns of LSAs. We performed 3D TOF MRA at 3.0 T for 100 healthy subjects. We assessed the number of LSAs and the number of branches arising from each LSA by evaluating MRA source images. In 200 hemispheres, 330 LSAs were visualized (mean=1.65/hemisphere). In 3.5% of all hemispheres, no LSA was depicted; one LSA was depicted in 39%, two in 46.5%, and three in 11%. The maximum number of depicted LSA branches was five in 2% of all subjects, four in 7%, three in 26%, and two in 49% (mean=2.3/subject). A large LSA trunk with three or more branches was found in 35% of subjects. Visualization of LSAs was possible in 96.5% of subjects by use of 3.0 T MRA. LSA branching patterns were variable, and a large LSA trunk with three or more branches was common. (author)

  12. Aortic Branch Artery Pseudoaneurysms Associated with Intramural Hematoma: When and How to Do Endovascular Embolization

    Energy Technology Data Exchange (ETDEWEB)

    Ferro, Carlo; Rossi, Umberto G., E-mail: urossi76@hotmail.com; Seitun, Sara [IRCCS San Martino University Hospital, IST, National Institute for Cancer Research, Department of Radiology and Interventional Radiology (Italy); Scarano, Flavio; Passerone, Giancarlo [IRCCS San Martino University Hospital, IST, National Institute for Cancer Research, Department of Cardiac Surgery (Italy); Williams, David M. [University of Michigan Medical Center, Department of Radiology, Division of Vascular and Interventional Radiology (United States)

    2013-04-15

    To describe when and how to perform endovascular embolization of aortic branch artery pseudoaneurysms associated with type A and type B intramural hematoma (IMH) involving the descending thoracic and abdominal aorta (DeBakey I and III) that increased significantly in size during follow-up. Sixty-one patients (39 men; mean {+-} standard deviation age 66.1 {+-} 11.2 years) with acute IMH undergoing at least two multidetector computed tomographic examinations during follow-up for 12 months or longer were enrolled. Overall, 48 patients (31 men, age 65.9 {+-} 11.5) had type A and type B IMH involving the descending thoracic and abdominal aorta (DeBakey I and III). Among the 48 patients, 26 (54 %; 17 men, aged 64.3 {+-} 11.4 years) had 71 aortic branch artery pseudoaneurysms. Overall, during a mean follow-up of 22.1 {+-} 9.5 months (range 12-42 months), 31 (44 %) pseudoaneurysms disappeared; 22 (31 %) decreased in size; two (3 %) remained stable; and 16 (22 %) increased in size. Among the 16 pseudoaneurysms with increasing size, five of these (three intercostal arteries, one combined intercostobronchial/intercostal arteries, one renal artery), present in five symptomatic patients, had a significant increase in size (thickness >10 mm; width and length >20 mm). These five patients underwent endovascular embolization with coils and/or Amplatzer Vascular Plug. In all patients, complete thrombosis and exclusion of aortic pseudoaneurysm and relief of back pain were achieved. Aortic branch artery pseudoaneurysms associated with type A and type B IMH involving the descending thoracic and abdominal aorta (DeBakey I and III) may be considered relatively benign lesions. However, a small number may grow in size or extend longitudinally with clinical symptoms during follow-up, and in these cases, endovascular embolization can be an effective and safe procedure.

  13. Transformation of a Ruptured Giant Pulmonary Artery Aneurysm into an Air Cavity After Transcatheter Embolization in a Behcet's Patient

    International Nuclear Information System (INIS)

    Cil, Barbaros E.; Turkbey, Baris; Canyigit, Murat; Kumbasar, Ozlem O.; Celik, Gokhan; Demirkazik, Figen B.

    2006-01-01

    Pulmonary artery aneurysms due to Behcet's disease are mainly seen in young males and very rarely in females. To our knowledge there are only 10 cases reported in the related literature. Emergent transcatheter embolization was performed in a female patient with a known history of Behcet's disease in whom massive hemoptysis developed because of rupture of a giant pulmonary artery aneurysm. At 6-month follow-up, transformation of the aneurysm sac into an air cavity was detected. To our knowledge, such a transformation has never been reported in the literature before. Embolization of the pulmonary artery aneurysm and the mechanism of cavity transformation are reviewed and discussed

  14. Transluminal Angioplasty of Peroneal Artery Branches in Diabetics: Initial Technical Experience

    International Nuclear Information System (INIS)

    Graziani, Lanfroi; Silvestro, Antonio; Monge, Luca; Boffano, Gian Mario; Kokaly, Francesco; Casadidio, Ilaria; Giannini, Francesco

    2008-01-01

    The present study aimed to report the technical feasibility of percutaneous transluminal angioplasty (PTA) of obstructed or insufficient collateral branches (anterior and posterior perforating branches) from distal peroneal to foot arteries in diabetic patients with chronic critical limb ischemia (CLI) and chronic noncrossable occlusion of the anterior and posterior tibial arteries. Twenty-four diabetic CLI patients (age, 67 ± 8 years; 87% males) undergoing collateral PTA were included. Baseline clinical angiographic and follow-up data were retrospectively reviewed. Collateral PTA was associated with a concomitant PTA of other sites in 21 (83%) cases. In 15 cases the treated collateral linked the peroneal with the plantaris communis; in 9 cases, the peroneal with the dorsalis pedis. Angiographic results of collateral PTA were good in 13 cases (<30% residual stenosis), whereas the result was considered moderate (30%-49% residual stenosis) in the remaining cases. Neither perforation nor acute occlusion of the treated collaterals or other relevant complications were observed. Mean follow-up was 32 ± 17 months. Major amputation was necessary for two (8.3%) patients. Cumulative limb salvage rates at 2 and 4 years were 96% and 87%, respectively. In conclusion, this initial experience shows that PTA of the collateral branches from distal peroneal to foot arteries is a feasible technique. Future studies are required to define the clinical role of this novel approach

  15. Central retinal vein occlusion with cilioretinal infarction from branch flow exclusion and choroidal arterial steal.

    Science.gov (United States)

    McLeod, David

    2009-01-01

    The first definitive study of retinal vein occlusion complicated by infarction within the territory of one or more cilioretinal arteries was published in 1976. Many individual cases and further case series have been reported in the interim, but the nature of the interrelationship is still under debate. A review was undertaken of the relevant clinical and fundus fluorescein angiographic characteristics of this combined retinal vascular disorder together with the pathophysiological mechanisms currently presented in the literature to explain their association. Scientific publications up to 2008 were evaluated by one of the authors of the original report. There are broad similarities between publications in their descriptions of the clinical features, but significant differences of detail and interpretation are also evident. Most of the mechanisms so far proposed to account for cilioretinal infarction after central or hemisphere retinal vein occlusion do not withstand critical scrutiny. Two related hypotheses are expounded that appear to satisfactorily elucidate this interrelationship -- branch flow exclusion and branch flow diversion (otherwise termed "choroidal arterial steal"). In eyes with a cilioretinal supply, the probability that cilioretinal infarction will complicate retinal vein occlusion increases with increasing severity of venous obstruction and the more distally the cilioretinal artery arises from the posterior ciliary arterial tree. A distal branch point also facilitates observation of dye front reciprocation within the artery. Indicators of the degree of venous obstruction that may be necessary to instigate cilioretinal infarction include very prolonged dye transit times in the central retinal circulation, exaggerated venous cyanosis and tortuosity, perivenous cotton-wool sentinels, and macular perivenular whitening.

  16. Endovascular treatment of acutely ruptured, wide-necked anterior communicating artery aneurysms using the Enterprise stent.

    Science.gov (United States)

    Huang, Qing-Hai; Wu, Yong-Fa; Shen, Jie; Hong, Bo; Yang, Peng-Fei; Xu, Yi; Zhao, Wen-Yuan; Liu, Jian-Min

    2013-02-01

    The treatment of anterior communicating artery (AcomA) wide-necked aneurysms with the Enterprise stent (Codman, Miami Lakes, FL, USA) has not been commonly described, due to the complexity of the vascular anatomy and the small vessels of the AcomA complex. To evaluate the feasibility, effectiveness and safety of Enterprise stent placement in AcomA aneurysms, we performed this retrospective study. Between November 2008 and December 2010, 27 wide-necked AcomA ruptured aneurysms were treated within 72 hours of ictus with the Enterprise stent. Data collected and analyzed were: demographic data, morphologic features of the aneurysm, treatment results and follow-up results. Twenty-nine Enterprise stents were successfully deployed in all 27 aneurysms, including Y-configuration stent deployment in two patients. The initial embolization degrees were Raymond class I in 20 patients, class II in five and class III in the other two. The angiographic follow-up of 21 patients (mean, 8.4 months) showed that all aneurysms remained stable or improved; there was no in-stent stenosis, recurrence or retreatment. The clinical follow-up of 26 patients (mean, 12.6 months) showed that 23 patients displayed no symptoms and no or mild disability; three patients remained with severe or moderately severe disability. The Enterprise stent is feasible and safe for endovascular embolization of wide-necked AcomA ruptured aneurysms. Further follow up is needed to assess the long-term efficacy of Enterprise stent placement in AcomA. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Coronary artery disease confined to secondary branches of the left coronary system

    International Nuclear Information System (INIS)

    Iskandrian, A.S.; Klein, B.L.; Segal, B.L.; Kimbiris, D.; Bemis, C.E.

    1981-01-01

    Among 3,000 patients studied by coronary arteriography during a 4-year period, 31 patients (1%) had coronary artery disease limited to a diagonal branch of the left anterior descending (15 patients), marginal branch of the left circumflex (10 patients), or to both branches (6 patients). Ten patients had 50-69% and twenty-one had greater than or equal to 70% diameter narrowing. The suitability for grafting was noted in 20 patients as judged by the caliber and distribution of the diseased branches. Collaterals were noted in seven patients. Disease was present in 28 men and 3 women (age range 38-70 years). At least one major coronary risk factor was present in 27 patients. Angina was noted in 27 patients; prior myocardial infarction was noted in 5 patients by history and in 4 by ECG. The left ventriculogram was normal in 22 patients and showed mild segmental asynergy in 9; ejection fraction was normal in all. Exercise ECGs were positive in 12 of 25 patients; exercise 201thallium scans were positive in 13. All patients responded to medical therapy. In conclusion, among the population of patients who undergo catheterization, coronary branch disease is rare. The clinical findings are indistinguishable from patients with major coronary disease. Prognosis remains benign and patients respond to medical therapy

  18. Arterial blood supply to the caudate lobe of the liver from the proximal branches of the right inferior phrenic artery in patients with recurrent hepatocellular carcinoma after chemoembolization

    International Nuclear Information System (INIS)

    Miyayama, Shiro; Yamashiro, Masashi; Shibata, Yoshihiro; Hashimoto, Masahiro; Yoshida, Miki; Tsuji, Kazunobu; Toshima, Fumihito; Matsui, Osamu

    2012-01-01

    The purpose of this study was to evaluate the arterial blood supply to the caudate lobe of the liver from the proximal branches of the right inferior phrenic artery (RIPA) in patients with recurrent hepatocellular carcinoma after transcatheter arterial chemoembolization (TACE). Thirteen patients, including 10 who had a history of TACE of the caudate artery (A1), underwent TACE of the proximal RIPA branches. Iodized oil distribution was evaluated by computed tomography (CT) 1-week after TACE. Angiographic findings were also evaluated. Previously embolized A1 was occluded (n=15) or attenuated (n=2). In one of three patients without A1 TACE, A1 was also attenuated. TACE was performed at the first branch of the proximal RIPA (n=8), the first branch of the anterior branch (n=6), and the first branch of the posterior branch (n=1), respectively. Iodized oil was mainly distributed into the dorsal part of the Siegel lobe (SP) (n=10), the caudate process (n=1), and both (n=2). In three of seven patients who had undergone serial RIPA angiography, RIPA parasitization to SP was suspected before A1 TACE. The proximal RIPA branches mainly supply the SP when A1 is attenuated. (author)

  19. Ocular neovascularization in eyes with a central retinal artery occlusion or a branch retinal artery occlusion

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    Mason lll JO

    2015-06-01

    Full Text Available John O Mason III,1,2 Shyam A Patel,1 Richard M Feist,1,2 Michael A Albert Jr,1,2 Carrie Huisingh,1 Gerald McGwin Jr,1,3 Martin L Thomley1,2 1Department of Ophthalmology, University of Alabama School of Medicine, Birmingham, AL, USA; 2Retina Consultants of Alabama, Callahan Eye Foundation Hospital, Birmingham, AL, USA; 3Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA Purpose: To investigate the ocular neovascularization (ONV rate in eyes with a branch retinal artery occlusion (BRAO or a central retinal artery occlusion (CRAO, and to study factors that may influence the ONV rate secondary to CRAO.Methods: This was a retrospective case series of consecutive patients (286 total eyes: 83 CRAOs and 203 BRAOs who were diagnosed with a retinal artery occlusion from 1998 to 2013 at the Retina Consultants of Alabama and University of Alabama at Birmingham, Birmingham, AL, USA. Generalized estimating equations were used to evaluate the association between hypothesized risk factors and ONV development.Results: Twelve (14.5% of the 83 eyes with a CRAO developed ONV. Eleven of 12 eyes (91.7% had iris neovascularization, ten of 12 eyes (83.3% had neovascular glaucoma, and two of 12 eyes (16.7% had neovascularization of the optic disc. The average time for ONV development secondary to CRAO was 30.7 days, ranging from the date of presentation to 137 days. Only two (<1.0% of the 203 eyes with a BRAO developed iris neovascularization. Diabetes mellitus type 2 was a risk factor for ONV development following a CRAO with an adjusted odds ratio of 5.2 (95% confidence interval: 1.4–19.8 (P=0.02.Conclusion: ONV is an important complication of CRAO and is a less-frequent complication of BRAO. Patients with a CRAO, especially those with diabetes mellitus type 2, should be closely monitored for the first 6 months for ONV. Keywords: neovascularization, neovascular glaucoma, retinal artery occlusion, central

  20. Rupture of splenic artery aneurysm in primipara five days after cesarean section: case report and review of the literature.

    Science.gov (United States)

    Barišić, Tatjana; Šutalo, Nikica; Letica, Ludvig; Kordić, Andrea Vladimira

    2015-11-01

    Splenic artery aneurysm (SAA) is a rare and usually asymptomatic vascular anomaly which carries the risk of rupture and fatal hemorrhage. It is more common in women and is usually associated with pregnancy. We present the case of rupture of SAA, 5 days after giving birth by cesarean section, which was diagnosed with Multi-Slice Computed Tomografy (MSCT) angiography and was successfully operated in the second emergency laparotomy, with the final good outcome for the mother. This case indicates that in case of sudden bleeding in the abdomen, with the development of hypovolemic shock, especially in the peripartum period, should be suspected rupture of SAA. The paper presents a critical review of this case, with a review of the literature.

  1. Late presenting, contained rupture of the superficial femoral artery following atherectomy and stenting: case report and literature review.

    Science.gov (United States)

    Clegg, Stacey; Aghel, Arash; Rogers, R Kevin

    2014-08-01

    Excisional atherectomy alone or followed by stenting is considered an appropriate treatment strategy for patients with lifestyle-limiting claudication due to obstructive infra-inguinal peripheral arterial disease (Ramaiah et al., J Endovasc Ther 2006;13:592-6021). We present a case of a 69-year-old man with eccentric severely calcified disease of the superficial femoral artery (SFA) treated with excisional atherectomy followed by stenting with an interwoven nitinol stent. The procedure was complicated by extravascular stent migration associated with a contained rupture presenting 30 days after the intervention. The complication was successfully treated with a stent graft. Although rare, pseudoaneurysms have been reported at the site of prior atherectomy; however, this case is the first description of a contained rupture post atherectomy associated with erosion of a nitinol stent into an extra-luminal position. The mechanism and management of this complication are discussed. © 2014 Wiley Periodicals, Inc.

  2. 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...

  3. Distinct agonist responsibilities of the first and second branches of mouse mesenteric artery.

    Science.gov (United States)

    Nobe, Koji; Hagiwara, Chiharu; Nezu, Yumiko; Honda, Kazuo

    2006-03-01

    The mesenteric artery (MA) is suitable for consideration as a typical micro-resistant artery for examination of arteriosclerosis. The MA is comprised of the first (MA1), second (MA2), and additional fine structural branches; however, differences in terms of responsibilities of these branches have not been assessed. The objective of this study was to differentiate contractile responses in the MAs of mice. MA2 rings (100 microm diameter, 1 mm length) displayed maximal force development (846.8 +/- 55.6 microN; n = 5) upon stimulation with 50 mM KCl under 400 microN resting tension. However, both MA1 and aorta required resting tension exceeding 600 microN. Treatment of MA2 with phenylephrine (PE; 10 microM), norepinephrine (NE; 10 microM), thromboxane A(2) (analog U46619; 100 nM), or prostaglandin F(2a) (PG; 10 microM) induced sustained contractions. Responses were 1507.8 +/- 88.8, 1543 + 5 +/- 149.6, 2088.6 +/- 151.6, and 1441.9 +/- 103.6 microN (n = 7), respectively. These values were markedly larger than those of the KCl-induced response. In MA1 and aorta, PE-induced and NE-induced responses were indistinct from the KCl response. This investigation revealed that MA1 exhibits responsibilities similar to those of the aorta, whereas MA2 possesses distinct responsibilities. MA2 might serve as a micro-resistant artery model.

  4. The Anterior Branch of the Left Inferior Phrenic Artery Arising from the Right Inferior Phrenic Artery: An Angiographic and CT Study

    International Nuclear Information System (INIS)

    Hieda, Masashi; Toyota, Naoyuki; Kakizawa, Hideaki; Ishikawa, Masaki; Horiguchi, Jun; Ito, Katsuhide

    2009-01-01

    The purpose of this study was to retrospectively analyze the frequency and anatomical pattern of the anterior branch of the left inferior phrenic artery (LIPA) arising from the right inferior phrenic artery (RIPA). Angiography of the RIPA for patients (n = 140) with hepatic malignancy was retrospectively reviewed. The frequency at which the anterior branch of the LIPA arose from the RIPA was 14.3% (20 of 140 patients [pts]). Among the three branches that may arise from the RIPA in these cases (the anterior branch of the LIPA and the anterior and posterior branches of the RIPA), the anterior branch of the LIPA was the first branch of the RIPA in 9 of 20 pts (45%), and the posterior branch of the RIPA in 11 of 20 pts (55%). The anterior branch of the LIPA ran along the ventral side of the esophagus or stomach and supplied the esophagogastric region and dome of the left diaphragm in all cases. In conclusion, the anterior branch of the LIPA arises from the RIPA at a comparatively high frequency. In embolization of the RIPA, to effectively treat and avoid possible complications, interventionalists should be aware of this potential variant anatomy.

  5. Anatomic renal artery branch microdissection to facilitate zero-ischemia partial nephrectomy.

    Science.gov (United States)

    Ng, Casey K; Gill, Inderbir S; Patil, Mukul B; Hung, Andrew J; Berger, Andre K; de Castro Abreu, Andre Luis; Nakamoto, Masahiko; Eisenberg, Manuel S; Ukimura, Osamu; Thangathurai, Duraiyah; Aron, Monish; Desai, Mihir M

    2012-01-01

    Robot-assisted and laparoscopic partial nephrectomies (PNs) for medial tumors are technically challenging even with the hilum clamped and, until now, were impossible to perform with the hilum unclamped. Evaluate whether targeted vascular microdissection (VMD) of renal artery branches allows zero-ischemia PN to be performed even for challenging medial tumors. A prospective cohort evaluation of 44 patients with renal masses who underwent robot-assisted or laparoscopic zero-ischemia PN either with anatomic VMD (group 1; n=22) or without anatomic VMD (group 2; n=22) performed by a single surgeon from April 2010 to January 2011. Zero-ischemia PN with VMD incorporates four maneuvers: (1) preoperative computed tomographic reconstruction of renal arterial branch anatomy, (2) anatomic dissection of targeted, tumor-specific tertiary or higher-order renal arterial branches, (3) neurosurgical aneurysm microsurgical bulldog clamp(s) for superselective tumor devascularization, and (4) transient, controlled reduction of blood pressure, if necessary. Baseline, perioperative, and postoperative data were collected prospectively. Group 1 tumors were larger (4.3 vs 2.6 cm; p=0.011), were more often hilar (41% vs 9%; p=0.09), were medial (59% and 23%; p=0.017), were closer to the hilum (1.46 vs 3.26 cm; p=0.0002), and had a lower C index score (2.1 vs 3.9; p=0.004) and higher RENAL nephrometry scores (7.7 vs 6.2; p=0.013). Despite greater complexity, no group 1 tumor required hilar clamping, and perioperative outcomes were similar to those of group 2: operating room time (4.7 and 4.1h), median blood loss (200 and 100ml), surgical margins for cancer (all negative), major complications (0% and 9%), and minor complications (18% and 14%). The median serum creatinine level was similar 2 mo postoperatively (1.2 and 1.3mg/dl). The study was limited by the relatively small sample size. Anatomic targeted dissection and superselective control of tumor-specific renal arterial branches facilitate

  6. Physiologic Functional Evaluation of Left Internal Mammary Artery Graft to Left Anterior Descending Coronary Artery Steal due to Unligated First Thoracic Branch in a Case of Refractory Angina

    Directory of Open Access Journals (Sweden)

    Fadi J. Sawaya

    2016-01-01

    Full Text Available Unligated side branches of the left internal mammary artery (LIMA have been described in the literature as a cause of coronary steal resulting in angina. Despite a number of studies reporting successful side branch embolization to relieve symptoms, this phenomenon remains controversial. Hemodynamic evidence of coronary steal using angiographic and intravascular Doppler techniques has been supported by some and rejected by others. In this case study using an intracoronary Doppler wire with adenosine, we demonstrate that a trial occlusion of the LIMA thoracic side branch with selective balloon inflation can confirm physiologic significant steal and whether coil embolization of the side branch is indicated.

  7. Vascular anatomy of the medial sural artery perforator flap: a new classification system of intra-muscular branching patterns.

    Science.gov (United States)

    Dusseldorp, Joseph R; Pham, Quy J; Ngo, Quan; Gianoutsos, Mark; Moradi, Pouria

    2014-09-01

    The medial sural artery perforator (MSAP) flap is a versatile fasciocutaneous flap. The main difficulty encountered when raising the MSAP flap is in obtaining adequate pedicle length during intra-muscular dissection. The objective of this study was to determine the pattern of intra-muscular course of the MSAP flap pedicle. 14 cadaveric specimens were dissected and CT angiograms of 84 legs were examined. The intra-muscular branching pattern and depths of the medial sural artery branches were analyzed. The number of perforators, position of the dominant perforator and both intra-muscular and total pedicle length were also recorded and compared to existing anatomical data. Three types of arterial branching pattern were identified within the medial gastrocnemius, demonstrating one (31%), two (59%) or three or more (10%) main branches. A dominant perforator from the medial sural artery was present in 92% of anatomical specimens (13/14). Vertically, the location of the perforator from the popliteal crease was on average 13 cm (±2 cm). Transversely, the perforator originated 2.5 cm (±1 cm) from the posterior midline. Using CT angiography it was possible in 10 consecutive patients to identify a more superficial intra-muscular branch and determine the leg with the optimal branching pattern type for flap harvest. This study is the first to describe the variability of the intra-muscular arterial anatomy of the medial head of gastrocnemius muscle. Surgeons utilizing the MSAP flap option should be aware of the possible branching pattern types and consequently the differing perforator distribution and depths of intra-muscular branches. Routine use of pre-operative CT angiogram may help determine which leg has the most favorable branching pattern type and intra-muscular course for flap harvest. Copyright © 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  8. Spontaneous Rupture of Splenic Artery Aneurysm during the First Trimester of Pregnancy: Report of an Extremely Rare Case and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Theodoros Pavlis

    2012-01-01

    Full Text Available Splenic artery aneurysm (SAA occurs predominantly in women and the majority of them are asymptomatic until rupture. In cases of spontaneous rupture of an SAA, maternal and fetal mortality rates remain extremely high. Furthermore, the spontaneous ruptures of SAAs predominantly appear during the third trimester of pregnancy. We present the third known case of spontaneous SAA rupture during the first trimester of pregnancy, which manifested as sudden hypovolemic collapse and was successfully confronted with combined aggressive resuscitation and emergency surgical operation.

  9. Analysis of anatomical variations of the main arteries branching from the abdominal aorta, with 64-detector computed tomography

    International Nuclear Information System (INIS)

    Kornafel, O.; Baran, B.; Pawlikowska, I.; Laszczynski, P.; Guzinski, M.; Sasiadek, M.

    2010-01-01

    Background: Great variability in the vasculature of the abdominal organs makes the pre-operative evaluation of arterial anatomical conditions extremely important and helpful. The aim of our study was to establish the prevalence of anatomical variations of the arteries branching from the abdominal aorta and to compare the results with the ones presented in the literature. Material/Methods: The material included computed tomography angiographies (CTA) of 201 patients (91 women and 110 men) performed between September 2007 and December 2008. The CTA examinations were conducted with a 64-detector CT scanner at the Department of Radiology of University Hospital in Wroclaw. Images were obtained during the arterial phase and were analyzed for the presence of potential anomalies of the branches of the abdominal aorta. Results: In 88 patients (43.8%), there were anatomical variations of the arteries branching from the abdominal aorta. Variations of the renal arteries were observed in 83 (41.3%) patients, anomalies of the celiac trunk in 9 patients (4.5%), including variations of the superior mesenteric artery in 4 (2%) patients. No anatomical anomalies of the inferior mesenteric artery were shown in this study. The most frequent anomaly of the renal vasculature was the presence of at least one additional renal artery, observed in 65 (32.3%) patients. This concerned the inferior renal polar artery mainly - in 30 (14.9%) patients. Presence of bilateral additional renal arteries was visualized in 10% (20/201) of the cases. The most frequent anomalies of the celiac trunk were the celiacmesenteric trunk (in 3 patients - 1.5%) and the hepatosplenic trunk (in 3 patients - 1.5%). The celiac-mesenteric trunk was also the most frequent variation of the superior mesenteric artery in our material. Conclusions: A large part of population - 43.8% of our patients - demonstrated variations of arteries branching from the abdominal aorta. The anomalies were significantly more often found

  10. Saved from a fatal flight: A ruptured splenic artery aneurysm in a pregnant woman

    Directory of Open Access Journals (Sweden)

    Anke C. Heitkamp

    2015-01-01

    Conclusion: In case of pregnant women with acute abdomen and hypovolemia, emergency physicians, surgeons, anesthesiologists, and gynecologists should be aware of the possibility of a ruptured SAA, apart from more common causes like placental abruption, placenta percreta, or uterine rupture. Early recognition and prompt multidisciplinary treatment might save the life of mother and child.

  11. Acute Subdural Hematoma and Subarachnoid Hemorrhage Caused by Ruptured Cortical Artery Aneurysm: Case Report and Review of Literature

    Science.gov (United States)

    Shekarchizadeh, Ahmad; Masih, Saburi; Reza, Pourkhalili; Seif, Bahram

    2017-01-01

    The present report describes an acute subdural hematoma (ASDH) associated with subarachnoid hemorrhage (SAH), due to ruptured cortical aneurysm. To our knowledge, extremely rare cases of this sort have been reported so far. A 23-year-old male patient without previous trauma presented with severe headache and rapidly decreasing level of consciousness to decerebrate status. Computed tomography (CT) scan has demonstrated an ASDH together with SAH. Hematoma has immediately been evacuated without any evaluation by angiography. After evacuation of the thick subdural clot, a 10-mm aneurysm was revealed on a precentral artery of frontal cortex, which was ligated. However, after 35 days the patient discharged with left side hemiparesis and dysphasia, and just after several months of admission he got symptom free. Ruptured cortical aneurysm should be considered as one of the causes of spontaneous ASDH. Vascular anomaly investigations are suggested for these cases, thus CT angiography or digital subtraction angiography has to be considered if clinical condition allows. PMID:28503501

  12. Isolated abducens nerve palsy associated with subarachnoid hemorrhage: a localizing sign of ruptured posterior inferior cerebellar artery aneurysms.

    Science.gov (United States)

    Burkhardt, Jan-Karl; Winkler, Ethan A; Lasker, George F; Yue, John K; Lawton, Michael T

    2018-06-01

    OBJECTIVE Compressive cranial nerve syndromes can be useful bedside clues to the diagnosis of an enlarging intracranial aneurysm and can also guide subsequent evaluation, as with an acute oculomotor nerve (cranial nerve [CN] III) palsy that is presumed to be a posterior communicating artery aneurysm and a surgical emergency until proven otherwise. The CN VI has a short cisternal segment from the pontomedullary sulcus to Dorello's canal, remote from most PICA aneurysms but in the hemodynamic pathway of a rupturing PICA aneurysm that projects toward Dorello's canal. The authors describe a cranial nerve syndrome for posterior inferior cerebellar artery (PICA) aneurysms that associates subarachnoid hemorrhage (SAH) and an isolated abducens nerve (CN VI) palsy. METHODS Clinical and radiological data from 106 surgical patients with PICA aneurysms (66 ruptured and 40 unruptured) were retrospectively reviewed. Data from a group of 174 patients with other aneurysmal SAH (aSAH) were analyzed in a similar manner to control for nonspecific effects of SAH. Univariate statistical analysis compared incidence and risk factors associated with CN VI palsy in subarachnoid hemorrhage. RESULTS Overall, 13 (4.6%) of 280 patients had CN VI palsy at presentation, and all of them had ruptured aneurysms (representing 13 [5.4%] of the 240 cases of ruptured aneurysms). CN VI palsies were observed in 12 patients with ruptured PICA aneurysms (12/66 [18.1%]) and 1 patient with other aSAH (1/174 [0.1%], p < 0.0001). PICA aneurysm location in ruptured aneurysms was an independent predictor for CN VI palsy on multivariate analysis (p = 0.001). PICA aneurysm size was not significantly different in patients with or without CN VI palsy (average size 4.4 mm and 5.2 mm, respectively). Within the PICA aneurysm cohort, modified Fisher grade (p = 0.011) and presence of a thick cisternal SAH (modified Fisher Grades 3 and 4) (p = 0.003) were predictors of CN VI palsy. In all patients with ruptured PICA

  13. Blood Pressure Response to Main Renal Artery and Combined Main Renal Artery Plus Branch Renal Denervation in Patients With Resistant Hypertension.

    Science.gov (United States)

    Fengler, Karl; Ewen, Sebastian; Höllriegel, Robert; Rommel, Karl-Philipp; Kulenthiran, Saaraaken; Lauder, Lucas; Cremers, Bodo; Schuler, Gerhard; Linke, Axel; Böhm, Michael; Mahfoud, Felix; Lurz, Philipp

    2017-08-10

    Single-electrode ablation of the main renal artery for renal sympathetic denervation showed mixed blood pressure (BP)-lowering effects. Further improvement of the technique seems crucial to optimize effectiveness of the procedure. Because sympathetic nerve fibers are closer to the lumen in the distal part of the renal artery, treatment of the distal main artery and its branches has been shown to reduce variability in treatment effects in preclinical studies and a recent randomized trial. Whether this optimized technique improves clinical outcomes remains uncertain. We report a 2-center experience of main renal artery and combined main renal artery plus branches renal denervation in patients with resistant hypertension using a multielectrode catheter. Twenty-five patients with therapy-resistant hypertension underwent renal sympathetic denervation with combined main renal artery and renal branch ablation and were compared to matched controls undergoing an ablation of the main renal artery only. BP change was assessed by ambulatory measurement at baseline and after 3 months. At baseline, BP was balanced between the groups. After 3 months, BP changed significantly in the combined ablation group (systolic/diastolic 24-hour mean and daytime mean BP -8.5±9.8/-7.0±10.7 and -9.4±9.8/-7.1±13.5 mm Hg, P renal artery and branches appears to improve BP-lowering efficacy and should be further investigated. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  14. Retrograde Embolization of the Left Vertebral Artery in a Type II Endoleak After Endovascular Treatment of Aortic Thoracic Rupture: Technical Note

    International Nuclear Information System (INIS)

    Rabellino, Martin; Garcia Nielsen, L.; Baldi, S.; Zander, T.; Arnaiz, L.; Llorens, R.; Zerolo, I.; Maynar, M.

    2009-01-01

    Endoleak is a frequent complication after endovascular repair of aortic rupture. We describe the case of a female patient with traumatic aortic injury, treated with endograft, who developed a type II endoleak through the left subclavian and vertebral arteries. Both arteries originated independently from the aortic arch, and were managed with coil embolization of each vessel. We also report our experience with treating the left vertebral artery by placing a microcatheter through the right vertebral one.

  15. Dexamethasone Implant (Ozurdex in a Case with Unilateral Simultaneous Central Retinal Vein and Branch Retinal Artery Occlusion

    Directory of Open Access Journals (Sweden)

    Taylan Ozturk

    2015-02-01

    Full Text Available Simultaneous branch retinal artery and vein occlusion is a rare condition that may cause severe visual loss, and its treatment is often unrewarding. Herein, we report a case with simultaneous central retinal vein and branch retinal artery occlusion; it was successfully treated with a single dexamethasone intravitreal implant. The affected eye attained a visual acuity level of 20/25 from the visual acuity of hand motions at presentation with a residual, but relatively diminished, altitudinal scotoma during a follow-up period of 6 months.

  16. Ultrasound assessment of the posterior circumflex humeral artery in elite volleyball players: Aneurysm prevalence, anatomy, branching pattern and vessel characteristics

    OpenAIRE

    van de Pol, Daan; Maas, Mario; Terpstra, Aart; Pannekoek-Hekman, Marja; Alaeikhanehshir, Sena; Kuijer, P. Paul F. M.; Planken, R. Nils

    2016-01-01

    Objectives To determine the prevalence of posterior circumflex humeral artery (PCHA) aneurysms and vessel characteristics of the PCHA and deep brachial artery (DBA) in elite volleyball players. Methods Two-hundred and eighty players underwent standardized ultrasound assessment of the dominant arm by a vascular technologist. Assessment included determination of PCHA aneurysms (defined as segmental vessel dilatation ?150 %), PCHA and DBA anatomy, branching pattern, vessel course and diameter. R...

  17. Branch retinal artery occlusion post-penetrating globe injury with intraocular foreign body.

    Science.gov (United States)

    Nagpal, Manish; Chaudhary, Pranita; Jain, Ashish

    2018-01-01

    Intraocular foreign body (IOFB) in cases of penetrating eye injury accounts for an important indication of vitreoretinal intervention following ocular trauma. Vascular occlusion as a complication of IOFB is rare. Here we present a case of a 34-year-old male with post-traumatic cataract and an intraocular metallic foreign body (IOFB) lodged in the superficial layers of the retina inferotemporal to the disc, causing an inferotemporal branch retinal artery occlusion. The case was managed by lensectomy with pars plana vitrectomy and IOFB removal followed by a second procedure of secondary IOL implantation. Final best-corrected visual acuity improved to 6/24. This case highlights an unusual sequelae following penetrating ocular trauma.

  18. Branch retinal artery occlusion post-penetrating globe injury with intraocular foreign body

    Directory of Open Access Journals (Sweden)

    Manish Nagpal

    2018-01-01

    Full Text Available Intraocular foreign body (IOFB in cases of penetrating eye injury accounts for an important indication of vitreoretinal intervention following ocular trauma. Vascular occlusion as a complication of IOFB is rare. Here we present a case of a 34-year-old male with post-traumatic cataract and an intraocular metallic foreign body (IOFB lodged in the superficial layers of the retina inferotemporal to the disc, causing an inferotemporal branch retinal artery occlusion. The case was managed by lensectomy with pars plana vitrectomy and IOFB removal followed by a second procedure of secondary IOL implantation. Final best-corrected visual acuity improved to 6/24. This case highlights an unusual sequelae following penetrating ocular trauma.

  19. Tl-201 myocardial perfusion scanning in patients with right bundle branch block coronary artery disease

    International Nuclear Information System (INIS)

    Shirani, J.; Malpani, A.R.; Blend, M.J.; Bekerman, C.

    1990-01-01

    This paper evaluates the specificity of stress T1-201 myocardial perfusion studies (T1-201 MPS) for coronary artery disease (CAD) in patients with right bundle branch block (RBBB). Twenty-four patients with RBBB and atypical chest pain with ECG findings limited to RBBB, adequate stress test (ie, >85% of maximal heart rate for age), and no clinical, hemodynamic, or ECG evidence of ischemia during exercise underwent T1-201 MPS. These perfusion patterns were compared with an equal number of age- and gender-matched controls with a normal ECG who met all other criteria mentioned above. Patients with RBBB showed a significantly higher frequency of reversible inferoposterior T1-201 defects (62.5% vs 20.8%)

  20. Aorto-right atrial fistula secondary to rupture of an occluded old saphenous venous graft to right coronary artery.

    Science.gov (United States)

    Balestrini, Carlos Sebastian; Saaibi, José Federico; Ortiz, Santiago Navas

    2014-09-01

    We report a case of an acquired aorta-right atrial fistula, secondary to a ruptured proximal anastomosis of an old saphenous vein graft 12 years after a coronary artery bypass surgery, in a 57 year old patient with multiple cardiovascular risk factors. On admission, he presented with congestive heart failure and on examination a continuous murmur was detected on the right parasternal border. Catheterization showed a fistula from the proximal anastomosis of an occluded right coronary artery saphenous vein graft draining to the right atrium with a large left to right shunt. The fistula was successfully occluded by a percutaneous approach with a Life Tech duct occluder with complete resolution of heart failure. The patient was discharged one week afterwards. After a two-year follow-up, the fistula remained occluded. © 2013 Wiley Periodicals, Inc.

  1. Superior mesenteric arterial branch occlusion causing partial jejunal ischemia: a case report

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    Van De Winkel Nele

    2012-02-01

    Full Text Available Abstract Introduction Ischemic bowel disease comprises both mesenteric ischemia and colonic ischemia. Mesenteric ischemia can be divided into acute and chronic ischemia. These are two separate entities, each with their specific clinical presentation and diagnostic and therapeutic modalities. However, diagnosis may be difficult due to the vague symptomatology and subtle signs. Case presentation We report the case of a 68-year-old Caucasian woman who presented with abdominal discomfort, anorexia, melena and fever. A physical examination revealed left lower quadrant tenderness and an irregular pulse. Computed tomography of her abdomen as well as computed tomography enterography, enteroscopy, angiography and small bowel enteroclysis demonstrated an ischemic jejunal segment caused by occlusion of a branch of the superior mesenteric artery. The ischemic segment was resected and an end-to-end anastomosis was performed. The diagnosis of segmental small bowel ischemia was confirmed by histopathological study. Conclusion Mesenteric ischemia is a pathology well-known by surgeons, gastroenterologists and radiologists. Acute and chronic mesenteric ischemia are two separate entities with their own specific clinical presentation, radiological signs and therapeutic modalities. We present the case of a patient with symptoms and signs of chronic mesenteric ischemia despite an acute etiology. To the best of our knowledge, this is the first report presenting a case of acute mesenteric ischemia with segmental superior mesenteric artery occlusion.

  2. Ischemic stroke related to intracranial branch atheromatous disease and comparison with large and small artery diseases.

    Science.gov (United States)

    Kwan, May Wai-Mei; Mak, Windsor; Cheung, Raymond Tak-Fai; Ho, Shu-Leong

    2011-04-15

    The mechanism of ischemic stroke in intracranial branch atheromatous disease (BAD) is different from large artery atherothrombotic disease (LAD) or lacunar infarction (LACI). The concept of BAD is underused in clinical practice and research. Patients admitted over 24-months with ischemic stroke caused by atherosclerotic disease were reviewed retrospectively and classified according to radiological±clinical criteria into LAD, BAD and LACI. The BAD cases were further divided into 5 BAD syndromes. Clinical characteristics, vascular risk factors, results of vascular workup and outcome among these subgroups were compared. 123 cases of LAD (17% of all stroke patients or 33% of all studied patients), 147 BAD (20% or 40%) and 102 LACI (14% or 27%) presented during the study period. Compared to LAD, BAD patients had milder neurological deficits, were less often diabetic and carotid stenosis was less common, while stenosis of the intracranial arteries was more frequent in BAD as compared with LACI patients. Outcome in BAD patients was intermediate between LAD and LACI. Comparisons among the BAD syndromes indicated they were homogenous conditions. BAD is the most prevalent ischemic stroke subtype in our cohort. The homogeneity among the BAD syndromes suggests they might represent a distinctive stroke entity. Copyright © 2011 Elsevier B.V. All rights reserved.

  3. The Posterior Cerebral Artery and its Main Cortical Branches Identified with Noninvasive Transcranial Color-Coded Duplex Sonography.

    Science.gov (United States)

    Frid, P E; Schreiber, S J; Pade, O; Doepp, F; Valdueza, J

    2015-11-01

    To differentiate PCA segments and cortical branches by means of transcranial color-coded duplex sonography (TCCD) and to measure flow parameters at rest and during visual stimulation. 60 healthy subjects with a good acoustic temporal bone window were examined. The main stem of the PCA (P1, P2 and P3) and 4 main cortical branches - the anterior temporal artery (ATA), the occipital temporal artery (OTA), the parietooccipital artery (POA) and the calcarine artery (CA) - were assessed using an axial transtemporal approach. Systolic and diastolic blood flow velocities (BFVs) were recorded at rest and during visual stimulation. Identification of the P1 segment of the PCA was successful in 97.5% (117/120) of cases. The P2 and P3 segments were visualized in all cases. The 4 main cortical branches could be identified to varying degrees: ATA in 88%, OTA in 96%, POA in 69% and CA in 62%. There was an evoked flow response in the P2 main stem and in all cortical branches. The most pronounced increase in diastolic/systolic BFV after visual stimulation test was seen in the CA (42%/35%), followed by P2 (30%/24%), the POA (27%/27%), the OTA (16%/13%) and the ATA (9%/8%). Insonation through the temporal bone window with TCCD confidently allows the assessment of the P1 to P3 segments of the PCA as well as the 2 proximal branches, the ATA and the OTA. An ultrasound-based classification of PCA anatomy and its cortical branches may be used as a noninvasive method for the evaluation of posterior circulation pathology.

  4. The central retinal artery occlusion in the right eye followed by a branch retinal artery occlusion in the left eye four days later

    Directory of Open Access Journals (Sweden)

    Cagatay Caglar

    2013-01-01

    Full Text Available A 65-year-old woman was admitted to our clinic with complaints of sudden, painless, decrease in vision, and sectoral visual field defect in the left eye and later presented to our clinic again with a history of sudden loss of vision in her right eye. In this case study we reported that the patient had branch retinal artery occlusion (BRAO in the left eye and at the same time progressing central retinal artery occlusion (CRAO in the right eye.

  5. Myocardial perfusion in patients with left bundle branch block and without coronary artery disease

    International Nuclear Information System (INIS)

    Narita, Michihiro; Kurihara, Tadashi; Murano, Kenichi; Usami, Masahisa; Honda, Minoru

    1992-01-01

    For the evaluation of myocardial perfusion in patients with left bundle branch block (LBBB), we performed exercise stress (Ex)-redistribution (RD) myocardial tomography with thallium-201 ( 201 Tl) in 23 patients with LBBB and without coronary artery disease (CAD). Myocardial images in patients with LBBB were compared with those of 9 patients with CAD who showed Ex induced transient septal defect. Bull'-eye maps ( 201 Tl distribution maps at Ex and RD and 201 Tl washout rate [WOR] map) were made from myocardial tomograms. In 23 patients with LBBB, 15 patients (65%) developed myocardial perfusion abnormality. In 10 (67%) of these 15 patients, transient perfusion defect appeared in the entire septum (diffuse type). On the other hand in 5 patients (33%), localized fixed perfusion defect developed at the boundary between septum and anterior wall (focal type). In focal type, every patient had other disease such as hypertension, aortic stenosis or sick sinus syndrome. While in patients with diffuse type, other diseases were observed in 30% (p 201 Tl WOR and 201 Tl uptake ratio of septum to lateral wall indicated that exercise induced septal defect was slighter in diffuse type than CAD. These points might be useful to differentiate whether CAD participates in the septal defect or not in patients with LBBB. (author)

  6. Evaluation of malposition of the branch pulmonary arteries using cardiovascular computed tomography angiography

    International Nuclear Information System (INIS)

    Liu, Hui; Juan, Yu-Hsiang; Wang, Qiushi; Huang, Hongfei; Yang, Lin; Xie, Zhaofeng; Chen, Jimei; Zhang, Xiaoshen; Liang, Changhong; Chung, Taylor; Kwong, Raymond Y.; Saboo, Sachin S.

    2014-01-01

    To analyze 15 cases of malposition of branch pulmonary arteries (MBPA) for the hospital-based prevalence, clinical information, surgical outcome, imaging findings, associated cardiovascular and airway abnormalities on cardiovascular computed tomography angiography (CCTA). We retrospectively searched for patients with MBPA from our database consisting of patients referred for CCTA due to known or suspected congenital heart disease and also from all patients receiving chest computed tomography (CT) during the same time period. We analyzed the hospital-based prevalence, image findings, associated cardiovascular anomalies, airway compression, and recorded the clinical information and surgical outcome. Our study showed 15 patients with MBPA (hospital-based prevalence: 0.33 % among patients with congenital heart disease and 0.06 % in all patients receiving chest CT or CCTA). Classic type was more common than lesser type (67 % versus 33 %). All patients had associated cardiovascular anomalies, including aortic arch abnormalities (80 %) and secondary airway compression (33 %). Surgery was performed in 67 % of cardiovascular anomalies and 60 % of airway stenoses. MBPA has a hospital-based prevalence of 0.33 % among patients with congenital heart disease and 0.06 % in all patients receiving either chest CT or CCTA. CCTA can delineate the anatomy of MBPA, associated cardiovascular and airway abnormalities for preoperative evaluation. (orig.)

  7. A framework for classification and segmentation of branch retinal artery occlusion in SD-OCT

    Science.gov (United States)

    Guo, Jingyun; Shi, Fei; Zhu, Weifang; Chen, Haoyu; Chen, Xinjian

    2016-03-01

    Branch retinal artery occlusion (BRAO) is an ocular emergency which could lead to blindness. Quantitative analysis of BRAO region in the retina is very needed to assessment of the severity of retinal ischemia. In this paper, a fully automatic framework was proposed to classify and segment BRAO based on 3D spectral-domain optical coherence tomography (SD-OCT) images. To the best of our knowledge, this is the first automatic 3D BRAO segmentation framework. First, a support vector machine (SVM) based classifier is designed to differentiate BRAO into acute phase and chronic phase, and the two types are segmented separately. To segment BRAO in chronic phase, a threshold-based method is proposed based on the thickness of inner retina. While for segmenting BRAO in acute phase, a two-step segmentation is performed, which includes the bayesian posterior probability based initialization and the graph-search-graph-cut based segmentation. The proposed method was tested on SD-OCT images of 23 patients (12 of acute and 11 of chronic phase) using leave-one-out strategy. The overall classification accuracy of SVM classifier was 87.0%, and the TPVF and FPVF for acute phase were 91.1%, 5.5%; for chronic phase were 90.5%, 8.7%, respectively.

  8. Evaluation of malposition of the branch pulmonary arteries using cardiovascular computed tomography angiography

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Hui [Guangdong Academy of Medical Sciences, Department of Radiology, Guangdong General Hospital, GuangZhou, GuangDong (China); Brigham and Women' s Hospital, Harvard Medical School, Cardiovascular Imaging Program, Department of Medicine (Division of Cardiovascular Medicine) and Radiology, Boston, MA (United States); Juan, Yu-Hsiang [Brigham and Women' s Hospital, Harvard Medical School, Cardiovascular Imaging Program, Department of Medicine (Division of Cardiovascular Medicine) and Radiology, Boston, MA (United States); Chang Gung Memorial Hospital, Linkou and Chang Gung University, Department of Medical Imaging and Intervention, Taoyuan (China); Wang, Qiushi; Huang, Hongfei; Yang, Lin [Guangdong Academy of Medical Sciences, Department of Radiology, Guangdong General Hospital, GuangZhou, GuangDong (China); Xie, Zhaofeng [Guangdong Academy of Medical Sciences, Department of Pediatric Cardiology, Guangdong General Hospital, GuangZhou, GuangDong (China); Chen, Jimei; Zhang, Xiaoshen [Guangdong Academy of Medical Sciences, Department of Cardiovascular Surgery, Guangdong General Hospital, GuangZhou, GuangDong (China); Liang, Changhong [Guangdong Academy of Medical Sciences, Department of Radiology, Guangdong General Hospital, GuangZhou, GuangDong (China); Guangdong Academy of Medical Sciences, Department of Radiology, Guangdong General Hospital, Guangzhou (China); Chung, Taylor [Children' s Hospital and Research Center Oakland, Department of Diagnostic Imaging, Oakland, CA (United States); Kwong, Raymond Y.; Saboo, Sachin S. [Brigham and Women' s Hospital, Harvard Medical School, Cardiovascular Imaging Program, Department of Medicine (Division of Cardiovascular Medicine) and Radiology, Boston, MA (United States)

    2014-12-15

    To analyze 15 cases of malposition of branch pulmonary arteries (MBPA) for the hospital-based prevalence, clinical information, surgical outcome, imaging findings, associated cardiovascular and airway abnormalities on cardiovascular computed tomography angiography (CCTA). We retrospectively searched for patients with MBPA from our database consisting of patients referred for CCTA due to known or suspected congenital heart disease and also from all patients receiving chest computed tomography (CT) during the same time period. We analyzed the hospital-based prevalence, image findings, associated cardiovascular anomalies, airway compression, and recorded the clinical information and surgical outcome. Our study showed 15 patients with MBPA (hospital-based prevalence: 0.33 % among patients with congenital heart disease and 0.06 % in all patients receiving chest CT or CCTA). Classic type was more common than lesser type (67 % versus 33 %). All patients had associated cardiovascular anomalies, including aortic arch abnormalities (80 %) and secondary airway compression (33 %). Surgery was performed in 67 % of cardiovascular anomalies and 60 % of airway stenoses. MBPA has a hospital-based prevalence of 0.33 % among patients with congenital heart disease and 0.06 % in all patients receiving either chest CT or CCTA. CCTA can delineate the anatomy of MBPA, associated cardiovascular and airway abnormalities for preoperative evaluation. (orig.)

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

    International Nuclear Information System (INIS)

    Bendel, Paula; Koskenkorva, Paeivi; Vanninen, Ritva; Koivisto, Timo; Aeikiae, Marja; Niskanen, Eini; Koenoenen, Mervi; Haenninen, Tuomo

    2009-01-01

    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

    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.)

  11. Complete Remission of Pancreatic Pseudoaneurysm Rupture with Arterial Embolization in a Patient with Poor Risk for Surgery: A Case Report

    Directory of Open Access Journals (Sweden)

    Kuang-En Chu

    2012-05-01

    Full Text Available Pancreatic pseudoaneurysm is a rare vascular complication of chronic pancreatitis resulting from erosion of the pancreatic or peripancreatic artery into a pseudocyst that is identified as a pulsating vascular malformation which may lead to lethal complications if left untreated. Many publications in the literature consider angiography as the first step in the management of pancreatic pseudoaneurysm to stabilize the patient’s critical condition; it should be followed by surgical intervention as the definite treatment. We report a rare case of pancreatic pseudoaneurysm rupture with hemodynamic embarrassment in a critical patient with multiple comorbid conditions and poor risk for surgery who responded dramatically to angiographic management as a single therapeutic modality without further surgical intervention. The results observed in our patient suggest that pancreatic pseudoaneurysm may be successfully managed with angiography only and that not all cases require surgical intervention. This is particularly relevant in critically ill patients in whom surgical intervention would be unfeasible.

  12. Preoperative Prediction of the Necessity for Anterior Clinoidectomy During Microsurgical Clipping of Ruptured Posterior Communicating Artery Aneurysms.

    Science.gov (United States)

    Kamide, Tomoya; Burkhardt, Jan-Karl; Tabani, Halima; Safaee, Michael M; Lawton, Michael T

    2018-01-01

    Although most posterior communicating artery (PCoA) aneurysms can be clipped easily with excellent results, some require anterior clinoidectomy for safe and complete clipping. To review our microsurgical series of ruptured PCoA aneurysms and identify the preoperative predictors for anterior clinoidectomy during microsurgical clipping for PCoA aneurysms. Results from microsurgical clipping of 104 patients with ruptured PCoA aneurysms were reviewed retrospectively. Distances and angles were obtained from computed tomographic angiography and compared between the anterior and nonanterior clinoidectomy groups. Anterior clinoidectomy was required in 19 of the 104 cases (18%). None developed surgical complications due to anterior clinoid process (ACP) resection, including postoperative visual deficit. Univariate and multivariate analyses revealed that the distances from the ACP tip to the aneurysmal proximal neck and from the ACP line to the aneurysmal proximal neck were statistically significant predictive factors for the need of anterior clinoidectomy. Based on a receiver operating characteristic analysis, the distances from the ACP tip to the aneurysmal proximal neck PCoA aneurysm surgery, the distances from the ACP tip to the aneurysmal proximal neck and from the ACP line to the aneurysmal proximal neck were both found to be useful predictors of whether anterior clinoidectomy was required. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Pontine infarction induced by injury of the perforating branch of the basilar artery after blunt head impact: case report.

    Science.gov (United States)

    Yanagawa, Youichi; Iwamoto, Shin-ichiro; Nishi, Kouichirou

    2008-08-01

    A 77-year-old male pedestrian was hit by a car. On admission, he had disturbance of consciousness and left hemiplegia. Computed tomography (CT) indicated only left frontal subcutaneous hematoma and minor hemorrhage in the left frontal lobe, suggesting axonal injury. CT on hospital day 2 revealed a low density area in the right paramedian pons, but CT angiography showed no dissection or occlusion of the vertebrobasilar artery. The diagnosis was pontine infarction resulting from shearing force injury to the paramedian branch of the basilar artery. He was transferred to another hospital for rehabilitation without improvement of symptoms on hospital day 51. Paramedian pontine infarction tends to occur in patients with risk factors for arteriosclerosis, including hypertension, diabetes mellitus, hyperlipidemia, or smoking. The present elderly patient had hypertension and hyperlipidemia, so arteriosclerosis in the paramedian branch may have contributed to his susceptibility to such injury.

  14. The surgical significance of the atrial branches of the coronary arteries.

    Science.gov (United States)

    Busquet, J; Fontan, F; Anderson, R H; Ho, S Y; Davies, M J

    1984-08-01

    The great number of open heart operations now performed via the right atrium, makes knowledge of the arrangement of the atrial arteries, particularly the sinus node artery, every important for the surgeon. Although studied by anatomists, little attention has been paid to the surgical significance of these arteries. We have therefore examined the distribution of the right atrial arteries and the course of the sinus node artery in 50 normal adult hearts by classic dissection following, in 30 cases, postmortem angiographic studies. Two major arteries of the right atrium were found to be nearly constant. The anterior artery was present in 96% of the cases and supplied the sinus node artery in 32 cases. Of most surgical significance was the lateral artery found in 90% of the cases. This lateral artery was the principal artery to the free atrial wall and in one case gave rise to the sinus node artery. The well-established preponderance of origin of the sinus node artery from the right coronary system (66%) as opposed to the left (30%) was confirmed. Infrequently, a double supply (4%) was seen. Variability was found in the course of the nodal artery relative to the cavoatrial junction - precaval (58%), retrocaval (36%) or encircling (6%).

  15. Tuberothalamic artery infarction following coil embolization of a ruptured posterior communicating artery aneurysm belonging to a transitional type posterior cerebral artery. A case report.

    Science.gov (United States)

    Lee, Kyeong Duk; Kwon, Soon Chan; Muniandy, Sarawana; Park, Eun Suk; Sim, Hong Bo; Lyo, In Uk

    2013-09-01

    There are many potential anatomical variations in the connection between the internal carotid artery and the posterior circulation through the posterior communicating artery (PCoA). We describe the endovascular treatment of an aneurysm arising near the origin of the PCoA belonging to a transitional type posterior cerebral artery. Coil embolization subsequently resulted in thrombo-occlusion of the adjacent PCoA causing thalamic infarction even though sufficient retrograde flow had been confirmed pre-operatively by Allcock's test.

  16. Tuberothalamic Artery Infarction Following Coil Embolization of a Ruptured Posterior Communicating Artery Aneurysm Belonging to a Transitional Type Posterior Cerebral Artery: A Case Report

    OpenAIRE

    Lee, Kyeong Duk; Kwon, Soon Chan; Muniandy, Sarawana; Park, Eun Suk; Sim, Hong Bo; Lyo, In Uk

    2013-01-01

    There are many potential anatomical variations in the connection between the internal carotid artery and the posterior circulation through the posterior communicating artery (PCoA). We describe the endovascular treatment of an aneurysm arising near the origin of the PCoA belonging to a transitional type posterior cerebral artery. Coil embolization subsequently resulted in thrombo-occlusion of the adjacent PCoA causing thalamic infarction even though sufficient retrograde flow had been confirm...

  17. Extracranial vertebral artery rupture likely secondary to "cupping therapy" superimposed on spontaneous dissection.

    Science.gov (United States)

    Choi, Jae Young; Huh, Chae Wook; Choi, Chang Hwa; Lee, Jae Il

    2016-12-01

    The extracranial vertebral artery (VA) is vulnerable to dissection and the V3 segment is the most common location for dissection. Dissection accounts for about 2% of all ischemic strokes and can occur after trauma or chiropractic neck maneuvers. We report an extremely rare case of spontaneous extracranial VA dissection presenting with posterior neck hematoma aggravated after cupping therapy, a treatment in traditional Oriental medicine. We treated the patient successfully by endovascular treatment without any complication. © The Author(s) 2016.

  18. Spontaneous Right Coronary Artery Rupture and Acute Cardiac Tamponade in Behçet's Disease.

    Science.gov (United States)

    Keskin, Muhammed; Bozbay, Mehmet; Kayacıoğlu, İlyas; Koçoğulları, Cevdet; Bozbay, Ayfer Yıldız; Hayıroğlu, Mert İlker; Gürkan, Ufuk; Eren, Mehmet

    2016-11-01

    Coronary involvement in Behçet's disease is extremely rare and it can bring devastating consequences when it occurs. In this report, we present a 29-year-old male patient with Behçet's disease who developed rapidly changing and progressive coronary artery involvements under medical treatment. Copyright © 2016 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  19. Tuberothalamic Artery Infarction Following Coil Embolization of a Ruptured Posterior Communicating Artery Aneurysm Belonging to a Transitional Type Posterior Cerebral Artery

    Science.gov (United States)

    Lee, Kyeong Duk; Kwon, Soon Chan; Muniandy, Sarawana; Park, Eun Suk; Sim, Hong Bo; Lyo, In Uk

    2013-01-01

    Summary There are many potential anatomical variations in the connection between the internal carotid artery and the posterior circulation through the posterior communicating artery (PCoA). We describe the endovascular treatment of an aneurysm arising near the origin of the PCoA belonging to a transitional type posterior cerebral artery. Coil embolization subsequently resulted in thrombo-occlusion of the adjacent PCoA causing thalamic infarction even though sufficient retrograde flow had been confirmed pre-operatively by Allcock’s test. PMID:24070079

  20. Renal allograft rupture: US diagnosis

    International Nuclear Information System (INIS)

    Maklad, N.F.

    1987-01-01

    The US appearances in seven pathologically and/or surgically proved cases of renal allograft rupture are presented. These include a triangular or amorphous echogenic area in the cortex and medulla in a polar location, an echogenic band or wavy, branching anechoic lines in the hyperechoic region, a subcapsular hematoma, and an extrarenal hematoma in direct continuity with the echogenic area. Duplex Doppler examination in renal allograft rupture shows marked reduction of absence of the diastolic component of the velocity waveform in the arcuate and interlobar arteries, with reduction in amplitude of the systolic wave form. Correlation of the US appearances with gross and microscopic pathologic findings indicates that the echogenic area is due to an intrarenal hematoma, while the echogenic band represents the cortical laceration with adherent blood clots. The US-duplex Doppler examination should be the primary diagnostic modality in this life-threatening condition

  1. Spontaneous Rupture of Superficial Femoral Artery Repaired with Endovascular Stent-Grafting with use of Rendez-Vous Technique, Followed by Delayed Infection

    International Nuclear Information System (INIS)

    Fanelli, Fabrizio; Cannavale, Alessandro; Gazzetti, Marianna; Fantozzi, Cristiano; Taurino, Maurizio; Speziale, Francesco

    2013-01-01

    This is the case of a 72-year-old man with lower limb ischemia due to spontaneous rupture of nonaneurysmal superficial femoral artery that developed into thigh hematoma. After failure of a Fogarty revascularization, an emergency endovascular procedure was performed to restore the arterial continuity. A rendezvous procedure was performed with a double femoral and popliteal approach and two covered stent-grafts were deployed. Patient’s clinical conditions immediately improved, but 4 months later the stent-grafts were surgically removed for infection and exteriorization. A femoropopliteal bypass was performed. After 1 year follow-up, the patient is in good clinical condition.

  2. Spontaneous Rupture of Superficial Femoral Artery Repaired with Endovascular Stent-Grafting with use of Rendez-Vous Technique, Followed by Delayed Infection

    Energy Technology Data Exchange (ETDEWEB)

    Fanelli, Fabrizio, E-mail: fabrizio.fanelli@uniroma1.it; Cannavale, Alessandro [University of Rome ' Sapienza,' , Department of Radiological Sciences, Vascular and Interventional Radiology Unit (Italy); Gazzetti, Marianna [Sapienza University of Rome ' Sapienza,' , Department of Surgery Paride Stefanini, Vascular Surgery Division, Policlinico Umberto I (Italy); Fantozzi, Cristiano; Taurino, Maurizio [University of Rome ' Sapienza,' , Department of Vascular Surgery (Italy); Speziale, Francesco [Sapienza University of Rome ' Sapienza,' , Department of Surgery Paride Stefanini, Vascular Surgery Division, Policlinico Umberto I (Italy)

    2013-02-15

    This is the case of a 72-year-old man with lower limb ischemia due to spontaneous rupture of nonaneurysmal superficial femoral artery that developed into thigh hematoma. After failure of a Fogarty revascularization, an emergency endovascular procedure was performed to restore the arterial continuity. A rendezvous procedure was performed with a double femoral and popliteal approach and two covered stent-grafts were deployed. Patient's clinical conditions immediately improved, but 4 months later the stent-grafts were surgically removed for infection and exteriorization. A femoropopliteal bypass was performed. After 1 year follow-up, the patient is in good clinical condition.

  3. Median Supraorbital Keyhole Approach for Clipping Ruptured Distal Anterior Cerebral Artery Aneurysm: Technical Report with Review of Literature.

    Science.gov (United States)

    Dhandapani, Sivashanmugam; Sahoo, Sushant Kumar

    2018-04-01

    The minimally invasive approach to distal anterior cerebral artery (DACA) aneurysms has not gained much acceptance due to difficulties associated with the conventional frontal paramedian approach. The more proximal basal interhemispheric approach, however, necessitates extensive dissection of soft tissues. We describe a novel minimally invasive median supraorbital keyhole craniotomy with a basal interhemispheric approach for clipping a ruptured DACA aneurysm. A 62-year-old patient presented with subarachnoid hemorrhage. Computed tomography angiography revealed a DACA aneurysm. The surgical technique involved a keyhole craniotomy made via an eyebrow incision extending between the supraorbital notches, and flush with the anterior cranial fossa. The dura was opened at the anterior part, the falx was cut, an interhemispheric dissection was carried out, adequate proximal control was obtained, and the aneurysm neck was dissected and clipped. A relevant review of the literature was carried out. The patient recovered well, with no residual aneurysm or forehead numbness, with good cosmesis. Compared with the previously described "keyhole unilateral interhemispheric" approaches, our technique has less likelihood of encountering bridging veins; easier cisternal cerebrospinal fluid release, making it feasible even in swollen brain; better proximal vascular control; and trajectory toward the neck rather than dome. The median supraorbital keyhole approach is a minimally invasive technique sufficient for clipping most DACA aneurysms, with easier access, better proximal control, and good cosmesis. Copyright © 2018 Elsevier Inc. All rights reserved.

  4. Ultrasound assessment of the posterior circumflex humeral artery in elite volleyball players: Aneurysm prevalence, anatomy, branching pattern and vessel characteristics.

    Science.gov (United States)

    van de Pol, Daan; Maas, Mario; Terpstra, Aart; Pannekoek-Hekman, Marja; Alaeikhanehshir, Sena; Kuijer, P Paul F M; Planken, R Nils

    2017-03-01

    To determine the prevalence of posterior circumflex humeral artery (PCHA) aneurysms and vessel characteristics of the PCHA and deep brachial artery (DBA) in elite volleyball players. Two-hundred and eighty players underwent standardized ultrasound assessment of the dominant arm by a vascular technologist. Assessment included determination of PCHA aneurysms (defined as segmental vessel dilatation ≥150 %), PCHA and DBA anatomy, branching pattern, vessel course and diameter. The PCHA and DBA were identified in 100 % and 93 % (260/280) of cases, respectively. The prevalence of PCHA aneurysms was 4.6 % (13/280). All aneurysms were detected in proximal PCHA originating from the axillary artery (AA). The PCHA originated from the AA in 81 % of cases (228/280), and showed a curved course dorsally towards the humeral head in 93 % (211/228). The DBA originated from the AA in 73 % of cases (190/260), and showed a straight course parallel to the AA in 93 % (177/190). PCHA aneurysm prevalence in elite volleyball players is high and associated with a specific branching type: a PCHA that originates from the axillary artery. Radiologists should have a high index of suspicion for this vascular overuse injury. For the first time vessel characteristics and reference values are described to facilitate ultrasound assessment. • Prevalence of PCHA aneurysms is 4.6 % among elite volleyball players. • All aneurysms are in proximal PCHA that originates directly from AA. • Vessel characteristics and reference values are described to facilitate US assessment. • Mean PCHA and DBA diameters can be used as reference values. • Radiologists need a high index of suspicion for this vascular overuse injury.

  5. VARIATIONAL ANATOMY OF PROFUNDA FEMORIS ARTERY AND ITS BRANCHES: A CADAVERIC STUDY

    Directory of Open Access Journals (Sweden)

    Tapan Kumar

    2015-09-01

    Full Text Available BACKGROUND: Accurate knowledge of anatomical variations regarding origins of the profunda femoris, medial and lateral femoral circumflex femoral arteries are important for clinicians in the present modern era of interventional radiology. Our aim of this study was to observe and identify the variations in origin of the Profunda femoris artery and its circumflex br anches. MATERIALS & METHODS: 66 femoral triangles were dissected on 33 cadavers (Both sides. The profunda femoris vessel and its medial and lateral circumflex arteries were dissected and identified. The distance of the site of origin of Profunda Femoris A rtery was measured from mid - inguinal point (MIP in centimetres with scale, thread, and digital callipers. The sites of origin of Medial Circumflex Femoral Artery and Lateral Circumflex Femoral Artery were also studied and the distances of origin of each of them were measured from the origin of the Profunda Femoris Artery and from the mid - inguinal point. All the data were interpreted in tables. RESULTS : The data from the study was analyzed using statistical methods and analyzed by using the statistical pa ckage SPSS (Statistical Package for Social Sciences version 16.0 for windows in present study for analyzing the data contingency table were created first and then analyzed by using the Pearson’s chi - square test. The present study encountered that, in appr oximately 50% cases the profunda femoris artery originated from the lateral aspect of the common femoral artery. The lateral and medial circumflex femoral artery commonly originated from the profunda femoris nearly close to its origin from common femoral a rtery. CONCLUSION: This knowledge of variation and position would be very useful in preventing the iatrogenic injury to these vessels during surgical procedures of the femoral triangle. So, this study would be useful for the clinician for surgical and therapeutic interventi on.

  6. Intrasylvian/Intracerebral Hematomas Associated with Ruptured Middle Cerebral Artery Aneurysms: A Single-Center Series and Literature Review.

    Science.gov (United States)

    Zhang, Yupeng; Hu, Quan; Xue, Hao; Zhang, Mingran; Shen, Jie; Deng, Lin; Liu, Qinglin; Li, Gang

    2017-02-01

    Ruptured middle cerebral artery (MCA) aneurysms usually lead to subarachnoid hemorrhage (SAH), and several cases have shown concomitant intrasylvian or intracerebral hematomas. The objective of this study was to compare the clinical and radiographic characteristics with their different outcomes. The charts of 30 consecutive patients with ruptured MCA aneurysm-related intracranial hematoma were retrospectively reviewed. These patients were dichotomized into an intrasylvian hematoma (ISH) group and an intracerebral hematoma (ICH) group by the presence of intrahematomal contrast-enhancing vessel; for patients under open surgery, hematoma type was further confirmed by intraoperative observation. The characteristics were compared between these 2 groups (ie, age, gender, history of hypertension, history of smoking, systolic pressure at admission, hematoma volume, size and side of aneurysms, the angle between the pointing direction of the aneurysm and the MCA trunk [denoted as α], middle line shifting, treatment modality, and outcome). All the angles are measured in the anterior-posterior projection. In our series, only hematoma volume, the angle α, and the middle line shift showed statistical significance regarding prognosis between 2 hematoma groups. An angle α between 109.0°and 216.0° is associated with ISH, whereas aneurysm with an angle beyond this range indicates ICH. In our series, patients in the ICH group had a larger hematoma volume compared with the ISH patients (33.3 ± 17.6 vs. 11.5 ± 10.5; P = 0.002). There exists no statistical difference regarding prognosis between these 2 groups, even although there is a trend toward worse recovery for patients in the ISH group (Glasgow Outcome Scale score, 3.0 ± 1.3 vs. 3.8 ± 1.9; P = 0.07). In our series, the prognosis of patients with ICH was worse than that of patients with ISH. Early discrimination of these 2 types of hematoma helps to predict future outcome; an angle (between the pointing direction of

  7. Anomalous properties of heat diffusion in living tissue caused by branching artery network. Qualitative description

    OpenAIRE

    Lubashevsky, I. A.; Gafiychuk, V. V.; Datsko, B. Y.

    2002-01-01

    We analyze the effect of blood flow through large arteries of peripheral circulation on heat transfer in living tissue. Blood flow in such arteries gives rise to fast heat propagation over large scales, which is described in terms of heat superdiffusion. The corresponding bioheat heat equation is derived. In particular, we show that under local strong heating of a small tissue domain the temperature distribution inside the surrounding tissue is affected substantially by heat superdiffusion.

  8. Prevalence and rupture rate of cerebral aneurysms discovered during intra-arterial chemotherapy of brain tumors.

    Science.gov (United States)

    Bourekas, E C; Newton, H B; Figg, G M; Slone, H W

    2006-02-01

    During the administration of intra-arterial (IA) chemotherapy for the treatment of brain tumors (BTs), angiography may demonstrate asymptomatic, incidental cerebral aneurysms. The prevalence and complication rate of incidental aneurysms in patients undergoing IA chemotherapy remains unknown. It remains unclear whether the presence of an aneurysm represents an increased risk or a contraindication to this form of treatment. We performed a chart and angiography review of BT patients receiving IA chemotherapy over the previous 16 months. Seventy-eight patients were identified with primary (39) and metastatic (39) BTs. The cohort consisted of 40 men and 38 women, with a mean age of 47.8 years (range, 22-80 years). During initial angiography, 8 patients (10.3%) were identified with incidental cerebral aneurysms. The aneurysms were saccular and varied in size from 2-4 mm (mean, 3 mm). Seven of the 8 patients continued IA chemotherapy after detection of the aneurysm, for a total of 35 IA procedures. Of these 7 patients, 5 expired from nonaneurysmal complications (mean survival, 5.4 months; range, 2-10 months); 4 from the primary tumor, and one from an infected craniotomy site. Two patients continue to survive; one remains in treatment, and the other has completed 12 months of IA therapy. There were no aneurysmal complications during or after IA treatment in any of the BT patients. Incidental aneurysms may be more common in patients with BTs than the general population. In our patient population, there was no indication that an incidental aneurysm was reason to preclude or delay the use of IA chemotherapy.

  9. Simultaneous occurrence of subarachnoid hemorrhage and epistaxis due to ruptured petrous internal carotid artery aneurysm. Association with transsphenoidal surgery and radiation therapy. Case report

    International Nuclear Information System (INIS)

    Endo, Hidenori; Fujimura, Miki; Inoue, Takashi; Matsumoto, Yasushi; Ogawa, Yoshikazu; Kawagishi, Jun; Jokura, Hidefumi; Shimizu, Hiroaki; Tominaga, Teiji

    2011-01-01

    A 62-year-old woman presented with simultaneous subarachnoid hemorrhage (SAH) and massive epistaxis. The patient had been treated for pituitary prolactinoma by two transsphenoidal surgeries, gamma knife radiosurgery, and conventional radiation therapy since age 43 years. Cerebral angiography showed left petrous internal carotid artery (ICA) aneurysm with slight stenosis on the adjacent left petrous ICA. She underwent superficial temporal artery-middle cerebral artery (STA-MCA) double anastomosis with endovascular internal trapping without complication the day after onset. Postoperative course was uneventful; the patient did not develop symptomatic vasospasm, recurrent epistaxis, or cerebrospinal fluid rhinorrhea. Postoperative angiography demonstrated complete disappearance of the aneurysm with patent STA-MCA anastomosis. The patient was discharged 2 months after surgery without neurological deficit. The present case is extremely rare with simultaneous onset of SAH and epistaxis caused by ruptured petrous ICA aneurysm. The transsphenoidal surgeries and radiation therapies might have been critical in the formation of the petrous ICA aneurysm. (author)

  10. Asymmetric Bilateral Variations in the Musculocutaneous and Median Nerves with High Branching of Brachial Artery

    Directory of Open Access Journals (Sweden)

    Vandana Tomar

    2012-01-01

    Full Text Available Brachial Plexus is formed by the union of the anterior rami of cervical 5, 6, 7, 8 and thoracic 1 nerves. These nerves unite and divide to form the key nerves innervating the upper limb. Variations in the course of these nerves are clinically important to anesthetists, neurologists and orthopedicians. We report bilateral variations in the arterial and neural structures in the upper limb of a 65 year old cadaver. The muscles of the arm on one side were innervated by the median nerve with absence of musculocutaneous. While on the other side the musculocutaneous nerve contributed to the formation of the median nerve. There was a presence of high bifurcation of brachial artery on both sides. Knowledge of such variations in the innervations of muscles and the arterial supply of the limbs are important to remember before performing any reconstructive procedures or interventions on the limb.

  11. Vascular type Ehlers-Danlos Syndrome with fatal spontaneous rupture of a right common iliac artery dissection: case report and review of literature

    Science.gov (United States)

    Abayazeed, Aly; Hayman, Emily; Moghadamfalahi, Mana; Cain, Darren

    2014-01-01

    Vascular Ehlers-Danlos Syndrome (previously Ehlers-Danlos IV) is a rare autosomal dominant collagen vascular disorder caused by a 2q31 COL3A1 gene mutation encoding pro-alpha1 chain of type III collagen (in contrast to classic Ehlers-Danlos, caused by a COL5A1 mutation). The vascular type accounts for less than 4% of all Ehlers-Danlos cases and usually has a poor prognosis due to life threatening vascular ruptures and difficult, frequently unsuccessful surgical and vascular interventions. In 70% of cases, vascular rupture or dissection, gastrointestinal perforation, or organ rupture is a presenting sign. We present a case of genetically proven vascular Ehlers-Danlos with fatal recurrent retroperitoneal hemorrhages secondary to a ruptured right common iliac artery dissection in a 30-year-old male. This case highlights the need to suspect collagen vascular disorders when a young adult presents with unexplained retroperitoneal hemorrhage, even without family history of such diseases. PMID:24967021

  12. Anatomy of Atrioventricular Node Artery and Pattern of Dominancy in Normal Coronary Subject: A Comparison between Individuals with and without Isolated Right Bundle Branch Block.

    Science.gov (United States)

    Kazemisaeid, Ali; Pakbaz, Marziyeh; Yaminisharif, Ahmad; Davoodi, Gholamreza; Lotfi Tokaldany, Masoumeh; Hakki Kazazi, Elham

    2012-11-01

    Isolated right bundle branch block (RBBB) is a common finding in the general population. The atrioventricular node (AVN) artery contributes to the blood supply of the right bundle branch. Our hypothesis was that the anatomy of the AVN artery and the pattern of dominancy differ between subjects with and without RBBB. We retrospectively studied the coronary angiography of 92 patients with RBBB and 184 age- and gender-matched controls without RBBB. All the subjects had angiographically proven normal coronary arteries. The dominant circulation and precise origin of the AVN artery were determined in each subject. Obtained data were compared between the two study groups. There was no significant difference between the two groups in terms of dominancy (p value = 0.200). Origination of the AVN artery from the right circulatory system was more common in both groups, but this pattern was more prevalent in the cases than in the controls (p value = 0.021). There was a great variation of the AVN artery origin. In the total study population, the AVN artery was more commonly separated from a non crux origin than from the crux area. The prevalence of the non-crux origination of the AVN artery was significantly higher in the cases than in the controls (p value AVN artery from the right circulatory system was more common in both groups, the prevalence of the right origin of the AVN artery was significantly higher in the cases than in the controls. We observed that the AVN artery most commonly originated from the dominant artery but not necessarily from the crux. The anatomy of the AVN artery but not the pattern of dominancy is somewhat different in subjects with RBBB compared with normal individuals.

  13. Compression of the medulla oblongata and acute respiratory failure caused by rupture of a thrombosed large aneurysm of the anterior inferior cerebellar artery.

    Science.gov (United States)

    Oyama, Hirofumi; Kito, Akira; Maki, Hideki; Hattori, Kenichi; Tanahashi, Kuniaki

    2010-01-01

    A 65-year-old female presented with an extremely rare case of a ruptured thrombosed large aneurysm of the anterior inferior cerebellar artery (AICA) in which a local hematoma compressed the medulla oblongata and caused acute respiratory failure. She first presented with dizziness, general fatigue, and nausea 2 months before admission. She was hospitalized for intense general fatigue, nausea, and occipitalgia. Computed tomography and T(1)-weighted magnetic resonance imaging showed a heterogeneous lesion around the right cerebello-medullary cistern. Angiography revealed a fusiform aneurysm of the right AICA. Asphyxia occurred 4 days after admission and the patient underwent an emergency operation. No subarachnoid hematoma was present, but a hematoma around the ruptured portion markedly compressed the medulla oblongata. The medulla oblongata was adequately decompressed after subtotal removal of the aneurysm. The patient's respiratory status and consciousness level recovered after the operation.

  14. Comparison of branch and distally focused main renal artery denervation using two different radio-frequency systems in a porcine model.

    Science.gov (United States)

    Mahfoud, Felix; Pipenhagen, Catherine A; Boyce Moon, L; Ewen, Sebastian; Kulenthiran, Saarraaken; Fish, Jeffrey M; Jensen, James A; Virmani, Renu; Joner, Michael; Yahagi, Kazuyuki; Tsioufis, Costas; Böhm, Michael

    2017-08-15

    Anatomic placement of lesions may impact efficacy of radio-frequency (RF) catheter renal denervation (RDN). However, it is unclear if it is necessary to perform treatments post bifurcation with systems that may provide deeper penetration to achieve successful RDN. Sixteen domestic swine (n=16) were randomly assigned to 4 groups: 1) 8 lesions created in the branch arteries using the Spyral catheter (SP8); 2) 8 lesions created in the branch arteries plus 4 lesions created in the main artery using the SP catheter (SP12); 3) 8 lesions created in the main artery using the EnligHTN catheter with the distal position as close as possible to the bifurcation (EN8); and 4) 12 lesions created in the main artery using the EN catheter with the distal position as close as possible to the bifurcation (EN12). Each arm showed statistically significant changes in kidney norepinephrine (NE, ng/g) between treated kidneys vs. untreated contralateral control. There were no statistically significant differences in tissue NE% reductions across each arm based on catheter, anatomic location, & number of lesions (p=0.563): EN8 -74±34%, EN12 -95±3%, SP8 -76±16%, SP12 -82±17% (p=0.496). A total of 46 lesions were measured for lesion depth: EN main (3.3±2.8mm) vs. SP branch (2.0±1.0mm, p=0.039), SP main (2.9±1.6mm) vs. SP branch (p=0.052), and EN main vs. SP main (p=0.337). Distally-focused main renal artery treatment using the EN system appears to be equally efficacious in reducing tissue NE levels compared with SP treatment in the branches plus main renal arteries, advocating for device-specific procedure execution. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Perforation of Axillary Vein by a Branch of the Axillary Artery: an Anatomical Study

    OpenAIRE

    Mahajan, Anita; Rana, K. K; Saha, S

    2012-01-01

    Anatomical variations in the region of axilla and pectoral region are very common. These variations need attention to avoid complications arising during surgeries and diagnostic and interventional invasive procedures in this region such as surgeries for breast carcinoma, venous access during central venous line, pacemaker and cardiac defibrillator implantation etc. During routine cadaveric dissection we had noticed a rare variation of axillary vein and artery. In this case axillary vein, just...

  16. Bilateral branch pulmonary artery stenosis and Mitral valve prolapse in a patient with Noonan syndrome: A case report

    Directory of Open Access Journals (Sweden)

    Meenakshi Kadiyala

    2014-01-01

    Full Text Available Rasopathy syndromes are a class of phenotypically similar, but genetically distinct multiple anomaly syndromes caused by germ line mutations in genes that encode protein components of the Ras/mitogen activated protein kinase (MAPK pathway. Noonan syndrome, cardiofaciocutaneous syndrome and Costello syndrome are part of this group of developmental syndromes and have similar cardiac abnormalities. A 19-year-old male presented with complaints of exertional breathlessness class I for 6 months. Clinical examination revealed characteristic facial features, skeletal abnormalities, growth and neurocognitive problems reported in patients with Noonan syndrome. There was evidence of severe pulmonary hypertension. Trans-thoracic echocardiography revealed right atrial and right ventricular enlargement, severe pulmonary hypertension, no intra cardiac shunt, prolapse of anterior mitral leaflet with mild mitral regurgitation. CT pulmonary angiogram revealed bilateral branch pulmonary artery stenosis. A final diagnosis of Noonan syndrome was made.

  17. Msx1 is expressed in retina endothelial cells at artery branching sites

    Directory of Open Access Journals (Sweden)

    Miguel Lopes

    2012-02-01

    Msx1 and Msx2 encode homeodomain transcription factors that play a role in several embryonic developmental processes. Previously, we have shown that in the adult mouse, Msx1lacZ is expressed in vascular smooth muscle cells (VSMCs and pericytes, and that Msx2lacZ is also expressed in VSMCs as well as in a few endothelial cells (ECs. The mouse retina and choroid are two highly vascularized tissues. Vessel alterations in the retina are associated with several human diseases and the retina has been intensely used for angiogenesis studies, whereas the choroid has been much less investigated. Using the Msx1lacZ and Msx2lacZ reporter alleles, we observed that Msx2 is not expressed in the eye vascular tree in contrast to Msx1, for which we establish the spatial and temporal expression pattern in these tissues. In the retina, expression of Msx1 takes place from P3, and by P10, it becomes confined to a subpopulation of ECs at branching points of superficial arterioles. These branching sites are characterized by a subpopulation of mural cells that also show specific expression programs. Specific Msx gene inactivation in the endothelium, using Msx1 and Msx2 conditional mutant alleles together with a Tie2-Cre transgene, did not lead to conspicuous structural defects in the retinal vascular network. Expression of Msx1 at branching sites might therefore be linked to vessel physiology. The retinal blood flow is autonomously regulated and perfusion of capillaries has been proposed to depend on arteriolar precapillary structures that might be the sites for Msx1 expression. On the other hand, branching sites are subject to shear stress that might induce Msx1 expression. In the choroid vascular layer Msx1lacZ is expressed more broadly and dynamically. At birth Msx1lacZ expression takes place in the endothelium but at P21 its expression has shifted towards the mural layer. We discuss the possible functions of Msx1 in the eye vasculature.

  18. Msx1 is expressed in retina endothelial cells at artery branching sites.

    Science.gov (United States)

    Lopes, Miguel; Goupille, Olivier; Saint Cloment, Cécile; Robert, Benoît

    2012-04-15

    Msx1 and Msx2 encode homeodomain transcription factors that play a role in several embryonic developmental processes. Previously, we have shown that in the adult mouse, Msx1(lacZ) is expressed in vascular smooth muscle cells (VSMCs) and pericytes, and that Msx2(lacZ) is also expressed in VSMCs as well as in a few endothelial cells (ECs). The mouse retina and choroid are two highly vascularized tissues. Vessel alterations in the retina are associated with several human diseases and the retina has been intensely used for angiogenesis studies, whereas the choroid has been much less investigated. Using the Msx1(lacZ) and Msx2(lacZ) reporter alleles, we observed that Msx2 is not expressed in the eye vascular tree in contrast to Msx1, for which we establish the spatial and temporal expression pattern in these tissues. In the retina, expression of Msx1 takes place from P3, and by P10, it becomes confined to a subpopulation of ECs at branching points of superficial arterioles. These branching sites are characterized by a subpopulation of mural cells that also show specific expression programs. Specific Msx gene inactivation in the endothelium, using Msx1 and Msx2 conditional mutant alleles together with a Tie2-Cre transgene, did not lead to conspicuous structural defects in the retinal vascular network. Expression of Msx1 at branching sites might therefore be linked to vessel physiology. The retinal blood flow is autonomously regulated and perfusion of capillaries has been proposed to depend on arteriolar precapillary structures that might be the sites for Msx1 expression. On the other hand, branching sites are subject to shear stress that might induce Msx1 expression. In the choroid vascular layer Msx1(lacZ) is expressed more broadly and dynamically. At birth Msx1(lacZ) expression takes place in the endothelium but at P21 its expression has shifted towards the mural layer. We discuss the possible functions of Msx1 in the eye vasculature.

  19. Aggressive Patch Augmentation May Reduce Growth Potential of Hypoplastic Branch Pulmonary Arteries After Tetralogy of Fallot Repair.

    Science.gov (United States)

    Wilder, Travis J; Van Arsdell, Glen S; Pham-Hung, Eric; Gritti, Michael; Hussain, Sara; Caldarone, Christopher A; Redington, Andrew; Hickey, Edward J

    2016-03-01

    Potential surgical strategies for hypoplastic branch pulmonary arteries (BPAs) during tetralogy of Fallot repair include (1) extensive patch augmentation to the hilum (PATCH), (2) limited extension arterioplasty to the proximal pulmonary artery (EXTENSION), or (3) leaving the native vessels unaugmented (NATIVE). We explored the effect of these strategies on reintervention and BPA growth. From 2000 to 2012, 434 children underwent complete tetralogy of Fallot repair. Risk-adjusted parametric models were used to analyze the risk of BPA reintervention for (1) all children, (2) children with BPAs of 4 mm or smaller, and (3) children with BPAs of 3 mm or smaller. Repeated-measures analysis of more than 2,000 echocardiograms was used to characterize postoperative BPA growth and right ventricular pressure by using nonlinear mixed models. Overall survival (99% [3 deaths]) was excellent. The 10-year freedom from BPA reintervention was 84%. In risk-adjusted models (including baseline BPA z-score), PATCH had a decreased freedom from reintervention (73%; p tetralogy of Fallot tend (∼85%) to grow well without instrumentation. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  20. Embolization of Hepatic Arterial Branches to Simplify Hepatic Blood Flow Before Yttrium 90 Radioembolization: A Useful Technique in the Presence of Challenging Anatomy

    International Nuclear Information System (INIS)

    Karunanithy, Narayan; Gordon, Fabiana; Hodolic, Marina; Al-Nahhas, Adil; Wasan, Harpreet S.; Habib, Nagy; Tait, Nicholas P.

    2011-01-01

    Purpose: In the presence of variant hepatic arterial anatomy, obtaining whole-liver coverage with yttrium 90 (Y90) radioembolization may be challenging. The purpose of this study was to determine whether a technique whereby variant hepatic arterial branches are embolized and then Y90 is administered selectively into one remaining hepatic arterial branch results in whole-liver coverage and effective therapy. A retrospective comparison of treatment response was made between a group of patients who underwent this technique before Y90 administration and a group of patients who received standard Y90 administration as a single dose into the proper hepatic artery or in divided doses into the immediate hepatic artery branches. The rest of the workup and treatment were identical in both groups, including routine embolization of potential nonhepatic, nontarget vessels (e.g., the gastroduodenal artery). Methods: A total of 32 patients (mean age 56.9 years, range 39–77 years) treated with Y90 between June 2004 and March 2008 were analyzed. The primary malignancy was colorectal in 29, breast in 2, and cholangiocarcinoma in 1. Group 1 comprised 20 patients who had no alterations to their hepatic arterial supply. Group 2 comprised 12 cases who had undergone prior embolization of hepatic arterial branches before administration of Y90. The response to treatment was assessed by comparing standardized uptake value (SUV) on the pre- and postprocedure fludeoxyglucose positron emission tomographic studies of representative lesions within the right and left lobes of the liver. Results: In group 1, significant response (P < 0.001) was seen among right lobe lesions but not among left lobe lesions (P = 0.549). In group 2, there was a significant response among both right (P = 0.028) and left (P = 0.014) lobe lesions. No difference was found in the response of right lobe lesions (P = 0.726) between groups 1 and 2; a significantly greater response was found in group 2 compared to group 1 (P

  1. Aneurisma de artéria ilíaca interna roto: relato de caso Ruptured internal iliac artery aneurysm: case report

    Directory of Open Access Journals (Sweden)

    Cristina Toledo Afonso

    2009-03-01

    Full Text Available Aneurismas isolados da artéria ilíaca interna são raros, acometem 0,1% da população e correspondem a 1% dos aneurismas aorto-ilíacos. Na maioria das vezes, os pacientes são assintomáticos, mas podem apresentar dor abdominal, massa pulsátil no hipogástrio ou na fossa ilíaca, sintomas compressivos urinários, gastrointestinais ou neurológicos. Podem ocasionar quadro de abdome agudo, principalmente quando há ruptura. O diagnóstico precoce dos aneurismas isolados de artéria ilíaca interna é incomum, sendo identificados quando mais volumosos ou rotos, o que aumenta significativamente sua morbimortalidade e torna seu prognóstico mais reservado. Dessa forma, representam um desafio terapêutico. A ligadura cirúrgica tem sido o tratamento mais comum, entretanto a cirurgia endovascular tem mostrado bons resultados, inclusive nos aneurismas rotos. É relatado caso de aneurisma de artéria ilíaca interna isolado roto diagnosticado durante laparotomia para abordagem de abdome agudo.Isolated internal iliac artery aneurysms are rare. They affect 0.1% of the population, and account for 1% of aortoiliac aneurysms. Patients are mostly asymptomatic, yet they can have abdominal pain, pulsatile mass in the hypogastrium or iliac fossa, or urinary, gastrointestinal or neurological compressive symptoms. Such aneurysms are likely to course with an acute abdomen, especially when ruptured. Early diagnosis of isolated internal iliac artery aneurysms is difficult, as they are more easily detected when larger or ruptured, which significantly raises their morbidity and mortality rate and determines a poor prognosis. Therefore, they are a therapeutic challenge. Surgical ligation has been the most common treatment; however, the endovascular approach has presented good outcomes, even in the event of ruptured aneurysms. A case of ruptured isolated iliac artery aneurysm diagnosed during a laparotomy (acute abdomen approach is reported.

  2. Iatrogenic dissection of the celiac artery and its branches during TAE for HCC: results of follow-up in 30 cases

    International Nuclear Information System (INIS)

    Yoon, Dae Young; Park, Jae Hyung; Chung, Jin Wook; Han, Joon Koo; Han, Man Chung; Suh, Chang Hae

    1993-01-01

    The authors analyzed 30 patients whose celiac artery or its branches were dissected during the procedure of transcatheter arterial embolization (TAE) for hepatocellular carcinoma (HCC) and were followed up angiographically. The incidence of arterial dissection was 1.25%. The dissection occurred most frequently in the celiac artery (40% 12/30) and the proper hepatic artery (28% 7/30). The frequency of arterial dissection was affected by the status of the vessel and the experience of the operator. The follow-up angiography revealed complete recanalization in 40% (12/30), irregularity and narrowing of the lumen in 23% (7/30), pseudoaneurysm formation in 23% (7/30), and complete obstruction in 13% (4/30) of the cases. The rate of recanalization in the celiac artery was lower than that of any other arteries in our series. Recanalization to a certain degree without therapeutic intervention was observed in 72% of the dissected arteries enabling and contributing to subsequent successful TAE within 2 months in 78% of the patients with the dissection

  3. Impact of Right-Sided Aneurysm, Rupture Status, and Size of Aneurysm on Perforator Infarction Following Microsurgical Clipping of Posterior Communicating Artery Aneurysms with a Distal Transsylvian Approach.

    Science.gov (United States)

    Tanabe, Jun; Ishikawa, Tatsuya; Moroi, Junta; Sakata, Yoshinori; Hadeishi, Hiromu

    2018-03-01

    Posterior communicating artery (PCoA) aneurysms are among the most common aneurysms. Because blockage of the PCoA and perforators can cause adverse outcomes, occlusion of these arteries by surgical clipping should be avoided. The impact of factors on PCoA perforator infarction when using a distal transsylvian approach for PCoA aneurysms was examined. A total of 183 patients underwent PCoA aneurysm clipping, excluding application of fenestrated clips. Patients were divided into 2 groups: patients with PCoA perforator infarction (infarction group) and patients without infarction (noninfarction group). Multiple factors were analyzed in the 2 groups. Twenty-two of the 183 patients (12.0%) showed perforator infarction, mainly on magnetic resonance imaging evaluation, resulting in permanent deficits in 2 patients (1.1%). The proportion of right-sided operations (86.4% vs. 53.4%; P = 0.005) and surgery for rupture (90.9% vs. 55.9%; P = 0.002) were significantly higher in the infarction group than in the noninfarction group. Aneurysms were significantly larger in the infarction group (8.4 ± 3.8 mm) than in the noninfarction group (6.3 ± 3.0 mm; P = 0.02). Ruptured status (odds ratio [OR], 7.35; P = 0.01), right side (OR, 5.19; P = 0.01), and aneurysm size (OR, 1.18; P = 0.02) remained independent predictors of perforator infarction on multivariate logistic regression analysis. Ruptured status, right side, and large PCoA aneurysm were independent predictors of PCoA perforator infarction. Symptoms due to PCoA perforating infarction were mostly transient and rarely affected outcomes. Copyright © 2018 Elsevier Inc. All rights reserved.

  4. Pulmonary branch arterial flow can be measured with cine MR velocity mapping

    International Nuclear Information System (INIS)

    Caputo, G.R.; Kondo, C.; Masui, T.; Foster, E.; Geraci, S.J.; O'Sullivan, M.; Higgins, C.B.

    1990-01-01

    This paper assesses the capability of cine MR phase velocity mapping (CVM) to measure main, right-sided, and left-sided pulmonary arterial (PA) blood flow. The authors examined a constant-flow phantom and nine healthy volunteers with use of 1.5-T MR imaging system (GE Signa) with phase velocity cine sequences. CVM correctly measured constant-flow phantom velocities (range, 20-190 cm/sec; r = .998, SEE = 4.2 cm/sec), and velocity with use of angulated planes to section the phantom tube perpendicularly. CVM peak systolic main PA velocity (79 cm/sec ± 10) correlated well with Doppler US measurements (80 cm/sec ± 7). CVM main PA flow correlated well with conventional cine MR LV stroke volume measurements (r = .98, SEE = 4.8 mL). Left and right PA flow on the angulated planes were 29 mL ± 7 and 34 mL ± 10, respectively

  5. Giant renal artery pseudoaneurysm caused by rupture of renal angiomyolipoma following pregnancy: Endovascular treatment and review of the literature

    Directory of Open Access Journals (Sweden)

    Ilkay S Idilman

    2014-01-01

    Full Text Available Renal angiomyolipoma is a hamartomatous, benign tumor composed of blood vessels, fatty tissue and smooth muscle cells, and is often detected incidentally. It can also be associated with the tuberous-sclerosis complex (TSC. Pregnancy and use of oral contraceptives are known to be associated with an increased risk of tumoral rupture and bleeding. Herein, we report a unique case of renal angiomyolipoma associated with TSC who presented with hypovolemic shock as a result of spontaneous rupture of a giant renal pseudoaneurysm, immediately after pregnancy. Emergency endovascular treatment was successful with sparing of most of the affected kidney as demonstrated by follow-up computed tomography imaging.

  6. Reconstruction of cervical scar contracture using axial thoracic flap based on the thoracic branch of the supraclavicular artery.

    Science.gov (United States)

    Ma, Xianjie; Li, Yang; Wang, Lu; Li, Weiyang; Dong, Liwei; Xia, Wei; Su, Yingjun

    2014-09-01

    Cervical scar contracture causes both physical and psychological distress for burn patients. Many pedicle flaps or skin grafting have been suggested for reconstruction of cervical scar contracture with variable results in the literature. The authors present the axial thoracic flap based on the thoracic branch of the supraclavicular artery (TBSA) for reconstruction of cervical scar contracture. Postburn scar contractures in anterior neck region of 66 patients had been reconstructed with the axial pattern thoracic flaps based on the TBSA, including 1 expanded and 10 nonexpanded pedicle flaps, and 9 expanded and 46 nonexpanded island pedicle flaps, during 1988 through 2012. After removing and releasing the cervical scar contracture, the flap was designed in the thoracic region. The axial artery of the flap is the TBSA bifurcating from the intersection point of sternocleidomastoid muscle and omohyoid muscle with several concomitant veins as the axial veins. The flap can be designed in a large area within the borders of the anterior border of the trapezius muscle superiorly, the middle part of the deltoid muscle laterally, the midsternal line medially, and the level 3 to 4 cm below nipples inferiorly. After incisions were made along the medial, inferior, and lateral border, dissection was performed toward the pedicle. Donor site was closed directly in expanded cases and with skin grafting in nonexpanded cases. Cervical scar contractures were repaired with good functional and cosmetic results in 64 cases among this cohort. Flap tip necrosis in other 2 cases, caused by postoperative hematoma, was repaired by skin grafting. The color and texture of all flaps were fitted with those of the surrounding skin. The donor sites all healed primarily. The flap sensation in the thoracic region regained in the early stage postoperatively and that in cervical area recovered completely after 6 months according to the report of the patients. With reliable blood supply based on the

  7. Investigation of the relative effects of vascular branching structure and gravity on pulmonary arterial blood flow heterogeneity via an image-based computational model.

    Science.gov (United States)

    Burrowes, Kelly S; Hunter, Peter J; Tawhai, Merryn H

    2005-11-01

    A computational model of blood flow through the human pulmonary arterial tree has been developed to investigate the relative influence of branching structure and gravity on blood flow distribution in the human lung. Geometric models of the largest arterial vessels and lobar boundaries were first derived using multidetector row x-ray computed tomography (MDCT) scans. Further accompanying arterial vessels were generated from the MDCT vessel endpoints into the lobar volumes using a volume-filling branching algorithm. Equations governing the conservation of mass and momentum were solved within the geometric model to calculate pressure, velocity, and vessel radius. Blood flow results in the anatomically based model, with and without gravity, and in a symmetric geometric model were compared to investigate their relative contributions to blood flow heterogeneity. Results showed a persistent blood flow gradient and flow heterogeneity in the absence of gravitational forces in the anatomically based model. Comparison with flow results in the symmetric model revealed that the asymmetric vascular branching structure was largely responsible for producing this heterogeneity. Analysis of average results in varying slice thicknesses illustrated a clear flow gradient because of gravity in "lower resolution" data (thicker slices), but on examination of higher resolution data, a trend was less obvious. Results suggest that although gravity does influence flow distribution, the influence of the tree branching structure is also a dominant factor. These results are consistent with high-resolution experimental studies that have demonstrated gravity to be only a minor determinant of blood flow distribution.

  8. Spinal arterial anatomy and risk factors for lower extremity weakness following endovascular thoracoabdominal aortic aneurysm repair with branched stent-grafts.

    Science.gov (United States)

    Chang, Catherine K; Chuter, Timothy A M; Reilly, Linda M; Ota, Maile K; Furtado, Andre; Bucci, Monica; Wintermark, Max; Hiramoto, Jade S

    2008-06-01

    To evaluate spinal arterial anatomy and identify risk factors for lower extremity weakness (LEW) following endovascular thoracoabdominal aortic aneurysm (TAAA) repair. A retrospective review was conducted of 37 patients (27 men; mean age 74.8+/-7.1 years, range 58-86) undergoing endovascular TAAA repair with branched stent-grafts at a single academic institution from July 2005 to December 2007. Data were collected on preoperative comorbidities, duration of operation, blood loss, type of anesthesia, extent of aortic coverage, blood pressure, cerebrospinal fluid (CSF) pressure and drainage, and postoperative development of LEW. Pre- and postoperative contrast-enhanced computed tomographic angiograms (CTA) in a 26-patient subset were analyzed to evaluate the number of patent intercostal and lumbar arteries before and after repair. All patients were neurologically intact at the end of the operation. Seven (19%) patients developed LEW postoperatively: 6 perioperatively and 1 after discharge. LEW was associated with postoperative hypotension, internal iliac artery (IIA) occlusion, and fewer patent segmental arteries on preoperative CTA. Lowest mean systolic blood pressure was segmental arteries in patients with or without LEW. Endovascular TAAA repair inevitably occludes direct inflow to lumbar and intercostal arteries. The distal segments of these arteries to the spine, however, are seen to remain patent through collaterals. Measures to preserve collateral pathways and increase perfusion pressure may help prevent or treat LEW.

  9. A Case of Ruptured Blood Blister-like Aneurysm Treated with Pipeline Embolization Device: Clinical Significance of Fetal-type Posterior Communicating Artery.

    Science.gov (United States)

    Park, Ki-Su; Kang, Dong-Hun; Son, Won-Soo; Park, Jaechan; Kim, Young-Sun; Kim, Byung Moon

    2017-03-01

    Blood-blister like aneurysms (BBAs) are challenging lesions because of their wide fragile neck. Flow-diverting stents (FDSs), such as the Pipeline Embolization Device (PED), have been applied to treat BBAs less amenable to more established techniques of treatment. However, the use of FDSs, including the PED, in acute subarachnoid hemorrhage (SAH) still remains controversial. We report a case of aneurysm regrowth following PED application for a ruptured BBA that overlapped the origin of the dominant posterior communicating artery (PCoA), which was successfully treated after coil trapping of the origin of the fetal-type PCoA. And, we discuss the clinical significance of the fetal-type PCoA communicating with a BBA in terms of PED failure.

  10. [A Case of Ruptured Internal Carotid-Posterior Communicating Artery Aneurysm Associated with Acute Subdural Hematoma, Extending from the Interhemispheric Space to the Posterior Fossa].

    Science.gov (United States)

    Otsuka, Hiroaki; Fukuda, Yuhtaka; Yoshimura, Shouta; Somagawa, Chika; Hiu, Takeshi; Ono, Tomonori; Ushijima, Ryujirou; Toda, Keisuke; Tsutsumi, Keisuke

    2016-06-01

    A 69-year-old woman was admitted to our hospital because of a sudden severe headache without a history of head trauma. CT and MRI revealed an acute subdural hematoma (ASDH) extending from the right interhemispheric space to the posterior fossa bilaterally, with a small amount of subarachnoid hemorrhage that was predominantly localized to the left side of the basal cistern. CT angiogram demonstrated a long protruding ruptured aneurysm at the junction of the right internal carotid and posterior communicating arteries (IC/PC AN) with a posteroinferior projection, associated with a small bleb located near the tentorial edge close to the ipsilateral posterior clinoid process, for which she received clipping surgery. Though rare, IC/PC AN could cause pure or nearly pure ASDH in the above-mentioned distribution. Therefore, in patients with such ASDH, especially without a history of head injury or precise information regarding the situation at the time of onset, urgent imaging evaluation and early intervention are essential to prevent devastating re-rupture events.

  11. Association of branched-chain amino acids with carotid intima-media thickness and coronary artery disease risk factors.

    Directory of Open Access Journals (Sweden)

    Ruiyue Yang

    Full Text Available BACKGROUND: Recent studies have determined that branched-chain (BCAAs and aromatic (AAAs amino acids are strongly correlated with obesity and atherogenic dyslipidemia and are strong predictors of diabetes. However, it is not clear if these amino acids are capable of identifying subjects with coronary artery disease (CAD, particularly with subclinical atherosclerosis who are at risk of developing CAD. METHODS: Four hundred and seventy two Chinese subjects (272 males and 200 females, 42-97 y of age undergoing physical exams were recruited at random for participation in the cross-sectional study. Serum BCAAs and AAAs were measured using our previously reported isotope dilution liquid chromatography tandem mass spectrometry method. Bilateral B-mode carotid artery images for carotid intima-media thickness (cIMT were acquired at end diastole and cIMT values more than 0.9 mm were categorized as increased. Correlations of BCAAs with cIMT and other CAD risk factors were analyzed. RESULTS: BCAAs and AAAs were significantly and positively associated with risk factors of CAD, e.g., cIMT, BMI, waist circumference, blood pressure, fasting blood glucose, TG, apoB, apoB/apoAI ratio, apoCII, apoCIII and hsCRP, and were significantly and negatively associated with HDL-C and apoAI. Stepwise multiple linear regression analysis revealed that age (β = 0.175, P<0.001, log BCAA (β = 0.147, P<0.001 and systolic blood pressure (β = 0.141, P = 0.012 were positively and independently associated with cIMT. In the logistic regression model, the most and only powerful laboratory factor correlated with increased cIMT was BCAA (the odds ratio of the fourth quartile compared to the first quartile was 2.679; P = 0.009. CONCLUSION: BCAAs are independently correlated with increased cIMT. This correlation would open a new field of research in the mechanistic understanding and risk assessment of CAD.

  12. Gated-SPECT myocardial scintigraphy in left bundle branch block: A study in patients with and without coronary artery disease

    International Nuclear Information System (INIS)

    Falcao, A.M.; Moffa, P.J.; Chalela, W.A.; Soares, J.; Oliveira, C.G.; Kreling, J.C.; Ferreira, B.A.; Uchida, A.H.; Meneghetti, J.C.

    2002-01-01

    Introduction: Myocardial perfusion scintigraphy (MPS) is a non-invasive method helpful for evaluating coronary heart disease. In left bundle branch block (LBBB), the myocardial scintigraphy frequently reveals septal abnormalities in the absence of coronary artery disease (CAD) and gives rise to 'false-positive' results in patients (pts) with suspected CAD. The purpose of this study was to assess the diagnostic role of ECG-gated SPECT in pts with complete LBBB, with and without known CAD. Methods. This study included 46 pts, 29 women (63%), with mean age 63.8 ± 11.6yr, divided into two groups: Group 1 (n=21 pts) with LBBB and CAD angiographically confirmed and Group 2 (n=25 pts) with LBBB and normal coronangiography. All pts underwent MPS at rest and two stress tests - dipyridamole (DIP) and treadmill exercise test (ET) with Bruce protocol. Myocardial perfusion, wall motility and wall thickening were analyzed qualitatively by consensus of two observers in anterior, septal, inferior, lateral and apical myocardial segments. Scores were attributed to: perfusion as normal, reversible or fixed defects; motility as normal, hypokinesia, akinesia or dyskinesia and thickening if present or absent. The left ventricle ejection fraction (LVEF) was automatically calculated from the ECG-gated SPECT. Results: The comparative analysis between groups 1 and 2 for both stresses (DIP and ET) for the parameters analyzed in the myocardial segments are presented: LVEF at rest, ET and DIP show statistically significant differences between groups 1 and 2 (p<0.0001). Conclusion: In the anterior and septal segments, only septal thickening was capable of differentiating between LBBB with and without CAD, independent of the kind of stress. In the other segments there was no influence of disturbance conduction for the perfusion analysis

  13. Understanding Spatially Complex Segmental and Branch Anatomy Using 3D Printing: Liver, Lung, Prostate, Coronary Arteries, and Circle of Willis.

    Science.gov (United States)

    Javan, Ramin; Herrin, Douglas; Tangestanipoor, Ardalan

    2016-09-01

    Three-dimensional (3D) manufacturing is shaping personalized medicine, in which radiologists can play a significant role, be it as consultants to surgeons for surgical planning or by creating powerful visual aids for communicating with patients, physicians, and trainees. This report illustrates the steps in development of custom 3D models that enhance the understanding of complex anatomy. We graphically designed 3D meshes or modified imported data from cross-sectional imaging to develop physical models targeted specifically for teaching complex segmental and branch anatomy. The 3D printing itself is easily accessible through online commercial services, and the models are made of polyamide or gypsum. Anatomic models of the liver, lungs, prostate, coronary arteries, and the Circle of Willis were created. These models have advantages that include customizable detail, relative low cost, full control of design focusing on subsegments, color-coding potential, and the utilization of cross-sectional imaging combined with graphic design. Radiologists have an opportunity to serve as leaders in medical education and clinical care with 3D printed models that provide beneficial interaction with patients, clinicians, and trainees across all specialties by proactively taking on the educator's role. Complex models can be developed to show normal anatomy or common pathology for medical educational purposes. There is a need for randomized trials, which radiologists can design, to demonstrate the utility and effectiveness of 3D printed models for teaching simple and complex anatomy, simulating interventions, measuring patient satisfaction, and improving clinical care. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  14. Late-Onset Massive Epistaxis due to a Ruptured Traumatic Internal Carotid Artery Aneurysm: A Case Report.

    Science.gov (United States)

    Arai, Nobuhiko; Nakamura, Akiyoshi; Tabuse, Masanao; Miyazaki, Hiromichi

    2017-01-01

    A traumatic internal carotid artery (ICA) aneurysm is rare and difficult to treat. Trapping of ICA is commonly performed owing to the difficulty of directly approaching ICA aneurysms. Recently, coiling the aneurysm itself was recommended if possible. However, it is controversial which of methods are best to completely treat aneurysm. We present the case of a 74-year-old man, who had experienced a head injury 8 years previously, with recurrent severe epistaxis. An ICA aneurysm was detected on computed tomography. The trapping and bypass was planned. However, sudden epistaxis occurred, we performed trapping to stop the bleeding and save his life. After the operation, no right ICA or aneurysm was detected. However, severe epistaxis recurred two months after the operation. In the second operation, a ligation of the common -/- external carotid artery and a severance of an ICA portion between the ophthalmic artery and the aneurysm were insufficient to stop the bleeding. This case indicates ICA trapping, even if a trapping portion is below an ophthalmic artery, is insufficient to treat an ICA aneurysm. ICA aneurysms should be suspected when a patient present with recurrent -/- massive epistaxis, who has a head injury history, even if it is far past.

  15. 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.

  16. Late-Onset Massive Epistaxis due to a Ruptured Traumatic Internal Carotid Artery Aneurysm: A Case Report

    OpenAIRE

    Arai, Nobuhiko; Nakamura, Akiyoshi; Tabuse, Masanao; Miyazaki, Hiromichi

    2016-01-01

    A traumatic internal carotid artery (ICA) aneurysm is rare and difficult to treat. Trapping of ICA is commonly performed owing to the difficulty of directly approaching ICA aneurysms. Recently, coiling the aneurysm itself was recommended if possible. However, it is controversial which of methods are best to completely treat aneurysm. We present the case of a 74-year-old man, who had experienced a head injury 8 years previously, with recurrent severe epistaxis. An ICA aneurysm was detected on ...

  17. Extrahepatic Pseudoaneurysms and Ruptures of the Hepatic Artery in Liver Transplant Recipients: Endovascular Management and a New Iatrogenic Etiology

    International Nuclear Information System (INIS)

    Saad, Wael E. A.; Dasgupta, Niloy; Lippert, Allison J.; Turba, Ulku C.; Davies, Mark G.; Kumer, Sean; Gardenier, Jason C.; Sabri, Saher S.; Park, Auh-Whan; Waldman, David L.; Schmitt, Timothy; Matsumoto, Alan H.; Angle, John F.

    2013-01-01

    To characterize extrahepatic pseudoaneurysm regarding incidence and etiology and determine the effectiveness of endovascular management. A retrospective audit of 1,857 liver transplants in two institutions was performed (1996–2009). Recipients’ demographics, clinical presentation, transplant type, biliary anastomosis, and presence of biliary endoprostheses were noted. Pseudoaneurysms were classified into iatrogenic (associated with biliary endoprosthesis or angioplasty) or spontaneous extrahepatic pseudoaneurysms. Spontaneous and iatrogenic pseudoaneurysms were compared for time from transplant, presenting symptoms, location in the arterial anatomy, and 3-month graft survival. Arterial patency and 6-month graft survival were calculated. Twenty pseudoaneurysms were found (1.1 %, 20/1,857): 9 (0.5 % of transplants, 9/1,857) were spontaneous and 11 (0.6 % of transplants, 11/1,857) were “iatrogenic” (due to minimally invasive procedures: 4 angioplasty and 7 biliary endoprostheses). Sixty percent (12/20) underwent endovascular management (4 coil embolization and 8 stent-grafts). Technical success was 83 % (10/12) with a mean arterial patency of 70 % (follow-up mean, 4.9; range, 0–18 months). The 1-, 3-, and 6-month graft survival was 70, 40, and 35 %, respectively. Due to minimally invasive procedures, posttransplant extrahepatic pseudoaneurysms are no longer an exclusive complication of the transplant surgery itself. Endovascular management is effective to stabilize patients but has not improved historic postsurgical graft survival.

  18. Extrahepatic Pseudoaneurysms and Ruptures of the Hepatic Artery in Liver Transplant Recipients: Endovascular Management and a New Iatrogenic Etiology

    Energy Technology Data Exchange (ETDEWEB)

    Saad, Wael E. A., E-mail: wspikes@yahoo.com; Dasgupta, Niloy; Lippert, Allison J.; Turba, Ulku C.; Davies, Mark G. [University of Virginia Health System, Division of Vascular Interventional Radiology, Department of Radiology (United States); Kumer, Sean [University of Virginia Health System, Division of Solid Organ Transplantation, Department of Surgery (United States); Gardenier, Jason C.; Sabri, Saher S.; Park, Auh-Whan [University of Virginia Health System, Division of Vascular Interventional Radiology, Department of Radiology (United States); Waldman, David L. [University of Rochester Medical Center, Department of Imaging Sciences (United States); Schmitt, Timothy [University of Virginia Health System, Division of Solid Organ Transplantation, Department of Surgery (United States); Matsumoto, Alan H.; Angle, John F. [University of Virginia Health System, Division of Vascular Interventional Radiology, Department of Radiology (United States)

    2013-02-15

    To characterize extrahepatic pseudoaneurysm regarding incidence and etiology and determine the effectiveness of endovascular management. A retrospective audit of 1,857 liver transplants in two institutions was performed (1996-2009). Recipients' demographics, clinical presentation, transplant type, biliary anastomosis, and presence of biliary endoprostheses were noted. Pseudoaneurysms were classified into iatrogenic (associated with biliary endoprosthesis or angioplasty) or spontaneous extrahepatic pseudoaneurysms. Spontaneous and iatrogenic pseudoaneurysms were compared for time from transplant, presenting symptoms, location in the arterial anatomy, and 3-month graft survival. Arterial patency and 6-month graft survival were calculated. Twenty pseudoaneurysms were found (1.1 %, 20/1,857): 9 (0.5 % of transplants, 9/1,857) were spontaneous and 11 (0.6 % of transplants, 11/1,857) were 'iatrogenic' (due to minimally invasive procedures: 4 angioplasty and 7 biliary endoprostheses). Sixty percent (12/20) underwent endovascular management (4 coil embolization and 8 stent-grafts). Technical success was 83 % (10/12) with a mean arterial patency of 70 % (follow-up mean, 4.9; range, 0-18 months). The 1-, 3-, and 6-month graft survival was 70, 40, and 35 %, respectively. Due to minimally invasive procedures, posttransplant extrahepatic pseudoaneurysms are no longer an exclusive complication of the transplant surgery itself. Endovascular management is effective to stabilize patients but has not improved historic postsurgical graft survival.

  19. Volume of myocardium perfused by coronary artery branches as estimated from 3D micro-CT images of rat hearts

    Science.gov (United States)

    Lund, Patricia E.; Naessens, Lauren C.; Seaman, Catherine A.; Reyes, Denise A.; Ritman, Erik L.

    2000-04-01

    Average myocardial perfusion is remarkably consistent throughout the heart wall under resting conditions and the velocity of blood flow is fairly reproducible from artery to artery. Based on these observations, and the fact that flow through an artery is the product of arterial cross-sectional area and blood flow velocity, we would expect the volume of myocardium perfused to be proportional to the cross-sectional area of the coronary artery perfusing that volume of myocardium. This relationship has been confirmed by others in pigs, dogs and humans. To test the body size-dependence of this relationship we used the hearts from rats, 3 through 25 weeks of age. The coronary arteries were infused with radiopaque microfil polymer and the hearts scanned in a micro- CT scanner. Using these 3D images we measured the volume of myocardium and the arterial cross-sectional area of the artery that perfused that volume of myocardium. The average constant of proportionality was found to be 0.15 +/- 0.08 cm3/mm2. Our data showed no statistically different estimates of the constant of proportionality in the rat hearts of different ages nor between the left and right coronary arteries. This constant is smaller than that observed in large animals and humans, but this difference is consistent with the body mass-dependence on metabolic rate.

  20. Ruptured eardrum

    Science.gov (United States)

    ... eardrum ruptures. After the rupture, you may have: Drainage from the ear (drainage may be clear, pus, or bloody) Ear noise/ ... doctor to see the eardrum. Audiology testing can measure how much hearing has been lost. Treatment You ...

  1. A case of basilar artery aneurysm rupture from 1836: lessons in clinical observation and the natural history of the disease.

    Science.gov (United States)

    Demetriades, Andreas K; Horiguchi, Takashi; Goodrich, James T; Kawase, Takeshi

    2014-11-01

    Although credit is given to Sir William Gull for highlighting the clinical picture of subarachnoid hemorrhage in 1859, we discuss a case presented by Mr. Egerton A. Jennings, Fellow of the Linnaean Society, published 23 years earlier in the 1836 edition of the Transactions of the Provincial Medical and Surgical Association. This case, probably the first reported in the English language of a basilar aneurysm rupture, is of medico-historical interest. Jennings provided a remarkably accurate and detailed description of the patient, who experienced coma as a result of the severity of subarachnoid hemorrhage. The detailed clinical observations on initial assessment and the description of the patient's deterioration to the time of death are a succinct representation of the natural history of this disease. The author's discussion provides evidence of a philosophy committed to medical education and progress at the time based on principles of rational observation, meticulous clinical acumen, insight into experimental physiology, and the awareness of ethical boundaries. In provincial 1836 England, similar to most of Europe, cerebral localization was elementary. Nonetheless, this case report highlights the attempt at linking structure to function by means of observation on the effects of lesioning. It provides evidence of an established thought process already in progress in England in the 19th century. It is characteristic that this thought process came from a surgical practitioner. The cultivation of practical observation in British surgical culture would allow the late 19th century surgeon scientists to match the contributions of British neurologists with landmark steps in the development and establishment of neurosurgery. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Delayed postpartum haemorrhage secondary to a ruptured uterine artery pseudo-aneurysm, successfully treated by transarterial embolisation.

    Science.gov (United States)

    Moatti, Zoe; Nisner, Tamar; Saini, Ashish; Karoshi, Mahantesh

    2011-12-01

    A 29-year-old woman (gravida 1, para 1) had an uneventful first pregnancy and a delivery by emergency caesarean section at term. The caesarean section was complicated by a massive obstetric haemorrhage of 5000 ml. After closure, an immediate re-laparotomy was indicated due to heavy vaginal bleeding. The site of bleeding was identified as an extension of the uterine incision, and was sutured. She was stabilised by transfusion of blood and blood products in the intensive therapy unit, and discharged 5 days later. The patient was re-admitted 6 weeks later with brisk, painless vaginal bleeding, passing large clots from a well-contracted uterus. Her haemoglobin decreased from 11.8 to 7.8 g/dl overnight. In view of her history, an urgent CT angiogram was performed, which revealed the presence of a pseudo-aneurysm arising from the left uterine artery. This was successfully occluded by transarterial embolisation, obviating the need for further surgical exploration.

  3. The changes in Doppler indices of fetal ductus venosus and umbilical artery after amnioinfusion for women with preterm premature rupture of membranes before 26 weeks' gestation.

    Science.gov (United States)

    Hsu, Te-Yao; Hsu, Jenn-Jeih; Fu, Hung-Chun; Ou, Chia-Yu; Tsai, Chih-Chang; Cheng, Bi-Hua; Fang, Fu-Min; Kao, Hui-Fen; Yang, Chun-Yuh; Tsai, Wen Lin; Sung, Chuen Chu; Tsai, Men-Yi

    2009-09-01

    To investigate the changes in Doppler indices of the fetal ductus venosus (DV) and umbilical artery (UMA) after amnioinfusion in pregnant women with preterm premature rupture of membranes (pPROM). Pregnancies with pPROM and severe oligohydramnios cause sequelae in newborns and mothers. This cross-sectional study included a group of 25 patients with pPROM before 26 weeks' gestation. Color Doppler imaging was used to measure the impedance index and quantitative blood flow in the DV and systolic/diastolic ratio (S/D) of the UMA before and 30 minutes after the end of amnioinfusion. The following velocity parameters were measured: (1) DV peak systolic velocity; (2) DV time-averaged velocity; (3) DV maximum forward velocity during atrial contraction; (4) DV S/D; (5) DV pulsatility index (PI); (6) DV Pourcelots resistance index (RI); (7) fetal heart rate; and (8) UMA S/D. Twenty-one of the 25 patients underwent a total of 27 amnioinfusions. The mean PI and RI of the DV, and S/D of the DV and UMA decreased significantly after amnioinfusion (PI, 0.75 +/- 0.24 vs. 0.60 +/- 0.18, p = 0.009; RI, 0.60 +/- 0.15 vs. 0.50 +/- 0.13; DV S/D, 3.07 +/- 1.81 vs. 2.13 +/- 0.66, p = 0.008; UMA S/D, 3.58 +/- 0.87 vs. 2.88 +/- 0.62, p = 0.001). Amnioinfusion increases the space for the fetuses and reduces the impedance of the fetoplacental circulation. Improvements in DV and UMA flow may benefit fetuses suffering severe oligohydramnios in mid-pregnancy.

  4. Microsurgical Repair of Ruptured Aneurysms Associated with Moyamoya-Pattern Collateral Vessels of the Middle Cerebral Artery: A Report of Two Cases.

    Science.gov (United States)

    Lang, Min; Moore, Nina Z; Witek, Alex M; Kshettry, Varun R; Bain, Mark D

    2017-09-01

    Patients with Moyamoya or other intracranial steno-occlusive disease are at risk for developing aneurysms associated with flow through collateral vessels. Because these lesions are rare, the optimal management remains unclear. Here, we describe 2 cases of microsurgical repair of ruptured collateral vessel aneurysms associated with middle cerebral artery (MCA) occlusion. The first patient was a 61-year-old man who presented with right frontal and intraventricular hemorrhage. Angiography revealed chronic right M1 occlusion and a 3-mm spherical lenticulostriate aneurysm. The frontal lobe hematoma was evacuated to reveal the aneurysm, which was safely cauterized and resected by coagulating and dividing the lenticulostriate parent vessel. The procedure was carried out with neuronavigation guidance and intraoperative neuromonitoring. The patient was discharged with no neurologic deficits. The second patient was a 53-year-old woman who presented with subarachnoid and intracerebral hemorrhage. Computed tomography angiogram showed a 2-mm saccular MCA aneurysm. Emergency left decompressive hemicraniectomy and hematoma evacuation were performed. The aneurysm, arising from a small collateral type vessel, was safely clipped without complications. Postoperative angiography revealed absence of the superior MCA trunk with a dense network of collateral vessels at the site of the clipped aneurysm. The patient recovered well and was ambulating independently 6 months postoperatively. No rebleeding occurred in the 2 patients. Our experience suggests that patients with MCA occlusion can harbor associated aneurysms related to flow through collateral vessels and can present with hemorrhage. Microsurgical repair of these aneurysms can be performed safely to prevent rebleeding. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Rupture disc

    International Nuclear Information System (INIS)

    Newton, R.G.

    1977-01-01

    The intermediate heat transport system for a sodium-cooled fast breeder reactor includes a device for rapidly draining the sodium therefrom should a sodium-water reaction occur within the system. This device includes a rupturable member in a drain line in the system and means for cutting a large opening therein and for positively removing the sheared-out portion from the opening cut in the rupturable member. According to the preferred embodiment of the invention the rupturable member includes a solid head seated in the end of the drain line having a rim extending peripherally therearound, the rim being clamped against the end of the drain line by a clamp ring having an interior shearing edge, the bottom of the rupturable member being convex and extending into the drain line. Means are provided to draw the rupturable member away from the drain line against the shearing edge to clear the drain line for outflow of sodium therethrough

  6. Globe Rupture

    Directory of Open Access Journals (Sweden)

    Reid Honda

    2017-07-01

    Full Text Available History of present illness: A 46-year-old male presented to the emergency department (ED with severe left eye pain and decreased vision after tripping and striking the left side of his head on the corner of his wooden nightstand. The patient arrived as an inter-facility transfer for a suspected globe rupture with a protective eye covering in place; thus, further physical examination of the eye was not performed by the emergency physician in order to avoid further leakage of aqueous humor. Significant findings: The patient’s computed tomography (CT head demonstrated a deformed left globe, concerning for ruptured globe. The patient had hyperdense material in the posterior segment (see green arrow, consistent with vitreous hemorrhage. CT findings that are consistent with globe rupture may include a collapsed globe, intraocular air, or foreign bodies. Discussion: A globe rupture is a full-thickness defect in the cornea, sclera, or both.1 It is an ophthalmologic emergency. Globe ruptures are almost always secondary to direct perforation via a penetrating mechanism; however, it can occur due to blunt injury if the force generated creates sufficient intraocular pressure to tear the sclera.2 Globes most commonly rupture at the insertions of the intraocular muscles or at the limbus. They are associated with a high rate of concomitant orbital floor fractures.2,3 Possible physical examination findings include a shallow anterior chamber on slit-lamp exam, hyphema, and an irregular “teardrop” pupil. Additionally, a positive Seidel sign, which is performed by instilling fluorescein in the eye and then examining for a dark stream of aqueous humor, is indicative of a globe rupture.4 CT is often used to assess for globe rupture; finds of a foreign body, intraocular air, abnormal contour or volume of the globe, or disruption of the sclera suggest globe rupture.2 The sensitivity of CT scan for diagnosis of globe rupture is only 75%; thus, high clinical

  7. Myocardial scintigraphy with thallium-201 and technetium-99m-hexakis-methoxyisobutylisonitrile in left bundle branch block: a study in patients with and without coronary artery disease

    International Nuclear Information System (INIS)

    Knapp, W.H.; Bentrup, A.; Schmidt, U.; Ohlmeier, H.; Bochum Univ. Hospital, Bad Oeynhausen

    1993-01-01

    In left bundle branch block (LBBB) thallium-201 myocardial scintigraphy frequently reveals septal abnormalities in the absence of coronary artery disease (CAD) and gives rise to 'false-positive' results in patients with suspected CAD. It has not yet been clarified which pathophysiological mechanism is responsible for these perfusion abnormalities. A total of 66 patients with constant LBBB were investigated with 201 Tl or technetium-99m-hexakis-methoxyisobutylisonitrile (MIBI), 62 underwent coronary angiography. Of 12 patients without left anterior descending artery (LAD) or right coronary artery (RCA) stenoses, 11 had a reversible septal activity deficit after 201 Tl stress injection, whereas 20 of 22 patients without relevant CAD showed a constant stress/rest septal deficit using MIBI. Regarding patients with significant LAD and/or RCA stenoses, both radio-pharmaceuticals almost always showed a 'reversible' septal deficit: With 201 Tl in 15 of 16 individuals and with MIBI in 14 of 15. In 12 patients 201 Tl was reinjected at rest. In those who had LAD or RCA stenoses (n=5), early septal activity uptake after stress injection was poorer than that after rest injection; in the absence of CAD (n=7), septal stress uptake corresponded with that of rest injection. It is concluded that septal perfusion abnormalities in LBBB and the absence of CAD are characterized by an exercise-independent reduction of septal blood flow per mass of viable myocardium and that stress/rest injection protocols of myocardial perfusion tracers are able to differentiate between LBBB with and without CAD. (orig.)

  8. Hepatic falciform artery

    International Nuclear Information System (INIS)

    Jaques, Paul F.; Mauro, Matthew A.; Sandhu, Jeet

    1997-01-01

    The hepatic falciform artery is an occasional terminal branch of the left or middle hepatic artery, and may provide an uncommon but important collateral route when the principal visceral arteries are occluded

  9. Ruptured Spleen

    Science.gov (United States)

    ... be caused by various underlying problems, such as mononucleosis and other infections, liver disease, and blood cancers. ... cause a ruptured spleen. For instance, people with mononucleosis — a viral infection that can cause an enlarged ...

  10. Ruptured Cervical Anellrysm with Neurofibromatosis

    African Journals Online (AJOL)

    rupture of an aneurysm of a lateral branch of the right thyrocervical trunk in a patient suffering from diffuse neurofibromatosis. The operative findings are reported. s. Air. Med. ... system demonstrated decreased power in all muscles of the right shoulder girdle and arm, without sensory change. The cranial nerves were normal.

  11. Sequential SPECT/CT imaging starting with stress SPECT in patients with left bundle branch block suspected for coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Engbers, Elsemiek M.; Mouden, Mohamed [Isala, Department of Cardiology, Zwolle (Netherlands); Isala, Department of Nuclear Medicine, Zwolle (Netherlands); Timmer, Jorik R.; Ottervanger, Jan Paul [Isala, Department of Cardiology, Zwolle (Netherlands); Knollema, Siert; Jager, Pieter L. [Isala, Department of Nuclear Medicine, Zwolle (Netherlands)

    2017-01-15

    To investigate the impact of left bundle branch block (LBBB) on sequential single photon emission computed tomography (SPECT)/ CT imaging starting with stress-first SPECT. Consecutive symptomatic low- to intermediate-risk patients without a history of coronary artery disease (CAD) referred for SPECT/CT were included from an observational registry. If stress SPECT was abnormal, additional rest SPECT and, if feasible, coronary CT angiography (CCTA) were acquired. Of the 5,018 patients, 218 (4.3 %) demonstrated LBBB. Patients with LBBB were slightly older than patients without LBBB (65±12 vs. 61±11 years, p<0.001). Stress SPECT was more frequently abnormal in patients with LBBB (82 % vs. 46 %, p<0.001). After reviewing stress and rest images, SPECT was normal in 43 % of the patients with LBBB, compared to 77 % of the patients without LBBB (p<0.001). Sixty-four of the 124 patients with LBBB and abnormal stress-rest SPECT underwent CCTA (52 %), which could exclude obstructive CAD in 46 of the patients (72 %). Sequential SPECT/CT imaging starting with stress SPECT is not the optimal imaging protocol in patients with LBBB, as the majority of these patients have potentially false-positive stress SPECT. First-line testing using CCTA may be more appropriate in low- to intermediate-risk patients with LBBB. (orig.)

  12. The hemodynamics in intracranial aneurysm ruptured region with active contrast leakage during computed tomography angiography

    Science.gov (United States)

    Li, Ming-Lung; Wang, Yi-Chou; Liou, Tong-Miin; Lin, Chao-An

    2014-10-01

    Precise locations of rupture region under contrast agent leakage of five ruptured cerebral artery aneurysms during computed tomography angiography, which is to our knowledge for the first time, were successfully identified among 101 patients. These, together with numerical simulations based on the reconstructed aneurysmal models, were used to analyze hemodynamic parameters of aneurysms under different cardiac cyclic flow rates. For side wall type aneurysms, different inlet flow rates have mild influences on the shear stresses distributions. On the other hand, for branch type aneurysms, the predicted wall shear stress (WSS) correlates strongly with the increase of inlet vessel velocity. The mean and time averaged WSSes at rupture regions are found to be lower than those over the surface of the aneurysms. Also, the levels of the oscillatory shear index (OSI) are higher than the reported threshold value, supporting the assertion that high OSI correlates with rupture of the aneurysm. However, the present results also indicate that OSI level at the rupture region is relatively lower.

  13. Double profunda brachii artery

    OpenAIRE

    Gavishiddappa A Hadimani; Jyoti V Hadimani; Ishwar B Bagoji; Shardha Bai Rathod; Balappa M Bannur

    2016-01-01

    Brachial artery (BA) is a continuation of the axillary artery at the lower border of teres major. In the cubital fossa, BA divides into radial artery and ulnar artery as terminal branches. Large branch given from the BA in the upper part is profunda brachii artery. In the present case, we noticed double profunda brachii that arises from the BA. They are profunda brachii artery 1 and profunda brachii artery 2. Profunda brachii artery 1 arises in the proximal part of the BA and profunda brachii...

  14. Double profunda brachii artery

    Directory of Open Access Journals (Sweden)

    Gavishiddappa A Hadimani

    2016-01-01

    Full Text Available Brachial artery (BA is a continuation of the axillary artery at the lower border of teres major. In the cubital fossa, BA divides into radial artery and ulnar artery as terminal branches. Large branch given from the BA in the upper part is profunda brachii artery. In the present case, we noticed double profunda brachii that arises from the BA. They are profunda brachii artery 1 and profunda brachii artery 2. Profunda brachii artery 1 arises in the proximal part of the BA and profunda brachii artery 2 arises distal to the profunda brachii artery 1. Both the arteries run inferolaterally in the spiral groove along with radial nerve. Variations of profunda brachii artery are important during harvesting of the lateral arm flaps and may lead to inadvertent injury during percutaneous arterial catheterization or injection of drugs.

  15. Multiple Vascular Accidents Including Rupture of a Sinus of Valsalva Aneurysm, a Minor Ischemic Stroke and Intracranial Arterial Anomaly in a Patient with Systemic Congenital Abnormalities: A Case Report

    Directory of Open Access Journals (Sweden)

    Masataka Nakajima

    2013-11-01

    Full Text Available A 39-year-old man with a history of rupture of a sinus of Valsalva aneurysm experienced an ischemic stroke. Although the patient presented left-sided hemiparesis for a week, no abnormal signals were indicated on diffusion-weighted imaging with repeated magnetic resonance scans. Carotid ultrasound and cerebral angiography were conducted, and they revealed hypoplasty of the left internal carotid artery with a low-lying carotid bifurcation at the level of the C6 vertebra. In addition, he was diagnosed with intellectual disabilities, evaluated by the Wechsler Adult Intelligence Scale-III, and congenital velopharyngeal insufficiency. We herein present the first report of a patient with cardio-cerebrovascular abnormalities, intellectual disabilities, and an otorhinolaryngological abnormality.

  16. ANATOMÍA MACROSCÓPICA E IMAGENOLÓGICA DE LAS RAMAS PRECOCES DE LA ARTERIA CEREBRAL MEDIA. Macroscopic and radiological anatomy of early branches of the middle cerebral artery

    Directory of Open Access Journals (Sweden)

    Fernando Martínez

    2016-03-01

    Full Text Available Las ramas precoces de la arteria cerebral media son ramas corticales originadas del tronco de la citada arteria. Se trata de arterias que pueden nutrir importantes áreas de los lóbulos temporal, frontal o la ínsula. Por lo tanto, la oclusión de una de estas ramas producirá un área de isquemia con potenciales consecuencias. Se estudiaron 20 hemisferios cerebrales  de cadáveres adultos conservados en formol, y 20 angiografías silvianas realizando una comparación y correlación. En las piezas anatómicas, la arteria cerebral media terminó por bifurcación en el 100% de los casos y dicha bifurcación se sitúo en la porción esfenoidal (M1 en la mayoría de las piezas. Se encontraron ramas precoces en número de1 a4 en el 80%, totalizando 28 arterias, de las cuales 23 tenían destino temporal y 5 frontales. En el material angiográfico la cerebral media terminó por bifurcación en el 95% de los casos y la misma se ubicó en M1 en la mayoría de los casos. Se encontraron ramas precoces en el 70% de los estudios analizados, totalizando 19 ramos. De los mismos, 16 fueron temporales, 1 frontal y en 2 casos no se pudo determinar su destino. Consideramos que los datos anatómicos y angiográficos obtenidos por este y otros estudios son de utilidad en la planificación del clipado de  los aneurismas de la cerebral media. The early branches of the middle cerebral artery are cortical branches that arise from the trunk of this artery. These branches can supply significant areas in the temporal, frontal or insular lobes. Therefore, their occlusion may lead to ischemia and potential sequelae. We studied 20 cerebral hemispheres of formalin-fixed adult cadavers and 20 silvian angiographies in order to compare and correlate them. In the anatomical specimens, the middle cerebral artery ended bifurcating in 100% of the cases and such bifurcation occurred at the sphenoidal segment (M1 in most cases. Early branches ranging from 1 to 4 were found in 80

  17. Endoscopic endonasal approach for the treatment of a large clival giant cell tumor complicated by an intraoperative internal carotid artery rupture

    Directory of Open Access Journals (Sweden)

    Iacoangeli M

    2013-01-01

    Full Text Available Maurizio Iacoangeli,1 Alessandro Di Rienzo,1 Massimo Re,2 Lorenzo Alvaro,1 Niccolò Nocchi,1 Maurizio Gladi,1 Maurizio De Nicola,3 Massimo Scerrati11Department of Neurosurgery, Università Politecnica delle Marche, Umberto I General Hospital, Ancona, Italy; 2Department of Ear, Nose, and Throat Surgery, Università Politecnica delle Marche, Umberto I General Hospital, Ancona, Italy; 3Department of Radiology, Interventional Radiology Section, Università Politecnica delle Marche, Umberto I General Hospital, Ancona, ItalyAbstract: Giant cell tumors (GCTs are primary bone neoplasms that rarely involve the skull base. These lesions are usually locally aggressive and require complete removal, including the surrounding apparently healthy bone, to provide the best chance of cure. GCTs, as well as other lesions located in the clivus, can nowadays be treated by a minimally invasive fully endoscopic extended endonasal approach. This approach ensures a more direct route to the craniovertebral junction than other possible approaches (transfacial, extended lateral, and posterolateral approaches. The case reported is a clival GCT operated on by an extended endonasal approach that provides another contribution on how to address one of the most feared complications attributed to this approach: a massive bleed due to an internal carotid artery injury.Keywords: clival giant cell tumor, endoscopic endonasal approach, internal carotid artery injury, minimally invasive surgery

  18. Rupture of major vessels after radiation

    International Nuclear Information System (INIS)

    Fajardo, L.F.; Lee, A.

    1975-01-01

    Rupture of irradiated large vessels is an uncommon complication which tends to occur in carotid, aorta, and femoral arteries, in decreasing order of incidence. It particularly affects men subjected to surgery and radiotherapy for epidermoid carcinomas in oropharynx, esophagus, or genitalia. Contrary to some opinion, radiation is not the most significant cause; this spontaneous arterial rupture can occur without radiation. The perforation is not associated with tumor invasion of arterial wall, as has been claimed. Surgical complications, especially necrosis of skin flaps, infection, and fistulas are most important etiologically. Only 2 of the 11 instances that we describe appear to have been caused mainly by radiation. The perforation is usually fatal, but several patients, including 3 of our series (2 carotid, 1 femoral), have been saved by hospital personnel aware of this complication. To prevent it, prolonged exposure or infection of arteries, whether irradiated or not, should be avoided. (auth)

  19. Ruptured Cervical Aneurysm with Neurofibromatosis | Smith | South ...

    African Journals Online (AJOL)

    A case is presented of spontaneous rupture of an aneurysm of a lateral branch of the right thyrocervical trunk in a patient suffering from diffuse neurofibromatosis. The operative findings are reported. S. Afr. Med. J., 48, 945 (1974). Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT ...

  20. Patterns of prefrontal dysfunction in alcoholics with and without Korsakoff’s syndrome, patients with Parkinson’s disease, and patients with rupture and repair of the anterior communicating artery

    Science.gov (United States)

    Dirksen, Courtney L; Howard, Julie A; Cronin-Golomb, Alice; Oscar-Berman, Marlene

    2006-01-01

    This study compared patterns of frontal-lobe dysfunction in alcoholics with Korsakoff’s syndrome (KS: n = 9), non-Korsakoff alcoholics (AL: n = 28), patients with Parkinson’s disease (PD: n = 18), and patients with rupture and repair of the anterior communicating artery (ACoA: n = 4) relative to healthy non-neurological control (NC) participants (n = 70). The tests administered were sensitive to functions of dorsolateral prefrontal and orbito-frontal subsystems. Measures included perseverative errors on the Wisconsin Card Sorting Test (WCST-pe), errors on object alternation (OA), errors on Trails B, number of words generated on the Controlled Oral Word Association Test (COWAT), and number of categories completed on the WCST (WCST-cc). KS patients were as impaired as AL participants on orbitofrontal measures and, on dorsolateral prefrontal measures, were impaired relative to AL participants, whose performance did not differ from controls. Patients with PD also were impaired on tests of orbitofrontal and dorsolateral prefrontal functioning but to a lesser extent than the KS patients. Moreover, most of the PD deficits were driven by the impaired performance of patients whose initial symptoms were on the right side of the body. The ACoA patients were significantly impaired on tests of orbitofrontal but not dorsolateral prefrontal functioning relative to the control group. Together, the results confirm different patterns of frontal-system impairments in patient groups having compromised frontal lobe functioning consequent to varying etiologies. PMID:19412479

  1. Biomechanical rupture risk assessment of abdominal aortic aneurysms based on a novel probabilistic rupture risk index.

    Science.gov (United States)

    Polzer, Stanislav; Gasser, T Christian

    2015-12-06

    A rupture risk assessment is critical to the clinical treatment of abdominal aortic aneurysm (AAA) patients. The biomechanical AAA rupture risk assessment quantitatively integrates many known AAA rupture risk factors but the variability of risk predictions due to model input uncertainties remains a challenging limitation. This study derives a probabilistic rupture risk index (PRRI). Specifically, the uncertainties in AAA wall thickness and wall strength were considered, and wall stress was predicted with a state-of-the-art deterministic biomechanical model. The discriminative power of PRRI was tested in a diameter-matched cohort of ruptured (n = 7) and intact (n = 7) AAAs and compared to alternative risk assessment methods. Computed PRRI at 1.5 mean arterial pressure was significantly (p = 0.041) higher in ruptured AAAs (20.21(s.d. 14.15%)) than in intact AAAs (3.71(s.d. 5.77)%). PRRI showed a high sensitivity and specificity (discriminative power of 0.837) to discriminate between ruptured and intact AAA cases. The underlying statistical representation of stochastic data of wall thickness, wall strength and peak wall stress had only negligible effects on PRRI computations. Uncertainties in AAA wall stress predictions, the wide range of reported wall strength and the stochastic nature of failure motivate a probabilistic rupture risk assessment. Advanced AAA biomechanical modelling paired with a probabilistic rupture index definition as known from engineering risk assessment seems to be superior to a purely deterministic approach. © 2015 The Author(s).

  2. Branched-chain amino acids increase arterial blood ammonia in spite of enhanced intrinsic muscle ammonia metabolism in patients with cirrhosis and healthy subjects

    DEFF Research Database (Denmark)

    Dam, Gitte; Keiding, Susanne; Munk, Ole Lajord

    2011-01-01

    Branched-chain amino acids (BCAA) are used in attempts to reduce blood ammonia in patients with cirrhosis and intermittent hepatic encephalopathy based on the hypothesis that BCAA stimulate muscle ammonia detoxification. We studied the effects of an oral dose of BCAA on the skeletal muscle...

  3. Hepatic Rupture Induced by Spontaneous Intrahepatic Hematoma

    Directory of Open Access Journals (Sweden)

    Jin-bao Zhou

    2018-01-01

    Full Text Available The etiology of hepatic rupture is usually secondary to trauma, and hepatic rupture induced by spontaneous intrahepatic hematoma is clinically rare. We describe here a 61-year-old female patient who was transferred to our hospital with hepatic rupture induced by spontaneous intrahepatic hematoma. The patient had no history of trauma and had a history of systemic lupus erythematosus for five years, taking a daily dose of 5 mg prednisone for treatment. The patients experienced durative blunt acute right upper abdominal pain one day after satiation, which aggravated in two hours, accompanied by dizziness and sweating. Preoperative diagnosis was rupture of the liver mass. Laparotomy revealed 2500 mL fluid consisting of a mixture of blood and clot in the peritoneal cavity. A 3.5 cm × 2.5 cm rupture was discovered on the hepatic caudate lobe near the vena cava with active arterial bleeding, and a 5  × 6 cm hematoma was reached on the right posterior lobe of the liver. Abdominal computed tomography (CT and laparotomy revealed spontaneous rupture of intrahepatic hematoma with hemorrhagic shock. The patient was successfully managed by suturing the rupture of the hepatic caudate lobe and clearing part of the hematoma. The postoperative course was uneventful, and the patient was discharged after two weeks of hospitalization.

  4. Open Treatment of Blunt Injuries of Supra-Aortic Branches: Case Series.

    Science.gov (United States)

    Sladojevic, Milos; Markovic, Miroslav; Ilic, Nikola; Pejkic, Sinisa; Banzic, Igor; Djoric, Predrag; Koncar, Igor; Tomic, Ivan; Davidovic, Lazar

    2016-02-01

    Blunt injuries of the supra-aortic branches are rare entity, and majority of patients die before arrival at the hospital. Those who arrive alive require complex and fast procedure that requires sternotomy. We report 3 successfully managed cases. We report 3 patients with injury of supra-aortic branches. One was treated urgently due to longitudinal rupture on the posterior wall of innominate artery after car accident, and another 2 had chronic false aneurysm located at the very orifice of the right subclavian and left common carotid artery. In first and second patient bypass grafting with a hand-made, Y-shaped, 8-mm Dacron graft from the ascending aorta to the right common carotid and proximal right subclavian artery were performed, whereas in last 1 bypass grafting from the ascending aorta to the cervical part of the left common carotid artery was performed. In our facility, there were no possibilities for any endovascular treatment. When endovascular technology is not available, open surgical repair of blunt injuries of supra-aortic vessels can be performed without complications. No matter to that, endovascular and hybrid procedures should be considered whenever possible. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Blunt splenic injury in a child with situs inversus totalis treated with transcatheter arterial embolization

    Directory of Open Access Journals (Sweden)

    Naoki Hashizume

    2016-10-01

    Full Text Available We report the first case of blunt splenic rupture in a child with situs inversus totalis treated with transcatheter arterial embolization (TAE. A 12-year-old girl fell roughly 4 feet onto the pavement while riding her bicycle. Contrast-enhanced computed tomography revealed situs inversus totalis, a massive hemorrhage in the abdominal cavity, and a ruptured spleen with extravasation. Arteriography showed that the internal organs were located opposite their normal positioning. TAE was carried out with gelfoam and a micro coils at the branch of the upper lobe of the splenic artery. TAE is effective for blunt splenic injury with extravasation in a child with situs inversus. In TAE, there is no technical difference about situs inversus excepted mirror image of abdominal vascular formation.

  6. [Right branch pulmonary artery stenosis with supravalvar aortic stenosis as a complication of Lecompte maneuver for tetralogy of Fallot associated with absent pulmonary valve].

    Science.gov (United States)

    Honda, Yoshihiro; Suzuki, Shoji; Kaga, Shigeaki; Yoshida, Yukiyo; Kimura, Mitsuhiro; Kamiya, Kentaro; Sakakibara, Kenji; Katsu, Masatake

    2015-05-01

    The patient was diagnosed with tetralogy of Fallot associated with absent pulmonary valve syndrome and a low birth weight of 1,912 g. He suffered from respiratory distress on day 14 and received non-invasive positive pressure ventilation. At 5 months of age and 4.1 kg, he underwent intracardiac repair including right ventricular outflow repair with a monocusp patch, patch closure of the ventricular septum defect and right pulmonary transposition to the anterior of the ascending aorta following the Lecompte maneuver for airway decompression. He was subsequently discharged to home and exhibited an uneventful clinical course with non-invasive positive pressure ventilation for 5 months postoperatively. However, right pulmonary artery and supra-aortic stenosis was noted 2 years after the operation. Computed tomography (CT) and angiography showed ascending aorta strangulation by the right pulmonary artery with right ventricular outflow regurgitation. Right pulmonary artery reconstruction using polytetrafluoroethylene graft interposition and repeat right ventricular outflow repair with bicuspid hand-sewn valves was therefore performed;the postoperative course was uneventful. Pre- and post-operative management using non-invasive positive pressure ventilation and airway decompression with pulmonary artery translocation is a useful strategy in patients exhibiting symptomatic tetralogy of Fallot associated with absent pulmonary valve syndrome in the neonatal period.

  7. A Case of Arterial and Venous Tear during Single Lead Extraction

    Directory of Open Access Journals (Sweden)

    Michael S. Green

    2016-01-01

    Full Text Available Transcutaneous lead extraction can be associated with significant morbidity and mortality. The risk of causing concomitant arterial and venous injury is rare. We report a case of marginal artery rupture with coronary sinus rupture after a CS lead extraction. A 71-year-old male was admitted for extraction of a 6-year-old implantable cardioverter-defibrillator lead due to fracture from insulation break. During the lead extraction, blood pressure fell precipitously and echocardiographic findings were consistent with pericardial effusion. After unsuccessful pericardiocentesis, open chest sternotomy and evacuation of hematoma was performed. Subsequent surgical repair of several injuries was completed including the distal coronary sinus, a large degloving injury of posterior portion of the heart, and first obtuse marginal branch bleed. This case demonstrates that when performing transcutaneous lead extraction (TLE with laser sheath, a degloving injury can cause arterial rupture with concomitant coronary sinus injury. A multidisciplinary team-based approach can ensure patient safety. Learning Objective. Implantable cardioverter-defibrillator leads will falter over time. With the advancement of new technology for extraction more frequent and serious complications will occur. Active fixation CS leads present unique challenges. In the presence of hemodynamic changes during extraction the occurrence of both an arterial and venous injury must be considered.

  8. Description of the celiac artery in domestic pigeons (Columba livia

    Directory of Open Access Journals (Sweden)

    Cibele Geeverghese

    2012-06-01

    Full Text Available This paper aimed to define the origin and distribution of the celiac artery and its collateral branches in 15 fowls from the Columba livia species, which were obtained from the Zoonosis Control Center of Brasilia, Brazil. In order to mark the arterial system of the specimens, the left brachiocephalic trunk was canullated and a colored water-latex solution was injected there. Afterwards, fowls were fixed in a 10% v/v formaldehyde solution and dissected with appropriate equipment, presenting the results described in this paper. The celiac artery originated from the ventral face of the descendent aorta. The first collateral branch arose from the celiac artery itself, forming the esophageal artery. Then, the celiac artery has bifurcated into two branches, named left and right branches of the celiac artery. The left branch emitted the proventricular ventral artery, followed by the splenic arteries, proventricular dorsal artery, and the left hepatic artery. The left branch has bifurcated into two branches, known as ventral and left gastric arteries. The right branch emitted the right hepatic artery, followed by the ileal artery and the right gastric artery. Finally, the right branch turned into the pancreaticoduodenal artery. Our findings showed a great similarity with the avian lineages of the Gallus gallus species, except for the lack of ileocecal artery, cystic branches, and dorsal gastric artery.

  9. Transcatheter Coil Embolization of Splenic Artery Aneurysm

    International Nuclear Information System (INIS)

    Yamamoto, Satoshi; Hirota, Shozo; Maeda, Hiroaki; Achiwa, Sachiko; Arai, Keisuke; Kobayashi, Kaoru; Nakao, Norio

    2008-01-01

    The purpose of this study was to evaluate clinical results and technical problems of transcatheter coil embolization for splenic artery aneurysm. Subjects were 16 patients (8 men, 8 women; age range, 40-80 years) who underwent transcatheter embolization for splenic artery aneurysm (14 true aneurysms, 2 false aneurysms) at one of our hospitals during the period January 1997 through July 2005. Two aneurysms (12.5%) were diagnosed at the time of rupture. Multiple splenic aneurysms were found in seven patients. Aneurysms were classified by site as proximal (or strictly ostial) (n = 3), middle (n = 3), or hilar (n = 10). The indication for transcatheter arterial embolization was a false or true aneurysm 20 mm in diameter. Embolic materials were fibered coils and interlocking detachable coils. Embolization was performed by the isolation technique, the packing technique, or both. Technically, all aneurysms were devascularized without severe complications. Embolized aneurysms were 6-40 mm in diameter (mean, 25 mm). Overall, the primary technical success rate was 88% (14 of 16 patients). In the remaining 2 patients (12.5%), partial recanalization occurred, and re-embolization was performed. The secondary technical success rate was 100%. Seven (44%) of the 16 study patients suffered partial splenic infarction. Intrasplenic branching originating from the aneurysm was observed in five patients. We conclude that transcatheter coil embolization should be the initial treatment of choice for splenic artery aneurysm

  10. Endovascular therapeutic strategies in ruptured intracranial aneurysms

    International Nuclear Information System (INIS)

    Machi, Paolo; Lobotesis, Kyriakos; Vendrell, Jean Francoise; Riquelme, Carlos; Eker, Omer; Costalat, Vincent; Bonafe, Alain

    2013-01-01

    The aim of the present study was to evaluate endovascular techniques used currently which were not available at the time of ISAT inclusion period, such as balloon remodelling and flow-divertion, in order to assess whether these new technologies have improved the endovascular approach outcomes. We present a review of articles, published in major journals, with the aim to evaluate the efficacy and the safety of coiling with balloon remodelling for the treatment of ruptured aneurysms in comparison to coiling performed without such coadjutant techniques. Furthermore, we reviewed publications reporting on the treatment of ruptured aneurysms in the acute phase with the one of the most recent technologies available nowadays: the flow diverting stent. Looking at the recent literature the results regarding ruptured aneurysms treated with balloon assisted coiling (BAC) have shown an improvement in terms of anatomical results and morbi-mortality rates. Case series of ruptured middle cerebral artery (MCA) aneurysms treated by EVT report results similar to those obtained by surgical clipping. Several articles recently report encouraging results in treating ruptured dissecting and blister aneurysms with flow diverters. Questions regarding the best treatment available for ruptured aneurysms are yet to be answered. Hence there is a need for a subsequent trial aiming to answer these unresolved issues

  11. Rupture of primigravid uterus and recurrent rupture

    Directory of Open Access Journals (Sweden)

    Nahreen Akhtar

    2016-08-01

    Full Text Available Uterine rupture is a deadly obstetrical emergency endangering the life of both mother and fetus. In Bangladesh, majority of deliveries arc attended by unskilled traditional birth attendant and maternal mortality is still quite high. It is rare Ln developed country but unfortunately it is common in a developing country like Bangladesh. We report a case history of a patient age 32yrs from Daudkandi, Comilla admitted with H/0 previous two rupture uterus and repair with no living issue. We did caesarean section at her 31+ weeks of pregnancy when she developed Jabour pain. A baby of 1.4 kg was delivered. During cesarean section, focal rupture was noted in previous scar of rupture. Unfortunately the baby expired in neonatal ICU after 36 hours.

  12. Advanced technical skills are required for microsurgical clipping of posterior communicating artery aneurysms in the endovascular era.

    Science.gov (United States)

    Sanai, Nader; Caldwell, Nolan; Englot, Dario J; Lawton, Michael T

    2012-08-01

    Many neurosurgeons feel competent clipping posterior communicating artery (PCoA) aneurysms and include this lesion in their practice. However, endovascular therapy removes simple aneurysms that would have been easiest to clip with the best results. What remains are aneurysms with complex anatomy and technical challenges that are not well described. A contemporary surgical series with PCoA aneurysms is reviewed to define the patients, microsurgical techniques, and outcomes in current practice. A total of 218 patients had 218 PCoA aneurysms that were treated microsurgically during an 11-year period. Complexities influencing aneurysm management included (1) large/giant size; (2) fetal posterior cerebral artery; (3) previous coiling; (4) anterior clinoidectomy; (5) adherence of the anterior choroidal artery (AChA); (6) intraoperative aneurysm rupture; (7) complex clipping; and (8) atherosclerotic calcification. Simple PCoA aneurysms were encountered in 113 patients (51.8%) and complex aneurysms in 105 (48.2%). Adherent AChA (13.8%) and intraoperative rupture (11.5%) were the most common complexities. Simple aneurysms had favorable outcomes in 86.6% of patients, whereas aneurysms with 1 or multiple complexities had favorable outcomes in 78.2% and 75.0%, respectively. Intraoperative rupture (P PCoA aneurysms requires advanced techniques including clinoidectomy, AChA microdissection, complex clipping, and facility with intraoperative rupture. Microsurgery is recommended for recurrent aneurysms after coiling, complex branches, aneurysms causing oculomotor nerve palsy, multiple aneurysms, and patients with hematomas.

  13. Hepatic rupture in preeclampsia

    International Nuclear Information System (INIS)

    Winer-Muram, H.T.; Muram, D.; Salazar, J.; Massie, J.D.

    1985-01-01

    The diagnosis of hepatic rupture in patients with pregnancy-induced hypertension (preeclampsia and eclampsia) is rarely made preoperatively. Diagnostic imaging can be utilized in some patients to confirm the preoperative diagnosis. Since hematoma formation precedes hepatic rupture, then, when diagnostic modalities such as sonography and computed tomography identify patients with hematomas, these patients are at risk of rupture, and should be hospitalized until the hematomas resolve

  14. An unusual, duplicate origin of the anterior choroidal artery with aneurysm: a case report.

    Science.gov (United States)

    Chenin, Louis; Chivot, Cyril; Toussaint, Patrick; Deramond, Hervé; Peltier, Johann

    2015-12-01

    Aneurysms of the anterior choroidal artery (AChoA) are rare and often difficult to treat. Variations may be present and must be identified prior to treatment. We report a unique case of a ruptured aneurysm located at the origin of a duplicate branch of the AChoA. A 56-year-old male was admitted to our university hospital for coma. A brain CT scan showed a subarachnoid hemorrhage, and CT angiography revealed a duplication of the right AChoA, with an aneurysm located at the branch's origin. We decided to embolize this aneurysm. Four weeks later, our patient was able to transfer to the rehabilitation unit. To the best of our knowledge, this is one of the first descriptions of an aneurysm located at the origin of a duplicate branch of the AChoA.

  15. Isolated iliac artery aneurysms with associated hydronephrosis.

    LENUS (Irish Health Repository)

    O'Driscoll, D

    2012-02-03

    An isolated iliac artery aneurysm is where there is aneurysmal dilatation of one or more branches of the iliac system, with no associated dilatation of the aorta. Such aneurysms are rare and comprise 1% of all intra-abdominal aneurysms. The signs and symptoms of such an aneurysm are influenced by its concealed location within the bony pelvis. Awareness of these special characteristics improves the chances of early diagnosis and proper treatment before possible rupture. We present the clinical and radiological features of three such aneurysms. Ultrasound was the first imaging modality to be performed. Ipsilateral hydronephrosis was demonstrated in each case, this lead to imaging the pelvis and the correct diagnosis. We review the clinical and radiological literature and conclude that the pelvis should be imaged in all cases of unexplained hydronephrosis.

  16. Aortic ruptures in seat belt wearers.

    Science.gov (United States)

    Arajärvi, E; Santavirta, S; Tolonen, J

    1989-09-01

    Several investigations have indicated that rupture of the thoracic aorta is one of the leading causes of immediate death in victims of road traffic accidents. In Finland in 1983, 92% of front-seat passengers were seat belt wearers on highways and 82% in build-up areas. The mechanisms of rupture of the aorta have been intensively investigated, but the relationship between seat belt wearing and injury mechanisms leading to aortic rupture is still largely unknown. This study comprises 4169 fatally injured victims investigated by the Boards of Traffic Accident Investigation of Insurance Companies during the period 1972 to 1985. Chest injuries were recorded as the main cause of death in 1121 (26.9%) victims, 207 (5.0%) of those victims having worn a seat belt. Aortic ruptures were found at autopsy in 98 victims and the exact information of the location of the aortic tears was available in 68. For a control group, we analyzed 72 randomly chosen unbelted victims who had a fatal aortic rupture in similar accidents. The location of the aortic rupture in unbelted victims was more often in the ascending aorta, especially in drivers, whereas in seat belt wearers the distal descending aorta was statistically more often ruptured, especially in right-front passengers (p less than 0.05). The steering wheel predominated statistically as the part of the car estimated to have caused the injury in unbelted victims (37/72), and some interior part of the car was the most common cause of fatal thoracic impacts in seat belt wearers (48/68) (p less than 0.001). The mechanism of rupture of the aorta in the classic site just distal to the subclavian artery seems to be rapid deceleration, although complex body movements are also responsible in side impact collisions. The main mechanism leading to rupture of the ascending aorta seems to be severe blow to the bony thorax. This also often causes associated thoracic injuries, such as heart rupture and sternal fracture. Injuries in the ascending

  17. Reconstruction of cica-contracture on the face and neck with skin flap and expanded skin flap pedicled by anterior branch of transverse cervical artery.

    Science.gov (United States)

    Chen, Baoguo; Song, Huifeng; Xu, Minghuo; Gao, Quanwen

    2016-09-01

    A high-quality flap is necessary for repairing faciocervical scar contractures. The supraclavicular region and chest wall are the preferred choices for reconstruction. The supraclavicular island flap (SIF) pedicled by the transverse cervical artery (TCA) has been reported. Compared to the traditional SIF flap, another type of flap pedicled by the anterior perforator of transverse cervical artery (ap-TCA) is more convenient for transfer to the faciocervical area. In this article, we use this type of perforator flap and expanded perforator flap to repair the faciocervical contracture. In this study, 10 cases (deformity caused by burn or trauma to the face and neck sites) with an average age of 32 years-old, were treated by ap-TCA flap and this type of expanded flap. In between, the flap was pre-expanded for approximately 3 months prior to transfer in 6 patients. Another 4 cases did not want the expander because of the long duration required for saline filling and potential complications of the expander. Bilateral prefabricated flaps were designed in two female cases. All 12 flaps in 10 patients were transferred tension-free to the defects and no flap was lost. The size of the flap ranged from 12 cm × 8 cm to 15 cm × 20 cm. All 12 flaps survived completely. The donor sites were closed directly in the above 6 patients where an expander had been used and reconstructed by split skin graft in 4 patients where no expander had been employed. Through a mean time of 6 months' follow-up, only one female patient was disappointed with the cicatrix that presented on the upper polar skin of both breasts, the other 9 patients were satisfied with both recipient function and appearance. The color and the texture matched well with the recipient area. The ap-TCA flap and expanded ap-TCA flap can be considered reliable options for faciocervical deformities as it can be easily elevated and it matches well with faciocervical area in color. With regards to the expanded flap, we

  18. Pulmonary Artery Pseudoaneurysm: A Rare Cause of Fatal Massive Hemoptysis

    Directory of Open Access Journals (Sweden)

    Himaja Koneru

    2018-01-01

    Full Text Available Pulmonary artery pseudoaneurysm (PAPA, an uncommon complication of pyogenic bacterial and fungal infections and related septic emboli, is associated with high mortality. The pulmonary artery (PA lacks an adventitial wall; therefore, repeated endovascular seeding of the PA with septic emboli creates saccular dilations that are more likely to rupture than systemic arterial aneurysms. The most common clinical presentation of PAPA is massive hemoptysis and resultant worsening hypoxemia. Computed tomography angiography is the preferred diagnostic modality for PAPA; typical imaging patterns include focal outpouchings of contrast adjacent to a branch of the PA following the same contrast density as the PA in all phases of the study. In mycotic PAPAs, multiple synchronous lesions are often seen in segmental and subsegmental PAs due to ongoing embolic phenomena. The recommended approach for a mycotic PAPA is prolonged antimicrobial therapy; for massive hemoptysis, endovascular treatment (e.g., coil embolization, stenting, or embolization of the feeding vessel is preferred. PAPA resection and lobectomy are a last resort, generally reserved for patients with uncontrolled hemoptysis or pleural hemorrhage. We present a case of a 28-year-old woman with necrotizing pneumonia from intravenous drug use who ultimately died from massive hemoptysis and shock after a ruptured PAPA.

  19. Ex vivo repair of renal artery aneurysm associated with surgical treatment of abdominal aortic aneurysm

    Directory of Open Access Journals (Sweden)

    Kostić Dušan M.

    2004-01-01

    Full Text Available INTRODUCTION Renal artery aneurysms is relatively uncommon with reported incidence ranges from 0.3% to 1%. However, considering all visceral artery aneurysms the percentage of renal artery aneurysms is relatively high between 15-25%. The distal forms of renal artery aneurysms sometimes require "ex vivo" reconstruction and kidney autotransplantation. CASE REPORT A 75-year-old male presented with the right abdominal and back pain. He suffered from a long history of arterial hypertension and chronic renal failure over the last few months (urea blood = 19.8 mmol/l; creatinine = 198 mmol/l. Duplex ultrasonography showed abdominal aortic aneurysm. Subsequent translumbarangiography revealed juxtarenal abdominal aortic aneurysm associated with distal right renal artery aneurysm. The operation was performed under combined thoracic epidural analgesia and general anesthesia using transperitoneal approach. After the laparotomy, the ascending colon was mobilized and reflected medially followed by Kocher maneuver. The result was visualization of the anterior aspect of the right kidney, the collecting system, ureter as well as the right renal vein and artery with large saccular aneurysm located distally. After mobilization of the renal vessels and careful dissection of the ureter, the kidney was explanted. The operation was continued by two surgical teams. The first team performed abdominal aortic aneurysm resection and reconstruction with bifurcated Dacron graft. The second team performed ex vivo reparation of renal artery aneurysm. All time during the explantation, the kidney was perfused by Collins' solution. The saccular right renal artery aneurysm 4 cm in diameter was located at the kidney hilus at the first bifurcation. Three branches originated from the aneurysm. The aneurysm was resected completely. The longest and widest of three branches arising from the aneurysmal sac was end-to-end anastomized with 6 mm PTFE graft. After this intervention, one of

  20. Multiple Re-entry Closures After TEVAR for Ruptured Chronic Post-dissection Thoraco-abdominal Aortic Aneurysm

    Directory of Open Access Journals (Sweden)

    R. Kinoshita

    Full Text Available Introduction: Although thoracic endovascular aortic repair (TEVAR has become a promising treatment for complicated acute type B dissection, its role in treating chronic post-dissection thoraco-abdominal aortic aneurysm (TAA is still limited owing to persistent retrograde flow into the false lumen (FL through abdominal or iliac re-entry tears. Report: A case of chronic post-dissection TAA treatment, in which a dilated descending FL ruptured into the left thorax, is described. The primary entry tear was closed by emergency TEVAR and multiple abdominal re-entries were closed by EVAR. In addition, major re-entries at the detached right renal artery and iliac bifurcation were closed using covered stents. To close re-entries as far as possible, EVAR was carried out using the chimney technique, and additional aortic extenders were placed above the coeliac artery. A few re-entries remained, but complete FL thrombosis of the rupture site was achieved. Follow-up computed tomography showed significant shrinkage of the FL. Discussion: In treating post-dissection TAA, entry closure by TEVAR is sometimes insufficient, owing to persistent retrograde flow into the FL from abdominal or iliac re-entries. Adjunctive techniques are needed to close these distal re-entries to obtain complete FL exclusion, especially in rupture cases. Recently, encouraging results of complete coverage of the thoraco-abdominal aorta with fenestrated or branched endografts have been reported; however, the widespread employment of such techniques appears to be limited owing to technical difficulties. The present method with multiple re-entry closures using off the shelf and immediately available devices is an alternative for the endovascular treatment of post-dissection TAA, especially in the emergency setting. Keywords: Aortic dissection, Ruptured aortic aneurysm, Post-dissection thoracoabdominal aortic aneurysm, Endovascular aortic repair, Reentry closure, Endovascular procedures

  1. Diagnosis of ruptured intracranial aneurysm in acute stage

    International Nuclear Information System (INIS)

    Yoshiyama, Masataka; Nakagawa, Toshifumi

    1980-01-01

    Subarachnoid hemorrhage at an acute stage within one day from the onset to the first CT scan was classified into subarachnoid hemorrhage secondary to intracranial aneurysm, subarachnoid hemorrhage of unknown origin and subarachnoid hemorrhage of which angiography could not be carried out, and the first CT findings, the severity, and the prognosis of these subarachnoid hemorrhage were compared and discussed. CT findings of subarachnoid hemorrhage secondary to intracranial aneurysm showed various changes according to progress in the severity with time, and intracranial hematoma, intraventricular clots and ventricular dilatation increased according to progress in the severity. Ruptured intracranial aneurysm in middle cerebral artery, anterior cerebral artery and anterior communicating artery could be found easily by CT, but that in internal carotid artery and vertabral basilar artery was difficult to be detected by CT. When cerebral angiography was carried out repeatedly for ruptured intracranial aneurysm of unknown origin, the time of performance must be consifered with attention to angiospasms or hematoma. (Tsunoda, M.)

  2. Spontaneous and traumatic hepatic rupture: imaging findings and minimally invasive treatment

    International Nuclear Information System (INIS)

    Palacio, Glaucia Andrade e Silva; D'Ippolito, Giuseppe

    2003-01-01

    Spontaneous hepatic bleeding is a rare condition. Our aim was to describe the imaging findings and minimally invasive treatment using transcatheter arterial embolization in patients with spontaneous and traumatic hepatic rupture. Three patients presented acute hemoperitoneum dur to hepatic rupture caused by spontaneous rupture of hepatocellular carcinoma, HELLP syndrome and a blunt hepatic trauma. The patients were submitted to ultrasound and computed tomography of the abdomen and subsequently treated by transcatheter arterial embolization. All patients underwent helical computed tomography before and after treatments. Computed tomography played an important role in the evaluation and follow-up in the therapeutic intervention. Different types of liver injuries were identified. Transcatheter arterial embolization blocked arterial hemorrhage in the patients who were hemodynamically unstable. The conclusion was: transcatheter arterial embolization is an effective and well-tolerated treatment method for the management of hepatic rupture and computed tomography is an excellent method for the diagnosis and follow-up of these patients. (author)

  3. Splenic rupture masquerading ruptured ectopic pregnancy | Kigbu ...

    African Journals Online (AJOL)

    The classical triad of presentation of delayed menses, irregular vaginal bleeding and abdominal pain may not be encountered at all! Overwhelming features of abdominal pain, amenorrhea, pallor, abdominal tenderness, shifting dullness with positive pregnancy test gave a clinical diagnosis of ruptured ectopic pregnancy.

  4. Hepatic artery aneurysms (HAAs)

    International Nuclear Information System (INIS)

    Nosratini, H.

    2004-01-01

    The hepatic artery aneurysms are rare, especially in interahepatic branches, The frequency consists of 75-80% extrahepatic and 20-25% intrahepatic. Catheterization is achieved usually from common femoral artery, other methods implemented in the case of unsuccessful catheterization from femoral artery, are translumbar and brachial catheterization. The study consist of 565 patients that were referred to the angiography ward, During seven years of assessment, five cases of hepatic artery aneurysm were found; this is a rare condition reported in the English literature. In the literature as well as in this case report the hepatic artery aneurysms are rare. In reported series the extrahepatic artery aneurysms are found more often than in the intrahepatic artery aneurysm but in this case report intrahepatic artery aneurysms are more than extrahepatic one. (author)

  5. Outcomes of fenestrated and branched endovascular repair of complex abdominal and thoracoabdominal aortic aneurysms.

    Science.gov (United States)

    Schanzer, Andres; Simons, Jessica P; Flahive, Julie; Durgin, Jonathan; Aiello, Francesco A; Doucet, Danielle; Steppacher, Robert; Messina, Louis M

    2017-09-01

    More than 80% of infrarenal aortic aneurysms are treated by endovascular repair. However, adoption of fenestrated and branched endovascular repair for complex aortic aneurysms has been limited, despite high morbidity and mortality associated with open repair. There are few published reports of consecutive outcomes, inclusive of all fenestrated and branched endovascular repairs, starting from the inception of a complex aortic aneurysm program. Therefore, we examined a single center's consecutive experience of fenestrated and branched endovascular repair of complex aortic aneurysms. This is a single-center, prospective, observational cohort study evaluating 30-day and 1-year outcomes in all consecutive patients who underwent fenestrated and branched endovascular repair of complex aortic aneurysms (definition: requiring one or more fenestrations or branches). Data were collected prospectively through an Institutional Review Board-approved registry and a physician-sponsored investigational device exemption clinical trial (G130210). We performed 100 consecutive complex endovascular aortic aneurysm repairs (November 2010 to March 2016) using 58 (58%) commercially manufactured custom-made devices and 42 (42%) physician-modified devices to treat 4 (4%) common iliac, 42 (42%) juxtarenal, 18 (18%) pararenal, and 36 (36%) thoracoabdominal aneurysms (type I, n = 1; type II, n = 4; type III, n = 12; type IV, n = 18; arch, n = 1). The repairs included 309 fenestrations, branches, and scallops (average of 3.1 branch arteries/case). All patients had 30-day follow-up for 30-day event rates: three (3%) deaths; six (6%) target artery occlusions; five (5%) progressions to dialysis; eight (8%) access complications; one (1%) paraparesis; one (1%) bowel ischemia; and no instances of myocardial infarction, paralysis, or stroke. Of 10 type I or type III endoleaks, 8 resolved (7 with secondary intervention, 1 without intervention). Mean follow-up time was 563 days (interquartile range

  6. Premature rupture of membranes

    Science.gov (United States)

    ... gov/ency/patientinstructions/000512.htm Premature rupture of membranes To use the sharing features on this page, ... water that surrounds your baby in the womb. Membranes or layers of tissue hold in this fluid. ...

  7. Ruptured submitral aneurysm

    Directory of Open Access Journals (Sweden)

    V. Shukla

    2016-09-01

    Full Text Available Submitral aneurysm is a rare entity, with around few hundred cases reported till date. Presentation can be varied. We describe here a case of submitral aneurysm in a young male with rupture into the left atrium cavity.

  8. Achilles Tendon Rupture

    Science.gov (United States)

    ... is a strong fibrous cord that connects the muscles in the back of your calf to your heel bone. If you overstretch your Achilles tendon, it can tear (rupture) completely or just partially. If your Achilles ...

  9. Coronary artery aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Koischwitz, D.; Harder, T.; Schuppan, U.; Thurn, P.

    1982-04-01

    Seven saccular coronary artery aneurysms have been demonstrated in the course of 1452 selective coronary artery angiograms. In six patients they were arterio-sclerotic; in one patient the aneurysm must have been congenital or of mycotic-embolic origin. The differential diagnosis between true aneurysms and other causes of vascular dilatation is discussed. Coronary artery aneurysms have a poor prognosis because of the possibility of rupture with resultant cardiac tamponade, or the development of thrombo-embolic myocardial infarction. These aneurysms can only be diagnosed by means of coronary angiography and require appropriate treatment.

  10. Ruptured cornual pregnancy

    International Nuclear Information System (INIS)

    Hussain, M.; Yasmeen, H.; Noorani, K.

    2003-01-01

    A case of ruptured cornual pregnancy is presented here. The patient presented with history of 30 weeks gestational amenorrhoea and pain in the lower abdomen and epigastrium for the last seven days. Ultrasound revealed a 29 weeks abdominal pregnancy with blood in the pelvic cavity. On laparotomy; there was a ruptured right cornual pregnancy, treated cornual resection and uterine repair. An alive male baby of one kg weight was delivered from the resected cornua of the uterus. (author)

  11. A Case of Segmental Arterial Mediolysis Presenting as Mucosal Gastric Hematoma

    Directory of Open Access Journals (Sweden)

    Shunsuke Sakuraba

    2017-01-01

    Full Text Available Background. Although segmental arterial mediolysis (SAM has been increasingly recognized as arteriopathy and there are some case reports about SAM, it is still very rare. It is characterized clinically by aneurysm, dissection, stenosis, and occlusion within splanchnic arterial branches, causing intra-abdominal hemorrhage or bowel ischemia. Mortality is as high as 50% in acute events. Case Presentation. A 51-year-old man was referred to our hospital with hematemesis. Gastroscopy revealed a submucosal-like tumor on the posterior wall of gastric angle with ulceration. Computed tomography indicated a tumor measuring 65×50 mm in the stomach, which was suspected to have invaded into the pancreas. Significant hematemesis recurred; the patient developed shock and underwent emergency distal gastrectomy, distal pancreatectomy, and splenectomy. The pathology and the clinical course were compatible with SAM splenic artery rupture causing retroperitoneal hemorrhage that penetrated into the stomach. After that surgery, aneurysm of common hepatic artery ruptured and coil embolization was performed. Conclusion. SAM is an important cause of intra-abdominal or retroperitoneal hemorrhage in patients without underlying disease. SAM typically presents as intra-abdominal hemorrhage, but, in this case, the retroperitoneal hemorrhage penetrated into the stomach and it looked like a submucosal tumor.

  12. Radiological evaluation of sinus valsalva rupture

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yul; Park, Jae Hyung; Yeon, Kyung Mo; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1984-03-15

    We obtained the following results by reviewing the radiographic findings of 15 cases of Sinus valsalva rupture who were diagnosed surgically at Seoul National University Hospital since 1979. 1. Among distribution was from 15 years to 40 years with the mean age of 24 years. Among the 15 cases, 9 cases were male and 7 were female. 2. Ruptured sinus is right coronary sinus projecting to right ventricle in all 15 cases. Combined diseases are ventricular septal defect in 12 cases, Aortic Valvular heart disease in 4 cases, and narrowing of right ventricular outflow tract in 2 cases, and aneurysmal dilatation of right pulmonary artery in 1 cases. 3. Chest X-ray findings were that of left to right shunt, i.e, cardiomegaly, increased pulmonary vascularity but were normal in 3 cases. 4. Aortography showed sequential leakage of dye from right coronary sinus to right ventricle and finally to pulmonary artery in 9 cases, and in 9 cases of them the leakage is directly to right ventricular outflow tract without filling of sinus portion of the ventricle., i.e., type I. 5. The leakage was well shown in left ventricular diastolic phase and not shown in systolic phase. 6. Ventricular septal defects were not detected definitely in spite of taking left ventriculography. 7. Cine angiography is essential for detecting accurate site, degree and direction of sinus valsalva rupture and other associated cardiac abnormality.

  13. Radiological evaluation of sinus valsalva rupture

    International Nuclear Information System (INIS)

    Lee, Yul; Park, Jae Hyung; Yeon, Kyung Mo; Han, Man Chung

    1984-01-01

    We obtained the following results by reviewing the radiographic findings of 15 cases of Sinus valsalva rupture who were diagnosed surgically at Seoul National University Hospital since 1979. 1. Among distribution was from 15 years to 40 years with the mean age of 24 years. Among the 15 cases, 9 cases were male and 7 were female. 2. Ruptured sinus is right coronary sinus projecting to right ventricle in all 15 cases. Combined diseases are ventricular septal defect in 12 cases, Aortic Valvular heart disease in 4 cases, and narrowing of right ventricular outflow tract in 2 cases, and aneurysmal dilatation of right pulmonary artery in 1 cases. 3. Chest X-ray findings were that of left to right shunt, i.e, cardiomegaly, increased pulmonary vascularity but were normal in 3 cases. 4. Aortography showed sequential leakage of dye from right coronary sinus to right ventricle and finally to pulmonary artery in 9 cases, and in 9 cases of them the leakage is directly to right ventricular outflow tract without filling of sinus portion of the ventricle., i.e., type I. 5. The leakage was well shown in left ventricular diastolic phase and not shown in systolic phase. 6. Ventricular septal defects were not detected definitely in spite of taking left ventriculography. 7. Cine angiography is essential for detecting accurate site, degree and direction of sinus valsalva rupture and other associated cardiac abnormality

  14. Failure analysis on a ruptured petrochemical pipe

    Energy Technology Data Exchange (ETDEWEB)

    Harun, Mohd [Industrial Technology Division, Malaysian Nuclear Agency, Ministry of Science, Technology and Innovation Malaysia, Bangi, Kajang, Selangor (Malaysia); Shamsudin, Shaiful Rizam; Kamardin, A. [Univ. Malaysia Perlis, Jejawi, Arau (Malaysia). School of Materials Engineering

    2010-08-15

    The failure took place on a welded elbow pipe which exhibited a catastrophic transverse rupture. The failure was located on the welding HAZ region, parallel to the welding path. Branching cracks were detected at the edge of the rupture area. Deposits of corrosion products were also spotted. The optical microscope analysis showed the presence of transgranular failures which were related to the stress corrosion cracking (SCC) and were predominantly caused by the welding residual stress. The significant difference in hardness between the welded area and the pipe confirmed the findings. Moreover, the failure was also caused by the low Mo content in the stainless steel pipe which was detected by means of spark emission spectrometer. (orig.)

  15. Fenestration of axillary vein by a variant axillary artery.

    Science.gov (United States)

    Hadimani, S; Desai, S D; Bagoji, I B; Patil, B S

    2013-01-01

    Variations of venous pattern in the arm are common. In this case report, we present a variation of axillary artery and vein. During routine educational dissections of axillary region, it was observed that a fenestrated axillary vein was perforated by a variant axillary artery in right arm of an old male cadaver. The axillary artery which was fenestrated through axillary vein had only two branches arising from its second part and no branches from its remaining distal parts. The branches are thoraco-acromial (usual) and another large collateral (unusual) branch. This collateral branch is the origin of several important arteries as the subscapular, circumflex scapular, posterior circumflex humeral and lateral thoracic arteries. We propose to name this artery as collateral axillary arterial trunk. The course of this collateral axillary arterial trunk and its branches and also clinical significance of this variation are discussed in the paper.

  16. Comparison between smaller ruptured intracranial aneurysm and larger un-ruptured intracranial aneurysm: gene expression profile analysis.

    Science.gov (United States)

    Li, Hao; Li, Haowen; Yue, Haiyan; Wang, Wen; Yu, Lanbing; ShuoWang; Cao, Yong; Zhao, Jizong

    2017-07-01

    As it grows in size, an intracranial aneurysm (IA) is prone to rupture. In this study, we compared two extreme groups of IAs, ruptured IAs (RIAs) smaller than 10 mm and un-ruptured IAs (UIAs) larger than 10 mm, to investigate the genes involved in the facilitation and prevention of IA rupture. The aneurismal walls of 6 smaller saccular RIAs (size smaller than 10 mm), 6 larger saccular UIAs (size larger than 10 mm) and 12 paired control arteries were obtained during surgery. The transcription profiles of these samples were studied by microarray analysis. RT-qPCR was used to confirm the expression of the genes of interest. In addition, functional group analysis of the differentially expressed genes was performed. Between smaller RIAs and larger UIAs, 101 genes and 179 genes were significantly over-expressed, respectively. In addition, functional group analysis demonstrated that the up-regulated genes in smaller RIAs mainly participated in the cellular response to metal ions and inorganic substances, while most of the up-regulated genes in larger UIAs were involved in inflammation and extracellular matrix (ECM) organization. Moreover, compared with control arteries, inflammation was up-regulated and muscle-related biological processes were down-regulated in both smaller RIAs and larger UIAs. The genes involved in the cellular response to metal ions and inorganic substances may facilitate the rupture of IAs. In addition, the healing process, involving inflammation and ECM organization, may protect IAs from rupture.

  17. Liver hydatid cyst ruptured into the thorax: CT angiography findings of a case

    International Nuclear Information System (INIS)

    Kara, K.; Ors, F.; Bozlar, U.; Tasar, M.

    2012-01-01

    Full text: Introduction: Intrathoracic rupture of hepatic hydatid cyst is a rare but severe condition causing a spectrum of lesions to the pleura, lung parenchyma, and bronchi. Pulmonary complications result from the proximity of hydatid cysts in the liver and the diaphragm. Objectives and tasks: In this report we aimed to present computed tomography (CT) angiography findings of a case with liver hydatid cyst ruptured into the thorax. The patient underwent CT angiography examination with suspicion of pulmonary embolism. Materials and methods: A 71-year-old female patient admitted to our emergency department with complaints of severe and persistent cough. Basal region of the right hemithorax could not get breath sounds on physical examination. Chest radiography revealed the presence of consolidation-effusion. The patient was treated with antibiotherapy for pneumonia and parapneumonic effusion. Because of the clinical symptoms and chest radiograph findings persisted the patient underwent CT angiography examination with suspicion of pulmonary embolism. Results: On CT angiography images pulmonary artery and its branches were normal. There were subtotal collapse in the right middle and lower lung lobes and complicated cystic lesion that has air densities in the basal interlobar space. Another thick walled complicated cystic lesion with multiple septations and air densities was detected in the right posterior liver lobe. The right hemidiaphragm was interrupted and the right liver lobe partially herniated into the thorax cavity. Serologic tests were positive for Echinococcus granulosus and there were prior therapy history for liver cyst hydatid. The diagnostic aspiration findings were consistent with hydatid cyst lesion. Conclusion: In patients with hepatic hydatid cyst associated with persistent and severe cough, thoracic rupture of the cyst should be considered in differential diagnosis. CT angiography is fast, non-invasive and effective method in the detection of

  18. Emergency Stenting of a Ruptured Infected Anastomotic Femoral Pseudoaneurysm

    International Nuclear Information System (INIS)

    Klonaris, Chris; Katsargyris, Athanasios; Matthaiou, Alexandros; Giannopoulos, Athanasios; Tsigris, Chris; Papadopouli, Katerina; Tsiodras, Sotiris; Bastounis, Elias

    2007-01-01

    A 74-year-old man presented with a ruptured infected anastomotic femoral pseudoaneurysm. Due to severe medical comorbidities he was considered unsuitable for conventional surgical management and underwent an emergency endovascular repair with a balloon-expandable covered stent. The pseudoaneurysm was excluded successfully and the patient had an uneventful postoperative recovery with long-term suppressive antimicrobials. He remained well for 10 months after the procedure with no signs of recurrent local or systemic infection and finally died from an acute myocardial infarction. To our knowledge, emergency endovascular treatment of a free ruptured bleeding femoral artery pseudoaneurysm has not been documented before in the English literature. This case illustrates that endovascular therapy may be a safe and efficient alternative in the emergent management of ruptured infected anastomotic femoral artery pseudoaneurysms when traditional open surgery is contraindicated

  19. An Anomalous Branching of Coeliac Trunk

    Directory of Open Access Journals (Sweden)

    Jadhav Surekha D

    2013-07-01

    Full Text Available Anatomical variations of the coeliac trunk arevery common. A variation of coeliac trunk oc-curs due to the developmental abnormalities inthe ventral splanchnic arteries. Present paperhighlights a rare variation of branching patternof coeliac trunk which was observed during rou-tine dissection. In a 63 year old male cadaver,we observed a bifurcation of coeliac trunk intoshort hepato-splenic and longer hepato-gastrictrunks. The hepato-splenic trunk divided intocommon hepatic artery and splenic artery. Cys-tic artery originated from proper hepatic arteryand then proper hepatic artery divided into rightand left hepatic arteries. Hepato-gastric trunkran laterally and upward, and then it divided intotwo branches: a left gastric artery and left ac-cessory hepatic artery. Knowledge of this rarevariation is clinically very important for sur-geons, especially while performing liver trans-plantation, gastric, gallbladder surgeries andtransarterial chemoembolization for hepatictumor and during invasive procedures like an-giography and also other radiological studies.

  20. Morphological characteristics associated with rupture risk of multiple intracranial aneurysms.

    Science.gov (United States)

    Wang, Guang-Xian; Liu, Lan-Lan; Wen, Li; Cao, Yun-Xing; Pei, Yu-Chun; Zhang, Dong

    2017-10-01

    To identify the morphological parameters that are related to intracranial aneurysms (IAs) rupture using a case-control model. A total of 107 patients with multiple IAs and aneurysmal subarachnoid hemorrhage between August 2011 and February 2017 were enrolled in this study. Characteristics of IAs location, shape, neck width, perpendicular height, depth, maximum size, flow angle, parent vessel diameter (PVD), aspect ratio (AR) and size ratio (SR) were evaluated using CT angiography. Multiple logistic regression analysis was used to identify the independent risk factors associated with IAs rupture. Receiver operating characteristic curve analysis was performed on the final model, and the optimal thresholds were obtained. IAs located in the internal carotid artery (ICA) was associated with a negative risk of rupture, whereas AR, SR1 (height/PVD) and SR2 (depth/PVD) were associated with increased risk of rupture. When SR was calculated differently, the odds ratio values of these factors were also different. The receiver operating characteristic curve showed that AR, SR1 and SR2 had cut-off values of 1.01, 1.48 and 1.40, respectively. SR3 (maximum size/PVD) was not associated with IAs rupture. IAs located in the ICA are associated with a negative risk of rupture, while high AR (>1.01), SR1 (>1.48) or SR2 (>1.40) are risk factors for multiple IAs rupture. Copyright © 2017 Hainan Medical University. Production and hosting by Elsevier B.V. All rights reserved.

  1. Acute interventional diagnosis and treatment of upper gastrointestinal arterial hemorrhage: its clinical value and influence factors

    International Nuclear Information System (INIS)

    Wang Yongli; Cui Shitao; Zhang Jiaxing; Ru Fuming; Xu Jiahua; Xu Jichong

    2009-01-01

    Objective: To evaluate emergent angiography and interventional management in treating massive upper gastrointestinal (GI) arterial hemorrhage, and to discuss the factors influencing the angiographic bleeding signs and the interventional therapeutic results. Methods: The clinical data of 56 patients with massive upper GI arterial hemorrhage, who underwent diagnostic arteriography and interventional management with trans-catheter vasopressin infusion and embolization, were retrospectively analyzed. Systolic blood pressure of both pre-and post-interventional therapy was recorded and statistically analyzed. The arteriographic positive rates were separately calculated according to the catheter tip's location, being placed at the 2nd grade branch or at the 3 rd -4 th grade branch of the artery, and the relation of the positive rate with the tip's location was analyzed. A comparison of the hemostatic effect between trans-catheter vasopressin infusion and trans-catheter embolization was made. Results: The average systolic blood pressure of pre-and post-procedure was (93.14 ± 18.63) mmHg and (11.64 ± 13.61) mmHg respectively, with a significant difference (P = 0.023). The angiographic bleeding signs were demonstrated in 12 cases (21.4%) with the catheter's tip at the 2nd grade branch and in 56 cases (100%) with the catheter's tip at the 3 rd -4 th grade branch,the difference between the two was of statistically significance (P < 0.05). The technical success rate and the clinical hemostasis rate of via catheter vasopressin infusion was 80% (16 / 20) and 55% (11/20) respectively. Of nine re-bleeding cases, seven were successfully controlled with embolization therapy by using microcatheter and two had to receive surgery because of arterial rupture which was proved by angiography. The technical and the clinical rates of success for transcatheter embolization therapy were 93% (42 / 45) and 89% (40 / 45) respectively. Recurrence of bleeding was seen in two patients who got

  2. Rupture, waves and earthquakes.

    Science.gov (United States)

    Uenishi, Koji

    2017-01-01

    Normally, an earthquake is considered as a phenomenon of wave energy radiation by rupture (fracture) of solid Earth. However, the physics of dynamic process around seismic sources, which may play a crucial role in the occurrence of earthquakes and generation of strong waves, has not been fully understood yet. Instead, much of former investigation in seismology evaluated earthquake characteristics in terms of kinematics that does not directly treat such dynamic aspects and usually excludes the influence of high-frequency wave components over 1 Hz. There are countless valuable research outcomes obtained through this kinematics-based approach, but "extraordinary" phenomena that are difficult to be explained by this conventional description have been found, for instance, on the occasion of the 1995 Hyogo-ken Nanbu, Japan, earthquake, and more detailed study on rupture and wave dynamics, namely, possible mechanical characteristics of (1) rupture development around seismic sources, (2) earthquake-induced structural failures and (3) wave interaction that connects rupture (1) and failures (2), would be indispensable.

  3. Radiological analysis of subarachnoid hemorrhage from ruptured intracranial aneurysms

    International Nuclear Information System (INIS)

    Lee, Jong Doo; Suh, Jung Ho; Kim, Dong Ik

    1988-01-01

    The CT findings of 98 patients with subarachnoid hemorrhage due to aneurysmal rupture were analyzed and compared with cerebral angiography for the purpose of preangiographic prediction of aneurysmal location as well as evaluation of the CT features corresponding to the vasospasm or ischemic neurologic dysfunctions. The results were as follows: 1.Aneurysms could be identified on initial cerebral angiography in 82 out of 98 patients with subarachnoid hemorrhage and anterior communicating artery aneurysms were most common (42 cases), followed by MCA, posterior communicating artery, ICA, basilar artery in order of frequency. 2.The CT findings of those patients were hemorrhage in subarachnoid space (69%), localized hematoma (47%), ventricular dilatation (31%), enhancing nodule (23%), cisternal enhancement (20%), cerebral infarction (15%), ventricular hemorrhage (14%), and epidural hemorrhage (3%). 3.Localized hematoma was more prevalent in anterior communicating artery aneurysm rupture (54%), and less frequently in MCA, posterior communicating artery and ICA aneurysms. 4.Most of aneurysmal sac could be identified as enhancing nodule on CT when the real size were over 1 cm. 5.The size of ruptured aneurysm could be predicted in many patients with ACA and MCA aneurysm according to the CT features such as hemorrhagic patterns, location of hematomas or enhancing nodules. 6.Localized hematoma or blood clots and cerebral infarction are considered to be the CT features corresponding to the angiographic vasospasm

  4. Duplicated middle cerebral artery

    Science.gov (United States)

    Perez, Jesus; Machado, Calixto; Scherle, Claudio; Hierro, Daniel

    2009-01-01

    Duplicated middle cerebral artery (DMCA) is an anomalous vessel arising from the internal carotid artery. The incidence DMCA is relatively law, and an association between this anomaly and cerebral aneurysms has been documented. There is a controversy whether DMCA may have perforating arteries. This is an important fact to consider in aneurysm surgery. We report the case of a 34-year-old black woman who suffered a subarachnoid hemorrhage and the angiography a left DMCA, and an aneurysm in an inferior branch of the main MCA. The DMCA and the MCA had perforating arteries. The aneurysm was clipped without complications. The observation of perforating arteries in our patient confirms that the DMCA may have perforating arteries. This is very important to be considered in cerebral aneurysms surgery. Moreover, the DMCA may potentially serve as a collateral blood supply to the MCA territory in cases of MCA occlusion. PMID:22140405

  5. Hepatic Rupture Caused by Hemolysis, Elevated Liver Enzyme, and Low Platelet Count Syndrome: A Case Report with Computed Tomographic and Conventional Angiographic Findings

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Cheong Bok; Ahn, Jae Hong; Choi, Soo Jung; Lee, Jong Hyeog; Park, Man Soo; Jung, Seung Mun; Ryu, Dae Sik [Dept. of Radiology, Asan Foundation, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung (Korea, Republic of)

    2013-03-15

    The authors recently obtained successful clinical outcome after embolization of the hepatic artery and right inferior phrenic artery in a pregnant patient with hemolysis, elevated liver enzyme, and low platelet count (HELLP) syndrome causing hepatic rupture. We report the computed tomographic and conventional angiographic findings in a case of HELLP syndrome, resulting in hepatic infarction and rupture with active bleeding.

  6. Total rupture of hydatid cyst of liver in to common bile duct: a case report.

    Science.gov (United States)

    Robleh, Hassan; Yassine, Fahmi; Driss, Khaiz; Khalid, Elhattabi; Fatima-Zahra, Bensardi; Saad, Berrada; Rachid, Lefriyekh; Abdalaziz, Fadil; Najib, Zerouali Ouariti

    2014-01-01

    Rupture of hydatid liver cyst into biliary tree is frequent complications that involve the common hepatic duct, lobar biliary branches, the small intrahepatic bile ducts,but rarely rupture into common bile duct. The rupture of hydatid cyst is serious life threating event. The authors are reporting a case of total rupture of hydatid cyst of liver into common bile duct. A 50-year-old male patient who presented with acute cholangitis was diagnosed as a case of totally rupture of hydatid cyst on Abdominal CT Scan. Rupture of hydatid cyst of liver into common bile duct and the gallbladder was confirmed on surgery. Treated by cholecystectomy and T-tube drainage of Common bile duct.

  7. Spontaneous Retroperitoneal Hemorrhage from Adrenal Artery Aneurysm

    International Nuclear Information System (INIS)

    Gonzalez Valverde, F.M.; Balsalobre, M.; Torregrosa, N.; Molto, M.; Gomez Ramos, M.J.; Vazquez Rojas, J.L.

    2007-01-01

    Spontaneous adrenal hemorrhage is a very rare but serious disorder of the adrenal gland that can require emergent treatment. We report on a 42-year-old man who underwent selective angiography for diagnosis and treatment of retroperitoneal hemorrhage from small adrenal artery aneurysm. This case gives further details about the value of transluminal artery embolization in the management of visceral aneurysm rupture

  8. Dez anos de experiência com artéria torácica interna direita através do seio transverso na revascularização da artéria circunflexa e seus ramos Ten years of experience with the right thoracic internal artery through transversus sinus in the left circunflex artery and his branches

    Directory of Open Access Journals (Sweden)

    Luís Roberto Gerola

    1993-12-01

    angioplastia, 7 apresentaram infarto do miocárdio não fatal e 1 paciente foi reoperado por oclusão das duas artérias torácicas internas. Foram realizados 69 cateterismos pós-operatórios, sendo 38 imediatos e 31 tardios, num período que variou de 3 a 120 meses (média de 51,6 meses. No período pós-operatório imediato, ATIE estava pérvia em 37 casos (97% e a ATID em 36 (95%. No reestudo tardio, a ATIE estava pérvia em 30 pacientes (97% e a ATID em 29 (92,7%. A análise atuarial mostrou que a percentagem de casos que apresentavam a ATIE pérvia foi de 97,6% em 1 ano e de 93,8% aos 5-10 anos de seguimento, enquanto que a incidência de casos em que a ATID estava pérvia foi de 92,1% em 1 ano e de 84,1% em 5 e 10 anos. Os resultados apresentados mostram que a revascularização de ramos da artéria coronária esquerda com as ATI E e ATI D proporciona aos pacientes uma boa evolução tardia, em decorrência da baixa incidência de eventos cardíacos durante o período estudado. A alta incidência de enxertos pérvios em 10 anos, com a utilização da ATID posicionada através do seio transverso, sugere que esta opção técnica deve ser sempre lembrada na revascularização da artéria circunflexa e seus ramos.From April 1983 to November 1993,185 patients were submitted to myocardial revascularization using bilateral thoracic internal artery. The left internal thoracic artery was used to left anterior descending artery and the right internal thoracic artery was used through transversus sinus to circunflex artery and his branches. We performed 38 angiographic studies during the late follow-up and demonstrated that the right internal thoracic artery was patent in 29 patients (92.7% and the left internal thoracic artery in 30 (97%. We conclude that myocardial revascularyzation should be performed using bilateral internal thoracic artery routinely.

  9. Double rupture disc experience

    International Nuclear Information System (INIS)

    1979-01-01

    Result of these observations, comparisons and evaluations can be summarized in the following list of concerns regarding the use of double rupture discs coupled to the liquid space of a steam generator that is subjected to a large leak sodium water reaction event. Single rupture disc show delayed collapse characteristics in LLTR Series I and double disc assemblies are presumed to be more complex with additional delay before opening to give pressure relief. Delayed failure increases pressures in the IHTS and must be adequately covered by design requirements. With CRBR design, the first disc may fail only partially reducing the loading on the second disc with the result that relief performance may not meet requirements

  10. Giant true celiac artery aneurysm

    International Nuclear Information System (INIS)

    Aljabri, Badr

    2009-01-01

    Celiac artery aneurysms are rare and usually asymptomatic. The management of these aneurysms is challenging, especially when they are large and involve the confluence of the trifurcation. We present here a case of a large celiac artery aneurysm involving its branches in a young woman. Preoperative investigations, intraoperative findings, and the operative procedure are also presented and discussed. (author

  11. COELIAC TRUNK BRANCHING PATTERN AND VARIATION

    Directory of Open Access Journals (Sweden)

    Jude Jose Thomson

    2017-01-01

    Full Text Available BACKGROUND Anatomical variations involving the visceral arteries are common. However, variations in coeliac trunk are usually asymptomatic, they may become important in patients undergoing diagnostic angiography for gastrointestinal bleeding or prior to an operative procedure. This study was useful for knowing the possible morphological variations before an upper abdominal surgery. MATERIALS AND METHODS This was a descriptive study done by cadaveric dissection, conducted on thirty cadavers. The coeliac trunk being examined for its origin, branching pattern, distribution, and variations. Results were statistically analysed and compared with the previous studies. RESULTS In our study, 60% of the coeliac trunk shows variations and 40% have normal branching pattern. A complete absence of coeliac trunk was observed in one case. In the present study the Right inferior phrenic artery arising from coeliac trunk in 2 cases (6.6% and left inferior phrenic artery arising from coeliac trunk in 3 cases (9.9%. Both inferior phrenic arteries are arising from coeliac trunk in 2 cases (6.6%. The common hepatomesenteric trunk and gastro splenic trunk was found in 1 case (3.3%. Hepatosplenic trunk was found in 2 cases (6.6%. In another 2 cases (6.6% gastric and hepatic artery originate from coeliac trunk but splenic artery has a separate origin from abdominal aorta. An absent trunk was also found in 1 case (3.3%. In 5 cases (16.7% showed trifurcation with variation in the branching pattern. CONCLUSION The branching pattern and extreme degree variability in coeliac trunk as brought out in the observations of the present study make it obvious that the present study almost falls in description with previous studies.

  12. Systematization and description of the internal carotid arteries and their main ramifications at the brain base in turtles (Trachemys scripta elegans).

    Science.gov (United States)

    Voll, Juliana; Campos, Rui

    2016-08-01

    Thirty turtle brains (Trachemys scripta elegans) were injected with latex to systematize and describe the internal carotid arteries and their main ramifications at the brain base. The internal carotid arteries had one intercarotid anastomosis. At the level of the tuber cinereum, the internal carotid artery bifurcated into its terminal branches, the rostral and the caudal branches. The rostral branch emitted the rostral choroid artery, the orbital artery, and a series of middle cerebral arteries. After giving off the last middle cerebral artery, the rostral branch continued as the rostral cerebral artery in the cerebral longitudinal fissure, and had one anastomosis with its contralateral homologous artery, the rostral communicating artery, making the first rostral closure of the cerebral arterial circle. Next, the rostral cerebral arteries anastomosed forming a rostral interhemispheric artery, making the second rostral closure of the cerebral arterial circle. The internal carotid artery, after emitting its rostral branch, continued caudally as the caudal branch. The caudal branch ran caudally along the ventral surface of the mesencephalic tegmentum, emitted the caudal cerebral artery and the mesencephalic artery, and continued caudomedially while progressively narrowing, and anastomosed with its contralateral homologous artery, forming the basilar artery. The narrower portion also emitted the trigeminal artery. The anastomosis of the caudal branches closed the cerebral arterial circle caudally. The internal carotid arteries exclusively supplied the cerebral arterial circle of the turtle. Anat Rec, 299:1090-1098, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  13. Long-term results after repair of ruptured and non-ruptured abdominal aortic aneurysm

    Directory of Open Access Journals (Sweden)

    Kuzmanović Ilija B.

    2004-01-01

    peripheral arteries and other vascular reconstructive procedures were the factors that significantly reduced long-term survival of patients operated immediately due to rupture. DISCUSSION This comprehensive study has searched for more factors than others had done before. The applied discriminative analysis numerically evaluated the influence of any risk factor of mortality. These factors were divided in three groups as follows: preoperative, operative and postoperative ones. Preoperative factors were sex, age, diabetes mellitus, arterial hypertension, obesity, COPD, and naturally, the indication for operative treatment of ruptured or non-ruptured abdominal aneurysm. Among all these factors, only obesity significantly reduced long-term survival of electively operated patients. It may be said that immediately operated patients who survived the first 30 postoperative days had quite good long-term survival. Operative factors such as type of operative procedure and vascular graft had no influence on long-term survival of patients in both groups. Postoperative risk factors were early postoperative complications, graft infection, symptomatic cerebrovascular disease, carotid endarterectomy, myocardial revascularization, ventral hernias, "other" non vascular operations, malignancy, mental disorders, peripheral aneurysms and occlusive vascular disease, and other vascular operations either due to aneurysm or peripheral occlusive disease. Early postoperative complications (even graft infection had no significant effect on long-term survival. Ventral hernias and peripheral aneurysms were factors that significantly decreased long-term survival of patients operated for rupture of the abdominal aneurysm. CONCLUSION It is interesting that endarterectomy, myocardial revascularization or malignancy after repair of the abdominal aneurysm (ruptured or non-ruptured had no effect on long-term survival.

  14. Do diabetes mellitus and systemic hypertension predispose to left ventricular free wall rupture in acute myocardial infarction?

    DEFF Research Database (Denmark)

    Melchior, T; Hildebrant, P; Køber, L

    1997-01-01

    Diabetes and systemic hypertension had no influence on left ventricular free wall rupture complicating acute myocardial infarction. Age <65 years and a history of coronary artery disease offers some protection from protection.......Diabetes and systemic hypertension had no influence on left ventricular free wall rupture complicating acute myocardial infarction. Age

  15. Sex differences in intracranial arterial bifurcations

    DEFF Research Database (Denmark)

    Lindekleiv, Haakon M; Valen-Sendstad, Kristian; Morgan, Michael K

    2010-01-01

    Subarachnoid hemorrhage (SAH) is a serious condition, occurring more frequently in females than in males. SAH is mainly caused by rupture of an intracranial aneurysm, which is formed by localized dilation of the intracranial arterial vessel wall, usually at the apex of the arterial bifurcation. T....... The female preponderance is usually explained by systemic factors (hormonal influences and intrinsic wall weakness); however, the uneven sex distribution of intracranial aneurysms suggests a possible physiologic factor-a local sex difference in the intracranial arteries....

  16. Arterial supply of the intestines of New Zealand rabbits (Oryctolagus cuniculus

    Directory of Open Access Journals (Sweden)

    Leandro Marcel Fernandes Cortellini

    2008-03-01

    Full Text Available The origin and ramification patterns of the intestinal arteries of rabbits were studied. The vessels were injected with a latex solution before dissection in 20 adult specimens. The cranial mesenteric artery originates from the abdominal aorta and gives off the following arteries: pancreatic branches; caudal pancreaticoduodenal; colic medium; jejunal (with variable number, ileocolic arteries, the colic branches, and ileal branches. The caudal mesenteric artery originates next to the end of the abdominal aorta and off a left colic artery that gives origin to the sigmoidal arteries and a cranial rectal artery.

  17. Arterial supply to the stomach of indigenous dog (Canis familiaris) in Bangladesh.

    Science.gov (United States)

    Awal, M A; Asaduzzaman, M; Anam, M K; Prodhan, M A; Kurohmaru, M

    2001-07-01

    Arterial supply to the stomach of dogs indigenous to Bangladesh was investigated by using latex. The hepatic, left gastric and splenic arteries sent their major branches to the stomach. The cranial and caudal branches of the left gastric artery supplied the lesser curvature of the stomach. The right gastric, and right and left gastroepiploic arteries also sent their branches to both the lesser and greater curvatures. Six or seven short gastric arteries from the splenic artery supplied the greater curvature. Anastomoses between the left and right gastric, between the left and right gastroepiploic, and between short gastric arteries and left gastric arteries were observed.

  18. Congenital coronary artery fistula

    International Nuclear Information System (INIS)

    Oh, Yeon Hee; Kim, Hong; Zeon, Seoc Kil; Suh, Soo Jhi

    1986-01-01

    Congenital coronary artery fistula (CCAF) is communication of a coronary artery or its main branch with one of the atria or ventricles, the coronary sinus, the superior vena cava, or the pulmonary artery. In Korean peoples, only 4 cases of the CCAF were reported as rare as worldwide and authors want to report another case of CCAF, confirmed by operation. 10-year-old girl shows a fistula between sinus node artery of the right coronary artery and right atrium on root aortogram with left-to-right shunt and Qp/Qs=1.58, in which simple ligation of the sinus node artery from right coronary artery was performed. All of the 5 Korean CCAF (4 were previously reported and 1 of authors) were originated from right coronary artery, and of which 4 were opening into right ventricle and 1 of authors were into right atrium. Associated cardiac anomaly was noted in only 1 case as single coronary artery. Ages were from 9 months of age to 10 years old and no adult left case were found. 3 were female and 2 were male patients.

  19. Bundle Branch Block

    Science.gov (United States)

    ... known cause. Causes can include: Left bundle branch block Heart attacks (myocardial infarction) Thickened, stiffened or weakened ... myocarditis) High blood pressure (hypertension) Right bundle branch block A heart abnormality that's present at birth (congenital) — ...

  20. Neuro-Oncology Branch

    Science.gov (United States)

    ... BTTC are experts in their respective fields. Neuro-Oncology Clinical Fellowship This is a joint program with ... can increase survival rates. Learn more... The Neuro-Oncology Branch welcomes Dr. Mark Gilbert as new Branch ...

  1. [Achilles tendon rupture].

    Science.gov (United States)

    Thermann, H; Hüfner, T; Tscherne, H

    2000-03-01

    The treatment of acute of Achilles tendon rupture experienced a dynamic development in the last ten years. Decisive for this development was the application of MRI and above all the ultrasonography in the diagnostics of the pathological changes and injuries of tendons. The question of rupture morphology as well as different courses of healing could be now evaluated objectively. These advances led consequently to new modalities in treatment concepts and rehabilitation protocols. The decisive input for improvements of the outcome results and particularly the shortening of the rehabilitation period came with introduction of the early functional treatment in contrast to immobilizing plaster treatment. In a prospective randomized study (1987-1989) at the Trauma Dept. of the Hannover Medical School could show no statistical differences comparing functional non-operative with functional operative therapy with a special therapy boot (Variostabil/Adidas). The crucial criteria for therapy selection results from the sonographically measured position of the tendon stumps in plantar flexion (20 degrees). With complete adaptation of the tendons' ends surgical treatment does not achieve better results than non-operative functional treatment in term of tendon healing and functional outcome. Regarding the current therapeutic standards each method has is advantages and disadvantages. Both, the operative and non-operative functional treatment enable a stable tendon healing with a low risk of re-rupture (1-2%). Meanwhile there is consensus for early functional after-treatment of the operated Achilles' tendons. There seems to be a trend towards non-operative functional treatment in cases of adequate sonographical findings, or to minimal invasive surgical techniques.

  2. Slow rupture of frictional interfaces

    OpenAIRE

    Sinai, Yohai Bar; Brener, Efim A.; Bouchbinder, Eran

    2011-01-01

    The failure of frictional interfaces and the spatiotemporal structures that accompany it are central to a wide range of geophysical, physical and engineering systems. Recent geophysical and laboratory observations indicated that interfacial failure can be mediated by slow slip rupture phenomena which are distinct from ordinary, earthquake-like, fast rupture. These discoveries have influenced the way we think about frictional motion, yet the nature and properties of slow rupture are not comple...

  3. The artery blood supply variant of the upper limb

    Science.gov (United States)

    MASLARSKI, IVAN

    2015-01-01

    Variations of arterial patterns in the upper limb have represented the most common subject of vascular anatomy. Different types of artery branching pattern of the upper limb are very important for orthopedists in angiographic and microvascular surgical practice. The brachial artery (BA) is the most important vessel in the normal vascular anatomy of the upper limb. The classical pattern of the palmar hand region distribution shows the superficial palmar arch. Normally this arch is formed by the superficial branch of the ulnar artery and completed on the lateral side by one of these arteries: the superficial palmar branch of the radial artery, the princeps pollicis artery, the superficial palmar branch of the radial artery or the median artery. After the routine dissection of the right upper limb of an adult male cadaver, we found a very rare variant of the superficial arch artery – a division in a higher level brachial artery. We found this division at 10.4 cm from the beginning of the brachial artery. This superficial brachial artery became a radial artery and was not involved in the formation of the palm arch. In the forearm region, the artery variant was present with the median artery and the ulnar artery, which form the superficial palm arch. PMID:26733754

  4. Outcome of emergency endovascular treatment of large internal iliac artery aneurysms with guidewires

    International Nuclear Information System (INIS)

    Cambj-Sapunar, Liana; Maskovic, Josip; Brkljacic, Boris; Radonic, Vedran; Dragicevic, Dragan; Ajduk, Marko

    2010-01-01

    Purpose: Guidewires have been reported as a useful occlusion material for large aneurysms of different locations with good short-term results. In this study we retrospectively evaluate long-term results of emergency embolization technique with guidewires in symptomatic internal iliac artery aneurysm (IIAA) impending rupture. Patients and methods: In four patients presented with acute abdominal pain, multidetector computed tomography revealed unstable, 7-14 cm large, IIAAs. Two patients were treated with coil embolization of distal branches followed by occlusion of aneurysmal sac with guidewires. In two patients embolization of aneurysmal sac alone was performed. Results: In three patients complete or near complete occlusion of the aneurysmal sac was achieved and abdominal pain ceased within hours. Two patients treated with embolization of distal iliac artery branches and aneurysmal sac developed claudication that lasted up to 1 year. Their aneurysms remained thrombosed and they were without symptoms until they died 31 and 56 months later of causes unrelated to IIAA. Two patients treated with embolization of the aneurysm alone were free of ischemic symptoms. Because of incomplete embolization of the sac in one patient open surgery treatment in a non-emergency setting was performed. Complete filling of aneurysmal sac was achieved in other patient but 2 years later his aneurysm re-opened and required open surgery treatment. Conclusion: Embolization of aneurysmal sac of large IIAA with guidewires may be effective for immediate treatment of impending rupture. Long-term results were better when embolization of the aneurysmal sac was combined with embolization of distal IIA branches.

  5. Branched polynomial covering maps

    DEFF Research Database (Denmark)

    Hansen, Vagn Lundsgaard

    1999-01-01

    A Weierstrass polynomial with multiple roots in certain points leads to a branched covering map. With this as the guiding example, we formally define and study the notion of a branched polynomial covering map. We shall prove that many finite covering maps are polynomial outside a discrete branch...... set. Particular studies are made of branched polynomial covering maps arising from Riemann surfaces and from knots in the 3-sphere....

  6. Slow rupture of frictional interfaces

    Science.gov (United States)

    Bar Sinai, Yohai; Brener, Efim A.; Bouchbinder, Eran

    2012-02-01

    The failure of frictional interfaces and the spatiotemporal structures that accompany it are central to a wide range of geophysical, physical and engineering systems. Recent geophysical and laboratory observations indicated that interfacial failure can be mediated by slow slip rupture phenomena which are distinct from ordinary, earthquake-like, fast rupture. These discoveries have influenced the way we think about frictional motion, yet the nature and properties of slow rupture are not completely understood. We show that slow rupture is an intrinsic and robust property of simple non-monotonic rate-and-state friction laws. It is associated with a new velocity scale cmin, determined by the friction law, below which steady state rupture cannot propagate. We further show that rupture can occur in a continuum of states, spanning a wide range of velocities from cmin to elastic wave-speeds, and predict different properties for slow rupture and ordinary fast rupture. Our results are qualitatively consistent with recent high-resolution laboratory experiments and may provide a theoretical framework for understanding slow rupture phenomena along frictional interfaces.

  7. Coronary Artery Anomalies in Animals

    Directory of Open Access Journals (Sweden)

    Brian A. Scansen

    2017-04-01

    Full Text Available Coronary artery anomalies represent a disease spectrum from incidental to life-threatening. Anomalies of coronary artery origin and course are well-recognized in human medicine, but have received limited attention in veterinary medicine. Coronary artery anomalies are best described in the dog, hamster, and cow though reports also exist in the horse and pig. The most well-known anomaly in veterinary medicine is anomalous coronary artery origin with a prepulmonary course in dogs, which limits treatment of pulmonary valve stenosis. A categorization scheme for coronary artery anomalies in animals is suggested, dividing these anomalies into those of major or minor clinical significance. A review of coronary artery development, anatomy, and reported anomalies in domesticated species is provided and four novel canine examples of anomalous coronary artery origin are described: an English bulldog with single left coronary ostium and a retroaortic right coronary artery; an English bulldog with single right coronary ostium and transseptal left coronary artery; an English bulldog with single right coronary ostium and absent left coronary artery with a prepulmonary paraconal interventricular branch and an interarterial circumflex branch; and a mixed-breed dog with tetralogy of Fallot and anomalous origin of all coronary branches from the brachiocephalic trunk. Coronary arterial fistulae are also described including a coronary cameral fistula in a llama cria and an English bulldog with coronary artery aneurysm and anomalous shunting vessels from the right coronary artery to the pulmonary trunk. These examples are provided with the intent to raise awareness and improve understanding of such defects.

  8. Retinal artery occlusion during carotid artery stenting with distal embolic protection device.

    Science.gov (United States)

    Kohara, Kotaro; Ishikawa, Tatsuya; Kobayashi, Tomonori; Kawamata, Takakazu

    2018-01-01

    Retinal artery occlusion associated with carotid artery stenosis is well known. Although it can also occur at the time of carotid artery stenting, retinal artery occlusion via the collateral circulation of the external carotid artery is rare. We encountered two cases of retinal artery occlusion that were thought to be caused by an embolus from the external carotid artery during carotid artery stenting with a distal embolic protection device for the internal carotid artery. A 71-year-old man presented with central retinal artery occlusion after carotid artery stenting using the Carotid Guardwire PS and a 77-year-old man presented with branch retinal artery occlusion after carotid artery stenting using the FilterWire EZ. Because additional new cerebral ischaemic lesions were not detected in either case by postoperative diffusion-weighted magnetic resonance imaging, it was highly likely that the debris that caused retinal artery occlusion passed through not the internal carotid artery but collaterals to retinal arteries from the external carotid artery, which was not protected by a distal embolic protection device. It is suggested that a distal protection device for the internal carotid artery alone cannot prevent retinal artery embolisation during carotid artery stenting and protection of the external carotid artery is important to avoid retinal artery occlusion.

  9. Arterial supply of the stomach of the Egyptian native goat

    Directory of Open Access Journals (Sweden)

    Reda Mohamed

    2017-03-01

    Full Text Available Objective: This study was conducted to investigate the origin, course and distribution of the arteries supplying the stomach of the goat which is of extreme clinical importance for surgeon during caprine rumenotomy. Materials and methods: Fifteen adult goats were used in this study to demonstrate the arterial supply of the stomach by injection of the thoracic aorta with red gum milk latex after general anesthesia and slaughtering of the animals. Gross dissection of the arteries of the stomach was done to detect the origin, course and distribution of these arteries. Results: The study revealed that the rumen was richly supplied by the right and left ruminal arteries as well as ruminal branches from the reticular artery. The reticulum was supplied with reticular branches of reticular and accessory reticular arteries. The omasum was vascularized by omasal branches of the left gastric artery. While the abomasum received its entire arterial supply from abomasal branches of the left gastric, left gastroepiploic, right gastric and right gastroepiploic arteries. Conclusion: The stomach of the goat receives its arterial supply from the branches of the right ruminal, left ruminal, reticular, left gastric and hepatic arteries. Rumenotomy could be done in the left aspect of the dorsal ruminal sac, between the area of anastomoses of the terminal branches of the left and right ruminal arteries as the blood supply was minimal, so that bleeding will be low. [J Adv Vet Anim Res 2017; 4(1.000: 80-87

  10. Atherosclerotic plaque rupture and thrombosis. Evolving concepts.

    Science.gov (United States)

    Fuster, V; Stein, B; Ambrose, J A; Badimon, L; Badimon, J J; Chesebro, J H

    1990-09-01

    Rupture of an atherosclerotic plaque associated with partial or complete thrombotic vessel occlusion is fundamental to the development of ischemic coronary syndromes. Plaques that produce only mild-to-moderate angiographic luminal stenosis are frequently those that undergo abrupt disruption, leading to unstable angina or acute myocardial infarction. Plaques with increased lipid content appear more prone to rupture, particularly when the lipid pool is localized eccentrically within the intima. Macrophages appear to play an important role in atherogenesis, perhaps by participating in the uptake and metabolism of lipoproteins, secretion of growth factors, and production of enzymes and toxic metabolites that may facilitate plaque rupture. In addition, the particular composition or configuration of a plaque and the hemodynamic forces to which it is exposed may determine its susceptibility to disruption. Exposure of collagen, lipids, and smooth muscle cells after plaque rupture leads to the activation of platelets and the coagulation cascade system. The resulting thrombus may lead to marked reduction in myocardial perfusion and the development of an unstable coronary syndrome, or it may become organized and incorporated into the diseased vessel, thus contributing to the progression of atherosclerosis. In unstable angina, plaque disruption leads to thrombosis, which is usually labile and results in only a transient reduction in myocardial perfusion. Release of vasoactive substances, arterial spasm, or increases in myocardial oxygen demand may contribute to ischemia. In acute myocardial infarction, plaque disruption results in a more persistent thrombotic vessel occlusion; the extent of necrosis depends on the size of the artery, the duration of occlusion, the presence of collateral flow, and the integrity of the fibrinolytic system. Thrombi that undergo lysis expose a highly thrombogenic surface to the circulating blood, which has the capacity of activating platelets and

  11. Branched polynomial covering maps

    DEFF Research Database (Denmark)

    Hansen, Vagn Lundsgaard

    2002-01-01

    A Weierstrass polynomial with multiple roots in certain points leads to a branched covering map. With this as the guiding example, we formally define and study the notion of a branched polynomial covering map. We shall prove that many finite covering maps are polynomial outside a discrete branch ...... set. Particular studies are made of branched polynomial covering maps arising from Riemann surfaces and from knots in the 3-sphere. (C) 2001 Elsevier Science B.V. All rights reserved.......A Weierstrass polynomial with multiple roots in certain points leads to a branched covering map. With this as the guiding example, we formally define and study the notion of a branched polynomial covering map. We shall prove that many finite covering maps are polynomial outside a discrete branch...

  12. Vortex dynamics in ruptured and unruptured intracranial aneurysms

    Science.gov (United States)

    Trylesinski, Gabriel

    Intracranial aneurysms (IAs) are a potentially devastating pathological dilation of brain arteries that affect 1.5-5 % of the population. Causing around 500 000 deaths per year worldwide, their detection and treatment to prevent rupture is critical. Multiple recent studies have tried to find a hemodynamics predictor of aneurysm rupture, but concluded with distinct opposite trends using Wall Shear Stress (WSS) based parameters in different clinical datasets. Nevertheless, several research groups tend to converge for now on the fact that the flow patterns and flow dynamics of the ruptured aneurysms are complex and unstable. Following this idea, we investigated the vortex properties of both unruptured and ruptured cerebral aneurysms. A brief comparison of two Eulerian vortex visualization methods (Q-criterion and lambda 2 method) showed that these approaches gave similar results in our complex aneurysm geometries. We were then able to apply either one of them to a large dataset of 74 patient specific cases of intracranial aneurysms. Those real cases were obtained by 3D angiography, numerical reconstruction of the geometry, and then pulsatile CFD simulation before post-processing with the mentioned vortex visualization tools. First we tested the two Eulerian methods on a few cases to verify their implementation we made as well as compare them with each other. After that, the Q-criterion was selected as method of choice for its more obvious physical meaning (it shows the balance between two characteristics of the flow, its swirling and deformation). Using iso-surfaces of Q, we started by categorizing the patient-specific aneurysms based on the gross topology of the aneurysmal vortices. This approach being unfruitful, we found a new vortex-based characteristic property of ruptured aneurysms to stratify the rupture risk of IAs that we called the Wall-Kissing Vortices, or WKV. We observed that most ruptured aneurysms had a large amount of WKV, which appears to agree with

  13. Untreated silicone breast implant rupture

    DEFF Research Database (Denmark)

    Hölmich, Lisbet R; Vejborg, Ilse M; Conrad, Carsten

    2004-01-01

    Implant rupture is a well-known complication of breast implant surgery that can pass unnoticed by both patient and physician. To date, no prospective study has addressed the possible health implications of silicone breast implant rupture. The aim of the present study was to evaluate whether untre...

  14. Duplication of Inferior Gluteal Artery and Course of Superior Gluteal Artery Through the Lumbosacral Trunk

    Directory of Open Access Journals (Sweden)

    Satheesha Nayak B

    2017-07-01

    Full Text Available Internal iliac artery (IIA shows great deal of variations in its branching pattern. The knowledge of its variant branches is required for successful surgical, orthopedic, plastic surgery and radiological procedures. We observed variations of some of the branches of right IIA in an adult male cadaver. The iliolumbar artery originated from the main trunk of the IIA. After this, IIA divided into anterior and posterior divisions. The posterior division gave lateral sacral and superior gluteal arteries. Superior gluteal artery pierced the lumbosacral trunk before leaving the pelvis. The anterior division further divided into anterior and posterior trunks. Anterior trunk gave rise to superior vesical, inferior vesical, middle rectal and obturator arteries. The posterior trunk gave two inferior gluteal arteries and an internal pudendal artery.

  15. Aortic rupture during aortoplasty in Takayasu arteritis – A rare complication: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Vimal Mehta

    2014-05-01

    Full Text Available Balloon angioplasty of the stenosed aorta is usually a relatively simple, yet potentially a catastrophic procedure. Aortic rupture during aortoplasty, though uncommon, carries a high mortality. We report case of a 39-year-old female with aortoarteritis with multiple arterial stenoses whose infra-renal abdominal aorta ruptured during balloon dilatation of the stent deployed in that segment. The site of aortic rupture was temporarily occluded by low-pressure inflation of the same balloon and then was sealed using a stent-graft introduced by contra-lateral femoral arterial access.

  16. Morphological parameters associated with ruptured posterior communicating aneurysms.

    Science.gov (United States)

    Ho, Allen; Lin, Ning; Charoenvimolphan, Nareerat; Stanley, Mary; Frerichs, Kai U; Day, Arthur L; Du, Rose

    2014-01-01

    The rupture risk of unruptured intracranial aneurysms is known to be dependent on the size of the aneurysm. However, the association of morphological characteristics with ruptured aneurysms has not been established in a systematic and location specific manner for the most common aneurysm locations. We evaluated posterior communicating artery (PCoA) aneurysms for morphological parameters associated with aneurysm rupture in that location. CT angiograms were evaluated to generate 3-D models of the aneurysms and surrounding vasculature. Univariate and multivariate analyses were performed to evaluate morphological parameters including aneurysm volume, aspect ratio, size ratio, distance to ICA bifurcation, aneurysm angle, vessel angles, flow angles, and vessel-to-vessel angles. From 2005-2012, 148 PCoA aneurysms were treated in a single institution. Preoperative CTAs from 63 patients (40 ruptured, 23 unruptured) were available and analyzed. Multivariate logistic regression revealed that smaller volume (p = 0.011), larger aneurysm neck diameter (0.048), and shorter ICA bifurcation to aneurysm distance (p = 0.005) were the most strongly associated with aneurysm rupture after adjusting for all other clinical and morphological variables. Multivariate subgroup analysis for patients with visualized PCoA demonstrated that larger neck diameter (p = 0.018) and shorter ICA bifurcation to aneurysm distance (p = 0.011) were significantly associated with rupture. Intracerebral hemorrhage was associated with smaller volume, larger maximum height, and smaller aneurysm angle, in addition to lateral projection, male sex, and lack of hypertension. We found that shorter ICA bifurcation to aneurysm distance is significantly associated with PCoA aneurysm rupture. This is a new physically intuitive parameter that can be measured easily and therefore be readily applied in clinical practice to aid in the evaluation of patients with PCoA aneurysms.

  17. Visceral artery aneurysms: Incidence, management, and outcome analysis in a tertiary care center over one decade

    Energy Technology Data Exchange (ETDEWEB)

    Pitton, Michael B.; Dappa, Evelyn; Jungmann, Florian; Kloeckner, Roman; Schotten, Sebastian; Wirth, Gesine M.; Mildenberger, Peter; Kreitner, Karl-Friedrich; Oberholzer, Katja; Dueber, Christoph [University Hospital of Mainz, Department of Diagnostic and Interventional Radiology, Mainz (Germany); Mittler, Jens; Lang, Hauke [University Hospital of Mainz, Department of Abdominal, Visceral and Transplantation Surgery, Mainz (Germany)

    2015-07-15

    To evaluate the incidence, management, and outcome of visceral artery aneurysms (VAA) over one decade. 233 patients with 253 VAA were analyzed according to location, diameter, aneurysm type, aetiology, rupture, management, and outcome. VAA were localized at the splenic artery, coeliac trunk, renal artery, hepatic artery, superior mesenteric artery, and other locations. The aetiology was degenerative, iatrogenic after medical procedures, connective tissue disease, and others. The rate of rupture was much higher in pseudoaneurysms than true aneurysms (76.3 % vs.3.1 %). Fifty-nine VAA were treated by intervention (n = 45) or surgery (n = 14). Interventions included embolization with coils or glue, covered stents, or combinations of these. Thirty-five cases with ruptured VAA were treated on an emergency basis. There was no difference in size between ruptured and non-ruptured VAA. After interventional treatment, the 30-day mortality was 6.7 % in ruptured VAA compared to no mortality in non-ruptured cases. Follow-up included CT and/or MRI after a mean period of 18.0 ± 26.8 months. The current status of the patient was obtained by a structured telephone survey. Pseudoaneurysms of visceral arteries have a high risk for rupture. Aneurysm size seems to be no reliable predictor for rupture. Interventional treatment is safe and effective for management of VAA. (orig.)

  18. Spontaneous and traumatic hepatic rupture: imaging findings and minimally invasive treatment; Ruptura hepatica espontanea e traumatica: aspectos tomograficos e do tratamento minimamente invasivo

    Energy Technology Data Exchange (ETDEWEB)

    Palacio, Glaucia Andrade e Silva; D' Ippolito, Giuseppe [Hospital Sao Luis, Sao Paulo, SP (Brazil). Setor de Disgnostico por Imagem]. E-mail: gl.palacio@bol.com.br; Farias, Andre P. [Hospital Sao Luis, Sao Paulo, SP (Brazil). Setor de Tomografia Computadorizada e Ressonancia Magnetica; Carnevale, Francisco Cesar [Hospital Sao Luis, Sao Paulo, SP (Brazil). Setor de Radiologia Intervencionista; Salem, Marcelo Zindel [Hospital Sao Luis, Sao Paulo, SP (Brazil). Setor de Gastroenterologia Cirurgica; Ricca, Artur Berti [Hospital Sao Luis, Sao Paulo, SP (Brazil)

    2003-12-01

    Spontaneous hepatic bleeding is a rare condition. Our aim was to describe the imaging findings and minimally invasive treatment using transcatheter arterial embolization in patients with spontaneous and traumatic hepatic rupture. Three patients presented acute hemoperitoneum dur to hepatic rupture caused by spontaneous rupture of hepatocellular carcinoma, HELLP syndrome and a blunt hepatic trauma. The patients were submitted to ultrasound and computed tomography of the abdomen and subsequently treated by transcatheter arterial embolization. All patients underwent helical computed tomography before and after treatments. Computed tomography played an important role in the evaluation and follow-up in the therapeutic intervention. Different types of liver injuries were identified. Transcatheter arterial embolization blocked arterial hemorrhage in the patients who were hemodynamically unstable. The conclusion was: transcatheter arterial embolization is an effective and well-tolerated treatment method for the management of hepatic rupture and computed tomography is an excellent method for the diagnosis and follow-up of these patients. (author)

  19. Mathematical modeling of coupled drug and drug-encapsulated nanoparticle transport in patient-specific coronary artery walls

    KAUST Repository

    Hossain, Shaolie S.; Hossainy, Syed F A; Bazilevs, Yuri; Calo, Victor M.; Hughes, Thomas Jr R

    2011-01-01

    The majority of heart attacks occur when there is a sudden rupture of atherosclerotic plaque, exposing prothrombotic emboli to coronary blood flow, forming clots that can cause blockages of the arterial lumen. Diseased arteries can be treated

  20. Blunt traumatic diaphragmatic rupture

    Directory of Open Access Journals (Sweden)

    Antonio Carlos Nogueira

    2011-09-01

    Full Text Available Traumatic injury of the diaphragm ranges from 0.6 to 1.2% and rise up to 5%among patients who were victims of blunt trauma and underwent laparotomy.Clinical suspicion associated with radiological assessment contributes to earlydiagnosis. Isolated diaphragmatic injury has a good prognosis. Generallyworse outcomes are associated with other trauma injuries. Bilateral andright diaphragmatic lesions have worse prognosis. Multi detector computed tomography (MDCT scan of the chest and abdomen provides better diagnosticaccuracy using the possibility of image multiplanar reconstruction. Surgicalrepair via laparotomy and/ or thoracotomy in the acute phase of the injury hasa better outcome and avoids chronic complications of diaphragmatic hernia.The authors present the case of a young male patient, victim of blunt abdominaltrauma due to motor vehicle accident with rupture of the diaphragm, spleenand kidney injuries. The diagnosis was made by computed tomography of thethorax and abdomen and was confirmed during laparotomy.

  1. Onyx combined with coiling embolization for endovascular treatment of complex intracranial ruptured aneurysms

    International Nuclear Information System (INIS)

    Wu Yongfa; Huang Qinghai; Yang Pengfei; Zhang Lei; Li Qiang; Liu Jianmin

    2011-01-01

    Objective: To study the therapeutic effect of Onyx combined with stent-assisted coiling in embolizing complex intracranial ruptured aneurysms. Methods: Onyx combined with stent-assisted coiling embolization was conducted in two patients with complex intracranial ruptured aneurysms. The clinical data were retrospectively analyzed. The related literature concerning intracranial complex aneurysm treated with Onyx was reviewed. Results: Two intracranial complex aneurysms were embolized with Onyx together with coils. The lesions were located at internal carotid arterial bifurcation (n=1) and at the anterior wall of internal carotid artery (n=1). Complete embolization of the aneurysms was achieved immediately after the procedure while the parent arteries remained patent. Conclusion: For the treatment of complex intracranial ruptured aneurysms Onyx combined with coiling embolization is safe, effective and feasible. This technique can improve the degree of embolization. To make the evaluation of the long-term efficacy further study is needed. (authors)

  2. Arterial vascularization of the pineal gland.

    Science.gov (United States)

    Kahilogullari, Gokmen; Ugur, Hasan Caglar; Comert, Ayhan; Brohi, Recep Ali; Ozgural, Onur; Ozdemir, Mevci; Karahan, Suleyman Tuna

    2013-10-01

    The arterial vascularization of the pineal gland (PG) remains a debatable subject. This study aims to provide detailed information about the arterial vascularization of the PG. Thirty adult human brains were obtained from routine autopsies. Cerebral arteries were separately cannulated and injected with colored latex. The dissections were carried out using a surgical microscope. The diameters of the branches supplying the PG at their origin and vascularization areas of the branches of the arteries were investigated. The main artery of the PG was the lateral pineal artery, and it originated from the posterior circulation. The other arteries included the medial pineal artery from the posterior circulation and the rostral pineal artery mainly from the anterior circulation. Posteromedial choroidal artery was an important artery that branched to the PG. The arterial supply to the PG was studied comprehensively considering the debate and inadequacy of previously published studies on this issue available in the literature. This anatomical knowledge may be helpful for surgical treatment of pathologies of the PG, especially in children who develop more pathology in this region than adults.

  3. Mycotic Aneurysm of the Celiac Trunk: From Early CT Sign to Rupture

    International Nuclear Information System (INIS)

    Serafino, Gianpiero; Vroegindeweij, Dammis; Boks, Simone; Harst, Erwin van der

    2005-01-01

    We present a case of the rapid development and rupture of a mycotic celiac trunk aneurysm. Initiallyon multislice computed tomography (ms-CT) there was a normal celiac trunk with minimal haziness of the surrounding fat. Only 2 weeks later the patient went into hypovolemic shock due to a ruptured celiac aneurysm. Although aneurysms of the visceral arteries are rare, they are of major clinical importance as they carry a life-threatening risk of rupture. This case illustrates the use of ms-CT in detecting and evaluating visceral aneurysms, in order to prevent emergency operation

  4. Clinical outcome of nonculprit plaque ruptures in patients with acute coronary syndrome in the PROSPECT study.

    Science.gov (United States)

    Xie, Yong; Mintz, Gary S; Yang, Junqing; Doi, Hiroshi; Iñiguez, Andrés; Dangas, George D; Serruys, Patrick W; McPherson, John A; Wennerblom, Bertil; Xu, Ke; Weisz, Giora; Stone, Gregg W; Maehara, Akiko

    2014-04-01

    The aim of this study was to report the frequency, patient and lesion-related characteristics, and outcomes of subclinical, nonculprit plaque ruptures in the PROSPECT (Providing Regional Observations to Study Predictors of Events in the Coronary Tree) study. Plaque rupture and subsequent thrombosis is the most common cause of acute coronary syndrome (ACS). Secondary, subclinical, nonculprit plaque ruptures have been seen in both stable patients and patients with ACS; however, reports of the natural history of these secondary plaque ruptures are limited. After successful stenting in 697 patients with ACS, 3-vessel grayscale and intravascular ultrasound virtual histology (IVUS-VH) was performed in the proximal-mid segments of all 3 coronary arteries as part of a prospective multicenter study. Among 660 patients with complete IVUS data, 128 plaque ruptures were identified in 105 nonculprit lesions in 100 arteries from 93 patients (14.1%). Although the minimum lumen area (MLA) was similar, the plaque burden was significantly greater in nonculprit lesions with a plaque rupture compared with nonculprit lesions without a plaque rupture (66.0% [95% confidence interval: 64.5% to 67.4%] vs. 56.0% [95% confidence interval: 55.6% to 56.4%]; p PROSPECT]; NCT00180466). Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  5. Morphological description of collateral branches from the abdominal aorta of lesser anteater (Tamandua tetradactyla

    Directory of Open Access Journals (Sweden)

    Breno Costa Macedo

    2013-03-01

    Full Text Available Tamandua tetradactyla, Xenarthra, is a native species from South America which, due to the few number of studies on its biology, still has many unknown aspects in its morphology. Taking into account the importance of morphological data for various studies, this paper aimed to elucidate the branching of the abdominal aorta in this species to foster the development of further studies. To do this, 4 specimens were used, 2 male and 2 female, all young, from the Bauxite Mine – Paragominas, Para, Brazil, donated after death due to running over to the Animal Morphology Research Laboratory (LaPMA of Universidade Federal Rural da Amazonia (UFRA. The arterial system was filled with contrasted latex and the animals were fixed in a formaldehyde solution (10%, and then dissected, in order to evidence the abdominal aorta and its collateral branches. The parietal branches consisted of 1 pair of caudal phrenic arteries, 2 pairs of intercostal arteries, and 3 pairs of lumbar arteries. Among the visceral branches, stood out: celiac artery; cranial mesenteric artery; adrenal arteries; renal arteries; caudal mesenteric artery; and external, internal, and median sacral iliac arteries, formed from the final portion of the abdominal aorta. Testicular and ovarian arteries originated from the renal arteries, differing from that described in various species.

  6. Geologic Inheritance and Earthquake Rupture Processes: The 1905 M ≥ 8 Tsetserleg-Bulnay Strike-Slip Earthquake Sequence, Mongolia

    Science.gov (United States)

    Choi, Jin-Hyuck; Klinger, Yann; Ferry, Matthieu; Ritz, Jean-François; Kurtz, Robin; Rizza, Magali; Bollinger, Laurent; Davaasambuu, Battogtokh; Tsend-Ayush, Nyambayar; Demberel, Sodnomsambuu

    2018-02-01

    In 1905, 14 days apart, two M 8 continental strike-slip earthquakes, the Tsetserleg and Bulnay earthquakes, occurred on the Bulnay fault system, in Mongolia. Together, they ruptured four individual faults, with a total length of 676 km. Using submetric optical satellite images "Pleiades" with ground resolution of 0.5 m, complemented by field observation, we mapped in detail the entire surface rupture associated with this earthquake sequence. Surface rupture along the main Bulnay fault is 388 km in length, striking nearly E-W. The rupture is formed by a series of fault segments that are 29 km long on average, separated by geometric discontinuities. Although there is a difference of about 2 m in the average slip between the western and eastern parts of the Bulnay rupture, along-fault slip variations are overall limited, resulting in a smooth slip distribution, except for local slip deficit at segment boundaries. We show that damage, including short branches and secondary faulting, associated with the rupture propagation, occurred significantly more often along the western part of the Bulnay rupture, while the eastern part of the rupture appears more localized and thus possibly structurally simpler. Eventually, the difference of slip between the western and eastern parts of the rupture is attributed to this difference of rupture localization, associated at first order with a lateral change in the local geology. Damage associated to rupture branching appears to be located asymmetrically along the extensional side of the strike-slip rupture and shows a strong dependence on structural geologic inheritance.

  7. Bilateral Internal Carotid Artery Occlusion, External Carotid Artery Stenosis, and Vertebral Artery Kinking: May It Be Asymptomatic?

    Science.gov (United States)

    Fatic, Nikola; Jaffer, Usman; Ivana, Saicic; Gordana, Globarevic-Vukcevic; Markovic, Dragan; Kostic, Dusan; Davidovic, Lazar

    2017-10-01

    The clinical spectrum of internal carotid artery occlusion ranges from being a completely asymptomatic occlusion to a devastating stroke or death. The prevalence of asymptomatic internal carotid artery occlusion is unknown, particularly for bilateral occlusion. The distal branches of the external carotid artery anastomose with distal branches of the internal carotid artery provide important sources of collateral circulation to the brain. Stenosis of the external carotid artery with ipsilateral/bilateral internal occlusion may result in ischemic sequelae. Coiling or kinking of the vertebral artery is a rare morphological entity that is infrequently reported because it remains asymptomatic and has no clinical relevance. Currently, there is little evidence to support management strategies for this disease entity and no official recommendations for asymptomatic bilateral carotid artery occlusion. We present a case of a 62-year-old female with asymptomatic bilateral internal carotid artery occlusion, bilateral external carotid artery stenoses, and bilateral kinking of the vertebral artery at the V2 segment, who has been successfully managed conservatively for over 5 years. An individualized approach to management of patients with bilateral internal carotid artery occlusion, especially in combination with external carotid artery stenosis and elongation malformations of the vertebral artery is key to a successful strategy. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Entanglement branching operator

    Science.gov (United States)

    Harada, Kenji

    2018-01-01

    We introduce an entanglement branching operator to split a composite entanglement flow in a tensor network which is a promising theoretical tool for many-body systems. We can optimize an entanglement branching operator by solving a minimization problem based on squeezing operators. The entanglement branching is a new useful operation to manipulate a tensor network. For example, finding a particular entanglement structure by an entanglement branching operator, we can improve a higher-order tensor renormalization group method to catch a proper renormalization flow in a tensor network space. This new method yields a new type of tensor network states. The second example is a many-body decomposition of a tensor by using an entanglement branching operator. We can use it for a perfect disentangling among tensors. Applying a many-body decomposition recursively, we conceptually derive projected entangled pair states from quantum states that satisfy the area law of entanglement entropy.

  9. Branches of the abdominal aorta in Aotus azarae infulatus

    Directory of Open Access Journals (Sweden)

    Bianca Mendonça Faria

    2016-05-01

    The genus Aotus is found in South America and is known for its nocturnal habit. The morphology of the genus is poorly understood even though it is used in biomedical research. The objective of this study was to identify the collateral branches of the abdominal aorta of two females and one male Aotus azarae infulatus (commonly known as the night monkey. The vessels were observed and stained with Neoprene latex and radiopaque contrast. The animals were fixed in an aqueous solution of 10% formaldehyde via intramuscular and intracavitary routes, dissected and radiographed. It was observed that the celiac artery was divided into three subjacent branches, the gastric, hepatic and splenic arteries. The left and right renal arteries originated from a common trunk in two animals (animals 1 and 2, while the adrenal artery in one of the animals was derived from the celiac trunk and renal artery (animal 2. In one animal the mesenteric artery flow gave rise to individual cranial rectal, sigmoid and left colic arteries (animal 3. In the three animals the abdominal aorta bifurcated in the final portion of the abdomen, with the external and internal iliac artery on each side, and then the median sacral artery. These anatomical variations need to be identified and reported because these animals are frequently used in clinical and surgical, veterinary practices.

  10. Surgical approach to posterior inferior cerebellar artery aneurysms.

    Science.gov (United States)

    La Pira, Biagia; Sturiale, Carmelo Lucio; Della Pepa, Giuseppe Maria; Albanese, Alessio

    2018-02-01

    The far-lateral is a standardised approach to clip aneurysms of the posterior inferior cerebellar artery (PICA). Different variants can be adopted to manage aneurysms that differ in morphology, topography, ruptured status, cerebellar swelling and surgeon preference. We distinguished five paradigmatic approaches aimed to manage aneurysms that are: proximal unruptured; proximal ruptured requiring posterior fossa decompression (PFD); proximal ruptured not requiring PFD; distal unruptured; distal ruptured. Preoperative planning in the setting of PICA aneurysm surgery is of paramount importance to perform an effective and safe procedure, to ensure an adequate PFD and optimal proximal control before aneurysm manipulation.

  11. Simultaneous bilateral patellar tendon rupture ?

    OpenAIRE

    Moura, Diogo Lino; Marques, Jos? Pedro; Lucas, Francisco Manuel; Fonseca, Fernando Pereira

    2016-01-01

    Bilateral patellar tendon rupture is a rare entity, often associated with systemic diseases and patellar tendinopathy. The authors report a rare case of a 34-year-old man with simultaneous bilateral rupture of the patellar tendon caused by minor trauma. The patient is a retired basketball player with no past complaints of chronic knee pain and a history of steroid use. Surgical management consisted in primary end-to-end tendon repair protected temporarily with cerclage wiring, followed by a s...

  12. Perforating arteries originating from the posterior communicating artery: a 7.0-Tesla MRI study

    OpenAIRE

    Conijn, Mandy M. A.; Hendrikse, Jeroen; Zwanenburg, Jaco J. M.; Takahara, Taro; Geerlings, Mirjam I.; Mali, Willem P. Th. M.; Luijten, Peter R.

    2009-01-01

    The aim of this study was to investigate the ability of time-of-flight (TOF) magnetic resonance (MR) angiography at 7.0?Tesla to show the perforating branches of the posterior communicating artery (PCoA), and to investigate the presence of such visible perforating branches in relation to the size of the feeding PCoA. The secondary aim was to visualise and describe the anterior choroidal artery and the perforating branches of the P1-segment of posterior cerebral artery (P1). Forty-six healthy ...

  13. Physiologic assessment of coronary artery fistula

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, N.C.; Beauvais, J. (Creighton Univ., Omaha, NE (USA))

    1991-01-01

    Coronary artery fistula is an uncommon clinical entity. The most common coronary artery fistula is from the right coronary artery to the right side of the heart, and it is less frequent to the pulmonary artery. The effect of a coronary artery fistula may be physiologically significant because of the steal phenomenon resulting in coronary ischemia. Based on published reports, it is recommended that patients with congenital coronary artery fistulas be considered candidates for elective surgical correction to prevent complications including development of congestive heart failure, angina, subacute bacterial endocarditis, myocardial infarction, and coronary aneurysm formation with rupture or embolization. A patient is presented in whom treadmill-exercise thallium imaging was effective in determining the degree of coronary steal from a coronary artery fistula, leading to successful corrective surgery.

  14. Physiologic assessment of coronary artery fistula

    International Nuclear Information System (INIS)

    Gupta, N.C.; Beauvais, J.

    1991-01-01

    Coronary artery fistula is an uncommon clinical entity. The most common coronary artery fistula is from the right coronary artery to the right side of the heart, and it is less frequent to the pulmonary artery. The effect of a coronary artery fistula may be physiologically significant because of the steal phenomenon resulting in coronary ischemia. Based on published reports, it is recommended that patients with congenital coronary artery fistulas be considered candidates for elective surgical correction to prevent complications including development of congestive heart failure, angina, subacute bacterial endocarditis, myocardial infarction, and coronary aneurysm formation with rupture or embolization. A patient is presented in whom treadmill-exercise thallium imaging was effective in determining the degree of coronary steal from a coronary artery fistula, leading to successful corrective surgery

  15. The diagnosis of breast implant rupture

    DEFF Research Database (Denmark)

    Hölmich, Lisbet R; Vejborg, Ilse; Conrad, Carsten

    2005-01-01

    participated in either one or two study MRI examinations, aiming at determining the prevalence and incidence of silent implant rupture, respectively, and who subsequently underwent explantation. Implant rupture status was determined by four independent readers and a consensus diagnosis of either rupture...... were in fact ruptured at surgery. Thirty-four of the 43 intact implants were described as intact at surgery. When categorising possible ruptures as ruptures, there were one false positive and nine false negative rupture diagnoses at MRI yielding an accuracy of 92%, a sensitivity of 89...

  16. Ruptured Ectopic Pregnancy

    Directory of Open Access Journals (Sweden)

    Valentina Park

    2016-09-01

    Full Text Available History of present illness: A 21-year-old female presented with sudden onset suprapubic abdominal pain associated with dysuria. The patient also experienced near syncope during bowel movements three times three days ago without falling or losing consciousness. She denied fever, nausea, and vomiting. She stated that she was five weeks pregnant by last menstrual period. She had an ultrasound a few weeks before that showed no intrauterine pregnancy, but she had not followed up for additional testing. Significant findings: The patient’s serum beta-hCG was 5,637 mIU/mL. The transvaginal ultrasound showed an empty uterus with free fluid posteriorly in the pelvis and Pouch of Douglas (00:00. A 4.5 cm heterogeneous mass was visible in the left adnexa concerning for an ectopic pregnancy (00:10. Discussion: Ectopic pregnancies are a leading cause of maternal morbidity and mortality, as well as decreased fertility.1,2 Differentiating between an ectopic pregnancy and a normal early pregnancy may be difficult, since ultrasound and quantitative beta-hCG may show inconclusive results.3,4 Patients who have used fertility treatment may further complicate the picture because they are at risk for heterotypic pregnancies.5 Ectopic pregnancies most commonly implant in the fallopian tube, but may alternatively implant in the ovary, cervix, abdomen, or uterine cornua.4 Ultrasonography may show an empty uterus, adnexal mass, pelvic free fluid, or an extra-uterine gestational sac, yolk sac, and/or embryo.6 Treatment options for ectopic pregnancy include surgery or methotrexate.2,4 Some patients may be candidates for close outpatient surveillance if the diagnosis is unclear or in very limited cases for early, non-ruptured ectopic pregnancies.2,4

  17. Endovascular Repair of Thoracoabdominal and Arch Aneurysms in Patients with Connective Tissue Disease Using Branched and Fenestrated Devices.

    Science.gov (United States)

    Clough, Rachel E; Martin-Gonzalez, Teresa; Van Calster, Katrien; Hertault, Adrien; Spear, Rafaëlle; Azzaoui, Richard; Sobocinski, Jonathan; Haulon, Stéphan

    2017-10-01

    Prophylactic open surgery is the standard practice in patients with connective tissue and thoracoabdominal aortic aneurysm (TAAA) and aortic arch disease. Branched and fenestrated devices offer a less invasive alternative but there are concerns regarding the durability of the repair and the effect of the stent graft on the fragile aortic wall. The aim of this study is to evaluate mid-term outcomes of fenestrated and/or branched endografting in patients with connective tissue disease. All patients with connective tissue disease who underwent TAAA or arch aneurysm repair using a fenestrated and/or branched endograft in a single, high-volume center between 2004 and 2015 were included. Ruptured aneurysms and acute aortic dissections were excluded from this study, but not chronic aortic dissections. In total, 427 (403 pararenal and TAAAs, and 24 arch aneurysms) endovascular interventions were performed during the study period. Of these, 17 patients (4%) (16 TAAAs, 1 arch) had connective tissue disease. All patients were classified as unfit for open repair. The mean age was 51 ± 8 years. Thirteen patients with TAAA were treated with a fenestrated, 1 with a branched, and 2 with a combined fenestrated/branch device. A double inner branch device was used to treat the arch aneurysm. The technical success rate was 100% with no incidence of early mortality, spinal cord ischemia, stroke, or further dissection. Postoperative deterioration in renal function was seen in 3 patients (18.8%) and no hemodialysis was required. The mean follow-up was 3.4 years (0.3-7.4). Aneurysm sac shrinkage was seen in 35% of patients (6/17) and the sac diameter remained stable in 65% of patients (11/17). No sac or sealing zone enlargement was observed in any of the patients and there were no conversions to open repair. Reintervention was required in 1 patient at 2 years for bilateral renal artery occlusion (successful fibrinolysis). One type II endoleak (lumbar) is under surveillance and 1 type

  18. Poisson branching point processes

    International Nuclear Information System (INIS)

    Matsuo, K.; Teich, M.C.; Saleh, B.E.A.

    1984-01-01

    We investigate the statistical properties of a special branching point process. The initial process is assumed to be a homogeneous Poisson point process (HPP). The initiating events at each branching stage are carried forward to the following stage. In addition, each initiating event independently contributes a nonstationary Poisson point process (whose rate is a specified function) located at that point. The additional contributions from all points of a given stage constitute a doubly stochastic Poisson point process (DSPP) whose rate is a filtered version of the initiating point process at that stage. The process studied is a generalization of a Poisson branching process in which random time delays are permitted in the generation of events. Particular attention is given to the limit in which the number of branching stages is infinite while the average number of added events per event of the previous stage is infinitesimal. In the special case when the branching is instantaneous this limit of continuous branching corresponds to the well-known Yule--Furry process with an initial Poisson population. The Poisson branching point process provides a useful description for many problems in various scientific disciplines, such as the behavior of electron multipliers, neutron chain reactions, and cosmic ray showers

  19. Perforating arteries originating from the posterior communicating artery: a 7.0-Tesla MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Conijn, Mandy M.A.; Hendrikse, Jeroen; Takahara, Taro; Mali, Willem P.T.M. [University Medical Center Utrecht, Department of Radiology (Hp E 01.132), P.O. Box 85500, Utrecht (Netherlands); Zwanenburg, Jaco J.M. [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands); Geerlings, Mirjam I. [University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands); Luijten, Peter R. [University Medical Center Utrecht, Department of Radiology (Hp E 01.132), P.O. Box 85500, Utrecht (Netherlands); University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands)

    2009-12-15

    The aim of this study was to investigate the ability of time-of-flight (TOF) magnetic resonance (MR) angiography at 7.0 Tesla to show the perforating branches of the posterior communicating artery (PCoA), and to investigate the presence of such visible perforating branches in relation to the size of the feeding PCoA. The secondary aim was to visualise and describe the anterior choroidal artery and the perforating branches of the P1-segment of posterior cerebral artery (P1). Forty-six healthy volunteers underwent TOF MR angiography at 7.0 Tesla. With 7.0-Tesla imaging, we visualised for the first time perforating arteries originating from the PCoA in vivo without the use of contrast agents. A perforating artery from the PCoA was found in a large proportion of the PCoAs (64%). The presence was associated with a larger diameter of the underlying PCoA (1.23 versus 1.06 mm, P = 0.03). The anterior choroidal artery was visible bilaterally in all participants. In 83% of all P1s, one or two perforating branches were visible. Non-invasive assessment of the perforating arteries of the PCoA together with the anterior choroidal artery and the perforating arteries of the P1 may increase our understanding of infarcts in the deep brain structures supplied by these arteries. (orig.)

  20. Perforating arteries originating from the posterior communicating artery: a 7.0-Tesla MRI study

    International Nuclear Information System (INIS)

    Conijn, Mandy M.A.; Hendrikse, Jeroen; Takahara, Taro; Mali, Willem P.T.M.; Zwanenburg, Jaco J.M.; Geerlings, Mirjam I.; Luijten, Peter R.

    2009-01-01

    The aim of this study was to investigate the ability of time-of-flight (TOF) magnetic resonance (MR) angiography at 7.0 Tesla to show the perforating branches of the posterior communicating artery (PCoA), and to investigate the presence of such visible perforating branches in relation to the size of the feeding PCoA. The secondary aim was to visualise and describe the anterior choroidal artery and the perforating branches of the P1-segment of posterior cerebral artery (P1). Forty-six healthy volunteers underwent TOF MR angiography at 7.0 Tesla. With 7.0-Tesla imaging, we visualised for the first time perforating arteries originating from the PCoA in vivo without the use of contrast agents. A perforating artery from the PCoA was found in a large proportion of the PCoAs (64%). The presence was associated with a larger diameter of the underlying PCoA (1.23 versus 1.06 mm, P = 0.03). The anterior choroidal artery was visible bilaterally in all participants. In 83% of all P1s, one or two perforating branches were visible. Non-invasive assessment of the perforating arteries of the PCoA together with the anterior choroidal artery and the perforating arteries of the P1 may increase our understanding of infarcts in the deep brain structures supplied by these arteries. (orig.)

  1. Perforating arteries originating from the posterior communicating artery: a 7.0-Tesla MRI study.

    Science.gov (United States)

    Conijn, Mandy M A; Hendrikse, Jeroen; Zwanenburg, Jaco J M; Takahara, Taro; Geerlings, Mirjam I; Mali, Willem P Th M; Luijten, Peter R

    2009-12-01

    The aim of this study was to investigate the ability of time-of-flight (TOF) magnetic resonance (MR) angiography at 7.0 Tesla to show the perforating branches of the posterior communicating artery (PCoA), and to investigate the presence of such visible perforating branches in relation to the size of the feeding PCoA. The secondary aim was to visualise and describe the anterior choroidal artery and the perforating branches of the P1-segment of posterior cerebral artery (P1). Forty-six healthy volunteers underwent TOF MR angiography at 7.0 Tesla. With 7.0-Tesla imaging, we visualised for the first time perforating arteries originating from the PCoA in vivo without the use of contrast agents. A perforating artery from the PCoA was found in a large proportion of the PCoAs (64%). The presence was associated with a larger diameter of the underlying PCoA (1.23 versus 1.06 mm, P = 0.03). The anterior choroidal artery was visible bilaterally in all participants. In 83% of all P1s, one or two perforating branches were visible. Non-invasive assessment of the perforating arteries of the PCoA together with the anterior choroidal artery and the perforating arteries of the P1 may increase our understanding of infarcts in the deep brain structures supplied by these arteries.

  2. Basilar artery angulation and vertigo due to the hemodynamic effect of dominant vertebral artery.

    Science.gov (United States)

    Cosar, Murat; Yaman, Mehmet; Eser, Olcay; Songur, Ahmet; Ozen, Oguz A

    2008-01-01

    Vertebral arteries form the basilar artery at the pontobulbar junction. The vertebral artery may have dominancy in one of them. The branches of basilar arteries supply blood for the vestibular nuclei and its connections. Vertigo is seen generally in the upper middle aged patients. Vertigo can be observed in dolichoectasia of basilar artery such as angulation and elongation, because of the diminished blood supply and changed hemodynamic factors of vestibular nuclei and its connections. We hypothesized that angulation or elongation of basilar artery can be estimated according to the unilateral vertebral artery dominant hypertensive patients. The basilar artery can angulate from the dominant side of vertebral artery to the recessive side. These angulation and elongation can effect the hemodynamic factors in absence of growing collateral arteries. So, the vertigo attacks may occur in these patients.

  3. Giant anurysin of the common hepatic artery

    International Nuclear Information System (INIS)

    Montenegro Gaite, T.; Gonzalez Garcia, A.; Cortes Gonzalez, A.; Mayol Deya, A.; Fernandez de Bobadilla, M.

    1994-01-01

    Hepatic artery aneurysms are relatively infrequent and asymptomatic processes, but are very important since their rupture can prove fatal. We present a case of partially thrombosed giant aneurysm of the common hepatic artery in a 55-year-old man. The patient presented relatively nonspecific clinical signs (pain in right abdomen was the major symptom), and was diagnosed by ultrasound computerized tomography (CT) and digital subtraction angiography. (Author) 12 refs

  4. Morphometry of the coronary ostia and the structure of coronary arteries in the shorthair domestic cat

    Science.gov (United States)

    Barszcz, Karolina; Kupczyńska, Marta; Klećkowska-Nawrot, Joanna; Janeczek, Maciej; Goździewska-Harłajczuk, Karolina; Dzierzęcka, Małgorzata; Janczyk, Paweł

    2017-01-01

    The aim of this study was to measure the area of the coronary ostia, assess their localization in the coronary sinuses and to determine the morphology of the stem of the left and right coronary arteries in the domestic shorthair cat. The study was conducted on 100 hearts of domestic shorthair cats of both sexes, aged 2–18 years, with an average body weight of 4.05 kg. A morphometric analysis of the coronary ostia was carried out on 52 hearts. The remaining 48 hearts were injected with a casting material in order to carry out a morphological assessment of the left and right coronary arteries. In all the studied animals, the surface of the left coronary artery ostium was larger than the surface of the right coronary artery ostium. There were four types of the left main coronary artery: type I (23 animals, 49%)–double-branched left main stem (giving off the left circumflex branch and the interventricular paraconal branch, which in turn gave off the septal branch), type II (12 animals, 26%)–double-branched left main stem (giving off the left circumflex branch and the interventricular paraconal branch without the septal branch), type III (11 animals, 23%)–triple-branched left main stem (giving off the left circumflex branch, interventricular branch and the septal branch, type IV (1 animal, 2%)–double-branched left main stem (giving off the interventricular paraconal branch and the left circumflex branch, which in turn gave off the septal branch). The left coronary artery ostium is greater than the right one. There is considerable diversity in the branches of proximal segment of the left coronary artery, while the right coronary artery is more conservative. These results can be useful in defining the optimal strategies in the endovascular procedures involving the coronary arteries or the aortic valve in the domestic shorthair cat. PMID:29020103

  5. Morphometry of the coronary ostia and the structure of coronary arteries in the shorthair domestic cat.

    Directory of Open Access Journals (Sweden)

    Karolina Barszcz

    Full Text Available The aim of this study was to measure the area of the coronary ostia, assess their localization in the coronary sinuses and to determine the morphology of the stem of the left and right coronary arteries in the domestic shorthair cat. The study was conducted on 100 hearts of domestic shorthair cats of both sexes, aged 2-18 years, with an average body weight of 4.05 kg. A morphometric analysis of the coronary ostia was carried out on 52 hearts. The remaining 48 hearts were injected with a casting material in order to carry out a morphological assessment of the left and right coronary arteries. In all the studied animals, the surface of the left coronary artery ostium was larger than the surface of the right coronary artery ostium. There were four types of the left main coronary artery: type I (23 animals, 49%-double-branched left main stem (giving off the left circumflex branch and the interventricular paraconal branch, which in turn gave off the septal branch, type II (12 animals, 26%-double-branched left main stem (giving off the left circumflex branch and the interventricular paraconal branch without the septal branch, type III (11 animals, 23%-triple-branched left main stem (giving off the left circumflex branch, interventricular branch and the septal branch, type IV (1 animal, 2%-double-branched left main stem (giving off the interventricular paraconal branch and the left circumflex branch, which in turn gave off the septal branch. The left coronary artery ostium is greater than the right one. There is considerable diversity in the branches of proximal segment of the left coronary artery, while the right coronary artery is more conservative. These results can be useful in defining the optimal strategies in the endovascular procedures involving the coronary arteries or the aortic valve in the domestic shorthair cat.

  6. Empirical description of bronchial and nonbronchial arteries with MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Yu Hong, E-mail: yuhong.2002@hotmail.co [Department of Imageology, Changzheng hospital, Second Military Medical University, Shanghai 200003 (China); Liu Shiyuan, E-mail: cjr.liushiyuan@vip.163.co [Department of Imageology, Changzheng hospital, Second Military Medical University, Shanghai 200003 (China); Li Huimin, E-mail: yuhongphd@163.co [Department of Imageology, Changzheng hospital, Second Military Medical University, Shanghai 200003 (China); Xiao Xiangsheng, E-mail: cjr.xxsh@vip.163.co [Department of Imageology, Changzheng hospital, Second Military Medical University, Shanghai 200003 (China); Dong Weihua, E-mail: dongweihua2000@163.co [Department of Imageology, Changzheng hospital, Second Military Medical University, Shanghai 200003 (China)

    2010-08-15

    Purpose: We aimed to retrospectively evaluate bronchial and nonbronchial systemic arteries using multi-detector row helical computed tomographic (MDCT) angiography in patients with pulmonary disorders. Materials and Methods: Thirty-nine patients (24 men, 15 women; mean age, 63.4 years; range, 20-82 years) with congenital and acquired pulmonary disorders of the bronchial and nonbronchial systemic arteries underwent multi-detector row helical computed tomographic angiography of the thorax using a 16-detector row scanner. Each of these patients had experienced an episode of hemoptysis. Computed tomographic angiogram data, which included maximum intensity projections, multiplanar reconstruction, and three-dimensional volume-rendered images, were used to retrospectively analyse the characteristics of the bronchial and nonbronchial systemic arteries. Results: We identified a total of 128 bronchial arteries (76 on the right side and 52 on the left) in 39 patients. We detected 42 nonbronchial systemic artery branches, including 19 internal mammary artery branches, 8 subclavian artery branches, 8 inferior phrenic artery branches, 5 intercostal artery branches, 1 thyrocervical trunk branch, and 1 celiac trunk branch. Thirty-five dilated and tortuous nonbronchial systemic arteries entered into the lung parenchyma and extended down to the lesions. Every case, except the one case of sequestration, was associated with pleural thickening where the vascular structures passed through the extrapleural fat. Conclusions: The variations in both the bronchial artery anatomy and the location and type of the nonbronchial arteries were great. Nonbronchial arteries may be a significant source of hemoptysis. MDCT angiography can be used to detect detailed anatomical information about the origins and courses of bronchial and nonbronchial systemic arteries and their pathophysiologic features.

  7. Size ratio correlates with intracranial aneurysm rupture status: a prospective study.

    Science.gov (United States)

    Rahman, Maryam; Smietana, Janel; Hauck, Erik; Hoh, Brian; Hopkins, Nick; Siddiqui, Adnan; Levy, Elad I; Meng, Hui; Mocco, J

    2010-05-01

    significantly smaller SRs (2.57 + or - 0.24 mm) compared with the ruptured group (4.08 + or - 0.54 mm; PIA maximum size and SR). Using stepwise selection, only SR remained in the final predictive model (OR, 2.12; 95% CI, 1.09 to 4.13). SR, the ratio between aneurysm size and parent artery diameter, can be easily calculated from 2-dimensional angiograms and correlates with IA rupture status on presentation in a blinded analysis. SR should be further studied in a large prospective observational cohort to predict true IA risk of rupture.

  8. Dynamic rupture models of earthquakes on the Bartlett Springs Fault, Northern California

    Science.gov (United States)

    Lozos, Julian C.; Harris, Ruth A.; Murray, Jessica R.; Lienkaemper, James J.

    2015-01-01

    The Bartlett Springs Fault (BSF), the easternmost branch of the northern San Andreas Fault system, creeps along much of its length. Geodetic data for the BSF are sparse, and surface creep rates are generally poorly constrained. The two existing geodetic slip rate inversions resolve at least one locked patch within the creeping zones. We use the 3-D finite element code FaultMod to conduct dynamic rupture models based on both geodetic inversions, in order to determine the ability of rupture to propagate into the creeping regions, as well as to assess possible magnitudes for BSF ruptures. For both sets of models, we find that the distribution of aseismic creep limits the extent of coseismic rupture, due to the contrast in frictional properties between the locked and creeping regions.

  9. Branching processes in biology

    CERN Document Server

    Kimmel, Marek

    2015-01-01

    This book provides a theoretical background of branching processes and discusses their biological applications. Branching processes are a well-developed and powerful set of tools in the field of applied probability. The range of applications considered includes molecular biology, cellular biology, human evolution and medicine. The branching processes discussed include Galton-Watson, Markov, Bellman-Harris, Multitype, and General Processes. As an aid to understanding specific examples, two introductory chapters, and two glossaries are included that provide background material in mathematics and in biology. The book will be of interest to scientists who work in quantitative modeling of biological systems, particularly probabilists, mathematical biologists, biostatisticians, cell biologists, molecular biologists, and bioinformaticians. The authors are a mathematician and cell biologist who have collaborated for more than a decade in the field of branching processes in biology for this new edition. This second ex...

  10. Branching trajectory continual integral

    International Nuclear Information System (INIS)

    Maslov, V.P.; Chebotarev, A.M.

    1980-01-01

    Heuristic definition of the Feynman continual integral over branching trajectories is suggested which makes it possible to obtain in the closed form the solution of the Cauchy problem for the model Hartree equation. A number of properties of the solution is derived from an integral representation. In particular, the quasiclassical asymptotics, exact solution in the gaussian case and perturbation theory series are described. The existence theorem for the simpliest continual integral over branching trajectories is proved [ru

  11. Common carotid artery disease in Takayasu's arteritis

    International Nuclear Information System (INIS)

    Hamdan, Nabil; Calderon, Luis I; Castro, Pablo and others

    2004-01-01

    Takayasu's arteritis is a disease of unknown etiology with main involvement of the common carotid 5 artery and its branches. we report the case of a 69 years old female patient with Tokays arteritis with 2 bilateral involvements of the common carotid arteries, treated with percutaneous angioplasty and Stent implantation

  12. Branches of the landscape

    International Nuclear Information System (INIS)

    Dine, Michael; O'Neil, Deva; Sun Zheng

    2005-01-01

    With respect to the question of supersymmetry breaking, there are three branches of the flux landscape. On one of these, if one requires small cosmological constant, supersymmetry breaking is predominantly at the fundamental scale; on another, the distribution is roughly flat on a logarithmic scale; on the third, the preponderance of vacua are at very low scale. A priori, as we will explain, one can say little about the first branch. The vast majority of these states are not accessible even to crude, approximate analysis. On the other two branches one can hope to do better. But as a result of the lack of access to branch one, and our poor understanding of cosmology, we can at best conjecture about whether string theory predicts low energy supersymmetry or not. If we hypothesize that are on branch two or three, distinctive predictions may be possible. We comment of the status of naturalness within the landscape, deriving, for example, the statistics of the first branch from simple effective field theory reasoning

  13. Physics of Earthquake Rupture Propagation

    Science.gov (United States)

    Xu, Shiqing; Fukuyama, Eiichi; Sagy, Amir; Doan, Mai-Linh

    2018-05-01

    A comprehensive understanding of earthquake rupture propagation requires the study of not only the sudden release of elastic strain energy during co-seismic slip, but also of other processes that operate at a variety of spatiotemporal scales. For example, the accumulation of the elastic strain energy usually takes decades to hundreds of years, and rupture propagation and termination modify the bulk properties of the surrounding medium that can influence the behavior of future earthquakes. To share recent findings in the multiscale investigation of earthquake rupture propagation, we held a session entitled "Physics of Earthquake Rupture Propagation" during the 2016 American Geophysical Union (AGU) Fall Meeting in San Francisco. The session included 46 poster and 32 oral presentations, reporting observations of natural earthquakes, numerical and experimental simulations of earthquake ruptures, and studies of earthquake fault friction. These presentations and discussions during and after the session suggested a need to document more formally the research findings, particularly new observations and views different from conventional ones, complexities in fault zone properties and loading conditions, the diversity of fault slip modes and their interactions, the evaluation of observational and model uncertainties, and comparison between empirical and physics-based models. Therefore, we organize this Special Issue (SI) of Tectonophysics under the same title as our AGU session, hoping to inspire future investigations. Eighteen articles (marked with "this issue") are included in this SI and grouped into the following six categories.

  14. Entrapment of the Martin-Gruber branch of median nerve in the forearm

    Directory of Open Access Journals (Sweden)

    Anu Vinod Ranade

    2016-07-01

    Full Text Available We report a rare case of a dual neuro-vascular variation, which was observed in the right extremity of male cadaver. About an inch inferior to the elbow joint, three branches arose from the median nerve. These were the anterior interosseous branch, a Martin-Gruber branch (MGB and a muscular branch. The MGB coursed infero-medially to join with the ulnar nerve by running posterior to the ulnar artery. It was surprising to observe that the MGB passed between the ulnar artery and its venae comitantes. There was an acute angulation of the MGB here, suggesting entrapment at this site.

  15. Management of Hepatic Rupture Diagnosed after an Emergency Cesarean Section

    Directory of Open Access Journals (Sweden)

    Gianluca Raffaello Damiani

    2014-01-01

    Full Text Available A careful management of hepatic capsular rupture, with massive hemoperitoneum which occurred 14 hours after an emergency cesarean section at 36 weeks of gestation, is meticulously reported. The grade of hepatic involvement varies from minor capsular laceration to extensive parenchymal rupture. Our management involved a combination of surgical interventions and aggressive supportive care. The patient was discharged after 53 days and 4 laparotomies and an unsuccessful attempt of superselective artery embolization. Ultrasound after 40 days from the last surgery showed uniform hepatic parenchyma free of focal lesions. Due to the rarity and the unpredictability nature of this devastating event we believe necessary to report our experience, reinforcing the importance of the postsurgery management.

  16. Vascular Rupture Caused by a Molding Balloon during Endovascular Aneurysm Repair: Case Report

    International Nuclear Information System (INIS)

    Lee, Hee Young; Do, Young Soo; Park, Hong Suk; Park, Kwang Bo; Kim, Young Wook; Kim, Dong Ik

    2011-01-01

    Endovascular aneurysm repair (EVAR) has been accepted as an alternative to traditional open surgery in selected patients. Despite the minimally invasiveness of this treatment, several complications may occur during or after EVAR. Complications include endoleak, aortic dissection, distal embolism, or iatrogenic injury to the access artery. However, there are few reports on the vascular rupture caused by a molding balloon during EVAR. We report two cases of infrarenal abdominal aortic aneurysms complicated by procedure-related aortic or iliac artery rupture by the molding balloon during EVAR. In our cases, we observed suddenly abrupt increase of the diameter of the endograft during balloon inflation, because we inflated the balloon rapidly. In conclusion, careful attention must be paid during inflation of the molding balloon to prevent vascular rupture.

  17. Peripheral aneurysm rupture in a patient with inactive systemic lupus erythematosus

    Energy Technology Data Exchange (ETDEWEB)

    Engelke, Christoph; Sabharwal, Tarun; Reidy, John F. [Department of Radiology, Guy' s and St. Thomas' Hospital Trust, St. Thomas' Street, London SE1 9RT (United Kingdom); Mohan, Aarthi R. [Department of Chest Medicine, Guy' s and St. Thomas' Hospital Trust, St. Thomas' Street, London SE1 9RT (United Kingdom)

    2002-12-01

    We describe a patient with inactive systemic lupus erythematosus (SLE) presenting with sudden haemothorax, due to a ruptured internal mammary artery (IMA) aneurysm 7 years after the corticosteroid treatment was terminated. The unusual imaging findings and the treatment with embolization are discussed with a view to the role of a regular vascular screening in this patient group. (orig.)

  18. True pancreaticoduodenal artery aneurysms: A decision analysis

    International Nuclear Information System (INIS)

    Takao, Hidemasa; Nojo, Takeshi; Ohtomo, Kuni

    2010-01-01

    Purpose: True pancreaticoduodenal artery aneurysms are rare. No definitive study evaluating the natural history of these lesions or their preferred method of treatment has been published. The purpose of this study was to evaluate the outcome of preventive treatment of unruptured pancreaticoduodenal artery aneurysms using a Markov model. Materials and methods: With the use of a Markov model, we performed a decision analysis to evaluate the outcome of preventive treatment of unruptured pancreaticoduodenal artery aneurysms. The risk of rupture and the mortality of preventive treatment are unknown. Therefore, we performed sensitivity analysis using these parameters. Effectiveness was measured in life expectancy. Results: For 80-year-old patients, preventive treatment was dominated by no treatment if mortality rates of preventive treatment were greater than 1.4%, greater than 2.6%, greater than 3.8%, and greater than 4.8% at annual rupture rates of 1%, 2%, 3%, and 4%, respectively. For 50-year-old patients, preventive treatment was dominated by no treatment if mortality rates of preventive treatment were greater than 3.3%, greater than 5.9%, greater than 8.0%, and greater than 9.7% at annual rupture rates of 1%, 2%, 3%, and 4%, respectively. Conclusion: The effectiveness of preventive treatment of unruptured pancreaticoduodenal artery aneurysms depends on the aneurysm rupture rate, mortality rate of preventive treatment, and patient age. Taking into account the effects of these parameters is important in making treatment decisions.

  19. Dynamic Rupture Benchmarking of the ADER-DG Method

    Science.gov (United States)

    Gabriel, Alice; Pelties, Christian

    2013-04-01

    We will verify the arbitrary high-order derivative Discontinuous Galerkin (ADER-DG) method in various test cases of the 'SCEC/USGS Dynamic Earthquake Rupture Code Verification Exercise' benchmark suite (Harris et al. 2009). The ADER-DG scheme is able to solve the spontaneous rupture problem with high-order accuracy in space and time on three-dimensional unstructured tetrahedral meshes. Strong mesh coarsening or refinement at areas of interest can be applied to keep the computational costs feasible. Moreover, the method does not generate spurious high-frequency contributions in the slip rate spectra and therefore does not require any artificial damping as demonstrated in previous presentations and publications (Pelties et al. 2010 and 2012). We will show that the mentioned features hold also for more advanced setups as e.g. a branching fault system, heterogeneous background stresses and bimaterial faults. The advanced geometrical flexibility combined with an enhanced accuracy will make the ADER-DG method a useful tool to study earthquake dynamics on complex fault systems in realistic rheologies. References: Harris, R.A., M. Barall, R. Archuleta, B. Aagaard, J.-P. Ampuero, H. Bhat, V. Cruz-Atienza, L. Dalguer, P. Dawson, S. Day, B. Duan, E. Dunham, G. Ely, Y. Kaneko, Y. Kase, N. Lapusta, Y. Liu, S. Ma, D. Oglesby, K. Olsen, A. Pitarka, S. Song, and E. Templeton, The SCEC/USGS Dynamic Earthquake Rupture Code Verification Exercise, Seismological Research Letters, vol. 80, no. 1, pages 119-126, 2009 Pelties, C., J. de la Puente, and M. Kaeser, Dynamic Rupture Modeling in Three Dimensions on Unstructured Meshes Using a Discontinuous Galerkin Method, AGU 2010 Fall Meeting, abstract #S21C-2068 Pelties, C., J. de la Puente, J.-P. Ampuero, G. Brietzke, and M. Kaeser, Three-Dimensional Dynamic Rupture Simulation with a High-order Discontinuous Galerkin Method on Unstructured Tetrahedral Meshes, JGR. - Solid Earth, VOL. 117, B02309, 2012

  20. Uterine Artery Anatomy Relevant to Uterine Leiomyomata Embolization

    International Nuclear Information System (INIS)

    Gomez-Jorge, Jackeline; Keyoung, Andrew; Levy, Elliot B.; Spies, James B.

    2003-01-01

    To categorize the anatomic variants of uterine arteries, and determine the incidence of menopausal symptoms where the tubo-ovarian branches were seen prior to embolization. Between July 1997 and June 2000, 257 (n = 257) uterine fibroid embolizations were performed at our institution. Arteriograms were retrospectively evaluated. Uterine arteries were classified into groups: type I (the uterine artery as first branch of the inferior gluteal artery), type II (the uterine artery as second or third branch of the inferior gluteal artery), type III (the uterine artery, the inferior gluteal and the superior gluteal arteries arising as a trifurcation), type IV (the uterine artery as first branch of the hypogastric artery), inconclusive, or not studied. Tubo-ovarian branches were recorded if visualized prior to and/or after embolization. Menopausal symptoms were recorded (n = 175 at 3 months, n = 139 at 6 months, n = 98 at 1 year, n = 22 at 2 years) using written questionnaires. Five hundred and fourteen uterine arteries (n = 514) were evaluated. There were 38% classifiable types, 23% inconclusive, and 39% not studied. Classification was as follows: type I, 45%; type II, 6%; type III, 43%; type IV, 6%. Among 256 patients, tubo-ovarian arteries were seen in 36 prior to embolization, but not afterwards. In this group, 25 patients reported transient menopausal symptoms (hot flashes, amenorrhea). Five patients did not report any menopausal symptoms. Six patients did not answer the questionnaires. Type I is the most common type of anatomy, followed by type III. The tubo-ovarian arteries may be visualized prior to and/or after embolization. The embolization was monitored to avoid embolization of the tubo-ovarian branches. Menopausal symptoms were transient all patients when the tubo-ovarian branches were seen prior to embolization

  1. Study of the renal segmental arterial anatomy with contrast-enhanced multi-detector computed tomography.

    Science.gov (United States)

    Rocco, Francesco; Cozzi, Luigi Alberto; Cozzi, Gabriele

    2015-07-01

    To use triphasic multi-detector computed tomography (MDCT) to study the renal segmental arterial anatomy and its relationship with the urinary tract to plan nephron-sparing surgery (NSS). One hundred and fifty nine patients underwent abdominal contrast-enhanced MDCT. We evaluated renal arteries and parenchymal vasculature. In 61 patients, the arteries and the urinary tract were represented simultaneously. 86.60% presented a single renal artery; 13.4%, multiple arteries. All single renal arteries divided into anterior and posterior branch before the hilum. The anterior artery branched into a superior, middle, and inferior branch. In 43.14%, the inferior artery arose before the others; in 45.75%, the superior artery arose before the others; in 9.80%, the branches shared a common trunk. In 26.80%, the posterior artery supplies the entire posterior surface; in 73.20%, it ends along the inferior calyx. In 96.73%, the upper pole was vascularized by the anterior superior branch and the posterior artery: the "tuning fork". MDCT showed four vascular segments in 96.73% and five in 3.27%. MDCT showed two avascular areas: the first along the projection of the inferior calyx on the posterior aspect, the second between the branches of the "tuning fork". The arterial phase provides the arterial tree representation; the delayed phase shows arteries and urinary tract simultaneously. MDCT provides a useful representation of the renal anatomy prior to intervascular-intrarenal NSS.

  2. Simultaneous bilateral patellar tendon rupture.

    Science.gov (United States)

    Moura, Diogo Lino; Marques, José Pedro; Lucas, Francisco Manuel; Fonseca, Fernando Pereira

    2017-01-01

    Bilateral patellar tendon rupture is a rare entity, often associated with systemic diseases and patellar tendinopathy. The authors report a rare case of a 34-year-old man with simultaneous bilateral rupture of the patellar tendon caused by minor trauma. The patient is a retired basketball player with no past complaints of chronic knee pain and a history of steroid use. Surgical management consisted in primary end-to-end tendon repair protected temporarily with cerclage wiring, followed by a short immobilization period and intensive rehabilitation program. Five months after surgery, the patient was able to fully participate in sport activities.

  3. Simultaneous bilateral patellar tendon rupture

    Directory of Open Access Journals (Sweden)

    Diogo Lino Moura

    Full Text Available ABSTRACT Bilateral patellar tendon rupture is a rare entity, often associated with systemic diseases and patellar tendinopathy. The authors report a rare case of a 34-year-old man with simultaneous bilateral rupture of the patellar tendon caused by minor trauma. The patient is a retired basketball player with no past complaints of chronic knee pain and a history of steroid use. Surgical management consisted in primary end-to-end tendon repair protected temporarily with cerclage wiring, followed by a short immobilization period and intensive rehabilitation program. Five months after surgery, the patient was able to fully participate in sport activities.

  4. Spontaneous rupture of vaginal enterocele

    DEFF Research Database (Denmark)

    Svendsen, J H; Galatius, H; Hansen, P K

    1985-01-01

    Spontaneous rupture of an enterocele is a rare complication. Only 24 cases including the present case have been reported in the literature. The patients were elderly and had had at least one vaginal operation. The patients were remarkably unaffected symptomatically on admission.......Spontaneous rupture of an enterocele is a rare complication. Only 24 cases including the present case have been reported in the literature. The patients were elderly and had had at least one vaginal operation. The patients were remarkably unaffected symptomatically on admission....

  5. Rupture luminescence from natural fibers

    Science.gov (United States)

    Li, W.; Haneman, D.

    1999-12-01

    Fibers of cotton and wool, and samples of paper, have been ruptured in tension in vacuum and in air, and give detectable luminescence in the visible range. All have a common emission peak at around 2.0 eV, which is ascribed to the deexcitation of states excited by the rupture of organic chain molecule bonds. Rubber bands give stronger emission in air, but no emission in vacuum, suggesting the material breaks only at weak interchain bonds. Mohair, cat, and horse hair also give emission in air. The phenomena reveal effects that would occur widely in nature.

  6. Anatomy of Inferior Mesenteric Artery in Fetuses

    Directory of Open Access Journals (Sweden)

    Ayesha Nuzhat

    2016-01-01

    Full Text Available Aim. To analyze Inferior Mesenteric Artery in fetuses through its site of origin, length, diameter, and variation of its branches. Method. 100 fetuses were collected from various hospitals in Warangal at Kakatiya Medical College in Andhra Pradesh, India, and were divided into two groups, group I (second-trimester fetuses and group II (third-trimester fetuses, followed by dissection. Result. (1 Site of Origin. In group I fetuses, origin of Inferior Mesenteric Artery was at third lumbar vertebra in 33 out of 34 fetuses (97.2%. In one fetus it was at first lumbar vertebra, 2.8%. In all group II fetuses, origin of Inferior Mesenteric Artery was at third lumbar vertebra. (2 Length. In group I fetuses it ranged between 18 and 30 mm, average being 24 mm except in one fetus where it was 48 mm. In group II fetuses the length ranged from 30 to 34 mm, average being 32 mm. (3 Diameter. In group I fetuses it ranged from 0.5 to 1 mm, and in group II fetuses it ranged from 1 to 2 mm, average being 1.5 mm. (4 Branches. Out of 34 fetuses of group I, 4 fetuses showed variation. In one fetus left colic artery was arising from abdominal aorta, 2.9%. In 3 fetuses, Inferior Mesenteric Artery was giving a branch to left kidney, 8.8%. Out of 66 fetuses in group II, 64 had normal branching. In one fetus left renal artery was arising from Inferior Mesenteric Artery, 1.5%, and in another fetus one accessory renal artery was arising from Inferior Mesenteric Artery and entering the lower pole of left kidney. Conclusion. Formation, course, and branching pattern of an artery depend on development and origin of organs to attain the actual adult position.

  7. Functional morphology, biomechanics and biomimetic potential of stem-branch connections in Dracaena reflexa and Freycinetia insignis.

    Science.gov (United States)

    Masselter, Tom; Eckert, Sandra; Speck, Thomas

    2011-01-01

    Branching in plants is one of the most important assets for developing large arborescent growth forms with complex crowns. While the form and development of branching in gymnosperms and dicotyledonous trees is widely understood, very little is known about branching patterns and the structure of branch-stem-junctions in arborescent monocotyledons. For a better and quantitative understanding of the functional morphology of branch-stem-junctions in arborescent monocotyledons, we investigated the two species Dracaena reflexa and Freycinetia insignis. While D. reflexa is able to develop large arborescent forms with conspicuous crowns by anomalous secondary growth, F. insignis remains relatively small and is only capable of primary growth. Biomechanical investigations were performed by applying vertical loads up to rupture to lateral branches of both species. This allows the analysis of the fracture mechanics and the determination of the maximal force, stress and strain at rupture as well as the fracture toughness. Functional morphology was correlated with the mechanical behaviour of these plants and compared to data of other dicotyledonous trees. The high energy absorption found in the rupture process of lateral branches of D. reflexa and F. insignis makes them promising biological concept generators with a high potential for biomimetic implementation, i.e., for the development of branched fibre-reinforced technical composites. A wide range of constructional elements with branched (sub-)structures can be optimised by using solutions inspired by plant ramifications, e.g., in automotive and aerospace engineering, architecture, sports equipment and prosthetic manufacturing.

  8. Analysis of 30 breast implant rupture cases.

    Science.gov (United States)

    Tark, Kwan Chul; Jeong, Hii Sun; Roh, Tae Suk; Choi, Jong Woo

    2005-01-01

    Breast implants used for augmentation mammoplasty or breast reconstruction could rupture from various causes such as trauma or spontaneous failure. The objectives of this study were to investigate the relationships between the causes of implant rupture and the degree of capsular contracture, and then to evaluate the relative efficacies of specific signs on magnetic resonance imaging (MRI) known to be beneficial for diagnosing the rupture. A retrospective review identified patients with prosthetic implant rupture or impending rupture treated by the senior author. The 30 cases of implant rupture available for review were classified into two groups: intracapsular and extracapsular ruptures. The 30 cases of breast implant ruptures were analyzed with respect to the clinical symptoms and signs, the causes of rupture, the degree of capsular contracture, and therapeutic plans. Among the 30 cases, 14 patients who had undergone MRI during the diagnostic period were analyzed with respect to the relationships between MRI readings and operative findings. Spontaneous rupture of membranes was most common (80%), followed by failure because of trauma (7%) and valve or implant base (4%). The symptoms during implant rupture were contour deformity, palpated mass-like lesions, pain, and focal inflammation. According to the analysis of specific MRI signs, the sensitivity and specificity of the linguine sign were 87% and 100%, respectively, for intracapsular rupture. For extracapsular rupture, the sensitivity and specificity of the linguine sign were, respectively, 67% and 75%. The sensitivity and specificity of the rat-tail sign and tear drop sign were 14% and 50%, respectively. Breast implant rupture was correlated with the degree of capsular contracture in our study. Among the various specific MRI signs used in diagnosing the rupture, the linguine sign was reliable and had a high sensitivity and specificity, especially in cases of intracapsular rupture. On the other hand, the rat

  9. Rupture of Achilles Tendon : Usefulness of Ultrasonography

    International Nuclear Information System (INIS)

    Kim, Nam Hyeon; Ki, Won Woo; Yoon, Kwon Ha; Kim, Song Mun; Shin, Myeong Jin; Kwon, Soon Tae

    1996-01-01

    To differentiate a complete rupture of Achilles tendon from an incomplete one which is important because its treatment is quite different. And it is necessary to know the exact site of the rupture preoperatively. Fifteen cases of fourteen patients which were diagnosed as Achilles tendon rupture by ultrasonography and surgery were reviewed. We compared sonographic rupture site with surgical findings. Ultrasonographic criteria for differentiation of complete and incomplete rupture was defined as follows : the discreteness, which means the proximal intervening hypoechogenicity to the interface echogenicity of distal margin of ruptured tendon : the slant sign, which represents the interface of ruptured distal margin which was seen over the 3/4 of the thickness of the tendon without intervening low echogeneicity : the invagination sign, which means the echogenic invagination from Kager triangle into posterior aspect of Achilles tendon over the half thickness of the tendon. The sites of complete tendon rupture were exactly corresponded to surgical finding in four cases of ten complete ruptures. And the discrepancy between sonographic and surgical findings in the site of complete rupture was 1.2 ± 0.4 cm in six cases. Three of ten complete ruptures showed the discreteness sign, all of ten showed the slant sign and two of ten showed the invagination sign. It is helpful to differentiate a complete from incomplete rupture of the Achilles tendon and to localize the site of the complete rupture with the ultrasonographic evaluation

  10. CT findings of subarachnoid hemorrhage due to ruptured cerebral aneurysm

    International Nuclear Information System (INIS)

    Kim, Pyo Nyun; Bae, Won Kyung; Kim, Il Young; Lee, Kyung Soo; Lee, Byoung Ho; Kim, Ki Jung

    1990-01-01

    CT scans were analysed retrospectively in 130 patients with subarachnoid hemorrhage (SAH) due to ruptured cerebral aneurysm to evaluate the relationship of the locations of aneurysms and the patterns of hemorrhage. Hemorrhage corresponded to the site of aneurysmal origin in a general way and in more specific ways to anterior communicating and middle cerebral artery aneurysms when there was parenchymal or cisternal hemorrhage. In anterior communicating artery aneurysm, SAH in the interhemispheric fissure, both sylvian fissures, and basal cistern was usually noted and intracerebral hemorrhage in anteroinferior frontal lobe was sometimes associated. In cases of middle cerebral artery aneurysm, hemorrhage in the ipsilateral sylvian fissure, interhemispheric fissure, and ipsilateral basal cistern was usual. Intracerebral hemorrhage in lateral temporal lobe was sometimes associated. Posterior communicating artery aneurysm demonstrated SAH in the ipsilateral basal cistern or in entire cisternal spaces specifically, so with higher incidence of involvement of the quadrigeminal and superior cerebellar cistern than anterior cerebral or middle cerebral artery aneurysm. We suggest the locations of aneurysm might be predicted with patterns of SAH and / or associated intracerebral hemorrhage with CT

  11. VD-411 branch driver

    International Nuclear Information System (INIS)

    Gorbunov, N.V.; Karev, A.G.; Mal'tsev, Eh.I.; Morozov, B.A.

    1985-01-01

    The VD-411 branch driver for CAMAC moduli control by the SM-4 computer is described. The driver realizes data exchange with moduli disposed in 28 crates grouped in 4 branches. Data exchange can be carried out either in the program regime or in the regime of direct access to the memory. Fulfilment of 11 block regimes and one program regime is provided for. A possibility of individual programming of exchange methods in block regimes is left for users for organisation of quicker and most flexible data removal from the CAMAC moduli. In the regime of direct access the driver provides data transmission at the size up to 64 Kwords placing it in the computer memory of 2 M byte. High rate of data transmission and the developed system of interruptions ensure efficient utilization of the VD-411 branch driver at data removal from facilities in high energy physics experiments

  12. Intraabdominal Hemorrhage Due to Spontaneous Rupture of Superior Mesenteric Artery

    Directory of Open Access Journals (Sweden)

    Onder Ozden

    2014-04-01

    Ehlers Danlos Syndrome Type IV should be kept in mind in cases of abdominal apoplexy. Repair of vascular complications could be impossible due to abnormal type III collagen leaded vascular fragility. [Cukurova Med J 2014; 39(2.000: 408-411

  13. A pregnant woman with spontaneous rupture of the uterine artery

    DEFF Research Database (Denmark)

    Jònsdòttir, Fjòla; Pinborg, Anja; Wilken-Jensen, Charlotte

    2014-01-01

    Pregnant women with acute abdominal pain are a clinical challenge. We present a rare but potential life-threatening condition of a pregnant woman with acute abdominal pain. The woman was in gestational week 37 with severe abdominal pain and was admitted to the labour ward. She became haemo...

  14. Transcatheter arterial embolization for traumatic bleeding control

    International Nuclear Information System (INIS)

    Ryu, Choon Wook; Lee, Sang Kwon; Suh, Kyung Jin; Kim, Tae Heon; Kim, Yong Joo; Kang, Duck Sik

    1989-01-01

    Angiography is essential for the detection of bleeding vessels in traumatic vascular injury. Immediately after the diagnosis, transcatheter embolization can be performed for the control of bleeding effectively and easily with proper use of embolic materials. Transcatheter embolization is believed to be the treatment of choice when emergency control is needed, where surgical approach is difficult and in those who are poor candidate for surgery. We have tried bleeding control in 18 cases of trauma over recent 4 years. The results were as follows; 1. Causes of bleeding(cases): Blunt or penetrating trauma (10), latrogenic trauma (8), (Postoperative (5), Needle biopsy (2), Percutaneous hepatic procedure (1)) 2. Embolized vessels: Renal artery branches (8), Hepatic artery branches (2), Arteries supplying chest wall (2), External carotid artery branches (3), Internal carotid artery (1), Circumflex humeral artery (1), Internal iliac artery branches (1). 3. Embolic agents: Gelfoam cubes (16), Stainless steel coils (3), Detachable latex balloon (1). 4. Successful bleeding control was achieved in 17 cases and reduction of the amount of bleeding in one case without significant complications

  15. PREMATURE RUPTURE OF THE MEMBRANES*

    African Journals Online (AJOL)

    In patients presenting with premature rupture of the membranes there are two factors which influence the foetal morbidity and mortality. These factors are prema- turity and intra-uterine infection. The purpose of this analysis was to elucidate which factor carried the greater risk to the foetus. Recently there has been a spate of.

  16. Spontaneous Splenic Rupture in Melanoma

    Directory of Open Access Journals (Sweden)

    Hadi Mirfazaelian

    2014-01-01

    Full Text Available Spontaneous rupture of spleen due to malignant melanoma is a rare situation, with only a few case reports in the literature. This study reports a previously healthy, 30-year-old man who came with chief complaint of acute abdominal pain to emergency room. On physical examination, abdominal tenderness and guarding were detected to be coincident with hypotension. Ultrasonography revealed mild splenomegaly with moderate free fluid in abdominopelvic cavity. Considering acute abdominal pain and hemodynamic instability, he underwent splenectomy with splenic rupture as the source of bleeding. Histologic examination showed diffuse infiltration by tumor. Immunohistochemical study (positive for S100, HMB45, and vimentin and negative for CK, CD10, CK20, CK7, CD30, LCA, EMA, and chromogranin confirmed metastatic malignant melanoma. On further questioning, there was a past history of a nasal dark skin lesion which was removed two years ago with no pathologic examination. Spontaneous (nontraumatic rupture of spleen is an uncommon situation and it happens very rarely due to neoplastic metastasis. Metastasis of malignant melanoma is one of the rare causes of the spontaneous rupture of spleen.

  17. Endovascular Treatment of Unusual Multiple Aneurysms of the Internal Carotid Artery-Posterior Communicating Artery Complex

    OpenAIRE

    Kubo, Michiya; Kuwayama, Naoya; Hirashima, Yutaka; Ohi, Masayoshi; Takami, Masaaki; Endo, Shunro

    2000-01-01

    A 79-year-old female presented with subarachnoid hemorrhage due to rupture of a rare true posterior communicating artery(PCoA)aneurysm and with poor general condition. Endovascular therapy was performed in the chronic stage. Right carotid angiography just before embolization demonstrated unusual multiple aneurysms of the internal carotid artery(ICA)-PCoA complex. Superselective an-giography and aneurysmography using microcatheter revealed two separate aneurysms arising from the PCoA and the I...

  18. Endometriosis-related spontaneous diaphragmatic rupture.

    Science.gov (United States)

    Triponez, Frédéric; Alifano, Marco; Bobbio, Antonio; Regnard, Jean-François

    2010-10-01

    Non-traumatic, spontaneous diaphragmatic rupture is a rare event whose pathophysiology is not known. We report the case of endometriosis-related spontaneous rupture of the right diaphragm with intrathoracic herniation of the liver, gallbladder and colon. We hypothesize that the invasiveness of endometriotic tissue caused diaphragm fragility, which finally lead to its complete rupture without traumatic event. The treatment consisted of a classical management of diaphragmatic rupture, with excision of the endometriotic nodule followed by medical ovarian suppression for six months.

  19. Comorbidity in patients with branch retinal vein occlusion

    DEFF Research Database (Denmark)

    Bertelsen, Mette; Linneberg, Allan; Rosenberg, Thomas

    2012-01-01

    To evaluate comorbidity before and after the diagnosis of branch retinal vein occlusion to determine whether it is a consequence of arterial thickening and therefore could serve as a diagnostic marker for other comorbidities and to evaluate the risk factors for the development of such occlusion....

  20. ACL Rupture in Collegiate Wrestler

    Directory of Open Access Journals (Sweden)

    Lindsay A. Palmer

    2016-05-01

    Full Text Available Objective: To educate others on unique Anterior Cruciate Ligament tears and percentage of usage of the ACL in normal daily function. Background: Patient is an eighteen year old male participating in wrestling and football at the time of the injury. Patient now only participates in wrestling. No previous knee or chronic injuries were reported prior to this injury. Patient was playing football during the time of injury. The patient stated that he planted his foot down and was tackled at the same time when the injury occurred. The patient felt his knee twist and buckle. Patient complained of clicking inside the knee and had minimal swelling. He also complained of it being difficult to bear weight at the time. The patient did not seek further treatment until two months after the injury occurred when he received an MRI. His MRI showed a positive finding for an Anterior Cruciate Ligament rupture. His previous Athletic Trainer could not find a positive diagnosis for the patient prior to the MRI. Differential Diagnosis: Possible meniscal or ACL injury. Treatment: Doctors officially diagnosed the injury as a complete rupture of the ACL. The patient did not receive surgery immediately. Doctors have stated that he only uses about 50% of his ACL on a daily basis compared to a normal person who uses about 95% of their ACL daily. Because of this, the patient played on his rupture for seven months before receiving surgery. He played a whole season of high school football and a whole season of wrestling his senior year with the ACL ruptured. The patient only used a brace for better comfort during the seven months. The patient then received reconstructive surgery to repair the rupture. A hamstring tendon graft was used to repair the ruptured ACL. Because a tendon was taken from the hamstring, patient experienced a tight ACL and hamstring of the left leg post-surgery. The patient participated in Physical Therapy for five months to strengthen and stretch the new

  1. A Retrospective Analysis of Ruptured Breast Implants

    Directory of Open Access Journals (Sweden)

    Woo Yeol Baek

    2014-11-01

    Full Text Available BackgroundRupture is an important complication of breast implants. Before cohesive gel silicone implants, rupture rates of both saline and silicone breast implants were over 10%. Through an analysis of ruptured implants, we can determine the various factors related to ruptured implants.MethodsWe performed a retrospective review of 72 implants that were removed for implant rupture between 2005 and 2014 at a single institution. The following data were collected: type of implants (saline or silicone, duration of implantation, type of implant shell, degree of capsular contracture, associated symptoms, cause of rupture, diagnostic tools, and management.ResultsForty-five Saline implants and 27 silicone implants were used. Rupture was diagnosed at a mean of 5.6 and 12 years after insertion of saline and silicone implants, respectively. There was no association between shell type and risk of rupture. Spontaneous was the most common reason for the rupture. Rupture management was implant change (39 case, microfat graft (2 case, removal only (14 case, and follow-up loss (17 case.ConclusionsSaline implants have a shorter average duration of rupture, but diagnosis is easier and safer, leading to fewer complications. Previous-generation silicone implants required frequent follow-up observation, and it is recommended that they be changed to a cohesive gel implant before hidden rupture occurs.

  2. Rupture of the long tendon of the biceps brachi muscle. An unusual case related to use of the pneumatic tourniquet.

    Science.gov (United States)

    Logel, R J

    1976-01-01

    Tourniquet paralysis, arterial spasm, aneurysm formation, and the post-ischemic hand syndrome are all complications of penumatic tourniquet use in surgery of the extremities. This is a case report of another complication of tourniquet use, rupture of the long tendon of the biceps brachii muscle. Some underlying pathologic or degenerative condition usually exists before rupture can occur. Both rheumatoid arthritis and local corticosteroid injections into the long tendon of the biceps probably accounted for weakening the tensile strength of the tendon and subsequent rupture in the case described.

  3. The bihemispheric posterior inferior cerebellar artery

    International Nuclear Information System (INIS)

    Cullen, Sean P.; Ozanne, Augustin; Alvarez, Hortensia; Lasjaunias, Pierre

    2005-01-01

    Rarely, a solitary posterior inferior cerebellar artery (PICA) will supply both cerebellar hemispheres. We report four cases of this variant. We present a retrospective review of clinical information and imaging of patients undergoing angiography at our institution to identify patients with a bihemispheric PICA. There were four patients: three males and one female. One patient presented with a ruptured arteriovenous malformation, and one with a ruptured aneurysm. Two patients had normal angiograms. The bihemispheric PICA was an incidental finding in all cases. The bihemispheric vessel arose from the dominant left vertebral artery, and the contralateral posterior inferior cerebellar artery was absent or hypoplastic. In all cases, contralateral cerebellar supply arose from a continuation of the ipsilateral PICA distal to the choroidal point and which crossed the midline dorsal to the vermis. We conclude that the PICA may supply both cerebellar hemispheres. This rare anatomic variant should be considered when evaluating patients with posterior fossa neurovascular disease. (orig.)

  4. Tracheobronchial Branching Anomalies

    International Nuclear Information System (INIS)

    Hong, Min Ji; Kim, Young Tong; Jou, Sung Shick; Park, A Young

    2010-01-01

    There are various congenital anomalies with respect to the number, length, diameter, and location of tracheobronchial branching patterns. The tracheobronchial anomalies are classified into two groups. The first one, anomalies of division, includes tracheal bronchus, cardiac bronchus, tracheal diverticulum, pulmonary isomerism, and minor variations. The second one, dysmorphic lung, includes lung agenesis-hypoplasia complex and lobar agenesis-aplasia complex

  5. Intermittency in branching models

    International Nuclear Information System (INIS)

    Chiu, C.B.; Texas Univ., Austin; Hwa, R.C.; Oregon Univ., Eugene

    1990-01-01

    The intermittency properties of three branching models have been investigated. The factorial moments show power-law behavior as function of small rapidity width. The slopes and energy dependences reveal different characteristics of the models. The gluon model has the weakest intermittency. (orig.)

  6. State-set branching

    DEFF Research Database (Denmark)

    Jensen, Rune Møller; Veloso, Manuela M.; Bryant, Randal E.

    2008-01-01

    In this article, we present a framework called state-set branching that combines symbolic search based on reduced ordered Binary Decision Diagrams (BDDs) with best-first search, such as A* and greedy best-first search. The framework relies on an extension of these algorithms from expanding a sing...

  7. Tracheobronchial Branching Anomalies

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Min Ji; Kim, Young Tong; Jou, Sung Shick [Soonchunhyang University, Cheonan Hospital, Cheonan (Korea, Republic of); Park, A Young [Soonchunhyang University College of Medicine, Asan (Korea, Republic of)

    2010-04-15

    There are various congenital anomalies with respect to the number, length, diameter, and location of tracheobronchial branching patterns. The tracheobronchial anomalies are classified into two groups. The first one, anomalies of division, includes tracheal bronchus, cardiac bronchus, tracheal diverticulum, pulmonary isomerism, and minor variations. The second one, dysmorphic lung, includes lung agenesis-hypoplasia complex and lobar agenesis-aplasia complex

  8. The ovarian and uterine arteries in the chinchilla (Chinchilla lanigera

    Directory of Open Access Journals (Sweden)

    A. Cevik-Demirkana

    2010-05-01

    Full Text Available The purpose of this study was to describe arteries supplying the ovaries and uterus in the chinchilla. Five healthy adult female chinchillas were used. In order to reveal the arterial network by dissecting under a stereoscopic microscope, latex coloured with red ink was injected through the common carotid artery. The ovaries of the chinchilla are supplied by the arteriae ovaricae which formed end-to-end anastomoses with the cranial termination of the arteria uterina. Soon after leaving the aorta abdominalis, the arteriae ovaricae extended 2-3mm caudolaterally, then released 1 branch and extended caudally and bifurcated into 2 further branches. One of these supplied branches to fat tissue. The other branch coursed caudally and anastomosed with the arteria circumflexa ilium profunda and dispersed into fat tissue. The arteria ovarica further subdivided into 2 rami ovaricae. The origins of the uterine arteries were exclusively from the left arteria iliaca externa. The arteria uterina gave a branch to the arteria umbilicalis and consecutive branches which supplied to the ureter, urinary bladder and cranial aspects of the vagina. It also gave rise to 2-3 branches to the cervix and further supplied 10-12 meandering branches to the uterine horns. The arteria uterina gave rise to many tortuous arteries to the uterus and provided 2 further branches to the ovary.

  9. Cavitation instability as a trigger of aneurysm rupture.

    Science.gov (United States)

    Volokh, K Y

    2015-10-01

    Aneurysm formation and growth is accompanied by microstructural alterations in the arterial wall. Particularly, the loss of elastin may lead to tissue disintegration and appearance of voids or cavities at the micron scale. Unstable growth and coalescence of voids may be a predecessor and trigger for the onset of macroscopic cracks. In the present work, we analyze the instability of membrane (2D) and bulk (3D) voids under hydrostatic tension by using two experimentally calibrated constitutive models of abdominal aortic aneurysm enhanced with energy limiters. The limiters provide the saturation value for the strain energy, which indicates the maximum energy that can be stored and dissipated by an infinitesimal material volume. We find that the unstable growth of voids can start when the critical stress is considerably less than the aneurysm strength. Moreover, this critical stress may even approach the arterial wall stress in the physiological range. This finding suggests that cavitation instability can be a rational indicator of the aneurysm rupture.

  10. Serial 5-Year Evaluation of Side Branches Jailed by Bioresorbable Vascular Scaffolds Using 3-Dimensional Optical Coherence Tomography: Insights From the ABSORB Cohort B Trial (A Clinical Evaluation of the Bioabsorbable Everolimus Eluting Coronary Stent System in the Treatment of Patients With De Novo Native Coronary Artery Lesions).

    Science.gov (United States)

    Onuma, Yoshinobu; Grundeken, Maik J; Nakatani, Shimpei; Asano, Taku; Sotomi, Yohei; Foin, Nicolas; Ng, Jaryl; Okamura, Takayuki; Wykrzykowska, Joanna J; de Winter, Robbert J; van Geuns, Robert-Jan; Koolen, Jacques; Christiansen, Evald; Whitbourn, Robert; McClean, Dougal; Smits, Pieter; Windecker, Stephan; Ormiston, John A; Serruys, Patrick W

    2017-09-01

    The long-term fate of Absorb bioresorbable vascular scaffold (Abbott Vascular, Santa Clara, CA) struts jailing side branch ostia has not been clarified. We therefore evaluate serially (post-procedure and at 6 months, 1, 2, 3, and 5 years) the appearance and fate of jailed Absorb bioresorbable vascular scaffold struts. We performed 3-dimensional optical coherence tomographic analysis of the ABSORB Cohort B trial (A Clinical Evaluation of the Bioabsorbable Everolimus Eluting Coronary Stent System in the Treatment of Patients With De Novo Native Coronary Artery Lesions) up to 5 years using a novel, validated cut-plane analysis method. We included 29 patients with a total of 85 side branch ostia. From the 12 ostia which could be assessed in true serial fashion, 7 showed a pattern of initial decrease in the ostial area free from struts, followed by an increase in strut-free ostial area toward the end of the 5 years of follow-up. In a repeated-measures analysis with time as fixed variable and ostial area free from struts as dependent variable, we showed a numeric decrease in the estimated ostial area free from struts from 0.75 mm 2 (baseline) to 0.68 mm 2 (first follow-up visit at 6 months or 1 year) and 0.63 mm 2 (second follow-up visit at 2 or 3 years). However, from the second visit to the 5-year follow-up visit, there was a statistically significant increase from 0.63 to 0.89 mm 2 ( P =0.001). Struts overlying an ostium divided the ostium into compartments, and the number of these compartments decreased over time. This study showed that in most cases, the side branch ostial area free from struts initially decreased. However, with full scaffold bioresorption, the ostial area free from scaffold increased between 2 to 3 years and 5 years in the vast majority of patients. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00856856. © 2017 American Heart Association, Inc.

  11. Dynamic rupture simulation of the 2017 Mw 7.8 Kaikoura (New Zealand) earthquake: Is spontaneous multi-fault rupture expected?

    Science.gov (United States)

    Ando, R.; Kaneko, Y.

    2017-12-01

    The coseismic rupture of the 2016 Kaikoura earthquake propagated over the distance of 150 km along the NE-SW striking fault system in the northern South Island of New Zealand. The analysis of In-SAR, GPS and field observations (Hamling et al., 2017) revealed that the most of the rupture occurred along the previously mapped active faults, involving more than seven major fault segments. These fault segments, mostly dipping to northwest, are distributed in a quite complex manner, manifested by fault branching and step-over structures. Back-projection rupture imaging shows that the rupture appears to jump between three sub-parallel fault segments in sequence from the south to north (Kaiser et al., 2017). The rupture seems to be terminated on the Needles fault in Cook Strait. One of the main questions is whether this multi-fault rupture can be naturally explained with the physical basis. In order to understand the conditions responsible for the complex rupture process, we conduct fully dynamic rupture simulations that account for 3-D non-planar fault geometry embedded in an elastic half-space. The fault geometry is constrained by previous In-SAR observations and geological inferences. The regional stress field is constrained by the result of stress tensor inversion based on focal mechanisms (Balfour et al., 2005). The fault is governed by a relatively simple, slip-weakening friction law. For simplicity, the frictional parameters are uniformly distributed as there is no direct estimate of them except for a shallow portion of the Kekerengu fault (Kaneko et al., 2017). Our simulations show that the rupture can indeed propagate through the complex fault system once it is nucleated at the southernmost segment. The simulated slip distribution is quite heterogeneous, reflecting the nature of non-planar fault geometry, fault branching and step-over structures. We find that optimally oriented faults exhibit larger slip, which is consistent with the slip model of Hamling et al

  12. Bronchial arteries: anatomy, function, hypertrophy, and anomalies.

    Science.gov (United States)

    Walker, Christopher M; Rosado-de-Christenson, Melissa L; Martínez-Jiménez, Santiago; Kunin, Jeffrey R; Wible, Brandt C

    2015-01-01

    The two main sources of blood supply to the lungs and their supporting structures are the pulmonary and bronchial arteries. The bronchial arteries account for 1% of the cardiac output but can be recruited to provide additional systemic circulation to the lungs in various acquired and congenital thoracic disorders. An understanding of bronchial artery anatomy and function is important in the identification of bronchial artery dilatation and anomalies and the formulation of an appropriate differential diagnosis. Visualization of dilated bronchial arteries at imaging should alert the radiologist to obstructive disorders that affect the pulmonary circulation and prompt the exclusion of diseases that produce or are associated with pulmonary artery obstruction, including chronic infectious and/or inflammatory processes, chronic thromboembolic disease, and congenital anomalies of the thorax (eg, proximal interruption of the pulmonary artery). Conotruncal abnormalities, such as pulmonary atresia with ventricular septal defect, are associated with systemic pulmonary supply provided by aortic branches known as major aortopulmonary collaterals, which originate in the region of the bronchial arteries. Bronchial artery malformation is a rare left-to-right or left-to-left shunt characterized by an anomalous connection between a bronchial artery and a pulmonary artery or a pulmonary vein, respectively. Bronchial artery interventions can be used successfully in the treatment of hemoptysis, with a low risk of adverse events. Multidetector computed tomography helps provide a vascular road map for the interventional radiologist before bronchial artery embolization. RSNA, 2015

  13. 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.

  14. Vascular patterns of upper limb: an anatomical study with accent on superficial brachial artery

    Directory of Open Access Journals (Sweden)

    David Kachlik

    2011-02-01

    Full Text Available The aim of the study was to evaluate the terminal segmentation of the axillary artery and to present four cases of anomalous branching of the axillary artery, the superficial brachial artery (arteria brachialis superficialis, which is defined as the brachial artery that runs superficially to the median nerve. Totally, 130 cadaveric upper arms embalmed by classical formaldehyde technique from collections of the Department of Anatomy, Third Faculty of Medicine, Charles University in Prague, were macroscopically dissected with special focus on the branching arrangement of the axillary artery. The most distal part of the axillary artery (infrapectoral part terminated in four cases as a bifurcation into two terminal branches: the superficial brachial artery and profunda brachii artery, denominated according to their relation to the median nerve. The profunda brachii artery primarily gave rise to the main branches of the infrapectoral part of the axillary artery. The superficial brachial artery descended to the cubital fossa where it assumed the usual course of the brachial artery in two cases and in the other two cases its branches (the radial and ulnar arteries passed superficially to the flexors. The incidence of the superficial brachial artery in our study was 5% of cases. The reported incidence is a bit contradictory, from 0.12% to 25% of cases. The anatomical knowledge of the axillary region is of crucial importance for neurosurgeons and specialists using the radiodiagnostic techniques, particularly in cases involving traumatic injuries. The improved knowledge would allow more accurate diagnostic interpretations and surgical treatment.

  15. A case of acute subdural hematoma due to ruptured aneurysm detected by postmortem angiography.

    Science.gov (United States)

    Inokuchi, Go; Makino, Yohsuke; Yajima, Daisuke; Motomura, Ayumi; Chiba, Fumiko; Torimitsu, Suguru; Hoshioka, Yumi; Iwase, Hirotaro

    2016-03-01

    Acute subdural hematoma (ASDH) is mostly caused by head trauma, but intrinsic causes also exist such as aneurysm rupture. We describe here a case involving a man in his 70s who was found lying on the bedroom floor by his family. CT performed at the hospital showed ASDH and a forensic autopsy was requested. Postmortem cerebral angiography showed dilatation of the bifurcation of the middle cerebral artery, which coincided with the dilated part of the Sylvian fissure. Extravasation of contrast medium into the subdural hematoma from this site was suggestive of a ruptured aneurysm. Autopsy revealed a fleshy hematoma (total weight 110 g) in the right subdural space and findings of brain herniation. As indicated on angiography, a ruptured saccular aneurysm was confirmed at the bifurcation of the middle cerebral artery. Obvious injuries to the head or face could not be detected on either external or internal examination, and intrinsic ASDH due to a ruptured middle cerebral artery aneurysm was determined as the cause of death. One of the key points of forensic diagnosis is the strict differentiation between intrinsic and extrinsic onset for conditions leading to death. Although most subdural hematomas (SDH) are caused by extrinsic factors, forensic pathologists should consider the possibility of intrinsic SDH. In addition, postmortem angiography can be useful for identifying vascular lesions in such cases.

  16. Post eclamptic aneurysmal rupture subarachnoid haemorrhage diagnosed in the puerperium

    International Nuclear Information System (INIS)

    Coolen, Teresa

    2006-01-01

    The incidence of subarachnoid and/or intracerebral haemorrhage in women during pregnancy is rare. The risk depends on the stage of pregnancy, but seems to be highest during the late third trimester, during delivery and in the puerperium. Headache can be a symptom of both preeclampsia, subarachnoid haemorrhage and other pathologies or conditions. It is essential for pregnant women with a suspected ruptured aneurysm to be investigated and treated without delay, irrespective of fear of harm to the foetus, to avoid complications from aneurysm rupture. This case study presents a 39-year-old woman who was 35 weeks and 3 days pregnant with known preeclampsia. She endured a headache for the three days leading up to the delivery with associated diplopia on the third day, but these symptoms were thought to be related to her preeclampsia. Over the three hours following childbirth, her headache became more severe and she suffered from vomiting, loss of vision, torticollis and seizures. Computed tomography (CT) of her head revealed a subarachnoid haemorrhage while CT angiography of the Circle of Willis failed to reveal an aneurysm and 4-vessel angiography only demonstrated an area slightly suspicious for the presence of an aneurysm. 3D rotational angiography clearly demonstrated a 1-2 mm aneurysm superior to the left terminal internal carotid artery. In this case, 3D rotational angiography proved to be a valuable additional technique. This patient underwent surgery for her ruptured aneurysm and has made an excellent recovery

  17. Angiographic findings of collateral vessels in cervicofacial vascular lesions with previously ligated carotid artery

    International Nuclear Information System (INIS)

    Na, Dong Gyu; Han, Moon Hee; Chang, Kee Hyun; Han, Gi Seok; Yeon, Kung Mo

    1995-01-01

    The purpose of this study is to describe the angiographic findings of collateral vessels in cervicofacial vascular lesions with previously ligated carotid arteries and to evaluate the extent of angiographic assessment needed before embolization. We retrospectively reviewed 10 cervicofacial vascular lesions with previously ligated carotid artery, which were 6 cases of arteriovenous malformation, 2 cases of carotid cavernous fistula, 1 case of hemangioma and 1 case of arteriovenous malformation with carotid cavernous fistula. The previously ligated arteries are proximal external carotid artery (n = 5), branches of external carotid artery (n = 2) and common carotid artery (n = 3). Common carotid artery or internal carotid artery (n = 9), vertebral artery (n = 5), ipsilateral external carotid artery (n = 4), contralateral external carotid artery (n = 5), costocervical trunk (n = 2), thyrocervical trunk (n = 2) were assessed by conventional angiography. Angiography of both carotid and vertebral arteries was performed in 5 cases. The collateral vascular channels were inferolateral trunk of internal carotid artery (n = 8), vertebral artery (n = 5), contralateral external carotid artery (n = 5), ipsilateral external carotid artery (n = 4), deep cervical artery (n = 2) and ascending cervical artery (n = 1). Embolization were performed in 9 cases with operative cannulation (n = 4), embolization via collateral branches of ipsilateral external carotid artery (n = 1), embolization via collateral branches of contralateral external carotid artery (n = 3) and balloon occlusion via direct puncture (n = 1). The collateral channels in cervicofacial vascular lesions with previously ligated carotid artery were inferolateral trunk of internal carotid artery, contralateral or ipsilateral external carotid artery, vertebral artery, deep cervical artery and ascending cervical artery on angiography. Complete angiographic assessment of possible collateral channels is mandatory for the

  18. Branching structure and strain hardening of branched metallocene polyethylenes

    International Nuclear Information System (INIS)

    Torres, Enrique; Li, Si-Wan; Costeux, Stéphane; Dealy, John M.

    2015-01-01

    There have been a number of studies of a series of branched metallocene polyethylenes (BMPs) made in a solution, continuous stirred tank reactor (CSTR) polymerization. The materials studied vary in branching level in a systematic way, and the most highly branched members of the series exhibit mild strain hardening. An outstanding question is which types of branched molecules are responsible for strain hardening in extension. This question is explored here by use of polymerization and rheological models along with new data on the extensional flow behavior of the most highly branched members of the set. After reviewing all that is known about the effects of various branching structures in homogeneous polymers and comparing this with the structures predicted to be present in BMPs, it is concluded that in spite of their very low concentration, treelike molecules with branch-on-branch structure provide a large number of deeply buried inner segments that are essential for strain hardening in these polymers

  19. Branching structure and strain hardening of branched metallocene polyethylenes

    Energy Technology Data Exchange (ETDEWEB)

    Torres, Enrique; Li, Si-Wan; Costeux, Stéphane; Dealy, John M., E-mail: john.dealy@mcgill.ca [Department of Chemical Engineering, McGill University, Montreal, Quebec H3A 0C4 (Canada)

    2015-09-15

    There have been a number of studies of a series of branched metallocene polyethylenes (BMPs) made in a solution, continuous stirred tank reactor (CSTR) polymerization. The materials studied vary in branching level in a systematic way, and the most highly branched members of the series exhibit mild strain hardening. An outstanding question is which types of branched molecules are responsible for strain hardening in extension. This question is explored here by use of polymerization and rheological models along with new data on the extensional flow behavior of the most highly branched members of the set. After reviewing all that is known about the effects of various branching structures in homogeneous polymers and comparing this with the structures predicted to be present in BMPs, it is concluded that in spite of their very low concentration, treelike molecules with branch-on-branch structure provide a large number of deeply buried inner segments that are essential for strain hardening in these polymers.

  20. Immediate endovascular treatment of an aortoiliac aneurysm ruptured into the inferior vena cava.

    Science.gov (United States)

    Kopp, Reinhard; Weidenhagen, Rolf; Hoffmann, Ralf; Waggershauser, Tobias; Meimarakis, Georgios; Andrassy, Joachim; Clevert, Dirk; Czerner, Stephan; Jauch, Karl-Walter

    2006-07-01

    An aortocaval fistula is a severe complication of an aortoiliac aneurysm, usually associated with high perioperative morbidity and mortality during open operative repair. We describe the successful endovascular treatment of a symptomatic infrarenal aortic aneurysm ruptured into the inferior vena cava with secondary interventional coiling of a persistent type II endoleak because of retrograde perfusion of the inferior mesenteric artery. Endovascular exclusion of ruptured abdominal aneurysms seems to be a valuable treatment option for selected patients even with complicated vascular conditions like an aortocaval fistula.

  1. A Segmental Hypoplastic Anterior Tibial Artery Coexisting with a Hypertrophied Perforating Fibular Artery a Case Report and Clinical Implications

    OpenAIRE

    Ariyo, Olutayo

    2015-01-01

    Vascular injuries of the lower limb, especially from penetrating gunshot wounds, and peripheral arterial diseases are on the increase and management of these and many other lower limb injuries involve increasing usage of vascular interventions like by-pass surgery, per-cutaneous transluminal angioplasty, arterial cannulation, arterial bypass graft or minimally invasive measures like percutaneous trans-arterial catheterization, among others. A thorough knowledge of infrapopliteal branching mos...

  2. Achilles tendon rupture in badminton.

    Science.gov (United States)

    Kaalund, S; Lass, P; Høgsaa, B; Nøhr, M

    1989-01-01

    The typical badminton player with an Achilles tendon rupture is 36 years old and, despite limbering up, is injured at the rear line in a sudden forward movement. He resumes work within three months and has a slight lack of dorsiflexion in the ankle as the main complication. Most patients resume badminton within one year, but some finish their sports career, mainly due to fear of a new injury. The investigation discusses predisposing factors and prophylactic measures. PMID:2605439

  3. Right bundle branch block

    DEFF Research Database (Denmark)

    Bussink, Barbara E; Holst, Anders Gaarsdal; Jespersen, Lasse

    2013-01-01

    AimsTo determine the prevalence, predictors of newly acquired, and the prognostic value of right bundle branch block (RBBB) and incomplete RBBB (IRBBB) on a resting 12-lead electrocardiogram in men and women from the general population.Methods and resultsWe followed 18 441 participants included...... in the Copenhagen City Heart Study examined in 1976-2003 free from previous myocardial infarction (MI), chronic heart failure, and left bundle branch block through registry linkage until 2009 for all-cause mortality and cardiovascular outcomes. The prevalence of RBBB/IRBBB was higher in men (1.4%/4.7% in men vs. 0.......5%/2.3% in women, P block was associated with significantly...

  4. Generalized Markov branching models

    OpenAIRE

    Li, Junping

    2005-01-01

    In this thesis, we first considered a modified Markov branching process incorporating both state-independent immigration and resurrection. After establishing the criteria for regularity and uniqueness, explicit expressions for the extinction probability and mean extinction time are presented. The criteria for recurrence and ergodicity are also established. In addition, an explicit expression for the equilibrium distribution is presented.\\ud \\ud We then moved on to investigate the basic proper...

  5. Tau leptonic branching ratios

    CERN Document Server

    Buskulic, Damir; De Bonis, I; Décamp, D; Ghez, P; Goy, C; Lees, J P; Lucotte, A; Minard, M N; Odier, P; Pietrzyk, B; Ariztizabal, F; Chmeissani, M; Crespo, J M; Efthymiopoulos, I; Fernández, E; Fernández-Bosman, M; Gaitan, V; Garrido, L; Martínez, M; Orteu, S; Pacheco, A; Padilla, C; Palla, Fabrizio; Pascual, A; Perlas, J A; Sánchez, F; Teubert, F; Colaleo, A; Creanza, D; De Palma, M; Farilla, A; Gelao, G; Girone, M; Iaselli, Giuseppe; Maggi, G; Maggi, M; Marinelli, N; Natali, S; Nuzzo, S; Ranieri, A; Raso, G; Romano, F; Ruggieri, F; Selvaggi, G; Silvestris, L; Tempesta, P; Zito, G; Huang, X; Lin, J; Ouyang, Q; Wang, T; Xie, Y; Xu, R; Xue, S; Zhang, J; Zhang, L; Zhao, W; Bonvicini, G; Cattaneo, M; Comas, P; Coyle, P; Drevermann, H; Engelhardt, A; Forty, Roger W; Frank, M; Hagelberg, R; Harvey, J; Jacobsen, R; Janot, P; Jost, B; Kneringer, E; Knobloch, J; Lehraus, Ivan; Markou, C; Martin, E B; Mato, P; Minten, Adolf G; Miquel, R; Oest, T; Palazzi, P; Pater, J R; Pusztaszeri, J F; Ranjard, F; Rensing, P E; Rolandi, Luigi; Schlatter, W D; Schmelling, M; Schneider, O; Tejessy, W; Tomalin, I R; Venturi, A; Wachsmuth, H W; Wiedenmann, W; Wildish, T; Witzeling, W; Wotschack, J; Ajaltouni, Ziad J; Bardadin-Otwinowska, Maria; Barrès, A; Boyer, C; Falvard, A; Gay, P; Guicheney, C; Henrard, P; Jousset, J; Michel, B; Monteil, S; Montret, J C; Pallin, D; Perret, P; Podlyski, F; Proriol, J; Rossignol, J M; Saadi, F; Fearnley, Tom; Hansen, J B; Hansen, J D; Hansen, J R; Hansen, P H; Nilsson, B S; Kyriakis, A; Simopoulou, Errietta; Siotis, I; Vayaki, Anna; Zachariadou, K; Blondel, A; Bonneaud, G R; Brient, J C; Bourdon, P; Passalacqua, L; Rougé, A; Rumpf, M; Tanaka, R; Valassi, Andrea; Verderi, M; Videau, H L; Candlin, D J; Parsons, M I; Focardi, E; Parrini, G; Corden, M; Delfino, M C; Georgiopoulos, C H; Jaffe, D E; Antonelli, A; Bencivenni, G; Bologna, G; Bossi, F; Campana, P; Capon, G; Chiarella, V; Felici, G; Laurelli, P; Mannocchi, G; Murtas, F; Murtas, G P; Pepé-Altarelli, M; Dorris, S J; Halley, A W; ten Have, I; Knowles, I G; Lynch, J G; Morton, W T; O'Shea, V; Raine, C; Reeves, P; Scarr, J M; Smith, K; Smith, M G; Thompson, A S; Thomson, F; Thorn, S; Turnbull, R M; Becker, U; Braun, O; Geweniger, C; Graefe, G; Hanke, P; Hepp, V; Kluge, E E; Putzer, A; Rensch, B; Schmidt, M; Sommer, J; Stenzel, H; Tittel, K; Werner, S; Wunsch, M; Beuselinck, R; Binnie, David M; Cameron, W; Colling, D J; Dornan, Peter J; Konstantinidis, N P; Moneta, L; Moutoussi, A; Nash, J; San Martin, G; Sedgbeer, J K; Stacey, A M; Dissertori, G; Girtler, P; Kuhn, D; Rudolph, G; Bowdery, C K; Brodbeck, T J; Colrain, P; Crawford, G; Finch, A J; Foster, F; Hughes, G; Sloan, Terence; Whelan, E P; Williams, M I; Galla, A; Greene, A M; Kleinknecht, K; Quast, G; Raab, J; Renk, B; Sander, H G; Wanke, R; Van Gemmeren, P; Zeitnitz, C; Aubert, Jean-Jacques; Bencheikh, A M; Benchouk, C; Bonissent, A; Bujosa, G; Calvet, D; Carr, J; Diaconu, C A; Etienne, F; Thulasidas, M; Nicod, D; Payre, P; Rousseau, D; Talby, M; Abt, I; Assmann, R W; Bauer, C; Blum, Walter; Brown, D; Dietl, H; Dydak, Friedrich; Ganis, G; Gotzhein, C; Jakobs, K; Kroha, H; Lütjens, G; Lutz, Gerhard; Männer, W; Moser, H G; Richter, R H; Rosado-Schlosser, A; Schael, S; Settles, Ronald; Seywerd, H C J; Saint-Denis, R; Wolf, G; Alemany, R; Boucrot, J; Callot, O; Cordier, A; Courault, F; Davier, M; Duflot, L; Grivaz, J F; Heusse, P; Jacquet, M; Kim, D W; Le Diberder, F R; Lefrançois, J; Lutz, A M; Musolino, G; Nikolic, I A; Park, H J; Park, I C; Schune, M H; Simion, S; Veillet, J J; Videau, I; Abbaneo, D; Azzurri, P; Bagliesi, G; Batignani, G; Bettarini, S; Bozzi, C; Calderini, G; Carpinelli, M; Ciocci, M A; Ciulli, V; Dell'Orso, R; Fantechi, R; Ferrante, I; Foà, L; Forti, F; Giassi, A; Giorgi, M A; Gregorio, A; Ligabue, F; Lusiani, A; Marrocchesi, P S; Messineo, A; Rizzo, G; Sanguinetti, G; Sciabà, A; Spagnolo, P; Steinberger, Jack; Tenchini, Roberto; Tonelli, G; Triggiani, G; Vannini, C; Verdini, P G; Walsh, J; Betteridge, A P; Blair, G A; Bryant, L M; Cerutti, F; Gao, Y; Green, M G; Johnson, D L; Medcalf, T; Mir, L M; Perrodo, P; Strong, J A; Bertin, V; Botterill, David R; Clifft, R W; Edgecock, T R; Haywood, S; Edwards, M; Maley, P; Norton, P R; Thompson, J C; Bloch-Devaux, B; Colas, P; Emery, S; Kozanecki, Witold; Lançon, E; Lemaire, M C; Locci, E; Marx, B; Pérez, P; Rander, J; Renardy, J F; Roussarie, A; Schuller, J P; Schwindling, J; Trabelsi, A; Vallage, B; Johnson, R P; Kim, H Y; Litke, A M; McNeil, M A; Taylor, G; Beddall, A; Booth, C N; Boswell, R; Cartwright, S L; Combley, F; Dawson, I; Köksal, A; Letho, M; Newton, W M; Rankin, C; Thompson, L F; Böhrer, A; Brandt, S; Cowan, G D; Feigl, E; Grupen, Claus; Lutters, G; Minguet-Rodríguez, J A; Rivera, F; Saraiva, P; Smolik, L; Stephan, F; Apollonio, M; Bosisio, L; Della Marina, R; Giannini, G; Gobbo, B; Ragusa, F; Rothberg, J E; Wasserbaech, S R; Armstrong, S R; Bellantoni, L; Elmer, P; Feng, Z; Ferguson, D P S; Gao, Y S; González, S; Grahl, J; Harton, J L; Hayes, O J; Hu, H; McNamara, P A; Nachtman, J M; Orejudos, W; Pan, Y B; Saadi, Y; Schmitt, M; Scott, I J; Sharma, V; Turk, J; Walsh, A M; Wu Sau Lan; Wu, X; Yamartino, J M; Zheng, M; Zobernig, G

    1996-01-01

    A sample of 62249 \\tau-pair events is selected from data taken with the ALEPH detector in 1991, 1992 and 1993. The measurement of the branching fractions for \\tau decays into electrons and muons is presented with emphasis on the study of systematic effects from selection, particle identification and decay classification. Combined with the most recent ALEPH determination of the \\tau lifetime, these results provide a relative measurement of the leptonic couplings in the weak charged current for transverse W bosons.

  6. Caliber-Persistent Artery

    Directory of Open Access Journals (Sweden)

    Sabrina Araújo Pinho Costa

    2015-01-01

    Full Text Available Caliber-persistent artery (CPLA of the lip is a common vascular anomaly in which a main arterial branch extends to the surface of the mucous tissue with no reduction in its diameter. It usually manifests as pulsatile papule, is easily misdiagnosed, and is observed more frequently among older people, suggesting that its development may involve a degenerative process associated with aging; CPLA is also characterized by the loss of tone of the adjacent supporting connective tissue. Although the diagnosis is clinical, high-resolution Doppler ultrasound is a useful noninvasive tool for evaluating the lesion. This report describes the case of a 58-year-old male patient who complained of a lesion of the lower lip with bleeding and recurrent ulceration. The patient was successfully treated in our hospital after a diagnosis of CPLA and is currently undergoing a clinical outpatient follow-up with no complaints.

  7. Geometric Deformations of the Thoracic Aorta and Supra-Aortic Arch Branch Vessels Following Thoracic Endovascular Aortic Repair.

    Science.gov (United States)

    Ullery, Brant W; Suh, Ga-Young; Hirotsu, Kelsey; Zhu, David; Lee, Jason T; Dake, Michael D; Fleischmann, Dominik; Cheng, Christopher P

    2018-04-01

    To utilize 3-D modeling techniques to better characterize geometric deformations of the supra-aortic arch branch vessels and descending thoracic aorta after thoracic endovascular aortic repair. Eighteen patients underwent endovascular repair of either type B aortic dissection (n = 10) or thoracic aortic aneurysm (n = 8). Computed tomography angiography was obtained pre- and postprocedure, and 3-D geometric models of the aorta and supra-aortic branch vessels were constructed. Branch angle of the supra-aortic branch vessels and curvature metrics of the ascending aorta, aortic arch, and stented thoracic aortic lumen were calculated both at pre- and postintervention. The left common carotid artery branch angle was lower than the left subclavian artery angles preintervention ( P Supra-aortic branch vessel angulation remains relatively static when proximal landing zones are distal to the left common carotid artery.

  8. Amnioinfusion for preterm premature rupture of membranes.

    Science.gov (United States)

    Hofmeyr, G Justus; Essilfie-Appiah, George; Lawrie, Theresa A

    2011-12-07

    Preterm premature rupture of membranes (PPROM) is a leading cause of perinatal morbidity and mortality. Amnioinfusion aims to restore amniotic fluid volume by infusing a solution into the uterine cavity. The objective of this review was to assess the effects of amnioinfusion for PPROM on perinatal and maternal morbidity and mortality. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2011). Randomised trials of amnioinfusion compared to no amnioinfusion in women with PPROM. Three review authors independently assessed trials for inclusion. Two review authors independently assessed trial quality and extracted data. Data were checked for accuracy. We included five trials but we only analysed data from four studies (with a total of 241 participants). One trial did not contribute any data to the review.Transcervical amnioinfusion improved fetal umbilical artery pH at delivery (mean difference 0.11; 95% confidence interval (CI) 0.08 to 0.14; one trial, 61 participants) and reduced persistent variable decelerations during labour (risk ratio (RR) 0.52; 95% CI 0.30 to 0.91; one trial, 86 participants).Transabdominal amnioinfusion was associated with a reduction in neonatal death (RR 0.30; 95% CI 0.14 to 0.66; two trials, 94 participants), neonatal sepsis (RR 0.26, 95% CI 0.11 to 0.61; one trial, 60 participants), pulmonary hypoplasia (RR 0.22; 95% CI 0.06 to 0.88; one trial, 34 participants) and puerperal sepsis (RR 0.20; 95% CI 0.05 to 0.84; one trial, 60 participants). Women in the amnioinfusion group were also less likely to deliver within seven days of membrane rupture (RR 0.18; 95% CI 0.05 to 0.70; one trial, 34 participants). These results should be treated with circumspection as the positive findings were mainly due to one trial with unclear allocation concealment. These results are encouraging but are limited by the sparse data and unclear methodological robustness, therefore further evidence is required before amnioinfusion for

  9. The common iliac artery in the ground squirrel (Citellus citellus

    Directory of Open Access Journals (Sweden)

    Blagojević M.

    2013-01-01

    Full Text Available The common iliac arteries (a. iliaca communis dextra et a. iliaca communis sinistra are the terminal branches of the abdominal aorta. The paired external iliac artery (a. iliaca externa dextra et a. iliaca externa sinistra is a stronger branch of the paired common iliac artery. Before they leave the abdominal cavity and continue as the femoral arteries (a. femoralis dextra et a. femoralis sinistra each external iliac artery forms the following branches: 1. The internal pudendal artery (a. pudenda interna which, with its branches, supplies the tensor fasciae latae and quadriceps muscles (a. circumflexa femoris lateralis, cranial region of the urinary bladder, cranial end of the uterine horn in females, the deferent duct and tail of the epididymis in males (a. umbilicalis the rectum, the external anal sphincter and perineum (a. rectalis caudalis with blood. 2. The obturator artery (a. obturatoria, which supplies both of the obturator muscles, as well as the proximal end of the adductor muscle. 3. The pudendoepigastric trunk (truncus pudendoepigastricus is a short vessel, which with its branches (a. pudenda externa, a. epigastrica caudalis et a. urethrogenitalis supplies the caudal end of the rectus abdominis muscle, tip of the penis, preputium, superficial inguinal lymph nodes, scrotum in males and inguinal mamma in females, transversus and internus abdominis muscles, neck of the urinary bladder, urethra, vagina and vulva in females and accessory glands in males. 4. Paired internal iliac arteries (a. iliaca interna dextra et a. iliaca interna sinistra are thinner branches than the external iliac arteries. The internal iliac artery with its branches supplies the cranial and caudal parts of the gluteal muscles (a. glutea cranialis et a. glutea caudalis, as well as the muscles of the lateral side of the tail (a. caudalis lateralis. [Projekat Ministarstva nauke Republike Srbije, br. 143018

  10. Size ratio performance in detecting cerebral aneurysm rupture status is insensitive to small vessel removal.

    Science.gov (United States)

    Lauric, Alexandra; Baharoglu, Merih I; Malek, Adel M

    2013-04-01

    The variable definition of size ratio (SR) for sidewall (SW) vs bifurcation (BIF) aneurysms raises confusion for lesions harboring small branches, such as carotid ophthalmic or posterior communicating locations. These aneurysms are considered SW by many clinicians, but SR methodology classifies them as BIF. To evaluate the effect of ignoring small vessels and SW vs stringent BIF labeling on SR ruptured aneurysm detection performance in borderline aneurysms with small branches, and to reconcile SR-based labeling with clinical SW/BIF classification. Catheter rotational angiographic datasets of 134 consecutive aneurysms (60 ruptured) were automatically measured in 3-dimensional. Stringent BIF labeling was applied to clinically labeled aneurysms, with 21 aneurysms switching label from SW to BIF. Parent vessel size was evaluated both taking into account, and ignoring, small vessels. SR was defined accordingly as the ratio between aneurysm and parent vessel sizes. Univariate and multivariate statistics identified significant features. The square of the correlation coefficient (R(2)) was reported for bivariate analysis of alternative SR calculations. Regardless of SW/BIF labeling method, SR was equally significant in discriminating aneurysm ruptured status (P analysis of alternative SR had a high correlation of R(2) = 0.94 on the whole dataset, and R = 0.98 on the 21 borderline aneurysms. Ignoring small branches from SR calculation maintains rupture status detection performance, while reducing postprocessing complexity and removing labeling ambiguity. Aneurysms adjacent to these vessels can be considered SW for morphometric analysis. It is reasonable to use the clinical SW/BIF labeling when using SR for rupture risk evaluation.

  11. Extrahepatic Arteries Originating from Hepatic Arteries: Analysis Using CT During Hepatic Arteriography and Visualization on Digital Subtraction Angiography

    International Nuclear Information System (INIS)

    Ozaki, Kumi; Kobayashi, Satoshi; Matsui, Osamu; Minami, Tetsuya; Koda, Wataru; Gabata, Toshifumi

    2017-01-01

    PurposeTo investigate the prevalence and site of origin of extrahepatic arteries originating from hepatic arteries on early phase CT during hepatic arteriography (CTHA) was accessed. Visualization of these elements on digital subtraction hepatic angiography (DSHA) was assessed using CTHA images as a gold standard.Materials and MethodsA total of 943 patients (mean age 66.9 ± 10.3 years; male/female, 619/324) underwent CTHA and DSHA. The prevalence and site of origin of extrahepatic arteries were accessed using CTHA and visualized using DSHA.ResultsIn 924 (98.0%) patients, a total of 1555 extrahepatic branches, representing eight types, were found to originate from hepatic arteries on CTHA. CTHA indicated the following extrahepatic branch prevalence rates: right gastric artery, 890 (94.4%); falciform artery, 386 (40.9%); accessory left gastric artery, 161 (17.1%); left inferior phrenic artery (IPA), 43 (4.6%); posterior superior pancreaticoduodenal artery, 33 (3.5%); dorsal pancreatic artery, 26 (2.8%); duodenal artery, 12 (1.3%); and right IPA, 4 (0.4%). In addition, 383 patients (40.6%) had at least one undetectable branch on DSHA. The sensitivity, specificity, and accuracy of visualization on DSHA were as follows: RGA, 80.0, 86.8, and 80.4%; falciform artery, 53.9, 97.7, and 80.0%; accessory LGA, 64.6, 98.6, and 92.3%; left IPA, 76.7, 99.8, and 98.7%; PSPDA, 100, 99.7, and 99.9%; dorsal pancreatic artery, 57.7, 100, and 98.8%; duodenal artery, 8.3, 99.9, and 98.7%; and right IPA, 0, 100, and 99.6%, respectively.ConclusionExtrahepatic arteries originating from hepatic arteries were frequently identified on CTHA images. These arteries were frequently overlooked on DSHA.

  12. Extrahepatic Arteries Originating from Hepatic Arteries: Analysis Using CT During Hepatic Arteriography and Visualization on Digital Subtraction Angiography

    Energy Technology Data Exchange (ETDEWEB)

    Ozaki, Kumi, E-mail: ozakik-rad@umin.org [Kanazawa University Graduate School of Medical Science, Department of Radiology (Japan); Kobayashi, Satoshi [Kanazawa University Graduate School of Medical Science, Department of Quantum Medicine Technology (Japan); Matsui, Osamu; Minami, Tetsuya; Koda, Wataru; Gabata, Toshifumi [Kanazawa University Graduate School of Medical Science, Department of Radiology (Japan)

    2017-06-15

    PurposeTo investigate the prevalence and site of origin of extrahepatic arteries originating from hepatic arteries on early phase CT during hepatic arteriography (CTHA) was accessed. Visualization of these elements on digital subtraction hepatic angiography (DSHA) was assessed using CTHA images as a gold standard.Materials and MethodsA total of 943 patients (mean age 66.9 ± 10.3 years; male/female, 619/324) underwent CTHA and DSHA. The prevalence and site of origin of extrahepatic arteries were accessed using CTHA and visualized using DSHA.ResultsIn 924 (98.0%) patients, a total of 1555 extrahepatic branches, representing eight types, were found to originate from hepatic arteries on CTHA. CTHA indicated the following extrahepatic branch prevalence rates: right gastric artery, 890 (94.4%); falciform artery, 386 (40.9%); accessory left gastric artery, 161 (17.1%); left inferior phrenic artery (IPA), 43 (4.6%); posterior superior pancreaticoduodenal artery, 33 (3.5%); dorsal pancreatic artery, 26 (2.8%); duodenal artery, 12 (1.3%); and right IPA, 4 (0.4%). In addition, 383 patients (40.6%) had at least one undetectable branch on DSHA. The sensitivity, specificity, and accuracy of visualization on DSHA were as follows: RGA, 80.0, 86.8, and 80.4%; falciform artery, 53.9, 97.7, and 80.0%; accessory LGA, 64.6, 98.6, and 92.3%; left IPA, 76.7, 99.8, and 98.7%; PSPDA, 100, 99.7, and 99.9%; dorsal pancreatic artery, 57.7, 100, and 98.8%; duodenal artery, 8.3, 99.9, and 98.7%; and right IPA, 0, 100, and 99.6%, respectively.ConclusionExtrahepatic arteries originating from hepatic arteries were frequently identified on CTHA images. These arteries were frequently overlooked on DSHA.

  13. Pulmonary Artery Dissection: A Fatal Complication of Pulmonary Hypertension

    Directory of Open Access Journals (Sweden)

    Chuanchen Zhang

    2016-01-01

    Full Text Available Pulmonary artery dissection is extremely rare but it is a really life-threatening condition when it happens. Most patients die suddenly from major bleeding or tamponade caused by direct rupture into mediastinum or retrograde into the pericardial sac. What we are reporting is a rare case of a 46-year-old female patient whose pulmonary artery dissection involves both the pulmonary valve and right pulmonary artery. The patient had acute chest pain and severe dyspnea, and the diagnosis of pulmonary artery dissection was confirmed by ultrasonography and CT angiography. Moreover, its etiology, clinical manifestations, and management are also discussed in this article.

  14. The branch librarians' handbook

    CERN Document Server

    Rivers, Vickie

    2004-01-01

    ""Recommended""--Booklist; ""an excellent addition...highly recommended""--Public Libraries; ""clear...very sound advice...strongly recommend""--Catholic Library World; ""excellent resource...organized...well written""--Against the Grain; ""interesting...thoroughly practical...a very good book...well organized...clearly written""--ARBA. This handbook covers a wide variety of issues that the branch librarian must deal with every day. Chapters are devoted to mission statements (the Dallas Public Library and Dayton Metro Library mission statements are highlighted as examples), library systems,

  15. Subarachnoid hemorrhage due to ruptured intracranial aneurysm following posterior reversible encephalopathy syndrome

    Directory of Open Access Journals (Sweden)

    Takamasa Nanba

    2016-01-01

    Full Text Available Although posterior reversible encephalopathy syndrome (PRES is rarely associated with subarachnoid hemorrhage, to our knowledge, rupture of a concomitant cerebral aneurysm following PRES has not been reported. We describe a patient with atypical PRES involving the brainstem, thalamus, and periventricular white matter without cortical or subcortical edema of the parietooccipital lobe on magnetic resonance imaging, with rupture of a concomitant cerebral aneurysm. Preexisting extremely high blood pressure may trigger atypical PRES, and failure to lower blood pressure may lead to a concomitant aneurysm rupture. In the future treatment of hypertensive urgency with a recurrence of symptoms and mean arterial blood pressure >150 mmHg, it is advisable to immediately hospitalize the patient for aggressive blood pressure management, especially if PRES is suspected based on clinical and radiological features.

  16. Acute retroperitoneal bleeding due to inferior mesenteric artery aneurysm: Case report

    Directory of Open Access Journals (Sweden)

    Ferrón JA

    2010-06-01

    Full Text Available Abstract Background Visceral artery aneurysms (VAA, although uncommon, are increasingly being detected. We describe a case of spontaneous retroperitoneal hemorrhage from a ruptured IMA aneurysm associated with stenosis of the superior mesenteric artery (SMA and celiac trunk, successfully treated with surgery. Methods A 65-year-old man presented with abdominal pain and hypovolemic shock. Abdominal CT scan showed an aneurysm of the inferior mesenteric artery with retroperitoneal hematoma. In addition, an obstructive disease of the superior mesenteric artery and celiac axis was observed. Results Upon emergency laparotomy a ruptured inferior mesenteric artery aneurysm was detected. The aneurysm was excised and the artery reconstructed by end-to-end anastomosis. Conclusions This report discusses the etiology, presentation, diagnosis and case management of inferior mesenteric artery aneurysms.

  17. Sequential Hybrid Repair of Aorta and Bilateral Common Iliac Arteries Secondary to Chronic Aortic Dissection with Extensive Aneurysmal Degeneration in a Marfan Patient.

    Science.gov (United States)

    Hinojosa, Carlos A; Anaya-Ayala, Javier E; Laparra-Escareno, Hugo; Lizola, Rene; Torres-Machorro, Adriana

    2017-09-01

    Marfan syndrome is a connective tissue disorder associated with aortic dissection, aneurysmal degeneration and rupture. These cardiovascular complications represent the main cause of mortality, therefore repair is indicated. We present a 35-year-old woman who experienced acute onset of chest pain. Her imaging revealed a chronic DeBakey type I dissection with aortic root dilation and descending thoracic aneurysmal degeneration. She underwent a Bentall procedure and endovascular exclusion of the descending thoracic aortic aneurysm. She was closely followed and 2 years later a computed tomography angiography (CTA) revealed the aneurysmal degeneration of the thoracoabominal aorta and bilateral iliac arteries. The patient underwent a composite reconstruction using multi-visceral branched and bifurcated Dacron grafts. At 5 years from her last surgery, a CTA revealed no new dissection or further aneurysmal degenerations. Aortic disease in Marfan patients is a complex clinical problem that may lead to secondary or tertiary aortic reconstructions; close follow-up is mandatory.

  18. Neck curve polynomials in neck rupture model

    International Nuclear Information System (INIS)

    Kurniadi, Rizal; Perkasa, Yudha S.; Waris, Abdul

    2012-01-01

    The Neck Rupture Model is a model that explains the scission process which has smallest radius in liquid drop at certain position. Old fashion of rupture position is determined randomly so that has been called as Random Neck Rupture Model (RNRM). The neck curve polynomials have been employed in the Neck Rupture Model for calculation the fission yield of neutron induced fission reaction of 280 X 90 with changing of order of polynomials as well as temperature. The neck curve polynomials approximation shows the important effects in shaping of fission yield curve.

  19. Acute Pectoralis Major Rupture Captured on Video

    Directory of Open Access Journals (Sweden)

    Alejandro Ordas Bayon

    2016-01-01

    Full Text Available Pectoralis major (PM ruptures are uncommon injuries, although they are becoming more frequent. We report a case of a PM rupture in a young male who presented with axillar pain and absence of the anterior axillary fold after he perceived a snap while lifting 200 kg in the bench press. Diagnosis of PM rupture was suspected clinically and confirmed with imaging studies. The patient was treated surgically, reinserting the tendon to the humerus with suture anchors. One-year follow-up showed excellent results. The patient was recording his training on video, so we can observe in detail the most common mechanism of injury of PM rupture.

  20. Traumatic rupture of an intracranial dermoid cyst

    Directory of Open Access Journals (Sweden)

    Raksha Ramlakhan, BMedSc, MBBCh

    2015-01-01

    Full Text Available Intracranial dermoid cysts are congenital tumors of ectodermal origin. Rupture of these cysts can occur spontaneously, but rupture in association with trauma is reported infrequently. The diagnosis of rupture is made by the presence of lipid (cholesterol droplets in the subarachnoid spaces and ventricles. Nonenhanced CT of the head demonstrates multiple foci of low attenuation that correspond with hyperintense signal on T1-weighted MRI. We present a case of an adult patient with rupture of an intracranial dermoid cyst, precipitated by minor trauma.

  1. CT diagnosis of ruptured abdominal aortic aneurysm

    International Nuclear Information System (INIS)

    Sacknoff, R.; Novelline, R.A.; Wittenberg, J.; Waltman, A.C.; De Luca, S.A.; Rhea, J.T.; Lawrason, J.N.

    1986-01-01

    Ruptured abdominal aortic aneurysm (AAA) is a life-threatening condition requiring immediate diagnosis and surgery. In a series of 23 consecutive patients scanned by CT for suspected ruptured AAA, CT proved 100% accurate. In seven patients with surgically or pathologically proved ruptured AAA, CT demonstrated a similar distribution of hemorrhage into the perirenal space and to a lesser degree into the anterior and posterior pararenal spaces. The 16 true-negative examinations included ten in patients with unruptured AAA and six in patients with other diseases. The authors conclude that patients in stable condition with suspected ruptured AAA should be examined by CT

  2. Angioplasty in stenosis of the innominate artery

    International Nuclear Information System (INIS)

    Kobinia, G.S.; Bergmann, H. Jr.

    1983-01-01

    We describe a successful percutaneous transluminal dilatation (PTD) of an innominate artery stenosis in a 40-year-old patient with aortic arch syndrome. Five years earlier both a left central carotid artery occlusion and an innominate and left subclavian artery stenosis were treated by grafting from the aorta to the distal vessels. At recurrence of the neurological symptoms, reocclusion of the graft to the innominate artery and subtotal stenosis of the left carotid anastomosis were noted. The prevent the hazards of a reoperation, the innominate artery stenosis was dilated by means of PTD via the right brachial artery. Success of the procedure was demonstrated by Doppler sonography and angiography. It appears that PTD serves as an excellent method of treating stenoses of the aortic arch branches in aortic arch syndrome. (orig.)

  3. HUMAN CORONARY ARTERIES- A STUDY BASED ON GROSS ANATOMY AND CORONARY CAST

    Directory of Open Access Journals (Sweden)

    Vijayamma K. N

    2018-01-01

    Full Text Available BACKGROUND Present study is an attempt to throw light upon the coronary arterial pattern, variations in arterial distribution and extent of intercoronary anastomosis and arterial preponderance in different age groups. MATERIALS AND METHODS Total of 115 hearts were made use for this study. Ninety hearts were dissected for the gross anatomical study of coronary arteries and 25 hearts including three fetal hearts were used for the coronary cast study. The right and left coronary arteries were traced from aortic sinus along the atrioventricular groove to the area of its termination. The atrial ventricular and septal branches were traced and looked for anastomosis. Coronary casts were prepared by injecting coloured liquid latex through the coronary ostia and the branching pattern and anastomosis were studied. The coronary arterial pattern, extent of distribution of its branches, arterial preponderance and variations were observed. RESULTS It was found that 73 % cases of SA nodal branch arise from right coronary artery and 27 % from circumflex branch of left coronary artery. SA node has dual blood supply from both coronary arteries in 4% cases. Right coronary preponderance was observed in 83% of cases and left coronary preponderance in 11 % cases, and balanced supply in 6% cases. Coronary cast was helpful to understand the branching pattern of vessels, and the anastomosis of small capillaries. It was also seen that all 11 % of left preponderance were seen in male hearts and all of the 31 female hearts dissected were right preponderant. CONCLUSION Coronary arteries are called end arteries functionally. Right coronary artery originates from anterior aortic sinus in all cases except one which takes origin from posterior left aortic sinus along with left coronary artery. Right coronary preponderance is observed in 83% cases. Left coronary artery branching pattern shows variability. Left coronary preponderance was observed in 11% and all cases are male

  4. Outcomes after open repair for ruptured abdominal aortic aneurysms in patients with friendly versus hostile aortoiliac anatomy

    NARCIS (Netherlands)

    van Beek, S. C.; Reimerink, J. J.; Vahl, A. C.; Wisselink, W.; Reekers, J. A.; Legemate, D. A.; Balm, R.

    2014-01-01

    In patients with a ruptured abdominal aortic aneurysm (RAAA), anatomic suitability for endovascular aneurysm repair (EVAR) depends on aortic neck and iliac artery characteristics. If the aortoiliac anatomy is unsuitable for EVAR ("hostile anatomy"), open repair (OR) is the next option. We

  5. Therapeutic effect of enterprise stent-assisted embolization for very small ruptured intracranial aneurysms.

    Science.gov (United States)

    Qin, Feiyun; Li, Zhenbao; Fang, Xinggen; Zhao, Xintong; Liu, Jiaqiang; Wu, Degang; Lai, Niansheng

    2017-08-01

    Enterprise stent has been widespread used in wide-necked intracranial aneurysms and good efficacy has been achieved, but there are few reports on its applications in very small ruptured intracranial aneurysms in literatures. This study aimed to evaluate the safety and efficacy of Enterprise stent-assisted coiling embolization of very small ruptured intracranial aneurysms.We retrospectively reviewed the clinical and imaging data from 37 patients with very small ruptured intracranial aneurysms who had SAC using Enterprise stents performed from February 2012 to July 2016 in our department. Data collected and analyzed included patient demographics, morphologic features of the aneurysm, treatment results, and follow-up results. Clinical outcomes were evaluated by the Glasgow Outcome Scale (GOS).Enterprise stents were successfully implanted in all 37 patients with very small ruptured intracranial aneurysms. Of the 37 individuals, 28 patients exhibited complete occlusion at Raymond grade I, 5 patients exhibited occlusion at Raymond grade II, and 4 patients at Raymond grade III. Procedure-related complications occurred in 3 of 37 patients (8.1%), including 1 case of intraprocedure aneurysm rupture who died from cerebral herniation caused by severe postoperative cerebral ischemia during the hospital stay, and the other 2 complications were acute in-stent thrombosis, and occlusion of parent artery caused by falling-off internal carotid artery plaque, respectively. A total of 36 patients underwent postoperative clinical follow-up visits for 6 to 24 months of which 31 patients recovered (GOS ≥ 4). One patient had hemiplegic paralysis, and no rehemorrhage was found. A total of 25 patients underwent follow-up digital subtraction angiography (DSA) at 3-21 months postintervention, in whom there were 22 cases with complete occlusion, 2 cases with recurrence of aneurysm neck, and 1 case with in-stent restenosis, but there was no patient with neurologic deficits.The Enterprise

  6. Variant anatomy of renal arteries in a Kenyan population.

    Science.gov (United States)

    Ogeng'o, Julius A; Masaki, Charles O; Sinkeet, Simeon R; Muthoka, Johnstone M; Murunga, Acleus K

    2010-01-01

    Variant anatomy of renal arteries is important in renal transplant, vascular reconstruction, and uroradiological procedures. The variations show ethnic and population differences. Data from Africans are scarce and altogether absent for Kenyans. To describe patterns of origin, trajectories and branching of renal arteries in a Kenyan population. Descriptive cross-sectional study conducted in the Department of Human Anatomy, University of Nairobi. Three hundred and fifty six kidneys from 178 cadavers and postmortem specimens were used in the study. Aorta, renal arteries and kidneys were exposed by dissection. Number, trajectories, level of branching, number of branches and point of entry into the kidney were recorded. Data was analyzed using SPSS version 16.0, and presented using macrographs, tables, and bar charts. Additional arteries occurred in 14.3% of the cases. In 82.4% of these, there was one additional artery. Fifty nine point five per cent of the double renal arteries were parallel and 7.1% crossed. Of the 305 single arteries, 76.4% showed hilar, 21.6% prehilar and 2% intraparenchymal branching. In the hilar branching, ladder type was present in 65% and fork type in 35%. Bifurcation and trifurcation were present in 59.6% and 33.1% respectively. Polar arteries were present in 16.9% cases. Over 14% of the Kenyan population may have additional renal arteries while more than 20% show early branching. Several trajectories and hilar branching patterns exist which renal transplant surgeons and radiologists should be aware of to avoid inadvertent vascular injury.

  7. Endoluminal Treatment of Ruptured Abdominal Aortic Aneurysm with Small Intestinal Submucosa Sandwich Endografts: A Pilot Study in Sheep

    International Nuclear Information System (INIS)

    Yamada, Katsuyuki; Pavcnik, Dusan; Uchida, Barry T.; Timmermans, Hans A.; Corless, Christopher L.; Yin, Qiang; Yamakado, Koichiro; Wha Park, Joong; Roesch, Josef; Keller, Frederick S.; Sato, Morio; Yamada, Ryusaku

    2001-01-01

    Purpose: To evaluate efficacy of small intestinal submucosa (SIS) Sandwich endografts for the treatment of acute rupture of abdominal aortic aneurysms (AAA) and to explore the short-term reaction of the aorta to this material.Methods: In eight adult sheep, an infrarenal AAA was created transluminally by dilation of a short Palmaz stent. In six sheep, the aneurysm was then ruptured by overdilation of the stent with a large angioplasty balloon. Two sheep with AAAs that were not ruptured served as controls. A SIS Sandwich endograft, consisting of a Z stent frame with 5 bodies and covered inside and out with SIS, was used to exclude the ruptured and non-ruptured AAAs. Follow-up aortography was done immediately after the procedure and before sacrifice at 4, 8, or 12 weeks. Autopsy and histologic studies followed.Results: Endograft placement was successful in all eight sheep. Both ruptured and non-ruptured AAAs were successfully excluded. Three animals with AAA rupture developed hind leg paralysis due to compromise of the arterial supply to the lower spinal cord and were sacrificed 1 day after the procedure. In five animals, three with rupture and two controls, follow-up aortograms revealed no aortic stenoses and no perigraft leaks. Gross and histologic studies revealed incorporation of the endografts into the aortic wall with replacement of SIS by dense neointima that was completely endothelialized in areas where the endograft was in direct contact with the aortic wall. In central portions of the endograft, in contact with the thrombosed aneurysm, endothelialization was incomplete even at 12 weeks.Conclusion: The SIS Sandwich endografts effectively excluded simple AAAs and ruptured AAAs. They were rapidly incorporated into the aortic wall. A detailed long-term study is warranted

  8. Recanalization of Splenic Artery Aneurysm After Transcatheter Arterial Embolization Using N-Butyl Cyanoacrylate

    International Nuclear Information System (INIS)

    Matsumoto, Keiji; Ushijima, Yasuhiro; Tajima, Tsuyoshi; Nishie, Akihiro; Hirakawa, Masakazu; Ishigami, Kousei; Yamaji, Yukiko; Honda, Hiroshi

    2010-01-01

    A 65-year-old woman who had been diagnosed as having microscopic polyangiitis developed sudden abdominal pain and entered a state of shock. Abdominal CT showed massive hemoperitoneum, and emergent angiography revealed a ruptured splenic artery aneurysm. After direct catheterization attempts failed due to tortuous vessels and angiospasm, transcatheter arterial embolization using an n-butyl cyanoacrylate (NBCA)-lipiodol mixture was successfully performed. Fifty days later, the patient developed sudden abdominal pain again. Repeated angiography demonstrated recanalization of the splenic artery and splenic artery aneurysm. This time, the recanalized aneurysm was embolized using metallic coils with the isolation method. Physicians should keep in mind that recanalization can occur after transcatheter arterial embolization using N-butyl cyanoacrylate, which has been used as a permanent embolic agent.

  9. Metformin treatment does not affect the risk of ruptured abdominal aortic aneurysms

    DEFF Research Database (Denmark)

    Kristensen, Katrine L.; Pottegård, Anton; Hallas, Jesper

    2017-01-01

    Objective: Diabetes counteracts formation and rupture of abdominal aortic aneurysms, possibly through arterial matrix accumulation. Use of metformin, on the other hand, reduces arterial accumulation of matrix molecules. Consequently, we hypothesized that metformin treatment may reverse...... the protective role of diabetes on the development and course of aneurysms, that is, that metformin would be associated with aneurysm rupture among individuals with diabetes. Methods: Using nationwide Danish registry data, we performed a nested case-control study on the association between long-term use....... In total, 22.4% of the case population were long-term metformin users compared with 28.8% of the controls. We found a statistically nonsignificant protective effect of long-term metformin use toward RAAA with crude odds ratio (OR) of 0.74 (confidence interval, 0.54-1.00). When adjusted for covariates...

  10. The Siesta Habit is Associated with a Decreased Risk of Rupture of Intracranial Aneurysms

    Directory of Open Access Journals (Sweden)

    Huibin Kang

    2017-09-01

    Full Text Available BackgroundPrevious studies have examined an association between the siesta habit and hypertension, as well as coronary heart disease. However, the relationship between a siesta and the risk of rupture of an intracranial aneurysm (IA has not yet been established. We aimed to investigate the effects of a siesta on the risk of rupture of IAs.MethodsWe prospectively enrolled consecutive patients diagnosed with IAs at our hospital between January 2016 and December 2016. Univariate and multivariate logistic regression analysis were performed to identify independent risk factors associated with IA rupture.ResultsWe studied 581 consecutive patients with 514 unruptured and 120 ruptured aneurysms. Univariate analysis demonstrated that hypertension, hyperlipidemia, diabetes mellitus, cigarette smoking, location, size, as well as shape and aspect ratio were associated with the risk of rupture of IAs. Multivariate analysis identified hypertension [odds ratio (OR 1.68, 95% confidence interval (CI 1.03–2.73], hyperlipidemia (OR 0.25, 95% CI 0.08–0.72, current cigarette smoking ≥20 cigarettes/day (d (OR 3.48, 95% CI 1.63–7.47, siesta (siesta time <1 h, OR 0.49, 95% CI 0.24–0.98 and siesta time ≥1 h, OR 0.32, 95% CI 0.19–0.57, location of largest aneurysm on the anterior communicating and internal carotid-posterior communicating artery (PCOM (anterior communicating artery OR 16.27, 95% CI 7.40–35.79 and PCOM OR 11.21, 95% CI 5.15–24.43, and size of aneurysm ≥7 mm (OR 2.19, 95% CI 1.21–3.97 as independent strong risk factors associated with risk of aneurysm rupture.ConclusionIn the present study, we found that a habitual siesta is a new predictive factor to assess the risk of rupture of an IA. We found the siesta habit may reduce the risk of aneurysm rupture. We also found that hypertension, hyperlipidemia, cigarette smoking, location, and size of aneurysm were associated with the risk of rupture of IAs.

  11. Predicting creep rupture from early strain data

    International Nuclear Information System (INIS)

    Holmstroem, Stefan; Auerkari, Pertti

    2009-01-01

    To extend creep life modelling from classical rupture modelling, a robust and effective parametric strain model has been developed. The model can reproduce with good accuracy all parts of the creep curve, economically utilising the available rupture models. The resulting combined model can also be used to predict rupture from the available strain data, and to further improve the rupture models. The methodology can utilise unfailed specimen data for life assessment at lower stress levels than what is possible from rupture data alone. Master curves for creep strain and rupture have been produced for oxygen-free phosphorus-doped (OFP) copper with a maximum testing time of 51,000 h. Values of time to specific strain at given stress (40-165 MPa) and temperature (125-350 deg. C) were fitted to the models in the strain range of 0.1-38%. With typical inhomogeneous multi-batch creep data, the combined strain and rupture modelling involves the steps of investigation of the data quality, extraction of elastic and creep strain response, rupture modelling, data set balancing and creep strain modelling. Finally, the master curves for strain and rupture are tested and validated for overall fitting efficiency. With the Wilshire equation as the basis for the rupture model, the strain model applies classical parametric principles with an Arrhenius type of thermal activation and a power law type of stress dependence for the strain rate. The strain model also assumes that the processes of primary and secondary creep can be reasonably correlated. The rupture model represents a clear improvement over previous models in the range of the test data. The creep strain information from interrupted and running tests were assessed together with the rupture data investigating the possibility of rupture model improvement towards lower stress levels by inverse utilisation of the combined rupture based strain model. The developed creep strain model together with the improved rupture model is

  12. Morphological characteristics of renal artery and kidney in rats.

    Science.gov (United States)

    Yoldas, Atilla; Dayan, Mustafa Orhun

    2014-01-01

    The gross anatomy and morphometry of the kidney and renal arteries were studied in the strains of laboratory rat: Sprague-Dawley (Sp) and Wistar (W) rats. Total of 106 three-dimensional endocasts of the intrarenal arteries of kidney that were prepared using standard injection-corrosion techniques were examined. A single renal artery was observed in 100% of the cases. The renal arteries were divided into a dorsal and a ventral branch. The dorsal and ventral branches were divided into two branches, the cranial and caudal branch. Renal arteries were classified into types I and II, depending on the cranial and caudal branches and their made of branching. The present study also showed that the right kidney was slightly heavier than the left one and that the kidney of the male was generally larger than that of the female. The mean live weights of the Sprague-Dawley and Wistar rats were found to be 258.26 ± 5.9 and 182.4 ± 19.05 g, respectively. The kidney weights were significantly correlated (P kidney weights were not found significantly correlated (P > 0.01) with the length of renal arteries.

  13. Presentation of an uncommon form of aortic dissection and rupture in Marifoan syndrome

    International Nuclear Information System (INIS)

    Delgado, I.; Ruiz, R.; Villanueva, J.M.; Fernandez Cueto, J.L.

    1995-01-01

    In Marfan syndrome, aneurysmatic enlargement of ascending aorta and dissection starting at the root are the most common cardiovascular complications. We present an infrequent case of a 15-year-old patient with a typical case of Marfan syndrome. CT disclosed an aorta and aortic arch of normal size with dissection originating distally with respect to the point where left subclavian artery arises. The disecction extended to descending aorta and to iliac and femoral arteries. Aortic rupture occurred in the arch, with massive hemothorax. The CT findings were confirmed at necropsy. 9 refs

  14. Classification of Distal Fingertip Amputation Based on the Arterial System for Replantation

    OpenAIRE

    Park, Hyun Chul; Bahar-Moni, Ahmed Suparno; Cho, Sang Hyun; Kim, Sang Soo; Park, Hyun Sik; Ahn, Sang Cheon

    2012-01-01

    During replantation of distal fingertip amputation, identification of the artery is the most important but time consuming procedure. Depending on the damaged arterial structure, we classified distal fingertip amputations into 4 zones, on the basis of three dimensional concept. Zone 1 injury was defined as damage to the proximal central pulp artery; zone 2 injury, damage to the branch of the central pulp artery; zone 3 injury, damage to the distal central pulp artery; and zone 4 injury, no inj...

  15. Correlation between atmospheric pressure changes and abdominal aortic aneurysm rupture: results of a single-center study.

    Science.gov (United States)

    Molacek, Jiri; Treska, Vladislav; Kasik, Miroslav; Houdek, Karel; Baxa, Jan

    2013-09-01

    There is much interest in all factors that influence the etiopathogenesis of abdominal aortic aneurysm (AAA) rupture. Apart from the well-established factors such as arterial hypertension, smoking, age, and genetic predisposition, less common factors that may play a role in the mechanism of the rupture are the subject of much discussion. These include atmospheric conditions, temperature, and atmospheric pressure. We conducted this study to investigate the effects of the absolute value of atmospheric pressure and its changes on the frequency of AAA rupture. We retrospectively examined 54 patients who underwent treatment for a ruptured AAA at the Clinic of Surgery in the University Hospital in Pilsen between 1 January 2005 and 31 December 2009. We collected data on the atmospheric pressure in this period from the Czech Hydrometeorological Institute in Pilsen. We did not find a significant difference in atmospheric pressure values between the days when the rupture occurred versus the other days (p atmospheric pressure during the 48 h preceding the rupture (Student's test p atmospheric pressure in that month. These findings suggest that atmospheric pressure and its changes do not affect the pathogenesis of AAA rupture.

  16. Quiver Varieties and Branching

    Directory of Open Access Journals (Sweden)

    Hiraku Nakajima

    2009-01-01

    Full Text Available Braverman and Finkelberg recently proposed the geometric Satake correspondence for the affine Kac-Moody group Gaff [Braverman A., Finkelberg M., arXiv:0711.2083]. They conjecture that intersection cohomology sheaves on the Uhlenbeck compactification of the framed moduli space of Gcpt-instantons on $R^4/Z_r$ correspond to weight spaces of representations of the Langlands dual group $G_{aff}^{vee}$ at level $r$. When $G = SL(l$, the Uhlenbeck compactification is the quiver variety of type $sl(r_{aff}$, and their conjecture follows from the author's earlier result and I. Frenkel's level-rank duality. They further introduce a convolution diagram which conjecturally gives the tensor product multiplicity [Braverman A., Finkelberg M., Private communication, 2008]. In this paper, we develop the theory for the branching in quiver varieties and check this conjecture for $G = SL(l$.

  17. Integrating over Higgs branches

    International Nuclear Information System (INIS)

    Moore, G.; Shatashvili, S.

    2000-01-01

    We develop some useful techniques for integrating over Higgs branches in supersymmetric theories with 4 and 8 supercharges. In particular, we define a regularized volume for hyperkaehler quotients. We evaluate this volume for certain ALE and ALF spaces in terms of the hyperkaehler periods. We also reduce these volumes for a large class of hyperkaehler quotients to simpler integrals. These quotients include complex coadjoint orbits, instanton moduli spaces on R 4 and ALE manifolds, Hitchin spaces, and moduli spaces of (parabolic) Higgs bundles on Riemann surfaces. In the case of Hitchin spaces the evaluation of the volume reduces to a summation over solutions of Bethe ansatz equations for the non-linear Schroedinger system. We discuss some applications of our results. (orig.)

  18. Presence of anatomical variations of the circle of Willis in patients undergoing surgical treatment for ruptured intracranial aneurysms

    Directory of Open Access Journals (Sweden)

    Stojanović Nebojša

    2009-01-01

    Full Text Available Background/Aim. The presence of aneurysmal changes on the brain blood vessels has been subject to numerous research. This study investigated the relation between ruptured aneurysms and anatomical configuration of the Circle of Willis, with the purpose to obtain an insight into their mutual connection. Methods. The analysis included 114 patients suffering from ruptured intracranial aneurysms. Preoperative cerebral angiography was performed and compared with the intraoperative findings in order to attain a precise insight into morphological changes occurring on the circle of Willis. Results. The prevalence of asymmetrical Willis in the whole group of patients was 64%. Within the group of patients suffering from multiple aneurysms, the presence of asymmetrical Willis' circle was 75.7%. The highest incidence of the asymmetrical Circle of Willis was found among patients with aneurysmal rupture detected at the anterior comunicative artery (ACoA site (72.7% among cases with solitary and 100% among those with multiple aneurysms. Morphological changes on the A1 segment of ACoA were observed in 50 (44% cases, with higher incidence found on the right side (60%. When comparing location of ruptured aneurysms between genders, a statistically significant prevalence of the ruptured aneurisms on ACoA was present in men, whereas women showed higher incidence of ruptured aneurysms on interior cartid artery (ICA site (p < 0.01. The linkage between aneurysms with hypoplasia of the A1 segment of ACA and decreasing of the angle at which segments A1 and A2 join suggests the relationship between their onset, corresponding configuration type of Willis and subsequent hemodynamic changes. Conclusion. High incidence of asymmetry of Willis circle in the group of patients with ruptured aneurysms imply association of asymmetrical configuration and disorder in haemodynamic relations with forming and rupture of intracranial aneurysms.

  19. Systematization, distribution and territory of the caudal cerebral artery on the brain's surface of the turkey (Meleagris gallopavo

    Directory of Open Access Journals (Sweden)

    Amarílis Díaz de Carvalho

    2014-10-01

    Full Text Available Thirty Meleagris gallopavo heads with their neck segments were used. Animals were contained and euthanized with the association of mebezonium iodide, embutramide and tetracaine hydrochloride (T 61, Intervet by intravenous injection. The arterial system was rinsed with cold saline solution (15°C, with 5000IU heparin and filled with red-colored latex. The samples were fixed in 20% formaldehyde for seven days. The brains were removed with a segment of cervical spinal cord and after, the dura-mater was removed and the arteries dissected. The cerebral carotid arteries, after the intercarotid anastomosis, were projected around the hypophysis, until they reached the tuber cinereum and divided into their terminal branches, the caudal branch and the rostral branch. The rostral branch was projected rostrolateralwards and gave off, in sequence, two collateral branches, the caudal cerebral and the middle cerebral arteries and the terminal branch was as cerebroethmoidal artery. The caudal cerebral artery of one antimere formed the interhemispheric artery, which gave off dorsal hemispheric branches to the convex surface of both antimeres. Its dorsal tectal mesencephalic branch, of only one antimere, originated the dorsal cerebellar artery. In the interior of the cerebral transverse fissure, after the origin of the dorsal tectal mesencephalic artery, the caudal cerebral artery emitted occipital hemispheric branches, pineal branches and medial hemispheric branches, on both antimeres. The caudal cerebral artery's territory comprehended the entire surface of the dorsal hemioptic lobe, the rostral surface of the cerebellum, the diencephalic structures, the caudal pole and the medial surface of the cerebral hemisphere and in the convex surface, the sagittal eminence except for its most rostral third. Due to the asymmetry found in the caudal cerebral arteries' ramifications, the models were classified into three types and their respective subtypes.

  20. Anatomical Study of Subclavian Artery and Its Branches

    Directory of Open Access Journals (Sweden)

    zahed Safikhani

    2006-02-01

    Conclusion: For preserving the integrity of important structures in the base of the neck, especially thyroid gland in surgery, this vascular variations are presented to physicians to keep in mind that such variations exists during diagnostic investigation and surgical procedures of the neck. An awareness of these variations is important, because this area in used for diagnostic and surgical procedures.

  1. Embolization of carotid artery branch in intractable epistaxis

    International Nuclear Information System (INIS)

    Kordecki, K.; Janica, J.; Lewszuk, A.; Lebkowska, U.; Ustymowicz, A.

    2008-01-01

    Long-term intractable epistaxis results in a series of complications including demise. Unprofessional therapy may account for severe topical and systemic complications. The authors assessed the efficacy and safety of embolization treatment of intractable epistaxis with the use of available embolizing materials. Embolization was performed in 58 patients (39 males aged 24-48 and 19 females aged 26-44) admitted to the ENT Department, Medical University of Bialystok in years 2000 -2005. 65 embolization procedures, including reembolizations, were performed. In 41 procedures (63%) a sponge was used, in 14 (21.6%) PVA, in 10 (15.4%) PVA and coils. In 9 patients, bleeding of a lesser intensity recurred within early hours following the procedure - 84.5% embolization success. On longer follow-up, embolization success was assessed to be 100%. Embolization with the use of proper embolisation materials is an efficient method of arresting spontaneous and posttraumatic epistaxis and may be a safe treatment procedure when performed by experienced medical personnel. (author)

  2. The coronary arteries of the agouti (Agouti paca, Linnaeus, 1766

    Directory of Open Access Journals (Sweden)

    Fabrício Singaretti de Oliveira

    2009-12-01

    Full Text Available The present study aimed to describe the coronary arteries in the agouti. Twelve hearts set, in a 10% formaldehyde aqueous solution, were used. The presence of left and right coronary arteries was observed in all hearts. The fi rst arose from the aorta, between the left auricle and the pulmonary trunk, and gave off into a circumfl ex branch, whichever was directed to the right surface of this viscerae, and an interventricular paraconal branch that went through the cardiac apex, on the left atrioventricular sulcus. In 91.6% of the cases, at its origin, the paraconal branch gave off a thick side branch to the left ventricle wall, and in 100% of the cases, went deep, characterizing a large myocardial bridge. In 8.4% of the cases, this thick side branch to the left ventricle wall originated directly from the left coronary artery and not from the paraconal branch, and alterations such those to the circumfl ex branch did not occur. Regarding the right coronary artery, the origin of this vessel was from the aorta, on the atrial surface, in the direction of the right ventricular border, going through the subsinuous interventricular sulcus as an interventricular subsinuous branch.

  3. Common and uncommon CT findings in rupture and impending rupture of abdominal aortic aneurysms

    International Nuclear Information System (INIS)

    Ahmed, M.Z.; Ling, L.; Ettles, D.F.

    2013-01-01

    The rapid imaging evaluation and diagnosis of rupture and impending rupture of an abdominal aortic aneurysm (AAA) is imperative. This article describes the imaging findings of rupture, impending rupture, and other abdominal aortic abnormalities. It is important not to overlook AAA as the consequences can be life threatening. All patients who had open or endovascular repair of AAA rupture over 6 years (2008–2012) were identified from our departmental database. The computed tomography (CT) images of 99 patients were reviewed for relevant findings. The mean age of the patients was 65 years and 85% were male

  4. Cranial pole nephrectomy in the pig model: anatomic analysis of arterial injuries in tridimensional endocasts.

    Science.gov (United States)

    Pereira-Sampaio, Marco A; Henry, Robert W; Favorito, Luciano A; Sampaio, Francisco J B

    2012-06-01

    To assess the intrarenal arteries injuries after cranial pole nephrectomy in a pig model to compare these findings with those in humans. Polyester resin was injected through the ureter and the renal artery to make three-dimensional casts of 61 pig kidneys. The cranial pole of the kidneys was sectioned at four different sites before the solidification of the resin, and the casts were examined for arterial damage. Section performed through the hilus (15 kidneys): The cranial division of the renal artery was sectioned in two (13.33%) cases, the ventral branch of the cranial division of the renal artery was sectioned in 13 (86.7%) cases, and the dorsal branch of the cranial division of the renal artery was sectioned in 11 (73.34%) cases. Section at 0.5 cm cranial to the hilus (16 kidneys): The cranial division of the renal artery was sectioned in 1 (6.25%) case, the ventral branch of the cranial division of the renal artery was sectioned in 14 (87.5%) cases, and the dorsal branch of the cranial division of the renal artery was sectioned in 13 (81.25%) cases. Section at 1.0 cm cranial to the hilus (15 kidneys): The ventral branch of the cranial division of the renal artery was sectioned in five (33.33%) cases, and the dorsal branch of the cranial division of the renal artery was injured in five (33.33%) cases. Section at 1.5 cm cranial to the hilus (15 kidneys): No lesions were found in the main arteries, only in the interlobular branches. As previously demonstrated in humans, sections at 1.0 cm or more cranially to the hilus in pigs also showed a significant decrease in damage to the major intrarenal arteries. Therefore, as regards arterial damage, the pig kidney is a useful model for partial nephrectomy in the cranial (upper) pole.

  5. Radionuclide scan findings in delayed splenic rupture

    International Nuclear Information System (INIS)

    Flickinger, F.W.; Jackson, G.L.

    1978-01-01

    An initial liver/spleen scan performed on a patient with blunt abdominal trauma was negative 3 days following the accident. A follow-up scan 7 days later showed definite evidence of splenic rupture, proved surgically. The authors conclude that, in such cases, spleen scans may be negative initially because of delayed splenic ruptures

  6. Rupture of esophagus by compressed air.

    Science.gov (United States)

    Wu, Jie; Tan, Yuyong; Huo, Jirong

    2016-11-01

    Currently, beverages containing compressed air such as cola and champagne are widely used in our daily life. Improper ways to unscrew the bottle, usually by teeth, could lead to an injury, even a rupture of the esophagus. This letter to editor describes a case of esophageal rupture caused by compressed air.

  7. Treatment Alternative for Irreparable Rotator Cuff Ruptures ...

    African Journals Online (AJOL)

    2016-09-03

    Sep 3, 2016 ... and such ruptures also lead to a pseudo-paralysis.[1,2]. Pain during daily ... 2) repairable rotator cuff rupture, as determined on MRI and during arthroscopy ..... functioning and lead to cosmetic deformities.[4]. Arthroplasty is a ...

  8. Uterine rupture without previous caesarean delivery

    DEFF Research Database (Denmark)

    Thisted, Dorthe L. A.; H. Mortensen, Laust; Krebs, Lone

    2015-01-01

    to uterine rupture when adjusted for parity, epidural analgesia and augmentation by oxytocin. CONCLUSION: Although uterine rupture is rare, its association with epidural analgesia and augmentation of labour with oxytocin in multipara should be considered. Thus, vigilance should be exercised when labour...

  9. Spontaneous rupture of choledochal cyst: case report

    International Nuclear Information System (INIS)

    Shin, Ho Seob; Nam, Kyung Jin; Lee, Jin Hwa; Kim, Chan Sung; Choi, Jong Cheol; Oh, Jong Young

    2002-01-01

    Spontaneous rupture of a choledochal cyst leading to biliary peritonitis is a rare complication which can be fatal if not promptly diagnosed. The authors report the ultrasound and CT findings of two cases of spontaneous choledochal cystic rupture and the biliary peritonitis which ensued

  10. Isolated gallbladder rupture following blunt abdominal injury

    African Journals Online (AJOL)

    2015-05-26

    May 26, 2015 ... Kaohsiung Medical University, Kaohsiung, Taiwan. Abstract. Isolated traumatic gallbladder rupture subsequent to blunt abdominal injury is rare. Most literatures on the subjects consist of case reports. We reported a rare case of isolated gallbladder rupture and discussed the possible predisposing factors to ...

  11. Spontaneous Achilles tendon rupture in alkaptonuria | Mohammed ...

    African Journals Online (AJOL)

    Spontaneous Achilles tendon ruptures are uncommon. We present a 46-year-old man with spontaneous Achilles tendon rupture due to ochronosis. To our knowledge, this has not been previously reported in Sudan literature. The tendon of the reported patient healed well after debridement and primary repairs.

  12. Spontaneous rupture of choledochal cyst: case report

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Ho Seob; Nam, Kyung Jin; Lee, Jin Hwa; Kim, Chan Sung; Choi, Jong Cheol; Oh, Jong Young [Dong-a University College of Medicine, Pusan (Korea, Republic of)

    2002-11-01

    Spontaneous rupture of a choledochal cyst leading to biliary peritonitis is a rare complication which can be fatal if not promptly diagnosed. The authors report the ultrasound and CT findings of two cases of spontaneous choledochal cystic rupture and the biliary peritonitis which ensued.

  13. Spontaneous rupture of adrenal metastasis from hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Chae Hun; Kim, Hyun Jin; Park, Soo Youn; Hwang, Seong Su; Choi, Hyun Joo [St. Vincent Hospital, Suwon (Korea, Republic of)

    2007-03-15

    Rupture of adrenal tumor from various primary origins is a rather rare event. We report here on a ruptured adrenal metastasis from hepatocellular carcinoma, and this ruptured metastasis was observed at the time of the initial diagnosis.

  14. Hepatocellular Carcinoma Supplied by the Right Lumbar Artery

    International Nuclear Information System (INIS)

    Miyayama, Shiro; Yamashiro, Masashi; Okuda, Miho; Yoshie, Yuichi; Sugimori, Natsuki; Igarashi, Saya; Nakashima, Yoshiko; Matsui, Osamu

    2010-01-01

    This study evaluated the clinical features of hepatocellular carcinoma (HCC) supplied by the right lumbar artery. Eleven patients with HCC supplied by the right lumbar artery were treated with chemoembolization. The patients' medical records were retrospectively analyzed. All patients underwent 6.7 ± 3.7 (mean ± SD) chemoembolization sessions, and the hepatic arterial branches were noted as being attenuated. The right inferior phrenic artery (IPA) was also embolized in 10 patients. The interval between initial chemoembolization and chemoembolization of the lumbar artery supply was 53.2 ± 26.9 months. Mean tumor diameter was 3.1 ± 2.4 cm and was located at the surface of S7 and S6. The feeding-branch arose proximal to the bifurcation of the dorsal ramus and muscular branches (n = 8) or from the muscular branches (n = 3) of the right first (n = 10) or second lumbar artery (n = 1). The anterior spinal artery originated from the tumor-feeding lumbar artery in one patient. All feeders were selected, and embolization was performed after injection of iodized oil and anticancer drugs (n = 10) or gelatin sponge alone in a patient with anterior spinal artery branching (n = 1). Eight patients died from tumor progression 10.1 ± 4.6 months later, and two patients survived 2 and 26 months, respectively. The remaining patient died of bone metastases after 32 months despite liver transplantation 10 months after chemoembolization. The right lumbar artery supplies HCC located in the bare area of the liver, especially in patients who undergo repeated chemoembolization, including chemoembolization by way of the right IPA. Chemoembolization by way of the right lumbar artery may be safe when the feeder is well selected.

  15. The efficiency of bank branches

    OpenAIRE

    Omid Takbiri; Mohammad Mohammadi; Bahman Naderi

    2015-01-01

    Banking industry has significant contribution in development of economies of developing countries. Most banks execute their operations through different branches. Therefore it is important to measure the relative efficiencies of these branches. Data envelopment analysis (DEA) is one of the most useful tools in measuring banks’ performance. The present paper aims to extract ranking pattern of banks based on performance evaluation using DEA analysis. In the present research, 120 bank branches o...

  16. Spiral CT angiography (SCTA) study of celiac artery and superior mesenteric artery

    International Nuclear Information System (INIS)

    Yuan Zhenguo; Zhou Cunsheng; Xu Zuodong; Shi Hao; Wang Tao

    1999-01-01

    Objective: To study the visualization capability and scanning technique of SCTA in celiac artery, superior mesenteric artery (SMA) and other branches. Methods: Thirty patients, with normal abdominal SCTA results, were given small injection test dose after plain scan. The abdominal aorta parallel to the body of pancreas was chosen as target vessel, the peak-time plus 2 seconds as the best delay scan time. Iodine contrast medium 90∼110 ml was injected into antecubital vein at the speed of 3.5 ml/s, then scan from cranial to caudal was performed. Pitch 1.0 and slice thickness 3.2 mm were selected as the scan parameters. Maximum intensity projection (MaxIP) was employed in all patients and shaded surface display (SSD) in 23 cases. Results: The display rate using MaxIP and SSD of celiac artery, splenic artery, common hepatic artery, proper hepatic artery and SMA were all 100%, the gastroduodenal artery 100% and 91%, the left gastric artery 83% and 87%, respectively. Conclusions: SCTA as a minimally invasive examination is a valuable method to detect and diagnose disease or variations of celiac artery, its branches and SMA. Spiral scanning technique and image processing have a decisive effect on the image quality

  17. Greater rupture risk for familial as compared to sporadic unruptured intracranial aneurysms.

    Science.gov (United States)

    Broderick, Joseph P; Brown, Robert D; Sauerbeck, Laura; Hornung, Richard; Huston, John; Woo, Daniel; Anderson, Craig; Rouleau, Guy; Kleindorfer, Dawn; Flaherty, Matthew L; Meissner, Irene; Foroud, Tatiana; Moomaw, E Charles J; Connolly, E Sander

    2009-06-01

    The risk of intracranial aneurysm (IA) rupture in asymptomatic members of families who have multiple affected individuals is not known. First-degree unaffected relatives of those with a familial history of IA who had a history of smoking or hypertension but no known IA were offered cerebral MR angiography (MRA) and followed yearly as part of a National Institute of Neurological Diseases and Stroke-funded study of familial IA (Familial Intracranial Aneurysm [FIA] Study). A total of 2874 subjects from 542 FIA Study families were enrolled. After study enrollment, MRAs were performed in 548 FIA Study family members with no known history of IA. Of these 548 subjects, 113 subjects (20.6%) had 148 IAs by MRA of whom 5 subjects had IA >or=7 mm. Two subjects with an unruptured IA by MRA/CT angiography (3-mm and 4-mm anterior communicating artery) subsequently had rupture of their IA. This represents an annual rate of 1.2 ruptures per 100 subjects (1.2% per year; 95% CI, 0.14% to 4.3% per year). None of the 435 subjects with a negative MRA have had a ruptured IA. Survival curves between the MRA-positive and -negative cohorts were significantly different (P=0.004). This rupture rate of unruptured IA in the FIA Study cohort of 1.2% per year is approximately 17 times higher than the rupture rate for subjects with an unruptured IA in the International Study of Unruptured Aneurysm Study with a matched distribution of IA size and location 0.069% per year. Small unruptured IAs in patients from FIA Study families may have a higher risk of rupture than sporadic unruptured IAs of similar size, which should be considered in the management of these patients.

  18. Triple Achilles Tendon Rupture: Case Report.

    Science.gov (United States)

    Saxena, Amol; Hofer, Deann

    We present a case report with 1-year follow-up data of a 57-year-old male soccer referee who had sustained an acute triple Achilles tendon rupture injury during a game. His triple Achilles tendon rupture consisted of a rupture of the proximal watershed region, a rupture of the main body (mid-watershed area), and an avulsion-type rupture of insertional calcific tendinosis. The patient was treated surgically with primary repair of the tendon, including tenodesis with anchors. Postoperative treatment included non-weightbearing for 4 weeks and protected weightbearing until 10 weeks postoperative, followed by formal physical therapy, which incorporated an "antigravity" treadmill. The patient was able to return to full activity after 26 weeks, including running and refereeing, without limitations. Copyright © 2017 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  19. MRI of tibialis anterior tendon rupture

    International Nuclear Information System (INIS)

    Gallo, Robert A.; DeMeo, Patrick J.; Kolman, Brett H.; Daffner, Richard H.; Sciulli, Robert L.; Roberts, Catherine C.

    2004-01-01

    Ruptures of the tibialis anterior tendon are rare. We present the clinical histories and MRI findings of three recent male patients with tibialis anterior tendon rupture aged 58-67 years, all of whom presented with pain over the dorsum of the ankle. Two of the three patients presented with complete rupture showing discontinuity of the tendon, thickening of the retracted portion of the tendon, and excess fluid in the tendon sheath. One patient demonstrated a partial tear showing an attenuated tendon with increased surrounding fluid. Although rupture of the tibialis anterior tendon is a rarely reported entity, MRI is a useful modality in the definitive detection and characterization of tibialis anterior tendon ruptures. (orig.)

  20. Methods and Technologies Branch (MTB)

    Science.gov (United States)

    The Methods and Technologies Branch focuses on methods to address epidemiologic data collection, study design and analysis, and to modify technological approaches to better understand cancer susceptibility.

  1. Applied anatomy of thyroid arteries for interventional embolization of Graves' disease

    International Nuclear Information System (INIS)

    Ding Zhongxiang; Zhao Wei; Hou Jialin; Xiang Shutian; Li Liyuan; Zou Zhirong; Li Xingguo; Song Dianping; Yuan Jianhua

    2007-01-01

    Objective: To explore the anatomy and imaging manifestations of thyroid arteries for improving the efficiency and lowering the complication in interventional embolization of Graves' disease. Methods: Thyroid arteries were investigated, including 16 adult cadavers (Cadaver group), 8 non-thyropathic patients (Normal group)and 17 Graves patients (Graves group). The inner diameters of the trunk and supplying branches of thyroid artery, the angles between the origination of branches and the beginning of the trunk, and the angles between the trunk of thyroid artery and carotid or subclavian artery were measured. In addition, data of the three groups were statistically analyzed. Results: Many non-thyroid arterial branches arose from thyroid artery, with no statistical difference in their indexes between Cadaver group and Normal group. The thyroid arteries showed much longer, obviously wider in diameter, and larger angles between the trunk of thyroid artery and carotid artery in Graves group than those of Cadaver group and Normal group; outcoming with significant statistical differences; and furthermore, with increase of interglandular branches and dangerous internal and external anastomoses. Conclusions: The specific thyroid arterial changes of Graves' disease are helpful for the interventional embolization. Non-thyroid branches and dangerous anastomoses should not be embolized as far as possible, for decreasing the complications of the interventional procedure for Graves' disease. (authors)

  2. Earthquake lights and rupture processes

    Directory of Open Access Journals (Sweden)

    T. V. Losseva

    2005-01-01

    Full Text Available A physical model of earthquake lights is proposed. It is suggested that the magnetic diffusion from the electric and magnetic fields source region is a dominant process, explaining rather high localization of the light flashes. A 3D numerical code allowing to take into account the arbitrary distribution of currents caused by ground motion, conductivity in the ground and at its surface, including the existence of sea water above the epicenter or (and near the ruptured segments of the fault have been developed. Simulations for the 1995 Kobe earthquake were conducted taking into account the existence of sea water with realistic geometry of shores. The results do not contradict the eyewitness reports and scarce measurements of the electric and magnetic fields at large distances from the epicenter.

  3. Traumatic rupture of the aorta

    International Nuclear Information System (INIS)

    Dorfman, G.S.; Paolella, L.P.; Haas, R.A.; Lambiase, R.E.; Cronan, J.J.

    1988-01-01

    To evaluate the acceptability of digital subtraction angiography (DSA) in the evaluation of traumatic rupture of the aorta (TRA), the authors obtained 56 thoracic aortograms in 55 consecutive trauma patients, using both DSA and cut-film angiography (CFA). Both studies were ranked blindly and assigned scores for quality and diagnosis. Interobserver variance for DSA and CFA quality rankings was insignificant. CFA achieved significantly higher ranking for quality. In the 56 examinations, CFA demonstrated seven abnormalities that demanded intervention for follow-up angiography. DSA demonstrated only five of these and found no additional abnormalities. While this evaluation applies only to the particular digital system that the authors tested, they found that DSA, as compared with CFA, failed to demonstrate significant aortic injury. The confidence of diagnosis was significantly greater with CFA. Similar double-blind evaluation is mandatory at any trauma center prior to converting from CFA to DSA in the diagnosis of this life-threatening condition

  4. Rupture of the meniscofibular ligament

    Directory of Open Access Journals (Sweden)

    Poyanli Oguz

    2010-05-01

    Full Text Available Abstract The meniscofibular ligament is an anatomically defined ligament of the knee in humans. However, there are no data regarding the prognosis following injury to this ligament. Our case was a 42-year-old man who presented at our clinic with pain of the lateral side of his left knee. MRI of his left knee revealed the rupture of the meniscofibular ligament. The mechanism of injury was consistent with anatomical and mechanical studies of the meniscofibular ligament. The patient was treated conservatively for 1 year, but his pain did not resolve completely. A case series of patients with the same injury is required to establish an effective treatment for this rare injury.

  5. Retroesophageal right subclavian artery: A case report and review ...

    African Journals Online (AJOL)

    Background: Variations of vessels arising from the aortic arch are numerous. One of the common anatomical variations is the right subclavian artery originating as the last branch of the aortic arch. This is a report of a case of an adult male cadaver with a retroesophageal right subclavian artery. Objective: To highlight the ...

  6. Segmental arterial mediolysis with mesangial cell hyperplasia

    DEFF Research Database (Denmark)

    Slavin, Richard E.; Leifsson, Páll Skúli

    2017-01-01

    doubt on this hypothesis. Methods and findings: SAM, reported in kidneys of slaughtered pigs, was believed to represent a dysfunctional development in a fight and flight response. Additionally some stenotic renal arteries described in cases of pheochromocytomas reportedly were caused by arterial spasm...... branches of the peripheral sympathetic nerves that innervate the large and medial sized muscular arteries targeted in SAM. Recognized stimuli for this response are iatrogenic sympathomimetic agonists and some B-2 agonists. However, these stimuli were not always apparent in published cases of SAM casting...

  7. Risk of rupture of unruptured cerebral aneurysms in elderly patients

    Science.gov (United States)

    Date, Isao; Tokunaga, Koji; Tominari, Shinjiro; Nozaki, Kazuhiko; Shiokawa, Yoshiaki; Houkin, Kiyohiro; Murayama, Yuichi; Ishibashi, Toshihiro; Takao, Hiroyuki; Kimura, Toshikazu; Nakayama, Takeo; Morita, Akio

    2015-01-01

    Objectives: The aim of this study was to identify risk factors for rupture of unruptured cerebral aneurysms (UCAs) in elderly Japanese patients aged 70 years or older. Methods: The participants included all patients 70 years of age or older in 3 prospective studies in Japan (the Unruptured Cerebral Aneurysm Study of Japan [UCAS Japan], UCAS II, and the prospective study at the Jikei University School of Medicine). A total of 1,896 patients aged 70 years or older with 2,227 UCAs were investigated. The median and mean follow-up periods were 990 and 802.7 days, respectively. Results: The mean aneurysm size was 6.2 ± 3.9 mm. Sixty-eight patients (3.6%) experienced subarachnoid hemorrhage during the follow-up period. Multivariable analysis per patient revealed that in patients aged 80 years or older (hazard ratio [HR], 2.02; 95% confidence interval [CI], 1.16–3.49, p = 0.012), aneurysms 7 mm or larger (HR, 3.08; 95% CI, 1.35–7.03, p = 0.007 for 7–9 mm; HR, 7.82; 95% CI, 3.60–16.98, p < 0.001 for 10–24 mm; and HR, 43.31; 95% CI, 12.55–149.42, p < 0.001 for ≥25 mm) and internal carotid–posterior communicating artery aneurysms (HR, 2.45; 95% CI, 1.23–4.88, p = 0.011) were independent predictors for UCA rupture in elderly patients. Conclusions: In our pooled analysis of prospective cohorts in Japan, patient age and aneurysm size and location were significant risk factors for UCA rupture in elderly patients. PMID:26511450

  8. Endoport-Assisted Microsurgical Treatment of a Ruptured Periventricular Aneurysm

    Directory of Open Access Journals (Sweden)

    Ching-Jen Chen

    2016-01-01

    Full Text Available Background and Importance. Ruptured periventricular aneurysms in patients with moyamoya disease represent challenging pathologies. The most common methods of treatment include endovascular embolization and microsurgical clipping. However, rare cases arise in which the location and anatomy of the aneurysm make these treatment modalities particularly challenging. Clinical Presentation. We report a case of a 34-year-old female with moyamoya disease who presented with intraventricular hemorrhage. CT angiography and digital subtraction angiography revealed an aneurysm located in the wall of the atrium of the right lateral ventricle. Distal endovascular access was not possible, and embolization risked the sacrifice of arteries supplying critical brain parenchyma. Using the BrainPath endoport system, the aneurysm was able to be accessed. Since the fusiform architecture of the aneurysm prevented clip placement, the aneurysm was ligated with electrocautery. Conclusion. We demonstrate the feasibility of endoport-assisted approach for minimally invasive access and treatment of uncommon, distally located aneurysms.

  9. Arterial stick

    Science.gov (United States)

    ... be some throbbing. Why the Test Is Performed Blood transports oxygen, nutrients, waste products, and other materials within ... venous blood) mainly in its content of dissolved gases . Testing arterial blood shows the makeup of the blood before any ...

  10. Tau hadronic branching ratios

    CERN Document Server

    Buskulic, Damir; De Bonis, I; Décamp, D; Ghez, P; Goy, C; Lees, J P; Lucotte, A; Minard, M N; Odier, P; Pietrzyk, B; Ariztizabal, F; Chmeissani, M; Crespo, J M; Efthymiopoulos, I; Fernández, E; Fernández-Bosman, M; Gaitan, V; Martínez, M; Orteu, S; Pacheco, A; Padilla, C; Palla, Fabrizio; Pascual, A; Perlas, J A; Sánchez, F; Teubert, F; Colaleo, A; Creanza, D; De Palma, M; Farilla, A; Gelao, G; Girone, M; Iaselli, Giuseppe; Maggi, G; Maggi, M; Marinelli, N; Natali, S; Nuzzo, S; Ranieri, A; Raso, G; Romano, F; Ruggieri, F; Selvaggi, G; Silvestris, L; Tempesta, P; Zito, G; Huang, X; Lin, J; Ouyang, Q; Wang, T; Xie, Y; Xu, R; Xue, S; Zhang, J; Zhang, L; Zhao, W; Bonvicini, G; Cattaneo, M; Comas, P; Coyle, P; Drevermann, H; Engelhardt, A; Forty, Roger W; Frank, M; Hagelberg, R; Harvey, J; Jacobsen, R; Janot, P; Jost, B; Kneringer, E; Knobloch, J; Lehraus, Ivan; Markou, C; Martin, E B; Mato, P; Minten, Adolf G; Miquel, R; Oest, T; Palazzi, P; Pater, J R; Pusztaszeri, J F; Ranjard, F; Rensing, P E; Rolandi, Luigi; Schlatter, W D; Schmelling, M; Schneider, O; Tejessy, W; Tomalin, I R; Venturi, A; Wachsmuth, H W; Wiedenmann, W; Wildish, T; Witzeling, W; Wotschack, J; Ajaltouni, Ziad J; Bardadin-Otwinowska, Maria; Barrès, A; Boyer, C; Falvard, A; Gay, P; Guicheney, C; Henrard, P; Jousset, J; Michel, B; Monteil, S; Pallin, D; Perret, P; Podlyski, F; Proriol, J; Rossignol, J M; Saadi, F; Fearnley, Tom; Hansen, J B; Hansen, J D; Hansen, J R; Hansen, P H; Nilsson, B S; Kyriakis, A; Simopoulou, Errietta; Siotis, I; Vayaki, Anna; Zachariadou, K; Blondel, A; Bonneaud, G R; Brient, J C; Bourdon, P; Passalacqua, L; Rougé, A; Rumpf, M; Tanaka, R; Valassi, Andrea; Verderi, M; Videau, H L; Candlin, D J; Parsons, M I; Focardi, E; Parrini, G; Corden, M; Delfino, M C; Georgiopoulos, C H; Jaffe, D E; Antonelli, A; Bencivenni, G; Bologna, G; Bossi, F; Campana, P; Capon, G; Chiarella, V; Felici, G; Laurelli, P; Mannocchi, G; Murtas, F; Murtas, G P; Pepé-Altarelli, M; Dorris, S J; Halley, A W; ten Have, I; Knowles, I G; Lynch, J G; Morton, W T; O'Shea, V; Raine, C; Reeves, P; Scarr, J M; Smith, K; Smith, M G; Thompson, A S; Thomson, F; Thorn, S; Turnbull, R M; Becker, U; Braun, O; Geweniger, C; Graefe, G; Hanke, P; Hepp, V; Kluge, E E; Putzer, A; Rensch, B; Schmidt, M; Sommer, J; Stenzel, H; Tittel, K; Werner, S; Wunsch, M; Beuselinck, R; Binnie, David M; Cameron, W; Colling, D J; Dornan, Peter J; Konstantinidis, N P; Moneta, L; Moutoussi, A; Nash, J; San Martin, G; Sedgbeer, J K; Stacey, A M; Dissertori, G; Girtler, P; Kuhn, D; Rudolph, G; Bowdery, C K; Brodbeck, T J; Colrain, P; Crawford, G; Finch, A J; Foster, F; Hughes, G; Sloan, Terence; Whelan, E P; Williams, M I; Galla, A; Greene, A M; Kleinknecht, K; Quast, G; Raab, J; Renk, B; Sander, H G; Wanke, R; Van Gemmeren, P; Zeitnitz, C; Aubert, Jean-Jacques; Bencheikh, A M; Benchouk, C; Bonissent, A; Bujosa, G; Calvet, D; Carr, J; Diaconu, C A; Etienne, F; Thulasidas, M; Nicod, D; Payre, P; Rousseau, D; Talby, M; Abt, I; Assmann, R W; Bauer, C; Blum, Walter; Brown, D; Dietl, H; Dydak, Friedrich; Ganis, G; Gotzhein, C; Jakobs, K; Kroha, H; Lütjens, G; Lutz, Gerhard; Männer, W; Moser, H G; Richter, R H; Rosado-Schlosser, A; Schael, S; Settles, Ronald; Seywerd, H C J; Saint-Denis, R; Wolf, G; Alemany, R; Boucrot, J; Callot, O; Cordier, A; Courault, F; Davier, M; Duflot, L; Grivaz, J F; Heusse, P; Jacquet, M; Kim, D W; Le Diberder, F R; Lefrançois, J; Lutz, A M; Musolino, G; Nikolic, I A; Park, H J; Park, I C; Schune, M H; Simion, S; Veillet, J J; Videau, I; Abbaneo, D; Azzurri, P; Bagliesi, G; Batignani, G; Bettarini, S; Bozzi, C; Calderini, G; Carpinelli, M; Ciocci, M A; Ciulli, V; Dell'Orso, R; Fantechi, R; Ferrante, I; Foà, L; Forti, F; Giassi, A; Giorgi, M A; Gregorio, A; Ligabue, F; Lusiani, A; Marrocchesi, P S; Messineo, A; Rizzo, G; Sanguinetti, G; Sciabà, A; Spagnolo, P; Steinberger, Jack; Tenchini, Roberto; Tonelli, G; Triggiani, G; Vannini, C; Verdini, P G; Walsh, J; Betteridge, A P; Blair, G A; Bryant, L M; Cerutti, F; Gao, Y; Green, M G; Johnson, D L; Medcalf, T; Mir, L M; Perrodo, P; Strong, J A; Bertin, V; Botterill, David R; Clifft, R W; Edgecock, T R; Haywood, S; Edwards, M; Maley, P; Norton, P R; Thompson, J C; Bloch-Devaux, B; Colas, P; Emery, S; Kozanecki, Witold; Lançon, E; Lemaire, M C; Locci, E; Marx, B; Pérez, P; Rander, J; Renardy, J F; Roussarie, A; Schuller, J P; Schwindling, J; Trabelsi, A; Vallage, B; Johnson, R P; Kim, H Y; Litke, A M; McNeil, M A; Taylor, G; Beddall, A; Booth, C N; Boswell, R; Cartwright, S L; Combley, F; Dawson, I; Köksal, A; Letho, M; Newton, W M; Rankin, C; Thompson, L F; Böhrer, A; Brandt, S; Cowan, G D; Feigl, E; Grupen, Claus; Lutters, G; Minguet-Rodríguez, J A; Rivera, F; Saraiva, P; Smolik, L; Stephan, F; Apollonio, M; Bosisio, L; Della Marina, R; Giannini, G; Gobbo, B; Ragusa, F; Rothberg, J E; Wasserbaech, S R; Armstrong, S R; Bellantoni, L; Elmer, P; Feng, Z; Ferguson, D P S; Gao, Y S; González, S; Grahl, J; Harton, J L; Hayes, O J; Hu, H; McNamara, P A; Nachtman, J M; Orejudos, W; Pan, Y B; Saadi, Y; Schmitt, M; Scott, I J; Sharma, V; Turk, J; Walsh, A M; Wu Sau Lan; Wu, X; Yamartino, J M; Zheng, M; Zobernig, G

    1996-01-01

    From 64492 selected \\tau-pair events, produced at the Z^0 resonance, the measurement of the tau decays into hadrons from a global analysis using 1991, 1992 and 1993 ALEPH data is presented. Special emphasis is given to the reconstruction of photons and \\pi^0's, and the removal of fake photons. A detailed study of the systematics entering the \\pi^0 reconstruction is also given. A complete and consistent set of tau hadronic branching ratios is presented for 18 exclusive modes. Most measurements are more precise than the present world average. The new level of precision reached allows a stringent test of \\tau-\\mu universality in hadronic decays, g_\\tau/g_\\mu \\ = \\ 1.0013 \\ \\pm \\ 0.0095, and the first measurement of the vector and axial-vector contributions to the non-strange hadronic \\tau decay width: R_{\\tau ,V} \\ = \\ 1.788 \\ \\pm \\ 0.025 and R_{\\tau ,A} \\ = \\ 1.694 \\ \\pm \\ 0.027. The ratio (R_{\\tau ,V} - R_{\\tau ,A}) / (R_{\\tau ,V} + R_{\\tau ,A}), equal to (2.7 \\pm 1.3) \\ \\%, is a measure of the importance of Q...

  11. 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.

  12. Medial circumflex femoral artery flap for ischial pressure sore

    Directory of Open Access Journals (Sweden)

    Palanivelu S

    2009-01-01

    Full Text Available A new axial pattern flap based on the terminal branches of the medial circumflex femoral artery is described for coverage of ischial pressure sore. Based on the terminal branches of the transverse branch of medial circumflex femoral artery, which exit through the gap between the quadratus femoris muscle above and the upper border of adductor magnus muscle below, this fascio cutaneous flap is much smaller than the posterior thigh flap but extremely useful to cover ischeal pressure sores. The skin redundancy below the gluteal fold allows a primary closure of the donor defect. It can also be used in combination with biceps femoris muscle flap.

  13. Arterial supply of the thoracic lobes of the thymus in dogs of the Great Dane race.

    Directory of Open Access Journals (Sweden)

    Rosana Marques Silva

    2007-09-01

    Full Text Available The origins, numbers and type of arterial branches responsible for the blood supply of thoracic lobes of the thymus were studied in 28 stillborn dogs of the Great Dane, of which 18 were males and 10 were females. The arterial systems of these animals were filled with aqueous solution of Neoprene Latex “450”, 50%. After, the specimens were fixed in 10% formaldehyde aqueous solution. The lobes of the thymus were supplied by direct or indirect arterial branches coming from the right and left internal thoracic arteries, pericardiacophrenicas arteries, right and left costocervicais trunks, and left subclavian artery. The left subclavian artery and brachiocephalic trunk emitted direct branches towards the left thoracic lobe of the thymus.

  14. Metrics for comparing dynamic earthquake rupture simulations

    Science.gov (United States)

    Barall, Michael; Harris, Ruth A.

    2014-01-01

    Earthquakes are complex events that involve a myriad of interactions among multiple geologic features and processes. One of the tools that is available to assist with their study is computer simulation, particularly dynamic rupture simulation. A dynamic rupture simulation is a numerical model of the physical processes that occur during an earthquake. Starting with the fault geometry, friction constitutive law, initial stress conditions, and assumptions about the condition and response of the near‐fault rocks, a dynamic earthquake rupture simulation calculates the evolution of fault slip and stress over time as part of the elastodynamic numerical solution (Ⓔ see the simulation description in the electronic supplement to this article). The complexity of the computations in a dynamic rupture simulation make it challenging to verify that the computer code is operating as intended, because there are no exact analytic solutions against which these codes’ results can be directly compared. One approach for checking if dynamic rupture computer codes are working satisfactorily is to compare each code’s results with the results of other dynamic rupture codes running the same earthquake simulation benchmark. To perform such a comparison consistently, it is necessary to have quantitative metrics. In this paper, we present a new method for quantitatively comparing the results of dynamic earthquake rupture computer simulation codes.

  15. Isolated Left Pulmonary Artery Agenesis: A Case Report

    Directory of Open Access Journals (Sweden)

    Tansel Ansal Balcı

    2012-08-01

    Full Text Available Unilateral pulmonary artery agenesis without any cardiovascular malformation is a rare anomaly. We present the imaging findings of a patient who was diagnosed as isolated left pulmonary artery agenesis. A 27-year-old female patient was admitted to our hospital due to dyspnea during exercise for five years. Chest X-ray revealed minimally small left pulmonary hilum and left lung. She was admitted to our clinic with the suspicion of pulmonary artery pathology. Absent perfusion of the left lung with normal ventilation was visualized on scintigraphy. MDCT angiography of pulmonary arteries showed absent left main pulmonary artery with systemic collaterals around left hemithorax. Pulmonary artery agenesis can be asymptomatic and isolated until adulthood. Both scintigraphy and CT angiography images of pulmonary artery agenesis of a patient are rare in the literature. Pulmonary ventilation- perfusion scintigraphy can be used not only for pulmonary embolism but also pathologies involving pulmonary artery and its branches. (MIRT 2012;21:80-83

  16. Multiple vascular anomalies involving renal, testicular and suprarenal arteries

    Directory of Open Access Journals (Sweden)

    Suresh Rao

    2015-09-01

    Full Text Available Knowledge of variations of blood vessels of the abdomen is important during operative, diagnostic and endovascular pro- cedures. During routine dissection of the abdominal cavity, we came across multiple vascular anomalies involving renal, suprarenal and testicular arteries. The left kidney was supplied by two renal arteries originating together from the abdomi- nal aorta, and the right kidney was supplied by two accessory renal arteries, one of which was arising from the right renal artery and the other one from the aorta (about 2 inches below the origin of the renal artery. Accessory renal veins were present on both sides. The right testicular artery was arising from the lower accessory renal artery. The left testicular artery was looping around the inferior tributary of the left renal vein, whereby forming a sharp kink. The left middle suprarenal artery was diving into three small branches; the upper two branches were supplying the left suprarenal gland, whereas the lower branch was supplying the left kidney. Furthermore, detailed literature and the clinical and surgical importance of the case are discussed. [Arch Clin Exp Surg 2015; 4(3.000: 168-171

  17. Misdiagnosed Chest Pain: Spontaneous Esophageal Rupture

    Science.gov (United States)

    Inci, Sinan; Gundogdu, Fuat; Gungor, Hasan; Arslan, Sakir; Turkyilmaz, Atila; Eroglu, Atila

    2013-01-01

    Chest pain is one of themost common complaints expressed by patients presenting to the emergency department, and any initial evaluation should always consider life-threatening causes. Esophageal rupture is a serious condition with a highmortality rate. If diagnosed, successful therapy depends on the size of the rupture and the time elapsed between rupture and diagnosis.We report on a 41-year-old woman who presented to the emergency department complaining of left-sided chest pain for two hours. PMID:27122690

  18. Eccentric pressurized tube for measuring creep rupture

    International Nuclear Information System (INIS)

    Schwab, P.R.

    1981-01-01

    Creep rupture is a long term failure mode in structural materials that occurs at high temperatures and moderate stress levels. The deterioration of the material preceding rupture, termed creep damage, manifests itself in the formation of small cavities on grain boundaries. To measure creep damage, sometimes uniaxial tests are performed, sometimes density measurements are made, and sometimes the grain boundary cavities are measured by microscopy techniques. The purpose of the present research is to explore a new method of measuring creep rupture, which involves measuring the curvature of eccentric pressurized tubes. Theoretical investigations as well as the design, construction, and operation of an experimental apparatus are included in this research

  19. Spontaneous distal rupture of the plantar fascia.

    Science.gov (United States)

    Gitto, Salvatore; Draghi, Ferdinando

    2018-07-01

    Spontaneous ruptures of the plantar fascia are uncommon injuries. They typically occur at its calcaneal insertion and usually represent a complication of plantar fasciitis and local treatment with steroid injections. In contrast, distal ruptures commonly result from traumatic injuries. We describe the case of a spontaneous distal rupture of the plantar fascia in a 48-year-old woman with a low level of physical activity and no history of direct injury to the foot, plantar fasciitis, or steroid injections. © 2017 Wiley Periodicals, Inc.

  20. Ideal Internal Carotid Artery Trapping Technique without Bypass in a Patient with Insufficient Collateral Flow

    OpenAIRE

    Chung, Joon Ho; Shin, Yong Sam; Lim, Yong Cheol; Park, Minjung

    2009-01-01

    Internal carotid artery (ICA) trapping can be used for treating intracranial giant aneurysm, blood blister-like aneurysms and ICA rupture during the surgery. We present a novel ICA trapping technique which can be used with insufficient collaterals flow via anterior communicating artery (AcoA) and posterior communicating artery (PcoA). A patient was admitted with severe headache and the cerebral angiography demonstrated a typical blood blister-like aneurysm at the contralateral side of PcoA. F...

  1. Accessory left gastric artery: angiographic anatomy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kang Soo; Lim, Hyung Guhn; Kim, Hong Soo; Jeon, Doo Sung [Presbyterian Medical Center, Chunju (Korea, Republic of); Chung, Jin Wook; Park, Jae Hyung [College of Medicine and the Institute of Radiation Medicine, Seoul National University, Seoul (Korea, Republic of); Song, Soon Young [Myongji Hospital, College of Medicine, Kwandong University, Seoul (Korea, Republic of)

    2000-09-01

    To evaluate the angiographic anatomy of the accessory left gastric artery (accLGA). We evaluated the angiographic findings of the accLGA in 50 patients (Angiostar; Siemens, Erlangen, Germany). Performing celiac and selective angiography in 50 and 34 patients, respectively. By means of celiac angiography, (1) site of origin, (2) anatomical course, (3) diameter, (4) degree of tortuosity, and (5) distal tapering were evaluated, while selective angiography was used to determine (1) arterial branching, (2) area of blood supply, and (3) patterns of gastric wall stain. Celiac angiography showed that the accLGA arose from the left hepatic artery (LHA) in 45 cases (90%) and from the proper hepatic artery in five (10%). If the accLGA arose from the LHA, its origin entirely depended on the branching pattern of the latter. It always arose from the lateral branch of the LHA furthest to the left and uppermost, and proximal to its umbilical point. The most common anatomical course of the accLGA, seen in 27 cases (54%), was between the S2 and S3 segmental branch. The diameter and degree of tortuosity of the accLGA were similar to those of adjacent intrahepatic branches in 21 (42%) and 33 cases (66%), respectively. The degree of tapering was less than that of adjacent intrahepatic vessel in 28 (56%). Selective angiography demonstrated esophageal branching of the acc LGA in 27 cases (79%), inferior phrenic arterial branching in three (9%), a mediastinal branch in one (3%), and hypervascularity of the lung in one (3%). In 15 cases (44%), bifurcation of the accLGA was recognized. The vascular territory of the accLGA was the gastric fundus together with the distal esophagus in 21 cases (62%), mainly the gastric fundus in six (18%), and mainly the distal esophagus in four (12%). The pattern of gastric mucosal stain was curvilinear wall in 31 cases (91%) and nodular in three (9%). A knowledge of the angiographic anatomy of the accLGA facilitates accurate recognition of this artery on

  2. Gene expression profiling reveals distinct molecular signatures associated with the rupture of intracranial aneurysm.

    Science.gov (United States)

    Nakaoka, Hirofumi; Tajima, Atsushi; Yoneyama, Taku; Hosomichi, Kazuyoshi; Kasuya, Hidetoshi; Mizutani, Tohru; Inoue, Ituro

    2014-08-01

    The rupture of intracranial aneurysm (IA) causes subarachnoid hemorrhage associated with high morbidity and mortality. We compared gene expression profiles in aneurysmal domes between unruptured IAs and ruptured IAs (RIAs) to elucidate biological mechanisms predisposing to the rupture of IA. We determined gene expression levels of 8 RIAs, 5 unruptured IAs, and 10 superficial temporal arteries with the Agilent microarrays. To explore biological heterogeneity of IAs, we classified the samples into subgroups showing similar gene expression patterns, using clustering methods. The clustering analysis identified 4 groups: superficial temporal arteries and unruptured IAs were aggregated into their own clusters, whereas RIAs segregated into 2 distinct subgroups (early and late RIAs). Comparing gene expression levels between early RIAs and unruptured IAs, we identified 430 upregulated and 617 downregulated genes in early RIAs. The upregulated genes were associated with inflammatory and immune responses and phagocytosis including S100/calgranulin genes (S100A8, S100A9, and S100A12). The downregulated genes suggest mechanical weakness of aneurysm walls. The expressions of Krüppel-like family of transcription factors (KLF2, KLF12, and KLF15), which were anti-inflammatory regulators, and CDKN2A, which was located on chromosome 9p21 that was the most consistently replicated locus in genome-wide association studies of IA, were also downregulated. We demonstrate that gene expression patterns of RIAs were different according to the age of patients. The results suggest that macrophage-mediated inflammation is a key biological pathway for IA rupture. The identified genes can be good candidates for molecular markers of rupture-prone IAs and therapeutic targets. © 2014 American Heart Association, Inc.

  3. Arterial stiffness

    Directory of Open Access Journals (Sweden)

    Ursula Quinn

    2012-09-01

    Full Text Available Measurements of biomechanical properties of arteries have become an important surrogate outcome used in epidemiological and interventional cardiovascular research. Structural and functional differences of vessels in the arterial tree result in a dampening of pulsatility and smoothing of blood flow as it progresses to capillary level. A loss of arterial elastic properties results a range of linked pathophysiological changes within the circulation including increased pulse pressure, left ventricular hypertrophy, subendocardial ischaemia, vessel endothelial dysfunction and cardiac fibrosis. With increased arterial stiffness, the microvasculature of brain and kidneys are exposed to wider pressure fluctuations and may lead to increased risk of stroke and renal failure. Stiffening of the aorta, as measured by the gold-standard technique of aortic Pulse Wave Velocity (aPWV, is independently associated with adverse cardiovascular outcomes across many different patient groups and in the general population. Therefore, use of aPWV has been proposed for early detection of vascular damage and individual cardiovascular risk evaluation and it seems certain that measurement of arterial stiffness will become increasingly important in future clinical care. In this review we will consider some of the pathophysiological processes that result from arterial stiffening, how it is measured and factors that may drive it as well as potential avenues for therapy. In the face of an ageing population where mortality from atheromatous cardiovascular disease is falling, pathology associated with arterial stiffening will assume ever greater importance. Therefore, understanding these concepts for all clinicians involved in care of patients with cardiovascular disease will become vital.

  4. Three dimensional CT angiography (3D-CTA) in ruptured aneurysm surgery on acute stage

    International Nuclear Information System (INIS)

    Matsumoto, Masato; Endo, Yuji; Nakano, Masayuki

    1998-01-01

    We evaluated three-dimensional CT angiography (3D-CTA) for the treatment of acutely ruptured cerebral aneurysms. Sixty patients with subarachnoid hemorrhage from cerebral aneurysms were investigated both by 3D-CTA and conventional angiography and 26 patients were studied using 3D-CTA without conventional angiography. In the 60 cases, both 3D-CTA and the conventional angiography revealed 100% accuracy in diagnosing ruptured aneurysms, and 3D-CTA and the conventional angiography showed 96% and 92% accuracy for unruptured aneurysms respectively. 3D-CTA was equal or superior to the conventional angiography. Based on these data, since December, 1996, we have operated on 26 consecutive patients with ruptured aneurysms located in the anterior circulation of the circle of Willis, using 3D-CTA without conventional angiography. Thirty-one aneurysms, including 5 associated unruptured aneurysms, were visualized by 3D-CTA and verified at surgery. All aneurysms were clipped successfully. We think that it will be possible to operate on most ruptured aneurysms using only 3D-CTA without the conventional angiography except for the cases of the following situations: if a cerebral infarction is present, conventional angiography is required to evaluate for a stenotic or occlusive lesion of the intracranial arteries, cervical carotid, or vertebral arteries; in cases of giant or large aneurysms, the dynamic information provided by the conventional angiography is needed in case bypass surgery is necessary; and for aneurysms close to bony structures, such as an internal carotid-ophthalmic artery aneurysm, conventional angiography is necessary. (author)

  5. Real-Time Detection of Rupture Development: Earthquake Early Warning Using P Waves From Growing Ruptures

    Science.gov (United States)

    Kodera, Yuki

    2018-01-01

    Large earthquakes with long rupture durations emit P wave energy throughout the rupture period. Incorporating late-onset P waves into earthquake early warning (EEW) algorithms could contribute to robust predictions of strong ground motion. Here I describe a technique to detect in real time P waves from growing ruptures to improve the timeliness of an EEW algorithm based on seismic wavefield estimation. The proposed P wave detector, which employs a simple polarization analysis, successfully detected P waves from strong motion generation areas of the 2011 Mw 9.0 Tohoku-oki earthquake rupture. An analysis using 23 large (M ≥ 7) events from Japan confirmed that seismic intensity predictions based on the P wave detector significantly increased lead times without appreciably decreasing the prediction accuracy. P waves from growing ruptures, being one of the fastest carriers of information on ongoing rupture development, have the potential to improve the performance of EEW systems.

  6. Carotid artery surgery

    Science.gov (United States)

    Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery ... through the catheter around the blocked area during surgery. Your carotid artery is opened. The surgeon removes ...

  7. Spontaneous rupture of ovarian cystadenocarcinoma: pre- and post-rupture computed tomography evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Salvadori, Priscila Silveira; Atzingen, Augusto Castelli von; D' Ippolito, Giuseppe [Universidade Federal de Sao Paulo (EPM/UNIFESP), Sao Paulo, SP (Brazil). Escola Paulista de Medicina; Bomfim, Lucas Novais [Universidade Tiradentes (UNIT), Maceio, AL, (Brazil)

    2015-09-15

    Epithelial ovarian tumors are the most common malignant ovarian neoplasms and, in most cases, eventual rupture of such tumors is associated with a surgical procedure. The authors report the case of a 54-year-old woman who presented with spontaneous rupture of ovarian cystadenocarcinoma documented by computed tomography, both before and after the event. In such cases, a post-rupture staging tends to be less favorable, compromising the prognosis. (author)

  8. Global catalog of earthquake rupture velocities shows anticorrelation between stress drop and rupture velocity

    Science.gov (United States)

    Chounet, Agnès; Vallée, Martin; Causse, Mathieu; Courboulex, Françoise

    2018-05-01

    Application of the SCARDEC method provides the apparent source time functions together with seismic moment, depth, and focal mechanism, for most of the recent earthquakes with magnitude larger than 5.6-6. Using this large dataset, we have developed a method to systematically invert for the rupture direction and average rupture velocity Vr, when unilateral rupture propagation dominates. The approach is applied to all the shallow (z earthquakes of the catalog over the 1992-2015 time period. After a careful validation process, rupture properties for a catalog of 96 earthquakes are obtained. The subsequent analysis of this catalog provides several insights about the seismic rupture process. We first report that up-dip ruptures are more abundant than down-dip ruptures for shallow subduction interface earthquakes, which can be understood as a consequence of the material contrast between the slab and the overriding crust. Rupture velocities, which are searched without any a-priori up to the maximal P wave velocity (6000-8000 m/s), are found between 1200 m/s and 4500 m/s. This observation indicates that no earthquakes propagate over long distances with rupture velocity approaching the P wave velocity. Among the 23 ruptures faster than 3100 m/s, we observe both documented supershear ruptures (e.g. the 2001 Kunlun earthquake), and undocumented ruptures that very likely include a supershear phase. We also find that the correlation of Vr with the source duration scaled to the seismic moment (Ts) is very weak. This directly implies that both Ts and Vr are anticorrelated with the stress drop Δσ. This result has implications for the assessment of the peak ground acceleration (PGA) variability. As shown by Causse and Song (2015), an anticorrelation between Δσ and Vr significantly reduces the predicted PGA variability, and brings it closer to the observed variability.

  9. Earthquake Rupture at Focal Depth, Part I: Structure and Rupture of the Pretorius Fault, TauTona Mine, South Africa

    Science.gov (United States)

    Heesakkers, V.; Murphy, S.; Reches, Z.

    2011-12-01

    We analyze the structure of the Archaean Pretorius fault in TauTona mine, South Africa, as well as the rupture-zone that recently reactivated it. The analysis is part of the Natural Earthquake Laboratory in South African Mines (NELSAM) project that utilizes the access to 3.6 km depth provided by the mining operations. The Pretorius fault is a ~10 km long, oblique-strike-slip fault with displacement of up to 200 m that crosscuts fine to very coarse grain quartzitic rocks in TauTona mine. We identify here three structural zones within the fault-zone: (1) an outer damage zone, ~100 m wide, of brittle deformation manifested by multiple, widely spaced fractures and faults with slip up to 3 m; (2) an inner damage zone, 25-30 m wide, with high density of anastomosing conjugate sets of fault segments and fractures, many of which carry cataclasite zones; and (3) a dominant segment, with a cataclasite zone up to 50 cm thick that accommodated most of the Archaean slip of the Pretorius fault, and is regarded as the `principal slip zone' (PSZ). This fault-zone structure indicates that during its Archaean activity, the Pretorius fault entered the mature fault stage in which many slip events were localized along a single, PSZ. The mining operations continuously induce earthquakes, including the 2004, M2.2 event that rejuvenated the Pretorius fault in the NELSAM project area. Our analysis of the M2.2 rupture-zone shows that (1) slip occurred exclusively along four, pre-existing large, quasi-planer segments of the ancient fault-zone; (2) the slipping segments contain brittle cataclasite zones up to 0.5 m thick; (3) these segments are not parallel to each other; (4) gouge zones, 1-5 mm thick, composed of white `rock-flour' formed almost exclusively along the cataclasite-host rock contacts of the slipping segments; (5) locally, new, fresh fractures branched from the slipping segments and propagated in mixed shear-tensile mode; (6) the maximum observed shear displacement is 25 mm in

  10. Common hepatic artery aneurysm: Pseudopseudocyst of the pancreas

    International Nuclear Information System (INIS)

    Shultz, S.; Druy, E.M.; Friedman, A.C.

    1985-01-01

    The preoperative diagnosis of hepatic artery aneurysm is uncommon, and its presentation as a pancreatic mass is rare. Because of its great potential for rupture early diagnosis and treatment is essential. The authors report two cases of aneurysms of the common hepatic artery, which on CT presented as a cystic mass in the head of the pancreas. These cases illustrate the importance of using 10-mm serial sections through the pancreas after a bolus injection of intravenous contrast material in order to allow distinction between hepatic artery aneurysm and other, more common, cystic masses of the pancreas

  11. Arthrographic diagnosis of ruptured calcaneofibular ligament. I

    International Nuclear Information System (INIS)

    Vuust, M.

    1980-01-01

    A new projection, oblique axial, is recommended for the arthrography of the acute sprained ankle for the correct diagnosis of a ruptured calcaneofibular ligament. Its value is experimentally confirmed. (Auth.)

  12. Right Diaphragm Spontaneous Rupture: A Surgical Approach

    Directory of Open Access Journals (Sweden)

    Duilio Divisi

    2011-01-01

    Full Text Available We present a case of spontaneous rupture of the diaphragm, characterized by nonspecific symptoms. The rapid diagnosis and appropriate surgical approach led to a positive resolution of the pathology.

  13. Traumatic Gallbladder Rupture Treated by Laparoscopic Cholecystectomy

    Science.gov (United States)

    Egawa, Noriyuki; Ueda, Junji; Hiraki, Masatsugu; Ide, Takao; Inoue, Satoshi; Sakamoto, Yuichiro; Noshiro, Hirokazu

    2016-01-01

    Abstract Gallbladder rupture due to blunt abdominal injury is rare. There are few reports of traumatic gallbladder injury, and it is commonly associated with other concomitant visceral injuries. Therefore, it is difficult to diagnose traumatic gallbladder rupture preoperatively when it is caused by blunt abdominal injury. We report a patient who underwent laparoscopic cholecystectomy after an exact preoperative diagnosis of traumatic gallbladder rupture. A 43-year-old man was admitted to our hospital due to blunt abdominal trauma. The day after admission, abdominal pain and ascites increased and a muscular defense sign appeared. Percutaneous drainage of the ascites was performed, and the aspirated fluid was bloody and almost pure bile. He was diagnosed with gallbladder rupture by the cholangiography using the endoscopic retrograde cholangiopancreatography technique. Laparoscopic cholecystectomy was performed safely, and he promptly recovered. If accumulated fluids contain bile, endoscopic cholangiography is useful not only to diagnose gallbladder injury but also to determine the therapeutic strategy. PMID:27462188

  14. Traumatic Gallbladder Rupture Treated by Laparoscopic Cholecystectomy

    Directory of Open Access Journals (Sweden)

    Noriyuki Egawa

    2016-05-01

    Full Text Available Gallbladder rupture due to blunt abdominal injury is rare. There are few reports of traumatic gallbladder injury, and it is commonly associated with other concomitant visceral injuries. Therefore, it is difficult to diagnose traumatic gallbladder rupture preoperatively when it is caused by blunt abdominal injury. We report a patient who underwent laparoscopic cholecystectomy after an exact preoperative diagnosis of traumatic gallbladder rupture. A 43-year-old man was admitted to our hospital due to blunt abdominal trauma. The day after admission, abdominal pain and ascites increased and a muscular defense sign appeared. Percutaneous drainage of the ascites was performed, and the aspirated fluid was bloody and almost pure bile. He was diagnosed with gallbladder rupture by the cholangiography using the endoscopic retrograde cholangiopancreatography technique. Laparoscopic cholecystectomy was performed safely, and he promptly recovered. If accumulated fluids contain bile, endoscopic cholangiography is useful not only to diagnose gallbladder injury but also to determine the therapeutic strategy.

  15. Development of rupture discs for the FBTR

    International Nuclear Information System (INIS)

    Chetal, S.C.; Raju, C.; Anandkumar, V.; Seetharaman, V.; Rajan, K.K.

    1984-01-01

    Rupture discs are required as a safety device for protecting the secondary sodium circuit and its components against high pressure surges due to accidental water steam leaks in sodium heated steam generator and the consequent sodium water reaction. For identical reasons, rupture discs are also required on the vessels used for decontamination of sodium components. Reverse buckling knife blade concept with austenitic stainless steel disc has been developed for the rupture disc assemblies required for Fast Breeder Test Reactor (FBTR). Hydroforming process without any die has been used for disc fabrication. One rupture disc assembly required for steam generator is undergoing sodium endurance test and has accumulated 4,500 hours. The present status of development work as demonstrated by room temperature experimental results as well as the scope for future work are discussed. (author)

  16. Cognitive frames in psychology: demarcations and ruptures.

    Science.gov (United States)

    Yurevich, Andrey V

    2009-06-01

    As there seems to be a recurrent feeling of crisis in psychology, its present state is analyzed in this article. The author believes that in addition to the traditional manifestations that have dogged psychology since it emerged as an independent science some new features of the crisis have emerged. Three fundamental "ruptures" are identified: the "horizontal" rupture between various schools and trends, the "vertical" rupture between natural science and humanitarian psychology, and the "diagonal" rupture between academic research and applied practice of psychology. These manifestations of the crisis of psychology have recently been compounded by the crisis of its rationalistic foundations. This situation is described in terms of the cognitive systems in psychology which include meta-theories, paradigms, sociodigms and metadigms.

  17. Traumatic Fundal Rupture of unscarred Uterus in a Primigravida ...

    African Journals Online (AJOL)

    Background: Uterine rupture is an infrequent but life threatening obstetric emergency. Rupture of previously scarred uterus is often encountered especially in multiparous women, but the traumatic rupture of an unscarred primigravid uterus as presented here is a relatively rare event. We report a case of rupture of an ...

  18. Describing Soils: Calibration Tool for Teaching Soil Rupture Resistance

    Science.gov (United States)

    Seybold, C. A.; Harms, D. S.; Grossman, R. B.

    2009-01-01

    Rupture resistance is a measure of the strength of a soil to withstand an applied stress or resist deformation. In soil survey, during routine soil descriptions, rupture resistance is described for each horizon or layer in the soil profile. The lower portion of the rupture resistance classes are assigned based on rupture between thumb and…

  19. Micromechanical properties and collagen composition of ruptured human achilles tendon

    DEFF Research Database (Denmark)

    Hansen, Philip; Kovanen, Vuokko; Hölmich, Per

    2013-01-01

    The Achilles tendon is one of the strongest tendons in the human body, and yet it frequently ruptures, which is a substantial clinical problem. However, the cause of ruptures remains elusive.......The Achilles tendon is one of the strongest tendons in the human body, and yet it frequently ruptures, which is a substantial clinical problem. However, the cause of ruptures remains elusive....

  20. Bladder And Uterine Rupture At Vaginal Birth After Cesarean Section

    African Journals Online (AJOL)

    Rupture of the uterus is still a major obstetric problem in developing countries. The urinary bladder is often affected especially when a lower segment Caesarean scar ruptures. We present a case of bladder rupture associated with uterine rupture in a patient who was attempting vaginal delivery after two previous Caesarean ...