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Sample records for jugular vein aorta

  1. Accuracy of Inferior Vena Cava, Aorta, and Jugular Vein Ultrasonographic Diameters in Identifying Pediatric Dehydration

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    Hamid Kariman

    2015-10-01

    Full Text Available Introduction: Evaluating intravascular volume is an important but complicated matter in management of critically ill patients, especially in children. Although invasive techniques have the ability to accurately estimate the intravascular volume, but they have dangerous side effects. Therefore, the present study was designed with the aim of comparing the diagnostic accuracy of sonographic diameters of inferior vena cava (IVC, aorta, internal jugular vein (IJV, and IVC/aorta ratio in identifying pediatric dehydration in children presented to the emergency department (ED. Methods: The present prospective cross-sectional study was carried out with the aim of determining the diagnostic accuracy of sonographic diameters of IVC, IJV, and aorta, in estimation of dehydration rate for children presented to the ED with mild to moderate dehydration. Their screening performance characteristics, such as area under the ROC curve, sensitivity and specificity, were calculated and used for this purpose. The data were analyzed using STATA 11.0 and 0.05 was considered as significance level. Results: In the end, 54 patients were enrolled in the study (57.4% male, mean age of 4.9 ± 2.7 years. Area under the ROC curve for IVC in diagnosis of moderate dehydration in sagittal and transverse planes were 0.775 (95% CI: 0.65 – 0.91 and 0.8086 (95%CI: 0.96 – 0.93, respectively. In addition, the diameter of aorta in this regard were 0.658 (95%CI: 0.51 – 0.81 for the sagittal and 0.7126 (95% CI: 0.57 – 0.86 for the transverse plane. IJV diameter had an area under the curve of 0.7332 (95% CI: 0.59 – 0.88. Comparing the area under the ROC curves for the studied parameters showed that IVC diameter in the sagittal (p = 0.004 and transverse (p < 0.001 planes is a better index for diagnosis of moderate dehydration. Conclusion: Based on the findings of the present study, it seems that IJV, IVC, and aorta diameters are not very accurate for determining the condition of

  2. Subclavian artery to internal jugular vein fistula following percutaneous internal jugular vein catheterization.

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    Merino-Angulo, J; Cortazar, J L; Saez-Garmendia, F; Montejo, M

    1984-01-01

    The percutaneous internal jugular vein approach is now a commonly performed procedure for central venous catheterization. Iatrogenic arteriovenous fistulae are a very infrequent complication. We report an asymptomatic subclavian artery to internal jugular vein fistula following two percutaneous internal jugular vein catheterization attempts.

  3. Effects of inorganic cations on K+-, 5-hydroxytryptamine- and noradrenaline-induced contractions of the isolated rat jugular vein and aorta

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    Gouw, M.A.M.; Wilffert, B.; Van Zwieten, P.A.

    1990-01-01

    We investigated the inhibitory effects of 1 mM of the inorganic cations, La3+, Cd2+, Mn2+, Ni2+and Co2+on contractions induced by K+(100 mM) and 5-hydroxytryptamine (5-HT, 10-5M) in the isolated rat jugular vein and on contractions induced by K+(100 mM), 5-HT (10-5) and noradrenaline (NA, 10-5M) in

  4. Internal Jugular Vein Thrombosis following Oropharyngeal Infection

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    Asli Bostanci

    2015-01-01

    Full Text Available Internal jugular vein thrombosis (IJVT is a rare condition which may lead to life-threatening complications such as sepsis and pulmonary embolism. Prolonged central venous catheterization, intravenous (IV drug use, trauma, and radiotherapy are the most frequent causes of the IJVT. IJVT that develops after the oropharyngeal infection is a quite rare situation today. In this paper, a 37-year-old woman was presented; swelling occurred on her neck after acute tonsillitis and she was diagnosed with IJVT through Doppler ultrasonography and magnetic resonance imaging and managed without complications. Early diagnosis and conservative treatment with broad-spectrum IV antibiotics and anticoagulant agents have a critical importance for the prevention of fatal complications.

  5. Internal Jugular Vein Entrapment in a Multiple Sclerosis Patient

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    Marian Simka

    2012-01-01

    Full Text Available We describe a multiple sclerosis patient presenting with compression of the internal jugular vein caused by aberrant omohyoid muscle. Previously this patient underwent balloon angioplasty of the same internal jugular vein. Ten months after this endovascular procedure, Doppler sonography revealed totally collapsed middle part of the treated vein with no outflow detected. Still, the vein widened and the flow was restored when the patient’s mouth opened. Thus, the abnormality was likely to be caused by muscular compression. Surgical exploration confirmed that an atypical omohyoid muscle was squeezing the vein. Consequently, pathological muscle was transected. Sonographic control three weeks after surgical procedure revealed a decompressed vein with fully restored venous outflow. Although such a muscular compression can be successfully managed surgically, future research has to establish its clinical relevance.

  6. Jugular-axillary vein bypass for salvage of arteriovenous access.

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    Fulks, K D; Hyde, G L

    1989-01-01

    Stenosis or occlusion of the subclavian vein can cause incapacitating upper extremity swelling and venous hypertension in the patient with an arteriovenous (AV) access. A case of subclavian vein occlusion is reported that was treated with internal jugular-axillary vein bypass. This procedure resulted in salvage of the access and rapid resolution of the associated upper extremity swelling. It was concluded that jugular-axillary vein bypass should be considered in patients who have massive upper extremity edema resulting from a functioning AV access and ipsilateral subclavian vein occlusion. Patients undergoing creation of an AV access who have had previous temporary subclavian catheters or previous early failure of an AV access should have phlebography before surgery.

  7. Common femoral vein reconstruction using internal jugular vein after blast injury.

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    Holt, Andrew M; West, Charles A; Davis, James A; Gilani, Ramyar; Askenasy, Eric

    2014-10-01

    Common femoral vein traumatic injuries are rare. Surgical management is controversial and by nature case specific. In this report, we present an unusual case of an isolated common femoral vein injury from a gunshot blast repaired with an interposition internal jugular vein bypass. To our knowledge, this is the first reported case of an isolated common femoral vein reconstructed in this manner.

  8. Valsalva and gravitational variability of the internal jugular vein and common femoral vein: Ultrasound assessment

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    Beddy, P. [Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland)]. E-mail: pbeddy@eircom.net; Geoghegan, T. [Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); Ramesh, N. [Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); Buckley, O. [Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); O' Brien, J. [Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); Colville, J. [Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); Torreggiani, W.C. [Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland)

    2006-05-15

    Purpose: Central venous cannulation via the common femoral vein is an important starting point for many interventions. The purpose of this study was to determine the optimum conditions for cannulation of the femoral vein and to compare these with the relative changes in the internal jugular vein. Methods: High-resolution 2D ultrasound was utilised to determine variability of the calibre of the femoral and internal jugular veins in 10 healthy subjects. Venous diameter was assessed during the Valsalva manoeuvre and in different degrees of the Trendelenburg position. Results: The Valsalva manoeuvre significantly increased the size of the femoral and internal jugular veins. There was a relatively greater increase in femoral vein diameter when compared with the internal jugular vein of 40 and 29%, respectively. Changes in body inclination (Trendelenburg position) did not significantly alter the luminal diameter of the femoral vein. However, it significantly increased internal jugular vein diameter. Conclusions: Femoral vein cannulation is augmented by the Valsalva manoeuvre but not significantly altered by the gravitational position of the subject.

  9. Malpostion of subclavin central venous cannulation into ipsilateral jugular vein -An unusal case report

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    Vishal

    2013-11-01

    Full Text Available ABSTRACT: Central venous catheterization (CVC via infraclavicular subclavian approach in neurosurgical pat ients is very common practice. Malpositioning of central venous catheter inserted into subclavian vein is a known and dreaded complication. Malpositioning of catheter tip into ipsilateral jugular vein is an unusual occurrence. We hereby describe a case whe re a subclavian central venous catheter malpositioned into ipsilateral jugular vein

  10. Malpostion of subclavin central venous cannulation into ipsilateral jugular vein -An unusal case report

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    Vishal; Sumantra; Rajnikant; Dilpreet; Shweta

    2013-01-01

    ABSTRACT: Central venous catheterization (CVC) via infraclavicular subclavian approach in neurosurgical pat ients is very common practice. Malpositioning of central venous catheter inserted into subclavian vein is a known and dreaded complication. Malpositioning of catheter tip into ipsilateral jugular vein is an unusual occurrence. We hereby describe a case whe re a subclavian central venous catheter malpositioned into ipsilateral jugular vein

  11. A Retrospective Study of Preferable Alternative Route to Right Internal Jugular Vein for Placing Tunneled Dialysis Catheters: Right External Jugular Vein versus Left Internal Jugular Vein.

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    Pei Wang

    Full Text Available Right internal jugular vein (IJV is a preferred access route for tunneled (cuffed dialysis catheters (TDCs, and both right external jugular vein (EJV and left IJV are alternative routes for patients in case the right IJV isn't available for TDC placement. This retrospective study aimed to determine if a disparity exists between the two alternative routes in hemodialysis patients in terms of outcomes of TDCs.49 hemodialysis patients who required TDCs through right EJV (n = 21 or left IJV (n = 28 as long-term vascular access were included in this study. The primary end point was cumulative catheter patency. Secondary end points include primary catheter patency, proportion of patients that never required urokinase and incidence of catheter-related bloodstream infections (CRBSI.A total of 20,870 catheter-days were evaluated and the median was 384 (interquartile range, 262-605 catheter-days. Fewer catheters were removed in the right EJV group than in the left IJV group (P = 0.007. Mean cumulative catheter patency was higher in the right EJV group compared with the left IJV group (P = 0.031. There was no significant difference between the two groups in the incidence of CRBSI, primary catheter patency or proportion of patients that never required urokinase use. Total indwell time of antecedent catheters was identified as an independent risk factor for cumulative catheter patency by Cox regression hazards test with an HR of 2.212 (95% CI, 1.363-3.588; p = 0.001.Right EJV might be superior to left IJV as an alternative insertion route for TDC placement in hemodialysis patients whose right IJVs are unavailable.

  12. Fenestrated internal jugular vein: a rare finding in neck dissection.

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    Moreno-Sánchez, M; Hernández Vila, C; González-García, R; Monje, F

    2015-09-01

    Fenestration of the internal jugular vein (IJV) is an extremely rare phenomenon. An 85-year-old woman was referred to our department with T2N0M0 squamous cell carcinoma of the right floor of the mouth. The patient underwent local resection, an ipsilateral modified type 3 radical neck dissection, and microsurgical reconstruction. During neck dissection, a fenestration was observed in the middle of the IJV. No structure passed through the fenestration. Such anatomical variations are rare, but clinicians and surgeons should be aware of them in order to avoid damage to the important vascular structures, especially if a neck dissection is performed.

  13. Port catheter fracture and migration in Internal Jugular Vein.

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    Doley, Rudra Prasad; Brar, Preetinder; Chaudhary, Sanchit; Bedi, Rajeev; Swami, Adarsh Chander; Wig, Jai Dev

    2012-01-01

    Central venous access devices for chemotherapy are being used extensively in patients with cancer. Spontaneous fracture and migration of the catheter is uncommon. We present the uncommon occurrence of a fracture and spontaneous migration of the fragment into the internal jugular vein as a delayed complication of a central venous access catheter implanted for chemotherapy administration. A patient with Ewing's sarcoma of the humerus with metastasis in the lungs underwent placement of a totally implantable venous access device. The port was in place for 1 year. The patient presented with pain in the right side of the neck. A chest X-ray demonstrated complete transection of the catheter and migration of the catheter fragment in the internal jugular vein. Both the migrated catheter fragment and the proximal part of the catheter were retrieved surgically. He had an uneventful recovery. Catheter fracture remains a potential complication, which must be recognized and treated promptly. Periodic chest imaging is recommended for detection and timely removal of the catheter.

  14. Spontaneous Internal Jugular Vein Thrombosis: A Case Report

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    Mustafa Serinken

    2010-12-01

    Full Text Available Internal jugular vein thrombosis (IJVT is an elusive vascular disease that is rarely seen, with potentially lethal complications such as sepsis and pulmonary embolism. Spontaneous IJVT is considered when no apparent predisposing cause of thrombosis is present. A previously healthy, 31-year-old woman presented to the university-based emergency department because of painless swelling in the right anterior side of her neck. Physical examination revealed a painless, soft and immobile mass in the right anterior side of her neck beneath the sternocleidomastoid muscle, without hyperemia or local heat. On ultrasonographic examination, a hyperechogenic mass was visualized around the thoracic entrance of the right internal jugular vein, which was suggestive of a thrombus. The patient was administered intravenous antibiotic and low-molecular-weight heparin followed by oral coumadin as anticoagulant therapy. Her complaints were relieved within 5 days. She was completely well after 6 months. Venous thrombosis generally results from impaired blood flow locally or systemically that leads to activation of coagulation. Primary care physicians should sustain a high index of suspicion in patients who present with undiagnosed swelling in the neck, or other signs and symptoms attributed to IJVT.

  15. Undivided Retromandibular Vein Continuing As External Jugular Vein With Facial Vein Draining Into It : An Anatomical Variation

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    Shahnaz Choudhary, Ashwani K Sharma, Harbans Singh

    2010-10-01

    Full Text Available Despite the fact that the blueprint of the whole body is unravelled, faultlessly during the growth anddevelopment of an animal; but amazingly variations do occur. During routine dissection of head and neckin a middle aged cadaver in the Post Graduate Department of Anatomy of this medical college, we foundvariation in the formation of external jugular vein on both sides, which was formed by the continuation ofundivided trunk of retromandibular vein. The facial vein and posterior auricular vein were the tributaries ofexternal jugular vein. The sound anatomical knowledge of variations of the veins of head and neck isessential to the success of surgical procedures. The embryological evaluation of the above anomaly wasdone and compared with the available literature which showed that the observed variation was rare

  16. Non-cuffed dual lumen catheters in the external jugular veins versus other central veins for hemodialysis patients.

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    Moini, Majid; Rasouli, Mohammad R; Kenari, Mohammad Mahmoodzadeh; Mahmoodi, Hamid Reza

    2009-01-01

    To compare prospective between insertion of non-cuffed dual lumen catheter in the external jugular vein and other central veins for hemodialysis (HD), we studied 68 chronic dialysis patients randomly allocated into two groups: one with external jugular vein catheterization as access for HD and another with other central venous catheterization, internal jugular or subclavian vein. Our results showed there were no significant differences regarding successful cannulation, com-plications, total numbers of dialysis, development of pain and infection at the site of cannulation, patency rate of the catheters, and efficacy of hemodialysis between both groups. In addition, the patency of the catheter in the external jugular vein was not affected by previous cannulation of other central veins. In contrast, there was a significant correlation between numbers of attempts for cannulation in both groups and development of hematoma and infection, (pvein may be an alternative for other central veins for insertion of temporary non-cuffed hemodialysis catheter.

  17. Incidental Detection of Internal Jugular Vein Thrombosis Secondary to Undiagnosed Benign Substernal Goiter

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    Mai Tone Lønnebakken

    2010-01-01

    This case illustrates that benign substernal goiter may be associated with asymptomatic internal jugular vein thrombosis. Carotid Doppler ultrasound should involve evaluation of the internal jugular vein concerning thrombosis as its presence may reveal space-occupying lesions in the thorax.

  18. Internal Jugular Vein Thrombosis in Isolated Tuberculous Cervical Lymphadenopathy

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    Sanjay Khaladkar

    2016-01-01

    Full Text Available Tuberculosis is a common infectious disease with a high prevalence in developing countries and presents a major public health issue. Internal jugular vein (IJV thrombosis is a rare complication in tuberculous cervical lymphadenopathy. We report a case of 26-year male patient with a history of low-grade evening rise in fever, dry cough, loss of appetite, and loss of weight with swelling in lower neck on right side. Ultrasonography (USG neck showed well-defined hypoechoic lymph nodes posterior to right IJV and common carotid artery in the lower neck at level IV and in the right supraclavicular region showing central necrotic areas with adjoining IJV thrombosis. The association between tuberculosis and deep vein thrombosis is rare. Awareness of IJV thrombosis in isolated cervical lymphadenopathy needs high diagnostic suspicion and prompt treatment to avoid fatal complication. Our case is rare as there was isolated tuberculous cervical lymphadenopathy with adjoining IJV thrombosis. Both USG and computed tomography (CT are accurate and reliable radiological investigations for detecting IJV thrombosis along with cervical lymph nodes. They are useful in assessing surrounding soft tissue and fat planes and knowing the size and extent of cervical lymphadenopathy. USG is inexpensive and readily available for monitoring response to treatment.

  19. Non-cuffed dual lumen catheters in the external jugular veins versus other central veins for hemodialysis patients

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    Moini Majid

    2009-01-01

    Full Text Available To compare prospective between insertion of non-cuffed dual lumen catheter in the external jugular vein and other central veins for hemodialysis (HD, we studied 68 chronic dialysis patients randomly allocated into two groups: one with external jugular vein catheterization as access for HD and another with other central venous catheterization, internal jugular or subclavian vein. Our results showed there were no significant differences regarding successful cannulation, com-plications, total numbers of dialysis, development of pain and infection at the site of cannulation, patency rate of the catheters, and efficacy of hemodialysis between both groups. In addition, the patency of the catheter in the external jugular vein was not affected by previous cannulation of other central veins. In contrast, there was a significant correlation between numbers of attempts for cannulation in both groups and development of hematoma and infection, (p< 0.05. In conclusion, our results showed that the external jugular vein may be an alternative for other central veins for insertion of temporary non-cuffed hemodialysis catheter.

  20. Internal jugular vein cannulation: A comparison of three techniques

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    Bikash R Ray

    2013-01-01

    Full Text Available Context: Ultrasound-guided internal jugular vein (IJV cannulation is known for increasing success rate and decreasing rate of complications. The ultrasound image can be used as a real time image during cannulation or to prelocate the IJV before attempting cannulation. Aims: This study compares both the ultrasound-guided technique with the classical anatomical landmark technique (central approach for right IJV cannulation in terms of success rate, complications, and time for cannulation. Settings and Design: A prospective, randomized, observational study was conducted at a tertiary care hospital. Material and Methods: One hundred twenty patients requiring IJV cannulation were included in this study and were randomly allocated in three groups. Number of attempts, success rate, venous access time, catheterization time, and complications were observed in each group. Statistical Analysis Used: Statistical analysis was performed using STATA-9 software. Demographic data were compared using one-way analysis of variance (ANOVA. Nonparametric data were compared using the Kruskall-Wallis test, and multiple comparisons were done applying The Mann-Whitney test for individual pairs of groups. Nominal data were compared by applying the Chi-square test and Fisher exact test. Results: Successful cannulation (≤3 attempt was achieved in 90.83% of patients without any statistical significant difference between the groups. Venous access time and catheterization time was found to be significantly less in both the ultrasound groups than the anatomical land mark group. Number of attempts and success in first attempt was similar between the groups. Conclusions: Both the ultrasound techniques are found to be better than the anatomical landmark technique. Further, ultrasound-guided prelocation was found to be as effective as ultrasound guided real-time imaging technique for right IJV cannulation.

  1. A safe and efficacious alternative: sonographically guided internal jugular vein puncture for intracranial endovascular intervention.

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    Yeh, C-H; Wu, Y-M; Toh, C-H; Chen, Y-L; Wong, H-F

    2012-01-01

    Transvenous interventions for intracranial vascular lesions are usually performed via venous access of a femoral vein puncture. However, the transjugular route is an alternative with a shorter and less tortuous vascular access for intracranial lesions. Although puncture of the internal jugular vein is generally believed to be too dangerous owing to potential hazardous complications, the safety of the sonographically guided retrograde internal jugular vein puncture technique for intracranial intervention has not been fully evaluated in the English literature. We present our experience with a total of 44 transjugular intervention procedures between April 1999 and June 2010. We believe sonographically guided internal jugular vein puncture is a safe and efficacious technique for establishing transvenous access for an intracranial endovascular intervention.

  2. Pediatric jugular vein aneurysm (phlebectasia): report of two cases and review of the literature.

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    Baker, Joe B; Ingraham, Christopher R; Fine, Gabriel C; Iyer, Ramesh S; Monroe, Eric J

    2017-06-01

    Jugular vein aneurysms are rare vascular abnormalities that are most commonly encountered in the pediatric population. We report two separate cases in infants, both of whom presented with enlarging neck masses and were found to have jugular vein aneurysms. Diagnosis was established with duplex ultrasonography, computed tomography angiography, digitally subtracted catheter venography, and magnetic resonance imaging in one case and magnetic resonance imaging with magnetic resonance angiography/magnetic resonance venography, gray scale ultrasonography, and digital subtraction catheter venography in the other case. Both aneurysms were treated by surgical resection.

  3. Sumatriptan does not affect arteriovenous oxygen differences in jugular and cubital veins in normal human subjects

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    Wienecke, T.; Hansen, J.M.; Petersen, J.;

    2008-01-01

    Arteriovenous anastomoses (AVAs) may open up during migraine attacks. In studies with anaesthetized and bilaterally vagosympatectomized pigs, triptans reduce AVA blood flow and increase the arteriovenous O-2 difference (AVDO(2)). To investigate whether subcutaneous sumatriptan 6 mg could induce...... changes in the AVDO(2), we measured the AVDO(2) in the external jugular vein in healthy subjects. We also measured the AVDO(2) in the internal jugular and cubital veins. There were no changes in AVDO(2) after subcutaneous sumatriptan, probably because AVA blood flow is limited in humans with an intact...

  4. Transcatheter closure of a residual aortopulmonary window through internal jugular vein access.

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    Prem Sekar, R; Bhima Shankar, P R; Cherian, Kotturathu Mamman

    2012-01-01

    The use of Amplatzer septal occluder for closing a residual aortopulmonary defect has been described. This is usually performed by femoral access. We report closure of a residual aortopulmonary defect using right internal jugular vein access in a patient who had no femoral access as a result of previous cannulation for surgical repair. The 1 cm defect was closed successfully using a 10 mm Amplatzer septal occluder. Technical difficulty anticipated was unfounded although it was more cumbersome than femoral access. Left to right cardiac defects including PDA and AP window are amenable to transcatheter closure through internal jugular vein access.

  5. The placement of an implantable chemoport via the external jugular vein as a primary route

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    Ahn, Moon Sang; Shin, Byung Seok [Chungnam National University Hospital, Daejeon (Korea, Republic of); Park, Mi Hyun [Taejon Veterans Hospital, Daejeon (Korea, Republic of)

    2008-03-15

    To evaluate the usefulness and safety of the placement of an implantable chemoport via external jugular vein as a primary route for chemotherapy. Between January 2006 and June 2007, a total of 108 implantable chemoports were placed on 325 patients for chemotherapy via the external jugular vein as a primary route. We placed a 9.6 F single lumen chemoport using a surgical procedure (n = 89) and an interventional procedure (n = 19), and evaluated the duration of catheterization days and treatment complications. An implantable chemoport was successfully installed in all cases. Furthermore, the duration of catheterization ranged from 2 to 461 days (mean: 187 days, total catheter days: 21,994). In addition, a total of 85 chemoports were removed due to complications (n = 7) and termination of chemotherapy (n 78). A transient pulmonary air embolism occurring during a procedure was observed in one case. No pneumothorax or catheter malpositions were observed in the study subjects. Two chemoports were removed two days after implantation due to persistent tachycardia. In addition, five late complications occurred, which resulted in catheter occlusion (3 cases) (3%, 0.14/1000 catheter day) and infection in (2 cases) (2%, 0.09/1000 Catheter days). Lastly, no symptoms were attributed to a central vein thrombosis. The results of this study suggest that the implantation of chemoports via the external jugular vein is a safe procedure. Moreover, the selection of the external jugular vein as a primary route is useful in determining chemoport insertion locations.

  6. Comparison of results of placement of cuffed -tunneled hemodialysis catheter in internal jugular vein with subclavian vein for long -term dialysis.

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    Zafarghandi, Mohammad-Reza; Nazari, Iraj; Taghavi, Morteza; Salimi, Javad; Moini, Majid; Askarpour, Shahnam

    2013-03-01

    was to comparison between internal jugular vs. subclavian vein cuffed tunnel catheter placement for dialysis. Cases who required central venous catheter for dialysis were included in this study. Forty cases were included in this study and divided to two groups. Catheters were placed randomly in internal jugular vein or subclavian. Patients were followed for 6 months. Early and late complications of catheter's placement were recorded. Analysis was done using Spss ver 13.0 (Chicago, IL, USA). There were no significant differences between subclavian and internal jugular vein regarding occurrence of infection resulted in extraction or treatment. Also there were no significant differences regarding occurrence of thrombosis resulted in extraction or treatment. Failure rate was significantly higher in cases with internal jugular vein catheter compared to cases with subclavian vein catheter (p=0.04). Failure rate was significantly higher in cases with internal jugular vein catheter compared to subclavian cathether. Subclavian catheter is more appropriate route for catheter placement.

  7. Ressecção de aneurisma venoso em veia jugular externa direita Resection of right external jugular vein aneurysm

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    Eduardo Pereira Savi

    2010-12-01

    Full Text Available O aneurisma venoso é uma anomalia rara, cujo diagnóstico pode ser realizado a partir de exames físicos e complementares. Sua raridade justifica a necessidade de investigação e de publicações de estudos de caso, objetivo maior deste estudo. Relata-se aqui o caso de uma paciente que apresentava um abaulamento cervical anterior assintomático, progressivo e com seis meses de evolução. A paciente foi submetida à cervicotomia anterior, sob anestesia geral, com ressecção do segmento venoso acometido e ligadura da veia jugular externa. Realizado o estudo, verificou-se que aneurismas venosos podem causar tromboflebite, embolia pulmonar ou rotura. Cirurgia profilática, quando oferece baixo risco, é cuidadosamente recomendada para pacientes com aneurismas abdominais e altamente recomendada para aneurismas do sistema venoso profundo dos membros inferiores. Outros aneurismas venosos devem ser tratados cirurgicamente quando sintomáticos, desfigurantes ou se apresentarem aumento progressivo.Venous aneurysms are a rare abnormality, usually found in physical or complementary exams. We report a case of a 43-year old female with an asymptomatic and progressive enlarging mass in the neck. She had no history of trauma or cervical puncture. Vascular ultrasound showed a right jugular veins aneurysm with 1,81 x 1,62 cm of diameter. She was undergone resection and ligation of right external jugular vein, under general anesthesia. Venous aneurysm can cause thrombophlebitis, pulmonary embolism or spontaneous rupture. Prophylactic surgery is cautiously recommended for low-risk patients with venous aneurysms of the abdomen and strongly recommended for most patients with lower extremity deep venous aneurysms. Other venous aneurysms should be excised only if they are symptomatic, enlarging, or disfiguring

  8. Hand Gangrene Following Unsuccessful Cannulation of the Internal Jugular Vein: a Case Report and Literature Review

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    Roettges, Paul S.; Murray, Peter M.; Hill, David

    2009-01-01

    Hand gangrene following vascular cannula placement is uncommon and is usually the result of thrombotic occlusion of an artery. We describe a case of hand gangrene resulting in wrist disarticulation, following multiple unsuccessful attempts at internal jugular vein cannulation in a critically ill patient.

  9. Internal jugular vein cannulation: an ultrasound-guided technique versus a landmark-guided technique

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    Gurkan Turker

    2009-01-01

    Full Text Available OBJECTIVES: To compare the landmark-guided technique versus the ultrasound-guided technique for internal jugular vein cannulation in spontaneously breathing patients. METHODS: A total of 380 patients who required internal jugular vein cannulation were randomly assigned to receive internal jugular vein cannulation using either the landmark- or ultrasound-guided technique in Bursa, Uludag University Faculty of Medicine, between April and November, 2008. Failed catheter placement, risk of complications from placement, risk of failure on first attempt at placement, number of attempts until successful catheterization, time to successful catheterization and the demographics of each patient were recorded. RESULTS: The overall complication rate was higher in the landmark group than in the ultrasound-guided group (p < 0.01. Carotid puncture rate and hematoma were more frequent in the landmark group than in the ultrasound-guided group (p < 0.05. The number of attempts for successful placement was significantly higher in the landmark group than in the ultrasound-guided group, which was accompanied by a significantly increased access time observed in the landmark group (p < 0.05 and p < 0.01, respectively. Although there were a higher number of attempts, longer access time, and a more frequent complication rate in the landmark group, the success rate was found to be comparable between the two groups. CONCLUSION: The findings of this study indicate that internal jugular vein catheterization guided by real-time ultrasound results in a lower access time and a lower rate of immediate complications.

  10. Internal Jugular Vein Cannulation: An Ultrasound-Guided Technique Versus a Landmark-Guided Technique

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    Turker, Gurkan; Kaya, Fatma Nur; Gurbet, Alp; Aksu, Hale; Erdogan, Cuneyt; Atlas, Ahmet

    2009-01-01

    OBJECTIVES To compare the landmark-guided technique versus the ultrasound-guided technique for internal jugular vein cannulation in spontaneously breathing patients. METHODS A total of 380 patients who required internal jugular vein cannulation were randomly assigned to receive internal jugular vein cannulation using either the landmark- or ultrasound-guided technique in Bursa, Uludag University Faculty of Medicine, between April and November, 2008. Failed catheter placement, risk of complications from placement, risk of failure on first attempt at placement, number of attempts until successful catheterization, time to successful catheterization and the demographics of each patient were recorded. RESULTS The overall complication rate was higher in the landmark group than in the ultrasound-guided group (p < 0.01). Carotid puncture rate and hematoma were more frequent in the landmark group than in the ultrasound-guided group (p < 0.05). The number of attempts for successful placement was significantly higher in the landmark group than in the ultrasound-guided group, which was accompanied by a significantly increased access time observed in the landmark group (p < 0.05 and p < 0.01, respectively). Although there were a higher number of attempts, longer access time, and a more frequent complication rate in the landmark group, the success rate was found to be comparable between the two groups. CONCLUSION The findings of this study indicate that internal jugular vein catheterization guided by real-time ultrasound results in a lower access time and a lower rate of immediate complications. PMID:19841706

  11. Appropriate posture of cancer patients treated with PICC to prevent internal jugular vein ectopic

    Institute of Scientific and Technical Information of China (English)

    Zhaoyan Liu

    2014-01-01

    Objective: We aimed to study the appropriate posture of peripheraly inserted central catheter (PICC) patients, to reduce the incidence of internal jugular vein heterotopia.Methods:From 2009 to 2013, a total of 290 cases with PICC were enroled in our study. They were divided into two groups. The patients in control group took regular position, which mean pros-tration, upper limb of tube side was abduction 90°, head moved to puncture side in order to block the internal jugular vein. On the basis of conventional body position putting, posture of patients in observation group was improved, the head remain neu-tral, and had 180° angle with trunk longitudinal axis, not favor any side. After ensuring the upper limb abduction, had 90° angle with the trunk, then catheter was inserted slowly. The jugular venous catheter heterotopia rate was judged by X-ray results. Results: The jugular venous catheter heterotopia rate of control group and observation was 12.8% and 0.68%, respectively. The diference between two groups was statisticaly significant (P < 0.01).Conclusion: The body posture improvement can prevent discomfort of patients and reduce the jugular venous catheter heterotopia rate of PICC.

  12. Endovascular Treatment of an Iatrogenic Right Internal Jugular Vein- Right Subclavian Artery Fistula and Pseudoaneurysm During the Attempt of a Hemodialysis Catheter Insertion: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Eui Min; Kim, Hyun Lee; Kim, Dong Hyun [Chosun University, Gwangju (Korea, Republic of)

    2009-02-15

    Complications during the placement of a central venous catheter, via the right internal jugular vein puncture include local hematoma, hemothorax, pneumothorax, central vein thrombosis, and hemopericardium. Iatrogenic right internal jugular vein-right subclavian artery fistula with the formation of right subclavian artery pseudoaneurysms is an extremely rare complication in patients undergoing a central vein puncture. We report the case of a patient who developed a local hematoma at the vein puncture site and dyspnea due to a right internal jugular vein-subclavian artery fistula and a right subclavian artery pseudoaneurysm at the mediastinum after puncture of right internal jugular vein. The patient was successfully treated by embolization using microcoils.

  13. 'Aorta-in-aorta' sign on chest radiograph representing enlarged left superior intercostal and hemiazygos veins

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    Sung, Yon Mi; Lee, Kyung Soo; Kim, Tae Sung [School of Medicine, Sungkyunkwan Univ., Seoul (Korea, Republic of)

    2002-06-01

    We recently encountered a patient with membranous obstruction of the inferior vena cava in whom the left superior intercostal and hemiazygos veins were dilated. At chest radiography, the dilation simulated the presence of a second aortic knob and descending thoracic aorta lateral to the originals, and an 'aorta-in-aorta' appearance was thus created.

  14. Central venous access through the external jugular vein in children submitted to bone marrow transplantation

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    José Luiz de Godoy

    2005-01-01

    Full Text Available Establishment of long-term central venous access is a sine qua non step for bone marrow transplantation in children. Most frequently, long-term central venous access has been obtained via blind percutaneous cannulation of subclavian and internal jugular veins or via internal jugular vein cutdown. In order to avoid some potential minor and major complications associated with the subclavian or internal jugular approaches, the authors describe an easy, simple and safe method for central venous access through an external jugular vein cutdown that should be of interest to readers involved in the field of bone marrow transplantation. It should be also considered for children as well as adults needing central venous access via an external catheter - or totally implantable port - for reasons other than bone marrow transplantation, such as total parenteral nutrition and administration of chemotherapeutic agents.O estabelecimento de um acesso venoso central de longa duração é uma condição sine qua non para realizar o transplante de medula óssea em crianças. Com frequência, este acesso tem sido obtido através da punção percutânea das veias subclávia e jugular interna ou via dissecção da jugular interna. Com o objetivo de evitar algumas complicações maiores e menores associadas com a subclávia e a jugular interna, os autores descrevem um método simples, fácil e seguro para o acesso venoso central através de dissecção da veia jugular externa. Este método deveria ser de interesse dos leitores envolvidos com o transplante de medula óssea e ser considerado também para crianças e/ou adultos que necessitem de cateter venoso central de longa permanência (externo ou totalmente implantável devido a outras razões, como a nutrição parenteral ou a administração de agentes quimioterápicos.

  15. Outcome of tunneled infusion catheters inserted via the right internal jugular vein

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    Shin, Sung Wook; Do, Young Soo; Choo, Sung Wook; Yoo, Wi Kang; Choo, In Wook [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Jae Hyung [Sanggye Paik Hospital, Inje University, Seoul (Korea, Republic of)

    2003-03-01

    To assess the outcome of tunneled central venous catheter placement via the right internal jugular vein. Between June 2001 and May 2002, 670 consecutive Hickman catheters were placed in 654 patients via the right internal jugular vein. The procedural complications arising and follow-up data obtained from May to July 2002 were evaluated. The technical success rate for catheter placement was 99.9% (669/670). Procedural complications were limited to eight cases (1.2%), including three pneumothoraces, one early migration of the catheter, one clinically unimportant air embolism, one catheter injury, one catheter kinking and one primary malpositioning in the azygos vein. Catheter dwelling time ranged from 1 to 407 (mean 107.1) days. During the follow-up period, 416 catheter were removed for various reasons: treatment had ended (n=334), patients declined treatment or their drug regimen was changed (n=16), late complications arose (n=53), or other circumstances intervened (n=13). Late complications included 44 cases of catheter-related infection (6.6%), five of catheter migration (0.7%), two of catheter occlusion (0.3%), one of thrombophlebitis (0.15%), and one of catheter-related right atrial thrombosis (0.15%). Only one instance of symptomatic venous thrombosis or stenosis was noted, namely the one case of thrombophlebitis. Because the incidence of subsequent symptomatic venous thrombosis or stenosis is lower, the preferred route for tunneled central venous catheter placement is the right internal jugular vein.

  16. Diffuse thyroid metastases and bilateral internal jugular vein tumor thrombus from renal cell cancer.

    Science.gov (United States)

    Jha, Priyanka; Shekhar, Mallika; Wan, Jennifer; Mari-Aparici, Carina

    2016-12-01

    Renal cell cancer rarely metastasizes to the thyroid gland, and it has been reported to present as a solitary mass. We present a case of diffuse thyroid cancer metastases from renal cell cancer. Bilateral internal jugular vein tumor thrombi were also present. To the best of our knowledge, this is the first description of diffuse thyroid metastases from renal cell cancer in the English literature. Renal cell cancer metastases should be considered in the differential of thyroid imaging abnormalities arising in the setting of known renal cell carcinoma, particularly late in the course of disease. This is frequently associated with internal jugular vein thrombi, which should be evaluated with an abnormal thyroid. Thyroglobulin levels are usually normal in such patients.

  17. Diffuse thyroid metastases and bilateral internal jugular vein tumor thrombus from renal cell cancer

    OpenAIRE

    Jha, Priyanka; Shekhar, Mallika; Wan, Jennifer; Mari-Aparici, Carina

    2016-01-01

    Renal cell cancer rarely metastasizes to the thyroid gland, and it has been reported to present as a solitary mass. We present a case of diffuse thyroid cancer metastases from renal cell cancer. Bilateral internal jugular vein tumor thrombi were also present. To the best of our knowledge, this is the first description of diffuse thyroid metastases from renal cell cancer in the English literature. Renal cell cancer metastases should be considered in the differential of thyroid imaging abnormal...

  18. Case Report: Management of unusual site for contrast media extravasation in right external jugular vein

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    Magdy Imam Abdel Aleem Taha Mohamed

    2015-12-01

    Full Text Available Contrast media extravasation is well known complication during power/pressure injection of contrast material. Despite reports of many cases of extravasation few consequences have been reported. We present a very rare case of contrast media extravasation in the neck after right external jugular vein cannulation which mandated early surgical intervention. On literature search, we did not find any similar report of such unique case.

  19. Variations in the anatomical relationship between the common carotid artery and the internal jugular vein

    Science.gov (United States)

    García, Alberto; Bustamante, Luis; Castillo, José Luis; Sebastián Martínez, Juan

    2015-01-01

    Introduction: The internal jugular vein locates anterior or anterolateral to the common carotid artery in two-thirds of the subjects studied by ultrasound when the head is in a rotated position. Aim: To identify variables associated with the anterior location of the internal jugular vein. Methods: Ultrasound examinations were performed with the patients in the supine position, with the head rotated to the opposite side. The proximal third of the neck was visualized transversely with a 7.5-mHz transducer. The relationship between the vessels was described in accordance with the proportion of the artery overlapped by the vein. Univariate comparisons and a multivariate analysis of potential variables that may affect the anatomic relationships were performed. Results: Seventy-eight patients were included, 44 of whom were men. The patients' ages ranged from 17 to 90 years (median 64.0, interquartile range 41-73). The right and left sides were studied 75 and 73 times, respectively. The vein was located lateral to the artery in 24.3% (95%CI= 17.4-32.2) of the studies, anterolateral in 33.8% (95%CI= 26.2-41.4) and anterior in 41.9% (95%CI= 33.9-49.8). The multivariate analysis identified age group (OR= 3.7, 95% CI 2.1-6.4) and, less significantly, the left side (OR= 1.7, 95%CI= 0.8-3.5) and male gender (OR= 1.2, 95%CI= 0.6-2.7) as variables associated with the anterior position of the vein. Conclusión: The anterior position of the internal jugular vein relative to the common carotid artery increases gradually with age. Additionally, left-sided localization and male sex further increased the probability of an anterior position. PMID:26309339

  20. Internal jugular vein thrombosis complicating cervicofacial infection of dental origin. Case report

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    Christos DENDRINOS

    2012-08-01

    Full Text Available Septic thrombosis of the internal jugular vein or Lemierre’s syndrome is a rare form of metastatic septic thromboembolitis, typically involving superinfection with Fusobacterium Necrophorum, internal jugular vein thrombosis and remote septic emboli.CASE REPORT: A 49-year-old male was referred for a painful cervicofacial swelling on the left, obliteration of the buccal sulcus, as well as swelling of both the soft and hard palate and the floor of the mouth ipsilaterally, accompanied by severe trismus and difficulty in swallowing. The patient underwent intraoral and extraoral incisions and drainage of the affected anatomical spaces and tracheotomy. The patient’s clinical condition was steadily improving; following examination with CT scan,9 days post-op, internal jugular vein thrombosis was diagnosed. The patient was put on anticoagulants. The postoperative course continued uneventfully, and the patient was discharged. One month post-operatively the vessel was normal and anticoagulant treatment was discontinued.CONCLUSION: Since Lemierre’s syndrome is not only rare but also tends to be underdiagnosed when there is no obvious cause of sepsis, it should be included in the differential diagnosis if the patient’s general contition deteriorates in spite of the treatment.

  1. Longer duration of catheter patency, but similar infection rates with internal jugular vein versus iliac vein tunneled cuffed hemodialysis catheters: a single-center retrospective analysis.

    Science.gov (United States)

    Wang, Lihua; Wei, Fang; Jiang, Aili; Chen, Haiyan; Sun, Guijiang; Bi, Xueqing

    2015-10-01

    Although tunneled cuffed catheters (TCCs) are widely used in hemodialysis, little is known about their complications in elderly patients with hemodialysis. Furthermore, there is no report about which vessel access, either jugular or iliac vein, is superior for elderly patients requiring TCCs. In the present study, we reviewed the clinical parameters of 127 patients aged over 65 years with 207 new TCC placements and measured the incidence of catheter patency, infection, dysfunction, and survival of TCCs. We found that the average primary catheter patency was substantially shorter in iliac vein TCCs than in internal jugular vein TCCs (373 vs. 641 catheter-days). Patients with iliac vein TCCs underwent more frequent exchanges than those with internal jugular vein TCCs. Infection-free survival was similar for both groups (p = 0.748), but dysfunction-free survival was significantly poorer in iliac vein TCC group than that in internal jugular vein TCC group (p = 0.001). Age and previous catheter placement were the independent risk factors for TCCs survival. Taken together, our results suggested that iliac vein TCCs present an increased risk of dysfunction compared to internal jugular vein TCCs in elderly hemodialysis patients.

  2. A Case Study of Deep Vein Thrombosis of the Right Internal Jugular Vein in a Healthy 21-Year-Old Male

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    Javier Corral

    2016-01-01

    Full Text Available We are reporting a case of a healthy 21-year-old male, with no significant past medical history, who was found to have an incidental nonocclusive deep vein thrombosis in the right internal jugular vein detected on a head MRI previously ordered for work-up of headaches. A follow-up upper extremity venous Doppler ultrasound confirmed the presence of a partially occlusive deep vein thrombosis in the right jugular vein. The case presented is unique for the reason that the patient is young and has no prior risk factor, personal or familial, for venous thrombosis except for associated polycythemia on clinical presentation.

  3. Thrombosis of the superior vena cava and auxiliary branches in patients with indwelling catheterization of the internal jugular vein

    Institute of Scientific and Technical Information of China (English)

    LI Han; WANG Shi-xiang; WANG Wei; XU Chen; SHEN Shen; YU Ling; ZHANG Gui-zhi

    2009-01-01

    Background Central venous thrombosis is a serious and life-threatening complication in hemodialysis (HD) patients with an indwelling catheter. The present study aimed to investigate the prevalence and characteristics of thrombosis of the superior vena cava and auxiliary branches in Chinese HD patients with an indwelling internal jugular venous catheter and to explore its risk factors.Methods Fifty-four patients on maintenance hemodialysis (MHD) with an indwelling catheter were enrolled in this cross-sectional study. The thrombosis of the internal jugular vein, subclavical vein, brachiocephalic vein and superior vena cava was assessed by vascular ultrasound. Collected were data on age, gender, ultrafiltration volume, Kt/V, blood pressure, levels of hemoglobin, serum albumin, lipid, calcium, and phosphorus, and parathyroid hormone.Results The patients were given short- or long-term double lumen central venous catheters. Among them, 42 patients had the catheter placed into the right internal jugular vein, and 12 patients into the left internal jugular vein. Different degrees of central venous thrombosis were found in 33 patients (61.1%). The prevalence of thrombosis in the jugular vein, brachiocephalic vein, subclavical vein and superior vena cava was 61.1% (33/54), 44.4% (24/54), 16.7% (9/54) and 5.6% (3/54), respectively. Among the 33 HD patients with central venous thrombosis, the percentages for one, two, three and four affected veins were 27.3% (9/33), 45.4% (15/33), 18.2% (6/33) and 9.1% (3/33), respectively. Twelve (12/33, 36.4%) of the 33 HD patients with central venous thrombosis had clinical symptoms. Nine patients (27.3%) had edema of the upper extremity and 3 (9.1%) had new-onset symptoms of pulmonary embolism such as cough, chest distress and short breath. The incidences of diabetes mellitus and malignant tumor and levels of lipoprotein a and homocysteic acid were significantly higher in the HD patients with central venous thrombosis than in those without

  4. Internal Jugular and Subclavian Vein Thrombosis in a Case of Ovarian Cancer

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    Hiroto Moriwaki

    2017-01-01

    Full Text Available Central venous catheter insertion and cancer represent some of the important predisposing factors for deep venous thrombosis (DVT. DVT usually develops in the lower extremities, and venous thrombosis of the upper extremities is uncommon. Early diagnosis and treatment of deep venous thrombosis are of importance, because it is a precursor of complications such as pulmonary embolism and postthrombotic syndrome. A 47-year-old woman visited our department with painful swelling on the left side of her neck. Initial examination revealed swelling of the region extending from the left neck to the shoulder without any redness of the overlying skin. Laboratory tests showed a white blood cell count of 5,800/mm3 and an elevated serum C-reactive protein of 4.51 mg/dL. Computed tomography (CT of the neck revealed a vascular filling defect in the left internal jugular vein to left subclavian vein region, with the venous lumina completely occluded with dense soft tissue. On the basis of the findings, we made the diagnosis of thrombosis of the left internal jugular and left subclavian veins. The patient was begun on treatment with oral rivaroxaban, but the left shoulder pain worsened. She was then admitted to the hospital and treated by balloon thrombectomy and thrombolytic therapy, which led to improvement of the left subclavian venous occlusion. Histopathologic examination of the removed thrombus revealed adenocarcinoma cells, indicating hematogenous dissemination of malignant cells.

  5. Internal Jugular and Subclavian Vein Thrombosis in a Case of Ovarian Cancer

    Science.gov (United States)

    Hayama, Nana; Morozumi, Shouko; Nakano, Mika; Nakayama, Akari; Takahata, Yoshiomi; Sakaguchi, Yuusuke; Inoue, Natsuki; Kubota, Toshiki; Takenoya, Akiko; Ishii, Yoshiko; Okubo, Haruka; Yamaguchi, Souta; Ono, Tsuyoshi; Oharaseki, Toshiaki; Yoshikawa, Mamoru

    2017-01-01

    Central venous catheter insertion and cancer represent some of the important predisposing factors for deep venous thrombosis (DVT). DVT usually develops in the lower extremities, and venous thrombosis of the upper extremities is uncommon. Early diagnosis and treatment of deep venous thrombosis are of importance, because it is a precursor of complications such as pulmonary embolism and postthrombotic syndrome. A 47-year-old woman visited our department with painful swelling on the left side of her neck. Initial examination revealed swelling of the region extending from the left neck to the shoulder without any redness of the overlying skin. Laboratory tests showed a white blood cell count of 5,800/mm3 and an elevated serum C-reactive protein of 4.51 mg/dL. Computed tomography (CT) of the neck revealed a vascular filling defect in the left internal jugular vein to left subclavian vein region, with the venous lumina completely occluded with dense soft tissue. On the basis of the findings, we made the diagnosis of thrombosis of the left internal jugular and left subclavian veins. The patient was begun on treatment with oral rivaroxaban, but the left shoulder pain worsened. She was then admitted to the hospital and treated by balloon thrombectomy and thrombolytic therapy, which led to improvement of the left subclavian venous occlusion. Histopathologic examination of the removed thrombus revealed adenocarcinoma cells, indicating hematogenous dissemination of malignant cells. PMID:28194291

  6. A novel method to estimate oxygen saturation of the internal jugular vein blood

    Science.gov (United States)

    Li, Kai; Pan, Boan; Gao, Yuan; Ruan, Zhengshang; Li, Ting

    2016-03-01

    This article introduces a novel method to estimate oxygen saturation of the internal jugular vein blood (SjvO2) by using Near Infrared spectroscopy (NIRS). The different positions of patients can affect the cross-sectional area (CSA) of the internal jugular vein (IJV), in other words, it causes the sectional change of the IJV blood volume. When lying position of patients, the CSA is larger than that keeping upper body 80 degree, and the CSA can compute quantitatively by the use of ultrasound and digital image processing methods. The entire method consist of constructing different position of patient (upper body rotation 0 and 80 degree), comparing the light absorption changes. SjvO2 has been determined from light absorption measurements in two wavelength, before and after the position changes. The method has been applied to the vertical area over the IJV of 11 patients who were placed a central venous catheter into a large vein in the neck for medical uses, using wavelength of 735 and 850 nm. At last, comparing the SjvO2NIRS which measured by NIRS noninvasively with SjvO2IJVBG which was quantified using a whole blood gas analyzer, we found there were some certain relativity. The results were influenced by vascular depth greatly.

  7. Anatomy of the junction of the inferior petrosal sinus and the internal jugular vein. Evaluation with MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Satoshi; Tomura, Noriaki; Kato, Koki; Hirano, Yosinori; Izumi, Jun-ichi; Watarai, Jiro [Akita Univ. (Japan). School of Medicine

    2000-07-01

    To evaluate the anatomy of the junction of the inferior petrosal sinus (IPS) and the internal jugular vein (IJV), magnetic resonance (MR) images of the jugular bulbs in 50 patients (age range, 15 to 83 years; mean age, 59.6 years) were retrospectively reviewed. Both MR imaging and intra-arterial digital subtraction angiography (IADSA) were performed in the 50 patients, and IPS venography was performed in 7 patients. Multiplanar reconstruction of the MR images was obtained using three-dimensional fast spoiled gradient-recalled acquisition in the steady state (3-D fast SPGR) with gadopentate dimegulmin (Gd-DTPA). IPS and other venous structures were identified around the jugular bulbs both on the MR images and by IPS venography. The diameters of the junctions of the IPS and IJV were measured on the MR images. IN 97 side (97%) of the 50 patients, a petrosal confluence was found on the medial side of the jugular bulb, connecting with the anterior condylar vein, inferior petroclival vein, basilar plexus and the IPS. Extracranial extension of the IPS was seen on 3 sides of 3 patients (right: 1, left: 2) (3%). All 3 patients showed the IPS connecting with the internal jugular vein below the anterior condylar vein. The minimum diameter of IPS-IJV junction was 1 mm or greater in all cases. In conclusion, the junction of the IPS and the IJV is easily identified by contrast-enhanced 3-D fast SPGR sequences, which is helpful for IPS catheterization in endovascular treatment. (author)

  8. Paraneoplastic Internal Jugular Vein Thrombosis Leading to Diagnosis of Bilateral Ovarian Ependymoma

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    Irappa Madabhavi

    2014-01-01

    Full Text Available Ovarian ependymomas are extremely rare tumors of the ovary. We present a case of a 67-year-old lady presented to us with swelling in the right side of neck for 2 months followed by pelvic pain, lower abdominal distention, and weight loss for 1 month. Her coagulation profile, blood chemistry, lipid profile, and tumor markers were within normal limits. Neck Doppler ultrasonography revealed thrombus in the right internal jugular vein and CT scan of the abdomen showed bilateral ovarian masses. Patient was subjected to debulking surgery for suspected ovarian cancer and microscopy revealed a highly cellular tumor composed of small cells with hyperchromatic, round-to-oval nuclei with scanty cytoplasm, and perivascular pseudorosettes. Diagnosis was confirmed by immunophenotype showing strong positivity to glial fibrillary acidic protein, estrogen receptors, and progesterone receptors. Patient was successfully managed with anticoagulants, adjuvant chemotherapy with BEP regimen, and letrozole. After ruling out other common conditions for thrombosis in this age group, this seems to be a paraneoplastic presentation of ovarian malignancy that preceded the diagnosis of ependymoma by 2 months. To the best of our knowledge this is the first case report in the world literature as “paraneoplastic internal jugular vein thrombosis leading to diagnosis of bilateral ovarian ependymoma.”

  9. Internal jugular vein: Peripheral vein adrenocorticotropic hormone ratio in patients with adrenocorticotropic hormone-dependent Cushing′s syndrome: Ratio calculated from one adrenocorticotropic hormone sample each from right and left internal jugular vein during corticotrophin releasing hormone stimulation test

    Directory of Open Access Journals (Sweden)

    Sachin Chittawar

    2013-01-01

    Full Text Available Background: Demonstration of central: Peripheral adrenocorticotropic hormone (ACTH gradient is important for diagnosis of Cushing′s disease. Aim: The aim was to assess the utility of internal jugular vein (IJV: Peripheral vein ACTH ratio for diagnosis of Cushing′s disease. Materials and Methods: Patients with ACTH-dependent Cushing′s syndrome (CS patients were the subjects for this study. One blood sample each was collected from right and left IJV following intravenous hCRH at 3 and 5 min, respectively. A simultaneous peripheral vein sample was also collected with each IJV sample for calculation of IJV: Peripheral vein ACTH ratio. IJV sample collection was done under ultrasound guidance. ACTH was assayed using electrochemiluminescence immunoassay (ECLIA. Results: Thirty-two patients participated in this study. The IJV: Peripheral vein ACTH ratio ranged from 1.07 to 6.99 ( n = 32. It was more than 1.6 in 23 patients. Cushing′s disease could be confirmed in 20 of the 23 cases with IJV: Peripheral vein ratio more than 1.6. Four patients with Cushing′s disease and 2 patients with ectopic ACTH syndrome had IJV: Peripheral vein ACTH ratio less than 1.6. Six cases with unknown ACTH source were excluded for calculation of sensitivity and specificity of the test. Conclusion: IJV: Peripheral vein ACTH ratio calculated from a single sample from each IJV obtained after hCRH had 83% sensitivity and 100% specificity for diagnosis of CD.

  10. Renal cell carcinoma and synchronous thyroid metastasis with neoplastic thrombosis of the internal jugular vein: report of a case.

    Science.gov (United States)

    Matei, Deliu-Victor; Brescia, Antonio; Nordio, Andrea; Spinelli, Matteo Giulio; Melegari, Sara; Cozzi, Gabriele; Andrioli, Massimiliano; Salvatori, Pietro

    2011-12-01

    A case of thyroid metastasis of a renal clear cell carcinoma is presented. The fine-needle aspiration cytology pointed out the primary tumor origin. The patient underwent robot-assisted radical nephrectomy and contextual thyroidectomy. During the operative procedure, a neoplastic thrombus extending from the thyroid metastasis and protruding into the internal jugular vein was found. As a result, thrombectomy and ligation of the internal jugular vein were required. In cases of single synchronous thyroid metastases form RCC, radical surgery should be advisable. Robotic approach allows to associate major surgery procedures, as nephrectomy, with radical metastasectomy.

  11. Anti-jugular vein thrombotic effect of Morinda citrifolia L. [noni] in male SD rats

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    Mian-Ying Wang

    2011-09-01

    Full Text Available Background: Venous thromboembolism (VTE is a common and serious medical condition, which is estimably responsible for more than 300,000 hospital admissions annually in the USA. Pulmonary embolism (PE is a major complication of VTE, which contributes to 12% death of hospitalized patients. Heparin is the most common anti-coagulant, but severe allergic reactions, bleeding, and thrombocytopenia limit its use. Thus, seeking a botanical, nontoxic antithrombotic alternative is an interesting area. Morinda citrifolia L. [noni] is a medicinal plant used in folk remedies by Polynesians for over 2,000 years. It has been reported to have a broad range of therapeutic and preventive effects. The bioactivities of NJ have been continuously discovered with antioxidative, anti-inflammatory, analgesic, and immune modifying activities. Our novel hypothesis is whether NJ has an anti-venous thrombotic effect in rodents. To examine our hypothesis, this study was designed to examine the anti-thrombotic effect of NJ on the jugular vein thrombosis model induced by ferric chloride in SD rats.Material and Methods: NJ and placebo used in this study were donated by Morinda Holding Inc. NJ was formulated with grape juice and blue berry juice. Placebo was prepared by using the same procedure of NJ preparation, but without NJ in it. Thirty-six male SD rats were divided into six groups. Anti-venous thrombotic activities of 5% NJ, 10% NJ, heparin, and 10% NJ plus heparin were examined and compared with the positive and blank controls. Thrombosis was induced by application of a filter paper soaked in 50% ferric chloride on the right jugular vein. AFunctional Foods in Health and Disease 2011; 9:297-3092-cm fragment of the occluded vein (thrombus was removed and weighed after 1-hour maturation. Blood samples were collected for platelet count, aPTT, and PT tests.Results: The weight of a 2-cm fragment of normal jugular vein was 9.9 ± 2.1 mg, while the weight of the occluded vein in

  12. 右颈内静脉加压对颈内静脉穿刺置管术的影响%Effect of Right Internal Jugular Vein Pressure on Internal Jugular Vein Catheterization

    Institute of Scientific and Technical Information of China (English)

    高恺; 张月秋; 高言国

    2016-01-01

    目的:探讨右颈内静脉加压对颈内静脉穿刺置管术的影响。方法:选取需进行右颈内静脉穿刺置管的低血容量性或脓毒性休克患者79例作为研究对象,随机分为对照组(C组)40例和颈内静脉加压组(P组)39例。所有患者均去枕平卧、Trendelenburg体位和头左侧偏转15°~30°,C组进行常规右颈内静脉穿刺置管,P组在C组基础上于患者右侧锁骨上窝靠近胸锁关节外侧凹陷处以食指中指二指并拢向内下方用力按压颈内静脉,以颈内静脉压瘪为宜。记录两组患者三次穿刺置管成功率、回血通畅率、穿刺失败率及血肿发生率。结果:P组穿刺置管成功率、回血通畅率、穿刺失败率及血肿发生率均优于C组,比较差异均有统计学意义(P<0.05)。结论:颈内静脉压迫明显有助于颈内静脉穿刺置管术的成功,减少了并发症。%Objective:To discuss the effect of right internal jugular vein pressure on internal jugular vein catheterization.Method:From May 2013 to March 2016,79 cases of low blood volume or septic shock with right internal jugular vein catheterization were selected as the research objects,they were divided into 40 cases of the control group(group C) and 39 cases of the internal jugular venous pressure group(group P).All patients had to lie,Trendelenburg position and the left side of the head deflection 15°-30°,group C were treated with conventional right internal jugular vein catheterization,group P was treated with an index finger and a middle finger were put together to push jugular veins hard inward and downward on the ipsilateral supraclavicular fossa near lateral recess of joints of the sternoclavicular joint until the veins were squashed based on group C,internal jugular vein press to make flat was appropriate.Three times puncture catheter success rate,the rate of return to blood,puncture failure rate and incidence of hematoma of two groups were

  13. Renal vein stenting via the right internal jugular approach with a provocative Valsalva maneuver to reduce the risk of stent migration.

    Science.gov (United States)

    Syed, Mubin I; Yu, Benjamin; Akhter, Talal; Shaikh, Azim

    2011-12-01

    An adult male with nutcracker syndrome was treated successfully by placement of a self-expanding stent in the left renal vein via a right internal jugular vein approach with a provocative Valsalva maneuver. Previous case reports have described renal vein stenting for this condition via common femoral vein approach. However, this study proposes the right internal jugular vein approach as a safer method for the treatment of nutcracker syndrome since the stent can be easily captured along the guidewire if undersized. This technique is based on the realization that the left renal vein diameter may increase by 50% to 58% during the Valsalva maneuver.

  14. Mediastinal B-Cell Lymphoma Presenting with Jugular-Subclavian Deep Vein Thrombosis as the First Presentation

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    Sherif Ali Eltawansy

    2015-01-01

    Full Text Available Jugular venous thrombosis infrequently could be secondary to malignancy and has seldom been reported secondary to mediastinal large B-cell lymphomas. The postulated mechanisms are mechanical compression that leads to stagnation of blood in the venous system of the neck and/or an increase in the circulating thrombogenic elements that could cause venous thromboembolism as a paraneoplastic phenomenon. We report the case of a middle aged male presenting with right sided neck pain and arm swelling secondary to ipsilateral jugular-subclavian deep vein thrombosis. Investigations revealed it to be secondary to a mediastinal mass shown on CT scan of the chest.

  15. Internal jugular versus subclavian vein catheterization for central venous catheterization in orthotopic liver transplantation.

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    Torgay, A; Pirat, A; Candan, S; Zeyneloglu, P; Arslan, G; Haberal, M

    2005-09-01

    The aim of this study was to compare incidence rates of mechanical and infectious complications associated with central venous catheterization via the internal jugular vein (IJV) versus the subclavian vein (SV) among 45 consecutive patients undergoing orthotopic liver transplantation (OLT) between January 2000 and June 2004. The subjects were divided into two groups according to the site of central venous catheterization (IJV or SV). We recorded each patient's physical characteristics, international normalized ratio (INR), partial thromboplastin time, platelet levels, number of puncture attempts, success/failure of central venous catheterization, duration of catheter placement, occurrence of catheter tip misplacement, arterial puncture, incidence of hematoma or pneumothorax, catheter-related infection, or bacterial colonization of the catheter. Senior staff anesthesiologists performed 22 SV and 23 IJV catheterizations for the 45 OLT procedures. The SV and IVJ groups both had minor coagulation abnormalities with slightly increased INR values at the time of catheterization. There were no significant differences between the groups with respect to success of central venous catheterization (100% for both), numbers of attempted punctures, duration of catheter placement, and incidence rates of mechanical and infectious complications. Both groups showed high frequencies of catheter tip misplacement, with right atrium as the site of misplacement in all cases. Two patients in the IJV group (8.7%) developed hematomas after accidental carotid artery puncture. The results suggest that, when performed by experienced anesthesiologists, central venous catheterization via the SV is an acceptable alternative to IJV catheterization for patients undergoing OLT.

  16. Transcutaneous pressure at which the internal jugular vein is collapsed on ultrasonic imaging predicts easiness of the venous puncture.

    Science.gov (United States)

    Joo, Woo Jin; Fukui, Michihiko; Kooguchi, Kunihiko; Sakaguchi, Masahiro; Shinzato, Taiichi

    2011-04-01

    Even though we use ultrasound guidance for central venous puncture, we sometimes experience difficulties. We infer that in such cases the vein is collapsed and that the transcutaneous ultrasound probe pressure at which the vein is collapsed (P (tc)) may predict the easiness of the venous puncture. We measured P (tc) and the diameter of the internal jugular vein in 47 adult patients in our ICU. After successful puncture, we also measured venous pressure (P (v)). The patients were divided into two groups based on the number of puncture attempts: ≥3 attempts constituted the "difficult group" and venous collapsibility and vertical diameter determine difficulty in performing venous puncture.

  17. Catheter venography for the assessment of internal jugular veins and azygous vein: position statement by expert panel of the International Society for Neurovascular Disease.

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    Simka, Marian; Hubbard, David; Siddiqui, Adnan H; Dake, Michael D; Sclafani, Salvatore J A; Al-Omari, Mamoon; Eisele, Carlos G; Haskal, Ziv J; Ludyga, Tomasz; Miloševič, Zoran V; Sievert, Horst; Stehling, Michael K; Zapf, Stefan; Zorc, Marjeta

    2013-05-01

    This document by an expert panel of the International Society for Neurovascular Disease is aimed at presenting current technique and interpretation of catheter venography of the internal jugular veins, azygous vein and other veins draining the central nervous system. Although interventionalists agree on general rules, significant differences exist in terms of details of venographic technique and interpretations of angiographic pictures. It is also suggested that debatable findings should be investigated using multimodal diagnostics. Finally, the authors recommend that any publication on chronic cerebrospinal venous insufficiency should include detailed description of venographic technique used, to facilitate a comparison of published results in this area.

  18. Cardiac Variation of Internal Jugular Vein for the Evaluation of Hemodynamics.

    Science.gov (United States)

    Nakamura, Kensuke; Qian, Kun; Ando, Takehiro; Inokuchi, Ryota; Doi, Kent; Kobayashi, Etsuko; Sakuma, Ichiro; Nakajima, Susumu; Yahagi, Naoki

    2016-08-01

    Evaluations of intravascular fluid volume are considered to be one of the most important assessments in emergency and intensive care. Focusing on pulse-induced variation of the internal jugular vein (IJV) area, i.e., cardiac variation, we investigated its correlation with various hemodynamic indices using newly developed software. Software that automatically can track and analyze the IJV during ultrasonography was developed. Eleven healthy patients were subjected to an exercise load to increase their stroke volume (SV) and a dehydration load to decrease their central venous pressure (CVP). The cardiac variation in the area of the IJV, CVP, the SV and the respiratory variation in the inferior vena cava (IVC) were evaluated. The exercise protocol increased the patients' mean SV by 14.5 ± 3.7 mL, and the dehydration protocol caused their mean CVP to fall by 3.75 ± 0.33 cm H2O, which resulted in the collapse index (max IJV area - min IJV area/max IJV area) changing from 0.32 ± 0.04 to 0.44 ± 0.06 and 0.49 ± 0.04, respectively (p variation in the area of the great veins is considered to be induced by venous return to the right atrium under negative pressure. It is possible that intravascular dehydration can be detected and hemodynamic indices, such as CVP and SV, can be estimated by evaluating cardiac variation in the area of the IJV.

  19. Fracture and migration into the coronary sinus of a totally implantable catheter introduced via the right internal jugular vein.

    Science.gov (United States)

    Pignataro, Bruno Soriano; Nishinari, Kenji; Wolosker, Nelson; Bomfim, Guilherme Andre Zoteli

    2014-12-01

    There has been an increase in the use of totally implantable devices. Catheter fractures are rare but known complications. This case report presents a rare migration site of the catheter fragment into the coronary sinus. The totally implantable catheter was introduced into the right internal jugular vein to deliver chemotherapy. Although it was an unusual site, the catheter fragment was removed without complications using loop-snare technique. 2014 BMJ Publishing Group Ltd.

  20. Ultrasound Versus the Landmark Technique: A Prospective Randomized Comparative Study of Internal Jugular Vein Cannulation in an Intensive Care Unit

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    B R Shrestha

    2011-06-01

    Full Text Available OBJECTIVE: The aim of this study is to find out if an ultrasound technique has advantages over the conventional landmark technique. METHODS: This is a prospective randomized comparative study on 120 patients requiring central venous cannulation of the right internal jugular vein. The study comprised of two groups: ultrasound and landmark groups, each consisting of 60 patients. The outcome measures were compared between the groups. RESULTS: Cannulation of the internal jugular vein was successful in 58 patients in the ultrasound group and in 53 in the landmark group. The number of attempts was 1.5 (1 - 3 and 2 (1 - 3 in the ultrasound and landmark group respectively (p = 0.001. The time taken for the successful cannulation was 4.9 +/- 1.7 minutes in the ultrasound approach and 8.0 +/- 2.8 minutes in the landmark approach (p = 0.00. The internal jugular vein diameter in the supine position was 11.2 +/- 1.5 mm which increased to 15.04 +/- 1.5 mm with a 15 degrees head-down position in the USG group (p = 0.001. The first attempt success rate was 39/60 (63% in the ultrasound group and 19/60 (32% with the landmark technique. The seven (12% failure cases in the landmark group were rescued by the ultrasound technique. Inadvertent carotid artery puncture occurred in 2/60 (3% and 6/60 (10% of patients in the ultrasound and land mark group respectively. CONCLUSIONS: Ultrasound improves success rate, minimizes cannulation time and complications during internal jugular vein cannulation. It can be employed as a rescue technique in cases of a failed landmark technique. Keywords:cannulation, central, landmark, technique, ultrasound.

  1. Placement of a Hemodialysis Catheter using the Dilated Right External Jugular Vein as a Primary Route

    Energy Technology Data Exchange (ETDEWEB)

    Park, Mi Hyun [Dankook University Hospital, Cheonan (Korea, Republic of); Shin, Byung Seok [Chungnam National University Hospital, Daejeon (Korea, Republic of)

    2010-08-15

    To evaluate the feasibility that a dilated right external jugular vein (EJV) could be a primary venous access site for large bore hemodialysis catheter placement. Between January 2008 and April 2009, a total of 173 hemodialysis catheters (14.5 F) were placed. Among them, we evaluated the clinical data of 42 patients who underwent placement through a dilated right EJV. We evaluated technical success, duration of catheterization in days, and the presence of complications. Technical success was achieved for 41 patients (98%). Catheter placement was unsuccessful in one patient due to narrowing of the EJV. The catheter dwell time ranged between 14 and 305 days (mean; 76 days, total catheter days: 3,111 days). A total of 26 hemodialysis catheters were removed due to complications (n=2) and termination of hemodialysis via the hemodialysis catheter (n=24). There was air embolization (n=1) and catheter kinking (n=3) during procedures and catheter related infections (n=2) during the follow-up period. The incidence of catheter related infection was 0.06 per 100 catheter days. No cases of catheter malfunction or symptomatic venous thrombosis were observed. We suggest that a dilated right EJV could be considered as a preferred primary route for hemodialysis catheter placement with easy access

  2. Thrombophlebitis of the internal jugular vein (Lemierre syndrome) - Clinical and CT findings

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    Kim, Bo Yeon; Yoon, Dae Young; Lim, Kyoung Ja; Seo, Young Lan; Yun, Eun Joo; Choi, Chul Soon; Bae, Sang Hoon [Dept. of Radiology, Kangdong Seong-Sim Hospital, Hallym Univ. Coll. of Medicine, Seoul (Korea, Republic of)], e-mail: evee0914@chollian.net; Kim, Hyeong Chul [Dept. of Radiology, Chuncheon Sacred Heart Hospital, Hallym Univ. Coll. of Medicine, Kangwon-do (Korea, Republic of); Kim, Eun Soo [Dept. of Radiology, Hallym Univ. Sacred Heart Hospital, Hallym Univ. Coll. of Medicine, Gyeonggi-do (Korea, Republic of); Baek, Sora [Dept. of Nuclear Medicine, Kangdong Seong-Sim Hospital, Hallym Univ. Coll. of Medicine, Seoul (Korea, Republic of)

    2013-07-15

    Background: Thrombophlebitis of the internal jugular vein (IJV) secondary to neck infection (so-called Lemierre syndrome) is a rare disease. Purpose: To evaluate the clinical and CT findings in patients with thrombophlebitis of the IJV. Material and Methods: The clinical and contrast-enhanced neck CT findings were retrospective analyzed in 10 patients (eight men, two women; mean age, 62.9{+-}8.3 years) with thrombophlebitis of the IJV. Results: Five patients (50%) had complications, including pneumonia (n = 3), neck abscess (n = 1), and thrombophlebitis of cerebral venous sinus (n = 1). All patients, except two who were lost to follow-up, had improved after antibiotics and anticoagulation therapy. Nine (90%) patients had underlying infectious processes in the neck. Contrast-enhanced neck CT of 12 IJVs (five right, three left, and two bilateral) affected by thrombophlebitis demonstrated > 5 cm in length (n = 8, 67%), ovoid shape (n = 7, 58%), complete occlusion of the lumen (n = 10, 83%), circumferential (n = 11, 92%), smooth (n = 8, 67%), and thick (=4 mm) (n = 8, 67%) rim enhancement, and adjacent soft tissue swelling (n = 11, 92%). Conclusion: Contrast-enhanced CT is useful in the diagnosis of thrombophlebitis of the IJV; characteristic CT findings of this unusual entity may be the main clue to the correct diagnosis.

  3. Assessment of Internal Jugular Vein Size in Healthy Subjects with Magnetic Resonance and Semiautomatic Processing

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    M. M. Laganà

    2016-01-01

    Full Text Available Background and Objectives. The hypothesized link between extracranial venous abnormalities and some neurological disorders awoke interest in the investigation of the internal jugular veins (IJVs. However, different IJV cross-sectional area (CSA values are currently reported in literature. In this study, we introduced a semiautomatic method to measure and normalize the CSA and the degree of circularity (Circ of IJVs along their whole length. Methods. Thirty-six healthy subjects (31.22 ± 9.29 years were recruited and the 2D time-of-flight magnetic resonance venography was acquired with a 1.5 T Siemens scanner. The IJV were segmented on an axial slice, the contours were propagated in 3D. Then, IJV CSA and Circ were computed between the first and the seventh cervical levels (C1–C7 and normalized among subjects. Inter- and intrarater repeatability were assessed. Results. IJV CSA and Circ were significantly different among cervical levels (p<0.001. A trend for side difference was observed for CSA (larger right IJV, p=0.06, but not for Circ (p=0.5. Excellent inter- and intrarater repeatability was obtained for all the measures. Conclusion. This study proposed a reliable semiautomatic method able to measure the IJV area and shape along C1–C7, and suitable for defining the normality thresholds for future clinical studies.

  4. Assessment of Internal Jugular Vein Size in Healthy Subjects with Magnetic Resonance and Semiautomatic Processing

    Science.gov (United States)

    Pelizzari, L.; Scaccianoce, E.; Dipasquale, O.; Ricci, C.; Baglio, F.; Cecconi, P.; Baselli, G.

    2016-01-01

    Background and Objectives. The hypothesized link between extracranial venous abnormalities and some neurological disorders awoke interest in the investigation of the internal jugular veins (IJVs). However, different IJV cross-sectional area (CSA) values are currently reported in literature. In this study, we introduced a semiautomatic method to measure and normalize the CSA and the degree of circularity (Circ) of IJVs along their whole length. Methods. Thirty-six healthy subjects (31.22 ± 9.29 years) were recruited and the 2D time-of-flight magnetic resonance venography was acquired with a 1.5 T Siemens scanner. The IJV were segmented on an axial slice, the contours were propagated in 3D. Then, IJV CSA and Circ were computed between the first and the seventh cervical levels (C1–C7) and normalized among subjects. Inter- and intrarater repeatability were assessed. Results. IJV CSA and Circ were significantly different among cervical levels (p < 0.001). A trend for side difference was observed for CSA (larger right IJV, p = 0.06), but not for Circ (p = 0.5). Excellent inter- and intrarater repeatability was obtained for all the measures. Conclusion. This study proposed a reliable semiautomatic method able to measure the IJV area and shape along C1–C7, and suitable for defining the normality thresholds for future clinical studies. PMID:27034585

  5. Variations in the anatomical relationship between the common carotid artery and the internal jugular vein: An ultrasonographic study

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    Mauricio Umaña Perea

    2015-07-01

    Full Text Available Introduction:The internal jugular vein locates anterior or anterolateral to the common carotid artery in two-thirds of the subjects studied by ultrasound when the head is in a rotated position.Aim:To identify variables associated with the anterior location of the internal jugular vein.Methods:Ultrasound examinations were performed with the patients in the supine position, with the head rotated to the opposite side. The proximal third of the neck was visualized transversely with a 7.5-mHz transducer. The relationship between the vessels was described in accordance with the proportion of the artery overlapped by the vein. Univariate comparisons and a multivariate analysis of potential variables that may affect the anatomic relationships were performed.Results:Seventy-eight patients were included, 44 of whom were men. The patients' ages ranged from 17 to 90 years (median 64.0, interquartile range 41-73. The right and left sides were studied 75 and 73 times, respectively. The vein was located lateral to the artery in 24.3% (95%CI= 17.4-32.2 of the studies, anterolateral in 33.8% (95%CI= 26.2-41.4 and anterior in 41.9% (95%CI= 33.9-49.8. The multivariate analysis identified age group (OR= 3.7, 95% CI 2.1-6.4 and, less significantly, the left side (OR= 1.7, 95%CI= 0.8-3.5 and male gender (OR= 1.2, 95%CI= 0.6-2.7 as variables associated with the anterior position of the vein.Conclusión:The anterior position of the internal jugular vein relative to the common carotid artery increases gradually with age. Additionally, left-sided localization and male sex further increased the probability of an anterior position.

  6. Achondroplasia in children: correlation of ventriculomegaly, size of foramen magnum and jugular foramina, and emissary vein enlargement.

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    Bosemani, Thangamadhan; Orman, Gunes; Hergan, Benedikt; Carson, Kathryn A; Huisman, Thierry A G M; Poretti, Andrea

    2015-01-01

    Achondroplasia is a skeletal dysplasia with diminished growth of the skull base secondary to defective enchondral bone formation. This leads to narrowing of the foramen magnum and jugular foramina, which further leads to ventricular dilatation and prominence of the emissary veins. The primary goal of our study was to determine a correlation between the degree of ventricular dilatation, jugular foramina and foramen magnum narrowing, as well as emissary vein enlargement. Conventional T2-weighted MR images were evaluated for surface area of the foramen magnum and jugular foramina, ventricular dilatation, and emissary veins enlargement in 16 achondroplasia patients and 16 age-matched controls. Ratios were calculated for the individual parameters using median values from age-matched control groups to avoid age as a confounder. Compared to age-matched controls, in children with achondroplasia, the surface area of the foramen magnum (median 0.50 cm(2), range 0.23-1.37 cm(2) vs. 3.14 cm(2), 1.83-6.68 cm(2), p magnum compression and (2) stable ventricular size facilitated by interdependent factors likely obviates the need for ventricular shunt placement.

  7. Placement of long-term hemodialysis catheter (permcath in patients with end-stage renal disease through external jugular vein

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    Ali Akbar Beigi

    2014-01-01

    Full Text Available Background: The number of patients with End-Stage Renal Disease (ESRD has progressively increased in the population. Kidney transplantation is the specific treatment for such patients; however a majority of patients will require hemodialysis before kidney transplantation. The present study aims to investigate using the external jugular vein (EJV for Permcath placement in these patients. Materials and Methods: This descriptive and analytical study was conducted in Alzahra Medical Center, Isfahan, in 2012. Catheters were inserted by cutting down the right EJV. The patency rate and potential complications were studied. The obtained data was analyzed using SPSS 21.0. Results: Out of 45 live patients, within three months of surgery, 40 patients (81.6% had no complications and dialysis continued through Permcath. Permcath Thrombosis occurred in two patients (4.4%. Catheter infection led to the removal of it in one patient (2.2% 1.5 months after surgery. And accidental catheter removal occurred in one patient. Conclusion: Placement of the permcath in the external jugular vein can be a safe, uncomplicated, and reliable method for patients requiring hemodialysis, and can be a life-saving alternative in patients without accessible internal jugular vein.

  8. Direct spread of thyroid follicular carcinoma to the parotid gland and the internal jugular vein: a case report

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    Alzaraa Ahmed

    2008-09-01

    Full Text Available Abstract Introduction The parotid gland and the great cervical veins are very rarely involved in a metastatic thyroid cancer. Case presentation We report an interesting case of an unusual metastasis of a thyroid follicular carcinoma including the histopathological and radiological findings. A woman was seen in the otolaryngology clinic with a mass at the angle of the left side of her jaw. Clinical examination and investigations confirmed a thyroid follicular carcinoma with metastases to the parotid gland and the internal jugular vein. Conclusion This is an educational case which highlights the importance of close communication between clinicians, histopathologists and radiologists to ensure that such rare cases are not missed.

  9. Endoprótese revestida de jugular preservada de bovino: estudo comparativo da resposta tecidual em aorta torácica descendente e veia cava inferior de suínos Bovine preserved jugular covered stent-graft: comparative study of tissue response at swine thoracic descendent aorta and inferior vena cava

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    Celso Luiz Muhlethaler Chouin

    2008-08-01

    Full Text Available OBJETIVO: Avaliar e comparar a resposta tecidual de uma endoprótese biosintetica implantada na aorta torácica descendente e veia cava inferior de suínos. MÉTODO: Foi implantada uma endoprótese auto-expansível composta de aço inoxidável, revestida por veia jugular de bovino, processada pelo método L-hydro, com auxilio de uma bainha de liberação Taheri-Leonhardt (Flórida, EUA na aorta torácica descendente, e a veia cava infra-renal de 10 suínos. Sessenta dias após, as endopróteses foram retiradas e analisadas sob o ponto de vista macro e microscópicos. Foram observados: perviedade, grau de incorporação a parede do vaso, tipo de reação inflamatória, e local de maior resposta, tanto em relação a camada do vaso quanto ao local de contato com o anel de aço RESULTADOS: Todas as endopróteses encontravam-se pérvias, e incorporadas à parede. No setor venoso, seis apresentaram traves fibrosas em sua luz, e quatro apresentaram fibrose perivascular. No setor arterial somente uma prótese apresentou discreta estenose, sem fibrose perivascular. A reação inflamatória crônica tipo corpo estranho ocorreu em 100% das peças, a camada média foi a mais acometida no setor venoso, enquanto a íntima foi mais constante na artéria, o grau de incorporação foi mais firme na veia em comparação a artéria. A reação tecidual mostrou maior tendência nas áreas em intimo contato com o anel de aço (intra-anelar, mais intensa na artéria do que na veia. CONCLUSÃO: A prótese apresentou baixa trombogenicidade em ambos os sistemas, houve maior reação tecidual e baixa biocompatibilidade no setor venoso.BACKGROUND: To evaluate and compare the tissue response, in swine, to a biosynthetic stent-graft when implanted in both thoracic aorta and inferior vena cava. METHOD: It was used a self-expanding stainless stent, covered by segment of bovine jugular veins, processed by the method L-hydro, and delivered by Taheri-Leonhardt system (Florida

  10. Comparison between long- and short-axis techniques for ultrasound-guided cannulation of internal jugular vein

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    Gentle Sunder Shrestha

    2016-01-01

    Full Text Available Context: Real-time ultrasound guidance for internal jugular (IJ vein cannulation enhances safety and success. Aims: This study aims to compare the long- and short-axis (LA and SA approaches for ultrasound-guided IJ vein cannulation. Subjects and Methods: Patients undergoing surgery and in intensive care unit requiring central venous cannulation were randomized to undergo either LA or SA ultrasound-guided cannulation of the IJ vein by a skilled anesthesiologist. First pass success, the number of needle passes, time required for insertion of guidewire, and complications were documented for each procedure. Results: The IJ vein was successfully cannulated in all patients. There are no significant differences between the two groups in terms of gender, diameter of IJ vein, margin of safety, and time required for insertion of guidewire. There was also no significant difference between the two groups in terms of side of IJ vein cannulated, patient on mechanical ventilation, number of skin puncture, number of needle redirections, first pass success, and carotid puncture. However, there is a significant relationship between the diameter of IJ vein with first pass (18.18 ± 4.72 vs. 15.21 ± 4.24; P < 0.004 and margin of safety with of incidence of carotid puncture (12.15 ± 4.03 vs. 6.59 ± 3.13; P < 0.016. Conclusions: Both techniques have similar outcomes when used for IJ vein cannulation.

  11. Correlation analysis of internal jugular vein abnormalities and cerebral venous sinus thrombosis

    Institute of Scientific and Technical Information of China (English)

    JIA Ling-yun; HUA Yang; JI Xun-ming; LIU Jiang-tao

    2012-01-01

    Background Cerebral venous sinus thrombosis (CVST) is a special form of stroke with multiple causes and risk factors.However,there are still a portion of cases with unknown reasons.The aim of this study was to investigate the relationship between internal jugular vein (IJV) abnormalities and the development of CVST.Methods A total of 51 CVST patients and 30 healthy controls were enrolled.The diameter,the maximum velocity (Vmax) and the reflux time in bilateral IJVs were measured by color Doppler flow imaging (CDFI).The paired t test was used to compare the numeric values between the bilateral IJVs.The Pearson chi-square test was used to evaluate the relationship between IJV abnormality and CVST,IJV abnormality and IJV reflux,respectively.Results Among the 51 CVST patients,20 (39%) patients were with normal IJV and 31 (61%) patients were with abnormal IJV.The types of IJV abnormality included annulus stenosis 19 cases (61%),hypoplasia 9 cases (29%),thrombosis 2 cases (7%) and anomalous valve 1 case (3%).In patients with unilateral IJV abnormality,the minimum diameter of the IJV on the lesion side was significantly smaller than that of the contralateral side (P <0.0001).When compared with contralateral side,the Vmax of the lesion side with unilateral annulus stenosis was significant higher,however,it was obvious lower in patients with unilateral hypoplasia (P <0.05).Furthermore,among 27 cases with unilateral IJV abnormality,all the CVST occurred on the same side as the IJV lesions.Conclusion IJV abnormality closely correlated with the development of CVST,which is a newly identified risk factor for CVST.

  12. Internal Jugular Vein Cross-Sectional Area Enlargement Is Associated with Aging in Healthy Individuals.

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    Christopher Magnano

    Full Text Available Internal jugular vein (IJV narrowing has been implicated in central nervous system pathologies, however normal physiological age- and gender-related IJV variance in healthy individuals (HIs has not been adequately assessed.We assessed the relationship between IJV cross-sectional area (CSA and aging.This study involved 193 HIs (63 males and 130 females who received 2-dimensional magnetic resonance venography at 3T. The minimum CSA of the IJVs at cervical levels C2/C3, C4, C5/C6, and C7/T1 was obtained using a semi-automated contouring-thresholding technique. Subjects were grouped by decade. Pearson and partial correlation (controlled for cardiovascular risk factors, including hypertension, heart disease, smoking and body mass index and analysis of variance analyses were used, with paired t-tests comparing side differences.Mean right IJV CSA ranges were: in males, 41.6 mm2 (C2/C3 to 82.0 mm2 (C7/T1; in females, 38.0 mm2 (C2/C3 to 62.3 mm2 (C7/T1, while the equivalent left side ranges were: in males, 28.0 mm2 (C2/C3 to 52.2 mm2 (C7/T1; in females, 27.2 mm2 (C2/C3 to 47.8 mm2 (C7/T1. The CSA of the right IJVs was significantly larger (p<0.001 than the left at all cervical levels. Controlling for cardiovascular risk factors, the correlation between age and IJV CSA was more robust in males than in the females for all cervical levels.In HIs age, gender, hand side and cervical location all affect IJV CSA. These findings suggest that any definition of IJV stenosis needs to account for these factors.

  13. Ultrasound-guided internal jugular vein access: Comparison between short axis and long axis techniques

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    Tarek F Tammam

    2013-01-01

    Full Text Available The use of real-time ultrasound (US is advantageous in the insertion of central venous catheters (CVCs in adults, especially in whom difficulties are anticipated for various reasons. The aim of the present study was to compare two different real-time 2-dimensional US-guided techniques [short axis view/out-of-plane approach (SAX OOP approach versus long axis view/in-plane approach (LAX IP approach] for internal jugular vein (IJV cannulation. In this prospective study, 90 critical care and hemodialysis patients were assigned for insertion of CVCs using either the real-time US-guided (SAX OOP approach or LAX IP approach or landmark technique (control group. Failed catheter placement, risk of complications from placement, failure on first attempt at placement, number of attempts until successful catheterization, time to successful catheterization, incidence of central line-associated blood stream infection (CLA-BSI and demographics of each patient were recorded. There were no significant differences in patient′s demographic characteristics, side of cannulation (right or left or presence of risk factors for difficult venous cannulation between the three groups of patients. Cannulation of the IJV was achieved in all patients by using US (SAX OOP and LAX IP approaches and in 27 of the patients (90% by using the landmark technique (P = 0.045. Average access time (skin to vein and number of attempts were comparable between the SAX OOP and the LAX IP approaches while significantly reduced in both US groups of patients compared with the landmark group (P <0.001. In the landmark group, puncture of the carotid artery occurred in 16.7% of the patients, hematoma in 23.3% of the patients, pneumothorax in 3.3% of the patients and CLA-BSI in 20% of the patients, which were all significantly increased compared with the US group (P <0.05. The findings of this study suggest that the SAX OOP and LAX IP approaches were comparable for cannulation of IJV in critical

  14. Perivenous application of fibrin glue prevents the early injury of jugular vein graft to arterial circulation in rabbits

    Institute of Scientific and Technical Information of China (English)

    WAN Li; LI Dian-yuan; YANG Bing; WU Qing-yu

    2006-01-01

    Background Placement of an external support has been reported to prevent intimal hyperplasia of vein grafts. However, it is limited by potential complications. In the present study, we investigated the effect of fibrin glue on preventing vein graft failure as perivenous application. Methods Twenty-four rabbits were divided into non-supported group (n=12) and fibrin glue group (n=12). All animals underwent unilateral jugular vein into common carotid artery interposition grafting and then fibrin glue was applied as perivenous support. Samples of tissues were harvested after 4 weeks. Results The vein grafts with fibrin glue demonstrated a statistically significant decrease in proliferating cell nuclear antigen in the medial/intimal region [13.38% (11.26%-15.11%)] compared with non-supported vein grafts [31.22% (27.15%-35.98%)] (P<0.001). Light microscopy showed remarkable attenuation of endothelial cell loss and numerous microvessels in neoadventitia in the fibrin glue group compared with the non-supported group. The smooth muscle cells migrated into adventitia significantly in fibrin glue group, whereas the smooth muscle cells migrated into intima in non-supported group.Conclusion Perivenous support of vein graft with fibrin glue in vivo can attenuate the severe injury encountered in the non-supported vein grafts exposed to artery.

  15. Balloon atrial septostomy through internal jugular vein in a 45-day-old child with transposition of great arteries

    Directory of Open Access Journals (Sweden)

    Padhi Sumanta

    2010-01-01

    Full Text Available Balloon atrial septostomy is a common palliative procedure in D-transposition of great arteries. It is technically easy before 2-3 weeks of age when the septum primum is thin. Femoral vein or umbilical vein, when available, is the common access used for this procedure. In situations when these accesses are not available or in case of inferior vena cava interruption, trans-hepatic access is used. Internal jugular vein (IJV access is not used as it is difficult to enter the left atrium through this route. We describe a case of successful Balloon atrial septostomy done through IJV in a 45-day-old child with emphasis on the technique, hardware and precautions necessary during the procedure.

  16. Training a sophisticated microsurgical technique: interposition of external jugular vein graft in the common carotid artery in rats.

    Science.gov (United States)

    Schleimer, Karina; Grommes, Jochen; Greiner, Andreas; Jalaie, Houman; Kalder, Johannes; Langer, Stephan; Koeppel, Thomas A; Jacobs, Michael; Kokozidou, Maria

    2012-11-11

    Neointimal hyperplasia is one the primary causes of stenosis in arterialized veins that are of great importance in arterial coronary bypass surgery, in peripheral arterial bypass surgery as well as in arteriovenous fistulas.(1-5) The experimental procedure of vein graft interposition in the common carotid artery by using the cuff-technique has been applied in several research projects to examine the aetiology of neointimal hyperplasia and therapeutic options to address it. (6-8) The cuff prevents vessel anastomotic remodeling and induces turbulence within the graft and thereby the development of neointimal hyperplasia. Using the superior caval vein graft is an established small-animal model for venous arterialization experiment.(9-11) This current protocol refers to an established jugular vein graft interposition technique first described by Zou et al., (9) as well as others.(12-14) Nevertheless, these cited small animal protocols are complicated. To simplify the procedure and to minimize the number of experimental animals needed, a detailed operation protocol by video training is presented. This video should help the novice surgeon to learn both the cuff-technique and the vein graft interposition. Hereby, the right external jugular vein was grafted in cuff-technique in the common carotid artery of 21 female Sprague Dawley rats categorized in three equal groups that were sacrificed on day 21, 42 and 84, respectively. Notably, no donor animals were needed, because auto-transplantations were performed. The survival rate was 100 % at the time point of sacrifice. In addition, the graft patency rate was 60 % for the first 10 operated animals and 82 % for the remaining 11 animals. The blood flow at the time of sacrifice was 8±3 ml/min. In conclusion, this surgical protocol considerably simplifies, optimizes and standardizes this complicated procedure. It gives novice surgeons easy, step-by-step instruction, explaining possible pitfalls, thereby helping them to gain

  17. Coarctation of the aorta and vein of Galen malformation - treatment considerations in a severely compromised patient.

    Science.gov (United States)

    Emmel, Mathias; Bennink, Gerardus; Meila, Dan; Brassel, Friedhelm

    2012-10-01

    A vein of Galen malformation - a rare cause of cardiac insufficiency in neonates - is sometimes associated with coarctation of the aorta, two diseases requiring urgent therapy in the neonatal period. We report on a term neonate in whom we first palliated the coarctation by stent implantation, providing time to treat the vein of Galen malformation by endovascular embolisation. Following this, the coarctation was surgically repaired and the stent was explanted.

  18. Bilateral surgical reconstruction for internal jugular veins disease in patients with chronic cerebrospinal venous insufficiency and associated multiple sclerosis.

    Science.gov (United States)

    Spagnolo, Salvatore; Scalise, Filippo; Barbato, Luciano; Grasso, Maria Antonietta; Tesler, Ugo F

    2014-10-01

    Chronic cerebrospinal venous insufficiency (CCSVI) is a vascular condition characterized by morphologic alterations involving efferent cerebral vascular paths. CCSVI has been implicated as a contributing factor to multiple sclerosis (MS) but this theory is highly controversial. We report 3 cases of CCSVI patients with MS who had undergone internal jugular veins (IJVs) angioplasty to restore vessels patency. All patients reported significant symptomatic improvement after angioplasty until symptoms recurred after restenosis of the treated IJVs. Surgical IJVs reconstruction was performed. Patients' symptoms gradually improved and the benefits were maintained at the 1-year follow-up.

  19. Anatomic relationship of the internal jugular vein and the common carotid artery in Chinese people

    Institute of Scientific and Technical Information of China (English)

    QIN Xiao-hui; ZHANG Hong; MI Wei-dong

    2010-01-01

    Background Variations in position and relationship between the internal jugular vein (IJV) and the common carotid artery (CCA) may lead to inadvertent artery puncture which could be disastrous during central venous access. We demonstrated the anatomic relationship of the IJV with CCA in order to find the optimal site and avoid damage of CCA.Methods Two hundred and twenty surgical patients were enrolled. We analyzed the distance and relationship between the IJV and CCA at three cross sections (upper border of the thyroid cartilage, cricoid cartilage and second tracheal ring) by ultrasonography and then measured the diameters of the IJV and CCA and the distances from the IJV and CCA to the skin.Results Twenty patients were excluded on the basis of exclusion criteria. From up to down at bilateral neck, the IJV became gradually more superficial while the CCA became deeper. The diameter of the IJV became gradually larger while that of the CCA gradually smaller. The IJV from lateral to the CCA gradually moved to the front of the CCA, so the percent overlap of the IJV and CCA was gradually increased. Compared with the left side at the same transverse scan level, the distance between the CCA and IJV was wider at the right side and the right IJV was wider. The IJV location in 11 patients was medial to the CCA at one or more transverse scan levels. The angle between the IJV and CCA was significantly small in elderly patients. The CCA had already furcated at the level of the upper border of the thyroid cartilage in seven patients at the right side and in 12 patients at the left side.Conclusions There are variations in the position and relationship between the IJV and CCA. it is relatively more difficult to puncture at the left side of the neck, at a lower position or in elderly patients. On the contrary, it is relatively easier to puncture at the right side, at the level of the cricoid cartilage or in younger patients.

  20. Ultrasound-guided cannulation of the internal jugular vein in robotic cardiac surgery

    Institute of Scientific and Technical Information of China (English)

    WANG Yao; WANG Gang; GAO Chang-qing

    2013-01-01

    Background Robotic assisted minimally invasive cardiac sugery is a new technique that uses small port sites and peripheral vessel cannulation for cardiopulmonary bypass (CPB) has been used.The right internal jugular vein (IJV)is commonly used for intraoperative venous access to the central circulation and identified with an external landmark.Previous studies have demonstrated the superiority of ultrasound guidance over external landmark technique in anaesthetic and intensive care settings.The aim of the present study was to delineate the utility of ultrasound-guided cannulation of the IJV during establishment of peripheral CPB in robotic cardiac surgery.Methods We prospectively studied 296 adult patients undergoing ultrasound-guided right IJV cannulation during establishment of peripheral CPB in robotic cardiac surgery at our institute from January 2007 to October 2012 (ultrasound group).The success rate,the first attempt success rate,access time and the complication rate of ultrasound-guided method were compared with the landmark-guided method used for 302 historical control patients (landmark group).Results In the ultrasound group,296 consecutive adult patients underwent ultrasound-guided right IJV cannulation during establishment of peripheral CPB in robotic cardiac surgery.In the landmark group,302 patients underwent right IJV cannulation using the landmark-guided technique.The success rate and the first attempt success rate in the ultrasound group were significantly higher than that in the landmark group (100% vs.88.1%,P <0.000 and 98.6% vs.38.4%,P <0.000).Average access time in the ultrasound group was shorter than that in the landmark group ((6.3±13.6) seconds;interquartile range (4-62) seconds vs.(44.5±129.5) seconds; interquartile range (5-986) seconds).The complication rate in the ultrasound group was significantly lower than that in the landmark group (0.3% vs.8.3%,P <0.000).Conclusion Compared with the landmark-guided approach

  1. Extra Luminal Entrapment of Guide Wire; A Rare Complication of Central Venous Catheter Placement in Right Internal Jugular Vein

    Directory of Open Access Journals (Sweden)

    Md Abu Masud Ansari

    2016-10-01

    Full Text Available Central venous Catheterization (CVC is a commonly performed procedure for venous access. It is associated with several complications. We report a rare case of extra luminal entrapment of guide wire during CVC placement in right jugular vein. We report a case of 28 years old female patient presented in our emergency with history of entrapped guide wire in right side of neck during CVC. X-ray showed coiling of guide wire in neck. CT Angiography showed guide wire coursing in between common carotid artery and internal jugular vein (IJV, closely abutting the wall of both vessels. The guide wire was coiled with end coursing behind the esophageal wall. Guide wire was removed under fluoroscopic guide manipulation under local anesthesia. We want to emphasize that even though CVC placement is common and simple procedure, serious complication can occur in hands of untrained operator. The procedure should be performed under supervision, if done by trainee. Force should never be applied to advance the guide wire if resistance is encountered.

  2. Comparison of two different approaches for internal jugular vein cannulation in surgical patients.

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    Chudhari L

    1998-07-01

    Full Text Available We compared the anterior approaches of internal jugular venous cannulation in 200 surgical patients, vis-Ã -vis the ease of cannulation and threading, number of attempts required and the incidence of complications following each route. The technique of posterior approach used in this study was found to have a higher rate of success in cannulation and lower rate of complication such as carotid puncture. The posterior approach was also a safe alternate route in obese or short necked patients.

  3. New device for saphenous vein-to-aorta proximal anastomosis without side-clamping

    Directory of Open Access Journals (Sweden)

    Tappainer Ernesto

    2007-05-01

    Full Text Available Abstract Background Side clamping to perform saphenous vein-to-aorta proximal anastomosis is a well known cause of cerebral embolization during coronary bypass surgery. Automatic and manual devices have been introduced to avoid aortic clamping and facilitate proximal anastomosis but the manual ones only allow the traditional hand-sewing running suture. Nevertheless, they are not easy to use and very expensive to buy. Methods We developed a simple object that helps to perform a manual proximal anastomosis without the need to clamp the side of the aorta. This device is a steel bar which blocks the aortic hole and simultaneously it provides a slit to receive the needle. Through the slit comes out a thin, sharp, straight, but also well directed and predictable jet of blood which could be easily controlled during the suture. Results The function of the object is quite different from other devices. Nothing is deployed in the aorta. The object is only placed on the aorta with the small appendage slipped into the hole. The main advantage of the device is that while manipulation of the aorta is avoided no foreign bodies are incorporated in the suture and – most importantly – the aortic intima is not touched at all. The main drawback of the device is the blood jet coming from the slit so that the blood pressure has to be lowered by vasodilators during the anastomosis. Moreover, the suture has to change direction and the needle has to enter the aortic wall first to slip out through the slit. Conclusion The object was named "Slit Device" and is not a routine instrument. It would be only an alternative to other anastomotic devices with the same surgical indications. In the case of ascending aortic disease and saphenous vein grafting, the Slit Device avoids aortic clamping thereby preventing atheroembolism and also avoiding the need for hypothermic circulatory arrest in patients with unclampable aorta.

  4. Influence of acute jugular vein compression on the cerebral blood flow velocity, pial artery pulsation and width of subarachnoid space in humans

    National Research Council Canada - National Science Library

    Frydrychowski, Andrzej F; Winklewski, Pawel J; Guminski, Wojciech

    2012-01-01

    ...) was measured using medical gas analyser. Bilateral jugular vein compression was achieved with the use of a sphygmomanometer held on the neck of the participant and pumped at the pressure of 40 mmHg, and was performed in the bend-over (BOPT...

  5. Use of optimized ultrasound axis along with marked introducer needle to prevent mechanical complications of internal jugular vein catheterization

    Directory of Open Access Journals (Sweden)

    Tanmoy Ghatak

    2013-01-01

    Full Text Available Internal jugular vein (IJV catheterization is a routine technique in the intensive care unit. Ultrasound (US guided central venous catheter (CVC insertion is now the recommended standard. However, mechanical complications still occur due to non-visualization of the introducer needle tip during US guidance. This may result in arterial or posterior venous wall puncture or pneumothorax. We describe a new technique of (IJV catheterization using US, initially the depth of the IJV from the skin is measured in short-axis and then using real time US long-axis view guidance a marked introducer needle is advanced towards the IJV to the defined depth measured earlier in the short axis and the IJV is identified, assessed and cannulated for the CVC insertion. Our technique is simple and may reduce mechanical complications of US guided CVC insertion.

  6. Venous compression syndrome of internal jugular veins prevalence in patients with multiple sclerosis and chronic cerebro-spinal venous insufficiency.

    Science.gov (United States)

    Mandolesi, Sandro; Niglio, Tarcisio; Orsini, Augusto; De Sio, Simone; d'Alessandro, Alessandro; Mandolesi, Dimitri; Fedele, Francesco; d'Alessandro, Aldo

    2016-01-01

    Analysis of the incidence of Venous Compression Syndrome (VCS) with full block of the flow of the internal jugular veins (IJVs) in patients with Multiple Sclerosis and Chronic cerebro-spinal venous insufficiency. We included 769 patients with MS and CCSVI (299 males, 470 females) and 210 controls without ms and ccsvi (92 males, 118 females). each subject was investigated by echo-color-doppler (ecd). morphological and hemodynamic ecd data were recorded by a computerized mem-net maps of epidemiological national observatory on ccsvi and they were analyzed by mem-net clinical analysis programs. VCS of IJVs occurs in 240 subjects affected by CCSVI and MS (31% of total) and in 12 controls (6% of total). The differences between the two groups are statistical significant (X² = 36.64, pCerebro-Spinal Venous Insufficiency, Multiple Sclerosis, Venous Compression Syndrome.

  7. Venous anastomosis in free flap reconstruction after radical neck dissection: is the external jugular vein a feasible option?

    Science.gov (United States)

    Reiter, Maximilian; Baumeister, Philipp

    2017-01-13

    Free microvascular tissue transfer has become a reliable and wellestablished technique in reconstructive surgery. Success rates greater than 95% are constantly reported in the literature. End-to-end anastomosis to the external jugular vein (EJ) is supposed to be equally successful as anastomosis to the internal jugular vein (IJ) in patients treated with selective neck dissection. No data has been published so far when the IJ had to be resected during neck dissection. The purpose of this study was to evaluate the success rate and complications of end-to-end anastomosis to the EJ in cases of (modified) radical neck dissection with resected IJ. A retrospective mono-center cohort study was performed. All patients with end-to-end anastomosis to either the IJ or EJ-system were reviewed. 423 free-tissue transfers performed between 2009 and 2016 were included. The overall success rate was 97.0% with an anastomotic revision rate due to venous thrombosis of 12.3%. In patients when the IJ had to be resected and the venous anastomosis was performed at the ipsilateral side to the EJ (n = 53), overall flap loss was significantly higher (5/53; 9.4%). The revision rate in these cases was 22.6%. Success rate of anastomosis to the EJ when the ipsilateral IJ was still intact was 100% (n = 20). Success rate when the anastomosis was performed at the contralateral side was 100%. End-to-end anastomosis to the EJ in cases with resected IJ is more likely to result in free flap loss. Furthermore, it is associated with a higher revision rate. Therefore, in cases with resected IJ, we suggest to plan the operation beforehand with anastomosis at the contralateral side whenever possible.

  8. Comparison of Brachial Vein Versus Internal Jugular Vein Approach for Access to the Right Side of the Heart With or Without Myocardial Biopsy.

    Science.gov (United States)

    Harwani, Neha; Chukwu, Ebere; Alvarez, Manrique; Thohan, Vinay

    2015-09-01

    Right heart catheterization (RHC) and endomyocardial biopsy are mainstay procedures for patients with heart failure and heart transplantation. Approaches are predominantly neck (internal jugular) or leg (femoral vein). We describe a novel arm (brachial/basilica vein) approach. Over 5.5 years, 1,130 right-sided cardiac procedures in 276 patients were analyzed retrospectively and divided into either neck or arm approach. Comparative analyses of procedural success, time, safety, efficacy, and cost were performed. Patient preference was assessed for those who had both neck and arm approaches. In patients receiving RHC (174 neck and 121 arm cases) and in those receiving RHC + biopsy (594 neck and 141 arm cases), mean elapsed and fluoroscopic times (minutes), respectively, were 60 ± 20 versus 62 ± 19 and 3.43 ± 3.8 versus 4.99 ± 5.2 (RHC neck vs arm, respectively), and 55 ± 19 versus 63 ± 17 and 4.14 ± 3.4 versus 5.22 ± 2.6 (RHC + biopsy neck vs arm, respectively). Procedural complications were low (n = 7, 0.6%) and restricted to the neck approach. Patients surveyed preferred the arm approach. In conclusion, RHC and endomyocardial biopsy through the brachial vein can be performed safely, timely, effectively, and at equivalent cost compared with a neck approach. We advocate that an arm approach be the preferred method for these procedures.

  9. Plasma concentrations of corticosterone and buprenorphine in rats subjected to jugular vein catheterization

    DEFF Research Database (Denmark)

    Goldkuhl, Renée; Jacobsen, Kirsten Rosenmaj; Kalliokoski, Otto Henrik;

    2010-01-01

    The present study investigated the postoperative plasma concentrations of corticosterone and buprenorphine in male Wistar and Sprague-Dawley rats, treated with buprenorphine administered either through subcutaneous (SC) injection or through voluntary ingestion (VI). The animals were treated...... with buprenorphine for pre-emptive analgesia prior to surgical placement of a jugular catheter, followed by automated blood sampling during 96 h. Buprenorphine was administered on a regular basis throughout the experiment, and blood was collected on selected time points. Body weight was measured before and 96 h...... after surgery. It was found that the two rat stocks responded in a similar manner to both buprenorphine treatments, with the exception of body weight change in Wistar rats, in which body weight was reduced after SC treatment. The plasma concentration of corticosterone was significantly higher in the SC...

  10. STUDY ON COMPARISON BETWEEN LANDMARK GUIDED (BRINKMAN'S TECHNIQUE ) AND ULTRASOUND GUIDED INTERNAL JUGULAR VEIN CANNULATION

    OpenAIRE

    Vinod; Sashi Walling

    2015-01-01

    Technique of cannulating the central veins , until recently has been based on landmark guided technique . Recently ultrasound machines with high frequency probes are being used to increase success rate and reducing complications. OBJECTIVE: In our study we compare landmark guided technique ( Brinkman's technique ) ( 1 ) with ultrasound guided technique. STUDY DESIGN: outcome was evaluated in terms of 1 ) Number of attempts 2 ) ...

  11. Direction of the J-Tip of the Guidewire to Decrease the Malposition Rate of an Internal Jugular Vein Catheter

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    Byeong jun Ahn

    2015-11-01

    Full Text Available Background We hypothesized that the direction of the J-tip of the guidewire during insertion into the internal jugular vein (IJV might determine its ultimate location. Methods In this study, 300 patients between the ages of 18 and 99 years who required central venous catheterization via IJV in the emergency department enrolled for randomization. IVJ catheterization was successful in 285 of 300 patients. An independent operator randomly prefixed the direction of the J-tip of the guidewire to one of three directions. Based on the direction of the J-tip, patients were allocated into three groups: the J-tip medial-directed group (Group A, the lateral-directed group (Group B, or the downward-directed group (Group C. Postoperative chest radiography was performed on all patients in order to visualize the location of the catheter tip. A catheter is considered malpositioned if it is not located in the superior vena cava or right atrium. Results Of the total malpositioned catheter tips (8 of 285; 2.8%, the majority (5 of 8; 62.5% entered the contralateral subclavian vein, 2 (25.0% were complicated by looping, and 1 (12.5% entered the ipsilateral subclavian vein. According to the direction of the J-tip of the guidewire, the incidence of malpositioning of the catheter tip was 4 of 92 in Group A (4.3%, 4 of 96 in Group B (4.2%, and there were no malpositions in Group C. There were no significant differences among the three groups (p = 0.114. Conclusions The direction of the J-tip of the guidewire had no statistically significant effect on incidence of malpositioned tips.

  12. Reflux venous flow in dural sinus and internal jugular vein on 3D time-of-flight MR angiography

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Jinhee; Kim, Bum-soo; Kim, Bom-yi; Choi, Hyun Seok; Jung, So-Lyung; Ahn, Kook-Jin; Byun, Jae Young [The Catholic University of Korea, Department of Radiology, Seoul St. Mary' s Hospital, School of Medicine, Seoul (Korea, Republic of)

    2013-10-15

    Reflux venous signal on the brain and neck time-of-flight magnetic resonance angiography (TOF MRA) is thought to be related to a compressed left brachiocephalic vein. This study is aimed to assess the prevalence of venous reflux flow in internal jugular vein (IJV), sigmoid sinus/transverse sinus (SS/TS), and inferior petrosal sinus (IPS) on the brain and neck TOF MRA and its pattern. From the radiology database, 3,475 patients (1,526 men, 1,949 women, age range 19-94, median age 62 years) with brain and neck standard 3D TOF MRA at 3 T and 1.5 T were identified. Rotational maximal intensity projection images of 3D TOF MRA were assessed for the presence of reflux flow in IJV, IPS, and SS/TS. Fifty-five patients (1.6 %) had reflux flow, all in the left side. It was more prevalent in females (n = 43/1,949, 2.2 %) than in males (n = 12/1,526, 0.8 %) (p = 0.001). The mean age of patients with reflux flow (66 years old) was older than those (60 years old) without reflux flow (p = 0.001). Three patients had arteriovenous shunt in the left arm for hemodialysis. Of the remaining 52 patients, reflux was seen on IJV in 35 patients (67.3 %). There were more patients with reflux flow seen on SS/TS (n = 34) than on IPS (n = 25). Venous reflux flow on TOF MRA is infrequently observed, and reflux pattern is variable. Because it is exclusively located in the left side, the reflux signal on TOF MRA could be an alarm for an undesirable candidate for a contrast injection on the left side for contrast-enhanced imaging study. (orig.)

  13. Preservation of the External Jugular Vein in Bilateral Radical Neck Dissections: Technique in Two Cases and Review of the Literature

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    Rodrigo Lima Bastos da Rocha

    2015-01-01

    Full Text Available Context. The possibility of cephalic venous hypertension with the resultant facial edema and elevated cerebrospinal fluid pressure continues to challenge head and neck surgeons who perform bilateral radical neck dissections during simultaneous or staged procedures. Case Report. The staged procedure in patients who require bilateral neck dissections allows collateral venous drainage to develop, mainly through the internal and external vertebral plexuses, thereby minimizing the risks of deleterious consequences. Nevertheless, this procedure has disadvantages, such as a delay in definitive therapy, the need for a second hospitalization and anesthesia, and the risk of cutting lymphatic vessels and spreading viable cancer cells. In this paper, we discuss the rationale and feasibility of preserving the external jugular vein. Considering the limited number of similar reports in the literature, two cases in which this procedure was accomplished are described. The relevant anatomy and technique are reviewed and the patients’ outcomes are discussed. Conclusion. Preservation of the EJV during bilateral neck dissections is technically feasible, fast, and safe, with clinically and radiologically demonstrated patency.

  14. Thrombosis of the internal jugular vein after tympanoplasty caused by interaction of oral contraceptives and hereditary hypofibrinolysis

    Directory of Open Access Journals (Sweden)

    Dubravka Ivić

    2011-08-01

    Full Text Available This case report describes a case of venous thrombosis in a young woman who had undergonetympanoplasty due to chronic otitis media.Other than that she was healthy. According to the anamnesis she stopped taking oral contraceptive pills (OCP a month before the surgery. She did not receive thromboprophylaxis before the surgerybecause it was estimated that there was a low risk for a thromboembolic incident. Several hours after the surgery she was still not responding properly to external stimulus and there was noverbal contact. An urgent computed tomography (CT scan of head and neck revealed thrombosis of the left internal jugular vein. She was admitted to the Intensive Care Unit (ICU and heparin therapy started. After a few days she was fully recovered. Later it was confirmed that the patient had an inherited fibrinolysis disorder caused by plasminogen activator inhibitor 1 (PAI-1 gene polymorphism. Our opinion is that the unexpected thrombotic incident was a result of interaction of multiple factors, including the venous stasis at the surgery site, decreased fibrinolysis ability, and the prothrombotic effect of OCP.

  15. A COMPARATIVE STUDY BETWEEN ULTRASOUND GUIDED CATHETERIZATION OF THE INTERNAL JUGULAR VEIN AND CLASSICAL LAND MARK TECHNIQUE

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    Henjarappa K S

    2014-12-01

    Full Text Available Background: Catheterization of Internal Jugular Vein (IJV is commonly attempted to obtain central venous access for hemodynamic monitoring, long term administration of fluids, total parenteral nutrition and hemodialysis in critical care patients. The safe puncture of the IJV is achieved by using anatomical land marks on skin surface. Ultrasound guidance could be beneficial in placing central venous catheters by improving the success rate, reducing the number of needle passes, decreasing access time and decreasing complications. Material and Methods: Sixty critical care patients were selected for IJV cannulation either by land mark technique or by ultrasound guided technique in two groups of thirty each. Results: In our study there was 100% success rate for first attempt cannulation in USG technique and where as it was 83.3% in LMG technique. The mean access time in USG technique was 152.50 ± 63.90 sec as against 323.23 ± 146.19 sec in LMG group. Conclusion: Ultrasound guided technique improves the cannulation of the IJV with respect to safety, rapidity and comfort to the patient during the procedure.

  16. Intraoperative radiation of canine carotid artery, internal jugular vein, and vagus nerve. Therapeutic applications in the management of advanced head and neck cancers

    Energy Technology Data Exchange (ETDEWEB)

    Mittal, B.B.; Pelzer, H.; Tsao, C.S.; Ward, W.F.; Johnson, P.; Friedman, C.; Sisson, G.A. Sr.; Kies, M. (Northwestern Univ., Chicago, IL (USA))

    1990-12-01

    As a step in the application of intraoperative radiotherapy (IORT) for treating advanced head and neck cancers, preliminary information was obtained on the radiation tolerance of the canine common carotid artery, internal jugular vein, and vagus nerve to a single, high-dose electron beam. Both sides of the neck of eight mongrel dogs were operated on to expose an 8-cm segment of common carotid artery, internal jugular vein, and vagus nerve. One side of the neck was irradiated, using escalating doses of 2500, 3500, 4500, and 5500 cGy. The contralateral side of the neck served as the unirradiated control. At 3 and 6 months after IORT, one dog at each dose level was killed. None of the dogs developed carotid bleeding at any time after IORT. Light microscopic investigations using hematoxylin-eosin staining on the common carotid artery and internal jugular vein showed no consistent changes that suggested radiation damage; however, the Masson trichrome stain and hydroxyproline concentration of irradiated common carotid artery indicated an increase in the collagen content of the tunica media. Marked changes in the irradiated vagus nerve were seen, indicating severe demyelination and loss of nerve fibers, which appeared to be radiation-dose dependent. Four patients with advanced recurrent head and neck cancer were treated with surgical resection and IORT without any acute or subacute complications. The role of IORT as a supplement to surgery, external beam irradiation, and chemotherapy in selected patients with advanced head and neck cancer needs further exploration.

  17. A SA study on complications in ultrasound guided catheterization of the internal jugular vein

    Directory of Open Access Journals (Sweden)

    Henjarappa KS

    2015-06-01

    Full Text Available Background: With the advanced knowledge in medical monitoring, ever increasing value has been placed on the establishment of central venous catheter. During the past few years, monitoring of central venous pressure has become an important aid in the management of critically ill patients. Doppler ultrasound was first used to assist central venous catheter insertion in 1984. Ultrasound has been applied to describe the anatomy of the IJV and to evaluate various techniques for percutaneous cannulation. Real time sonography improves access to the vein compared with the traditional method. Ultrasound guided cannulation limits complications and also the decreases the cannulation time. For reducing the complication in traditional method we have conducted the study through ultrasound guide and observed the complications in new method. Methods: Thirty critical care patients were selected for IJV cannulation either by ultrasound guided technique. This study conducted in department of anesthesiology and critical care, M. S. Ramaiah medical college, Bangalore. Results: In our study there was 100% success rate for first attempt cannulation in USG technique. The mean access time in USG technique was 152.50 +/- 63.90 sec. in USG technique arrhythmias were noted in 1 (3.3% case during the study. No cases of haematoma, pneumothorax, haemothorax, nerve Injury, carotid artery puncture and catheter malposition were noted during the study in USG technique. Conclusion: Ultrasound guided technique improves the cannulation of the IJV with respect to safety, rapidity and comfort to the patient during the procedure. [Int J Res Med Sci 2015; 3(3.000: 693-697

  18. Crouzon’s Syndrome with Life-Threatening Ear Bleed: Ruptured Jugular Vein Diverticulum Treated by Endovascular Embolization

    Energy Technology Data Exchange (ETDEWEB)

    Mondel, Prabath Kumar, E-mail: prabathmondel@gmail.com; Anand, Sunanda, E-mail: sunandaanand@gmail.com; Limaye, Uday S., E-mail: uslkem@gmail.com [Lilavati Hospital and Research Centre, Department of Interventional Neuroradiology (India)

    2015-08-15

    Crouzon’s syndrome is the commonest variety of syndromic craniosynostosis. Life-threatening ear bleed due to ruptured jugular venous diverticulum in Crouzon’s syndrome has not been described previously. In patients with syndromic craniosynostosis, definitive repair of jugular diverticulum by open surgery is fraught with high risk of bleeding, poor functional outcomes, and even death. A 24-year-old woman with Crouzon’s syndrome presented with conductive hearing loss and recurrent episodes of torrential bleeding from her left ear. On computed tomography, a defect in the roof of jugular fossa containing jugular venous diverticulum immediately inferior to the bony external auditory canal was seen. The clinical presentation, imaging features, and endovascular management of Crouzon’s syndrome due to a ruptured jugular venous diverticulum is described.

  19. Influence of acute jugular vein compression on the cerebral blood flow velocity, pial artery pulsation and width of subarachnoid space in humans.

    Directory of Open Access Journals (Sweden)

    Andrzej F Frydrychowski

    Full Text Available PURPOSE: The aim of this study was to assess the effect of acute bilateral jugular vein compression on: (1 pial artery pulsation (cc-TQ; (2 cerebral blood flow velocity (CBFV; (3 peripheral blood pressure; and (4 possible relations between mentioned parameters. METHODS: Experiments were performed on a group of 32 healthy 19-30 years old male subjects. cc-TQ and the subarachnoid width (sas-TQ were measured using near-infrared transillumination/backscattering sounding (NIR-T/BSS, CBFV in the left anterior cerebral artery using transcranial Doppler, blood pressure was measured using Finapres, while end-tidal CO(2 was measured using medical gas analyser. Bilateral jugular vein compression was achieved with the use of a sphygmomanometer held on the neck of the participant and pumped at the pressure of 40 mmHg, and was performed in the bend-over (BOPT and swayed to the back (initial position. RESULTS: In the first group (n = 10 during BOPT, sas-TQ and pulse pressure (PP decreased (-17.6% and -17.9%, respectively and CBFV increased (+35.0%, while cc-TQ did not change (+1.91%. In the second group, in the initial position (n = 22 cc-TQ and CBFV increased (106.6% and 20.1%, respectively, while sas-TQ and PP decreases were not statistically significant (-15.5% and -9.0%, respectively. End-tidal CO(2 remained stable during BOPT and venous compression in both groups. Significant interdependence between changes in cc-TQ and PP after bilateral jugular vein compression in the initial position was found (r = -0.74. CONCLUSIONS: Acute bilateral jugular venous insufficiency leads to hyperkinetic cerebral circulation characterised by augmented pial artery pulsation and CBFV and direct transmission of PP into the brain microcirculation. The Windkessel effect with impaired jugular outflow and more likely increased intracranial pressure is described. This study clarifies the potential mechanism linking jugular outflow insufficiency with arterial small vessel cerebral

  20. Influence of acute jugular vein compression on the cerebral blood flow velocity, pial artery pulsation and width of subarachnoid space in humans.

    Science.gov (United States)

    Frydrychowski, Andrzej F; Winklewski, Pawel J; Guminski, Wojciech

    2012-01-01

    The aim of this study was to assess the effect of acute bilateral jugular vein compression on: (1) pial artery pulsation (cc-TQ); (2) cerebral blood flow velocity (CBFV); (3) peripheral blood pressure; and (4) possible relations between mentioned parameters. Experiments were performed on a group of 32 healthy 19-30 years old male subjects. cc-TQ and the subarachnoid width (sas-TQ) were measured using near-infrared transillumination/backscattering sounding (NIR-T/BSS), CBFV in the left anterior cerebral artery using transcranial Doppler, blood pressure was measured using Finapres, while end-tidal CO(2) was measured using medical gas analyser. Bilateral jugular vein compression was achieved with the use of a sphygmomanometer held on the neck of the participant and pumped at the pressure of 40 mmHg, and was performed in the bend-over (BOPT) and swayed to the back (initial) position. In the first group (n = 10) during BOPT, sas-TQ and pulse pressure (PP) decreased (-17.6% and -17.9%, respectively) and CBFV increased (+35.0%), while cc-TQ did not change (+1.91%). In the second group, in the initial position (n = 22) cc-TQ and CBFV increased (106.6% and 20.1%, respectively), while sas-TQ and PP decreases were not statistically significant (-15.5% and -9.0%, respectively). End-tidal CO(2) remained stable during BOPT and venous compression in both groups. Significant interdependence between changes in cc-TQ and PP after bilateral jugular vein compression in the initial position was found (r = -0.74). Acute bilateral jugular venous insufficiency leads to hyperkinetic cerebral circulation characterised by augmented pial artery pulsation and CBFV and direct transmission of PP into the brain microcirculation. The Windkessel effect with impaired jugular outflow and more likely increased intracranial pressure is described. This study clarifies the potential mechanism linking jugular outflow insufficiency with arterial small vessel cerebral disease.

  1. The effects of the Trendelenburg position and the Valsalva manoeuvre on internal jugular vein diameter and placement in children

    Science.gov (United States)

    Dincyurek, Gamze Naime; Mogol, Elif Basagan; Turker, Gurkan; Yavascaoglu, Belgin; Gurbet, Alp; Kaya, Fatma Nur; Moustafa, Bachri Ramadan; Yazici, Tolga

    2015-01-01

    INTRODUCTION We compared the effects of various surgical positions, with and without the Valsalva manoeuvre, on the diameter of the right internal jugular vein (RIJV). METHODS We recruited 100 American Society of Anesthesiologists physical status class I patients aged 2–12 years. The patients’ heart rate, blood pressure, peripheral oxygen saturation and end-tidal CO2 pressure were monitored. Induction of anaesthesia was done using 1% propofol 10 mg/mL and fentanyl 2 µg/kg, while maintenance was achieved with 2% sevoflurane in a mixture of 50/50 oxygen and air (administered via a laryngeal mask airway). The RIJV diameter was measured using ultrasonography when the patient was in the supine position. Thereafter, it was measured when the patient was in the supine position + Valsalva, followed by the Trendelenburg, Trendelenburg + Valsalva, reverse Trendelenburg, and reverse Trendelenburg + Valsalva positions. A 15° depression or elevation was applied for the Trendelenburg position, and an airway pressure of 20 cmH2O was applied in the Valsalva manoeuvre. During ultrasonography, the patient’s head was tilted 20° to the left. RESULTS When compared to the mean RIJV diameter in the supine position, the mean RIJV diameter was significantly greater in all positions (p < 0.001) except for the reverse Trendelenburg position. The greatest increase in diameter was observed in the Trendelenburg position with the Valsalva manoeuvre (p < 0.001). CONCLUSION In paediatric patients, the application of the Trendelenburg position with the Valsalva manoeuvre gave the greatest increase in RIJV diameter. The reverse Trendelenburg position had no significant effect on RIJV diameter. PMID:25597750

  2. The progestin levonorgestrel induces endothelium-independent relaxation of rabbit jugular vein via inhibition of calcium entry and protein kinase C: role of cyclic AMP

    Science.gov (United States)

    Herkert, Olaf; Kuhl, Herbert; Busse, Rudi; Schini-Kerth, Valérie B

    2000-01-01

    The progestin and oestrogen component of oral contraceptives have been involved in the development of venous thromboembolic events in women. In the present study we determined the vasoactive effects of sex steroids used in oral contraceptives in isolated preconstricted rabbit jugular veins in the presence of diclofenac and examined the underlying mechanisms.The natural hormone progesterone, the synthetic progestins levonorgestrel, 3-keto-desogestrel, gestodene and chlormadinone acetate, and the synthetic estrogen 17 α-ethinyloestradiol induced concentration-dependent relaxations of endothelium-intact veins constricted with U46619. Levonorgestrel also inhibited constrictions evoked by either a high potassium (K+) solution or phorbol myristate acetate (PMA) in the absence and presence of extracellular calcium (Ca2+). In addition, levonorgestrel depressed contractions evoked by Ca2+ and reduced 45Ca2+ influx in depolarized veins.Relaxations to levonorgestrel in U46619-constricted veins were neither affected by the presence of the endothelium nor by the inhibitor of soluble guanylyl cyclase, NS2028, but were significantly improved either by the selective cyclic AMP phosphodiesterase inhibitor rolipram or in the absence of diclofenac, and decreased by the protein kinase A inhibitor, Rp-8-CPT-cAMPS. Rolipram also potentiated relaxations to levonorgestrel in PMA-constricted veins in the presence, but not in the absence of extracellular Ca2+. Levonorgestrel increased levels of cyclic AMP and inhibited PMA-induced activation of protein kinase C in veins.These findings indicate that levonorgestrel caused endothelium-independent relaxations of jugular veins via inhibition of Ca2+ entry and of protein kinase C activation. In addition, the cyclic AMP effector pathway contributes to the levonorgestrel-induced relaxation possibly by depressing Ca2+ entry. PMID:10952682

  3. US-guided placement of temporary internal jugular vein catheters: immediate technical success and complications in normal and high-risk patients

    Energy Technology Data Exchange (ETDEWEB)

    Oguzkurt, Levent [Baskent University, Adana Teaching and Medical Research Center, Department of Radiology, Adana (Turkey)]. E-mail: loguzkurt@yahoo.com; Tercan, Fahri [Baskent University, Adana Teaching and Medical Research Center, Department of Radiology, Adana (Turkey); Kara, Gulcan [Baskent University, Adana Teaching and Medical Research Center, Department of Radiology, Adana (Turkey); Torun, Dilek [Baskent University, Adana Teaching and Medical Research Center, Department of Nephrology, Adana (Turkey); Kizilkilic, Osman [Baskent University, Adana Teaching and Medical Research Center, Department of Radiology, Adana (Turkey); Yildirim, Tulin [Baskent University, Adana Teaching and Medical Research Center, Department of Radiology, Adana (Turkey)

    2005-07-01

    Objective: : To evaluate the technical success and immediate complication rates of temporary internal jugular vein (IJV) haemodialysis catheter placement in normal and high-risk patients. Methods and materials: Two-hundred and twenty temporary internal jugular vein catheters inserted under ultrasound guidance in 172 patients were prospectively analyzed. Of 172 patients, 93 (54%) were males and 79 (46%) were females (age range, 18-83; mean, 56.0 years). Of 220 catheters, 171 (78%) were placed in patients who had a risk factor for catheter placement like patients with disorder of haemostasis, poor compliance, and previous multiple catheter insertion in the same IJV. Forty-seven (21.3%) procedures were performed on bed-side. A catheter was inserted in the right IJV in 178 procedures (80.9%) and left IJV in 42 procedures. Of 172 patients, 112 (65%) had only one catheter placement and the rest had had more than one catheter placement (range, 1-5). Results: Technical success was achieved in all patients (100%). Average number of puncture was 1.24 (range, 1-3). One hundred and eighty-three insertions (83.1%) were single-wall punctures, whereas 37 punctures were double wall punctures. Nine (4%) minor complications were encountered. Inadvertent carotid artery puncture without a sequel in four procedures (1.8%), oozing of blood around the catheter in three procedures (1.4%), a small hematoma in one procedure (0.4%), and puncture through the pleura in one procedure (0.4%) without development of pneumothorax. Oozing of blood was seen only in patients with disorder of haemostasis. Conclusion: Ultrasound-guided placement of internal jugular vein catheters is very safe with very high success rate and few complications. It can safely be performed in high-risk patients, like patients with disorders of haemostasis and patients with previous multiple catheter insertion in the same vein.

  4. Spontaneous fracture and migration of catheter of a totally implantable venous access port via internal jugular vein--a case report.

    Science.gov (United States)

    Ko, Seung Yeon; Park, Sun Cheol; Hwang, Jeong Kye; Kim, Sang Dong

    2016-04-11

    The totally implantable venous access ports (TIVAPs) are indicated for patients undergoing chemotherapy, total parenteral nutrition and long-term antibiotic treatment. But, among their complications, the fracture and migration of the catheter of a TIVAP via internal jugular vein represents a very rare but potentially severe condition. A 50-year-old woman indentified with a spontaneous fracture and migration of catheter of a TIVAP via right internal jugular vein after adjuvant chemotherapy for ovary cancer. She had been not evaluated and not managed with the heparin lock flush solution during three months after adjuvant chemotherapy. And then, she complained right neck bulging during saline infusion via a TIVAP and a chest radiography showed the fractured and migrated catheter of a TIVAP in right atrium. So, we emergently removed the catheter fragment by a goose neck snare via right femoral vein. After then, there was no problem. If the fractured catheter of a TIVAP is detected, it is desirable to remove a fragment by an endovascular approach if it is possible.

  5. Influence of Acute Jugular Vein Compression on the Cerebral Blood Flow Velocity, Pial Artery Pulsation and Width of Subarachnoid Space in Humans

    OpenAIRE

    Frydrychowski, Andrzej F.; Pawel J Winklewski; Wojciech Guminski

    2012-01-01

    PURPOSE: The aim of this study was to assess the effect of acute bilateral jugular vein compression on: (1) pial artery pulsation (cc-TQ); (2) cerebral blood flow velocity (CBFV); (3) peripheral blood pressure; and (4) possible relations between mentioned parameters. METHODS: Experiments were performed on a group of 32 healthy 19-30 years old male subjects. cc-TQ and the subarachnoid width (sas-TQ) were measured using near-infrared transillumination/backscattering sounding (NIR-T/BSS), CBFV i...

  6. Influence of Acute Jugular Vein Compression on the Cerebral Blood Flow Velocity, Pial Artery Pulsation and Width of Subarachnoid Space in Humans

    OpenAIRE

    Frydrychowski, Andrzej F.; Winklewski, Pawel J.; Wojciech Guminski

    2012-01-01

    PURPOSE: The aim of this study was to assess the effect of acute bilateral jugular vein compression on: (1) pial artery pulsation (cc-TQ); (2) cerebral blood flow velocity (CBFV); (3) peripheral blood pressure; and (4) possible relations between mentioned parameters. METHODS: Experiments were performed on a group of 32 healthy 19-30 years old male subjects. cc-TQ and the subarachnoid width (sas-TQ) were measured using near-infrared transillumination/backscattering sounding (NIR-T/BSS), CBFV i...

  7. COMPARISON OF ISOFLURANE AND SEVOFLURANE ANESTHESIA IN HOLSTEIN CALVES FOR PLACEMENT OF PORTAL AND JUGULAR VEIN CANNULAS

    Directory of Open Access Journals (Sweden)

    Glen Sellers

    2013-01-01

    Full Text Available Isoflurane and sevoflurane are the two most commonly used inhalation anesthetics in veterinary medicine today. This study compared the anesthetic effects between isoflurane and sevoflurane in 17 calves undergoing surgery for placement of portal and jugular vein cannulas. Using a randomized control trial, calves were assigned to receive sevoflurane or isoflurane. Anesthesia was induced with xylazine and ketamine then maintained with the assigned inhalation anesthetic. Parameters for heart rate, respiratory rate, indirect blood pressures, oxygen hemoglobin saturation and end-tidal carbon dioxide were monitored and recorded during surgery. The anesthetic concentrations of the vaporizers were adjusted according to the calves’ responses, e.g., blood pressure, eye position, respiratory and heart rate, to surgical stimulation. Upon discontinuation of the inhalation anesthetic, calves were placed in sternal recumbency and recovery variables including time to extubation, time to first movement, attempts to stand and time to standing were observed and recorded. Statistical analysis was performed using a two-sample t-test on the recorded variables. There were no statistical differences between isoflurane and sevoflurane for any of the parameters recorded during anesthetic maintenance or recovery. The results of this study showed a faster time to first movement and extubation, 3.38±1.85 min and 11.75±3.73 min for sevoflurane compared to 7.56±5.34 min and 15.56±8.69 min for isoflurane, respectively. Attempts to stand were 3.00±2.14 for sevoflurane and 3.22±1.79 for isoflurane. Though the time to standing during recovery was not statistically different between anesthetics, the values did indicate a quicker trend of recovery from sevoflurane. Both inhalation anesthetics produced comparable anesthetic qualities and there were no statistical differences between the parameters recorded during maintenance of anesthesia. On the basis of the

  8. Inhibitory effect of sustained perivascular delivery of paclitaxel on neointimal hyperplasia in the jugular vein after open cutdown central venous catheter placement in rats

    Science.gov (United States)

    Kim, Seongyup; Kim, Younglim; Hwang, Ji Woong

    2017-01-01

    Purpose Inhibitory effect of paclitaxel on neointimal hyperplasia after open cutdown has not been elucidated. Methods For the control group (n = 16), silicone 2.7-Fr catheters were placed via the right external jugular vein with the cutdown method. For the treatment group (n = 16), a mixture of 0.65 mg of paclitaxel and 1 mL of fibrin glue was infiltrated around the exposed vein after cutdown. After scheduled intervals (1, 2, 4, and 8 weeks), the vein segment was harvested and morphometric analysis was performed on cross-sections. Results Proliferation of smooth muscle cell (SMC) was strongly suppressed in the treatment group, and the ratio of neointima to vein wall was significantly reduced in the treatment group (8 weeks; 0.63 ± 0.08 vs. 0.2 ± 0.08, P < 0.05). Luminal patency was significantly more preserved in the treatment group, and the luminal area was significantly wider in the paclitaxel-treated group compared to the control group (8 weeks; 1.91 ± 0.43 mm2 vs. 5.1 ± 0.43 mm2, P < 0.05). Mean SMC counts measured at 1 and 2 weeks after cutdown were significantly lower in the treatment group (2 weeks; 115 ± 22 vs. 62 ± 22). Paclitaxel was undetectable in systemic circulation (<10 ng/mL). Conclusion Sustained perivascular delivery of paclitaxel with fibrin glue was effective in inhibiting neointimal hyperplasia in rat jugular vein after open cutdown. PMID:28203557

  9. Successful percutaneous transcatheter patent foramen ovale closure through the right internal jugular vein using a steerable catheter.

    Science.gov (United States)

    Hascoet, Sebastien; Fraisse, Alain; Elbaz, Meyer

    2013-10-01

    Percutaneous transcatheter closure of a patent foramen ovale (PFO) remains challenging when femoral venous approach is not available. We describe the successful closure of a PFO using the right internal jugular venous approach and a deflectable catheter delivery system in a patient with a PFO, recurrent stroke, and an inferior vena cava filter.

  10. Aorta-LITA Bypass Grafting with Saphenous Vein in a Patient Undergoing Coronary Artery Surgery with Subclavian Artery Stenosis

    Directory of Open Access Journals (Sweden)

    Kerim Çağlı

    2011-12-01

    Full Text Available The internal thoracic artery (ITA is the primary graft for coronary artery bypass grafting and can not be used if there is subclavian artery stenosis (SAS. Aorto-axillary, carotid-subclavian bypass and also angioplasty with stenting or other interventional treatments are acceptable procedures for SAS treatment. Aorta-ITA bypass with saphenous vein can be alternative and simple technique for SAS to save Winslow pathway for patients with peripheral artery disease.

  11. Evaluation of pulsatility index and diameter of the jugular vein and superficial body temperature as physiological indices of temperament in weaned beef calves: relationship with serum cortisol concentrations, rectal temp..

    Science.gov (United States)

    The relationship between temperament, pulsatility index and diameter of the jugular vein, and body temperature was assessed in Angus crossbred calves (262±24.9 days old). Temperament scores were used to classify calves as calm (n=31), intermediate (n=32), or temperamental (n=28). Blood samples were ...

  12. [Tunnelled internal jugular vein catheters with taurolidine lock: an acceptable challenge to arterio-venous fistula in 70 years old haemodialyzed patients: a prospective pilot study].

    Science.gov (United States)

    Branger, Bernard; Reboul, Pascal; Prelipcean, Camélia; Noguera, Maria Eugenia; Cariou, Sylvain; Granolleras, Céline; Vecina, Frédérique; Zabadani, Bachir; Boubenider, Samir; Rousseau, Philippe; Deshodt, Gérard; Ramperez, Pierre; Hory, Bernard; Picard, Eric; Branchereau, Pascal; Fabbro-Peray, Pascale; Fourcade, Jacques

    2011-07-01

    Arteriovenous fistula (AVF) is still in 2010 the gold standard of vascular(2) access in haemodialysis (HD) patients. Nevertheless it may be difficult to obtain and/or to use AVF in elderly. With this prospective randomised pilot study, we compare two strategies of vascular access in 70 years old or more new HD patients. AVF were compared to tunnelled jugular vein catheters (TIJC) with taurolidine as bacterial lock solution. Results were as follow: [table: see text] The responses with the visual analogic scale of comfort was 8/10 for TIJC and 5/10 with AVF * Ptaurolidine because of partial clotting of catheters. Albuminemia was significantly lower in AVF failure patients compared to AVF success patients (24.8g/L vs 31.1g/L). This pilot study allows to conclude that TIJC is an acceptable challenge to AVF in haemodialysed patients of 70 years or more in a two years long use.

  13. Calcitonin gene-related peptide in blood: is it increased in the external jugular vein during migraine and cluster headache? A review

    DEFF Research Database (Denmark)

    Tfelt-Hansen, Peer; Le, Han

    2009-01-01

    The involvement of calcitonin gene-related peptide (CGRP) in migraine pathophysiological mechanisms is shown by the facts that CGRP can induce migraine and that two CGRP antagonists, olcegepant and telcagepant, are effective in the treatment of migraine attacks. Increase of the neuropeptide CGRP...... during migraine and cluster headache attacks in the extracerebral circulation as measured in the external jugular vein (EJV) has been regarded as an established fact. Then in 2005, a study, using the migraine patients as their own controls, showed; however, no changes of CGRP in EJV. For migraine...... there is thus some uncertainty as to whether CGRP is increased in all migraine patients and more research is needed. In contrast, there are three 'positive' studies in cluster headache in which both sumatriptan, O(2) and spontaneous resolution normalized CGRP. The source of an increase of CGRP in EJV is most...

  14. Ultrasound and Fluoroscopy-Guided Placement of Central Venous Ports via Internal Jugular Vein: Retrospective Analysis of 1254 Port Implantations at a Single Center

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Se Jin; Kimn, Hyo Cheol; Chung, Jin Wook; Yin, Yong Hu; Jae, Hwan Jun; Park, Jae Hyung [Seoul National University College of Medicine, Seoul (Korea, Republic of); An, Sang Bu [National Cancer Center, Goyang (Korea, Republic of)

    2012-06-15

    To assess the technical success and complication rates of the radiologic placement of central venous ports via the internal jugular vein. We retrospectively reviewed 1254 central venous ports implanted at our institution between August 2002 and October 2009. All procedures were guided by using ultrasound and fluoroscopy. Catheter maintenance days, technical success rates, peri-procedural, as well as early and late complication rates were evaluated based on the interventional radiologic reports and patient medical records. A total of 433386 catheter maintenance days (mean, 350 days; range 0-1165 days) were recorded. The technical success rate was 99.9% and a total of 61 complications occurred (5%), resulting in a post-procedural complication rate of 0.129 of 1000 catheter days. Among them, peri-procedural complications within 24 hours occurred in five patients (0.4%). There were 56 post-procedural complications including 24 (1.9%, 0.055 of 1000 catheter days) early and 32 (2.6%, 0.074 of 1000 catheter days) late complications including, infection (0.6%, 0.018 of 10000 catheter days), thrombotic malfunction (1.4%, 0.040 of 1000 catheter days), nonthrombotic malfunction (0.9%, 0.025 of 1000 catheter days), venous thrombosis (0.5%, 0.014 of 1000 catheter days), as well as wound problems (1.1%, 0.032 of 1000 catheter days). Thirty six CVPs (3%) were removed due to complications. Bloodstream infections and venous thrombosis were the two main adverse events prolonging hospitalization (mean 13 days and 5 days, respectively). Radiologic placement of a central venous port via the internal jugular vein is safe and efficient as evidenced by its high technical success rate and a very low complication rate.

  15. Evaluation of the efficacy of a novel radical neck dissection preserving the external jugular vein, greater auricular nerve, and deep branches of the cervical nerve

    Directory of Open Access Journals (Sweden)

    Li Y

    2013-04-01

    Full Text Available Yadong Li, Jinsong Zhang, Kai Yang Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China Background: Conventional radical neck dissection often causes a variety of complications. Although the dissection method has been improved by retaining some tissues to reduce complications, the incomplete dissection may cause recurrence of disease. In the present study, we developed a novel radical neck dissection, which preserves the external jugular vein, the greater auricular nerve, and the deep branches of the cervical nerve, to effectively reduce complications and subsequently, to promote the postoperative survival quality. Methods: A total of 100 cases of radical neck dissection were retrospectively analyzed to evaluate the efficacy, rate of complication, and postoperative dysfunction of patients treated with the novel radical neck dissection. Data analysis was performed using the Chi-square test. Results: Compared with conventional radical neck dissection, the novel radical neck dissection could significantly reduce complications and promote postoperative survival quality. Particularly, the preservation of the external jugular vein reduced the surgical risk (ie, intracranial hypertension and complications (eg, facial edema, dizziness, headache. Preservation of the deep branches of the cervical nerve and greater auricular nerve resulted in relatively ideal postoperative functions of the shoulders and ear skin sensory function (P 0.05. Conclusion: Our novel radical neck dissection procedure could effectively reduce the complications of intracranial hypertension, shoulder dysfunction, and ear sensory disturbances. It can be used as a regular surgical approach for oral carcinoma radical neck dissection. Keywords: oral cancer, head and neck cancer, squamous cell carcinoma, survival quality, neck dissection, recurrence

  16. In situ digestion, in vitro harvest and culture of jugular vein endothelial cells in rabbits%兔颈静脉内皮细胞的原位消化、体外获取及培养

    Institute of Scientific and Technical Information of China (English)

    孙彦隽; 刘锦纷; 马宁

    2012-01-01

    目的 建立兔颈静脉内皮细胞原位消化、体外获取及培养的方法.方法 仅解剖游离单侧兔颈静脉,并保留在原位,对侧颈静脉不进行解剖游离.阻断该静脉段的两端并插管,向该静脉段内灌注Ⅰ型胶原酶进行原位消化.切取该颈静脉段,离体状态下获取兔颈静脉内皮细胞,使用EGM-2培养基培养并传代.倒置显微镜、透射电镜观察获取的兔颈静脉内皮细胞,免疫组化法检测Ⅷ因子.结果 获取的兔颈静脉内皮细胞原代培养7~10d左右可达到80%融合.光镜下细胞为短梭形或多角形,呈“鹅卵石”样排列.透射电镜可见内皮细胞特征性的Weibel-Palade小体.兔Ⅷ因子相关抗原免疫组化检测阳性.获取的兔颈静脉内皮细胞进行冻存、复苏和传代后均可以正常生长.结论 成功建立了兔颈静脉内皮细胞原位消化、体外获取及培养的方法.%Objective To establish the methodology for in situ digestion,in vitro harvest and culture of jugular vein endothelial cells in rabbits.Methods The jugular vein was dissected and kept in situ unilaterally,with the contralateral jugular vein intact.Both terminals of the dissected vein were occluded for cannulation and were subjected to type Ⅰ collagenase injection for in situ digestion.The operated jugular vein was resectcd for collecting endothelial cells in vitro,followed by culture and passage using EGM-2 culture medium.The jugular vein endothelial cells were observed under inverted light microscopy and transmission electron microscopy for morphological examination.In addition,factor Ⅷ was measured by immunohistochemistry assay.Results Of all jugular vein endothelial cells harvested,80% underwent fusion after a 7-to-10-day primary passage.These cells appeared in short spindle-like,polygonal or cobblestone-like arrangement under microscope.The characteristic Weible- Palade bodies of endothelial cells were found under transmission electron microscope

  17. Slit-like jugular foramen due to abnormal bone growth at jugular fossa

    Directory of Open Access Journals (Sweden)

    Budhiraja V

    2010-05-01

    Full Text Available An abnormal unilateral blockage of the jugular foramen by a bone growth converting it into a slit was noted in a skull during osteology demonstration classes for medical undergraduates. The left jugular foramen was narrowed by a thick bony projection filling the jugular fossa. This kind of narrowing of the foramen might results in neurovascular symptoms as it transmits important cranial nerves and internal jugular vein. Injury of ninth, tenth and eleventh cranial nerves can occur due to narrowing of jugular foramen know as Vernet’s syndrome is discussed along with case.

  18. Effects of the Trendelenburg Position and Positive End-Expiratory Pressure on the Internal Jugular Vein Cross-Sectional Area in Children With Simple Congenital Heart Defects.

    Science.gov (United States)

    Kim, Hee Yeong; Choi, Jae Moon; Lee, Yong-Hun; Lee, Sukyung; Yoo, Hwanhee; Gwak, Mijeung

    2016-05-01

    Catheterization of the internal jugular vein (IJV) remains difficult in pediatric populations. Increasing the cross-sectional area (CSA) of the IJV facilitates cannulation and decreases complications. We aimed to evaluate the Trendelenburg position and the levels of positive end-expiratory pressure (PEEP) at which the maximum increase of CSA of the IJV occurred in children undergoing cardiac surgery.In this prospective study, the CSA of the right IJV was assessed using ultrasound in 47 anesthetized pediatric patients with simple congenital heart defects. The baseline CSA was obtained in response to a supine position with no PEEP and compared with 5 different randomly ordered maneuvers, that is, a PEEP of 5 and 10 cm H2O in a supine position and of 0, 5, and 10 cm H2O in a 10° Trendelenburg position. Hemodynamic variables, including blood pressure and heart rate, maximum and minimum diameters, and CSA, were measured.All maneuvers increased the CSA of the right IJV with respect to the control condition. In the supine position, the CSA was increased by 9.4% with a PEEP of 5 and by 19.5% with a PEEP of 10 cm H2O. The Trendelenburg tilt alone increased the CSA by 19.0%, and combining the 10° Trendelenburg with a 10 cm H2O PEEP resulted in the largest IJV CSA increase (33.3%) compared with the supine position with no PEEP. Meanwhile, vital signs remained relatively steady during the experiment.The application of the Trendelenburg position and a 10 cm H2O PEEP thus significantly increases the CSA of the right IJV, perhaps improving the chances of successful cannulation in pediatric patients with simple congenital heart defects.

  19. Normal sizes of internal jugular veins in children/adolescents aged birth to 18 years at rest and during the Valsalva maneuver

    Energy Technology Data Exchange (ETDEWEB)

    Eksioglu, Ayse Secil, E-mail: yucelsecil@yahoo.com [Dr. Sami Ulus Women and Children' s Hospital, Radiology Department, Babür Caddesi No:4, 06080 Altındağ, Ankara (Turkey); Tasci Yildiz, Yasemin, E-mail: ytasciyildizl@yahoo.com [Dr. Sami Ulus Women and Children' s Hospital, Radiology Department, Babür Caddesi No:4, 06080 Altındağ, Ankara (Turkey); Senel, Saliha, E-mail: drsaliha007@yahoo.com.tr [Dr. Sami Ulus Women and Children' s Hospital, Department of Pediatrics, Babür Caddesi No:4, 06080 Altındağ, Ankara (Turkey)

    2014-04-15

    Objectives: We aimed to establish normal ultrasonographic (US) values of internal jugular vein (IJV) sizes in children/adolescents aged birth to 18 years and to determine the correlation of US measurements with age, height, weight and body surface area (BSA) of children in different age groups. Methods: Two hundred and thirty-six healthy children (0–18 years) were divided into four groups according to their age (0–2, 3–6, 7–12, and 13–18 years). US measurements (transverse, anteroposterior diameter, and cross-sectional area at rest and during the Valsalva maneuver) of bilateral IJVs were taken at the level of cricoid cartilage. Results: Our study gives information about the reference values in children between birth to 18 years of age. There were significant differences between measurements taken at rest and during the Valsalva maneuver in all age groups. Moderate to strong correlations (clinically significant) between age, height and BSA of the subjects and IJV measurements were detected only in the 0–2 years age group. The strength of the correlations decreased with increasing age. Pearson's correlation revealed that height had the strongest and weight had the weakest correlation with US measurements. ‘Height’ was an independent variable on the right, and ‘age’ on the left side, except for rest CSA, when a regression analysis was performed for clinically significant correlations. Conclusions: Determination of normal reference values for US measurements of the IJV and knowledge of correlation with age, height, weight and BSA might be valuable during interventional procedures and for the diagnosis of phlebectasia in children/adolescents.

  20. 65例志愿者颈静脉形态及血流动力学研究%The morphologic and hemodynamic abnormalities study of jugular vein in volunteers

    Institute of Scientific and Technical Information of China (English)

    唐乐梅; 刘铁利; 孙博; 宁殿秀; 苗延巍

    2015-01-01

    Objective To investigate jugular vein morphological changes with three dimension phase contrast magnetic resonance venography(3D PC MRV),and to explore hemodynamic features using MR phase contrast cine (MR PC cine).Methods Sixty-five healthy volunteers performed 3D PC MRV and MR PC-cine sannings.MRV ranged from torcular herophili to brachiocephalic veins, and the raw data of PC-cine was acquired at cervical 2-3(C2-C3)level perpendicular to the Jugular veins(JVs)with the maximum encoding velocity of 50 cm/sec.Jugular vein showing absent or tip shape(cross-sectional area less than 12.5 mm2 )was considered abnormal,and flat,crescent,oval,round shapes were considered normal.Data of PC-cine was processed by computer to evaluate the hemodynamic features.Results Nine (13.85%)of 65 cases were abnormal that unilateral jugular vein showing needle-pointed narrow or absent,and 8 cases on the left,and one case on the right;Weak correlation was found between jugular veins pattern and the age.The right sided values in volunteers were higher than that of the left side.Conclusion The morphology and hemodynamics of jugular veins in volunteers showed significant difference between sides,and weak correlation is found between the morphology and aging.%目的:应用三维相位对比磁共振血管成像技术(3D PC MRV)及 MR 相位对比电影法(MR PC-cine)探讨正常人颈静脉的形态及血流动力学特征。方法65例志愿者进行颈静脉3D PC MRV 及 MR PC-cine 扫描。扫描范围为窦汇至头臂静脉水平;颈静脉形态的判断标准如下:颈静脉缺如、针尖状狭窄(横截面积<12.5 mm2)、局部不显示视为异常;扁平状、新月形、椭圆形、圆形视为正常表现。MR PC-cine 序列扫描定位于 C2~C3水平,与颈静脉走行方向垂直,速率编码(VENC)为50 cm/s。结果65例志愿者中,9例(13.85%)出现单侧颈静脉针尖状狭窄或缺如,左侧(8例)异常的比例高于右侧(1例)(P <0.05);颈静脉形态异常

  1. Sonographic evaluation of intravascular volume status: Can internal jugular or femoral vein collapsibility be used in the absence of IVC visualization?

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    Alistair Kent

    2015-01-01

    Full Text Available Introduction: Inferior vena cava collapsibility index (IVC-CI has been shown to correlate with both clinical and invasive assessment of intravascular volume status, but has important limitations such as the requirement for advanced sonographic skills, the degree of difficulty in obtaining those skills, and often challenging visualization of the IVC in the postoperative patient. The current study aims to explore the potential for using femoral (FV or internal jugular (IJV vein collapsibility as alternative sonographic options in the absence of adequate IVC visualization. Methods: A prospective, observational study comparing IVC-CI and Fem- and/or IJV-CI was performed in two intensive care units (ICU between January 2012 and April 2014. Concurrent M-mode measurements of IVC-CI and FV- and/or IJV-CI were collected during each sonographic session. Measurements of IVC were obtained using standard technique. IJV-CI and FV-CI were measured using high-frequency, linear array ultrasound probe placed in the corresponding anatomic areas. Paired data were analyzed using coefficient of correlation/determination and Bland-Altman determination of measurement bias. Results: We performed paired ultrasound examination of IVC-IJV (n = 39 and IVC-FV (n = 22, in 40 patients (mean age 54.1; 40% women. Both FV-CI and IJV-CI scans took less time to complete than IVC-CI scans (both, P < 0.02. Correlations between IVC-CI/FV-CI (R 2 = 0.41 and IVC-CI/IJV-CI (R 2 = 0.38 were weak. There was a mean -3.5% measurement bias between IVC-CI and IJV-CI, with trend toward overestimation for IJV-CI with increasing collapsibility. In contrast, FV-CI underestimated collapsibility by approximately 3.8% across the measured collapsibility range. Conclusion: Despite small measurement biases, correlations between IVC-CI and FV-/IJV-CI are weak. These results indicate that IJ-CI and FV-CI should not be used as a primary intravascular volume assessment tool for clinical decision support in

  2. Internal Jugular Vein Cross-Sectional Area and Cerebrospinal Fluid Pulsatility in the Aqueduct of Sylvius: A Comparative Study between Healthy Subjects and Multiple Sclerosis Patients.

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    Clive B Beggs

    Full Text Available Constricted cerebral venous outflow has been linked with increased cerebrospinal fluid (CSF pulsatility in the aqueduct of Sylvius in multiple sclerosis (MS patients and healthy individuals. This study investigates the relationship between CSF pulsatility and internal jugular vein (IJV cross-sectional area (CSA in these two groups, something previously unknown.65 relapsing-remitting MS patients (50.8% female; mean age = 43.8 years and 74 healthy controls (HCs (54.1% female; mean age = 43.9 years were investigated. CSF flow quantification was performed on cine phase-contrast MRI, while IJV-CSA was calculated using magnetic resonance venography. Statistical analysis involved correlation, and partial least squares correlation analysis (PLSCA.PLSCA revealed a significant difference (p<0.001; effect size = 1.072 between MS patients and HCs in the positive relationship between CSF pulsatility and IJV-CSA at C5-T1, something not detected at C2-C4. Controlling for age and cardiovascular risk factors, statistical trends were identified in HCs between: increased net positive CSF flow (NPF and increased IJV-CSA at C5-C6 (left: r = 0.374, p = 0.016; right: r = 0.364, p = 0.019 and C4 (left: r = 0.361, p = 0.020; and increased net negative CSF flow and increased left IJV-CSA at C5-C6 (r = -0.348, p = 0.026 and C4 (r = -0.324, p = 0.039, whereas in MS patients a trend was only identified between increased NPF and increased left IJV-CSA at C5-C6 (r = 0.351, p = 0.021. Overall, correlations were weaker in MS patients (p = 0.015.In healthy adults, increased CSF pulsatility is associated with increased IJV-CSA in the lower cervix (independent of age and cardiovascular risk factors, suggesting a biomechanical link between the two. This relationship is altered in MS patients.

  3. 颈外静脉行PICC置管中及时发现异位的效果观察%Observation of the effect of PICC in the external jugular vein for the timely detection of ectopic

    Institute of Scientific and Technical Information of China (English)

    张鸿雁; 王仙珍; 周璐

    2016-01-01

    目的:评价颈外静脉行PICC置管过程中通过送管异常及时发现导管异位的临床效果。方法:将接受颈外静脉穿刺行PICC置管中通过送管异常确定异位的患者40例,用超声来检验判断正确与否。结果:通过送管异常能及时发现导管异位占95%。结论:通过送管异常能及时发现并调整PICC导管,取得良好效果。%Objective To evaluate the extemal jugular vein of PICC through a process of tube feeding abnormal timely detection of clinical effect of catheter ectopia.Method 40 cases of ectopic patients were accepted external jugular vein puncture for PICC tube by tube feeding abnormalities,they were identified with ultrasound,to test the justment is correct or not.Results Through tube feeding abnormalies can discover catheter heterotopia accounted for 95%.Conclusion Through tube feeding anomaly can be found in time and adjust the PICC catheter heterotopia,achieve good results.

  4. The analysis on risk factors of misplacement of subclavian venous catheterization into ipsilateral internal jugular vein%锁骨下静脉置管误入同侧颈内静脉的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    邢顺鹏; 皋源; 闻大翔; 何征宇; 杭燕南

    2014-01-01

    Objective To identify the risk factors of misplacement of subclavian venous catheterization into ipsilateral internal jugular vein.Methods From January 2011 to December 2012,subclavian venous catheterization was successfully performed with Seldinger method for 178 patients in department of surgical intensive care unit,Renji Hospital.The patients' sex,age,side and site of paracentesis,direction of puncture needle,direction of puncture needle bevel,direction of the J-Tip of the guidewire and position of the head during puncture were recorded.They were subjected to single factor analysis,and then independent risk factors for subclavian venous catheterization into ipsilateral internal jugular vein were determined with multivariate stepwise non-conditional logstic regression analysis.Results Single factor analysis showed that subclavian venous catheterization into ipsilateral internal jugular vein had no correlation with sex(P=0.504),age(P=0.504),direction of puncture needle (P=0.370),direction of puncture needle bevel (P=0.670),but had a correlation with paracentesis side (P=0.012),paracentesis site (P=0.012),direction of the J-Tip of the guidewire (P=0.000),and position of the patient head (P=0.030).Multivariate stepwise non-conditional logistic regression analysis showed that subclavian venous catheterization on the right side [odds ratio (OR) =55.373,95% confidence interval (CI):5.145-595.845,x2=10.965,P=0.001],J-Tip of the guidewire directed toward internal jugular vein (OR=24.116,95% CI:6.848-84.918,x2=24.558,P=0.000),and the head to the contralateral side of puncture(OR=3.681,95% CI:1.210-11.199,x2=5.268,P=0.022) were independent factors.A total of 29 cases (16.29%) of patients experienced invasion of ipsilateral internal jugular vein during subclavian venous catheterization.Conclusions Subclavian venous catheterization misplacement into ipsilateral internal jugular vein is common.The risk factor of the catheter misplacement into ipsilateral internal

  5. Percutaneous Placement of Central Venous Catheters: Comparing the Anatomical Landmark Method with the Radiologically Guided Technique for Central Venous Catheterization Through the Internal Jugular Vein in Emergent Hemodialysis Patients

    Energy Technology Data Exchange (ETDEWEB)

    Koroglu, M.; Demir, M.; Koroglu, B.K.; Sezer, M.T.; Akhan, O.; Yildiz, H.; Yavuz, L.; Baykal, B.; Oyar, O. [Suleyman Demirel Univ., Isparta (Turkey). Depts. of Radiology, Internal Medicine and Anesthesiology

    2006-02-15

    Purpose: To compare the success and immediate complication rates of the anatomical landmark method (group 1) and the radiologically (combined real-time ultrasound and fluoroscopy) guided technique (group 2) in the placement of central venous catheters in emergent hemodialysis patients. Material and Methods: The study was performed prospectively in a randomized manner. The success and immediate complication rates of radiologically guided placement of central venous access catheters through the internal jugular vein (n = 40) were compared with those of the anatomical landmark method (n 40). The success of placement, the complications, the number of passes required, and whether a single or double-wall puncture occurred were also noted and compared. Results: The groups were comparable in age and sex. The indication for catheter placement was hemodialysis access in all patients. Catheter placement was successful in all patients in group 2 and unsuccessful in 1 (2.5%) patient in group 1. All catheters functioned adequately and immediately after the placement (0% initial failure rate) in group 2, but 3 catheters (7.5% initial failure rate) were non-functional just after placement in group 1. The total number of needle passes, double venous wall puncture, and complication rate were significantly lower in group 2. Conclusion: Percutaneous central venous catheterization via the internal jugular vein can be performed by interventional radiologists with better technical success rates and lower immediate complications. In conclusion, central venous catheterization for emergent dialysis should be performed under both real-time ultrasound and fluoroscopic guidance.

  6. A single-center experience of 2153 tunneled-cuffed catheter insertions radiologically placed via the internal jugular vein: An evaluation of technical success and complication rates relative to underlying disease conditions

    Energy Technology Data Exchange (ETDEWEB)

    Park, Chan; Yim, Nm Yeol; Kim, Yong Tae; Noh, Hoon; Ki, So Yeon; Kim Jae Kyu; Kim, Hyoung Ook; Chang, Nam Kyu [Dept. of Radiology, Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2015-01-15

    To evaluate the technical success and complication rates of tunneled-cuffed catheter insertions radiologically placed via the internal jugular vein in patients with different types of underlying diseases. A total of 2153 tunneled-cuffed catheter insertions performed in 1926 patients between January 2008 and December 2012 were retrospectively reviewed. All procedures were conducted using sonography and fluoroscopy. The number of catheter maintenance days, technical success rates, and complication rates were analyzed based on radiologic and medical records. A total of 204809 catheter maintenance days (mean, 95.35 days; range, 0-1710 days) were recorded. Technical success was achieved in 2148 insertions (99.77%). A total of 185 complications (8.61%, 0.903/1000 catheter days) were observed, including 22 procedure-related complications (1.02%). A total of 143 catheters (6.66%) were removed due to complications. Significant differences in complication rates were observed between patients with or without underlying hematologic diseases (11.65% vs. 7.02%, respectively; p = 0.000). Significant differences in catheter thrombosis were observed between patients in which right-sided or left-sided venous approaches were used (0.81% vs. 2.70%, respectively; p = 0.010). The very high technical success rates and very low procedure-related complication rates indicate insertion of a tunneled-cuffed catheter radiologically placed via the internal jugular vein is safe and effective.

  7. Modelo experimental estável de aneurisma sacular em artéria carótida de suínos utilizando veia jugular interna Stable experimental model of carotid artery saccular aneurysm in swine using the internal jugular vein

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    Severino Lourenço da Silva Júnior

    2013-04-01

    Full Text Available OBJETIVO: Desenvolver um modelo experimental estável de aneurisma sacular em carótida de suínos utilizando veia jugular interna. MÉTODOS: Em 12 suínos sadios, com peso variando entre 25 e 50kg, cinco machos e sete fêmeas, foi confeccionado aneurisma na artéria carótida comum direita. Após arteriotomia elíptica, foi realizada anastomose terminolateral com coto distal de veia jugular interna. O volume do aneurisma era calculado de maneira que o valor não excedesse em 27 vezes o valor da área da arteriotomia. Após seis dias, era realizada angiografia e análise microscópica do aneurisma para avaliar perviedade e trombose parcial ou total. RESULTADOS: Houve ganho de peso significante dos suínos no intervalo de tempo entre a confecção do aneurisma e a angiografia (p = 0,04. Foi observada perviedade aneurismática em dez suínos (83%. Ocorreram infecções de feridas operatórias em dois animais (16,6%, ambas com início de aparecimento em três dias após a confecção do aneurisma. Análise histológica dos aneurismas mostrou trombos ocluindo parcialmente a luz em nove suínos (75%. Nesses animais, observou-se que, em média, 9% da luz aneurismática estava preenchida por trombos. CONCLUSÃO: Pôde ser desenvolvido um modelo experimental estável de aneurisma sacular em carótida de suínos utilizando veia jugular interna.OBJECTIVE: To develop an experimental model of stable saccular aneurysm in carotid of pigs using the internal jugular vein. METHODS: In 12 healthy pigs, weighing between 25 and 50kg, five males and seven females, we made a right common carotid artery aneurysm. After elliptical arteriotomy, we carried out a terminolateral anastomosis with the distal stump of the internal jugular vein. Aneurysm volume was calculated so that the value did not exceed 27 times the area of the arteriotomy. After six days angiography and microscopic examination were performed to assess patency of the aneurysm and the presence of total or

  8. Central venous infusion port inserted via high versus low jugular venous approaches: Retrospective comparison of outcome and complications

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hong Suk [Research Institute and Hospital, National Cancer Center, 809 Madu 1-dong, Ilsan-gu, Goyang-si, Gyeonggi-do 411-764 (Korea, Republic of); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)], E-mail: hpark@dreamwiz.com; Kim, Young Il; Lee, Sang Hyun; Kim, Jung Im; Seo, Hyobin; Lee, Sang Min; Lee, Youkyung; Lim, Min Kyung [Research Institute and Hospital, National Cancer Center, 809 Madu 1-dong, Ilsan-gu, Goyang-si, Gyeonggi-do 411-764 (Korea, Republic of); Park, Young Suk [Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2009-12-15

    Purpose: To retrospectively compare immediate and long-term outcome of central venous infusion port inserted via right high versus low jugular vein approaches. Materials and methods: The study included 163 patients (125 women patients, 38 men patients; age range, 18-79 years; mean age, 53 years); 142 patients underwent port insertion with low jugular vein approach and 21 patients with high jugular vein approach. The causes of high jugular vein puncture were metastatic lymphadenopathy (n = 7), operation scar (n = 6), radiation scar (n = 5), failure of low jugular vein puncture (n = 2), and abnormal course of right subclavian artery (n = 1). Medical records and radiologic studies were reviewed retrospectively to determine and compare the outcome and the occurrence of complication related to port. Results: The procedure-related complications were all minor (n = 14, 8.6%) in both groups; hematoma (n = 4, 2.8% in low jugular puncture group and n = 1, 4.8% in high jugular puncture group, p = 0.6295), air embolism (n = 2, 1.4% in low jugular puncture group and n = 0 in high jugular puncture group, p = 0.5842) and minor bleeding (n = 5, 3.5% in low jugular vein puncture group and n = 2, 9.5% in high jugular vein puncture group, p = 0.2054). The average length of follow-up was 431 days for low jugular vein puncture group and 284 days for high jugular vein puncture group. The difference between two groups was significant (p = 0.0349). The reasons for catheter removal were patients' death (59 in low jugular puncture group and 14 in high jugular puncture group, p = 0.0465), suspected infection (11 in low jugular vein puncture group and 2 in high jugular vein puncture group, p = 0.8242), catheter occlusion (four in low jugular vein puncture group and one in high jugular vein puncture group, p = 0.6583). The catheter tip migrated upward an average of 1.86 cm (range, -0.5 to 5.0 cm) in low jugular vein puncture group and 1.56 cm (range, 0-3.6 cm) in high jugular vein

  9. Trombose séptica de seios cavernosos, transverso e sigmóide e de veia jugular, associada à meningite, secundária a furúnculo nasal: Relato de Caso Septic thrombosis of cavernous, transverse, sigmoid sinuses and jugular vein, associated with meningitis, secondary to nasal furuncle: Case report

    Directory of Open Access Journals (Sweden)

    Hélio Utida

    2002-06-01

    Full Text Available Os autores descrevem um caso de furúnculo nasal que evoluiu com trombose séptica de seio cavernoso, bilateral e assimétrica, e de seios transverso e sigmóide e de veia jugular interna a esquerda, associada à meningite bacteriana, em um paciente previamente hígido. Apesar da trombose séptica extensa de seios venosos, o paciente apresentou boa evolução, após tratamento clínico agressivo com antibióticos, corticosteróides e anticoagulantes. Porém, manteve como seqüela: paresia de VI nervo à esquerda e lesão parcial de nervo óptico homolateral.The authors report a case of nasal furuncle that progressed to septic bilateral and asymmetric thrombosis of cavernous, transverse, sigmoid sinus and internal jugular vein, associated with bacterial meningitis, in a previously healthy patient. In spite of the extensive thrombosis, the patient presented a good evolution, after an aggressive clinical treatment with antibiotics, corticosteroids and anticoagulants. However, there remained paresis of the VI nerve on the left and partial lesion of the homolateral optic nerve.

  10. Optimal Axis View for Ultrasound-Guided Approach to Internal Jugular Vein Catheterization%超声引导颈内静脉穿刺置管穿刺面的选择

    Institute of Scientific and Technical Information of China (English)

    潘露菲; 苏靖诚; 李明惠; 谭宪湖

    2014-01-01

    Objective To observe the clinical effects of ultrasound-guided internal jugular vein catheterization with different axis views ,long axis view ,short axis view ,long-short axis view ,and to identify the optimal axis view for internal jugular vein catheterization .Methods One hundred and eighty patients requiring ultrasound-guided internal jugular vein catheterization were included in this study ,they were randomly divided into three groups ,long axis group , short axis group ,long-short axis group ,with 60 cases in each group .Their baseline characteristics and details of cathe-terization were recorded .Results Needle redirections , venous access time , total procedure time , technical difficulty reduced significantly in the long axis group and long-short axis group compared with short axis group ( P<0 .05 ) .The complication rates of short axis group ,long axis group,long-short axis group were 18.33%(11/60),6.67%(4/60), 1.67%(1/60),respectively.The complication rate in the long-short axis group was significantly lower than that in the short axis group ( P<0 .05 ) .Conclusion The long-short-axis ultrasound-guided technique has the benefits of long-axis and short-axis ultrasound-guided techniques ,with high first-pass success rate and less complication rate ,which is a safe,fast,and the best technique for ultrasound-guided internal jugular vein catheterization .%目的:比较超声引导下行颈内静脉穿刺置管术短轴面、长轴面和长短轴面法的临床效果,探讨最佳穿刺面。方法择期手术需行超声引导下颈内静脉穿刺置管术的患者180例,按随机数字表法分为短轴面组、长轴面组和长短轴面组,每组60例,记录一般资料和穿刺情况。结果长轴面组和长短轴面组改变方向次数、成功刺入颈内静脉时间、总穿刺时间、技术难度评分明显少于短轴面组(P<0.05)。短轴面组、长轴面组、长短轴面组并发症发生率为18.33%(11/60)、6.67

  11. Safety of a training program for ultrasound-guided internal jugular vein catheterization in critically ill patients Segurança de um programa de treinamento para punção de veia jugular interna guiada por ultrassom em pacientes críticos

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    Felippe Leopoldo Dexheimer Neto

    2011-08-01

    Full Text Available OBJECTIVES: Evaluate the safety and effectiveness of a training program for performing ultrasound-guided internal jugular vein cannulation in critically ill patients. METHODS: Cohort prospective study, evaluating adult patients admitted in a teaching intensive care unit (ICU. Catheter placement was performed by an ICU medical resident. The patient's baseline characteristics, vessel's position and operator experience were the evaluated variables. The main outcomes were cannulation success rate and incidence of major complications. RESULTS: A total of 118 consecutive patients were enrolled between May 2008 and November 2009. The success rate of ultrasound guided catheter placement was 90% (106/118, 77% in the first attempt. Major complications occurred in 4% of the cases (n = 5 and were not associated with the analyzed variables. Inability to place the guide wire was the reason for 58% (7/12 of the failures. Operators with more than 15 previous ultrasound guided cannulations had an increased success rate (95% vs. 79%, p = 0.01 and increased failure was related to previous catheterization (26% vs. 7%, p = 0.02. CONCLUSION: Learning ultrasound guidance for IJV vein cannulation was safe and feasible in ICU patients. This process was not associated to complications and better results were achieved across the spectrum of operator experienceOBJETIVO: Avaliar a segurança e efetividade de um programa de treinamento para cateterização da veia jugular interna guiada por ultrassom em pacientes críticos. MÉTODOS: Estudo de coorte prospectivo, avaliando pacientes adultos internados em uma unidade de terapia intensiva com programa de ensino. Os médicos residentes do serviço realizaram as punções de veia jugular interna guiadas por ultrassom. Foram avaliadas as características de base dos pacientes, sintopia dos vasos e experiência dos operadores. Os desfechos primários foram a taxa de sucesso da cateterização e a incidência de complica

  12. Trombosis de la vena yugular interna y mediastinitis aguda necrosante descendente debido a una faringoamigdalitis aguda Thrombosis of the internal jugular vein and descending necrotizing mediastinitis due to acute pharyngotonsilitis

    Directory of Open Access Journals (Sweden)

    Celia Sánchez Acedo

    2010-09-01

    Full Text Available El síndrome de Lemierre es una patología muy infrecuente en la época actual, pero muy grave, y siempre debe considerarse ante un cuadro de fiebre con antecedente de infección orofaríngea, tumefacción laterocervical a lo largo del músculo esternocleidomastoideo y signos de sepsis. El diagnóstico de este síndrome es fundamentalmente clínico, y las pruebas complementarias tan sólo ayudan a confirmar el cuadro. Presentamos el caso de un varón de 31 años que acudió a urgencias con clínica de faringoamigdalitis junto con tumefacción en la región submandibular izquierda e importante dolor cervical ipsilateral, que mostró un deterioro rápido y progresivo del estado general pese al tratamiento antibiótico intravenoso. Finalmente tuvo que ser intervenido debido al desarrollo de mediastinitis aguda necrosante descendente desde la región pretiroidea hasta el diafragma, con trombosis de la vena yugular interna izquierda. Se le realizó toracotomía urgente y cervicotomía izquierda con drenaje de abundante material purulento y ligadura de la vena yugular interna.Lemierre syndrome is a potentially fatal condition after an oropharyngeal infection. It is characterized by thrombophlebitis of head and neck veins with systemic dissemination of septic emboli. The diagnosis of this syndrome is mainly clinical and complementary test only serve as aid to confirm it. We report an unusual case of Lemierre syndrome in a 31-year-old man caused by Gemella spp. and Streptococcus pyogenes. It developed following a pharyngotonsillitis infection, which deteriorated rapidly and progressively despite intravenous antibiotic treatment. He finally had to be intervened due to developing acute descending necrotizing mediastinitis from the pre-thyroid region to the diaphragm, with thrombosis of the internal jugular vein. An urgent thoracotomy and left cervicotomy was performed, with drainage of abundant purulent material and ligature of the internal jugular vein

  13. Feasibility study of indwelling subcutaneous sneak method of internal jugu-lar vein puncture%皮下潜行法颈内静脉穿刺置管的可行性研究

    Institute of Scientific and Technical Information of China (English)

    张为民; 申伟林; 靳菲; 赵君; 张帅; 王聚民

    2014-01-01

    目的:皮下潜行法颈内静脉穿刺置管与中路颈内静脉穿刺置管进行比较,评价其可行性。方法选择脊柱手术病人80例,随机分为2组,每组40例,A组皮下潜行法颈内静脉穿刺置管,B组中路颈内静脉穿刺置管。观察记录总穿刺成功率、一次试穿成功率、置管成功率及并发症,并均于术后摄胸部平片观察中心静脉导管的位置,记录导管留置时间及导管相关性感染发生率。结果 A组穿刺总成功率97.50%,一次试穿成功率90.00%,无误穿动脉、气胸、血胸及导管异位等并发症发生,与B组比较无显著差异(P>0.05)。 A组导管平均留置时间(15.2±2.3)d,无导管相关性感染,B组导管平均留置时间(9.5±1.5)d,导管相关性感染4例(10.00%)。 A组导管相关感染率明显低于(P=0.04),而导管留置时间明显高于B组(P=0.00)存在明显区别。结论皮下潜行法颈内静脉穿刺置管具有操作容易、安全性大、导管留置时间长、导管相关性感染率低等特点,具有实用价值。%Objective To subcutaneous sneak method of internal jugular vein catheterization and middle internal jugular vein puncture compared catheterization, to evaluate its feasibility. Methods 80 cases of spinal operation patients, randomly divided into 2 groups, 40 cases in each group, A group was prowling the method of internal jugular vein catheterization, B group the middle internal jugular vein catheterization. Observe and record the success rate, a try on the success rate, success rate and complications of catheterization total puncture, and all the plain chest film of central venous catheter position after operation to record, indwelling catheter time and incidence of catheter related infections. Results In A group, puncture success rate of 97.50%, a try on the success rate of 90%, no errors, pneumothorax, hemothorax and perforating artery catheter heterotopia and other

  14. Emergent Median Sternotomy for Mediastinal Hematoma: A Rare Complication following Internal Jugular Vein Catheterization for Chemoport Insertion—A Case Report and Review of Relevant Literature

    Directory of Open Access Journals (Sweden)

    Saptarshi Biswas

    2014-01-01

    Full Text Available Mediastinal hematoma is a rare complication following insertion of a central venous catheter with only few cases reported in the English literature. We report a case of a 71-year-old female who was admitted for elective chemoport placement. USG guided right internal jugular access was attempted using the Seldinger technique. Resistance was met while threading the guidewire. USG showed a chronic clot burden in the RIJ. A microvascular access was established under fluoroscopic guidance. Rest of the procedure was completed without any further issues. Following extubation, the patient complained of right-sided chest pain radiating to the back. Chest X-ray revealed a contained white out in the right upper lung field. She became hemodynamically unstable. Repeated X-ray showed progression of the hematoma. Median Sternotomy showed posterior mediastinal hematoma tracking into right pleural cavity. Active bleeding from the puncture site at RIJ-SCL junction was repaired. Patient had an uneventful recovery. Injury to the central venous system is the result of either penetrating trauma or iatrogenic causes as in our case. A possible explanation of our complication may be attributed to the forced manipulation of the dilator or guidewire against resistance. Clavicle and sternum offer bony protection to the underlying vital venous structures and injuries often need sternotomy with or without neck extension. Division of the clavicle and disarticulation of the sternoclavicular joint may be required for optimum exposure. Meticulous surgical technique, knowledge of the possible complications, and close monitoring in the postprocedural period are of utmost importance. Chest X-ray showed to be routinely done to detect any complication early.

  15. Preliminary experiences of Rex shunt for extrahepatic portal vein obstruction via a conduit of internal jugular vein%颈内静脉搭桥Rex手术治疗小儿肝外门静脉梗阻的初步探讨

    Institute of Scientific and Technical Information of China (English)

    温哲; 王哲; 刘涛; 张向向; 王红英; 申刚; 张靖; 梁奇峰; 刘斐

    2016-01-01

    Objective To evaluate the outcomes of treating extrahepatic portal vein obstruction (EHPVO) by Rex shunt (superior mesenteric-left port vein bypass) with internal jugular vein graft.Methods From October 2014 to June 2015,8 patients of extrahepatic portal vein obstruction underwent Rex shunting with internal jugular vein as a venous graft.The surgical outcomes were evaluated over a follow-up period of 1-9 months.A median longitudinal abdominal incision was made.After peritoneal cavity was satisfactorily opened,round hepatic ligament was resected and lifted.For inflow vein,left portal vein in Rex recess was liberated for around 3 cm.Superior mesenteric vein was identified by tracking mid-colon vein and dissected around 3 crn for outflow.Through 2 small transverse incisions on left side of neck,7~9 cm of left internal jugular vein was harvested as a venous graft.Shunt was established by two end-to-side anastomoses at both ends of jugular vein graft between left portal and superior mesenteric veins.Results There were 5 boys and 3 girls with an average age of 4 (1.3~7) years.The manifestations included gastrointestinal hemorrhage (n =6),hypersplenism (n =6) and hemorrhage & splenomegaly (n =4).Preoperative liver function and blood coagulation were all normal while endoscopy revealed esophageal gastric varices (n =7).Portal vein cavernoma was identified by ultrasound and computed tomography (CT).Portal vein system retrograde angiography showed the presence of left portal vein bifurcation (n =7) and unidentifiable (n =1) (confirmed intraoperatively as atresia).Vascular patency of left portal vein in Rex recess was confirmed (n =7) during surgical exploration followed by Rex shunting.Warren shunt was performed for left portal vein atresia.After shunting,angiography through superior mesenteric vein demonstrated patency of vein graft,better development of intrahepatic portal system and regression of extrahepatic collateral varicose vessels.Portal vein pressure (PVP) was

  16. Application of hydrocolloid dressings in internal jugular vein catheter nursing in cardiac surgery%水胶体敷料在心外科留置颈内静脉导管患者护理中的应用

    Institute of Scientific and Technical Information of China (English)

    岳爱学; 冯箐娴; 王小芳; 杨茹冰; 曹浩

    2015-01-01

    Objective To investigate the role of hydrocolloid dressing in nursing care for internal jugular vein in-dwelling catheter in the patients with cardiac surgical operation. Methods 108 cases of patients with internal jugular vein indwelling catheter, which performed from April to December 2013 in Department of Cardiac Surgery, Shanghai East Hospital, Tongji University School of Medicine, were randomly divided into the experimental group (54 cases) and the control group (54 cases). The experimental group was applied with a hydrocolloid dressing (Algoplaque®) to fix in-ternal jugular indwelling catheter, while the control group with a 3M transparent dressing. The catheter-related local skin allergy and infection were observed in both groups. Results The occurrence rates of catheter-related local skin in-fection in the control group and the experimental group were 9.25% and 3.70%, respectively. The occurrence rates of catheter-related local skin allergy in the control group and the experimental group were 9.25%and 0.00%, respectively. The differences on both catheter-related local skin infection and allergy rates were statistically significant between the two groups (P<0.01). Conclusion The application of a hydrocolloid dressing (Algoplaque®) can significantly reduce the occurrence rates of catheter-related local skin allergy and infection, and thus deserves the clinical expansion.%目的:探讨水胶体敷料在心脏外科手术患者留置颈内静脉导管护理中的应用效果。方法选取2013年4~12月上海同济大学附属东方医院心外科留置颈内静脉导管患者108例,按照随机数字表法分为试验组(54例)和对照组(54例)。试验组采用安普贴薄膜,对照组采用3M透明敷料换药。观察两组颈内静脉穿刺点局部皮肤过敏率及局部感染率。结果对照组和试验组导管固定处局部感染发生率分别为9.25%、3.70%,局部皮肤过敏率分别为9.25%、0.00%,两组患者差异均

  17. 改进颈静脉穿刺技术在下肢深静脉血栓介入治疗中的应用%Internal jugular vein puncture techniques in interventional therapy of lower extremity deep venous thrombosis

    Institute of Scientific and Technical Information of China (English)

    张岩; 王秀平; 刘建

    2013-01-01

    Objective To evaluate the internal jugular vein puncture technique for interventional treatment of lower extremity deep venous thrombosis.Methods From February 2009 to November 2012,56 patients with lower extremity deep venous thrombosis required transjugular interventional therapy.Two methods of internal jugular vein puncture using a guide wire marking and fine needle puncture techniques was 100%without complication perforating artery.Results In 18 patients,the fine needle puncture was successful in the first attempt(12),after multiple punctures(3),unsuccessful despite repeated punctures(3)with erroneous carotid artery punctures in 2 patients.No pneumothorax,hemothorax,or cervical hematoma occurred with either technique.Conclusions Both transjugular vein puncture techniques are simple and safe with high success and low complication rates for treatment of lower extremity deep venous thrombosis.%目的:探讨改进的颈静脉穿刺技术在下肢深静脉血栓介入治疗中的应用价值。方法2009年2月~2012年11月期间,在下肢深静脉血栓介入治疗中对56例需要经颈静脉入路者,对颈内静脉穿刺进行了导丝标记法和细针穿刺法两种技术改进,观察穿刺技术改进后颈内静脉穿刺的成功率及并发症发生情况。结果38例采用导丝标记法,均一次穿刺成功,其一次穿刺成功率为100%,无1例误穿动脉;18例采用细针穿刺法,其中12例一次穿刺成功,3例多次穿刺成功,3例反复穿刺失败,2例误穿颈动脉。两种穿刺技术均未发生颈部血肿、气胸、血胸等与颈静脉穿刺相关的并发症。结论上述两种改进颈静脉穿刺技术,操作简单,成功率和安全性高,创伤小,在下肢深静脉血栓介入治疗中具有一定的应用价值。

  18. External jugular venous aneurysm: A clinical curiosity

    Science.gov (United States)

    Mohanty, Debajyoti; Jain, Bhupendra Kumar; Garg, Pankaj Kumar; Tandon, Anupama

    2013-01-01

    Jugular venous aneurysm is an extremely rare condition. The patients presented with a painless swelling in the neck that appears while coughing, straining, bending, or breath holding. Detection of a soft and compressible swelling in the course of an external jugular vein (EJV) superficial to the sternomastoid muscle, non-filling on compression of the EJV during Valsalva maneuver clinches the diagnosis of EJV aneurysm. Color Doppler ultrasound allows precise delineation of the lesion and is considered the gold standard for confirming the diagnosis. Surgical excision is indicated mostly for cosmetic reasons and symptomatic aneurysms. We, herein, report a patient with saccular external jugular venous aneurysm to highlight the typical clinical presentation and diagnosis of this rare entity. PMID:23633867

  19. Nursing Experience of Internal Jugular Vein Catheter of Patients with Severe Renal Failure Blood Dialysis%急危重症肾功能衰竭血液净化透析患者颈内静脉置管护理体会

    Institute of Scientific and Technical Information of China (English)

    陆莲英

    2013-01-01

    Objective:To internal jugular vein indwelling tube nursing care in acute and severe renal failure in hemodialysis patients,sum up the internal jugular vein indwelling clinical nursing experience and understanding on the tube. Method:92 patients with severe renal failure used internal jugular vein catheter hemodialysis therapy,the treatment of patients with tracking and timely effective nursing science at any time,nursing registration in detail. Result:92 cases were puncture,included 84 cases of right internal jugular vein,8 cases of left internal jugular vein,used Seldinger catheter technology,puncture success,without the occurrence of serious complications associated with catheterization. Conclusion:Internal jugular vein catheterization has the advantages of simple operation,less complications and infection rate,after the relevant operation after the effective specification care of internal jugular vein catheter in patients,the advantages of its remaining time is relatively long,can play a therapeutic application,for patients with renal failure and recovery has a far-reaching significance in the treatment of severe renal failure in patients with blood purification.%目的:针对颈内静脉置管护理在急危重症肾功能衰竭患者血液透析中的应用,总结出颈内静脉置管的临床护理经验及体会。方法:针对性的对92例急危重症肾功能衰竭患者进行颈内静脉置管术行血液透析治疗,随时跟踪观察患者的治疗情况并及时进行有效科学的护理,详细登记护理体会。结果:穿刺92例,其中右侧颈内静脉84例,左侧颈内静脉8例,均采用seldinger置管技术,穿刺成功,未发生与置管相关的严重并发症。结论:颈内静脉置管术具有操作简便、并发症少、感染率小等特点,经过术后有效的规范对患者颈内静脉置管护理的相关操作,其留管时间相对较长的优势,可在急危重症肾功能衰竭患者血液净化

  20. 预防PICC置管时异位入颈内静脉的改进方法%The improvement method of preventing PICC catheter heterotopia into the internal jugular vein

    Institute of Scientific and Technical Information of China (English)

    黎逢弟; 陈其欣; 练国香; 梁红梅

    2015-01-01

    Objective:To explore the effective method of preventing tube ectopic into the internal jugular vein for Peripherally inserted central catheters ( PICC) . Methods:160 patients with PICC were randomly divided into the control group and experimental group,80 cases of each group. In the control group,a position of 90° abduction was adopted between upper limb and the trunk,when the catheter tip reached the shoulders,the patients were turned over with their heads to the side. While in the experimental group,the catheter was shaping before intubation,and the patients raise their arms and close the heads to the upper limbs when the catheter tip reached the shoulders. After catheter,the comparison was made with the incidence of catheter ectopic. Results:The incidence of catheter heterotopia in experimental group was significantly lower than that of the control group (P<0. 05). Conclusion:It can reduce the inci-dence of heterotopia into the internal jugular vein catheter with shaping the catheter before intubation,and raise the patients′arms and close their heads to the upper limbs when the catheter tip reached the shoulders. It is worthy of clinical application.%目的::探讨经外周置入中心静脉导管( PICC)置管时预防导管异位入颈内静脉的有效方法。方法:将2012年10月~2014年3月我院160例行PICC置管患者随机等分为对照组和试验组,对照组采用常规的患者上肢外展与躯干呈90°体位,当导管头端到达肩部时采用偏头法;试验组送管前对导管进行塑形、当导管头端送至肩峰时再采用举臂贴头体位。置管后比较导管异位入颈内静脉的发生率。结果:试验组导管异位入颈内静脉的发生率明显低于对照组,两组比较差异有统计学意义(P<0.05)。结论:在PICC置管时采用对导管塑形和举臂贴头法能明显降低导管异位入颈内静脉的发生率,值得临床推广应用。

  1. Safe and easy method with little modification in technique is useful for successful internal jugular vein cannulation on the same side even after intra-arterial puncture without using ultrasound guidance in adult cardiac patients

    Directory of Open Access Journals (Sweden)

    Rajesh Thosani

    2016-01-01

    Full Text Available Background: The modification in technique is useful for successful right-sided internal jugular vein (IJV cannulation on the same side even after intra-arterial puncture without using ultrasound guidance in adult patients. Materials and Methods: This study was carried out in total 160 adult patient from American Society of Anesthesiologists Grade II to III patients male (n = 95 and female (n = 65 who underwent cardiac surgery where cannulation was done on right sided by triple lumen catheter (7 French using Seldinger technique. Results: Majority of patients were cannulated successfully by Seldinger technique with single or double attempt except for five patients in which arterial puncture occurred. All five patients were cannulated successfully on the same side with this modified technique without any significant major complications. They were managed by application of blocker at the end of arterial needle puncture without removing it. In our routine practice, we were used to removing this needle and applying compression for few minutes to prevent hematoma formation after an arterial puncture. In this study, cannula was used as a marker or guideline for the relocation of IJV on the same side and recannulation was performed by changing the direction of needle on same side lateral to the previous one and without going towards the same direction to prevent the arterial puncture again. Conclusion: Most simple and useful modified technique for institutes where the complications are most common with trainee doctors and in hospitals where there is no advanced facility like ultrasound-guided cannulation available. By this modification, it will be time saving, very comfortable, and user-friendly technique with high success rate.

  2. Flebectasia jugular em crianças: relato de caso Jugular phlebectasia in children: a case report

    Directory of Open Access Journals (Sweden)

    Raquel C. de Oliveira

    2004-04-01

    Full Text Available Massas cervicais na infância que aparecem apenas ao esforço físico são raras, tendo como principais diagnósticos diferenciais laringocele, cisto ou tumor do mediastino superior e flebectasia jugular. A flebectasia jugular é uma dilatação sacular ou fusiforme anormal da veia jugular. Relatamos um caso de flebectasia de veia jugular externa em uma criança saudável. Várias hipóteses têm sido propostas para explicar a etiologia da flebectasia jugular, dentre elas, a anormalidade anatômica de sua parede, compressão mecânica da veia braquiocefálica, lesões adquiridas da veia e idiopática. Geralmente, é uma condição assintomática, cujo diagnóstico pode ser estabelecido a partir de uma forte suspeita clínica, sendo comprovado por exames complementares. O tratamento pode ser conservador ou cirúrgico dependendo da sintomatologia.Neck masses that appear only on straining are rare in children and should be differentiated between laryngoceles, superior mediastinal tumors or cysts and jugular phlebectasia. The latter being an abnormal fusiform or saccular dilatation of the jugular vein. We report a case of external jugular phlebectasia in a healthy child. A variety of ethiological hypotheses have been proposed: anatomic abnormality of the vein, mechanical compression of the brachiocephalic vein, acquired lesion of the vein and idiopathic. Most patients are asymptomatic, the diagnosis can be established clinically and confirmed by imaging studies. Conservative or surgery management will be chosen according to the symptoms.

  3. A RARE CASE OF EXTENSIVE THROMBOSIS OF INFERIOR VENA CAVA, PORTAL VEIN, SPLENIC VEIN AND SUPERIOR MESENTRIC VEIN

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    Giridhar

    2015-03-01

    Full Text Available While the most common presentation of venous thromboembolic disease is deep vein thrombosis (DVT or pulmonary thromboembolism, rarer manifestations are thrombosis of jugular vein, cerebral sinus and inferior vena cava. Here we are presenting a rare case of inferior vena caval thrombosis with multiple thrombus in portal vein, splenic vein and superior mesenteric vein

  4. Jugular venous oximetry

    Directory of Open Access Journals (Sweden)

    Avanish Bhardwaj

    2015-01-01

    Full Text Available The measurement of saturation of venous blood as it drains out of brain by sampling it from the jugular bulb provides us with an estimate of cerebral oxygenation, cerebral blood flow and cerebral metabolic requirement. Arterio-jugular venous difference of the oxygen content (AVDO 2 and jugular venous oxygen saturation (SjVO 2 values per se helps clinicians in identifying the impairment of cerebral oxygenation due to various factors thereby prompting implementation of corrective measures and the prevention of secondary injury to the brain due to ischaemia. SjVO 2 values are also used for prognostication of patients after traumatic brain injury and in other clinical situations. Sampling and measuring SjVO 2 intermittently or continuously using fibreoptic oximetry requires the tip of the catheter to be placed in the jugular bulb, which is a relatively simple bedside procedure. In the review below we have discussed the relevant anatomy, physiology, techniques, clinical applications and pitfalls of performing jugular venous oximetry as a tool for measurement of cerebral oxygenation.

  5. Streptococcus pyogenes Phospholipase A2 Induces the Expression of Adhesion Molecules on Human Umbilical Vein Endothelial Cells and Aorta of Mice

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    Masataka Oda

    2017-06-01

    Full Text Available The Streptococcus pyogenes phospholipase A2 (SlaA gene is highly conserved in the M3 serotype of group A S. pyogenes, which often involves hypervirulent clones. However, the role of SlaA in S. pyogenes pathogenesis is unclear. Herein, we report that SlaA induces the expression of intercellular adhesion molecule 1 (ICAM1 and vascular cell adhesion molecule 1 (VCAM1 via the arachidonic acid signaling cascade. Notably, recombinant SlaA induced ICAM1 and VCAM1 expression in human umbilical vein endothelial cells (HUVECs, resulting in enhanced adhesion of human monocytic leukemia (THP-1 cells. However, C134A, a variant enzyme with no enzymatic activity, did not induce such events. In addition, culture supernatants from S. pyogenes SSI-1 enhanced the adhesion of THP-1 cells to HUVECs, but culture supernatants from the ΔslaA isogenic mutant strain had limited effects. Aspirin, a cyclooxygenase 2 inhibitor, prevented the adhesion of THP-1 cells to HUVECs and did not induce ICAM1 and VCAM1 expression in HUVECs treated with SlaA. However, zileuton, a 5-lipoxygenase inhibitor, did not exhibit such effects. Furthermore, pre-administration of aspirin in mice intravenously injected with SlaA attenuated the transcriptional abundance of ICAM1 and VCAM1 in the aorta. These results suggested that SlaA from S. pyogenes stimulates the expression of adhesion molecules in vascular endothelial cells. Thus, SlaA contributes to the inflammation of vascular endothelial cells upon S. pyogenes infection.

  6. Evaluación hidromecánica de venas yugulares bovinas frescas y fijadas en glutaraldehído para uso como bioimplante cardiovascular Hydromechanical evaluation of bovine jugular veins fixed in glutaldehyde for its use as cardiovascular implant

    Directory of Open Access Journals (Sweden)

    John Bustamante

    2007-08-01

    Full Text Available Muchas de las enfermedades cardiovasculares congénitas pueden intervenirse mediante cirugía, con implantes biológicos o artificiales, lo cuales permitirán restablecer la funcionalidad del sistema cardiovascular. Por sus propiedades, los injertos biológicos procedentes de donantes cadavéricos (homoinjertos son los más apropiados para cirugías reconstructivas del tracto de salida ventricular, pero infortunadamente son difíciles de adquirir ya que se obtienen de donantes con pocas semanas de nacidos, pretendiendo que se correlacionen con las dimensiones y geometría de la estructura nativa a reparar. Con este proyecto se evaluó el comportamiento hidrodinámico de tramos valvulados de venas yugulares bovinas, obtenidas en la Central Ganadera de Medellín, montando el segmento venoso de estudio en un banco de pruebas que emulaba las condiciones del tracto de salida del ventrículo derecho y tronco de la pulmonar, con el fin de analizar su comportamiento en condiciones similares a las que debe afrontar el vaso como bioimplante en la corrección de alteraciones cardiovasculares congénitas en neonatos y niños.Many congenital heart diseases may be treated surgically with biological or artificial implants that will allow the restoration of cardiovascular system functionality. Due to its properties, the biologic implants obtained from dead donors (homografts are the most appropriate for ventricular output reconstructive surgeries. Unfortunately, these are difficult to acquire, because they are obtained from newborn donors and may be correlated to the dimensions and geometry of the native structure to be repaired. This project evaluated the hydrodynamic behavior of valvular segments of bovine jugular veins (obtained from the Livestock Central in Medellin, mounting the venous segment on a test bank that simulated the right ventricle output tract and the pulmonary trunk, in order to analyze its behavior in similar conditions to those that the

  7. Brachial plexus palsy due to subclavian artery pseudo aneurysm from internal jugular cannulation

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    Modi Manisha

    2007-01-01

    Full Text Available Internal jugular vein is the preferred route for central venous cannulation because of easy accessibility and high success rate. Arterial puncture is the most common complication, the reported incidence being 9.3%. However, brachial plexus palsy following arterial puncture is a rare complication of this procedure. We report a case of brachial plexus palsy due to compression by right subclavian pseudoaneurysm as a result of internal jugular vein cannulation in chronic renal failure patient.

  8. Ultrasound-guided Techniques for Puncture and Catheterization of Internal Jugular Vein in Patients with Severe Trauma%超声引导颈内静脉穿刺置管术在重症创伤患者中的应用

    Institute of Scientific and Technical Information of China (English)

    范娟; 李宏; 杜建文

    2013-01-01

    Objective To explore the value of ultrasound-guided puncture and catheterization of the internal jugular vein in patients with severe trauma. Methods The right internal jugular vein was identified with ultrasound and centered on the screen. Ultrasound-Guided puncture and catheterization of the internal jugular vein was performed in real time after local anesthesia. Results In 50 cases, the success rate of puncture and catheterization at the first attempt was 100% during 1 to 3 min, without any complications including artery injury, hemorrhage, pneumothorax and nerve injury. Conclusion First-aid fast track can save time for emergency operation. Ultrasound-guided techniques can significantly improve the safety and effectiveness of catheterization. Compared with traditional method of anatomy, ultrasound -guided techniques have the significant advantages of improvement of successful rate of first attempt, reduction of the complication and time, which are the powerful tool of vascular access, especially for the critically ill.%目的:探讨超声引导技术对严重创伤患者行颈内静脉穿刺置管的应用价值.方法:首先选择并用超声技术定位右侧颈内静脉,局麻后,超声引导直视完成颈内静脉穿刺插管.结果:50例患者均1次穿刺成功并顺利置入中心静脉导管,成功率100%,穿刺时间为1~3 min;无动脉损伤、出血、气胸、神经损伤等并发症.结论:绿色通道手术目的是争取抢救时间,超声引导是提高血管置管安全性和有效性的有效手段.相对于传统的解剖定位法,它可以提高一针到位率、总成功率、降低并发症和减少置管时间,其已成为建立血管通路的有力工具,特别适合应用于危重患者的快速抢救.

  9. 端坐位对经外周静脉留置中心静脉导管异位至颈内静脉的复位效果观察%The role of sitting-up-straight position on correction of PICC heterotopia in internal jugular vein

    Institute of Scientific and Technical Information of China (English)

    邓德琴; 赵加全; 韩兴平

    2014-01-01

    Objective To study the role of sitting-up-straight position on correction of peripherally inserted central catheter(PICC)heterotopia in internal jugular vein.Methods 104 cases with PICC heterotopia in internal jugular vein were collected, and randomly divided into the observation group and the control group, 52 cases in each group. The patients with PICC heterotopia in the observation group were instructed to take the position of sitting up straight, while the control group were in horizontal position.Results The reduction rate of observation group was 98.08%(51/52), which was significantly higher than the control group of 94.23%(49/52).Conclusion sitting-up-straight position on correction of peripherally inserted central catheter(PICC)heterotopia in internal jugular vein is simple and convenient, and good for higher reduction rate.%目的:研究分析端坐位对经外周静脉留置中心静脉导管(PICC)异位至颈内静脉复位的临床效果。方法选取2011年3月~2013年11月治疗采取PICC置管且导管异位至颈内静脉复位者104例,随机将其分成观察组与对照组两组,每组52例,对照组患者选择平卧位复位;观察组患者选择端坐位复位。结果观察组患者复位的成功率为98.08%(51/52),明显高于对照组的94.23%(49/52),差异有统计学意义(P<0.05)。结论端坐位对PICC导管异位至颈内静脉的复位成功率更高。

  10. Prospects of Jugular Venous Pulse Assessment

    Directory of Open Access Journals (Sweden)

    M D Bhattarai

    2010-09-01

    Full Text Available There is no controversy regarding the current clinical method of examination of waveform of jugular vein pulse. However there are limitations of clinical assessment of central venous pressure by jugular vein pressure measurement from the level of sternal angle. There are variations in the reported distances from sternal angle to right atrium as well as to upper limit of JVP. In erect position, anterior end of fourth intercostal space is at about the level of mid-right atrium. In patients with visible JVP at neck in erect position, measurement of CVP can be done more accurately directly from the anterior end of fourth intercostal space. For others, the position of mid-right atrium can be marked in lateral chest wall first in erect position at the mid-point of an anteroposterior line from anterior end of fourth intercostal space to back. Subsequently in reclining position, the vertical height of venous pressure can be measured from the horizontal plane of the midpoint marked at lateral chest wall to visible upper limit of JVP. Such measurement can be done in a more reliable way with venous pressure (VP manometer with its indicator rod at the horizontal plane of mid-right atrium and with its horizontal surface at upper limit of JVP. The venous pressure manometer can also be used to measure relatively less reliable upper limb venous pressure (ULVP, as indicated by the vertical distance at which veins of upper limb collapse, especially when JVP is not visualized due to subnormal CVP as in hypovolemia. Keywords: CVP, JVP, right atrium, sternal angle, upper limp venous pressure, venous pressure, venous pressure manometer

  11. Human Internal Jugular Valve M-mode Ultrasound Characterization

    OpenAIRE

    Menegatti, Erica; Tessari, Mirko; Gianesini, Sergio; Vannini, Maria Elena; Sisini, Francesco; Zamboni, Paolo

    2013-01-01

    In humans the mechanism governing the internal jugular vein (IJV) valve opening and closure is still unclear. M-mode is used in echo-cardiology for the heart valves assessment. Sometimes it was performed also in deep peripheral veins and in vena cava assessment, but never in the IJV valve. Aim of the present study is to investigate the IJV valves physiology in healthy volunteers, by means of both B and M-mode ultrasound. Eighty-three (83) healthy volunteers (35 Male, 48 Female, 25.7±6.7 y.o.)...

  12. Ligation of superior mesenteric vein and portal to splenic vein anastomosis after superior mesenteric-portal vein confluence resection during pancreaticoduodenectomy – Case report

    Directory of Open Access Journals (Sweden)

    Jianlin Tang

    2014-12-01

    Conclusion: The lessons we learned are (1 Before SMPV confluence resection, internal jugular vein graft should be ready for reconstruction. (2 Synthetic graft is an alternative for internal jugular vein graft. (3 Direct portal vein to SMV anastomosis can be achieved by mobilizing liver. (4 It is possible that venous collaterals secondary to SMV tumor obstruction may have allowed this patient's post-operative survival.

  13. 五甲基槲皮素对行颈静脉移植的心肌重构大鼠的治疗作用%Treatment of 3,3',4',5,7-Pentamethylquercetin for myocardial remodeling rat with jugular Vein graft

    Institute of Scientific and Technical Information of China (English)

    毛张凡; 徐小惠; 黄杰; 耿庆

    2012-01-01

    目的 研究五甲基槲皮素(PMQ)对行自体颈静脉移植的心肌重构大鼠模型的治疗作用.方法 30只SD大鼠随机分为模型组、溶剂组和治疗组,建立大鼠颈部自体静脉移植模型后,每晨分别给予生理盐水、溶剂和25 mg/kg PMQ灌胃,均于第15天开始皮下注射血管紧张素Ⅱ[Ang Ⅱ,288 μg/(kg·d)],于21 d后取材.测量心脏指数、左心指数,测量心肌羟脯氨酸含量,免疫组化测量胶原I、Ⅲ容积分数(CVF)比值CVF I/Ⅲ;测量新生内膜和中膜的厚度比及面积比.结果 PMQ能显著抑制心肌的肥厚及纤维化,并能抑制移植静脉内膜的增生,而溶剂则无此作用.结论 PMQ对心肌重构及移植静脉内膜增生均有改善作用,有潜力成为冠状动脉旁路移植术(CABG)术后的治疗药物.%Objective To investigate the treatment effect of Pentamethylquercetin (PMQ) on Ang Ⅱ induced cardiac remodeling rats with jugular vein graft. Methods 30 SD rats were randomly assigned to 3 groups with 10 rals in each group. Reversed jugular vein was implanted into the carotid artery and Angiotensin Ⅱ [Ang Ⅱ , 288 μg/(kg-d)] was injected sub-culaneously daily from the 15i.h day in all rats. Saline, solvent and PMQ (25 mg/kg) were administrated daily via gavage for 21 days in control group, solvent group and PMQ treatment group. The rats were euthanized on the 21st day, the vein grafts and hearts were harvested. The heart weigh! index and the left ventricular weight index were measured; myocardial hydrox-yproline content was measured; CVF Ⅰ /Ⅲ was calculated; intimal hypcrplasia of ihe vein grafts was assessed. Results Myocardial hypertrophy and fibrosis were decreased by PMQ and intimal hyperplasia was reduced, the effect was not found in solvent Conclusion PMQ can improve the cardiac remodeling and neoinlima hyperplasia of vein graft, so PMQ has the potential to therapy patients with coronary heart disease that have accepted coronary artery bypass grafting

  14. Segmentation method for the portal vein and aorta based on pyramid model and Mean Shift algorithm%基于金字塔模型和Mean Shift算法的门静脉和主动脉分割方法

    Institute of Scientific and Technical Information of China (English)

    郑建立; 于颖; 陈兆学; 聂生东

    2011-01-01

    目的 基于目前临床在绘制肝门静脉和主动脉的时间-密度曲线方面存在的问题,提出一种准确分割肝脏CT灌注成像(CTPI)图中肝脏门静脉和主动脉的方法.方法 采用金字塔模型,结合Mean Shift分割算法对肝脏CTPI图像中的门静脉和主动脉进行分割,并在此基础上计算时间一密度曲线.结果 此方法能实现对肝脏CTPI图像中门静脉和主动脉的有效分割,绘制出准确、平滑而无毛刺的门静脉和主动脉的时间-密度曲线.结论 此方法有助于临床客观、准确地评估肝功能和诊断病变.%Objective To develop a method for accurate segmentation of the portal vein and aorta parts in CT perfusion imaging (CTPI) of liver, and to solve problems existing in drawing of clinic time-density curve of the portal vein and aorta.Methods Combining the pyramid model and the Mean Shift algorithm to segment the portal vein and aorta from the liver CT PI, the time-density curve (TDC) of portal vein and aorta were drawn based on the obtained segmentation results.Results The experiment results showed that the portal vein and aorta were segmented correctly from liver CT perfusion images with the presented method.TDC of the portal vein and aorta were drawn accurately and smoothly without burrs.Conclusion The presented method is of great sense and application value for accurate evaluation on liver function and diagnosis of liver pathology.

  15. Contemporary management of jugular paragangliomas.

    Science.gov (United States)

    Wanna, George B; Sweeney, Alex D; Haynes, David S; Carlson, Matthew L

    2015-04-01

    Jugular paragangliomas are generally benign slow-growing tumors that can cause pulsatile tinnitus, hearing loss, and cranial nerves neuropathy. Progressive growth can also lead to intracranial extension. Historically, the treatment of choice for these lesions has been gross total resection. However, over the last 15 years, many groups have adopted less invasive management strategies including stereotactic radiation therapy, subtotal resection, and primary observation in order to reduce treatment-associated morbidity. The focus of this article is to review the modern management of jugular paraganglioma, highlighting the evolving treatment paradigm at the Otology Group of Vanderbilt.

  16. [The longitudinal increase of the internal jugular vein and the upper v. cava as measured between the mastoid to the heart: parameter for timing the re-operation after ventriculocardiostomy (author's transl)].

    Science.gov (United States)

    Müke, R; Glashoff, M

    1976-04-01

    Some time after ventriculo-cardiostomy in children with hydrocephalus the cardiac catheter is retracting out of the right atrium into the upper veins due to the increase of body length during growth. This might endanger proper functioning of the valve. Therefore most authors are in favour of a prophylactic elongation of the catheter by re-operation. In order to roughly predict the time for re-operation we measured course of the catheter in 4120 children. As a basis for long time supervision of children with this shunt operation we thus propose a curve of length increase of the blood vessels concerned, based on our data, in connection with the known curve of length increase of the body.

  17. Glomus jugulare tumor with intra- and extracranial extension. A case report with MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Morisako, Toshitaka; Goya, Tomokazu; Wakisaka, Shinichiro; Kinoshita, Kazuo

    1987-11-01

    A case of glomus jugulare tumor with intra- and extracranial extension is described. The patient was a 63-year-old woman who complained of gait and memory disturbances. On admission neurological examination revealed recent memory disturbance, left deafness, left XI, XIIth cranial nerve palsies, and slight ataxic gait. Roentgenogram of the skull showed an enlarged left jugular foramen with bone erosion. Plain X-ray computerized tomography scan (X-CT) indicated obstructive hydrocephalus and X-CT with contrast enhancement revealed a mass lesion in the left posterior cranial fossa extending through enlarged left jugular foramen to the extracranial space toward the level of C/sub 2/. Cerebral angiography demonstrated a large mass with blood supply from branches of left external carotid and vertebral arteries. The tumor stain was not remarkable. Left internal jugular vein was completely obstructed at the level of the second cervical vertebral body. Magnetic resonance imaging (MRI) clearly showed the tumor extending from the anterolateral portion to the second cervical vertebral body through the enlarged jugular foramen to the posterior cranial fossa. Brain stem and cerebellar hemisphere which were markedly compressed by the mass were clearly visualized. At first a ventriculo-peritoneal shunt was made and four weeks later subtotal removal of the tumor was undertaken. Histopathology of tumor specimen showed typical glomus jugulare tumor. MRI was considered to be very useful for the diagnosis and treatment of the glomus jugulare tumor with intra- and extracranial extension

  18. A rare cause of conductive hearing loss: High lateralized jugular bulb with bony dehiscence.

    Science.gov (United States)

    Barr, James G; Singh, Pranay K

    2016-06-01

    We present a rare case of pediatric conductive hearing loss due to a high lateralized jugular bulb. An 8-year-old boy with a right-sided conductive hearing loss of 40 dB was found to have a pink bulge toward the inferior part of the right eardrum. Computed tomography showed a high, lateralized right jugular bulb that had a superolaterally pointing diverticulum that bulged into the lower mesotympanum and posterior external auditory meatus. It was explained to the child's parents that it is important never to put any sharp objects into the ears because of the risk of injury to the jugular vein. A high, lateralized jugular bulb with a diverticulum is a rare anatomic abnormality. Correct diagnosis of this abnormality is important so that inappropriate intervention does not occur.

  19. How to objectively assess jugular primary venous obstruction

    Directory of Open Access Journals (Sweden)

    Paolo Zamboni

    2014-12-01

    Full Text Available Last January The Lancet published the article by Traboulsee et al. Prevalence of extracranial venous narrowing on catheter venography in people with multiple sclerosis, their sibilings, and unrelated healthy controls: a blinded, case control study. These Authors confirmed the presence of chronic cerebrospinal venous insufficiency with a high prevalence of about 70% in the Canadian population, but without significant differences between patients and healthy controls, yet. However, they used a criterion never published to assess stenosis, in alternative to the classic measurement of the diameter in the segment immediately preceding the narrowest point. Traboulsee et al. measure the stenosis along the entire length of the internal jugular vein, by comparing the maximum diameter with the narrowest point. It has been demonstrated, from normal anatomy findings, how the jugular bulb diameter normally exceeds 50% of the minimum diameter of the internal jugular vein, clearly showing the reason why Traboulsee et al. did not find significant differences between people with multiple sclerosis, their sibilings, and unrelated healthy controls. Furthermore, as the outcome measure of Traboulsee et al., wall stenosis is a neglected part of primary venous obstruction, because in the majority of cases obstruction is the consequence of intraluminal obstacles, as a considerable part of truncular venous malformations, and/or compression; rarely of external hypoplasia. Finally, several recently published methods can be adopted for objective assessment of restricted jugular flow in course of chronic cerebrospinal venous insufficiency, by the means of non invasive magnetic resonance imaging, ultrasound and plethysmography. This may help us in improving the assessment of cerebral venous return in the near future.

  20. MISPLACEMENTS OF CENTRAL VENOUS CATHETERS: INTERNAL JUGULAR VERSUS SUBCLAVIAN ACCESS IN CRITICAL CARE PATIENTS

    OpenAIRE

    2007-01-01

    Aim; In central venous catheterization (CVC), misplacement is not a rare complication since this is a blinded procedure. The aim of this study was to compare the misplacement risks of the access of internal jugular vein with that of subclavian vein catheterizations. Methods;The records of a total of 1092 patients in whom central venous catheters were placed between 2002 and 2006 in Anesthesiology Intensive Care Unit and the location of the tips was confirmed radiologically were retrospe...

  1. Mupirocin for the reduction of colonization of internal jugular cannulae: a randomized controlled trial

    NARCIS (Netherlands)

    R.L.R. Hill; A. P. Fisher; R. J. Ware; S. Wilson; M. W. Casewell

    1990-01-01

    textabstractIn a prospective study, 218 cardiothoracic patients, in whom 'Abbocath-T' cannulae had been inserted preoperatively into the internal jugular vein, were randomized to receive skin preparation of the insertion site with tincture of iodine (108 controls) or tincture of iodine followed by a

  2. Comparison of cephalic and jugular plasma lactate concentrations in sick cats: a pilot study.

    Science.gov (United States)

    Sachs, Emily K J; Julius, Tracy M; Claypool, Sean-Paul A; Clare, Monica C

    2017-03-01

    To compare plasma lactate concentration (PLC) in paired cephalic and jugular blood samples from sick cats. An additional objective was to determine whether hypotensive cats (Doppler blood pressure cats. Doppler blood pressure measurements were obtained and then blood samples were collected from both a cephalic intravenous catheter at the time of placement and from a jugular vein by direct venipuncture. There was no significant difference between the mean cephalic PLC (2.0 mmol/L, standard deviation [SD]: 1.1, min-max: 0.6-5.3) and the mean jugular PLC (2.1 mmol/L, SD: 1.6, min-max: 0.7-7.8; P = 0.88) in this population of sick cats. Hypotensive cats also had no significant difference between the mean cephalic PLC (2.8 mmol/L, SD: 1.4, min-max: 1.6-5.3) and the mean jugular PLC (3.2 mmol/L, SD: 2.6, min-max: 0.7-7.8; P = 0.77). There was not a significant difference between cephalic and jugular PLC in this population of sick cats. Further studies are needed to confirm whether cephalic and jugular PLCs may be used interchangeably in sick and hypotensive cats. © Veterinary Emergency and Critical Care Society 2017.

  3. Varicosity of the pulmonary veins

    Energy Technology Data Exchange (ETDEWEB)

    Leicher-Dueber, A.; Lindner, P.; Schild, H.; Plewe, G.

    1986-04-01

    Varicosity of the pulmonary veins is a rare anomaly of the pulmonary vascular system. The varices do not usually change in size over years, do not cause symptoms and need no therapy. However, raised left atrial pressure can cause increase in the diameter of pulmonary vein varices. A case of lung vein varicosity in the right middle and upper lobe associated with coarctation of the aorta and an anomalous upper-middle lobe vein was observed over a period of 10 years. Increase in left atrial pressure (aortic and relative mitral regurgitation) led to enlargement of the pulmonary veins.

  4. Jugular bulb diverticulum combined with high jugular bulb: a case report with CT and MRA findings

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Seog Wan [College of Medicine, Chonbuk National Univ., Jeonju (Korea, Republic of)

    2004-12-01

    Jugular bulb diverticulum is a rare condition that is characterized by the outpouching of the jugular bulb, and this can lead to hearing loss, tinnitus and vertigo. A few reports have revealed the radiologic findings about jugular bulb diverticulum, but none of them have described the MRA findings concerning this lesion. We present here the CT and MR venography findings in regards to a large high jugular blub and diverticulum we observed in a 47-year-old woman.

  5. [Internal jugular thrombophlebitis: complications of the cervical oncological surgery. A case report].

    Science.gov (United States)

    Alvarez Marcos, C A; Noval Menéndez, J; Alfonso Megido, J; Domínguez Iglesias, F; Hevia Llama, R; Ramos Barriga, M A

    1995-01-01

    Internal jugular vein thrombophlebitis is an infrequent complications, associated in the past to pharyngeal and amygdaline infections but related today to the use of catheters and intravenous drugs. The present paper reports the case of a patient who underwent total laryngectomy and functional neck dissection, developing recurrent neumonias and sepsis in the postoperative period which were secondary to an homolateral jugular thrombophlebitis. A physical exploration with no findings and the poor resolution of CT scan and ultrasound due to postsurgical alterations, lead to a late diagnosis and fatal evolution, in spite of the medical and surgical treatment.

  6. Surgery of Glomus Jugulare Tumors.

    Science.gov (United States)

    Pareschi, Roberto; Righini, Stefano; Destito, Domenico; Raucci, Aldo Falco; Colombo, Stefano

    2003-08-01

    The treatment of choice for glomus jugulare tumors is still controversial. High rates of morbidity, incomplete resection, and the aggressive behavior of these tumors are the main arguments for advocates of primary radiotherapy. However, constant refinements in skull base techniques have made complete resection of these lesions a realistic goal. The high probability of achieving local control of these tumors by surgery has convinced us to support this option strongly. Between 1993 and 2000 we diagnosed 52 glomus tumors of the temporal bone. Of these patients, only 42 had a class C lesion (glomus jugulare) and were included in this study; 37 of these patients underwent surgery, 10 of whom had intracranial extension of the disease. The overall resection rate was 96 %. Facial nerve function at 1 year was House-Brackmann grade I to II in 52 % of patients and grade III or better in 84 % of patients. Hospitalization was shorter than 14 days in 33 patients (89 %). All patients with pharyngolaryngeal palsy had sufficient compensation at discharge. Twelve vocal chord Teflon injections were performed after surgery to reduce hoarseness and aspiration. No patient died. No relapse was observed (mean follow-up, 4.9 years).

  7. Intradural jugular foramen tumors Tumores intradurais do forame jugular

    Directory of Open Access Journals (Sweden)

    João Paulo Mattos

    2004-12-01

    Full Text Available Eleven patients with jugular foramen lesions with or without extradural extension were operated at University Hospital of Campinas (UNICAMP, in Campinas, Brazil, between 1998 and 2001. Neck dissection, mastoidectomy without transposition of the facial nerve and myofascial flap reconstruction of the cranial base with an especially developed technique were carried out in 7 patients. Four patients were operated using retrosigmoid craniectomy. Total excision was accomplished in 9 cases. All patients did not show evidence of disease progression at least after 2 years follow-up. There was no mortality. New lower cranial nerve deficits occurred in 5 patients. Nine maintain or improved their preoperative status based on Karnofsky and Glasgow Outcome Scale. A complex anatomy of this region demand wide exposures for treat those tumors. For this reason, an adequate approach for curative resection of most lesions and an efficient skull base reconstruction decreasing postoperative morbidity are essential.Onze pacientes com lesões expansivas do forame jugular associadas ou não a componente extradural foram submetidos a ressecção cirúrgica no Hospital das Clínicas da Universidade Estadual de Campinas (UNICAMP entre 1998 e 2001. Foi utilizada cirurgia combinada com dissecção do pescoço, mastoidectomia sem transposição do nervo facial e técnica de reconstrução miofascial da base do crânio desenvolvida por um dos autores. Quatro pacientes foram operados via craniectomia retrosigmoidea. Ressecção total foi feita em 9 pacientes, subtotal em um e parcial em outro. Nenhum dos 11 pacientes teve progressão da doença em 2 anos de acompanhamento. Não houve mortalidade. Cinco pacientes tiveram déficits adicionais de nervos cranianos baixos. Nove pacientes mantiveram ou melhoraram suas pontuações de acordo com a escala de Karnofsky. Para adequada abordagem do paciente com tumor de forame jugular, são necessários bom conhecimento anatômico da regi

  8. Glomus jugulare (Type A: A case review

    Directory of Open Access Journals (Sweden)

    Vinod T Kandakure

    2012-01-01

    Full Text Available We report a glomus jugulare tumor in a 60 yrs old female; non diabetic, non hypertensive who presented with continuous pulsatile hissing tinnitus in right ear with progressive hearing impairment and fullness in the ear. Detailed history and examination with aid of investigations it turned out to be glomus jugulare, treated by surgical excision by post auricular hypotympanotomy approach.

  9. Ligation of superior mesenteric vein and portal to splenic vein anastomosis after superior mesenteric-portal vein confluence resection during pancreaticoduodenectomy – Case report

    Science.gov (United States)

    Tang, Jianlin; Abbas, Jihad; Hoetzl, Katherine; Allison, David; Osman, Mahamed; Williams, Mallory; Zelenock, Gerald B.

    2014-01-01

    62 year old Caucasian female with pancreatic head mass abutting the superior mesenteric vein (SMV) presented with fine needle aspiration biopsy confirmed diagnosis of ductal adenocarcinoma. CT scan showed near complete obstruction of portal vein and large SMV collateral development. After 3 months of neoadjuvant therapy, her portal vein flow improved significantly, SMV collateral circulation was diminished. Pancreaticoduodenectomy (PD) and superior mesenteric portal vein (SMPV) confluence resection were performed; A saphenous vein interposition graft thrombosed immediately. The splenic vein remnant was distended and adjacent to the stump of the portal vein. Harvesting an internal jugular vein graft required extra time and using a synthetic graft posed a risk of graft thrombosis or infection. As a result, we chose to perform a direct anastomosis of the portal and splenic vein in a desperate situation. The anastomosis decompressed the mesenteric venous system, so we then ligated the SMV. The patient had an uneventful postoperative course, except transient ascites. She redeveloped ascites more than one year later. At that time a PET scan showed bilateral lung and right femur metastatic disease. She expired 15 months after PD. Conclusion The lessons we learned are (1) Before SMPV confluence resection, internal jugular vein graft should be ready for reconstruction. (2) Synthetic graft is an alternative for internal jugular vein graft. (3) Direct portal vein to SMV anastomosis can be achieved by mobilizing liver. (4) It is possible that venous collaterals secondary to SMV tumor obstruction may have allowed this patient's post-operative survival. PMID:25568802

  10. Effect of lifting arm abutting head method on correcting displacement of PICC into internal jugular vein in preterm infants%举臂靠头法纠正早产儿PICC异位于颈静脉的效果观察

    Institute of Scientific and Technical Information of China (English)

    邓桂珍; 谭瑞贞; 邓玉环; 邵巧仪

    2015-01-01

    Objective To analyze the effect of lifting arm abutting head method on correcting displacement of PICC into internal jugular vein in preterm infants. Methods Between June 2013 to October 2014 42 premature infants with peripherally inserted central catheter ( PICC) heterotopia were selected in the study. Twenty-two of them were randomly selected in experimental group and they adopted the method of lifting arm abutting head to correct catheter heterotopia. The remaining 20 cases were in control group and adopted conventional method. Results There was statistical significance in the differences of adjusting times and successful rate between the control group and the experimental group (t=3. 89,χ2 =78. 49,P0. 05). Conclusion Lifting arm abutting head method to adjust PICC heterotopia is simple and easy to operate. It can not only help to reduce the pain of patients, but reduce patients’ family burden.%目的:分析举臂靠头法在早产儿经外周静脉穿刺置入中心静脉导管( PICC)异位于颈静脉的处理效果。方法选取2013年6月到2014年10月行PICC置管导管尖端异位于颈静脉的早产儿42例作研究对象,随机选取22例为实验组,采用举臂靠头法对异位的导管进行调整,监测调整后效果,其余20例为对照组,以常规方法调整。结果实验组调整次数及成功率与对照组相比较,两者有统计学意义(t=3.89,χ2=78.49,均P0.05)。结论采取举臂靠头法对PICC异位于颈静脉进行正位,操作简单、方便,减少病人的痛苦,减轻家庭负担。

  11. An ectopic hamartomatous thymoma compressing left jugular vein

    African Journals Online (AJOL)

    2014-05-07

    May 7, 2014 ... neck (frequently on the left) and does not usually impact adjacent ... manifests distinct pathological features, the lesion is either ... After the diagnosis and treatment of this patient, we believe that EHT or ... Department of Thoracic Surgery, School of Medicine, .... without postoperative pathology and IHC.

  12. Case of huge neurofibroma expanding extra- and intracranially through the enlarged jugular foramen. CT scan findings and surgical approach

    Energy Technology Data Exchange (ETDEWEB)

    Hanakita, Junya; Imataka, Kiyoharu; Handa, Hajime (Kyoto Univ. (Japan). Faculty of Medicine)

    1984-01-01

    The surgical approach to the jugular foramen has been considered to be very difficult and troublesome, because of the location in which important structures, such as the internal jugular vein, internal carotid artery and lower cranial nerves, converge in the narrow deep space. A case of huge neurofibroma, which extended from the tentorium cerebelli through the dilated jugular foramen to the level of the vertebral body of C/sub 3/ was presented. A 12-year-old girl was admitted with complaints of visual disturbance and palsy of the V-XII cranial nerves of the left side. Plain skull film showed prominent widening of the cranial sutures and enlargement of the sella turcica. Horizontal CT scan with contrast showed symmetrical ventricular dilatation and a heterogeneously enhanced mass, which was situated mainly in the left CP angle. Coronal CT scan with contrast revealed a huge mass and enlarged jugular foramen, through which the tumor extended to the level of the vertebral body of C/sub 3/. Occlusion of the sigmoid sinus and the internal jugular vein of the left side was noticed in the vertebral angiography. Two-stage approach, the first one for removal of the intracranial tumor and the second one for extracranial tumor, was performed for its huge tumor. Several authors have reported excellent surgical approaches for the tumors situated in the jugular foramen. By our approach, modifying Gardner's original one, a wide operative field was obtained to remove the tumor around the jugular foramen with success. Our approach for the jugular foramen was described with illustrations.

  13. A pilot/introducer needle for central vein cannulation.

    Science.gov (United States)

    Suzuki, T; Kanazawa, M; Kinefuchi, Y; Fukuyama, H; Takiguchi, M; Yamamoto, M; Abe, K; Okuda, Y

    1995-12-01

    A kit for safe and easy insertion of a central vein cannula was devised. A small gauge (22 gauge) metal pilot needle was equipped with a Y-shaped hub which had a side-port to accept a small gauge (0.46 mm) Seldinger guide wire. Once the needle reached the vein, guidewire was threaded in through the side-port. There was no need to remove the pilot needle and no need to repeat vein puncture with a larger-bore needle. Three puncture methods were used with the kit: (1) the central approach via the internal jugular vein, (2) the supraclavicular approach via the junction of the internal jugular vein and subclavian vein, and (3) the infraclavicular approach via the subclavian vein. Each method was used on 20 patients, for total of 60 patients, with a high success rate. Less than 3 minutes were required from puncture to catheter insertion. No serious complications were encountered.

  14. Seldinger Technique for Placement of "Peripheral" Internal Jugular Line: Novel Approach for Emergent Vascular Access.

    Science.gov (United States)

    Ash, Adam J; Raio, Christopher

    2016-01-01

    This is a case report describing the ultrasound-guided placement of a peripheral intravenous catheter into the internal jugular vein of a patient with difficult vascular access. Although this technique has been described in the past, this case is novel in that the Seldinger technique was used to place the catheter. This allows for safer placement of a longer catheter (2.25″) without the need for venous dilation, which is potentially hazardous.

  15. Autogenous vein graft thrombosis following exposure to calcium-free solutions (calcium paradox).

    Science.gov (United States)

    Nozick, J H; Farnsworth, P; Montefusco, C M; Parsonnet, V; Ruigrok, T J; Zimmerman, A N

    1981-01-01

    The morphological and functional effects of calcium-free and calcium-containing solutions on canine jugular vein intima were examined under conditions which closely resemble those techniques currently employed in peripheral vascular and aortocoronary bypass surgery. Veins that had been exposed only to calcium-containing solutions remained patent for the duration of the experimental period. Vein perfusion with a calcium-free solution, however, resulted in disruption of the jugular vein intima once calcium ions were reintroduced. Autogenous as a femoral arterial graft became thrombosed within 60 minutes. It is therefore suggested that vein grafts of autogenous origin be irrigated with calcium-containing solutions to prevent intimal damage and thrombosis.

  16. Primary leiomyosarcoma of the innominate vein.

    Science.gov (United States)

    Illuminati, Giulio; Miraldi, Fabio; Mazzesi, Giuseppe; D'urso, Antonio; Ceccanei, Gianluca; Bezzi, Marcello

    2007-01-01

    Primary venous leiomyosarcoma is rare. We report the case of a primary leiomyosarcoma of the left innominate vein, with neoplastic thrombus extending into the left jugular and subclavian veins. The tumor was curatively resected en bloc with anterior mediastinal and laterocervical lymphatics, through a median sternotomy prolonged into left cervicotomy. Primary venous sarcomas may be associated with prolonged survival in individual cases, with curative resection recommended as the standard treatment, in the absence of distant spread.

  17. Stenting of the Superior Vena Cava and Left Brachiocephalic Vein with Preserving the Central Venous Catheter in Situ

    Energy Technology Data Exchange (ETDEWEB)

    Isfort, Peter; Penzkofer, Tobias; Goerg, Fabian; Mahnken, Andreas H. [University Hospital RWTH Aachen, Aachen(Korea, Republic of)

    2011-10-15

    Stenting of the central veins is well established for treating localized venous stenosis. The techniques regarding catheter preservation for central venous catheters in the superior vena cava have been described. We describe here a method for stent implantation in the superior vena cava and the left brachiocephalic vein, and principally via a single jugular venous puncture, while saving a left sided jugular central venous catheter in a patient suffering from central venous stenosis of the superior vena cava and the left brachiocephalic vein.

  18. Varicose Veins

    Science.gov (United States)

    Varicose veins are swollen, twisted veins that you can see just under the skin. They usually occur in ... of the body. Hemorrhoids are a type of varicose vein. Your veins have one-way valves that help ...

  19. Collet-Sicard Syndrome from Thrombosis of the Sigmoid-Jugular Complex: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Tom P. B. Handley

    2010-01-01

    Full Text Available Purpose. Collet-Sicard syndrome is a very rare condition characterised by unilateral palsy of the IX–XII cranial nerves. It is distinguished from Villaret syndrome by lack of presence of sympathetic involvement. Current literature contains only two cases of Collet-Sicard syndrome due to idiopathic internal jugular vein thrombosis. Method and Results. We report the case of Collet-Sicard syndrome in a 30-year-old man who presented with delayed development of XIth nerve dysfunction, due to internal jugular vein-sigmoid sinus thrombosis. A multidisciplinary team approach was employed in the management of this patient. At three-month followup, he had significantly improved swallowing, and repeat computed tomography neck scan showed partial recanalisation of the right internal jugular vein. Conclusion. In suspected Collet-Sicard syndrome, a focal primary lesion or metastasis to the temporal bone must be excluded, and sigmoid-jugular complex thrombosis should be considered in the differential diagnosis. Early recognition and treatment may result in significant functional recovery.

  20. Trombectomia com cateter de Fogarty no tratamento da tromboflebite jugular experimental em eqüinos Thrombectomy with Fogarty's catheter as a treatment of induced jugular thrombophlebitis in horses

    Directory of Open Access Journals (Sweden)

    Carlos A. Hussni

    2009-01-01

    Full Text Available Trombose da veia jugular é problema freqüente na medicina eqüina, implicando muitas vezes em conseqüências fatais. O objetivo deste trabalho foi avaliar em eqüinos a aplicabilidade da trombectomia com cateter de Fogarty, técnica rotineiramente empregada pela medicina humana, no restabelecimento da perviedade vascular. Foram utilizados 10 eqüinos divididos em dois grupos de cinco animais, em que se induziu a trombose da veia jugular direita, através do acesso cirúrgico à veia e aplicação de sutura estenosante e injeção de glicose a 50%. No grupo controle avaliou-se a evolução da tromboflebite sem qualquer tipo de intervenção terapêutica. Os animais do grupo tratado foram submetidos à trombectomia com cateter de Fogarty. Foram avaliados os parâmetros clínicos gerais, regionais, ultra-sonográficos e angiográficos, nos momentos pré-indução (M-PRÉ, indução da trombose (MTI e 10 dias de evolução da trombose (M10. A técnica empregada induziu a tromboflebite, que obstruiu completamente um segmento da veia jugular de todos os animais. Os animais do grupo controle mantiveram os trombos obstruindo totalmente o lume vascular até o final do período de avaliação, sendo que avaliações regionais mostraram principalmente o edema parotídeo e o ingurgitamento vascular, cranial à tromboflebite da veia jugular. O grupo tratado apresentou as veias jugulares pérvias ao final do experimento, confirmadas pelos exames ultra-sonográficos e angiográficos, com remissão total dos sinais clínicos. Concluiu-se que a técnica da trombectomia com cateter de Fogarty foi eficiente na desobstrução da veia jugular submetida à trombose experimental.Thrombosis of jugular vein is a common problem in the equine medicine, implying frequently in fatal outcomes. The diagnosis is relatively simple, based on the clinical findings, angiographics images and ultrasonographycs. The therapeutic employed to a large extent of the cases is

  1. Partial duplication of the internal yugular vein and its relation with the espinal nerve. Description of two cases.

    Directory of Open Access Journals (Sweden)

    Luis Miguel TORRES-MORIENTES

    2016-03-01

    Full Text Available Introduction and objective: Duplication of internal jugular vein is a rare finding and, in most cases, it is diagnosed incidentally in the neck dissection. Description: We present two cases of unilateral partial duplication of the internal jugular vein after neck dissection in two patients with laryngeal carcinomas. Discussion: The internal jugular vein drains the blood of cranial cavity. Duplication can be unilateral, bilateral, partial or total. In some cases it is due to the passage of nerve structures causing a duplicate vein with an anterior and posterior branch. Conclusions: Duplication of internal jugular vein is a rare entity, but it is necessary to remember its existence in neck surgery, when reading angiograms and when placing central catheters.

  2. A comparative review of multidetector CT angiography and MRI in the diagnosis of jugular foramen lesions

    Energy Technology Data Exchange (ETDEWEB)

    Christie, A., E-mail: andychristie90@hotmail.co [Radiology Department, Institute of Neurosciences, Glasgow, Scotland (United Kingdom); Teasdale, E. [Radiology Department, Institute of Neurosciences, Glasgow, Scotland (United Kingdom)

    2010-03-15

    Aim: To compare the efficiency of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) in the diagnosis of jugular foramen lesions. Materials and methods: The imaging of 15 patients with tumours predominantly occurring at the jugular foramen was retrospectively reviewed, with postoperative pathology data available for 11 patients. MDCT was performed at arterial phase and MRI with standard sequences and contrast enhancement. All imaging was blindly re-reported by an experienced neuroradiologist. Results: Pathology reported six glomus jugulare tumours and five neuromas, which were all correctly diagnosed using MDCT. A confident diagnosis was also made in the remaining four cases based on the pattern of enhancement. Only glomus tumours enhanced in the arterial phase. Overall, MRI was used to make a confident diagnosis in eight patients. One showed no enhancement and was correctly diagnosed as a neuroma, and seven demonstrated the tumour flow voids characteristic of a glomus tumour. The remaining seven cases all showed a similar enhancement pattern and could not be confidently differentiated between a neuroma or a glomus tumour. MDCT angiography enabled a confident assessment of the jugular vein in all cases, but MRI was inconclusive in a third of cases. Also, in the nine cases of glomus tumour diagnosed using MDCT, an enlarged feeding artery was identified in eight patients. Conclusion: MDCT is more accurate than MRI in diagnosing glomus tumours, and in particular, neuromas. It also offers valuable preoperative vascular information to the surgeon.

  3. [Curriculum vitae aortae].

    Science.gov (United States)

    Solberg, S

    1998-12-10

    The Greek word aorta means lifter. The vessel was so termed because Aristotle, who first described it, assumed that the heart was lifted by/hanging in aorta. Leonardo da Vinci described the detailed anatomy of aorta. During the 17th century our present understanding of the aorta and the circulation of blood took form due to the descriptions given by William Harvey. The first known operation for abdominal aortic aneurysm was performed in London in 1817 by Sir Astley Cooper who ligated the infrarenal aorta above the aneurysm. Puncture with needles and application of electricity were later tried in order to induce thromboses in the aneurysm. In 1948 Albert Einstein was operated with wrapping of his abdominal aneurysm with cellophane. In 1955 he suffered rupture and died after having refused operation. In 1951 the first successful operation for abdominal aortic aneurysm was performed in Paris by Charles Dubost. With slight modifications, the same operative technique is used today.

  4. Dural sinus thrombosis - A rare manifestation of internal jugular venous occlusion

    Directory of Open Access Journals (Sweden)

    Pooja Binnani

    2012-01-01

    Full Text Available The dural sinus thrombosis is an uncommon complication of a commonly done procedure of central venous catheterisation. We present a case of massive hemorrhagic venous infarct with gross cerebral edema due to dural sinus thrombosis along with right internal jugular vein thrombus. A 21-year-old male patient presented to the emergency department with fever and swelling of the right neck four days following discharge after his prior hospitalization two weeks ago for acute renal failure due to severe gastroenteritis, when he underwent hemodialysis through right internal jugular access. On presentation, he was conscious, with swelling on right side of the neck, which was diagnosed as right internal jugular vein occlusion. However, he rapidly dete-riorated and developed signs of raised intracranial pressure despite being on treatment with heparin. He was diagnosed as having massive hemorrhagic cerebral venous infarct with gross cerebral edema complicated with shift of the ventricles to the left due to dural sinus thrombosis. Despite emergency decompressive craniotomy, he succumbed in the next two days due to coning. Asymptomatic catheter-related thrombosis is frequent in the intensive care units, but major complications like retrograde extension into dural sinus causing thrombosis is rare. A high index of suspicion is required to diagnose this major catastrophe for an early and meaningful intervention.

  5. Spider Veins

    Science.gov (United States)

    ... How to Choose the Best Skin Care Products Spider Veins Treatment Options Learn more about treatment options ... severe venous disease. What you should know about spider veins The exact cause of spider veins is ...

  6. Clinical value and influencing factors of intraoperative monitoring of jugular venous oxygen saturation

    Directory of Open Access Journals (Sweden)

    Jie SONG

    2016-10-01

    Full Text Available Intraoperative jugular venous oxygen saturation (SjvO2 monitoring has been widely used in clinic, which can monitor cerebral blood flow (CBF and oxygen metabolism. Reverse puncture and catheterization through jugular vein for monitoring SjvO2 is easy to operate and can collect blood samples repeatedly. It is an effective method for real-time dynamic evaluation of cerebral oxygen supply-demand and neurological function. This article reviews the clinical significance and influencing factors of SjvO2 monitoring during operation. It notes in particular that SjvO2 can not be used as the only way to monitor CBF and oxygen metabolism, and a comprehensive evaluation should be done combining with the change of other parameters. DOI: 10.3969/j.issn.1672-6731.2016.10.014

  7. Reducing intimal hyperplasia in vein grafts harvested by a no-touch harvesting technique

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    Objective To investigate the effect of no-touch harvesting technique in reducing vein graft intimal hyperplasia. Methods This longitudinal trial compared graft angiostenosis of two groups undergoing jugular vein to carotid artery interposition grafting in rabbit model. Conventional group:12 rabbits had their veins stripped,distended,and stored in heparinized saline solution. No-touch group:12 rabbits had veins removed with surrounding tissues,but were not distended,and stored in heparinized blood. The graft...

  8. Adaptation of the Main Peripheral Artery and Vein to Long Term Confinement (MARS 500)

    OpenAIRE

    Philippe Arbeille; Romain Provost; Nicole Vincent; Andre Aubert

    2014-01-01

    PURPOSE: The objective was to check if 520 days in confinement (MARS 500), may affect the main peripheral arterial diameter and wall thickness and the main vein size. METHOD: Common carotid (CC) femoral artery (FA) portal vein (PV), jugular (JG), femoral vein (FV) and tibial vein were assessed during MARS 500 by echography, performed by the subjects. A hand free volumic echographic capture method and a delayed 3D reconstruction software developed by our lab were used for collecting and measur...

  9. Coarctation of the Aorta

    Science.gov (United States)

    ... of the aorta (aneurysm) Aortic rupture or tear (dissection) Premature coronary artery disease — narrowing of the blood ... have a higher risk of aortic rupture, aortic dissection or other complications during pregnancy and delivery. Doctors ...

  10. Complete morphometric analysis of jugular foramen and its clinical implications

    Science.gov (United States)

    Das, Sushant Swaroop; Saluja, Sandeep; Vasudeva, Neelam

    2016-01-01

    Introduction: Tumors affecting structures in the vicinity of jugular foramen such as glomus jugulare require microsurgical approach to access this region. These tumors tend to alter the normal architecture of the jugular foramen by invading it. Therefore, it is not feasible to have correct anatomic visualization of the foramen in the presence of such pathologies. Hence, a comprehensive knowledge of the jugular foramen is needed by all the neurosurgeons while doing surgery in this region. Aim: Due to the inadequate knowledge of the accurate morphology of the jugular foramen in different sexes, the aim of this osteological study was to provide a complete morphometry including gender differences and describe some morphological characteristics of the jugular foramen in an adult Indian population. Materials and Methods: The study was done on 114 adult human dry skulls (63 males and 51 females) collected from the osteology museum in the department. Various dimensions of both endo- and exocranial aspect of jugular foramen were measured. Presence and absence of domed bony roof of jugular fossa and compartmentalization of jugular foramen were also noticed. Statistical analysis was done using Chi-square test and Student's t-test in SPSS version 23. Results: All the parameters of right jugular foramen were greater than the left side, except the distance of stylomastoid foramen from lateral margin of jugular foramen (SMJF) which was greater on the left side. Gender differences between various measurements of jugular foramen, presence of dome of jugular fossa, and compartmentalization patterns were reported. Conclusion: This study gives knowledge about the various parameters, anatomical variations of jugular foramen in both sexes of an adult Indian population, and its clinical impact on the surgeries of this region. PMID:27891036

  11. Seldinger Technique for Placement of “Peripheral” Internal Jugular Line: Novel Approach for Emergent Vascular Access

    OpenAIRE

    2016-01-01

    This is a case report describing the ultrasound-guided placement of a peripheral intravenous catheter into the internal jugular vein of a patient with difficult vascular access. Although this technique has been described in the past, this case is novel in that the Seldinger technique was used to place the catheter. This allows for safer placement of a longer catheter (2.25″) without the need for venous dilation, which is potentially hazardous.

  12. Seldinger Technique for Placement of “Peripheral” Internal Jugular Line: Novel Approach for Emergent Vascular Access

    Directory of Open Access Journals (Sweden)

    Adam J. Ash, DO

    2016-01-01

    Full Text Available This is a case report describing the ultrasound-guided placement of a peripheral intravenous catheter into the internal jugular vein of a patient with difficult vascular access. Although this technique has been described in the past, this case is novel in that the Seldinger technique was used to place the catheter. This allows for safer placement of a longer catheter (2.25” without the need for venous dilation, which is potentially hazardous.

  13. Jugular venous pooling during lowering of the head affects blood pressure of the anesthetized giraffe

    DEFF Research Database (Denmark)

    Brøndum, E.; Hasenkam, John Michael; Secher, Niels H.;

    2009-01-01

    in the upright position so that we could lower the head. In the upright position, mean arterial pressure (MAP) was 193 +/- 11 mmHg (mean +/- SE), carotid flow was 0.7 +/- 0.2 l/min, and carotid cross-sectional area was 0.85 +/- 0.04 cm(2). Central venous pressure (CVP) was 4 +/- 2 mmHg, jugular flow was 0...... veins collapsed and blood was returned to the central circulation, and CVP and cardiac output were restored. The results demonstrate that in the upright-positioned, anesthetized giraffe cerebral blood flow is governed by arterial pressure without support of a siphon mechanism and that when the head.......7 +/- 0.2 l/min, and jugular cross-sectional area was 0.14 +/- 0.04 cm(2) (n = 4). Carotid arterial and jugular venous pressures at head level were 118 +/- 9 and -7 +/- 4 mmHg, respectively. When the head was lowered, MAP decreased to 131 +/- 13 mmHg, while carotid cross-sectional area and flow remained...

  14. Coarctation of the Aorta

    Science.gov (United States)

    ... of any of these risk factors or a family history of congenital heart disease. Complications Untreated coarctation of the aorta frequently leads to complications. Some complications may be a result of long-standing high blood pressure caused by the aortic coarctation. Complications are also possible ...

  15. Jugular valve function and petrosal sinuses pressure: a computational model applied to sudden sensorineural hearing loss

    Directory of Open Access Journals (Sweden)

    Mirko Tessari

    2017-04-01

    Full Text Available Reports of extra-cranial venous outflow disturbances have recently been linked to sudden sensorineural hearing loss (SSNHL. Aims of the present study are: i to quantify, with mathematical model, the impact of jugular valve function on the pressure of the superior and inferior petrosal sinuses (SPS, IPS and the main auricolar veins; ii to verify the feasibility of the application of mathematical model in the clinical setting in terms of consistency respect to the usual measures of SSNHL outcome. Extra-cranial venous outflow and post analysis were respectively blindly assessed by echo colour-Doppler (ECD and a validated mathematical model for the human circulation. The pilot study was conducted on 1 healthy control and in a group of 4 patients with different outcome of SSNHL. The main finding was the significant increased pressure calculated in the SPS and IPS of patients with ipsilateral jugular obstruction due to not mobile valve leaflets (6.55 mmHg, respect to the other subjects without extracranial complete obstruction (6.01 mmHg, P=0.0006. Moreover, we demonstrated an inverted correlation between the extrapolated pressure values in the SPS/IPS and the mean flow measured in the correspondent internal jugular vein (r= –0.87773; r-squared= 0.7697; P=0.0009. The proposed mathematical model can be applied to venous extra-cranial ECD investigation in order to derive novel clinical information on the drainage of the inner ear. Such clinical information seems to provide coherent parameters potentially capable to drive the prognosis. This innovative approach was proven to be feasible by the present pilot investigation and warrants further studies with an increased sample of patients.

  16. Unrecognised guide wire migration during internal jugular cannulation and its retrieval--a case report.

    Science.gov (United States)

    Adenekan, A T; Onakpoya, U U; Faponle, A F; Olateju, S O

    2013-03-01

    The objective of this article is to report a case of unrecognised missed guide wire diagnosed two months after right internal jugular cannulation and which was successfully retrieved from the right femoral vein. The case record of a patient that had retained intravenous guide wire was reviewed with relevant literature. A 40-yr-old female had an emergency left thoracotomy on account of haemorrhagic pleural effusion. A right internal jugular central venous catheter (CVC) insertion was performed for resuscitation and haemodynamic monitoring before induction of anaesthesia. A follow-up thoraco-abdominal Computed tomography (CT) scan taken after 8 weeks showed a pigtail intravascular metallic foreign body traversing the distal superior vena cava, right atrium, inferior vena cava, and ending at the right femoral vein. The guide wire was successfully removed via a right femoral venotomy under local anaesthesia. Intravascular loss of a guide wire is a rare complication of CVC insertion. If basic precautionary measures were taken, the loss of guide wire would have been avoided.

  17. Direct US-guided puncture of the innominate veins for central venous access.

    Science.gov (United States)

    Lau, T N; Kinney, T B

    2001-05-01

    Maintenance of functioning venous access is recognized as the Achilles heel of long-term hemodialysis treatment. In patients who require catheter-directed hemodialysis, the internal jugular veins are recognized as the optimal veins for insertion of dialysis catheters. When these sites are no longer available, alternative venous access sites are required. The authors describe two hemodialysis patients with limited access sites in whom hemodialysis catheters were successfully inserted directly into the innominate veins with use of ultrasound-guided punctures.

  18. Infecção de corrente sanguínea relacionada a cateter venoso central (ICSRC em enfermarias: estudo prospectivo comparativo entre veia subclávia e veia jugular interna Catheter-associated bloodstream infections (CA-BSI in wards: a prospective comparative study between subclavian and jugular access

    Directory of Open Access Journals (Sweden)

    Gustavo Lopes Gomes Siqueira

    2011-09-01

    Full Text Available CONTEXTO: Hemocultura positiva associada a cateter venoso central tem sido estudada em unidades de terapia intensiva (UTI, mas ainda é controverso se o acesso jugular tem maior incidência de complicações infecciosas que o acesso na veia subclávia. OBJETIVO: Comparar índice de infecção entre os acessos na jugular interna e os na veia subclávia em pacientes internados nas enfermarias de cirurgia. MÉTODOS: Estudo prospectivo, descritivo e comparativo com 114 cateteres em 96 pacientes admitidos nas enfermarias de cirurgia de um Hospital Quaternário, tendo como variáveis o local de inserção, número de lumens, tempo de uso, comparando-os com o índice de complicações infecciosas. RESULTADOS: O índice de infecção foi de 9,64% (11 cateteres, sem significância estatística quando comparados o número de lumens (mono versus duplo e infecção (p=0,274; também sem significância estatística a comparação entre o tempo de uso (>14 dias e infecção (p=0,156. Comparando os acessos jugular e subclávia, encontramos significância estatística tendo infecção em 17,2% na subclávia e 1,8% na jugular, com p=0,005. Índice de Hemocultura positivo associado a cateter venoso central foi maior no acesso subclávia quando comparado com jugular interna, com OR 11,2, IC95% (1,4-90,9; p=0,023. CONCLUSÕES: O acesso venoso central na jugular interna tem menor risco de infecção se comparado com subclávia em enfermarias.BACKGROUND: Positive hemoculture associated with central venous catheters has been studied in intensive care units (ICU, but is still controversial if the internal jugular vein access has a higher incidence of infection than subclavian or femoral vein access. OBJECTIVE: To compare catheter-related bloodstream infection (CABSI rates between internal jugular and subclavian vein access in patients admitted to surgical wards. METHODS: This is a prospective, descriptive and comparative study of 114 central venous catheters placed in

  19. Subdiaphragmatic venous stasis and tissular hypoperfusion as sources of metabolic acidosis during passive portal-jugular and caval-jugular bypasses in dogs Estase venosa subdiafragmática e hipoperfusão tissular como fontes de acidose metabólica durante desvios porta-jugular e cava-jugular passivos em cães

    Directory of Open Access Journals (Sweden)

    Antônio Roberto de Barros Coelho

    2000-06-01

    Full Text Available Subdiafragmatic venous decompression during anhepatic stage of canine orthotopic liver transplantation attenuates portal and caval blood stasis and minimize hipoperfusion and metabolic acidosis observed with occlusion of portal and caval veins. During two hours, six dogs submitted to portal-jugular and caval-jugular passive shunts, with maintenance of arterial hepatic flow, were evaluated for pH, carbon dioxide tension (PCO2, base deficit (BD and oxygen tension (PO2 in portal, caval and systemic arterial blood, as well as for increments of BD (DBD in portal and caval blood. With a confidence level of 95%, the results showed that: 1. There were not changes of pH anDBD in portal and systemic arterial blood in the majority of studied times; 2. There was metabolic acidosis in caval blood; 3. The negative increments of BD (DBD were higher in caval blood than in splancnic venous blood at T10, T30 and T105; and, 4. Deoxigenation of portal and caval blood were detected. Acid-base metabolism and oxigenation monitoring of subdiaphramatic venous blood can constitute an effective way to evaluate experimental passive portal-jugular and caval-jugular bypass in dogs.A descompressão venosa subdiafragmática durante a fase anhepática do transplante ortotópico de fígado em cães atenua a estase de sangue nas veias Porta e Cava Inferior e minimiza a hipoperfusão tissular e a acidose metabólica observadas na oclusão dessas veias. Durante duashoras, seis cães submetidos a desvios porta-jugular e cava-jugular passivos, com permanência do fluxo arterial hepático, foram avaliados através de pH, PCO2, DB e PO2 no sangue portal, da Veia Cava Inferior e arterial sistêmico, bem como por incrementos de DB (DDB no sangue portal e da Veia Cava Inferior. Os resultados obtidos permitem concluir com uma confiança de 95% que: 1. Não foram constatadas alterações de pH e DB no sangue portal e arterial sistêmico na maioria dos tempos estudados; 2. Houve acidose

  20. To reduce catheter-related bloodstream infections: is the subclavian route better than the jugular route for central venous catheterization?

    Science.gov (United States)

    Nagashima, Goro; Kikuchi, Toshiki; Tsuyuzaki, Hitomi; Kawano, Rumiko; Tanaka, Hiroyuki; Nemoto, Hiroshi; Taguchi, Kazumi; Ugajin, Kazuhisa

    2006-12-01

    The most important targets of hospital-acquired infection control are to reduce the incidence of surgical-site, catheter-related, and ventilator-associated infections. In this report, we address previously presented infection-control strategies for central venous (CV) line catheterization, using a CV catheter-related infection surveillance system. Data concerning CV catheter insertion were collected from all facilities in our 650-bed hospital, excluding the operating and hemodialysis wards. Collected data included the insertion method, purpose, length of catheter inserted, duration of catheterization, infection rate, and complication rate. Catheter-related infection was diagnosed based on bacteriological examinations from blood cultures. The total number of catheterizations was 806 a year, and average duration of catheterization was 9.8 days. The purpose of catheterization was nutritional support in 210 cases, hemodialysis in 96 cases, cardiac support in 174 cases, and other treatments in 260 cases. In 66 cases, the purpose of CV catheter was not specified. The rate of positive cultures was 7.1%, and complications other than infection occurred in 0.5%. The main causative organisms were methicillin-resistant Staphylococcus aureus (MRSA) in 38.6%, coagulase-negative Staphylococcus epidermidis (CNS) in 33.3%, and S. aureus in 12.3% of infections. Infection rates were 3.8 per 1000 catheter-days in subclavian, 6.1 in jugular, and 15.7 in femoral vein catheterization. In high-risk departments (intensive care unit [ICU] and emergency departments) the infection rate was 5.4 for subclavian and 10.2 for jugular catheterization, whereas it was 3.6 for subclavian and 4.6 for jugular catheterization in noncritical-care departments. Considering complications such as pneumothorax, CV catheterization of the jugular vein is recommended in certain situations.

  1. Multiple vascular anomalies involving testicular, suprarenal arteries and lumbar veins

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    P Jyothsna

    2012-01-01

    Full Text Available Testicular arteries arise from the abdominal aorta and the inferior suprarenal artery from the renal artery. There are reports about variant origin and course of these arteries. Accessory testicular artery is also a common finding but its providing origin to inferior suprarenal artery is an important observation. During a routine dissection of abdomen of approximately 55-year-old male cadaver, unique vascular abnormality was observed. On the left side, a common arterial trunk originating from abdominal aorta immediately branched to give rise to superior testicular and inferior suprarenal arteries, the former after a short course hooked by the left suprarenal vein. In addition, the left suprarenal vein, second left lumbar vein, and left testicular vein joined to form a common trunk which drained into the left renal vein. A sound knowledge of vascular variations in relation to the kidney and suprarenal gland is important to surgeons dissecting the abdominal cavity.

  2. Clinical Features of Primary Vein Grafts in Free Tissue Transfers

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    Mitsuru Nemoto

    2015-01-01

    Full Text Available The outcomes of free tissue transfers combined with vein grafts have been inconsistent, and discussions continue regarding their appropriate use. Of the 142 free tissue transfers that we performed from January 2004 to December 2011, we retrospectively analyzed 15 consecutive patients who underwent free tissue transfers in combination with vein grafts. Etiologies included trauma (8 patients, infection (4, and tumor (3. Types of free tissue transfers were fibula (4, anterolateral thigh (3, groin (3, jejunum (3, latissimus dorsi (1, and dorsal pedis (1. Vein grafts were used for the artery (6, vein (2, or both (7. The donor veins were the saphenous vein (12 and the external jugular vein (3. The mean length of the grafted veins was 10.8 cm (range: 4–18 cm. Even though complications of congestion occurred in 2 patients, these flaps survived by reexploration. The flap success rate was 15 of 15 (100% of vein grafted free flaps versus 124 of 127 (97.6% of free flaps not requiring vein grafts. To improve the success rate of free tissue transfers combined with vein grafts, securing healthy recipient vessels, meticulous surgical handling, a reliable vascular anastomosis technique, and strict postoperative monitoring are crucial.

  3. Complete morphometric analysis of jugular foramen and its clinical implications

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    Sushant Swaroop Das

    2016-01-01

    Conclusion: This study gives knowledge about the various parameters, anatomical variations of jugular foramen in both sexes of an adult Indian population, and its clinical impact on the surgeries of this region.

  4. Radiotherapy for jugulo-tympanic paragangliomas (Glomus jugulare tumours)

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    Sharma, P.D.; Johnson, A.P.; Whitton, A.C.

    1984-06-01

    Parasympathetic paraganglia are found in the region of the jugular bulb, in association with the tympanic branch of the glossopharyngeal nerve and the auricular branch of the vagus. The name commonly applied to these structures is 'glomus jugulare'. Tumours arising from these paraganglia (paragangliomas or glomus jugulare tumours) are usually histologically benign but locally destructive. They may involve the middle ear, the temporal bone, or the jugular foramen, and may extend into the neck or cranium. Very occasionally they are malignant and metastasise (Taylor et al., 1965). The clinical features of these tumours and the techniques for their diagnosis are well established, but treatment remains controversial. Radiotherapy has been the preferred treatment at St. Bartholomew's Hospital, London, and sixty cases seen at this hospital between 1942 and 1982 are reviewed here.

  5. Facts about Coarctation of the Aorta

    Science.gov (United States)

    ... Websites Information For... Media Policy Makers Facts about Coarctation of the Aorta Recommend on Facebook Tweet Share ... the body, is narrower than usual. What is Coarctation of the Aorta? Coarctation of the aorta is ...

  6. Computed tomographic findings in a case of renal vein thrombosis with nephrotic syndrome.

    Science.gov (United States)

    Adler, J; Greweldinger, J; Hallac, R; Frier, S

    1981-01-01

    Renal vein thrombosis is a complication of the nephrotic syndrome presumably related to compression of renal veins by edematous parenchyma and a concomitant hypercoagulable state. The diagnosis has been made by demonstrating marked widening of the left renal vein as it crosses horizontally anterior to the aorta on computed tomography. Inferior venacavography confirmed the presence of thrombosis within the vessels. CT is suggested as a method for noninvasive imaging of the renal veins which might eliminate the need for venography.

  7. Endovascular treatment of jugular bulb diverticula causing debilitating pulsatile tinnitus.

    Science.gov (United States)

    Mortimer, Alex M; Harrington, Tim; Steinfort, Brendan; Faulder, Ken

    2016-03-01

    We describe the case of a patient who presented with debilitating pulsatile tinnitus in association with two jugular bulb diverticula. The diverticula were treated with stenting of the jugular bulb and coil embolization of the diverticula over two procedures. This resulted in successful resolution of symptoms and at 10 months follow-up the patient is asymptomatic. The technique is discussed with regard to similar published cases and surrogate measures of safety taken from the literature pertaining to idiopathic intracranial hypertension.

  8. New treatment of vertigo caused by jugular bulb abnormalities.

    Science.gov (United States)

    Hitier, Martin; Barbier, Charlotte; Marie-Aude, Thenint; Moreau, Sylvain; Courtheoux, Patrick; Patron, Vincent

    2014-08-01

    Jugular bulb abnormalities can induce tinnitus, hearing loss, or vertigo. Vertigo can be very disabling and may need surgical treatments with risk of hearing loss, major bleeding or facial palsy. Hence, we have developed a new treatment for vertigo caused by jugular bulb anomalies, using an endovascular technique. Three patients presented with severe vertigos mostly induced by high venous pressure. One patient showed downbeat vertical nystagmus during the Valsalva maneuver. The temporal-bone computed tomography scan showed a high rising jugular bulb or a jugular bulb diverticulum with dehiscence and compression of the vestibular aqueduct in all cases. We plugged the upper part of the bulb with coils, and we used a stent to maintain the coils and preserving the venous permeability. After 12- to 24-month follow-up, those patients experienced no more vertigo, allowing return to work. The 3-month arteriographs showed good permeability of the sigmoid sinus and jugular bulb through the stent, with complete obstruction of the upper part of the bulb in all cases. Disabling vertigo induced by jugular bulb abnormalities can be effectively treated by an endovascular technique. This technique is minimally invasive with a probable greater benefit/risk ratio compare with surgery. © The Author(s) 2013.

  9. We still go for the jugular: implications of the 3SITES central venous catheter study for nephrology.

    Science.gov (United States)

    Wyatt, Christina M; Vassalotti, Joseph A

    2016-03-01

    The 3SITES study randomly assigned a nontunneled central venous catheter site in over 3000 adults treated in intensive care units. The subclavian site was associated with a lower rate of short-term complications, including catheter-related bloodstream infection and deep venous thrombosis, compared to the femoral or internal jugular site. Nephrologists should be aware of this study and should continue to advocate for alternatives to subclavian vein catheter placement in patients with chronic kidney disease who are expected to require arteriovenous access for dialysis in the future.

  10. Connexin43 Inhibition Prevents Human Vein Grafts Intimal Hyperplasia

    Science.gov (United States)

    Longchamp, Alban; Allagnat, Florent; Alonso, Florian; Kuppler, Christopher; Dubuis, Céline; Ozaki, Charles-Keith; Mitchell, James R.; Berceli, Scott; Corpataux, Jean-Marc

    2015-01-01

    Venous bypass grafts often fail following arterial implantation due to excessive smooth muscle cells (VSMC) proliferation and consequent intimal hyperplasia (IH). Intercellular communication mediated by Connexins (Cx) regulates differentiation, growth and proliferation in various cell types. Microarray analysis of vein grafts in a model of bilateral rabbit jugular vein graft revealed Cx43 as an early upregulated gene. Additional experiments conducted using an ex-vivo human saphenous veins perfusion system (EVPS) confirmed that Cx43 was rapidly increased in human veins subjected ex-vivo to arterial hemodynamics. Cx43 knock-down by RNA interference, or adenoviral-mediated overexpression, respectively inhibited or stimulated the proliferation of primary human VSMC in vitro. Furthermore, Cx blockade with carbenoxolone or the specific Cx43 inhibitory peptide 43gap26 prevented the burst in myointimal proliferation and IH formation in human saphenous veins. Our data demonstrated that Cx43 controls proliferation and the formation of IH after arterial engraftment. PMID:26398895

  11. Internal jugular catheter malposition in a patient with end stage renal disease: a case report.

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    Farzaneh Ebrahimifard

    2014-09-01

    Full Text Available A 30-year-old female with end-stage renal disease was a candidate for dual lumen catheter placement. After catheter insertion, O2 saturation measurement of the aspirated blood from the catheter was similar to that of arterial blood. They referred the patient to our hospital after 48 hours. Diagnostic procedures revealed that the tip of the catheter had entered the pleural cavity. Catheter removal in the CPR room resulted in hemorrhagic shock. The patient was resuscitated and stabilized and sent to the operating room. A laceration found at the junction of right jugular and right subclavian veins and was surgically repaired. The patient was discharged after ten days without any complication.

  12. Aneurismas da aorta Aortic aneurysms

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    Januário M Souza

    1992-09-01

    Full Text Available Entre janeiro de 1979 e janeiro de 1992, foram realizadas 212 operações para correção de aneurismas e de dissecções da aorta. Neste trabalho serão analisados 104 procedimentos cirúrgicos (em 97 pacientes para correção de aneurismas. A idade dos pacientes variou de 14 a 79 anos (média 59,5 anos e o sexo predominante foi o masculino, com 75 pacientes. Os aneurismas localizavam-se na aorta ascendente em 46 pacientes, na croça em 8, na aorta descendente em 8, na aorta toráco-abdominal em 8, na aorta abdominal em 21, na aorta descendente e abdominal em 2, na aorta ascendente e tóraco-abdominal em 2, na aorta ascendente e descendente em 1, na aorta ascendente, croça e descendente em 1. Doenças cardiovasculares associadas estavam presentes em 39 pacientes, sendo valvopatia aórtica em 18 (excluídos os pacientes com ectasiaânulo-aórtíca, insuficiência coronária em 17, coarctação da aorta em 2, persistência do canal arterial em 1 e valvopatia mitral e aórtica em 1. A mortalidade imediata (hospitalar e/ou 30 dias foi de 14,4%, sendo de 27,7% (5/18 para pacientes com mais de 70 anos e de 11,3% (9/79 para pacientes com idade inferior a 70 anos. Os aneurismas localizados na aorta ascendente e croça foram operados como o auxílio de circulação extracorpórea. Parada circulatória e hipotermia profunda foram utilizadas em todos os pacientes com aneurisma da croça. O estudo tomográfico e angiográfico deve ser de toda a aorta, pela possibilidade de aneurismas de localizações múltiplas.Among 212 patients undergoing operation for aortic aneurysm and aortic dissection between January 1979 and January 1992, 97 were operated on for aneurysms. The aneurysms were localized in: ascending aorta in 46 patients, transverse aortic arch in 8, descending aorta in 8, thoracoabdominal aorta in 8, abdominal (infrarenal aorta in 21, descending and abdominal aorta in 2, ascending and thoracoabdominal aorta in 2, ascending and descending in 1

  13. Varicose vein - noninvasive treatment

    Science.gov (United States)

    Sclerotherapy; Laser therapy - varicose veins; Radiofrequency vein ablation; Endovenous thermal ablation; Ambulatory phlebectomy; Transilluminated power phlebotomy; Endovenous laser ablation; Varicose vein ...

  14. Internal jugular pressure increases during parabolic flight.

    Science.gov (United States)

    Martin, David S; Lee, Stuart M C; Matz, Timothy P; Westby, Christian M; Scott, Jessica M; Stenger, Michael B; Platts, Steven H

    2016-12-01

    One hypothesized contributor to vision changes experienced by >75% of International Space Station astronauts is elevated intracranial pressure (ICP). While no definitive data yet exist, elevated ICP might be secondary to the microgravity-induced cephalad fluid shift, resulting in venous congestion (overfilling and distension) and inhibition of cerebrospinal and lymphatic fluid drainage from the skull. The objective of this study was to measure internal jugular venous pressure (IJVP) during normo- and hypo-gravity as an index of venous congestion. IJVP was measured noninvasively using compression sonography at rest during end-expiration in 11 normal, healthy subjects (3 M, 8 F) during normal gravity (1G; supine) and weightlessness (0G; seated) produced by parabolic flight. IJVP also was measured in two subjects during parabolas approximating Lunar (1/6G) and Martian gravity (1/3G). Finally, IJVP was measured during increased intrathoracic pressure produced using controlled Valsalva maneuvers. IJVP was higher in 0G than 1G (23.9 ± 5.6 vs. 9.9 ± 5.1 mmHg, mean ± SD P < 0.001) in all subjects, and IJVP increased as gravity levels decreased in two subjects. Finally, IJVP was greater in 0G than 1G at all expiration pressures (P < 0.01). Taken together, these data suggest that IJVP is elevated during acute exposure to reduced gravity and may be elevated further by conditions that increase intrathoracic pressure, a strong modulator of central venous pressure and IJVP However, whether elevated IJVP, and perhaps consequent venous congestion, observed during acute microgravity exposure contribute to vision changes during long-duration spaceflight is yet to be determined. Published 2016. This article is a U.S. Government work and is in the public domain in the USA. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

  15. Atherosclerotic Human Aorta

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    Igor A. Sobenin

    2011-01-01

    Full Text Available We have evaluated the binding of sialylated and desialylated lipoproteins to collagen isolated from the proteoglycan and musculoelastic layers of intima and media of uninvolved human aorta and atherosclerotic lesions. Comparing various collagen preparations from the uninvolved intima-media, the binding of sialylated apoB-containing lipoproteins was best to collagen from the intimal PG-rich layer. Binding of sialylated apoB-containing lipoproteins to collagen from this layer of fatty streak and fibroatheroma was 1.4- and 3.1-fold lower, respectively, in comparison with normal intima. Desialylated VLDL versus sialylated one exhibited a greater binding (1.4- to 3.0-fold to all the collagen preparations examined. Desialylated IDL and LDL showed a higher binding than sialylated ones when collagen from the intimal layers of fibroatheroma was used. Binding of desialylated HDL to collagen from the intimal PG-rich layer of normal tissue, initial lesion, and fatty streak was 1.2- to 2.0-fold higher compared with sialylated HDL.

  16. Combined aortic valve replacement and coronary artery bypass grafting for a calcified ascending aorta.

    Science.gov (United States)

    Baba, Hironori; Umesue, Masayoshi; Matsui, Kanzi

    2012-04-01

    Although a severely calcified ascending aorta is encountered infrequently, it presents formidable problems during cardiac surgery. We describe a case of severe aortic valve stenosis and coronary artery disease combined with a severely calcified ascending aorta. The patient was an 80-year-old man with a calcified ascending aorta. He successfully underwent an aortic valve replacement and a single coronary artery bypass graft (CABG) using a saphenous vein graft with the proximal end connected on a Dacron patch, which was used for aortoplasty of the calcified plate along the aortotomy. These procedures were performed under moderate hypothermia with aortic clamping. This patch aortoplasty can be a useful alternative in cases that require aortotomy and proximal anastomoses of a CABG on a calcified ascending aorta.

  17. Varicose vein stripping

    Science.gov (United States)

    ... vein stripping; Venous reflux - vein stripping; Venous ulcer - veins Images Circulatory system References American Family Physician. Management of varicose veins. www.aafp.org/afp/2008/1201/p1289.html . ...

  18. Deep Vein Thrombosis

    Science.gov (United States)

    Deep vein thrombosis, or DVT, is a blood clot that forms in a vein deep in the body. Most deep vein ... the condition is called thrombophlebitis. A deep vein thrombosis can break loose and cause a serious problem ...

  19. Hematoma da aorta ascendente Intramural hematoma of the ascending aorta

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    Noedir Antônio G. Stolf

    2006-12-01

    Full Text Available É relatado o caso de um paciente do sexo masculino com idade de 71 anos, dando entrada no pronto-atendimento com palidez cutaneomucosa, acompanhada de hipertensão arterial sistêmica e dor torácica. Na investigação diagnóstica não foi evidenciada alteração compatível com isquemia miocárdica aguda. A radiografia de tórax evidenciava alargamento importante do mediastino. Ao ecocardiograma, a aorta ascendente media 47 mm, no nível do tronco pulmonar. Um dia após o eco, o paciente foi submetido a exame de ressonância magnética (RNM, quando se evidenciou aorta ascendente de 62 mm, sem evidenciar fluxo em falsa luz ou "flap" intimal, mas mostrando hematoma intramural da aorta ascendente, estendendo-se da raiz da aorta até um terço proximal do arco aórtico. Procedeu-se a correção cirúrgica, sendo realizada substituição da aorta ascendente e parte do arco aórtico (hemiarco, com preservação da valva aórtica pela suspensão das comissuras. Paciente evolui bem sem intercorrência, recebendo alta no nono dia de pós-operatório. Enfatizamos nesse relato de caso a semelhança do quadro clínico do hematoma intramural da aorta com o quadro de dissecção da aorta, a importância de se estabelecer diagnóstico correto e o melhor tratamento.It is reported the case of a 71 year old male patient admitted to the emergency service pale and with systemic arterial hypertension and thoracic pain. In the diagnostic investigation, there was no evidence of compatible with acute myocardial ischemia. The thorax x-ray showed important enlargement of the mediastinum. In the echocardiogram the ascending aorta measured 47mm, at the level of the pulmonary artery. One day after the echo, submitted to exam of magnetic resonance (RNM, the ascending aorta had a diameter of 62mm, without false lumen flow or intimal "flap", but showing intramural hematoma envolving the ascending aorta and the proximal portion of the aorta. It was submitted to the surgical

  20. Management Strategy for Patients With Chronic Subclavian Vein Thrombosis.

    Science.gov (United States)

    Keir, Graham; Marshall, M Blair

    2017-02-01

    We performed a systematic review to determine best practice for the management of patients with chronic or subacute subclavian vein thrombosis. This condition is best managed with surgical excision of the first rib followed by long-term anticoagulation. Interventional techniques aimed at restoring patency are ineffective beyond 2 weeks postthrombosis. Additional therapeutic options should be made based on the severity of symptoms as well as vein status. Patients with milder symptoms are given decompression surgery followed by anticoagulation whereas patients with more severe symptoms are considered for either a jugular vein transposition or saphenous patch based on the vein characteristics. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  1. Jugular Venous Flow Abnormalities in Multiple Sclerosis Patients Compared to Normal Controls

    Science.gov (United States)

    Sethi, Sean K.; Utriainen, David T.; Daugherty, Ana M.; Feng, Wei; Hewett, J. Joseph; Raz, Naftali; Haacke, E. Mark

    2014-01-01

    Background To determine if extracranial venous structural and flow abnormalities exist in patients with multiple sclerosis (MS). Methods Magnetic resonance imaging was used to assess the anatomy and function of major veins in the neck in 138 MS patients and 67 healthy controls (HC). Time-of-flight (TOF) MR angiography (MRA) was used to assess stenosis while 2D phase contrast flow quantification (PCFQ) was used to assess flow at the C2/C3 and C5/C6 levels. Venous flow was normalized to the total arterial flow. The MS patients were divided into stenotic and non-stenotic groups based on MRA assessment, and each group was compared to the HC group in anatomy and flow. Results The MS group showed lower normalized internal jugular vein (IJV) blood flow (tIJV/tA) than the HC group (p < 0.001). In the MS group, 72 (52%) evidenced stenosis (ST) while 66 (48%) were non-stenotic (NST). In the HC group, 11 (23%) showed a stenosis while 37 (77%) were non-stenotic. The ST-MS group had lower IJV flow than both HC and NST-MS groups. Conclusion After categorizing the MS population into two groups based upon anatomical stenosis determined from an absolute quantification of IJV cross-section, clear differences in IJV flow between the stenotic MS and HC samples became evident. Despite the unknown etiology of MS, abnormal venous flow was noted in a distinct group of MS patients compared to HC. PMID:25316522

  2. Evaluation of left renal vein entrapment using multidetector computed tomography

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    Poyraz, Ahmet K.; Onur, Mehmet R. [Dept. of Radiology, Firat Univ. School of Medicine, Elazig (Turkey)], e-mail: akursadpoyraz@yahoo.com.tr; Firdolas, Fatih [Dept. of Urology, Firat Univ. School of Medicine, Elazig (Turkey); Kocakoc, Ercan [Dept. of Radiology, Bezmialem Vakif Univ., School of Medicine, Istanbul (Turkey)

    2013-03-15

    Background: Nutcracker syndrome, also called left renal vein entrapment syndrome, is a cause of non-glomerular hematuria with difficulties in diagnosis. Multidetector computed tomography (MDCT) is a powerful tool to prevent unnecessary diagnostic procedures. Purpose: To retrospectively determine the prevalence of nutcracker phenomenon and nutcracker syndrome seen in MDCT in consecutive patients. Material and Methods: The institutional review board approved the study and waived the requirement for informed consent. Abdominal contrast-enhanced MDCT scans were reviewed from 1000 consecutive patients. MDCT scan assessment included renal vein diameter measurements and evaluation for the presence of anterior or posterior left renal vein entrapment. Electronic medical records and urine analysis reports of patients with left renal vein entrapment were reviewed. Student's t test was used to assess differences in renal vein diameter in patients with left renal vein entrapment. Results: Left renal vein entrapment was observed in 10.9% (109), retroaortic left renal vein in 6.5% (65), entrapment of left renal vein between superior mesenteric artery and aorta in 4.1% (41), and circumaortic left renal vein in 0.3% (3) of patients. Mean diameters of right (8.8 {+-} 1.9 mm) and unentrapped left (8.9 {+-} 1.8 mm) renal veins were not significantly different (P = 0.1). The mean diameter of anterior entrapped left renal veins (10.3 {+-} 2 mm) was significantly greater (P = 0.04) than contralateral renal veins (8.6 {+-} 2.1 mm) in their widest portion. In 8.8% of patients with the left renal vein entrapment, urine analysis showed isomorphic hematuria or proteinuria with no other known cause. Varicocele and pelvic congestion were seen in 5.5% of patients with the left renal vein entrapment. Conclusion: Left renal vein entrapment is not a rare entity and renal nutcracker phenomenon might be underdiagnosed.

  3. STUDY ON MORPHOLOGICAL VARIATIONS IN STRUCTURE OF THE JUGULAR FORAMEN

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    Shruthi B.N

    2015-12-01

    Full Text Available Background: The jugular foramen is difficult to understand and to access surgically; the difficulties in exposing this foramen are created by its deep location and the surrounding structures, such as the carotid artery anteriorly, the facial nerve laterally, the hypoglossal nerve medially and the vertebral artery inferiorly, all of which block access to the foramen and require careful management. It is difficult to conceptualize because it varies in size and shape in different crania, between the two sides the same cranium, from its intracranial to extracranial end in the same foramen and because of its complex irregular shape, its curved course, its formation by two bones and the numerous nerves and venous channels that pass through it. The present study is concentrated to study morphological features of jugular foramen. Material and Methods: The present study was undertaken in 250(500 sides adult south Indian skulls from different regions of south India, from different medical colleges. We have observed the size of foramen and presence of jugular fossa. Result: Out of 250 skulls in 20.8% of cases the right foramina were larger than the left, in 24.8% of cases the left foramina were larger than the right and in 8% cases were equal on both sides. The jugular fossa present bilaterally in 60%, on the right only in 21.6% cases, on the left only in 7.6% cases and was absent in 10.8% cases. Conclusion: The present study concludes that there is no significance different between size of foramen in right and left side. The jugular fossa or bulb present bilaterally in majority of cases.

  4. Transposition of cephalic vein to rescue hemodialysis access arteriovenous fistula and treat symptomatic central venous obstruction

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    Felipe Jose Skupien

    2014-03-01

    Full Text Available It is known that stenosis or central venous obstruction affects 20 to 50% of patients who undergo placement of catheters in central veins. For patients who are given hemodialysis via upper limbs, this problem causes debilitating symptoms and increases the risk of loss of hemodialysis access. We report an atypical case of treatment of a dialysis patient with multiple comorbidities, severe swelling and pain in the right upper limb (RUL, few alternative sites for hemodialysis vascular access, a functioning brachiobasilic fistula in the RUL and severe venous hypertension in the same limb, secondary to central vein occlusion of the internal jugular vein and right brachiocephalic trunk. The alternative surgical treatment chosen was to transpose the RUL cephalic vein, forming a venous necklace at the anterior cervical region, bypassing the site of venous occlusion. In order to achieve this, we dissected the cephalic vein in the right arm to its junction with the axillary vein, devalved the cephalic vein and anastomosed it to the contralateral external jugular vein, providing venous drainage to the RUL, alleviating symptoms of venous hypertension and preserving function of the brachiobasilic fistula.

  5. Internal Jugular Vein Catheterization with Seldinger Technique, previous Needle Puncture: Complications

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    Carrizo G

    2016-06-01

    Full Text Available Central venous catheterization (CVC is a common procedure performed daily for its outnumbered indications, complication rates range are up to 15%. The previous puncture with a fine needle with the Seldinger technique can reduce even more the possible complications, guaranteeing a high percentage of success. The objective was to determine the number of CVC per puncture with Seldinger technique performed by general surgery residents and identify number and type of mechanical complications, related to the residence year. A descriptive transversal cut study has been carried out, between March and November of 2014. A number of 243 patients were evaluated, observing that 41% of the cases were to measure CVP and hemodynamic monitoring; 76% of the punctures were done by 1º and 2º year residents, presenting only 10% on mechanic complications, most frequently on arterial puncture. In conclusion, previous puncture with needle with the Seldinger technique is safer, more secure, lower cost, and reduces the number of complications, it is a variant puncture under ultrasound guidance.

  6. Portal Vein Thrombosis

    OpenAIRE

    Hakan Demirci

    2016-01-01

    Portal vein thrombosis is an important cause of presinusoidal portal hypertension. Portal vein thrombosis commonly occurs in patient with cirrhosis, malignancy and prothrombotic states. Patients with acute portal vein thrombosis have immediate onset. Patients with chronic portal vein thrombosis have developed portal hypertension and cavernous portal transformation. Portal vein thrombosis is diagnosed with doppler ultrasound, computed tomography and magnetic resonance imaging. Therapy with low...

  7. Focus on Varicose Veins

    Science.gov (United States)

    ... veins, which are the visible purple or greenish-blue veins that appear in our legs. Spider veins or teleangiectesias are tiny veins that you ... reduce leg swelling and decrease the risk of blood clots. Prescription ... sclerosing solution into spider, reticular or varicose veins. This is a minimally ...

  8. Coarctation of the Aorta (For Teens)

    Science.gov (United States)

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Coarctation of the Aorta KidsHealth > For Teens > Coarctation of ... of Yourself en español Estrechamiento aórtico What Is Coarctation of the Aorta? The aorta (pronounced: ay-OR- ...

  9. Spider Vein Removal

    Science.gov (United States)

    Spider veins: How are they removed? I have spider veins on my legs. What options are available ... M.D. Several options are available to remove spider veins — thin red lines or weblike networks of ...

  10. A metastatic glomus jugulare tumor. A temporal bone report

    Energy Technology Data Exchange (ETDEWEB)

    El Fiky, F.M.; Paparella, M.M.

    1984-01-01

    The clinicopathologic findings in the temporal bone of a patient with a highly malignant metastasizing glomus jugulare tumor are reported. The patient exhibited all the symptoms of primary malignant tumors of the ear, including facial paralysis, otorrhea, pain, hearing loss, tinnitus, dizziness, and vertigo. He was treated with cobalt irradiation followed by radium implant in the ear canal for a residual tumor; then a left-sided radical mastoidectomy was performed.

  11. Sclerotherapy of Varicose Veins and Spider Veins

    Science.gov (United States)

    ... you as to whether the procedure was a technical success when it is completed. Your interventional radiologist ... Varicose Veins) Phlebectomy of Varicose Veins Contrast Materials Anesthesia Safety Sponsored by Please note RadiologyInfo.org is ...

  12. Vein Problems Related to Varicose Veins

    Science.gov (United States)

    ... telangiectasias. Spider veins involve the capillaries, the smallest blood vessels in the body. Spider veins often appear on the legs and face. They're red or blue and usually look like a spider web or ...

  13. Portal Vein Thrombosis

    Directory of Open Access Journals (Sweden)

    Hakan Demirci

    2016-01-01

    Full Text Available Portal vein thrombosis is an important cause of presinusoidal portal hypertension. Portal vein thrombosis commonly occurs in patient with cirrhosis, malignancy and prothrombotic states. Patients with acute portal vein thrombosis have immediate onset. Patients with chronic portal vein thrombosis have developed portal hypertension and cavernous portal transformation. Portal vein thrombosis is diagnosed with doppler ultrasound, computed tomography and magnetic resonance imaging. Therapy with low molecular weight heparin achieves recanalization in more than half of acute cases.

  14. MORPHOLOGICAL AND MORPHETRIC STUDY OF JUGULAR FORAMEN IN SOUTH INDIAN POPULATION

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    Shifan Khanday

    2013-12-01

    Full Text Available Background: The jugular foramen, the bony opening on the basis of skull, is an opening through which pass the ninth, tenth, and eleventh cranial nerves, two dural sinuses, and the meningeal branches of the occipital and ascending pharyngeal arteries. The increasing use of modern diagnostic procedures and new surgical approaches has created a need for much more detailed anatomical studies and explanations. This article reveals some additional features. Material and Methods: 324 jugular foramina of skulls of persons of unknown age and gender were examined. The morphological characteristics of all the investigated jugular foramina were described, measured, and compared, taking into consideration their side. Results: Jugular foramina were studied for a review of its morphology, morphometry and its comparison with previous studies. Different shapes and sizes of jugular foramen were seen. Laterality was also noticed, compartmentation was also observed which was found to be statistically significant. Conclusions: A detailed examination of the jugular foramen anatomy was performed. The main types of jugular foramina and the frequencies of bipartite or tripartite division were established. Several dimensions of the parts of the jugular foramen were measured. Some new data could provide important information about the anatomy of the jugular foramen for reliable surgical interventions in this area.

  15. A morphological and morphometric study of jugular foramen in dry skulls with its clinical implications

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    Chandni Gupta

    2014-01-01

    Full Text Available Objective: Jugular foramen of human skull is one of the most interesting foramina. It is a complex bony canal, numerous vital structures, including nerves and vessels are transmitted through it. Most of the intracranial and extra cranial lesions of posterior cranial fossa might affect the structures in jugular foramen in addition to intrinsic abnormalities. As the neurosurgeons have become courageous in approaching this area, so there is a need to become familiar with this area. Hence, the present study was done to examine the anatomy of jugular foramen, including its morphological features and dimensions. Materials and Methods: The study was carried out on 50 dried skulls. 100 jugular foramina were studied on both right and left side of skulls. The length, width of jugular foramen and width and depth of jugular fossa were measured using vernier calipers. Presence of dome, complete and incomplete septation was also looked for. Results: The mean right and left anteroposterior diameter, latero-medial diameter, area, jugular fossa width, depth in our study was 11.22, 16.52, 187.34, 6.83, 11.58 mm and 9.52, 16.02, 153.2, 5.69, 11.13 mm. Dome was present in jugular foramen in 74% on the right side and 58% on the left side. Complete septation in jugular foramen is seen in 44% on the right side and 42% on the left side. Conclusion: This study will help the neurosurgeons while doing surgery in this region.

  16. Blood pooling in extrathoracic veins after glossopharyngeal insufflation

    DEFF Research Database (Denmark)

    Mijacika, Tanja; Frestad, Daria; Kyhl, Kasper

    2017-01-01

    Purpose: Trained breath-hold divers hyperinflate their lungs by glossopharyngeal insufflation (GPI) to prolong submersion time and withstand lung collapse at depths. Pulmonary hyperinflation leads to profound hemodynamic changes. Methods: Thirteen divers performed preparatory breath-holds followed...... divers in a sub-study. Results: After GPI, pulmonary volume increased by 0.8 ± 0.6 L above total lung capacity. The diameter of the superior caval (by 36 ± 17%) and intrathoracic part of the inferior caval vein decreased (by 21 ± 16%), while the diameters of the internal jugular (by 53 ± 34%), hepatic...

  17. Left testicular artery arching over the ipsilateral renal vein

    Institute of Scientific and Technical Information of China (English)

    Munekazu Naito; Hayato Terayama; Yoichi Nakamura; Shogo Hayashi; Takayoshi Miyaki; Masahiro Itoh

    2006-01-01

    Aim: To report two cases of the left testicular artery arching over the left renal vein (LRV) before running downward to the testis. Methods: The subjects were obtained from two Japanese cadavers. During the student course of gross-anatomical dissection, the anatomical relationship between the testicular vessels and the renal vein was specifically observed. Results: The arching left testicular artery arose from the aorta below the LRV and made a loop around the LRV, which appeared to be mildly compressed between the arching artery and the psoas major muscle.Conclusion: Clinically, compression of the LRV between the abdominal aorta and the superior mesenteric artery occasionally induces LRV hypertension, resulting in varicocele, orthostatic protenuria and hematuria. Considering that the incidence of a left arching testicular artery is higher than that of a right one, an arching left artery could be an additional cause of LRV hypertension.

  18. Radiotherapy in glomus jugulare and glomus tympanicum tumors. Zur Radiotherapie der Glomus-jugulare-et-tympanicum-Tumoren

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    Feyerabend, T.; Richter, E.; Kapp, B.; Bohndorf, W. (Wuerzburg Univ. (Germany, F.R.). Klinik und Poliklinik fuer Strahlentherapie); Ptok, M. (Wuerzburg Univ. (Germany, F.R.). Klinik und Poliklinik fuer Hals-, Nasen- und Ohrenkranke)

    1989-09-01

    Glomus jugulare tumors are difficult to manage therapeutically due to their localisation. Operation may be successful in small tumors but can be hazardous in larger lesions mainly because of bleeding and palsy of cranial nerves. In these cases there should be used radiation therapy under the condition that it is planned by use of computed tomography. Moreover reproducibility of radiation treatment set-up is vital. In this way tumor regression may be achieved. Four own illustrative cases are demonstrated. According to the stage of disease a modified treatment strategy is presented which integrates surgical procedures, angiographic embolisation and radiotherapy. (orig.).

  19. Acute spontaneous isolated dissection of abdominal aorta

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    Ali Akbar beigi

    2009-09-01

    Full Text Available

    • Aortic dissection occurs when the layers of the aorta separate as a result of extra luminal cavity of blood through an intimal tear. Dissection limited to the abdominal aorta is rare. Unfortunately, the appropriate management of dissecting aneurysm of abdominal aorta is not documented yet. A 43 years old man was admitted to Al-zahra hospital in Isfahan with sudden onset of periumbilical abdominal pain. CT scan confirmed infrarenal dissection of abdominal aorta. Performing laparotomy, aorta was repaired using bifurcate collagen-coated Dacron graft. Surgical intervention with synthetic graft is recommended in patients with dissecting aortic aneurysm of infrarenal segments where the extent of dissection is limited and accessible.
    • Keywords: Aneurysm, Aortic dissection, Aortic aneurysm abdominal surgery.

  20. Head and Neck Veins of the Mouse. A Magnetic Resonance, Micro Computed Tomography and High Frequency Color Doppler Ultrasound Study.

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    Marcello Mancini

    Full Text Available To characterize the anatomy of the venous outflow of the mouse brain using different imaging techniques. Ten C57/black male mice (age range: 7-8 weeks were imaged with high-frequency Ultrasound, Magnetic Resonance Angiography and ex-vivo Microcomputed tomography of the head and neck. Under general anesthesia, Ultrasound of neck veins was performed with a 20 MHz transducer; head and neck Magnetic Resonance Angiography data were collected on 9.4 T or 7 T scanners, and ex-vivo Microcomputed tomography angiography was obtained by filling the vessels with a radiopaque inert silicone rubber compound. All procedures were approved by the local ethical committee. The dorsal intracranial venous system is quite similar in mice and humans. Instead, the mouse Internal Jugular Veins are tiny vessels receiving the sigmoid sinuses and tributaries from cerebellum, occipital lobe and midbrain, while the majority of the cerebral blood, i.e. from the olfactory bulbs and fronto-parietal lobes, is apparently drained through skull base connections into the External Jugular Vein. Three main intra-extracranial anastomoses, absent in humans, are: 1 the petrosquamous sinus, draining into the posterior facial vein, 2 the veins of the olfactory bulb, draining into the superficial temporal vein through a foramen of the frontal bone 3 the cavernous sinus, draining in the External Jugular Vein through a foramen of the sphenoid bone. The anatomical structure of the mouse cranial venous outflow as depicted by Ultrasound, Microcomputed tomography and Magnetic Resonance Angiography is different from humans, with multiple connections between intra- and extra-cranial veins.

  1. Portal Vein Thrombosis

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    Ronny Cohen

    2015-01-01

    Full Text Available Portal vein thrombosis (PVT is the blockage or narrowing of the portal vein by a thrombus. It is relatively rare and has been linked with the presence of an underlying liver disease or prothrombotic disorders. We present a case of a young male who presented with vague abdominal symptoms for approximately one week. Imaging revealed the presence of multiple nonocclusive thrombi involving the right portal vein, the splenic vein, and the left renal vein, as well as complete occlusion of the left portal vein and the superior mesenteric vein. We discuss pathogenesis, clinical presentation, and management of both acute and chronic thrombosis. The presence of PVT should be considered as a clue for prothrombotic disorders, liver disease, and other local and general factors that must be carefully investigated. It is hoped that this case report will help increase awareness of the complexity associated with portal vein thrombosis among the medical community.

  2. Late onset of clinically apparent central vein stenosis due to previous central venous catheter in a patient with inherited thrombophilia.

    Science.gov (United States)

    Eleftheriadis, Theodoros; Liakopoulos, Vassilios; Antoniadi, Georgia; Pissas, Georgios; Leivaditis, Konstantinos; Stefanidis, Ioannis

    2014-04-01

    We describe a case of a patient with a functional kidney transplant who was admitted to our department with clinically evident central vein stenosis (CVS) 7 years after the removal of a central venous catheter (CVC) from the right internal jugular vein. The catheter was used as a hemodialysis access for a 2-month period. In the interval before his last admission, the patient suffered two episodes of deep vein thrombosis. Investigation revealed heterozygosity for factor V Leiden, the most common inherited thrombophilia encountered in 5% of Caucasians, and anticoagulation treatment was started. Magnetic resonance angiography showed stenosis just after the convergence of the right subclavian vein with the internal jugular vein to the innominate vein. Transluminal angioplasty restored venous patency and right upper arm edema resolved. Coexistence of CVS, accompanied by hemodynamic changes and endothelial dysfunction, with thrombophilia fulfill all the elements of the Virchow's triad. Therefore, the patient was at great risk for central vein thrombosis, from which he was possibly protected by the early administration of anticoagulant treatment. This case indicates that CVS can be asymptomatic for several years after CVC removal and also raises the question if thrombophilia workup and investigation for CVS may be beneficial in every patient with CVC placement in order to avoid any harmful outcomes.

  3. The risk of catheter-related bloodstream infection with femoral venous catheters as compared to subclavian and internal jugular venous catheters: a systematic review of the literature and meta-analysis.

    Science.gov (United States)

    Marik, Paul E; Flemmer, Mark; Harrison, Wendy

    2012-08-01

    Catheter-related bloodstream infections are an important cause of morbidity and mortality in hospitalized patients. Current guidelines recommend that femoral venous access should be avoided to reduce this complication (1A recommendation). However, the risk of catheter-related bloodstream infections from femoral as compared to subclavian and internal jugular venous catheterization has not been systematically reviewed. A systematic review of the literature to determine the risk of catheter-related bloodstream infections related to nontunneled central venous catheters inserted at the femoral site as compared to subclavian and internal jugular placement. MEDLINE, Embase, Cochrane Register of Controlled Trials, citation review of relevant primary and review articles, and an Internet search (Google). Randomized controlled trials and cohort studies that reported the frequency of catheter-related bloodstream infections (infections per 1,000 catheter days) in patients with nontunneled central venous catheters placed in the femoral site as compared to subclavian or internal jugular placement. Data were abstracted on study design, study size, study setting, patient population, number of catheters at each insertion site, number of catheter-related bloodstream infections, and the prevalence of deep venous thrombosis. Studies were subgrouped according to study design (cohort and randomized controlled trials). Meta-analytic techniques were used to summarize the data. Two randomized controlled trials (1006 catheters) and 8 cohort (16,370 catheters) studies met the inclusion criteria for this systematic review. Three thousand two hundred thirty catheters were placed in the subclavian vein, 10,958 in the internal jugular and 3,188 in the femoral vein for a total of 113,652 catheter days. The average catheter-related bloodstream infections density was 2.5 per 1,000 catheter days (range 0.6-7.2). There was no significant difference in the risk of catheter-related bloodstream

  4. Comparison of jugular and transverse facial venous sinus blood analytes in healthy and critically ill adult horses.

    Science.gov (United States)

    Lascola, Kara M; Vander Werf, Karie; Freese, Stephanie; Morgera, Alison; Schaeffer, David J; Wilkins, Pamela

    2017-03-01

    To compare blood gas, electrolyte, and metabolic analysis results between blood obtained by jugular and transverse facial venous sinus (TFVS) venipuncture in healthy adult horses and sick adult horses presented for emergency evaluation. Prospective, experimental study, from June 2012 to October 2013. Large animal university teaching hospital. Ten healthy adult University-owned horses and 48 client-owned adult horses (≥2 years old) presenting to the large animal hospital emergency service for medical or surgical evaluation of systemic illness. Venipunctures (jugular vein [JV] and TFVS) were performed using preheparinized syringes and obtained prior to institution of medical therapy. Samples were analyzed in random order within a 10-minute interval using a point-of-care blood gas analyzer (NOVA Critical Care Xpress) that also reports electrolyte and metabolite results. Comparisons between venipuncture sites were analyzed using the Student's paired t-test for normally distributed data and the Wilcoxon paired test for nonnormally distributed data. Bland-Altman analysis was used to assess agreement between venipuncture sites. There were no statistically significant differences found between variables for JV and TFVS in healthy horses. In sick horses, JV measurements were greater than TFVS for ionized calcium (P = 0.002) and glucose (P = 0.001), and less than TFVS for hematocrit (P = 0.015). Bland-Altman plots demonstrated small biases but overall agreement between sites. The TFVS can be used interchangeably with JV for venous blood gas analysis in healthy horses. In sick horses, identified differences were small and likely not clinically important. The reliability of this point-of-care blood gas analyzer for measurement of hematocrit remains to be determined. © Veterinary Emergency and Critical Care Society 2017.

  5. [Subclavian vein puncture as a primary approach for pacemaker lead implantation].

    Science.gov (United States)

    Kronski, D; Haas, H

    2001-12-01

    In the beginning of transvenous pacemaker therapy, the external or alternatively internal jugular vein was commonly used for lead implantation. Due to frequent long-term complications both approaches are nowadays obsolete. In most pacemaker centers implantation via the cephalic vein has become standard. As an alternative, in 1975 Sterz et al. introduced puncture of the subclavian vein in the Seldinger technique as an approach for lead implantation. At this time, the commonly used introducers of pacemaker leads had to be cut for removal. No earlier than 1980 "peel away" introducers were commercially available. Since then, we consequently use this technique for implantation of single or dual chamber pacemaker devices. In the course of the last seven years merely 1.5-2% of implantations were performed via the cephalic vein; no jugular vein approach was performed. Due to a routinely performed subclavian vein puncture, we were able to optimize the procedure, proven by an enormous reduction in implantation time (local anesthesia - skin closure), x-ray time and complication rate. In the year 2000 we performed 52 implantations of a single chamber device with an average fluoroscopy time of 1.5 (0.3-9.3) minutes, radiation dose of 4.5 (0.1-47) Gycm(2) and implantation time of 17.6 (8-40) minutes and 144 implantations of a dual chamber device with an average fluoroscopy time of 2.86 (0.7-6.6) minutes, radiation dose of 8.31 (0.7-28) Gycm(2) and implantation time of 21.25 (10-45) minutes. Complications were rare, clinically irrelevant arterial punctures. Neither nerval damage nor pneumothoraces with the necessity for chest tube placement were seen in the above mentioned time frame. No early or late thrombosis of the subclavian vein was encountered.    The primary subclavian vein approach led to an enormous reduction in overall procedure time without significant morbidity.

  6. Anatomical variation of thyroid veins on contrast-enhanced multi-detector row computed tomography

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    Tomita, Hayato, E-mail: m04149@yahoo.co.jp [Department of Radiology, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, 1197-1 Yasashicho, Asahi-ku, Yokohama, Kanagawa 241-0811 (Japan); Yamada, Takayuki; Murakami, Kenji; Hashimoto, Kazuki; Tazawa, Yoko; Kumano, Reiko [Department of Radiology, St. Marianna University School of Medicine, Yokohama City Seibu Hospital, 1197-1 Yasashicho, Asahi-ku, Yokohama, Kanagawa 241-0811 (Japan); Nakajima, Yasuo [Department of Radiology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa 216-8511 (Japan)

    2015-05-15

    Highlights: • This is the first study to demonstrate the anatomy of thyroid veins on contrasted-enhanced MDCT. • Identifying the thyroid vein on MDCT prior to selective venous sampling of parathyroid hormone provides clinical information to interventional radiologist. • Detecting especially the inferior thyroid veins with individual variability in numbers, locations, and lengths may have an effect on SVS for HPT and decrease the difficulty and time of the procedure. - Abstract: Objective: The objective of this study was to clarify the anatomical variation of thyroid veins into the systemic vein using contrast-enhanced multi-detector row computed tomography (MDCT). Design and methods: : The subjects were 80 patients (34 males and 46 females; mean age, 50.1 years; age range, 15–92 years) with neck diseases who underwent MDCT. The number and location of inflow points of the thyroid veins into the systemic vein, and the length from the junction of bilateral brachiocephalic veins to the orifice of inferior thyroid vein were investigated by reviewing the axial and coronal images. Results: All superior thyroid veins were detected. Right and left middle thyroid veins were identified in 39 and 29 patients, respectively. Right inferior thyroid veins, left inferior thyroid veins, and common trunks were detected in 43, 46, and 39 patients, respectively; in five patients, two left thyroid veins were identified. All left inferior thyroid veins and 34 common trunks flowed into the innominate vein, while right ones had some variations in inflow sites. Mean lengths were 3.01 ± 1.30 cm (range, 0.5–6.19) and 2.04 ± 0.91 cm (0.5–4.4) in the left inferior thyroid vein and common trunk, and 1.96 ± 1.05 cm (0.81–4.8) and 1.65 ± 0.69 cm (0.63–2.94) in the right one flowing into the right internal jugular vein and the innominate vein, respectively. Conclusions: The numbers and orifices of thyroid veins were identified at high rates on contrast-enhanced MDCT. This

  7. Cirurgia da aorta descendente e tóraco-abdominal com técnica de oclusão proximal isolada da aorta ("open distal" Surgical treatment of descending thoracic and thoracoabdominal aorta with the "open distal" technique

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    Bayard Gontijo Filho

    1995-09-01

    case. Surgical exposure was obtained either by left thoracotomy or thoraco-phreno-laparotomy. Heparin was used in a dosis of 1.5 mg/kg and all the blood was collected from the patient and returned through the femoral vein. There were 4(11.4% hospital deaths and 2 (5,8% patients with thoracoabdominal aneurysms developed paraplegia. Morbi - mortality of the group was related to the pre-operative clinical condition and extension of the disease. In our opinion ODT is a simple and effective surgical technique for diseases of the descending thoracic and thoraco-abdominal aorta. Maybe for extensive resections with long aortic cross clamping time, other methods providing a better spinal cord protection should be evaluated

  8. Left Hand-assisted Laparoscopic Nephrectomy With Renal Vein Thrombectomy for Stage T3b Renal Cell Carcinoma.

    Science.gov (United States)

    Ghareeb, George M; Kenleigh, Dorian A; Brown, James A

    2016-04-01

    A 60-year-old male was found to have an 8.0 cm left renal mass and associated renal vein thrombus on computed tomography. The thrombus extended 3 mm beyond the right aortic border to within 1.6 cm of the left border of the inferior vena cava. The patient underwent left nephrectomy with renal vein thrombectomy using a hand-assisted laparoscopic approach. The tumor thrombus was "milked" proximally back into left renal vein, which was then divided with an endovascular stapler. Left renal vein thrombi extending to right margin of the aorta can be managed with hand-assisted laparoscopic approach.

  9. Human Aorta Is a Passive Pump

    Science.gov (United States)

    Pahlevan, Niema; Gharib, Morteza

    2012-11-01

    Impedance pump is a simple valveless pumping mechanism that operates based on the principles of wave propagation and reflection. It has been shown in a zebrafish that a similar mechanism is responsible for the pumping action in the embryonic heart during early stages before valve formation. Recent studies suggest that the cardiovascular system is designed to take advantage of wave propagation and reflection phenomena in the arterial network. Our aim in this study was to examine if the human aorta is a passive pump working like an impedance pump. A hydraulic model with different compliant models of artificial aorta was used for series of in-vitro experiments. The hydraulic model includes a piston pump that generates the waves. Our result indicates that wave propagation and reflection can create pumping mechanism in a compliant aorta. Similar to an impedance pump, the net flow and the flow direction depends on the frequency of the waves, compliance of the aorta, and the piston stroke.

  10. Inhibitory Effect of TLR4 Gene Silencing on Intimal Hyperplasia of Vein Grafting.

    Science.gov (United States)

    Zhu, Zhicheng; Xu, Rihao; Zheng, Xiaomei; Wang, Tiance; Li, Dan; Wang, Yong; Liu, Kexiang

    2016-10-01

    The present study aimed to explore the regulating effect of Toll-like receptor 4 (TLR4) on intimal hyperplasia in rat vein grafts. Rat models of external jugular vein carotid artery bypass grafting were established. Afterward, TLR4 small interfering RNA (siRNA) recombinant plasmids were constructed, which were transfected into rat vein graft bypass to study the effect of TLR4 silencing on intimal hyperplasia and to explore the underlying mechanisms. Real-time polymerase chain reaction and Western blot were used to detect the expression levels of TLR4 and inflammatory factors in TLR4 siRNA-transfected vein graft bypass. The intimal thickness was evaluated using hematoxylin-eosin staining. Compared with the scramble siRNA group, the intimal thickness of vein grafting was decreased significantly, while the inflammatory factors including interleukin (IL) 1β, IL-6, and tumor necrosis factor α in grafted vein were dramatically downregulated in the TLR4 siRNA group. These results showed that local silencing of TLR4 in the vein grafts could inhibit intimal hyperplasia by downregulating the expression of inflammatory factors in the vein grafts, suggesting that TLR4 can be used as a new target for therapy of vascular intimal hyperplasia. © The Author(s) 2016.

  11. Jugular neck dissection for NO neck supraglottic carcinoma

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    Petrović Željko

    2004-01-01

    Full Text Available Appropriate management of patients with supraglottic laryngeal carcinoma and negative findings in the neck is still controversial. A prospective and retrospective study comprised 193 patients who were treated primary surgically between 1976 and 1993. They all had clinically and ultrasound negative findings on the neck (NO. Supraglottic carcinomas usually spread regionally. Metastases develop in the jugular group, between level II-IV. The incidence of metastases has been reported to vary from 12 to 62.5%. The size and localization of the primary tumor, its histological grade, genotype of the malignant cells, imunological and other elucidated factors can all affect the incidence of regional spread. AIM Aim of this study was to specify the incidence of occult cervical metastases; to analyze the distribution of occult metastases related to tumor localization; to specify the distribution of occult metastases related to local spread; to analyze the distribution of occult metastases according to localization in the neck. RESULTS All patients had primary surgery of primary tumor and bilateral jugular, selective neck dissection at the level II-IV with histological examination of removed lymphoid tissue. Out of 193 patients, metastatic deposits were detected in 35(18%. Occult metastases were found in patients with carcinoma of the epilarynx in 19% (14/72 of cases, and in 17% (21/121 patients with carcinoma of the supraglottis excluding the epilarynx. This difference in frequency is not statistically significant. The incidence of occult metastases in epilaryngeal tumors did not depend on the degree of local spread. Even relatively small tumors (T1 and T2 yielded occult metastases in 33% (5/15, and 24% (6/25 of patients, respectively. In patients with T1 tumors localized at the supraglottis, excluding the epilarinx, occult metastases were not found. In the supragiottis excluding the epilarynx increased local spread was associated an increase of occult

  12. Multiple tuberculous aneurysms of the aorta.

    Science.gov (United States)

    Pierret, Charles; Tourtier, Jean-Pierre; Grand, Bertrand; Boddaert, Guillaume; Laurian, Claude; de Kerangal, Xavier

    2011-06-01

    Tuberculous aneurysms of the aorta are quite rare, but are exceptional when found in multiple locations. We report the case of multiple tuberculous aortic aneurysms of the thoracic and abdominal aorta in a 19-year-old female discovered when she consulted for thrombocytopenic purpura. The treatment for both locations included prolonged antituberculous therapy and surgical resection with cryopreserved aortic allograft patch for the reconstruction.

  13. Calcification of thoracic aorta - solar eclipse sign.

    Science.gov (United States)

    Dhoble, Abhijeet; Puttarajappa, Chethan

    2008-08-29

    Calcification of thoracic aorta is very common in old people, especially ones with hypertension. This can sometime be visible on plain chest radiograph. We present a case of a male patient who had extensive deposition of calcium in the thoracic aorta. The relationship between aortic calcification and coronary atherosclerosis remains contentious. Computed tomography of the thorax can display this calcification which appears like 'solar eclipse'.

  14. The influence of steroids on the vascular tension of isolated superficial nasal and facial veins in gilts during sexual maturation.

    Science.gov (United States)

    Grzegorzewski, W J; Muszak, J; Tabecka-Łonczyńska, A; Stefańczyk-Krzymowska, S

    2010-01-01

    The arrangement of the superficial facial veins enables blood flow from the nasal cavity into the peripheral circulation by two pathways: through the facial vein into the external jugular vein and through the frontal vein into the cavernous sinus. The venous cavernous sinus is the site where hormones and pheromones permeate from venous blood into the arterial blood supplying the brain and hypophysis. The present study was designed to: (1) determine whether estradiol (E2) and progesterone (P4) affect the vascular tone of the superficial veins of the nose and face in maturating prepubertal gilts (PP) and in prepubertal gilts deprived of ovarian hormones (PPov), and (2) to analyze the immunolocalization of progesterone receptors (PR), and estradiol receptors alpha (ER alpha) and beta (ER beta) in these veins. The influence of hormones on the vascular tension differed depending on the type of vessel, the hormonal status and dose of hormone used. Estradiol decreased the vascular tension in the nasal and facial veins of PP gilts (P tension in the proximal and distal parts of the facial vein (P tension in the proximal segment of the nasal vein and in the distal segment of the frontal and facial veins, and decreased the tension in the distal segment of the nasal and facial veins (P tension of distal and proximal segments of the nasal vein (P tension of the distal part of the nasal vein (P superficial nasal and facial veins. In conclusion, the ovarian steroid hormones that modulate the vascular tension of the nasal and facial veins in prepubertal gilts may influence the transfer of boar pheromones from the nasal mucosa to the brain via local humoral pathway during sexual maturation.

  15. Effects of amino acids infused into the vein on ghrelin-induced GH, insulin and glucagon secretion in lactating cows.

    Science.gov (United States)

    Fukumori, Rika; Yokotani, Akinori; Sugino, Toshihisa; Itoh, Fumiaki; Kushibiki, Shiro; Shingu, Hiroyuki; Moriya, Naoko; Hasegawa, Yoshihisa; Kojima, Masayasu; Kangawa, Kenji; Obitsu, Taketo; Taniguchi, Kohzo

    2011-04-01

    To investigate the effects of amino acids on ghrelin-induced growth hormone (GH), insulin and glucagon secretion in lactating dairy cattle, six Holstein cows were randomly assigned to two infusion treatments in a cross-over design. Mixture solution of amino acids (AMI) or saline (CON) was continuously infused into the left side jugular vein via catheter for 4 h. At 2 h after the start of infusion, synthetic bovine ghrelin was single injected into the right side jugular vein through the catheter. Ghrelin injection immediately increased plasma GH, glucose and non-esterified fatty acids (Pghrelin injection in both treatments. The peak value of plasma insulin concentration was greater in AMI compared with CON (Pghrelin action which in turn enhances insulin and glucagon secretions in lactating cows.

  16. [Right ovarian vein syndrome].

    Science.gov (United States)

    Arvis, G

    1985-01-01

    Right ovarian vein syndrome is revealed in pregnancy by right lumbar pains, and even by nephritic colics. It results from a congenital malposition of the right ovarian vein, which presses the right ureter on the external iliac artery. Diagnosis is by intravenous urography and retrograde ureteral pyelography. If pain persists despite treatment by analgesics, it may be necessary to place a double-J catheter, and to operate after delivery to ligate the ovarian vein.

  17. Postpartum renal vein thrombosis.

    Science.gov (United States)

    Rubens, D; Sterns, R H; Segal, A J

    1985-01-01

    Renal vein thrombosis in adults is usually a complication of the nephrotic syndrome. Rarely, it has been reported in nonnephrotic women postpartum. The thrombosis may be a complication of the hypercoagulable state associated with both the nephrotic syndrome and pregnancy. Two postpartum patients with renal vein thrombosis and no prior history of renal disease are reported here. Neither patient had heavy proteinuria. In both cases, pyelonephritis was suspected clinically and the diagnosis of renal vein thrombosis was first suggested and confirmed by radiologic examination. Renal vein thrombosis should be considered in women presenting postpartum with flank pain.

  18. Comparison between mechanical properties of human saphenous vein and umbilical vein

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    Hamedani Borhan

    2012-08-01

    Full Text Available Abstract Background As a main cause of mortality in developed countries, Coronary Artery Disease (CAD is known as silent killer with a considerable cost to be dedicated for its treatment. Coronary Artery Bypass Graft (CABG is a common remedy for CAD for which different blood vessels are used as a detour. There is a lack of knowledge about mechanical properties of human blood vessels used for CABG, and while these properties have a great impact on long-term patency of a CABG. Thus, studying these properties, especially those of human umbilical veins which have not been considered yet, looks utterly necessary. Methods Umbilical vein, as well as human Saphenous vein, are respectively obtained after cesarean and CABG. First, histological tests were performed to investigate different fiber contents of the samples. Having prepared samples carefully, force-displacement results of samples were rendered to real stress–strain measurements and then a fourth-order polynomial was used to prove the non-linear behavior of these two vessels. Results Results were analyzed in two directions, i.e. circumferentially and longitudinally, which then were compared with each other. The comparison between stiffness and elasticity of these veins showed that Saphenous vein’s stiffness is much higher than that of umbilical vein and also, it is less stretchable. Furthermore, for both vessels, longitudinal stiffness was higher than that of circumferential and in stark contrast, stretch ratio in circumferential direction came much higher than longitudinal orientation. Conclusion Blood pressure is very high in the region of aorta, so there should be a stiff blood vessel in this area and previous investigations showed that stiffer vessels would have a better influence on the flow of bypass. To this end, the current study has made an attempt to compare these two blood vessels’ stiffness, finding that Saphenous vein is stiffer than umbilical vein which is somehow as stiff as

  19. The role of prourokinase gene in protecting vein grafts from intimal hyperplasia

    Institute of Scientific and Technical Information of China (English)

    黄志雄; 郭加强; 胡盛寿

    2003-01-01

    Objective To study the duration of prourokinase gene expression in vein grafts and the role of the prourokinase gene in protecting vein grafts from neointimal hyperplasia.Methods Fifty-four Wistar rats were used in this study. In each rat, the jugular vein was excised and distended for 30 minutes using a solution containing either Adv5-CMV (control group) or Adv5-CMV/Pro-UK (treatment group). Next, the jugular vein was reversed and interposed into the divided carotid artery of the same rat. On the 14th day after transfection, vein grafts of the control group were collected in order to perform a fibrinolysis test for prourokinase (Pro-UK) activity. On the 2nd, 7th, 14th, 28th, and 60th day, the vein grafts of the treatment group were likewise collected in order to detect prourokinase activity. On the 28th day, the vein grafts of both groups were explanted to evaluate the 3H-TDR incorporation so that pathologic analysis could be performed.Results Pro-UK activity could not be detected in the control group, while in the treatment group, the Pro-UK activity could be detected from the 2nd day onwards, peaking on the 7th day and declining from the 14th day, but yet persisting at a low level for a further month. The amount of 3H-TDR incorporated in the control group was higher than that in the treatment group. Pathologic analysis demonstrated that vein grafts of both groups exhibited wall thickening, but that the degree of graft neointimal hyperplasia and reduction of the graft lumen was greater in the control group than that in the treatment group. The occlusion rate of grafts in the control group was 20%. All grafts in the treatment group were patent.Conclusions Pro-UK gene transfer before vein grafting in vitro results in a high level of gene expression in the vein graft from the 7th day to 14th day. And its gene expression in the vein graft could reduce neointimal hyperlasia in the vein graft.

  20. Estudo da resposta tissular à endoprótese recoberta de jugular bovina em veia cava inferior de suínos Bovine jugular covered stent-graft implanted in swine inferior vena cava - a study of tissue response

    Directory of Open Access Journals (Sweden)

    Cristina Ribeiro Riguetti Pinto

    2006-06-01

    Full Text Available OBJETIVO: Avaliar a resposta tissular a uma endoprótese, com cobertura biológica heteróloga, implantada em veia cava inferior de suínos. MÉTODO: Desenvolvemos uma endoprótese auto-expansível, revestida com um segmento de jugular bovina, conservada por processo L-hydro e suturada em um stent de aço inoxidável 316L. O dispositivo introdutor utilizado foi a bainha de liberação da endoprótese aórtica Taheri-Leonhardt (Flórida, EUA. Foram implantadas endopróteses em 10 suínos, todas na veia cava infra-renal. Os animais foram submetidos à flebografia peroperatória. À necropsia, após 2 meses, cada endoprótese foi retirada em bloco e analisada macroscopicamente, visando a avaliação da perviedade, aderência aos tecidos vizinhos e incorporação à parede venosa; e, histopatologicamente, visando a resposta histológica ao enxerto. RESULTADOS: Na análise macroscópica, todas as endopróteses encontravam-se pérvias e totalmente incorporadas à parede venosa, porém seis apresentavam trabeculações grosseiras no seu interior e quatro algum grau de fibrose perivascular. Três animais desenvolveram linfocele, uma retroperitoneal e as outras na parede abdominal. No estudo histopatológico, observamos reação inflamatória granulomatosa tipo corpo estranho em todos os casos, sendo predominante na camada média (80%. CONCLUSÃO: O modelo estudado apresentou baixa trombogenicidade, corroborando com a eficácia do meio de conservação e material escolhidos; porém, baixa biocompatibilidade, provavelmente pelo obstáculo imunológico dos xenoenxertos e resposta tissular exagerada do território venoso.OBJECTIVE: To evaluate tissue response to a bovine jugular vein covered stent when implanted in the swine inferior vena cava. METHOD: We developed a self-expanding stent, using a segment of L-hydro conserved bovine jugular vein, which was trimmed and sutured to a 316L stainless steel stent. We used the Taheri-Leonhardt delivery system for

  1. What Causes Varicose Veins?

    Science.gov (United States)

    ... blood flow, and thin, stretched walls. The middle image shows where varicose veins might appear in a leg. Figure A shows ... blood flow, and thin, stretched walls. The middle image shows where varicose veins might appear in a leg. Older age or ...

  2. Microsurgical Bypass Training Rat Model, Part 1: Technical Nuances of Exposure of the Aorta and Iliac Arteries.

    Science.gov (United States)

    Tayebi Meybodi, Ali; Lawton, Michael T; Mokhtari, Pooneh; Yousef, Sonia; Gandhi, Sirin; Benet, Arnau

    2017-06-21

    Animal models using rodents are frequently used for practicing microvascular anastomosis-an essential technique in cerebrovascular surgery. However, safely and efficiently exposing rat's target vessels is technically difficult. Such difficulty may lead to excessive hemorrhage and shorten animal survival. This limits the ability to perform multiple anastomoses on a single animal and may increase the overall training time and costs. We report our model for microsurgical bypass training in rodents in 2 consecutive articles. In part 1, we describe the technical nuances for a safe and efficient exposure of the rat abdominal aorta and common iliac arteries (CIAs) for bypass. Over a 2-year period, 50 Sprague-Dawley rats underwent inhalant anesthesia for practicing microvascular anastomosis on the abdominal aorta and CIAs. Lessons learned regarding the technical nuances of vessel exposure were recorded. Several technical nuances were important for avoiding intraoperative bleeding and preventing animal demise while preparing an adequate length of vessels for bypass. The most relevant technical nuances include (1) generous subcutaneous dissection; (2) use of cotton swabs for the blunt dissection of the retroperitoneal fat; (3) combination of sharp and blunt dissection to isolate the aorta and iliac arteries from the accompanying veins; (4) proper control of the posterior branches of the aorta; and (5) efficient division and mobilization of the left renal pedicle. Applying the aforementioned technical nuances enables safe and efficient preparation of the rat abdominal aorta and CIAs for microvascular anastomosis. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Brain nonoxidative carbohydrate consumption is not explained by export of an unknown carbon source: evaluation of the arterial and jugular venous metabolome

    DEFF Research Database (Denmark)

    Rasmussen, Peter; Nyberg, Nils; Jaroszewski, Jerzy W.;

    2010-01-01

    Brain activation provokes nonoxidative carbohydrate consumption and during exercise it is dominated by the cerebral uptake of lactate resulting in that up to approximately 1 mmol/ 100 g of glucose equivalents cannot be accounted for by cerebral oxygen uptake. The fate of this 'extra' carbohydrate...... uptake is unknown, but it may be that brain metabolism is balanced by a yet-unidentified substance(s). This study used a nuclear magnetic resonance-based metabolomics approach to plasma samples obtained from the brachial artery and the right internal jugular vein in 16 healthy young males to identify...... carbon species going to and from the brain. We observed a carbohydrate accumulation of 255+/-37 micromol/100 g glucose equivalents at exhaustion not accounted for by the oxygen uptake. Although the cumulated uptake was lower than earlier observed, the results show that glucose and lactate are responsible...

  4. Posterior Nutcracker Syndrome Associated with Interrupted Left Inferior Vena Cava with Azygos Continuation and Retroaortic Right Renal Vein

    Energy Technology Data Exchange (ETDEWEB)

    Luo, Xiao Li; Zhou, Xiao Dong [Xijing Hospital, Fourth Military Medical University, Shaanxi (China); Qian, Gen Nian; Xiao, Hui; Zhao, Chun Lei [Fuzhou General Hospital, Fujian (China)

    2012-06-15

    Various anatomic anomalies have been considered the causes of nutcracker syndrome (NCS). Posterior NCS refers to the condition, in which vascular narrowing was secondary to the compression of the retroaortic left renal vein while it is crossing between the aorta and the vertebral column. Here, we report an unusual case of posterior NCS associated with a complicated malformation of the interrupted left inferior vena cava with azygos continuation and retroaortic right renal vein, diagnosed by both color Doppler ultrasonography and CT angiography.

  5. Bovine pericardium for portal vein reconstruction in abdominal surgery: a surgical guide and first experiences in a single center.

    Science.gov (United States)

    Jara, Maximilian; Malinowski, Maciej; Bahra, Marcus; Stockmannn, Martin; Schulz, Antje; Pratschke, Johann; Puhl, Gero

    2015-01-01

    Resection and reconstruction of infiltrated vessels achieve resectability of extended pancreatic tumors. The aim of the present study was to assess the feasibility of bovine pericardium as graft material for the individualised portal vein reconstruction and demonstrate a surgical technique for abdominal vein repair. We performed a MEDLINE search to review the methods for complex abdominal vein reconstruction in the course of extended pancreatectomy. Moreover, clinical data of patients receiving portal vein reconstruction using a bovine pericardial patch at our institution were retrospectively analyzed. Based on the results of a review of the literature, autologous venous grafts using the internal jugular vein represent the most popular option for segmental portal vein reconstruction in case of impossible direct suture. At our center, segmental portal vein reconstruction with bovine pericardial patch in course of pancreatic surgery was performed in 4 patients. No case of vascular complications such as occlusion, segmental stenosis or thrombosis occurred. Our experience suggests a surgical procedure for an individual size-matched portal vein reconstruction using bovine pericardium. Although first results appear promising, prospective studies are required to objectively assess the patency of bovine pericardium compared with autologous and synthetic interposition grafts for portal vein reconstruction. © 2015 S. Karger AG, Basel.

  6. Optimal positioning of right-sided internal jugular venous catheters: Comparison of intra-atrial electrocardiography versus Peres′ formula

    Directory of Open Access Journals (Sweden)

    Joshi Anish

    2008-01-01

    Full Text Available Central venous catheters are routinely placed in patients undergoing major surgeries where expected volume and hemodynamic disturbances are likely consequences. The incorrect positioning may give false central venous pressure (CVP readings leading to incorrect volume replacement and other serious complications. 50 American Society of Anaesthesiologists grade II-IV patients aged 18-60 years were selected for right-sided internal jugular vein (IJV catheterization using Seldinger′s technique. In group A, central venous catheterization was done under electrocardiography (ECG guidance. In group B, the catheter was inserted blindly using Peres′ formula of "height (in cm/10". The position of the tip of central venous catheter was confirmed radiologically by postoperative chest X-ray. 92% of patients in group A had radiologically correct positioning of catheter tip i.e. above the carina, while in group B 48% patients had over-insertion of the catheter in to the right atrium. Intra-atrial ECG technique to judge correct tip positioning is simple and economical. It can determine the exact position intraoperatively and can justify a delayed postoperative chest X-ray to confirm CVC line tip placement.

  7. Cardiac tamponade secondary to perforation of innominate vein following central line insertion in a neonate

    Directory of Open Access Journals (Sweden)

    Ramkumar Dhanasekaran

    2014-01-01

    Full Text Available Cardiac tamponade following central line in a neonate is rare and an uncommon situation; however, it is potentially reversible when it is diagnosed in time. We report a case of cardiac tamponade following central line insertion. A 10-day-old 2.2 kg girl operated for obstructed total anomalous pulmonary venous connections had neckline slipped out during extubation. Attempted cannulations of right femoral vein were unsuccessful. At the end of the left internal jugular vein cannulaton, there was a sudden cardiorespiratory arrest. Immediate transthoracic echocardiogram showed left pleural and pericardial collection. Chest was opened and the catheter tip was seen in the thoracic cavity after puncturing the innominate vein. The catheter was removed and the vent was repaired.

  8. Pseudoprominent aorta: Radiographic findings and CT correlation

    Energy Technology Data Exchange (ETDEWEB)

    Brown, K.T.; Shepard, J.A.O.; Stewart, W.J.

    1985-05-01

    The presence of a persistent left-sided superior vena cava (LSVC) in the absence of a right-sided superior vena cava (RSVC) may be suspected on a posteroanterior (PA) chest radiograph because of a prominent-appearing ascending aorta, which results from the absence of the RSVC. In the absence of an RSVC, the right upper lobe abuts and outlines the course of the ascending aorta, allowing better demonstration of its profile. This report describes a patient with this finding on a PA chest radiograph. Computed tomographic correlation is presented.

  9. Digital subtraction angiography of the thoracic aorta

    Energy Technology Data Exchange (ETDEWEB)

    Grossman, L.B.; Buonocore, E.; Modic, M.T.; Meaney, T.F.

    1984-02-01

    Forty-three patients with acquired and congenital abnormalities of the thoracic aorta were studied using digital subtraction angiography (DSA) after an intravenous bolus injection of 40 ml of contrast material. Abnormalities studied included coarctation, pseudocoarctation, Marfan syndrome, cervical aorta, double aortic arch, aneurysm, dissection, and tumor. Twenty-four patients also had conventional angiography. DSA was accurate in 95% of cases; in the other 5%, involving patients with acute type I dissection, the coronary arteries could not be seen. The authors concluded that in 92% of their patients, DSA could have replaced the standard aortogram.

  10. Mycotic aneurysm rupture of the descending aorta

    Energy Technology Data Exchange (ETDEWEB)

    Gufler, H.; Buitrago-Tellez, C.H.; Nesbitt, E.; Hauenstein, K.H. [Department of Radiology, Albert-Ludwigs-Universitaet, Freiburg (Germany)

    1998-03-01

    A 69-year-old diabetic male with salmonella bacteremia developed hypovolemic shock and swelling of the neck. A CT examination revealed massive mediastinal hemorrhage extending into the neck soft tissues caused by false aneurysm rupture of the descending thoracic aorta. Aortography showed continuous extravasation from a large leak at the medial side of the descending thoracic aorta. Although surgical intervention was immediately performed, the patient died 3 weeks later from multiple-organ failure. In this report, CT and angiographic findings of mycotic aneurysm rupture are presented and a review is given. (orig.) With 2 figs., 11 refs.

  11. Congenital preduodenal portal vein

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Jin; Hwang, Mi Soo; Huh, Young Soo; Park, Bok Hwan [College of Medicine, Youngnam University, Gyeongsan (Korea, Republic of)

    1991-03-15

    Congenital preduodenal portal vein, first reported by Knight in 1921, is an extremely rare congenital anomaly in which the portal vein passes anteriorly to the duodenum rather than posteriorly in its normal location. It is of surgical significance because it may cause difficulties in operations involving the gall bladder, biliary duct, or duodenum. Recently, we experienced 2 cases of preduodenal portal vein. One was found during surgical exploration for the diagnosis and correction of malrotation of the bowels and the other in a 3 day-old male newborn associated with dextrocardia, situs inversus, and duodenal obstruction by diaphragm. We report these 2 cases with a review of the literature.

  12. Umbilical and portal vein calcification following umbilical vein catheterization

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, K.; Fendel, H.; Hartl, M.

    1989-07-01

    Calcifications of the umbilical vein and intrahepatic branches of the portal vein developed in a newborn who had inserted an umbilical vein catheter for 11 days postnatally. The calcified intrahepatic portal veins can still be demonstrated sonographically at the age of three years, whereby these calcifications were no longer detectable radiologically. (orig.).

  13. Morphological variations of a jugular foramen in North Indian human adult skulls

    Directory of Open Access Journals (Sweden)

    Ruchira Sethi

    2011-01-01

    Full Text Available Aims: To assess the size and bridging patterns of jugular foramina of adult human skulls. Materials and Methods: The study was conducted on 56 adult North - Indian skulls procured from Department of Anatomy of Santosh Medical College, Ghaziabad. The jugular foramina were observed by naked eye and with magnifying lens to assess the variations in size and bridging patterns. Results: The jugular foramen was larger on the right side in 53.5% skulls and on the left side in 7.1% skulls. In the remaining skulls (39.4% it was equal on both sides. Complete tripartite division was observed in 10.7% cases. Incomplete division was seen in 7.1% cases on right side and 3.5% cases on the left side. Incomplete division was never observed bilaterally. An additional accessory foramen was observed to be communicating with posterior condylar canal. Conclusion: The variations observed in present study are of immense value to ENT surgeons while performing middle ear surgeries for various jugular foramen tumors. Also, the bridging patterns cause compression to structures passing through this foramen hence accentuating the clinical presentations of Glomus jugulare.

  14. Abdominal aorta transplantation after programmed cryopreservation

    Institute of Scientific and Technical Information of China (English)

    Song Gu; Chang-Jian Liu; Tong Qiao; Xue-Mei Sun; Jun-Hao Chen

    2004-01-01

    AIM: To study the morphologic and cellular immunologic changes after homologous transplantation of the abdominal aorta in rats after programmed cryopreservation (-196°C).METHODS: Abdominal aorta was harvested from anesthetized Spraque Dawley (SD) rats for cryopreservation (group B) or immediate implantation (group A). The survival rates and apoptotic rates of aortic endothelial cells (ECs)were examined. The patency rates, histology and cellular immunologic changes of the abdominal aorta were examined on days 1, 3, 7, 14, 30, 60 after transplantation respectively.RESULTS: The survival rate of ECs after programmed cryopreservation was 90.1±1.79%, about 3.4% lower than that of uncryopreservation (93.5±1.96%). The apoptotic rates of ECs was increased after cryopreservation (7.15%vs 4.86%, P<0.05). The patency rate of group B was significantly higher than that of group A (91.6±12.9% vs 62.5±26.2%, P<0.01). CD4/CD8 ratio, TCR αβ and CD11b/CD18 ratio of group B were significantly lower than those of group A (P<0.05). Revivification of the cryopreserved abdominal aorta showed normal adventitia and intact smooth muscle cells.CONCLUSION: Cryopreservation can reduce homologous abdominal aortic antigenecity. Even if without administration of immunosuppressive agents, it is still feasible to implement homologous artery grafting in rats.

  15. Thoracic aorta stent grafting through transapical access.

    NARCIS (Netherlands)

    Saouti, N.; Vos, J.A.; Heuvel, D. van de; Morshuis, W.J.; Heijmen, R.H.

    2015-01-01

    BACKGROUND: To describe the transapical approach for thoracic endovascular aortic repair (TEVAR). METHODS: Three patients, 2 elective and 1 emergent, with thoracic aorta aneurysm are described with vascular or direct aortic inaccessible access, who underwent TEVAR through transapical access. The tec

  16. Platelet affinity for burro aorta collagen

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, M.D.

    1977-10-01

    Despite ingenious concepts, there are no unequivocal clues as to what, when, and how some undefined biochemical factor(s) or constituent(s) that localizes in the arterial wall can precipitate a thromboatheromatous lesion or arterial disease. The present study focused on the extraction, partial purification, and characterization of a collagen-active platelet stimulator from the aortas of aged burros. The aggregator moiety in the aorta extracts invariably had a higher affinity for platelets in citrated platelet-rich plasma of human beings than for platelets of homologous burros. The platelet-aggregating factor(s) in the aorta extract was retained by incubation with ..cap alpha..-chymotrypsin. Platelet-aggregating activity was rapidly abolished after incubation with collagenase, as determined by platelet-aggregometry tests. Evidence based on light microscope and polysaccharide histochemical reactions indicates a probability that the intracellular amorphous matrix (PAS-positive) and filamentous components (PTAH-positive) expelled from smooth muscle cells disrupted during homogenization of the aorta may be a principal source of a precursor collagen species which is a potent inducer of platelet aggregation.

  17. A Surgical Procedure for the Chronic Cannulation of the Carotid Artery and the Jugular Vein in Dogs,

    Science.gov (United States)

    1986-05-01

    diffirents composis tout en enregistrant la pression art~rlelle sur des chiens conscients, mobiles ou l6girement restreints. (il) TABLE OF CONTENTS...the dog. A tethering anchor (Alick King Chatham Medical Arts, Los Angeles) was secured to the left side ahove the scapular region. This provided an...In the next six dogs, the use of the miniature mobile infusion pumps was initiated to continually flush the cannulae with minute volumes of sterile

  18. Pretreatment with intraluminal rapamycin nanoparticle perfusion inhibits neointimal hyperplasia in a rabbit vein graft model

    Directory of Open Access Journals (Sweden)

    Kai Liu

    2010-10-01

    Full Text Available Kai Liu1*, Guangqing Cao1*, Xiquan Zhang1, Ruifang Liu2, Weiwei Zou3, Shuming Wu11Departments of Cardiovascular Surgery, 2Anesthesia, Qilu Hospital of Shandong University, Jinan; 3The School of Pharmaceutical Science, Shandong University, Jinan, Shandong, People’s Republic of China; *Kai Liu and Guangqing Cao contributed equally to this work.Purpose: Poly lactic-co-glycolic acid nanoparticles (PLGA-NP are widely used as a biodegradable biomaterial in medicine. Rapamycin-eluting stents have been used for prevention of restenosis during surgery. This study investigated the effect of pretreatment with intraluminal perfusion of carbopol-encapsulated rapamycin-loaded PLGA nanoparticles (RAP-PLGA-NP on neointimal hyperplasia in a rabbit vein graft model.Methods: A segment of common carotid artery was replaced with a segment of external jugular vein in 60 rabbits which were then separated into four treatment groups, ie, Group 1, in which vein grafts were pretreated with intraluminal RAP-PLGA-NP perfusion, Group 2 in which vein grafts underwent equivalent empty vehicle (PLGA-NP perfusion, Group 3, in which vein grafts received no treatment, and Group 4, which served as a sham operation group receiving normal vein contrast. On postoperative day 28, the grafts and normal veins were harvested for histologic examination, flow cytometry analysis, and high-performance liquid chromatography measurement.Results: Compared with Group 1, the intima of the grafts were thickened, the ratio of intimal area to vessel area increased, and the collagen volume index of the vein grafts increased significantly in Groups 2 and 3. The cell proliferation index in Group 1 (21.11 ± 3.15% was much lower than that in Group 2 (30.35 ± 2.69% and in Group 3 (33.86 ± 8.72%. By high-performance liquid chromatography measurement, retention of rapamycin was detected in Group 1 (11.2 ± 0.37 µg/10 mg 28 days after single drug perfusion.Conclusion: Pretreatment with intraluminal RAP

  19. Surgery of gigantic infrarenal aneurysm of abdominal aorta

    Directory of Open Access Journals (Sweden)

    N. Rustempašić

    2005-08-01

    Full Text Available The case shows gigantic aneurysm of abdominal aorta, localized infrarenally, as well as aneurysms of bilateral iliac arteries, which were solved successfully by resection of aneurism of abdominal aorta, closure of iliac arteries near aortic bifurcation, and interposition of aorta-bifemural vascular graft. There were no postoperative complications,and final outcome was fully satisfactory.

  20. Deep vein thrombosis.

    Science.gov (United States)

    Bandyopadhyay, Gargi; Roy, Subesha Basu; Haldar, Swaraj; Bhattacharya, Rabindra

    2010-12-01

    Occlusive clot formation in the veins causes venous thrombosis, the site most common in the deep veins of leg, called deep vein thrombosis. The clot can block blood flow and when it breaks off, called an embolism which in turn can damage the vital organs. Venous thrombosis occurs via three mechanisms ie, Virchow's triad. The mechanisms are decreased flow rate of blood, damage to the blood vessel wall and an increased tendency of the blood to clot. There are several factors which can increase a person's risk for deep vein thrombosis. The symptoms of deep vein thrombosis in the legs are pain, swelling and redness of the part. One variety of venous thrombosis is phlegmasia alba dolens where the leg becomes pale and cool. Investigations include Doppler ultrasound examination of the limb, D-dimer blood test, plethysmography of the legs, x-rays to show vein in the affected area (venography). Hospitalisation is necessary in some cases with some risk factors. The mainstream of treatment is with anticoagulants, mostly low molecular weight heparin for 6 months. Deep venous thrombosis is a rising problem. Early diagnosis and treatment is associated with a good prognosis.

  1. Mesenteric vein thrombosis: CT identification

    Energy Technology Data Exchange (ETDEWEB)

    Rosen, A.; Korobkin, M.; Silverman, P.M.; Dunnick, N.R.; Kelvin, F.M.

    1984-07-01

    Superior mesenteric vein thrombosis was identified on computed tomographic scans in six patients. In each case, contrast-enhanced scans showed a high-density superior mesenteric vein wall surrounding a central filling defect. Four fo the six patients had isolated superior mesenteric vein thrombosis. A fifth patient had associated portal vein and splenic vein thrombosis, and the sixth patient had associated portal vein and inferior vena cava thrombosis. One of the six patients had acute ischemic bowel disease. The other five patients did not have acute ischemic bowel symptoms associated with their venous occlusion. This study defines the computed tomographic appearance of mesenteric vein thrombosis.

  2. [Ascending aorta-supraceliac++ aorta bypass. Correction of a case of atypical coarctation in the adult].

    Science.gov (United States)

    Vaquero, F; Zorita, A; Samos, R F; Vázquez, J G; Ortega, J M; Morán, C F

    1993-01-01

    A case of atypic coarctation at the aortic arch in an adult patient is described. Coarctation was surgically treated by a retrosternal bypass from the ascendant aorta to the supra-celiac aorta. After a short prelude the clinical case is summarized. Furthermore, the etiopathogenic features of the disease, the different diagnostic methods and the multiple surgical procedures are discussed. Finally, we briefly review the literature.

  3. Reducing intimal hyperplasia in vein grafts harvested by a no-touch harvesting technique

    Institute of Scientific and Technical Information of China (English)

    Hai-chen Wang; Wu-jun Xue; Miao-miao Liu

    2009-01-01

    Objective To investigate the effect of no-tonch harvesting technique in reducing vein graft intimal hyperplasin. A4othods This longitudinal trial compared graft ungiestenosis of two groups undergoing jugular vein to carotid artery interposition grafting in rabbit model. Conventional group: 12 rabbits had their veins stripped, distended, and stored in heparinized saline solution. No-touch group: 12 rabbits had veins removed with surrounding tissues, but were not distended, and stored in heparinized blood. The grafts were removed 4 weeks following grafting, and morphometry and immunohistochemistry assessment were performed. Results The intimal thickness, degree of anginstennsis and proliferation index of vascular smooth muscle cells of no-touch group were significantly reduced (P< 0.01) compared with those of the conventional group. The proliferating cell nuclear antigen pnsitive-staining cells were significantly increased (P<0.01) in the conventional group compared with whose in the no-touch group. Conclusion Harvesting the vein graft with no-touch harvesting technique could significantly reduce intimul hyperpinsin of the vein graft.

  4. Use of Brilliant Blue FCF during vein graft preparation inhibits intimal hyperplasia.

    Science.gov (United States)

    Osgood, Michael J; Sexton, Kevin; Voskresensky, Igor; Hocking, Kyle; Song, Jun; Komalavilas, Padmini; Brophy, Colleen; Cheung-Flynn, Joyce

    2016-08-01

    Intimal hyperplasia remains the primary cause of vein graft failure for the 1 million yearly bypass procedures performed using human saphenous vein (HSV) grafts. This response to injury is caused in part by the harvest and preparation of the conduit. The use of Brilliant Blue FCF (FCF) restores injury-induced loss of function in vascular tissues possibly via inhibition of purinergic receptor signaling. This study investigated whether pretreatment of the vein graft with FCF prevents intimal hyperplasia. Cultured rat aortic smooth muscle cells (A7r5) were used to determine the effect of FCF on platelet-derived growth factor-mediated migration and proliferation, cellular processes that contribute to intimal hyperplasia. The effectiveness of FCF treatment during the time of explantation on preventing intimal hyperplasia was evaluated in a rabbit jugular-carotid interposition model and in an organ culture model using HSV. FCF inhibited platelet-derived growth factor-induced migration and proliferation of A7r5 cells. Treatment with FCF at the time of vein graft explantation inhibited the subsequent development of intimal thickening in the rabbit model. Pretreatment with FCF also prevented intimal thickening of HSV in organ culture. Incorporation of FCF as a component of vein graft preparation at the time of explantation represents a potential therapeutic approach to mitigate intimal hyperplasia, reduce vein graft failure, and improve outcome of the autologous transplantation of HSV. Copyright © 2016. Published by Elsevier Inc.

  5. Non-contact wide-field hemodynamic imaging reveals the inverted jugular venous pulse waveform

    CERN Document Server

    Amelard, Robert; Greaves, Danielle K; Pfisterer, Kaylen J; Leung, Jason; Clausi, David A; Wong, Alexander

    2016-01-01

    Cardiovascular disease is the leading cause of death globally. Cardiovascular monitoring is important to prevent diseases from progressing. The jugular venous pressure waveform (JVP) is able to provide important information about cardiac health. Factors such as mechanical deformations, electric abnormalities, and irregular external forces change the fundamental shape of the JVP. However, current methods for measuring the JVP require invasive catheter insertion, or subjective qualitative visual inspection of the patient's jugular pulse. Thus, JVP are not routinely performed, and are scheduled only when there is probable cause for catheterisation. Non-invasive monitoring methods would benefit JVP monitoring. Recently, there has been a surge in focus on photoplethysmographic imaging (PPGI) systems. These systems are non-contact wide-field imaging systems able to assess blood pulse waveforms across a large area of the body. However, PPGI has not been previously explored for measuring jugular venous pulse. In this...

  6. The influence of steroids on vascular tension of isolated superficial veins of the nose and face during the estrous cycle of gilts.

    Science.gov (United States)

    Grzegorzewski, W J; Chłopek, J; Tabecka-Łonczyńska, A; Stefańczyk-Krzymowska, S

    2010-01-15

    The arrangement of the superficial facial veins enables blood flow from the nasal cavity into the peripheral circulation by two pathways: through the frontal vein into the cavernous sinus and through the facial vein into the external jugular vein. The current study was designed to determine whether estradiol and progesterone affect the vascular tone of the superficial veins of the nose and face in cycling gilts (Sus scrofa f. domestica) and to analyze the immunolocalization of progesterone receptors and estradiol receptors in these veins. The influence of hormones on vascular tension differed depending on the type of vessel and the phase of the estrous cycle. Estradiol decreased vascular tension in the nasal vein during the follicular phase (Pnose and face. In conclusion, the effect of ovarian steroid hormones on the vascular tension of the superficial veins of the nose and face in female pigs as well as the reactivity of these veins to steroid boar pheromones can affect the blood supply from the nasal cavity to the venous cavernous sinus. We propose that the ovarian steroid hormones that modulate the vascular tension of the nasal and facial veins may also influence the action of boar pheromones absorbed into the nasal mucosa in gilts and may reach the brain via local destination transfer.

  7. Transcatheter closure of patent foramen ovale using the internal jugular venous approach.

    Science.gov (United States)

    Węglarz, Przemysław; Konarska-Kuszewska, Ewa; Zębik, Tadeusz; Kuszewski, Piotr; Drzewiecka-Gerber, Agnieszka; Motyka, Marek; Ludyga, Tomasz; Bajor, Grzegorz

    2014-01-01

    Transcatheter closure of patent foramen ovale is routinely performed using the transfemoral approach, which is safe and technically easy. Our case represents the rare situation where the procedure needs to be performed using the right internal jugular venous approach. According to our best knowledge this is the first report of a patent foramen ovale closure procedure with access through the internal jugular with necessity to advance the guide wire and transseptal sheath into the left ventricle. Developing alternative techniques of transcatheter patent foramen ovale closure seems to be especially important in rare cases where transfemoral access is unavailable.

  8. Skull Base Aneurysmal Bone Cyst Presented with Foramen Jugular Syndrome and Multi-Osseous Involvement

    Directory of Open Access Journals (Sweden)

    Leila Aghaghazvini

    2012-01-01

    Full Text Available Aneurysmal bone cyst (ABC is an expansile bone lesion that usually involves the long bones. Skull base involvement is rare. Hereby, we describe a 17-year-old man with hoarseness, facial asymmetry, left sided sensorineural hearing loss and left jugular foramen syndrome. CT scan and MRI showed a skull base mass that was confirmed as ABC in histopathology. The case was unusual and interesting due to the clinical presentation of jugular foramen syndrome and radiological findings such as severe enhancement and multiosseous involvement.Keywords: Bone Cysts,Aneurysmal,Petrous Bone,Skull Base,Cranial Fossa,Posterior

  9. Skull base aneurysmal bone cyst presented with foramen jugular syndrome and multi-osseous involvement.

    Science.gov (United States)

    Aghaghazvini, Leila; Sedighi, Nahid; Karami, Parisa; Yeganeh, Omid

    2012-09-01

    Aneurysmal bone cyst (ABC) is an expansile bone lesion that usually involves the long bones. Skull base involvement is rare. Hereby, we describe a 17-year-old man with hoarseness, facial asymmetry, left sided sensorineural hearing loss and left jugular foramen syndrome. CT scan and MRI showed a skull base mass that was confirmed as ABC in histopathology. The case was unusual and interesting due to the clinical presentation of jugular foramen syndrome and radiological findings such as severe enhancement and multiosseous involvement.

  10. [The effect of zeolite (clinoptilolite) on the post-feeding dynamics of N metabolism in the portal vein, jugular vein and the rumen fluid of bulls].

    Science.gov (United States)

    Jacobi, U; Vrzgula, L; Blazovský, J; Havassy, I; Ledecký, V; Bartko, P

    1984-04-01

    If easily digestible saccharides are deficient in the feed ration of bulls with the live weight of 300 kg and at simultaneous single application of urea at a rate of 0.2 g per 1 kg live weight, zeolite (with 50.6% clinoptilolite content) administered at a rate of 2.5% per 1 kg dry matter influenced significantly (P less than 0.05) the ammonia concentration in rumen, v. portae and v. jugularis. The rumen contents and blood were sampled at the intervals of 0, 15, 30, 60, 90, 120, 180 and 360 minutes after feeding. Basal feed ration consisted of 1 kg feed mixture and 3 kg meadow hay. After urea administration, zeolite reduced the ammonia concentration in rumen by 20-40% in comparison with the control group and in v. portae by 60-70%. In v. jugularis in the 90th minute after feeding significant hyperammonemia was observed in bulls with no zeolite supplement. Zeolite administration did not influence urea concentration in plasma.

  11. [Ascending aorta replacement late after aortic valve replacement].

    Science.gov (United States)

    Hayashi, Yasunari; Ito, Toshiaki; Maekawa, Atsuo; Sawaki, Sadanari; Fujii, Genyo; Hoshino, Satoshi; Tokoro, Masayoshi; Yanagisawa, Junji

    2013-07-01

    Replacement of the asceding aorta is indicated in patients undergoing aortic valve replacement( AVR), if the diameter of the ascending aorta is greater than 5.0 cm. If the diameter of the asceding aorta is from 4.0 to 5.0 cm, it was arguable whether replacement of the ascending aorta should be performed. Nine patients who underwent reoperative ascending aorta replacement after AVR were reviewed retrospectively. Reoperation on the asending aorta replacement was performed 11.8±7.2 years (range 1y5m~23y3m) after AVR. Mean patient age was 69.9±6.3 (range 60~81). In 2 cases, reoperations were performed early year after AVR. Although ascending aorta was dilated at the 1st operation, replacement wasn't performed for the age and minimally invasive cardiac surgery (MICS). In 3 cases, reoperations were performed more than 10 years later. On these cases, ascending aorta aneurysm and dissection occurred with no pain and were pointed out by computed tomography(CT) or ultrasonic cardiogram(UCG). We think that patients with dilatation of the ascending aorta should undergo AVR and aorta replacement at the 1st operation regardness of age. It is important that patients who underwent AVR should undergo a regular checkup on the ascending aorta.

  12. Sequential saphenous vein grafting combined with selective arterialization of middle cardiac vein during off-pump coronary artery bypass surgery

    Institute of Scientific and Technical Information of China (English)

    YU Yang; QI Dan-ni; GU Cheng-xiong

    2010-01-01

    @@ Currently coronary artery bypass grafting (CABG) is the most commonly used procedure for revascularization of coronary heart disease. However it may not be suitable for the patients with diffuse coronary artery diseases. Under this circumstance, retrograde perfusion via cardiac venous system, namely retrograde coronary venous bypass graft (CVBG), may be the proper therapeutic selection.1 The idea of myocardial revascularization by means of grafting the coronary venous system is more than a century old. However, few clinical trials and long-term outcome data have been presented. The use of venous arterialization has not been widely used. We report the use of a sequential saphenous vein graft from the aorta to middle cardiac vein in a patient with diffuse lesions in right coronary artery during off-pump coronary artery bypass surgery (OPCAB).

  13. Significance of changes in transforming growth factor-β mRNA levels in autogenous vein grafts

    Institute of Scientific and Technical Information of China (English)

    尤文俊; 萧明第; 袁忠祥

    2004-01-01

    Background This study was designed to investigate changes in mRNA levels of transforming growth factor-β(TGF-β), collagen Ⅰ, and collagen Ⅲ in autogenous vein grafts. Methods Twenty-four New Zealand rabbits were randomly divided into 4 groups with 6 rabbits each. The external jugular veins of the New Zealand rabbits were harvested and grafted into the ipsilateral carotid artery. All rabbits were fed with a standard diet. After the operation, the rabbits were sacrificed at 1, 2, 3, or 4 weeks. TGF-β, collagen Ⅰ, and collagen Ⅲ mRNA levels in the venous grafts were measured by semiquantitative methods at every time point. The contralateral external jugular veins were also harvested and analyzed as controls. Glyceraldehyde-3-phosphate dehydrogenase was used as an internal standard to normalize all samples for potential variations in mRNA content. In order to observe the expression of TGF-β protein, immunohistochemical SABC methods were used. Results One week postoperation, the mRNA level of TGF-β was upregulated to 1.73±0.19 in the vein graft and 1.21±0.16 in the control vein (P<0.01). High mRNA levels were maintained until week 4 postoperation. The mRNA levels of collagen Ⅰ and collagen Ⅲ were also significantly increased to 2.18±0.21 versus 1.12±0.24 and 1.08±0.13 versus 0.83±0.12, respectively (P<0.05). Immunohistochemical staining revealed a higher density of TGF-β expression in the vein grafts.Conclusions An uninterrupted increase in mRNA levels of TGF-β, collagen Ⅰ, and collagen Ⅲ is observed in autogenous vein grafts. This increase may be the major cause of intimal hyperplasia, sclerosis, and even graft failure.

  14. Atrophic coarctation of the abdominal aorta.

    Science.gov (United States)

    Wiest, J W; Traverso, L W; Dainko, E A; Barker, W F

    1980-01-01

    Two cases illustrate the clinical manifestations and angiographic findings associated with segmental stenosis of the abdominal aorta. Such lesions represent the chronic occlusive stage of Takayasu's disease, a nonspecific inflammatory arteritis of uncertain etiology. While the disease is considered autoimmune, an infectious process may be involved. Complications typically associated with stenotic lesions of the abdominal aorta are secondary renal hypertension and ischemic symptoms secondary to vascular insufficiency. Surgical correction, the treatment of choice, has achieved excellent results for these well-localized lesions. Secondary renal hypertension was relieved by a spenorenal shunt and the disease has since been controlled with conservative management in the first patient. An aortofemoral bypass graft successfully alleviated the vascular insufficiency in the second patient, although the patient unfortunately expired from a refractory postoperative cardiac complication. Images Fig. 1. Fig. 2. Fig. 3. Fig. 4. PMID:6102453

  15. Endovascular Therapy Is Effective for Leriche Syndrome with Deep Vein Thrombosis

    Directory of Open Access Journals (Sweden)

    Tasuku Higashihara

    2015-01-01

    Full Text Available A 65-year-old man presented to our hospital due to intermittent claudication and swelling in his left leg. He had Leriche syndrome and deep vein thrombosis. We performed endovascular therapy (EVT for Leriche syndrome, and a temporary filter was inserted in the inferior vena cava. He received anticoagulation therapy for deep vein thrombosis. The stenotic lesion in the terminal aorta was stented with an excellent postprocedural angiographic result and dramatic clinical improvement after EVT. This case suggests that EVT can be a treatment for Leriche syndrome.

  16. Extralobar pulmonary sequestration with venous drainage to the portal vein: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kamata, S.; Sawai, T.; Nose, K.; Hasagawa, T.; Nakajima, K.; Soh, H.; Okada, A. [Department of Paediatric Surgery, Osaka University Medical School, 2-2 Yamadaoka, Suita, Osaka 565-0871 (Japan)

    2000-07-01

    Venous drainage to the portal vein in pulmonary sequestration is rare. A 7-month-old girl was referred to our hospital following surgery for ventricular septal defect because of a left upper abdominal mass with a large feeding artery from the abdominal aorta and venous drainage to the portal vein. She had had frequent pulmonary infections and was growth retarded. MRI demonstrated that the mass was above the left diaphragm, suggesting extralobar sequestration. An extralobar sequestered lung was resected at thoracotomy. Diagnostic problems and clinical features are presented. (orig.)

  17. Uterus transplantation model in sheep with heterotopic whole graft and aorta and cava anastomoses.

    Science.gov (United States)

    Gonzalez-Pinto, I M; Tryphonopoulos, P; Avison, D L; Nishida, S; Tekin, A; Santiago, S; Tzakis, A G

    2013-06-01

    Uterine transplantation in the sheep model has been described as a partial or whole orthotopic graft from a living donor with vascular anastomoses. As an alternative to surrogate pregnancy or adoption uterus transplantation might be indicated for cases of infertility of uterine origin. The main complications might be rejection and thrombosis. The objective of this work was to develop a model of whole uterus transplantation that was applicable to the human setting, using grafts obtained from brain-dead donors, and suitable for immunologic and viability follow-up with a reduced risk of thrombosis. Two donors and 1 recipient were operated. The first graft was used for an anatomic study; the second was used for transplantation. The donor operation consisted of an en bloc harvest of the uterus, adnexa, and proximal vagina with the distal aorta and cava. After harvest the donor sheep was humanely killed. In the recipient ewe, heterotopic implantation was performed in the lower abdomen. An End-to-side anastomoses of aorta and cava were performed below the recipient's renal vessels. A cutaneous vaginal stoma was performed in the right lower quadrant. The recipient ewe was humanely killed for an autopsy study. The anatomy of uterine veins of the ewe differs from the human. The uterine and ovarian veins join, forming the utero-ovarian vein, which drains at the confluence of the common iliac to the cava. En bloc harvesting allows for rapid graft preparation, with vascular cuffs easily anastomosed with a low risk of thrombosis. The vaginal stoma seems appropriate to facilitate follow-up and graft biopsy. This approach can be a suitable experimental model applicable to humans using grafts from brain-dead donors.

  18. Specific echocardiographic findings useful for the diagnosis of common pulmonary vein atresia

    Directory of Open Access Journals (Sweden)

    Hiroyuki Nagasawa

    2015-12-01

    Full Text Available In this paper, we report a case of common pulmonary vein atresia, which is a very rare disease characterized by cyanosis, heart failure and pulmonary hypertension. Reverse flow in the pulmonary artery at end-diastole as well as in the isthmus of the aorta from early systole to end-diastole detected by echocardiography were found to be specific features useful in diagnosing the disease.

  19. Changes in aorta alpha1-adrenoceptor number and affinity during one year of streptozotocin-induced diabetes in rats.

    Science.gov (United States)

    Schulingkamp, Robert J; Aloyo, Vincent; Tallarida, Ronald J; Raffa, Robert B

    2005-04-01

    alpha(1)-Adrenoceptor function and density in isolated thoracic aorta were measured during the course of streptozotocin-induced diabetes in rats. Diabetes was induced by a single tail vein injection of streptozotocin (60 mg/kg) and was verified by four measures (blood glucose level, increase in food intake, increase in water intake, and characteristic weight changes). Diabetes produced a significant increase in isolated aorta sensitivity to alpha(1)-adrenoceptor activation, manifested as a significant (p 0.05) in either agonist (phenylephrine) or antagonist (prazosin) affinities (K(A) and pA(2) values, respectively). These results suggest compensatory mechanisms in receptor number and abnormalities in 2nd messenger transduction and can help direct efforts for improving antihypertensive or other pharmacological therapy for diabetic patients.

  20. Deep Vein Thrombosis

    Centers for Disease Control (CDC) Podcasts

    2012-04-05

    This podcast discusses the risk for deep vein thrombosis in long-distance travelers and ways to minimize that risk.  Created: 4/5/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 4/5/2012.

  1. Retinal vein occlusion

    Science.gov (United States)

    ... decrease the risk of retinal vein occlusion. These measures include: Eating a low-fat diet Getting regular exercise Maintaining an ideal weight Not smoking Aspirin or other blood thinners may help prevent blockages in the other eye. Controlling diabetes may ...

  2. The vein collar

    DEFF Research Database (Denmark)

    Lundgren, F; Schroeder, Torben Veith

    2012-01-01

    Randomized studies evaluating the effect of a vein collar at the distal anastomosis of PTFE-grafts show conflicting results. The study of the Joint Vascular Research Group (JVRG) of UK found improved primary patency while the Scandinavian Miller Collar Study (SCAMICOS) found neither any effect...

  3. Deep Vein Thrombosis

    African Journals Online (AJOL)

    OWNER

    Il s'agissait de la main et les recherches en ligne. Des termes ..... Cerrato D, Ariano G, and Fiacchino F : Deep vein ... Surg 1988; 75: 1053–7. 19. Salzman ... Alikhan R, Cohen AT, Combe S, Samama .... Kakkar AK, Williamson RCN. Thrombo.

  4. [Ovarian vein syndrome].

    Science.gov (United States)

    Ferrero Doria, R; Guzmán Valls, P; López Alba, J; Tomás Ros, M; Rico Galiano, J L; Fontana Compiano, L O

    1996-04-01

    The Ovarian Vein Syndrome has been the subject of controversy ever since first described as such by Clark in 1964. This is an uncommon entity within urologic sings and symptoms which appears as a recurrent nephritic colic coinciding with menstruation or during the immediately preceding days. The authors review a clinical case from our Urology Service, including some considerations on the case.

  5. Cucumber vein yellowing virus

    Science.gov (United States)

    Cucurbits are an important crop of temperate, subtropical and tropical regions of the world. Cucumber vein yellowing virus (CVYV) is a major viral pathogen of cucurbits. This chapter provides an overview of the biology of CVYV and the disease it causes....

  6. Squash vein yellowing virus

    Science.gov (United States)

    Cucurbits are an important crop of temperate, subtropical and tropical regions of the world. Squash vein yellowing virus (SqVYV) is a major viral pathogen of cucurbits. This chapter provides an overview of the biology of SqVYV and the disease it causes....

  7. Using tunneled femoral vein catheters for "urgent start" dialysis patients: a preliminary report.

    Science.gov (United States)

    Hingwala, Jay; Bhola, Cynthia; Lok, Charmaine E

    2014-01-01

    Multiple benefits of arteriovenous fistulas (AVF) and arteriovenous grafts (AVGs) exist over catheters. As part of a strategy to preserve thoracic venous sites and reduce internal jugular (IJ) vein catheter use, we inserted tunneled femoral vein catheters in incident "urgent start" dialysis patients while facilitating a more appropriate definitive dialysis access. "Urgent start" dialysis patients between January 15, 2013 and January 15, 2014 who required chronic dialysis, and did not have prior modality and vascular access plans, had tunneled femoral vein catheters inserted. We determined the femoral vein catheter associated infections rates, thrombosis, and subsequent dialysis access. Eligible patients were surveyed on their femoral vein catheter experience. Twenty-two femoral vein catheters were inserted without complications. Subsequently, one catheter required intraluminal thrombolytic locking, while all other catheters maintained blood flow greater than 300 ml/min. There were no catheter-related infections (exit site infection or bacteremia). Six patients continued to use their tunneled catheter at report end, one transitioned to peritoneal dialysis, thirteen to an arteriovenous graft, and two to a fistula. One patient received a tunneled IJ vein catheter. Of the patients who completed the vascular access survey, all indicated satisfaction with their access and that they had minimal complaints of bruising, bleeding, or swelling at their access sites. Pain/discomfort at the exit site was the primary complaint, but they did not find it interfered with activities of daily living. Femoral vein tunneled catheters appear to be a safe, well tolerated, and effective temporary access in urgent start dialysis patients while they await more appropriate long-term access.

  8. Migration of central lines from the superior vena cava to the azygous vein

    Energy Technology Data Exchange (ETDEWEB)

    Haygood, T.M., E-mail: tamara.haygood@mdanderson.org [University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1475, Houston, TX 77030 (United States); Malhotra, K., E-mail: kmalhotra@mdanderson.org [University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1475, Houston, TX 77030 (United States); Ng, C., E-mail: cng@mdanderson.org [University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1475, Houston, TX 77030 (United States); Chasen, B., E-mail: beth.chasen@mdanderson.org [University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1475, Houston, TX 77030 (United States); McEnery, K.W., E-mail: kmcenery@mdanderson.org [University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1475, Houston, TX 77030 (United States); Chasen, M., E-mail: mchasen@mdanderson.org [University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1475, Houston, TX 77030 (United States)

    2012-01-15

    Aim: To report 11 cases of central venous access catheters migrating from the superior vena cava to the azygos vein in order to raise radiologists' awareness of this possibility. Materials and methods: This is a retrospective review of the clinical history and imaging of 11 patients whose central line migrated from the superior vena cava to the azygos vein. The time course of migration, access route of the catheters, outcome, and depth of placement in the superior vena cava were evaluated. Results: All of these catheters were placed from the left; six through the subclavian vein, four as PICC lines, and one from the left internal jugular vein. Seven of the catheters were originally positioned in the superior vena cava. Four of the catheters were originally positioned in the azygos vein and were repositioned into the superior vena cava at the time of placement. The time to migration ranged from 2 to 126 days, average 43 days. In three cases, the migration was not reported at the first opportunity, resulting in a delay in diagnosis ranging from 10 to 27 days. All but one of the catheters extended at least 3.5 cm (range 1.8-7 cm) below the top of the right mainstem bronchus when in the superior vena cava. Conclusion: Risk factors for migration into the azygos vein include placement from a left-sided approach and original positioning in the azygos vein with correction at placement. The depth of placement in the superior vena cava was not a protective factor. It is important to recognize migration because of the elevated risk of complications when central lines are placed in the azygos vein.

  9. Endovenous treatments for varicose veins

    NARCIS (Netherlands)

    R.R. van den Bos (Renate)

    2011-01-01

    textabstractEndovenous treatment is currently one of the most frequently used methods for treating varicose veins in the Netherlands. Varicose veins are tortuous and enlarged veins due to weakening in the vein’s wall or valves. They are manifestations of chronic venous disease (CVD), which may lead

  10. [Takayasu's disease disclosed by isolated involvement of the ascending aorta].

    Science.gov (United States)

    Marcaggi, X; Courant, N; Soubrier, M; Kemeny, J L; Camilleri, L; Lusson, J R; Cassagnes, J

    1992-03-01

    The authors report the histological discovery of a case of Takayasu syndrome affecting the ascending aorta. This involvement appearing to concern only the aorta, with no symptomatic complaints nor any laboratory abnormalities indicative of an inflammatory syndrome, corticosteroids were not prescribed. Management consisted of biennial monitoring by transthoracic and transesophageal ultrasonography of the aorta and the supra-aortic main vessels together with monitoring of laboratory parameters.

  11. AORTA: Adding Organizational Reasoning to Agents

    DEFF Research Database (Denmark)

    Jensen, Andreas Schmidt; Dignum, Virginia

    2014-01-01

    the expected behavior of the agents. Agents need to be able to reason about the regulations, so that they can act within the expected boundaries and work towards the objectives of the organization. This extended abstract introduces AORTA, a component that can be integrated into agents’ reasoning mechanism......, allowing them to reason about (and act upon) regulations specified by an organizational model using simple reasoning rules. The added value is that the organizational model is independent of that of the agents, and that the approach is not tied to a specific organizational model....

  12. 血液透析患者颈内静脉导管所在血管内的血栓形成分析%Venous thrombosis around internal jugular venous indwelling catheter in hemodialysis patients

    Institute of Scientific and Technical Information of China (English)

    李寒; 王世相

    2009-01-01

    Objective To investigate the prevalence, characteristics and risk factors of superior vena cava and auxiliary branchs thrombosis in hemodialysis patients with internal jugular venous indwelling catheter. Methods A total of 43 cases on hemodialysis (HD) with indwelling short-term catheter in internal jugular vein from June to December in 2007 were enrolled in this study. The clinical data and biochemical indicators were collected to investigate the prevalence, characteristics and risk factors of venous thrombosis around indwelling catheter, such as, superior vena cava and auxiliary branehs in these patients. Results Short-term double Iumen internal jugular venous catheter were placed in 43 HD patients. Different degrees of central vein thrombosis were found in 21 of the 43 HD patients (48.8%). The ratio of thrombosis in jugular vein, brachiocephalic vein, subclavical vein and uperior vena cava was 100% (21/21), 28.6% (6/21), 23.8%(5/21) and 19.0%(4/21), respectively. Ten of the 21 HD patients (47.6%) with central vein thrombosis presented clinical symptoms. Five cases developed edema of the upper extremity, 2 cases had new-onset symptom's pulmonary embolism, and 3 eases developed blood overflowed from inlet port of circum-catheter. The ratio of diabetes mellitus, malignant tumor, the prevalence of increased level of serum lipoprotein a and plasma homocysteic acid were significantly higher in the HD patients with central vein thrombosis than that in those without central vein thrombosis. The odds ratio of diabetes mellitus, malignant tumor, high serum lipoprotein a and high plasma homocysteic acid was 5.758, 4.750, 6.967 and 8.533, respectively. Conclusions The prevalence of central vein thrombosis in HD patients with short-term indwelling catheter in internal jugular vein is quite high. Its clinical symptom is insidious but dangerous. Diabetes mellitus, malignant tumor, high serum lipoprotein a and high plasma homocysteic acid may be the important risk factors of

  13. Minimally invasive research of presigmoidal approach for exposure of jugular foramen region utilizing virtual reality system

    Directory of Open Access Journals (Sweden)

    Ke TANG

    2015-04-01

    Full Text Available Objective To discuss minimally invasive tactics for exposure of jugular foramen region in transpetrosal-presigmoidal approach based on virtual reality image model. Methods CT and MRI scans were performed to 15 adult cadaver heads (30 sides, and image data was inputted into Vitrea virtual reality system to establish three-dimensional anatomical model of jugular foramen region. The transpetrosal-presigmoidal approach was simulated with selecting osseous landmark points to draw a cylinder. Minimally invasive simulation was performed by reducing the diameter of cylinder. Anatomic exposures in surgical trajectory following minimally invasive design were observed, measured and compared.  Results Spacial sequence of nerves and vessels of jugular foramen region was exposured clearly with the route simulating transpetrosal-presigmoidal approach. Route before and after minimally invasive design passed through the interval between vertical segment of facial nerve and sigmoid sinus. There was a part of sigmoid sinus in the route. Cerebellar hemisphere was not included in the route. Data measurement and comparative analysis showed that volume of route, petrosal osseous structure and venous sinus involved in route before minimally invasive design was more than that after minimally invasive design. The differences reached statistical significance (P = 0.000. The volumes of lower cranial nerves between routes before and after minimally invasive design did not show significant differences (P = 0.552.  Conclusions Minimally invasive route of transpetrosal-presigmoidal approach is helpful to reduce surgical injury of vital structures in effective exposure for target structures of jugular foramen region. DOI: 10.3969/j.issn.1672-6731.2015.04.011

  14. Dynamic Morphology of the Aorta. Pre- and postoperative imaging

    NARCIS (Netherlands)

    van Prehn, J.

    2009-01-01

    With endovascular treatment of the aorta a folded covered stentgraft is introduced in the aorta via the femoral arteries. Adequate pre-operative planning is necessary to allow for proper stentgraft sizing. Stentgrafts should be adequately oversized to ensure good apposition to the aortic wall and pr

  15. Coil embolization of an anastomotic leak after ascending aorta replacement

    DEFF Research Database (Denmark)

    Nørgaard, Anders; Andersen, Lars Ib; Haahr, P.E.

    2008-01-01

    Surgical treatment of diseases of the thoracic aorta (aneurysms, dissections, and ruptures) may be associated with serious postoperative complications. Endovascular repair of thoracic aorta pathology is less invasive and offers a therapeutic alternative in high-surgical-risk patients, particularly...... accepted--embolization with endovascular coils--successfully resulting in occlusion of the leakage....

  16. Management of the atherosclerotic ascending aorta with endoaortic occlusion.

    Science.gov (United States)

    Liddicoat, J R; Doty, J R; Stuart, R S

    1998-04-01

    Application of an external cross-clamp to an atherosclerotic ascending aorta increases the risk of an embolic event and traumatic injury of the aorta. Currently, there are limited management options in these patients when the clinical situation requires cardiac arrest during an operation. We present our approach to these patients using the Heartport Endoaortic Clamp (Heartport, Redwood City, CA).

  17. Stent migration during transcatheter management of coarctation of aorta.

    Science.gov (United States)

    Kannan, Bhava R J; Srinivasan, Muthusamy

    2012-02-15

    A 13-year-old girl underwent endovascular stent placement for coarctation of aorta. The fully expanded stent migrated to ascending aorta which could be stabilized, recrimped, and repositioned with a 20-mm goose neck snare. Postdilatation was performed from the left brachial route resulting in a good outcome.

  18. Ethanol disrupts the formation of hypochord and dorsal aorta during the development of embryonic zebrafish

    Institute of Scientific and Technical Information of China (English)

    QIAN Linxi; WANG Yuexiang; JIANG Qiu; ZHONG Tao; SONG Houyan

    2005-01-01

    Exposure to ethanol during human embryonic period has severe teratogenic effects on the cardiovascular system. In our study, we demonstrated that ethanol of gradient concentrations can interfere with the establishment of circulatory system in embryonic zebrafish. The effective concentration to cause 50% malformations (EC50) was 182.5 mmol/L. The ethanol pulse exposure experiment displayed that dome stage during embryogenesis is the sensitive time window to ethanol. It is found that 400 mmol/L ethanol pulse exposure can induce circulatory defects in 43% treated embryos. We ruled out the possibility that ethanol can interfere with the process of hematopoiesis in zebrafish. By employing in situ hybridization with endothelial biomarker (Flk-1), we revealed that ethanol disrupts the establishment of trunk axial vasculature, but has no effect on cranial vessels. Combined with the results of semi-thin histological sections, the in situ hybridization experiments with arterial and venous biomarkers (ephrinB2, ephB4) suggested that ethanol mainly interrupts the development of dorsal aorta while has little effect on axial vein. Further study indicated the negative influence of ethanol on the development of hypochord in zebrafish. The consequent lack of vasculogenic factors including Radar and Ang-1 partly explains the defects in formation and integrity of dorsal aorta. These results provide important clues to the study of adverse effects of ethanol on the cardiovascular development in human fetus.

  19. Enxertos vasculares homólogos e heterólogos conservados em glicerina na fleboplastia da jugular em eqüinos Arterial homograft and venous heterograft conserved in glycerin in the phleboplasty of the jugular in equines

    Directory of Open Access Journals (Sweden)

    D.R. Stainki

    2005-02-01

    Full Text Available Doze eqüinos foram divididos aleatoriamente em dois grupos de seis animais (grupos I e II, com a finalidade de estudar a compatibilidade tecidual e a propriedade de indução de trombos de dois tecidos biológicos conservados em glicerina a 98%. Esses tecidos foram usados na restauração da jugular externa e se constituíram de artéria carótida comum homóloga (ACCHo, no grupo I, e veia jugular externa heteróloga (VJEHe, no grupo II. Para a restauração, utilizaram-se duas técnicas de anastomose da jugular, sendo, no grupo I, a técnica de bypass e, no grupo II, a substituição de um segmento da jugular esquerda por meio de anastomose vascular término-terminal. Para avaliar a trombogênese local e a histocompatibilidade, foram realizados exames clínicos, hematológicos, ecoDopplercardiográficos e histológicos dos segmentos vasculares enxertados. Os segmentos foram colhidos após 45 dias da avaliação pós-operatória, tendo a jugular direita como testemunha para os exames histológicos. Ambos os tecidos foram compatíveis quando implantados nos eqüinos, sem processo inflamatório acentuado, indicativo de rejeição. A técnica de bypass não foi eficiente na restauração da jugular, ocorrendo trombose obliterante dos enxertos de ACCHo. A substituição completa do segmento da jugular por VJEHe pode ser viável para o restabelecimento do fluxo sangüíneo da jugular de eqüinos, desde que se mantenha a igualdade dos diâmetros entre o enxerto e o vaso receptor.Twelve horses were randomly divided into two groups of six animals each (groups I and II in order to study the compatibility and trombogenicity of two biological tissues conserved in glycerin at 98% which were used to restore the external jugular. The tissues consisted of arterial homograft - ACCHo (group I and venous heterograft - VJEHe (group II. Two different techniques for jugular anastomosis were performed - bypass in group I and replacement of a segment of the left

  20. No increase of calcitonin gene-related peptide in jugular blood during migraine

    DEFF Research Database (Denmark)

    Tvedskov, Jesper; Lipka, Kerstin; Ashina, Messoud

    2005-01-01

    Increased calcitonin gene-related peptide (CGRP) in external jugular venous blood during migraine attack is one of the most cited findings in the headache literature. The finding has not been convincingly reproduced and is based on comparison with historic control subjects. The validity of this f......Increased calcitonin gene-related peptide (CGRP) in external jugular venous blood during migraine attack is one of the most cited findings in the headache literature. The finding has not been convincingly reproduced and is based on comparison with historic control subjects. The validity...... in 17 patients, whereas only cubital fossa blood could be sampled in an additional 4 patients. CGRP was measured with the same assay as most previous studies (assay I) and furthermore with a more sensitive and validated assay (assay II). For assay I, mean CGRP concentration in external jugular venous...... blood during attack was 17.18 pmol/L compared with 15.88 pmol/L outside of attack. Mean difference was 1.81 pmol/L (95% confidence interval [CI]: -2.88, 6.41; p = 0.44). In peripheral blood during attack, CGRP was 16.86 pmol/L compared with 17.57 pmol/L outside of attack. Mean difference was -0.79 pmol...

  1. Retroaortic left renal vein joining the left common iliac vein

    Energy Technology Data Exchange (ETDEWEB)

    Brancatelli, G.; Galia, M.; Finazzo, M.; Sparacia, G.; Pardo, S.; Lagalla, R. [Dept. of Radiology ' ' P. Cignolini' ' , Univ. of Palermo (Italy)

    2000-11-01

    Retroaortic left renal vein joining the left common iliac vein is a rare congenital anomaly in the development of the inferior vena cava. To our knowledge, only one case has been reported in the literature; however, its imaging features have never been described. A 27-year-old male presented with a 1-year history of recurrent right flank pain, dysuria, hematuria, and fever (39 C). Computed tomography and MR venography showed a retroaortic left renal vein joining the left common iliac vein. We present the CT and MR venography findings and discuss their feasibility in showing this congenital anomaly. (orig.)

  2. 明视深静脉穿刺置管术犬实验研究%Research on visual deep vein puncture and catheterization

    Institute of Scientific and Technical Information of China (English)

    冯继泽

    2011-01-01

    Objective To investigate the effect and adverse reaction of the self - made visual deep vein puncture needle. Methods Sixty adult dogs were randomly divided into jugular vein puncture group ( 30 dogs ) and femoral vein puncture group ( 30 dogs ). Vein display, success catheterization, and edema after pressure injection of saline were ohserved and compared between two groups. Results The vein puncture was clearly showed and the catheterization was successful in both groups. The definition in femoral vein group was slightly higher than that in jugular vein. Edema occurred in puncture site after local pressure injection in both groups; but the edema was more ohvious in femoral vein group compared with that in jugular vein group ( P <0. 05 ). Conclusion Visual puncture technique can effectively improve the precision and security of puncture , facilitate the operation of difficult puncture, and reduce the incidence of puncture complications.%目的 探讨自制可视深静脉穿刺针的穿刺效果及不良反应.方法 将60只成年犬随机分为两组,各30只,颈内静脉组采用颈内静脉穿刺,股静脉组采用股静脉穿刺,分别观察能否清晰显示静脉、穿刺置管是否成功,对加压注入0.9%氯化钠溶液后水肿情况及恢复情况进行对比分析.结果 两组不同路径穿刺均能较清晰显示静脉、穿刺置管是否成功,在清晰程度上股静脉组清晰度略高于颈内静脉组,加压注水后穿刺局部都有水肿,但颈内静脉组水肿程度轻,且差异具有统计学意义(P<0.05).结论 应用明视穿刺技术可有效提高穿刺精确度,解决困难穿刺的问题,并可减少穿刺并发症的发生,提高穿刺的安全性.

  3. Perfusion of veins at arterial pressure increases the expression of KLF5 and cell cycle genes in smooth muscle cells

    Energy Technology Data Exchange (ETDEWEB)

    Amirak, Emre [Section of Molecular Medicine, National Heart and Lung Institute, Imperial College London, Sir Alexander Fleming Building, South Kensington Campus, London SW7 2AZ (United Kingdom); Zakkar, Mustafa; Evans, Paul C. [Cardiovascular Sciences, Bywaters Center for Vascular Inflammation, National Heart and Lung Institute, Imperial College London, Hammersmith Hospital, London W12 ONN (United Kingdom); Kemp, Paul R., E-mail: p.kemp@imperial.ac.uk [Section of Molecular Medicine, National Heart and Lung Institute, Imperial College London, Sir Alexander Fleming Building, South Kensington Campus, London SW7 2AZ (United Kingdom)

    2010-01-01

    Vascular smooth muscle cell (VSMC) proliferation remains a major cause of veno-arterial graft failure. We hypothesised that exposure of venous SMCs to arterial pressure would increase KLF5 expression and that of cell cycle genes. Porcine jugular veins were perfused at arterial or venous pressure in the absence of growth factors. The KLF5, c-myc, cyclin-D and cyclin-E expression were elevated within 24 h of perfusion at arterial pressure but not at venous pressure. Arterial pressure also reduced the decline in SM-myosin heavy chain expression. These data suggest a role for KLF5 in initiating venous SMCs proliferation in response to arterial pressure.

  4. Cephalic vein aneurysm.

    Science.gov (United States)

    Faraj, Walid; Selmo, Francesca; Hindi, Mia; Haddad, Fadi; Khalil, Ismail

    2007-11-01

    Cephalic vein aneurysms are rare malformations that may develop in any part of the vascular system, and their history, presentation, and management vary depending on their site. The etiology of venous aneurysms remains unclear, although several theories have been elaborated. Venous aneurysms are unusual vascular malformations that occur equally between the sexes and are seen at any age; they can present as either a painful or a painless subcutaneous mass. No serious complications have been reported from upper extremity venous aneurysms. Surgical excision is the definitive management for most of these. The case reported here presented with a painless and mobile, soft, subcutaneous mass that caused only cosmetic concern.

  5. Historical Overview of Varicose Vein Surgery

    NARCIS (Netherlands)

    van den Bremer, Jephta; Moll, Frans L.

    2010-01-01

    Varicose veins are as old as Hippocrates. Varicose vein treatments come and go. Surgery for varicose vein disease is one of the commonest elective general surgical procedures. The history of varicose vein surgery has been traced. We note the first descriptions of varicose veins, and we particularly

  6. phenoVein - A software tool for leaf vein segmentation and analysis

    OpenAIRE

    Bühler, Jonas; Rishmawi, Louai; Pflugfelder, Daniel; Huber, Gregor; Scharr, Hanno; Hülskamp, Martin; Koornneef, Maarten; SCHURR, ULRICH; Jahnke, Siegfried

    2015-01-01

    phenoVein is a software tool dedicated to automated segmenting and analyzing images of leaf veins. It includes comfortable manual correction features. Advanced image filtering automatically emphasizes veins from background and compensates for local brightness inhomogeneities. Phenotypical leaf vein traits being calculated are total vein density, vein lengths and widths and skeleton graph statistics. For determination of vein widths, a model based vein edge estimation approach has been impleme...

  7. COARCTATION OF AORTA AND TAKAYASU ARTERITIS FOR LSCS: ANAESTHESIA MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Rashmi

    2015-10-01

    Full Text Available Coarctation of aorta is a congenital disorder with 5-10% incidence. It occurs in about 1 in 10,000 births .It may remain asymptomatic till adulthood. During pregnancy, early gestational hypertension is the presenting sign. Difference in blood pressure in upper and lower limb is a characteristic finding of coarctation of aorta. Association of bicuspid aortic valve and ventricular septal defect is seen in 50% patients of coarctation. Major cardiovascular complications are infrequent but continue to be a source of concern for patients with coarctation who become pregnant. Coarctation of aorta commonly located at the junction of the arch of aorta and proximal descending aorta at the level of ductal structure, may be diagnosed for the first time during pregnancy. Dilatation and dissection of the aorta can lead to increased maternal mortality; significant stenosis is a contraindication to pregnancy. However, successful pregnancies have been reported in women with uncorrected coarctation if preconception risk stratification is done. Here is a case of LSCS with coarctation of aorta and Takayasu arteritis done successfully under epidural anaesthesia.

  8. Rapamycin-loaded nanoparticles for inhibition of neointimal hyperplasia in experimental vein grafts

    Directory of Open Access Journals (Sweden)

    Ma Hao

    2011-05-01

    Full Text Available Abstract Background Nanoparticles possess several advantages as a carrier system for intracellular delivery of therapeutic agents. Rapamycin is an immunosuppressive agent which also exhibits marked antiproliferative properties. We investigated whether rapamycin-loaded nanoparticles(NPs can reduce neointima formation in a rat model of vein graft disease. Methods Poly(lactic-co-glycolic acid (PLGA NPs containing rapamycin was prepared using an oil/water solvent evaporation technique. Nanoparticle size and morphology were determined by dynamic light scattering methodology and electron microscopy. In vitro cytotoxicity of blank, rapamycin-loaded PLGA (RPLGA NPs was studied using MTT Assay. Excised rat jugular vein was treated ex vivo with blank-NPs, or rapamycin-loaded NPs, then interposed back into the carotid artery position using a cuff technique. Grafts were harvested at 21 days and underwent morphometric analysis as well as immunohistochemical analysis. Results Rapamycin was efficiently loaded in PLGA nanoparticles with an encapsulation efficiency was 87.6%. The average diameter of NPs was 180.3 nm. The NPs-containing rapamycin at 1 ng/ml significantly inhibited vascular smooth muscular cells proliferation. Measurement of rapamycin levels in vein grafts shown that the concentration of rapamycin in vein grafts at 3 weeks after grafting were 0.9 ± 0.1 μg/g. In grafted veins without treatment intima-media thickness was 300.4 ±181.5 μm after grafting 21 days. Whereas, Veins treated with rapamycin-loaded NPs showed a reduction of intimal-media thickness of 150.2 ± 62.5 μm (p = 0.001. CD-31 staining was used to measure luminal endothelial coverage in grafts and indicated a high level of endothelialization in 21 days vein grafts with no significant effect of blank or rapamycin-loaded NPs group. Conclusions We conclude that sustained-release rapamycin from rapymycin loaded NPs inhibits vein graft thickening without affecting the

  9. Application of right jugular vessels to build extracorporeal membrane oxygenation for treating the critically ill children%右侧颈部置管建立体外膜肺氧合治疗危重症患儿

    Institute of Scientific and Technical Information of China (English)

    闫宪刚; 陆铸今; 郑继翠; 张文波; 陆国平; 贾兵

    2016-01-01

    Objective To summarize the experience in applying a technique of inserting a cannula through right internal jugular vein and common carotid artery to build extracorporeal membrane oxygenation (ECMO) for critically ill children.Method The data of critically ill patients received ECMO support through right internal jugular vein and common carotid artery between December 2011 and December 2015 from Children's Hospital of Fudan University were analyzed retrospectively.The data included diagnosis,age,body weight,time of cannula and ECMO running,complication and prognosis.Result In total 28 patients received ECMO support,3 patients of post-cardiac surgery with transthoracic cannula were excluded.Twenty-five patients inserted cannula through neck vessels were enrolled,15 boys and 10 girls,the median age was 1.8 years (range,1 d-13 years),the median weight was 12.0 (2.8-50.0) kg.All the cannula sites were right internal jugular vein and right common carotid artery,before cannula use 5 patients had been inserted central vein tube and 3 patients with blood filter tube in right internal jugular vein,in one case cannula was applied during cardiopulmonary resuscitation.V-A ECMO had been built for all the cases successfully,the median operation time was (45 ± 26) min.The pump flow was 80-150 ml/(kg · min),the median duration of ECMO support was 153 (14-567) h.Sixteen (64%) patients weaned off ECMO successfully,15 (60%) survived to hospital discharge.About the complication of cannula,six patients developed cannula site bleeding,and two patients required re-fixation of cannula,one patient's external jugular vein had been hurt and sutured for bleeding.Conclusion Application of right jugular vessels to build ECMO is easy and safe for treating the sick children.The skill should be proficient to assure ECMO run and reduce the complications.%目的 总结经右侧颈部血管切开置管建立体外膜肺氧合(ECMO)的技术体会.方法 回顾性分析2011年12月至2015年12

  10. Leiomyosarcoma of the renal vein

    Directory of Open Access Journals (Sweden)

    Lemos Gustavo C.

    2003-01-01

    Full Text Available Leiomyosarcoma of the renal vein is a rare tumor of complex diagnosis. We presented a case of renal vein leiomyosarcoma detected in a routine study. The primary treatment was complete surgical removal of the mass. In cases where surgical removal is not possible the prognosis is poor, with high rates of local recurrence and distant spread.

  11. Agenesis of the iliac veins.

    Science.gov (United States)

    Thomas, M L; Posniak, H V

    1984-01-01

    Three case reports of patients with the rare anomaly of agenesis of the iliac veins are presented. It is emphasised that full phlebographic investigation should be carried out in such patients before surgical treatment is considered. It is pointed out that surgical ablation may exacerbate the symptoms of leg swelling and varicose veins for which the patients seek advice.

  12. Infrared imaging of varicose veins

    Science.gov (United States)

    Noordmans, Herke Jan; de Zeeuw, Raymond; Verdaasdonk, Ruud M.; Wittens, Cees H. A.

    2004-06-01

    It has been established that varicose veins are better visualized with infrared photography. As near-infrared films are nowadays hard to get and to develop in the digital world, we investigated the use of digital photography of varicose veins. Topics that are discussed are illumination setup, photography and digital image enhancement and analysis.

  13. 10-Minute Conultation Varicose veins

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    A 55 year old woman presents with a history of tortuous veins on both legs and a related ache towards the end of the day.She finds these veins unsightly and would like to know whether she can have them treated.

  14. [Endovascular repair for coarctation of the aorta in an adult].

    Science.gov (United States)

    Hayashi, Jun; Abe, Kazuo; Hata, Masaki; Nagano, Naoko; Hamasaki, Azumi; Suzuki, Kenji

    2013-09-01

    A 27-year-old woman with Turner's syndrome who underwent successful endovascular treatment for coarctation of the aorta is presented. She was admitted to our hospital complaining of upper extremity hypertension. Computed tomography revealed discrete stenosis of the proximal descending aorta and developed collateral circulation. After endovascular repair with a balloon expandable stent, her transcoarctation gradient fell from 44 mmHg preoperatively to less than 10 mmHg. She was discharged with no complications on the 7th postoperative day. Coarctation of the aorta in an adult patient could be safely and effectively managed by endovascular treatment.

  15. 39例超声引导下颈内静脉置管异位的原因分析与对策%Analysis and countermeasures of 39 cases of ultrasound guided internal jugular venous catheter heterotopia

    Institute of Scientific and Technical Information of China (English)

    江群; 泰英; 廖丽; 阳静; 梁英; 殷利

    2012-01-01

    Objective: Analyse the ectopic position, causes, and countermeasures of 39 cases of the ultrasound guided internal jugular venous catheter hetero-topia. Methods :2428 clinical cases reviewed retrospectively using ultrasound guided internal jugular venous catheter in our hospital's cath lab during March -December 2010. Results:39 cases of catheter heterotopia happened. The left side was significantly higher than occurred in the right(P<0.05), higher in female than male( P <0.05). The left side prone to happen in the contralateral innominate vein. The right side prone to happen in the ipsilateral axillary vein. Conclusion; Internal jugular venous catheter heterotopia was related to patients' gender,individual factors,vascular parts chosen for operation,the operators' skill levels,operators' personal habits,and the hospital's management factors.The success rate and complications can be improved by enhancing the operators' own awareness of improving their operatory skills, the carefulness of choosing the venipuncture parts, confirmation by using X-ray after the success of the puncture in time.%目的:总结39例超声引导下颈内静脉置管异位的部位、原因和对策.方法:回顾性分析我院导管室2010年3 ~12月期间采用超声引导下行颈内静脉置管2428例患者的临床资料.结果:发生导管异位39例,左侧异位发生率显著高于右侧(P<0.05),女性高于男性(P<0.05),左侧异位易发生在对侧的无名静脉,右侧异位易发生在同侧的腋静脉.结论:颈内静脉置管异位与患者性别、个体因素、血管选择部位、操作者技能水平、操作者的个人习惯有关.操作者重视自身技术水平的提高,操作中认真选择穿刺部位,穿刺成功后及时行X线检查确认,能提高颈内静脉穿刺置管成功率,减少并发症的发生.

  16. An intermediate term benefits and complications of gamma knife surgery in management of glomus jugulare tumor.

    Science.gov (United States)

    Hafez, Raef F A; Morgan, Magad S; Fahmy, Osama M

    2016-02-15

    Glomus tumors are rare skull base slow-growing, hypervascular neoplasms that frequently involve critical neurovascular structures, and delay in diagnosis is frequent. Surgical removal is rarely radical and is usually associated with morbidity or mortality. Gamma knife surgery (GKS) has gained an increasing dependable role in the management of glomus jugulare tumors, with high rate of tumor growth control, preserving or improving clinical status and with limited complications. This study aims to evaluate intermediate term benefits and complications of gamma knife surgery in management of twenty-two patients bearing growing glomus jugulare tumors at the International Medical Center (IMC), Cairo, Egypt, between 2005 and 2011. The mean follow-up period was 56 months (range 36-108 months); there were 3 males, 19 females; mean age was 43.6 years; 15 patients had GKS as the primary treatment; 2 patients had surgical residuals; 2 had previous radiation therapy; and 3 previously underwent endovascular embolization. The average tumor volume was 7.26 cm3, and the mean marginal dose was 14.7 Gy. Post gamma knife surgery through the follow-up period neurological status was improved in 12 patients, 7 showed stable clinical condition and 3 patients developed new moderate deficits. Tumor volume post GKS was unchanged in 13 patients, decreased in 8, and showed tumor regrowth in 1 patient. Tumor progression-free survival in our studied patients was 95.5% at 5 and 7 years of the follow-up period post GKS. Gamma knife surgery could be used safely and effectively with limited complications as a primary management tool in the treatment of glomus jugulare tumors controlling tumor growth with preserving or improving clinical status especially those who do not have significant cranial or cervical extension, elderly, and surgically unfit patients; moreover, it is safe and highly effective as adjuvant therapy as well.

  17. The safety and efficacy of gamma knife surgery in management of glomus jugulare tumor

    Science.gov (United States)

    2010-01-01

    Background Glomus jugulare is a slowly growing, locally destructive tumor located in the skull base with difficult surgical access. The operative approach is, complicated by the fact that lesions may be both intra and extradural with engulfment of critical neurovascular structures. The tumor is frequently highly vascular, thus tumor resection entails a great deal of morbidity and not infrequent mortality. At timeslarge residual tumors are left behind. To decrease the morbidity associated with surgical resection of glomus jugulare, gamma knife surgery (GKS) was performed as an alternative in 13 patients to evaluate its safety and efficacy. Methods A retrospective review of 13 residual or unresectable glomus jagulare treated with GKS between 2004 and 2008.. Of these, 11 patients underwent GKS as the primary management and one case each was treated for postoperative residual disease and postembolization. The radiosurgical dose to the tumor margin ranged between 12-15 Gy. Results Post- gamma knife surgery and during the follow-up period twelve patients demonstrated neurological stability while clinical improvement was achieved in 5 patients. One case developed transient partial 7th nerve palsy that responded to medical treatment. In all patients radiographic MRI follow-up was obtained, the tumor size decreased in two cases and remained stable (local tumor control) in eleven patients. Conclusions Gamma knife surgery provids tumor control with a lowering of risk of developing a new cranial nerve injury in early follow-up period. This procedure can be safely used as a primary management tool in patients with glomus jugulare tumors, or in patients with recurrent tumors in this location. If long-term results with GKS are equally effective it will emerge as a good alternative to surgical resection. PMID:20819207

  18. The safety and efficacy of gamma knife surgery in management of glomus jugulare tumor

    Directory of Open Access Journals (Sweden)

    Hafez Raef FA

    2010-09-01

    Full Text Available Abstract Background Glomus jugulare is a slowly growing, locally destructive tumor located in the skull base with difficult surgical access. The operative approach is, complicated by the fact that lesions may be both intra and extradural with engulfment of critical neurovascular structures. The tumor is frequently highly vascular, thus tumor resection entails a great deal of morbidity and not infrequent mortality. At timeslarge residual tumors are left behind. To decrease the morbidity associated with surgical resection of glomus jugulare, gamma knife surgery (GKS was performed as an alternative in 13 patients to evaluate its safety and efficacy. Methods A retrospective review of 13 residual or unresectable glomus jagulare treated with GKS between 2004 and 2008.. Of these, 11 patients underwent GKS as the primary management and one case each was treated for postoperative residual disease and postembolization. The radiosurgical dose to the tumor margin ranged between 12-15 Gy. Results Post- gamma knife surgery and during the follow-up period twelve patients demonstrated neurological stability while clinical improvement was achieved in 5 patients. One case developed transient partial 7th nerve palsy that responded to medical treatment. In all patients radiographic MRI follow-up was obtained, the tumor size decreased in two cases and remained stable (local tumor control in eleven patients. Conclusions Gamma knife surgery provids tumor control with a lowering of risk of developing a new cranial nerve injury in early follow-up period. This procedure can be safely used as a primary management tool in patients with glomus jugulare tumors, or in patients with recurrent tumors in this location. If long-term results with GKS are equally effective it will emerge as a good alternative to surgical resection.

  19. Sagittal vein thrombosis caused by central vein catheter.

    Directory of Open Access Journals (Sweden)

    Feridoun Sabzi

    2015-03-01

    Full Text Available Cerebral venous thrombosis, including thrombosis of cerebral veins and major dural sinuses, is an uncommon disorder in the general population. However, it has a higher frequency among patients younger than 40 years of age, patients with thrombophilia, pregnant patients or those receiving hormonal contraceptive therapy or has foreign body such as catheter in their veins or arterial system. In this case report, we described clinical and radiological findings in a patient with protein C-S deficiency and malposition of central vein catheter.

  20. Effects of Moderate Hyperventilation on Jugular Bulb Gases under Propofol or Isoflurane Anesthesia during Supratentorial Craniotomy

    Institute of Scientific and Technical Information of China (English)

    Lan Meng; Shu-Qin Li; Nan Ji; Fang Luo

    2015-01-01

    Background:The optimal ventilated status under total intravenous or inhalation anesthesia in neurosurgical patients with a supratentorial tumor has not been ascertained.The purpose of this study was to intraoperatively compare the effects of moderate hyperventilation on the jugular bulb oxygen saturation (SjO2),cerebral oxygen extraction ratio (O2ER),mean arterial blood pressure (MAP),and heart rate (HR) in patients with a supratentorial tumor under different anesthetic regimens.Methods:Twenty adult patients suffered from supratentorial tumors were randomly assigned to receive a propofol infusion followed by isoflurane anesthesia after a 30-min stabilization period or isoflurane followed by propofol.The patients were randomized to one of the following two treatment sequences:hyperventilation followed by normoventilation or normoventilation followed by hyperventilation during isoflurane or propofol anesthesia,respectively.The ventilation and end-tidal CO2 tension were maintained at a constant level for 20 min.Radial arterial and jugular bulb catheters were inserted for the blood gas sampling.At the end of each study period,we measured the change in the arterial and jugular bulb blood gases.Results:The mean value of the jugular bulb oxygen saturation (SjO2) significantly decreased,and the oxygen extraction ratio (O2ER) significantly increased under isoflurane or propofol anesthesia during hyperventilation compared with those during normoventilation (SjO2:t =-2.728,P =0.011 or t =-3.504,P =0.001;O2ER:t =2.484,P =0.020 or t =2.892,P =0.009).The SjO2 significantly decreased,and the O2ER significantly increased under propofol anesthesia compared with those values under isoflurane anesthesia during moderate hyperventilation (SjO2:t =-2.769,P =0.012;O2ER:t =2.719,P =0.013).In the study,no significant changes in the SjO2 and the O2ER were observed under propofol compared with those values under isoflurane during normoventilation.Conclusions:Our results suggest that the

  1. Brain Oxygen Monitoring via Jugular Venous Oxygen Saturation in a Patient with Fulminant Hepatic Failure

    Directory of Open Access Journals (Sweden)

    Yerim Kim

    2016-08-01

    Full Text Available Fulminant hepatic failure (FHF is often accompanied by a myriad of neurologic complications, which are associated with high morbidity and mortality. Although appropriate neuromonitoring is recommended for early diagnosis and to minimize secondary brain injury, individuals with FHF usually have a high chance of coagulopathy, which limits the ability to use invasive neuromonitoring. Jugular bulb venous oxygen saturation (JvO2 monitoring is well known as a surrogate direct measures of global brain oxygen use. We report the case of a patient with increased intracranial pressure due to FHF, in which JvO2 was used for appropriate brain oxygen monitoring.

  2. Magnetic resonance imaging of congenital abnormalities of the thoracic aorta

    Energy Technology Data Exchange (ETDEWEB)

    Soler, R.; Rodriguez, E.; Requejo, I.; Fernandez, R. [Department of Radiology, Hospital Juan Canalejo, La Coruma (Spain); Raposo, I. [Department of Pediatric Cardiology, Hospital Juan Canalejo, La Coruna (Spain)

    1998-05-01

    This article outlines the ability of MR imaging in the detection and presurgical evaluation of congenital abnormalities of the thoracic aorta (CATA). Congenital abnormalities of the thoracic aorta may be found incidentally on chest radiographs in patients without symptoms, or it can be associated with clinical findings which are very variable depending on the association with congenital cardiac malformations or vascular ring. When CATA is suspected as the cause of anomalies in the mediastinum in asymptomatic patients, confirmation of the abnormality should be by MR imaging allowing precise evaluation of the thoracic aorta and origin of the principal arteries. When CATA is considered because clinical findings indicate coarctation of the aorta, vascular ring or associated cardiac disorder, evaluation with ultrasound can be complemented by MR, which in most cases will replace the diagnostic catheterization. (orig.) With 12 figs., 24 refs.

  3. Active axial stress in mouse aorta.

    Science.gov (United States)

    Agianniotis, A; Rachev, A; Stergiopulos, N

    2012-07-26

    The study verifies the development of active axial stress in the wall of mouse aorta over a range of physiological loads when the smooth muscle cells are stimulated to contract. The results obtained show that the active axial stress is virtually independent of the magnitude of pressure, but depends predominately on the longitudinal stretch ratio. The dependence is non-monotonic and is similar to the active stress-stretch dependence in the circumferential direction reported in the literature. The expression for the active axial stress fitted to the experimental data shows that the maximum active stress is developed at longitudinal stretch ratio 1.81, and 1.56 is the longitudinal stretch ratio below which the stimulation does not generate active stress. The study shows that the magnitude of active axial stress is smaller than the active circumferential stress. There is need for more experimental investigations on the active response of different types of arteries from different species and pathological conditions. The results of these studies can promote building of refined constrictive models in vascular rheology. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. Calcification of thoracic aorta – solar eclipse sign

    Science.gov (United States)

    Dhoble, Abhijeet; Puttarajappa, Chethan

    2008-01-01

    Background Calcification of thoracic aorta is very common in old people, especially ones with hypertension. This can sometime be visible on plain chest radiograph. Case Presentation We present a case of a male patient who had extensive deposition of calcium in the thoracic aorta. Conclusion The relationship between aortic calcification and coronary atherosclerosis remains contentious. Computed tomography of the thorax can display this calcification which appears like 'solar eclipse'. PMID:18759981

  5. Endovascular management of recurrent adult coarctation of the aorta.

    Science.gov (United States)

    Kpodonu, Jacques; Ramaiah, Venkatesh G; Rodriguez-Lopez, Julio A; Diethrich, Edward B

    2010-11-01

    Traditional open surgical repair has proven to be an effective treatment for the management of primary and recurrent coarctation of the thoracic aorta. Potential complications at short-term and long-term follow-up have included recurrent coarctation, hypertension, premature coronary artery disease, cerebrovascular disease, and anastomotic pseudoaneurysm. Endovascular repair of recurrent coarctation of the thoracic aorta offers a less invasive treatment approach in potential high-risk surgical patients.

  6. Surgical treatment of penetrating atherosclerotic ulcer of the descending aorta

    Directory of Open Access Journals (Sweden)

    Kovačević Pavle

    2013-01-01

    Full Text Available Introduction. The term “penetrating atherosclerotic ulcer” (PAU of the aorta describes the condition in which ulceration of an aortic atherosclerotic lesion penetrates the internal elastic lamina into media. PAU is a high-risk lesion due to its deleterious effects on the integrity of aortic wall, with potentially fatal outcome. Case report. A patient with intensive, sharp chest pain irradiating to the back but with no signs of myocardial ischemia on an electrocardiogram was referred to our hospital. Transthoracic echocardiography showed no pathological changes of the ascending aorta. However, multislice computed tomography (CT showed an aortic ulcer with varying degree of the subadventitial hemorrhage in the region of the thoracic aorta at the level of Th 8-9. Due to imminent rupture of the penetrating aortic ulcer, the patient was promptly prepared for surgery. A 15 cm long subadventitial hematoma was found intraoperatively in the right posterolateral aspect of the descending aorta, 5 cm above the diaphragm and 7 cm below the origin of the left subclavial artery. The affected segment of the aorta was resected, followed by an inlay aortic reconstruction with a Dacron tube graft of 24 mm. Control CT revealed satisfactory reconstruction of the descending aorta. Conclusion. PAU is a rare, but potentially fatal disease. Open surgery in patients with PAU is an effective treatment strategy, although endovascular treatment options are emerging.

  7. Vein matching using artificial neural network in vein authentication systems

    Science.gov (United States)

    Noori Hoshyar, Azadeh; Sulaiman, Riza

    2011-10-01

    Personal identification technology as security systems is developing rapidly. Traditional authentication modes like key; password; card are not safe enough because they could be stolen or easily forgotten. Biometric as developed technology has been applied to a wide range of systems. According to different researchers, vein biometric is a good candidate among other biometric traits such as fingerprint, hand geometry, voice, DNA and etc for authentication systems. Vein authentication systems can be designed by different methodologies. All the methodologies consist of matching stage which is too important for final verification of the system. Neural Network is an effective methodology for matching and recognizing individuals in authentication systems. Therefore, this paper explains and implements the Neural Network methodology for finger vein authentication system. Neural Network is trained in Matlab to match the vein features of authentication system. The Network simulation shows the quality of matching as 95% which is a good performance for authentication system matching.

  8. Desvios porta-jugular e cava-jugular passivos em cães: Investigação de pressões sangüíneas

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    Coelho Antônio Roberto Barros

    1999-01-01

    Full Text Available Os principais objetivos dos desvios veno-venosos durante o transplante ortotópico de fígado são: atenuação da estase venosa subdiafragmática, manutenção do retorno satisfatório de sangue ao coração e perfusão tissular eficiente. Investigações sobre PP, PVCIIH, PVC, PAM e PPR, bem como D PP e D PVCIIH foram conduzidas em seis cães, sob anestesia geral, com fígados perfundidos pela Artéria Hepática, submetidos a desvios porta-jugular e cava-jugular passivos durante 2 horas. Estes desvios não foram capazes de evitar estagnação de sangue na VP e VCIIH, acarretando estase e menor retorno sangüíneo ao coração, sugeridos por aumentos significativos de PP e PVCIIH e quedas significantes nos níveis de PVC. Os valores de PAM não apresentaram diferenças significativas em relação ao tempo T0, na maior parte dos tempos avaliados, enquanto que os valores de PPR foram significativamente menores que os verificados no tempo T0, na maioria dos tempos estudados. Tais pressões mantiveram-se, respectivamente, acima de 100 e 50 mm de Hg, atribuindo-se tais resultados, em parte, à vasoconstricção arteriolar generalizada. Incrementos de pressão na VP (D PP foram significativamente menos elevados que aqueles verificados na VCIIH (D PVCIIH, atribuindo-se tal diferença à complacência esplâncnica. Decréscimos ulteriores dos níveis de PP e PVCIIH sugerem queda do fluxo arterial para os territórios esplâncnico e sistêmico, decorrente de diminuição do retorno sangüíneo ao coração. Determinações de PP, PVCIIH, PVC, PAM e PPR podem constituir meio prático de avaliação hemodinâmica do desvio veno-venoso.

  9. Low incidence of complications after cephalic vein cutdown for pacemaker lead implantation in children weighing less than 10 kilograms: A single-center experience with long-term follow-up.

    Science.gov (United States)

    Kircanski, Bratislav; Vasic, Dragan; Savic, Dragutin; Stojanov, Petar

    2015-08-01

    Only a few studies on the cephalic vein cutdown technique for pacemaker lead implantation in children weighing ≤10 kg have been reported even though the procedure is widely accepted in adults. The purpose of this study was to prove that cephalic vein cutdown for pacemaker lead implantation is a reliable technique with a low incidence of complications in children weighing ≤10 kg. The study included 44 children weighing ≤10 kg with an endocardial pacemaker. Cephalic, subclavian, and axillary vein diameters were measured by ultrasound before implantation. The measured diameters were used to select either an endocardial or epicardial surgical technique. Regular 6-month follow-up visits included pacemaker interrogation and clinical and ultrasound examinations. Two dual-chamber and 42 single-chamber pacemakers were implanted. Mean weight at implantation was 6.24 kg (range 2.25-10.40 kg), and mean age was 11.4 months (range 1 day-47 months). In 40 children (90.1%), the ventricular leads were implanted using the cephalic vein cutdown technique, and implantation was accomplished via the prepared right external jugular vein in 4 of the children (9.9%). The atrial leads were implanted using axillary vein puncture and external jugular vein preparations. Mean follow-up was 8.9 years (range 0-20.9 years). Only 1 pacemaker-related complication was detected (a lead fracture near the connector that was successfully resolved using a lead repair kit). The cephalic vein cutdown technique is feasible and reliable in children weighing ≤10 kg, which justifies the application of additional surgical effort in the treatment of these small patients. Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  10. Severe progressive sensorineural hearing loss improved after removal of large jugular foramen schwannoma.

    Science.gov (United States)

    Oishi, Naoki; Kohno, Naoyuki; Shiokawa, Yoshiaki

    2011-06-01

    We report a very rare case of hearing improvement after removal of the intracranial part of a jugular foramen schwannoma (JFS) presenting with chronic and severe progressive sensorineural hearing loss (SNHL). The patient presented with progressive hearing impairment in his right ear, lasting 2 years. The patient's pure tone audiogram revealed severe SNHL. His speech discrimination score (SDS) was 0%. Auditory-evoked brain responses (ABRs) comprised only I waves following 30-100dB stimulation, although distortion-product otoacoustic emissions (DPOAEs) had good responses. These test results indicated that his hearing impairment was retrocochlear SNHL. Magnetic resonance imaging revealed within the right jugular foramen a large intracranial-extracranial tumor that compressed the brainstem. The intracranial part of the tumor was resected through retrosigmoidal craniotomy, and the tumor was pathologically diagnosed as a schwannoma. Several months after the operation, the patient's auditory thresholds improved to a level consistent with mild SNHL, ABR V waves emerged following 60-90dB stimulation, and SDS improved significantly to 95%. This case demonstrates that hearing improvement can be achieved after surgery for JFS presenting with severe and chronic progressive SNHL, and that good DPOAE responses and the presence of ABR I waves may be predictors of postoperative hearing recovery in JFS.

  11. Impact of middle and lower jugular neck dissection on supraclavicular lymph node metastasis from endometrial carcinoma

    Science.gov (United States)

    2012-01-01

    Supraclavicular lymph node metastasis from endometrial carcinoma is considerably rarer than metastasis from uterine cervical cancer. To date, there have been no reported cases regarding systematic neck dissection as a salvage treatment. In this report, we describe the neck dissection procedure carried out on a 74-year-old woman with supraclavicular lymph node metastasis. Our objective was to histologically determine the origin of the metastasis while simultaneously providing appropriate treatment. The patient’s past medical history included two prior cases of cancer: rectal cancer 7 years earlier and endometrial adenocarcinoma 4 years earlier. We determined that middle and lower jugular neck dissection was appropriate in treating this case based on the results of our preoperative FDG-PET and tumor markers. This surgery provided histological evidence that metastasis occurred from endometrial carcinoma. Middle and lower jugular neck dissection was expected to improve the patient’s prognosis without impacting the patient’s active daily life. We have continued to monitor the patient closely over an extended period. PMID:22788987

  12. Neonatal renal vein thrombosis.

    Science.gov (United States)

    Brandão, Leonardo R; Simpson, Ewurabena A; Lau, Keith K

    2011-12-01

    Neonatal renal vein thrombosis (RVT) continues to pose significant challenges for pediatric hematologists and nephrologists. The precise mechanism for the onset and propagation of renal thrombosis within the neonatal population is unclear, but there is suggestion that acquired and/or inherited thrombophilia traits may increase the risk for renal thromboembolic disease during the newborn period. This review summarizes the most recent studies of neonatal RVT, examining its most common features, the prevalence of acquired and inherited prothrombotic risk factors among these patients, and evaluates their short and long term renal and thrombotic outcomes as they may relate to these risk factors. Although there is some consensus regarding the management of neonatal RVT, the most recent antithrombotic therapy guidelines for the management of childhood thrombosis do not provide a risk-based algorithm for the acute management of RVT among newborns with hereditary prothrombotic disorders. Whereas neonatal RVT is not a condition associated with a high mortality rate, it is associated with significant morbidity due to renal impairment. Recent evidence to evaluate the effects of heparin-based anticoagulation and thrombolytic therapy on the long term renal function of these patients has yielded conflicting results. Long term cohort studies and randomized trials may be helpful to clarify the impact of acute versus prolonged antithrombotic therapy for reducing the morbidity that is associated with neonatal RVT.

  13. [Ultrasonic guided cannulation of the axillary vein in intensive care patients].

    Science.gov (United States)

    Schregel, W; Höer, H; Radtke, J; Cunitz, G

    1994-10-01

    attempted CV catheters, 43 were placed successfully. In 2 cases the axillary vein could not be encountered by the puncture needle. Guide-wire placement did not succeed in 4 patients. One catheter was malpositioned in the ipsilateral internal jugular vein. Four inadvertent punctures of the axillary artery remained without sequelae after compression. No further puncture-related complications were observed. With high US intensity score the number of puncture attempts necessary for successful vein cannulation was lower. On the other hand, complications and puncture failure seemed to be more frequent in patients with lower US intensity scores. DISCUSSION. CV access via the axillary vein had a satisfying success rate (43/50) and proved to be a safe procedure in our ICU patients despite higher risk factors compared to a healthy population. Although ethical reasons did not allow a randomised comparison with the standard technique, location of the axillary vein by Doppler US is likely to improve cannulation results and reduce complications induced by "blind" needle probing. With a low US intensity score, the rate of successful punctures is lower and complication rates increase. In some patients, e.g., those with extended tumour operations involving the head and neck, CV access via the axillary vein may be of high clinical value.

  14. A Vein Map Biometric System

    Directory of Open Access Journals (Sweden)

    Felix Fuentes

    2013-08-01

    Full Text Available There is increasing demand world-wide, from government agencies and the private sector for cutting-edge biometric security technology that is difficult to breach but userfriendly at the same time. Some of the older tools, such as fingerprint, retina and iris scanning, and facial recognition software have all been found to have flaws and often viewed negatively because of many cultural and hygienic issues associated with them. Comparatively, mapping veins as a human barcode, a new technology, has many advantages over older technologies. Specifically, reproducing a three-dimensional model of a human vein system is impossible to replicate. Vein map technology is distinctive because of its state-of-the-art sensors are only able to recognize vein patterns if hemoglobin is actively flowing through the person

  15. Morphological Evidence of Telocytes in Mice Aorta

    Institute of Scientific and Technical Information of China (English)

    Hong-Qi Zhang; Shan-Shan Lu; Ting Xu; Yan-Ling Feng; Hua Li; Jun-Bo Ge

    2015-01-01

    Background:Telocytes (TCs) are a novel type of interstitial cells,which have been recently described in a large variety of cavitary and noncavitary organs.TCs have small cell bodies,and remarkably thin,long,and moniliform prolongations called telopodes (Tps).Until now,TCs have been found in various loose connective tissues surrounding the arterioles,venules,and capillaries,but as a histological cellular component,whether TCs exist in large arteries remains unexplored.Methods:TCs were identified by transmission electron microscope in the aortic arch of male C57BL/6 mice.Results:TCs in aortic arch had small cell bodies (length:6.06-13.02 μm; width:1.05-4.25 μm) with characteristics of specific long (7.74-39.05 μm),thin,and moniliform Tps; TCs distributed in the whole connective tissue layer of tunica adventitia:TCs in the innermost layer of tunica adventitia,located at the juncture between media and adventitia,with their long axes oriented parallel to the outer elastic membrane; and TCs in outer layers oftunica adventitia,were embedded among transverse and longitudinal oriented collagen fibers,forming a highly complex three-dimensional meshwork.Moreover,desmosomes were observed,serving as pathways connecting neighboring Tps.In addition,vesicles shed from the surface of TCs into the extracellular matrix,participating in some biological processes.Conclusions:TCs in aorta arch are a newly recognized complement distinct from other interstitial cells in large arteries,such as fibroblasts.And further biologically functional correlations need to be elucidated.

  16. Intramural aortic hematomas; Intramurale Haematome der Aorta

    Energy Technology Data Exchange (ETDEWEB)

    Raab, B.W.; Vosshenrich, R.; Fischer, U.; Funke, M.; Grabbe, E. [Goettingen Univ. (Germany). Abt. fuer Roentgendiagnostik

    2001-08-01

    Intramural hematomas (IMH) are regarded as a hemorrhage into the aortic wall. In general a traumatic form can be differentiated from a spontaneous non-traumatic. There is a predisposition of IMH with arterial hypertension and mesoectodermal dysplastic syndromes. The diagnosis is established with the clinical presentation in combination with the findings of different imaging modalities. Acute and subacute discomfort associated with a tendency of collaps are considered as typical presenting complaints. A semicircular or concentric thickening of the aortic wall with the absence of blood flow or a dissection membran are typical findings in transesophageal echocardiography, computed tomography and magnetic resonance tomography. From a differential diagnostic point of view a distinction from atherosclerotic wall changes, intraluminal thrombi and inflammatory aortic diseases is essential. The IMH is considered as an early presentation of aortic dissection, put into and treated according to the Stanford classification. In the course of natural history an IMH can disappear, rupture or progress into a classic aortic dissection. (orig.) [German] Das intramurale Haematom (IMH) ist eine Einblutung in die Aortenwand. Grundsaetzlich kann zwischen traumatischer Genese und einer atraumatischen spontanen Form unterschieden werden. Praedisponierend sind arterielle Hypertension und mesoektodermale Dysplasiesyndrome. Die Diagnose ergibt sich aus der Klinik und den Befunden in den bildgebenden Verfahren. Zu den klinischen Symptomen zaehlen akut oder subakut auftretende Schmerzen, assoziiert mit einer Kollapsneigung. Typische Befunde in der transoesophagealen Echokardiographie, der Computer- oder der Magnetresonanztomographie sind eine halbmondfoermige oder konzentrische Wandverdickung der Aorta ohne Nachweis von Blutfluss oder einer Dissektionsmembran mit Dichtewerten bzw. Signalintensitaeten in Abhaengigkeit vom Alter der Einblutung. Differenzialdiagnostisch ist eine Abgrenzung

  17. Morphological Evidence of Telocytes in Mice Aorta

    Directory of Open Access Journals (Sweden)

    Hong-Qi Zhang

    2015-01-01

    Full Text Available Background: Telocytes (TCs are a novel type of interstitial cells, which have been recently described in a large variety of cavitary and noncavitary organs. TCs have small cell bodies, and remarkably thin, long, and moniliform prolongations called telopodes (Tps. Until now, TCs have been found in various loose connective tissues surrounding the arterioles, venules, and capillaries, but as a histological cellular component, whether TCs exist in large arteries remains unexplored. Methods: TCs were identified by transmission electron microscope in the aortic arch of male C57BL/6 mice. Results: TCs in aortic arch had small cell bodies (length: 6.06-13.02 μm; width: 1.05-4.25 μm with characteristics of specific long (7.74-39.05 μm, thin, and moniliform Tps; TCs distributed in the whole connective tissue layer of tunica adventitia: TCs in the innermost layer of tunica adventitia, located at the juncture between media and adventitia, with their long axes oriented parallel to the outer elastic membrane; and TCs in outer layers of tunica adventitia, were embedded among transverse and longitudinal oriented collagen fibers, forming a highly complex three-dimensional meshwork. Moreover, desmosomes were observed, serving as pathways connecting neighboring Tps. In addition, vesicles shed from the surface of TCs into the extracellular matrix, participating in some biological processes. Conclusions: TCs in aorta arch are a newly recognized complement distinct from other interstitial cells in large arteries, such as fibroblasts. And further biologically functional correlations need to be elucidated.

  18. Incidence of cannula associated deep vein thrombosis after veno-venous ECMO.

    Science.gov (United States)

    Menaker, Jay; Tabatabai, Ali; Rector, Raymond; Dolly, Katelyn; Kufera, Joseph; Lee, Eugenia; Kon, Zachary; Sanchez, Pablo; Pham, Si; Herr, Daniel L; Mazzeffi, Michael; Rabinowitz, Ronald P; OʼConnor, James V; Stein, Deborah M; Scalea, Thomas M

    2017-02-13

    Limited literature regarding the incidence of cannula associated deep vein thrombosis (CaDVT) following veno-venous extracorporeal membrane oxygenation (VV ECMO) exists. The purpose of this study was to identify the incidence of post decannulation CaDVT and identify any associated risk factors. Forty eight patients were admitted between August 2014 and January 2016 to the Lung Rescue Unit were included in the study. Protocolized anticoagulation levels (partial thromboplastin time 45-55 second) and routine post decannulation DVT screening were in place during the study period. Forty-one (85.4%) patients had CaDVT. Of those with CaDVT, 31 (76%) patients were treated with full anti-coagulation therapy. 34 (76%) patients with right internal jugular cannulation had CaDVT at cannula site. Twenty-five (61%) patients had CaDVT in the lower extremity. (18 associated right femoral vein cannulation; 7 left femoral vein cannulation) 18 (44%) patients had both upper and lower extremity CaDVT. Overall, patients with CaDVT tended to be older, have a higher body mass index (BMI) and on ECMO longer (p=NS). Mean PTT during time on ECMO between patients that did and did not have CaDVT did not differ. No clinical evidence of pulmonary embolism was seen.

  19. Comparing the Rates of Dopamine Hemodynamic Effect Onset after Infusion through Peripheral Veins in Three Regions

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    Deokkyu Kim

    2017-02-01

    Full Text Available Background Dopamine is an inotropic agent that is often selected for continuous infusion. For hemodynamic stability, the rate of infusion is controlled in the range of 5-15 μg/kg/min. This study aimed to compare the time intervals from the administration of dopamine to the onset of its hemodynamic effects when dopamine was administered through three different peripheral veins (the cephalic vein [CV], the great saphenous vein [GSV], and the external jugular vein [EJV]. Methods Patients in group 1, group 2, and group 3 received dopamine infusions in the CV, GSV, and EJV, respectively. A noninvasive continuous cardiac output monitor (NICCOMO™, Medis, Ilmenau, Germany was used to assess cardiac output (CO and systemic vascular resistance (SVR. Six minutes after intubation, baseline heart rate (HR, systolic blood pressure (BP, diastolic BP, mean arterial pressure (MAP, CO, and SVR values were recorded and dopamine infusion was initiated at a dose of 10 μg/kg/min. Hemodynamic changes at 0, 4, 8, 12, and 15 minutes postinfusion were recorded. Results No statistically significant differences were observed among the three groups with respect to the rate of hemodynamic change. In all groups, systolic BP, diastolic BP, MAP, and SVR tended to increase after decreasing for the first 4 minutes; in contrast, HR and CO decreased until 8 minutes, after which they tended to reach a plateau. Conclusions For patients under general anesthesia receiving dopamine at 10 μg/kg/min, there were no clinical differences in the effect of dopamine administered through three different peripheral veins.

  20. [Surgery of essential varicose veins].

    Science.gov (United States)

    Maraval, M

    1994-03-15

    Idiopathic varicose veins of the lower limbs are a frequent but benign disorder. Surgery is only a moment in the course of the disease. Although not the only treatment of essential varicose veins, surgery by an experienced team performing crossectomy, stripping by intussusception using a stripper, and phlebectomy gives fully satisfactory results, both to patient and to physician, in over 80% of cases. New techniques were recently developed that, at present, have not confirmed early hopes.

  1. Portal Vein Thrombosis in non cirrhotic patients

    NARCIS (Netherlands)

    M.C.W. Spaander (Manon)

    2010-01-01

    textabstractExtrahepatic portal vein thrombosis (EPVT) is the most common cause of portal hypertension in non- cirrhotic patients. EPVT has been defined as an obstruction of the extrahepatic portal vein with or without involvement of the intrahepatic portal veins. Although the portal vein accounts f

  2. Right thoracotomy approach for repair of recurrent or complex coarctation of the aorta using an extra-anatomic ascending aorta to descending aorta bypass graft off-pump.

    Science.gov (United States)

    Tabry, Imad F; Zachariah, Zachariah P

    2013-01-01

    A previously described but rarely used surgical technique for the repair of complex or recurrent coarctation of the aorta through a right thoracotomy approach is presented in detail. It has the advantages of being simple and avoiding left chest re-entry, median sternotomy and cardiopulmonary bypass altogether.

  3. Sulforaphane reduces advanced glycation end products (AGEs)-induced inflammation in endothelial cells and rat aorta.

    Science.gov (United States)

    Matsui, T; Nakamura, N; Ojima, A; Nishino, Y; Yamagishi, S-I

    2016-09-01

    Advanced glycation end products (AGEs)-receptor RAGE interaction evokes oxidative stress and inflammatory reactions, thereby being involved in endothelial cell (EC) damage in diabetes. Sulforaphane is generated from glucoraphanin, a naturally occurring isothiocyanate found in widely consumed cruciferous vegetables, by myrosinase. Sulforaphane has been reported to protect against oxidative stress-mediated cell and tissue injury. However, effects of sulforaphane on AGEs-induced vascular damage remain unclear. In this study, we investigated whether and how sulforaphane could inhibit inflammation in AGEs-exposed human umbilical vein ECs (HUVECs) and AGEs-injected rat aorta. Sulforaphane treatment for 4 or 24 h dose-dependently inhibited the AGEs-induced increase in RAGE, monocyte chemoattractant protein-1 (MCP-1), intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecular-1 (VCAM-1) gene expression in HUVECs. AGEs significantly stimulated MCP-1 production by, and THP-1 cell adhesion to, HUVECs, both of which were prevented by 1.6 μM sulforaphane. Sulforaphane significantly suppressed oxidative stress generation and NADPH oxidase activation evoked by AGEs in HUVECs. Furthermore, aortic RAGE, ICAM-1 and VCAM-1 expression in AGEs-injected rats were increased, which were suppressed by simultaneous infusion of sulforaphane. The present study demonstrated for the first time that sulforaphane could inhibit inflammation in AGEs-exposed HUVECs and AGEs-infused rat aorta partly by suppressing RAGE expression through its anti-oxidative properties. Inhibition of the AGEs-RAGE axis by sulforaphane might be a novel therapeutic target for vascular injury in diabetes. Copyright © 2016 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

  4. Elastic fibers and collagen distribution in human aorta

    Science.gov (United States)

    Vieira-Damiani, G.; Ferro, D. P.; Adam, R. L.; de Thomaz, A. A.; Pelegati, V.; Cesar, C. L.; Metze, K.

    2011-03-01

    Elastic and collagen fibers are essential components of the aorta, the remodeling of these structures is accompanied with aging in various diseases and life-threatening events. While the elastic fibers confer resilience to major blood vessels collagen confers resistance to the same. Elastic fibers are easily visualized in the fluorescent light when stained with hematoxylin eosin. Second Harmonic Generation (SHG) is a non linear signal that occurs only in molecules without inversion symmetry and is particularly strong in the collagen fibers arranged in triple helices. The aim of this paper is to describe the distribution of collagen in the thickness of the thoracic aorta, and to demonstrate the distribution of between elastic fibers. The images were acquired in a multifoton microscopy and both signals, Two-phtoton excitaded fluorescence (TPEF) and SHG, were excited by a Ti:Sapphire laser. We used a band pass filter to filter the SHG signal from the TPEF signal. The thickness of the aorta varies 2-3 mm, and the image was composed of the juxtaposition of images of 220 x 220 microns. We acquired images of a histological slide of the thoracic aorta stained with picrosirius red (specific for collagen) at a wavelength of 670nm SHG subsequently acquired images with the same region and observed that the images are overlapping. Therefore, the following images were acquired by confocal microscopy (fluorescence of eosin for visualization of elastic fibers) and for collagen SHG. After reconstruction of the images, we observed the distribution of collagen along the aorta.

  5. Multiple variations of the branches of abdominal aorta

    Directory of Open Access Journals (Sweden)

    Kafa IM

    2010-06-01

    Full Text Available Multiple variations were found in a 54-year-old male cadaver during routine dissections of abdominal retroperitoneal region. Right inferior phrenic artery was arising from right renal artery, while the right middle and superior suprarenal artery branched from the right inferior phrenic artery. Left inferior phrenic artery was originating from the abdominal aorta below celiac trunk. The left middle suprarenal artery appeared as the branch of celiac trunk. Double left renal artery was arising separately from the left side of the aorta. The upper left renal artery showed approximately 80º of kinking which then crossed the lower one and entered to the inferior pole of hilum of kidney. Left testicular artery was originating from the upper left renal artery after this kinking. The left and right fourth lumbar arteries and median sacral artery have branched from a common trunk posterior to the abdominal aorta.In spite of these abundant variations in the branches, abdominal aorta itself did not show any variation, spanning normally between the levels of T12–L4 vertebrae. The variations of abdominal aorta may have clinical importance, especially in surgical and radiologic investigations.

  6. Increased RhoA translocation in aorta of diabetic rats

    Institute of Scientific and Technical Information of China (English)

    Jiping TANG; Ikuyo KUSAKA; Amber R MASSEY; Shadon ROLLINS; John H ZHANG

    2006-01-01

    Aim: To analyze RhoA expression and activation in the aorta of diabetic rats. Methods: Male SD rats (n=70) were divided into 2 groups: the diabetic group and the control group. Diabetes was induced by intravenous injection of streptozotocin (55 mg/kg). The Rats were studied 3 weeks after the induction of diabetes. Western blotting was used to measure the expression and activation of Rho. Results: Heart rate was measured 24 h/d; it decreased by 58±13 beats/min in the diabetic rats. Isometric tension showed that the contraction of diabetic aorta was significantly reduced compared with that of control aorta when stimulated by KCl and serotonin. The relaxation of the diabetic aorta was reduced when stimulated by acetylcholine. An enhanced RhoA translocation in the aortic tissues of diabetic rats was determined by a 90% increase in membrane-bound RhoA, indicating that the activation of RhoA is markedly increased in the diabetic aorta. Conclusion: Our data suggest that upregulated RhoA could be involved in the vascular dysfunction of diabetic rats.

  7. Isolated left innominate vein aneurysm: A rare cause of mediastinal widening

    Directory of Open Access Journals (Sweden)

    S G Dua

    2011-01-01

    Full Text Available Mediastinal widening in an adult is mostly nodal in origin. Occasionally vascular aneurysms may be the underlying cause, in which case the aorta or its branches are most frequently involved. Thoracic venous aneurysms, on the other hand, have been reported only in anecdotes, with fusiform aneurysm of the superior vena cava being the commonest. Isolated aneurysms involving the brachiocephalic/innominate vein are extremely rare. We describe detection of a saccular aneurysm of the innominate vein, as the underlying cause of mediastinal widening seen on a chest radiograph in a 42-year-old asymptomatic woman. The characteristic radiological findings of thoracic venous aneurysms are described with particular reference to the importance of multiplanar computed tomography in such settings. Also discussed is the role of imaging in the diagnosis and guiding the management of this rare entity.

  8. Comparing of the cost of special nursing and application effect between two ways of deep veins catheter in patients with chemotherapy%肿瘤患者化疗中2种深静脉置管应用效果及专项护理成本比较

    Institute of Scientific and Technical Information of China (English)

    刘芳; 方少梅; 邱丽文; 王秀文

    2011-01-01

    目的 对PICC及颈内静脉置管的实际护理成本与现行收费标准进行对比,证实实际护理成本与现行收费之间的偏差,在此基础上对比两者在肿瘤患者化疗中的利弊.方法 用项目成本阶梯分摊法,对接受PICC及颈内静脉置管患者实际投入的人力、财力、物力进行测量、归集、统计,核算出的实际护理成本并与其现行的收费标准进行对比;分析其成本及临床应用价值.结果 PICC实际成本(2259.99±30.99)元与现行收费标准1532.79元差价为-727.20元,颈内静脉置管实际成本(393.86±33.93)元与现行收费标准292.13元差价为-101.73元;PICC后并发症发生率为12%,颈内静脉置管为17%.HCC及颈内静脉置管实际专项护理成本大于现行收费价格,PICC的单次护理成本是颈内静脉置管的5.74倍,以一年4~6个化疗疗程计算,PICC护理成本与颈内静脉置管总成本(1年内)比较无显著差异,并发症发生率比较无显著差异.结论 临床应用PICC的优点多于颈内静脉置管,应优选PICC,次选颈内静脉置管.%Objective To confirm the deviation between the present charge and real cost of nursing by comparing them between PICC and jugular veins catheter,and the advantages and disadvantages were weighed between them in tumor patients undergoing chemotherapy.Methods The cost of manpower,financial resources or materials for 106 patients with PICC,68 patients with jugular veins catheter were measured,accounted and statistically analyzed with the ladder sharing method for project cost.Comparing the cost between calculation cost and current charging standard,and the cost and clinical application was studied.Results The real cost of PICC was (2259.99±30.99)Yuan and current charging standard was 1532.79 Yuan,the deviation was -727.20 Yuan,and the real cost of jugular veins catheter was (393.86±33.93) Yuan,and current charging standard was 292.13 Yuan,the deviation was -101.73 Yuan.The complication

  9. Different Quality of Enhanced CT Image by Right or Left Side Ulnar Vein Injection in Hypertension Patients%左右肘静脉注射对比剂对高血压患者CT增强效果的影响

    Institute of Scientific and Technical Information of China (English)

    苏云杉; 张勇; 李颖文; 牛云; 张联璧

    2012-01-01

    Objective To explore the different infulencing factors for the incidence rate of jugular vein reverse current by comparing with hypertension patients and controls after use left or right side ulnar vein injection. Methods According to blood pressure, 531 patients without space occupying disease of neck and mediastinum were randomly devided into 2 groups: hypertension patients group and controls group. Each patients was performed CT enhanced examination with left or right side ulnar vein injection, and the incidence rate of jugular vein reverse current was recorded, in order to compare the incidence rate of vein reverse current between hypertension patients and controls. Result The incidence rate of jugular vein reverse current had more preferential in left side ulnar vein injection than right side injection, and it was obviously associated with blood pressure. Conclusion Using left side ulnar vein injection, the incidence rate of jugular vein reverse current will be reduced significantly in hypertension patients underging CT enhance examination.%目的 对比有无高血压患者在行头颈部CT增强检查时,选择经左或右肘静脉注射对比剂时颈静脉逆流的发生率,探讨其中差异的影响因素.方法 对531例无颈部及上纵膈占位性病变患者按照对比随机分组法,根据有无高血压进行分组,并随机选择左、右肘静脉注射对比剂行头颈部CT增强检查,记录颈部静脉逆流情况,对比有无高血压所致颈静脉逆流发生率的关系.结果 选择左肘静脉注射对比剂产生颈部静脉逆流发生率较选择右肘静脉侧高,且与高血压有明显关系.结论 在高血压患者中选择以右肘静脉注射对比剂,在头颈部CT增强扫描时可以明显减少颈部静脉逆流的发生.

  10. REcanalisation and Balloon-Oriented Puncture for Re-Insertion of Dialysis Catheter in Nonpatent Central Veins (REBORN).

    Science.gov (United States)

    Too, Chow Wei; Sayani, Raza; Lim, Elvin Yuan Ting; Leong, Sum; Gogna, Apoorva; Teo, Terence K

    2016-08-01

    To describe a technique involving REcanalisation and Balloon-Oriented puncture for Re-insertion of dialysis catheter in Nonpatent central veins (REBORN) and to report long-term results. This is a retrospective study of ten subjects in whom dialysis catheters were inserted using the REBORN technique from March 2012 to October 2014 and followed up till April 2016. Data on the duration of catheter usage, complications and reasons for removal were obtained. Seven patients had partially occluded lower internal jugular veins (IJV) recanalised in an antegrade fashion via a more cranial puncture. The balloon was then inflated at usual puncture site with an 18G needle. The collapsed balloon was cannulated with a guide wire, and both balloon and guide wire were advanced together into the superior vena cava. This was followed by tunnelled catheter placement using standard techniques. Two patients had catheters placed in the subclavian vein using a similar antegrade technique, and one patient had catheter placed via the left IJV following retrograde recanalisation from a right femoral puncture. Mean duration of catheter use was 278 days (range 32-503). Three catheters were removed due to matured arteriovenous accesses. Four patients had successful catheter change over the same subcutaneous track due to catheter malfunction. One catheter was removed after 7 months because of sepsis. No complications were reported. The REBORN technique allows for the preservation of central veins for future haemodialysis access, which can be challenging in patients requiring long-term dialysis.

  11. Why Current Doppler Ultrasound Methodology Is Inaccurate in Assessing Cerebral Venous Return: The Alternative of the Ultrasonic Jugular Venous Pulse

    Directory of Open Access Journals (Sweden)

    Paolo Zamboni

    2016-01-01

    Full Text Available Assessment of cerebral venous return is growing interest for potential application in clinical practice. Doppler ultrasound (DUS was used as a screening tool. However, three meta-analyses of qualitative DUS protocol demonstrate a big heterogeneity among studies. In an attempt to improve accuracy, several authors alternatively measured the flow rate, based on the product of the time average velocity with the cross-sectional area (CSA. However, also the quantification protocols lacked of the necessary accuracy. The reasons are as follows: (a automatic measurement of the CSA assimilates the jugular to a circle, while it is elliptical; (b the use of just a single CSA value in a pulsatile vessel is inaccurate; (c time average velocity assessment can be applied only in laminar flow. Finally, the tutorial describes alternative ultrasound calculation of flow based on the Womersley method, which takes into account the variation of the jugular CSA overtime. In the near future, it will be possible to synchronize the electrocardiogram with the brain inflow (carotid distension wave and with the outflow (jugular venous pulse in order to nicely have a noninvasive ultrasound picture of the brain-heart axis. US jugular venous pulse may have potential use in neurovascular, neurocognitive, neurosensorial, and neurodegenerative disorders.

  12. Why Current Doppler Ultrasound Methodology Is Inaccurate in Assessing Cerebral Venous Return: The Alternative of the Ultrasonic Jugular Venous Pulse.

    Science.gov (United States)

    Zamboni, Paolo

    2016-01-01

    Assessment of cerebral venous return is growing interest for potential application in clinical practice. Doppler ultrasound (DUS) was used as a screening tool. However, three meta-analyses of qualitative DUS protocol demonstrate a big heterogeneity among studies. In an attempt to improve accuracy, several authors alternatively measured the flow rate, based on the product of the time average velocity with the cross-sectional area (CSA). However, also the quantification protocols lacked of the necessary accuracy. The reasons are as follows: (a) automatic measurement of the CSA assimilates the jugular to a circle, while it is elliptical; (b) the use of just a single CSA value in a pulsatile vessel is inaccurate; (c) time average velocity assessment can be applied only in laminar flow. Finally, the tutorial describes alternative ultrasound calculation of flow based on the Womersley method, which takes into account the variation of the jugular CSA overtime. In the near future, it will be possible to synchronize the electrocardiogram with the brain inflow (carotid distension wave) and with the outflow (jugular venous pulse) in order to nicely have a noninvasive ultrasound picture of the brain-heart axis. US jugular venous pulse may have potential use in neurovascular, neurocognitive, neurosensorial, and neurodegenerative disorders.

  13. Case report: (Pre)syncopal symptoms associated with a negative internal jugular venous pressure

    DEFF Research Database (Denmark)

    Olesen, Niels; van Lieshout, Johannes J; Fisher, James P;

    2014-01-01

    A siphon is suggested to support cerebral blood flow but appears not to be established because internal jugular venous (IJV) pressure is close to zero in upright humans. Thus, in eleven young healthy males, IJV pressure was 9 ± 1 mmHg (mean ± SE) when supine and fell to 3 ± 1 mmHg when seated......, and middle cerebral artery mean blood velocity (MCA Vmean; P ... MCA Vmean decreased and yet within the time of observation ScO2 was not necessarily affected. These findings support the hypothesis that a negative IJV pressure that is a prerequisite for creation of a siphon provokes venous collapse inside the dura, and thereby limits rather than supports CBF....

  14. Repeated Hemothorax Following Ipsilateral Left Internal Jugular and Left Subclavian Venous Catheterization(Olgu Bildirimi)

    OpenAIRE

    ÜLGER,, F.; SARIHASAN, B.; ŞENEL, A.

    2009-01-01

    Aynı Taraf Sol İnternal Jugular ve Subklavian Venöz Kateterizasyondan Sonra Tekrarlayan Hemotoraks Kritik hastada en sık kullanılan invaziv girişimlerden birisi de santral kateterizasyon işlemidir. Kateterizasyon sıklıkla internal juguler ve subklavian vene uygulanır. Bu venler hemo-dinamik monitorizasyona izin verdiği gibi ilaç ve sıvı tedavileri, kan transfüzyonu ve total pa-renteral beslenmeye için de olanak sağlar. Komplikasyonlar internal juguler vende %1-4 sıklıkla arter delinmesi ve...

  15. Cough syncope in a 43-year-old woman with glomus jugulare tumor

    Directory of Open Access Journals (Sweden)

    Susanta Bandyopadhyay

    2014-01-01

    Full Text Available We present an unusual case of recurrent cough syncope in a 43-year-old woman, which was initially thought to be seizures. Syncopal episodes were triggered by paroxysms of cough and were characterized by unresponsiveness and myoclonic jerks in her extremities. She had a left-sided glomus jugulare tumor that extended into the posterior cranial fossa with evidence of worsening communicating hydrocephalus on brain imaging. We postulate that bouts of cough produced increased intracranial pressure both by raising intrathoracic and intraabdominal pressures as well as by transient obstruction to cerebrospinal fluid flow secondary to intermittent tonsillar herniation during cough. This resulted in diffuse decrease in cerebral blood flow causing syncope. The patient's syncopal episodes decreased in frequency once an external ventricular drain was placed followed by a ventriculoperitoneal shunt. Search for factors that can increase intracranial pressure seems warranted in patients with recurrent cough syncope.

  16. Tenascin C protects aorta from acute dissection in mice

    Science.gov (United States)

    Kimura, Taizo; Shiraishi, Kozoh; Furusho, Aya; Ito, Sohei; Hirakata, Saki; Nishida, Norifumi; Yoshimura, Koichi; Imanaka-Yoshida, Kyoko; Yoshida, Toshimichi; Ikeda, Yasuhiro; Miyamoto, Takanobu; Ueno, Takafumi; Hamano, Kimikazu; Hiroe, Michiaki; Aonuma, Kazutaka; Matsuzaki, Masunori; Imaizumi, Tsutomu; Aoki, Hiroki

    2014-02-01

    Acute aortic dissection (AAD) is caused by the disruption of intimomedial layer of the aortic walls, which is immediately life-threatening. Although recent studies indicate the importance of proinflammatory response in pathogenesis of AAD, the mechanism to keep the destructive inflammatory response in check is unknown. Here, we report that induction of tenascin-C (TNC) is a stress-evoked protective mechanism against the acute hemodynamic and humoral stress in aorta. Periaortic application of CaCl2 caused stiffening of abdominal aorta, which augmented the hemodynamic stress and TNC induction in suprarenal aorta by angiotensin II infusion. Deletion of Tnc gene rendered mice susceptible to AAD development upon the aortic stress, which was accompanied by impaired TGFβ signaling, insufficient induction of extracellular matrix proteins and exaggerated proinflammatory response. Thus, TNC works as a stress-evoked molecular damper to maintain the aortic integrity under the acute stress.

  17. Complications of Central Venous Totally Implantable Access Port: Internal Jugular Versus Subclavian Access

    Directory of Open Access Journals (Sweden)

    Pil Young Jung

    Full Text Available Background: Totally implantable access port (TIAP provides reliable, long term vascular access with minimal risk of infection and allows patients normal physical activity. With wide use of ports, new complications have been encountered. We analyzed TIAP related complications and evaluated the outcomes of two different percutaneous routes of access to superior vena cava. Methods: All 172 patients who underwent port insertion with internal jugular approach (Group 1, n = 92 and subclavian approach (Group 2, n = 79 between August 2011 and May 2013 in a single center were analyzed, retrospectively. Medical records were analyzed to compare the outcomes and the occurrence of port related complications between two different percutaneous routes of access to superior vena cava. Results: Median follow-up for TIAP was 278 days (range, 1-1868. Twenty four complications were occurred (14.0%, including pneumothorax (n = 1, 0.6%, migration/malposition (n = 4, 2.3%, pinch-off syndrome (n = 4, 2.3%, malfunction (n = 2, 1.1%, infection (n = 8, 4.7%, and venous thrombosis (n = 5, 2.9%. The overall incidence was 8.7% and 20.3% in each group (p = 0.030. Mechanical complications except infectious and thrombotic complications were more often occurred in group 2 (p = 0.033. The mechanical complication free probability is significantly higher in group 1 (p = 0.040. Conclusions: We suggest that the jugular access should be chosen in patients who need long term catheterization because of high incidence of mechanical complication, such as pinch-off syndrome.

  18. Giant Candida mycetoma in an ascending aorta tubular graft.

    Science.gov (United States)

    Di Benedetto, Giuseppe; Citro, Rodolfo; Longobardi, Antonio; Mastrogiovanni, Generoso; Panza, Antonio; Iesu, Severino; Bossone, Eduardo

    2013-09-01

    We report the case of a 46-year-old male hospitalized for abdominal pain and fever with history of a David procedure followed by an aortic valve replacement due to severe aortic regurgitation. Transesophageal echocardiography (TEE) and computed tomography showed a large mass floating in the aorta. After surgical excision of the vegetation, attached to the Dacron prosthesis, histological examination revealed Candida hyphae and spores confirming the diagnosis of a mycetoma in an ascending aorta tubular graft. At six-month follow-up, the patient was in good clinical condition without recurrence of the fungal mass on TEE. © 2013 Wiley Periodicals, Inc.

  19. Demonstration of coarctation of the aorta by magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Amparo, E.; Higgins, C.B.; Shafton, E.P.

    1984-12-01

    The physical findings in coarctation of the aorta are sufficiently characteristic to allow a reasonably accurate clinical diagnosis. The preoperative evaluation has been accomplished by catheterization, aortography, intravenous digital subtraction angiography, computed tomography (CT), and two-dimensional (2D) echocardiography. The authors report a case of coarctation of the aorta clinically suspected in a 29-year-old man. Magnetic resonance imaging (MRI) was the initial preoperative imaging technique. In retrospect, it provided sufficient information for preoperative evaluation so that other imaging techniques would not have been required.

  20. The AORTA Architecture: Integrating Organizational Reasoning in Jason

    DEFF Research Database (Denmark)

    Jensen, Andreas Schmidt; Dignum, Virginia; Villadsen, Jørgen

    2014-01-01

    the expected behavior of the agents. Agents need to be able to reason about the regulations, so that they can act within the expected boundaries and work towards the objectives of the organization. In this paper, we describe the AORTA (Adding Organizational Reasoning to Agents) architecture for making agents...... organization-aware. It is designed such that it provides organizational reasoning capabilities to agents implemented in existing agent programming languages without being tied to a specific organizational model. We show how it can be integrated in the Jason agent programming language, and discuss how...... the agents can coordinate their organizational tasks using AORTA....

  1. The occurrence of a pseudoaneurysm of the hepatic artery within the thrombosed portal vein of a patient with chronic pancreatitis: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Soo; Jang, Kyung Mi; Kim, Min Jeong; Yoon, Hoi Soo; Lee, Hyun; Jeon, Eui Yong; Lee, Kwan Seop; Lee, Yul [College of Medicine, Hallym University, Anyang (Korea, Republic of)

    2008-04-15

    A pseudoaneurysm is an uncommon but important life threatening complication of chronic pancreatitis. The arteries most commonly affected by a pseudoaneurysm are (in decreasing percent occurrence), the splenic (40%), gastroduodenal (30%), pancreaticoduodenal (20%), gastric (5%), hepatic (2%), and others (superior mesenteric, jejunal, ileocecal, and aorta) (1-3%). Thrombosis of the splenic or portal vein is another important complication of chronic pancreatitis. In this case report, we present a rare complication in the form of a right hepatic artery pseudoaneurysm which developed within the thrombosed right portal vein of a 35-year-old woman afflicted with chronic pancreatitis.

  2. Minimally invasive treatments for perforator vein insufficiency.

    Science.gov (United States)

    Kuyumcu, Gokhan; Salazar, Gloria Maria; Prabhakar, Anand M; Ganguli, Suvranu

    2016-12-01

    Incompetent superficial veins are the most common cause of lower extremity superficial venous reflux and varicose veins; however, incompetent or insufficient perforator veins are the most common cause of recurrent varicose veins after treatment, often unrecognized. Perforator vein insufficiency can result in pain, skin changes, and skin ulcers, and often merit intervention. Minimally invasive treatments have replaced traditional surgical treatments for incompetent perforator veins. Current minimally invasive treatment options include ultrasound guided sclerotherapy (USGS) and endovascular thermal ablation (EVTA) with either laser or radiofrequency energy sources. Advantages and disadvantages of each modality and knowledge on these treatments are required to adequately address perforator venous disease.

  3. Transaortic Intra-Aortic Balloon Pump Catheter Insertion through a Separate Saphenous Vein Graft in Patients with Severe Aortoiliac Disease

    Directory of Open Access Journals (Sweden)

    Faruk Toktas

    2014-01-01

    Full Text Available Background. Intra-aortic balloon pump (IABP is the most widely used mechanical assist device for hemodynamic support in high risk patients undergoing cardiac surgery. The aim of our study was to confirm whether transaortic route is a suitable alternative to allow IABP insertion in patients with severe aortoiliac diseases. Methods. This study included 7 consecutive patients undergoing coronary artery bypass grafting for severe coronary artery disease associated with severe aortoiliac disease. These patients could not be weaned from cardiopulmonary bypass and required the IABP support, which were placed through the ascending aorta. IABP catheter was inserted indirectly through a separate saphenous vein graft anastomosed to the ascending aorta by an end-to-side manner under a partial occluding clamp and advanced to the desired position in the descending thoracic aorta and exteriorly brought into the subcutaneous tissues in the jugulum. Results. The procedure was successfully performed in all the patients. The mean duration of IABP support was 54.0±13.4 hours. There were no in-hospital mortality and complications related to transaortic route. IABP removal did not require repeat sternotomy. At postoperative 6th month, multislice CT examination showed thrombotic occlusion at the remnant of the saphenous vein graft. Conclusions. This technique is a simple, reliable, and reproducible option in patients with severe aortoiliac disease in whom retrograde femoral route is not possible.

  4. Diagnostic value of color doppler ultrasonography in detecting stenosis and occlusion of central veins in patients with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Masoud Pezeshki Rad

    2015-01-01

    Full Text Available Venography is an invasive diagnostic test that uses contrast material that provides a picture of the condition of the veins. But, complications, including adverse effects on the kidney, do occur. On the other hand, with the current technological development, application of ultrasound in the diagnosis of obstructive diseases of the veins is gaining popularity, being non-invasive, easy to perform and cost-effective. The aim of this study was to evaluate the diagnostic value of Doppler sonography in the diagnosis of central vein stenosis. In this descriptive-analytical study, 41 hemodialysis patients who had been referred for 50 upper limb venographies to the radiology department of Imam Reza (AS were included. Patients with chronic kidney disease with a history of catheterization of the vein, jugular or subclavian, and who had established fistulas or synthetic vascular grafts were targeted. Central venous ultrasound was performed on both sides to evaluate stenosis or occlusion. Venography was performed by the radiologist the next day or the day before hemodialysis. Data on demographic characteristics, findings of clinical examination and findings of ultrasound as well as venography were recorded by using the SPSS software, Chi-square test and Spearman correlation, and Kappa agreement was calculated for sensitivity, specificity and predictive values. Twenty-three (56% patients were male subjects and 18 patients (44% were female. Twenty-three (56% patients of the study population were aged 60 years. The overall sensitivity, specificity and positive predictive value and negative predictive value of Doppler sonography in the proximal veins in hemodialysis patients compared with venography were, respectively, 80.9%, 79.3%, 73.9% and 85.1%. Color Doppler sonography, as a non-invasive method, could be a good alternative for venography in the assessment of the upper limb with central vein stenosis and occlusion.

  5. Diagnostic value of color doppler ultrasonography in detecting stenosis and occlusion of central veins in patients with chronic kidney disease.

    Science.gov (United States)

    Rad, Masoud Pezeshki; Kazemzadeh, Gholam Hosain; Ziaee, Masood; Azarkar, Ghodsieh

    2015-03-01

    Venography is an invasive diagnostic test that uses contrast material that provides a picture of the condition of the veins. But, complications, including adverse effects on the kidney, do occur. On the other hand, with the current technological development, application of ultrasound in the diagnosis of obstructive diseases of the veins is gaining popularity, being non-invasive, easy to perform and cost-effective. The aim of this study was to evaluate the diagnostic value of Doppler sonography in the diagnosis of central vein stenosis. In this descriptive-analytical study, 41 hemodialysis patients who had been referred for 50 upper limb venographies to the radiology department of Imam Reza (AS) were included. Patients with chronic kidney disease with a history of catheterization of the vein, jugular or subclavian, and who had established fistulas or synthetic vascular grafts were targeted. Central venous ultrasound was performed on both sides to evaluate stenosis or occlusion. Venography was performed by the radiologist the next day or the day before hemodialysis. Data on demographic characteristics, findings of clinical examination and findings of ultrasound as well as venography were recorded by using the SPSS software, Chi-square test and Spearman correlation, and Kappa agreement was calculated for sensitivity, specificity and predictive values. Twenty-three (56%) patients were male subjects and 18 patients (44%) were female. Twenty-three (56%) patients of the study population were aged 60 years. The overall sensitivity, specificity and positive predictive value and negative predictive value of Doppler sonography in the proximal veins in hemodialysis patients compared with venography were, respectively, 80.9%, 79.3%, 73.9% and 85.1%. Color Doppler sonography, as a non-invasive method, could be a good alternative for venography in the assessment of the upper limb with central vein stenosis and occlusion.

  6. An Anatomical Study of the Middle Temporal Vein and the Drainage Vascular Networks to Assess the Potential Complications and the Preventive Maneuver During Temporal Augmentation Using Both Anterograde and Retrograde Injections.

    Science.gov (United States)

    Tansatit, Tanvaa; Apinuntrum, Prawit; Phetudom, Thavorn

    2015-10-01

    Non-thrombotic pulmonary embolism has recently been reported as a remote complication of filler injections to correct hollowing in the temporal region. The middle temporal vein (MTV) has been identified as being highly susceptible to accidental injection. The anatomy and tributaries of the MTV were investigated in six soft embalmed cadavers. The MTV was cannulated and injected in both anterograde and retrograde directions in ten additional cadavers using saline and black filler, respectively. The course and tributaries of the MTV were described. Regarding the infusion experiment, manual injection of saline was easily infused into the MTV toward the internal jugular vein, resulting in continuous flow of saline drainage. This revealed a direct channel from the MTV to the internal jugular vein. Assessment of a preventive maneuver during filler injections was effectively performed by pressing at the preauricular venous confluent point against the zygomatic process. Sudden retardation of saline flow from the drainage tube situated in the internal jugular vein was observed when the preauricular confluent point was compressed. Injection of black gel filler into the MTV and the tributaries through the cannulated tube directed toward the eye proved difficult. The mechanism of venous filler emboli in a clinical setting occurs when the MTV is accidentally cannulated. The filler emboli follow the anterograde venous blood stream to the pulmonary artery causing non-thrombotic pulmonary embolism. Pressing of the pretragal confluent point is strongly recommended during temporal injection to help prevent filler complications, but does not totally eliminate complication occurrence. This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full

  7. Extrahepatic Portal Vein Obstruction and Portal Vein Thrombosis in Special Situations: Need for a New Classification

    Science.gov (United States)

    Wani, Zeeshan A.; Bhat, Riyaz A.; Bhadoria, Ajeet S.; Maiwall, Rakhi

    2015-01-01

    Extrahepatic portal vein obstruction is a vascular disorder of liver, which results in obstruction and cavernomatous transformation of portal vein with or without the involvement of intrahepatic portal vein, splenic vein, or superior mesenteric vein. Portal vein obstruction due to chronic liver disease, neoplasm, or postsurgery is a separate entity and is not the same as extrahepatic portal vein obstruction. Patients with extrahepatic portal vein obstruction are generally young and belong mostly to Asian countries. It is therefore very important to define portal vein thrombosis as acute or chronic from management point of view. Portal vein thrombosis in certain situations such as liver transplant and postsurgical/liver transplant period is an evolving area and needs extensive research. There is a need for a new classification, which includes all areas of the entity. In the current review, the most recent literature of extrahepatic portal vein obstruction is reviewed and summarized. PMID:26021771

  8. Extrahepatic portal vein obstruction and portal vein thrombosis in special situations: Need for a new classification

    Directory of Open Access Journals (Sweden)

    Zeeshan A Wani

    2015-01-01

    Full Text Available Extrahepatic portal vein obstruction is a vascular disorder of liver, which results in obstruction and cavernomatous transformation of portal vein with or without the involvement of intrahepatic portal vein, splenic vein, or superior mesenteric vein. Portal vein obstruction due to chronic liver disease, neoplasm, or postsurgery is a separate entity and is not the same as extrahepatic portal vein obstruction. Patients with extrahepatic portal vein obstruction are generally young and belong mostly to Asian countries. It is therefore very important to define portal vein thrombosis as acute or chronic from management point of view. Portal vein thrombosis in certain situations such as liver transplant and postsurgical/liver transplant period is an evolving area and needs extensive research. There is a need for a new classification, which includes all areas of the entity. In the current review, the most recent literature of extrahepatic portal vein obstruction is reviewed and summarized.

  9. Endovascular covered stent treatment for descending aorta pseudoaneurysm following coarctation of the aorta repair in an infant.

    Science.gov (United States)

    Takawira, Farirai F; Sinyangwe, Greenwood; Mooloo, Rene

    2010-12-01

    The development of a pseudoaneurysm is a rare complication following repair of a coarctation of the aorta. Surgical management of pseudoaneurysms is associated with high morbidity and mortality. We describe the successful endovascular deployment of a covered stent in a sick infant with a descending aorta pseudoaneurysm, following the repair of an aortic coarctation. We highlight the challenges we encountered. Endovascular repair is a safe palliative alternative to re-do open surgery in unstable infants with large pseudoaneurysms following aortic coarctation repair. The role of endovascular stents as the final definitive therapy will remain limited by the deployable, small-size stents in small, growing children.

  10. Improved technique of heterotopic auxiliary rat liver transplantation with portal vein arterialization.

    Science.gov (United States)

    Schleimer, Karina; Stippel, Dirk L; Tawadros, Samir; Hölzen, J; Hölscher, A H; Beckurts, K Tobias E

    2006-04-01

    In acute, potentially reversible hepatic failure, auxiliary liver transplantation is a promising alternative approach. Using the auxiliary partial orthotopic liver transplantation (APOLT) method--the orthotopic implantation of auxiliary segments--most of the technical problems (lack of space for the additional liver mass, the portal vein reconstruction, and the venous outflow) are avoided, but extensive resections of the native liver and the graft are necessary. Erhard described the heterotopic auxiliary liver transplantation (HALT) with portal vein arterialization (PVA). Initial clinical results demonstrated that an adequate liver function can be achieved using this technique. We developed and improved a technique of HALT with flow-regulated PVA in the rat to perform further investigations. The aim of this paper is to explain in detail this improved experimental surgical technique. Liver transplantations were performed in 122 male Lewis rats: After a right nephrectomy, the liver graft, which was reduced to about 30% of the original size, was implanted into the right upper quadrant of the recipient's abdomen. The infrahepatic caval vein was anastomosed end-to-side. The donor's portal vein was completely arterialized to the recipient's right renal artery in stent technique. Using a stent with an internal diameter of 0.3 mm, the flow in the arterialized portal vein was regulated to achieve physiologic parameters. The celiac trunk of the graft was anastomosed to the recipient's aorta, end-to-side. The bile duct was implanted into the duodenum. After improvements of the surgical technique, we achieved a perioperative survival of 90% and a 6-week survival of 80% in the last 112 transplantations. We developed a standardized and improved technique, which can be used for experiments of regeneration and inter-liver competition in auxiliary liver transplantation. Furthermore, this technique is suitable for the investigation of the influence of portal vein arterialization and

  11. Usability of ringed polytetrafluoroethylene grafts for middle hepatic vein reconstruction during living donor liver transplantation.

    Science.gov (United States)

    Hwang, Shin; Jung, Dong-Hwan; Ha, Tae-Yong; Ahn, Chul-Soo; Moon, Deok-Bog; Kim, Ki-Hun; Song, Gi-Won; Park, Gil-Chun; Jung, Sung-Won; Yoon, Sam-Youl; Namgoong, Jung-Man; Park, Chun-Soo; Park, Yo-Han; Park, Hyeong-Woo; Lee, Hyo-Jun; Lee, Sung-Gyu

    2012-08-01

    Large vein allografts are suitable for middle hepatic vein (MHV) reconstruction, but their supply is often limited. Although polytetrafluoroethylene (PTFE) grafts are unlimitedly available, their long-term patency is relatively poor. We intended to enhance the clinical usability of PTFE grafts for MHV reconstruction during living donor liver transplantation (LDLT). Two sequential studies were performed. First, PTFE grafts were implanted as inferior vena cava replacements into dogs. Second, in a 1-year prospective clinical trial of 262 adults undergoing LDLT with a modified right lobe, MHV reconstruction with PTFE grafts was compared with other types of reconstruction, and the outcomes were evaluated. In the animal study, PTFE grafts induced strong inflammatory reactions and luminal thrombus formation, but the endothelial lining was well developed. In the clinical study, the reconstruction techniques were revised to make a composite PTFE graft with an artery patch on the basis of the results of the animal study. MHVs were reconstructed with cryopreserved iliac veins (n = 122), iliac arteries (n = 43), aortas (n = 13), and PTFE (n = 84), and these reconstructions yielded 6-month patency rates of 75.3%, 35.2%, 92.3%, and 76.6%, respectively. The overall 6-month patency rates for the iliac vein and PTFE grafts were similar (P = 0.92), but the 6-month patency rates with vein segment 5 were 51.0% and 34.7%, respectively (P = 0.001). The overall graft and patient survival rates did not differ among these 4 groups. In conclusion, ringed PTFE grafts combined with small vessel patches showed high patency rates comparable to those of iliac vein grafts; thus, they can be used for MHV reconstruction when other sizable vessel allografts are not available.

  12. Isolated Anomalous Origin of Left Pulmonary Artery From the Descending Aorta: An Embryologic Ambiguity.

    Science.gov (United States)

    Gnanappa, Ganesh Kumar; Laohachai, Karina; Orr, Yishay; Ayer, Julian

    2016-11-01

    Anomalous origin of a branch pulmonary artery from the aorta is a rare malformation, accounting for 0.12% of all congenital heart defects. Anomalous origin of the left pulmonary artery from the aorta (ALPA) constitutes a small proportion of these cases. ALPA has been reported to arise from the ascending aorta with various embryologic postulates. We report a case of isolated ALPA arising from the descending aorta in association with a patent ductus arteriosus, to emphasize its embryologic ambiguity.

  13. Segmentation of the thoracic aorta in noncontrast cardiac CT images.

    Science.gov (United States)

    Avila-Montes, Olga C; Kurkure, Uday; Nakazato, Ryo; Berman, Daniel S; Dey, Damini; Kakadiaris, Ioannis A

    2013-09-01

    Studies have shown that aortic calcification is associated with cardiovascular disease. In this study, a method for localization, centerline extraction, and segmentation of the thoracic aorta in noncontrast cardiac-computed tomography (CT) images, toward the detection of aortic calcification, is presented. The localization of the right coronary artery ostium slice is formulated as a regression problem whose input variables are obtained from simple intensity features computed from a pyramid representation of the slice. The localization, centerline extraction, and segmentation of the aorta are formulated as optimal path detection problems. Dynamic programming is applied in the Hough space for localizing key center points in the aorta which guide the centerline tracing using a fast marching-based minimal path extraction framework. The input volume is then resampled into a stack of 2-D cross-sectional planes orthogonal to the obtained centerline. Dynamic programming is again applied for the segmentation of the aorta in each slice of the resampled volume. The obtained segmentation is finally mapped back to its original volume space. The performance of the proposed method was assessed on cardiac noncontrast CT scans and promising results were obtained.

  14. Surgical exclusion of postsurgical pseudoaneurysm of the ascending aorta

    Directory of Open Access Journals (Sweden)

    Ramachandra Barik

    2014-01-01

    Full Text Available Pseudoaneurysm of ascending aorta after cardiac surgery is rare in children. We report a case of successful surgical exclusion of ascending aortic pseudoaneurysm in a 15-year-old boy. The neck of the aneurysm was in close proximity to the right coronary artery (RCA.

  15. Ischemic colitis complicating reconstruction of the abdominal aorta

    DEFF Research Database (Denmark)

    Schroeder, T V; Christoffersen, J K; Andersen, J

    1985-01-01

    A review of 23 patients with ischemic colitis after surgical treatment of the abdominal aorta disclosed a pathogenetic heterogeneous finding. Ligation of the inferior mesenteric artery, abolished collateral blood supply or nonocclusive low flow state, or both, was a common feature. An incidence...

  16. Trauma to the Thoracic Aorta and the Great Vessels

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Min Ji; Kim, Young Tong; Jou, Sung Shick; Kim, Sang Won; Shin, Hyeong Cheol; Kim, Il Young [Soonchunhyang University Cheonan Hospital, Cheonan (Korea, Republic of)

    2009-04-15

    Trauma to the thoracic aorta and the great vessels carries a high mortality rate. The survival rate can be improved if these patients are given prompt and appropriate treatment. Various types of vascular injury are caused by blunt, penetrating, iatrogenic trauma. This article reviews the multimodality imaging of traumatic injuries to the aortic and great vessels

  17. Mineralization of human aortas with coarctation: quantitative electron probe microanalysis

    Energy Technology Data Exchange (ETDEWEB)

    Krefting, E.R.; Roehrig, T.; Broecker, W.; Anyanwu, E.; Schlake, W.; Dittrich, H.; Hoehling, H.J.

    1982-01-01

    Aortas with coarctation (isthmus stenosis) are obviously an ideal model to investigate pressure dependent changes of the aorta, as one can compare the proximal region (high pressure) with the distal region (low pressure). 7 aortas of patients aged from 2 months to 54 years were investigated. The concentrations of Na, Mg, P, S, C1, K, and Ca were determined by electronprobe microanalysis. Ca and P are constituent parts of the developing mineral and are mainly discussed. The Ca/P ratio (by weight) is about 0.3 in the unmineralized and about 2 in the mineralized tissue. Mineralization is demonstrated by a parallel increase of Ca, P, and the Ca/P ratio. Enrichments of Ca and P are found above all in a subintimal band. Usually they occur proximally and distally, but are much more pronounced proximally. Even in the aorta of a 2 month old infant enrichments were found proximally, but not distally. Thus mineral deposits occur very early in regions of hypertension. The differences between the proximal and distal region may demonstrate the influence of blood pressure on vascular mineralization. The mineralization starts in small compartments, which increase in size and number in the process of mineralization. Mineralized regions could often be localized by cathodoluminescence. But to demonstrate and localize the initial mineral deposits and to quantify element contents, electronprobe microanalysis became indispensable.

  18. Xanthorrhizol induces endothelium-independent relaxation of rat thoracic aorta.

    Science.gov (United States)

    Campos, M G; Oropeza, M V; Villanueva, T; Aguilar, M I; Delgado, G; Ponce, H A

    2000-06-08

    Xanthorrhizol, a bisabolene isolated from the medicinal plant Iostephane heterophylla, was assayed on rat thoracic aorta rings to elucidate its effect and likely mechanism of action, by measuring changes of isometric tension. Xanthorrhizol (1, 3, 10, 30 and 100 microg/mL) significantly inhibited precontractions induced by KCI-; (60mM), noradrenaline (10(-6) M) or CaCl2 (1.0 mM). Increasing concentrations of external calcium antagonized the inhibitory effect on KCl-induced contractions. The vasorelaxing effect of xanthorrhizol was not affected by indomethacin (10 microM) or L-NAME (100 microM) in intact rat thoracic aorta rings precontracted by noradrenaline, which suggested that the effect was not mediated through either endothelium-derived prostacyclin (PGI2) or nitric oxide release from endothelial cells. Endothelium removal did not affect the relaxation induced by xanthorrhizol on rat thoracic aorta rings, discarding the participation of any substance released by the endothelium. Xanthorrhizol inhibitory effect was greater on KCI- and CaCl2-induced contractions than on those induced by noradrenaline. Xanthorrhizol inhibitory effect in rat thoracic aorta is likely explained for interference with calcium availability by inhibiting calcium influx through both voltage- and receptor-operated channels.

  19. Angiosarcoma of common iliac vein

    Science.gov (United States)

    Ibis, Kamuran; Usta, Ufuk; Cosar, Rusen; Ibis, Cem

    2015-01-01

    Angiosarcoma is a rare malignant tumour of endothelial cells. Primary angiosarcoma of venous origin is extremely rare, and has a very poor prognosis. A 63-year-old woman with retroperitoneal mass underwent en bloc resection on a part of iliac vein followed by adjuvant radiotherapy. No recurrence was detected during 3 years of follow-up. PMID:25596292

  20. A breakthrough technique for the removal of a hemodialysis catheter stuck in the central vein: endoluminal balloon dilatation of the stuck catheter.

    Science.gov (United States)

    Hong, Joon Ho

    2011-01-01

    Hemodialysis (HD) catheters can get stuck in the central vein after long-term use and their removal might become difficult especially in patients with fibrosed or occluded central veins. Herein, a breakthrough technique is reported for the easy removal of a stuck HD catheter from the central vein. Attempts were made to remove a tunneled double-lumen HD catheter from the central vein of a 74-year-old woman, only to find that the catheter was stuck. The patient was transferred to the operating room and a skin incision was made in the neck and the subcutaneous portion of the HD catheter was retrieved from the tunnel. Under fluoroscopy, a guide wire was inserted into one lumen of the HD catheter and advanced into the right atrium beyond the catheter tip. A 5 mm × 4 cm balloon angioplasty catheter was then inserted into the HD catheter lumen over the guide wire and advanced into the jugular vein junction of the HD catheter around the thoracic inlet. The balloon was inflated to its maximum dimension and pressure. This endoluminal dilatation of the HD catheter was continued by deflating the balloon and then pushing the angioplasty catheter 4 cm at a time towards the tip of the HD catheter in the right atrium. After a second balloon angioplasty catheter of 6 mm × 4 cm was used to expand the entire segment of the other lumen, the HD catheter was pulled out easily from the central vein without any resistance. The endoluminal balloon dilatation of the HD catheter not only separates the stuck HD catheter from the adherent vein by breaking the adhesions between them, but also expands the vein simultaneously, thus enabling easy removal of the HD catheter.

  1. Clinical studies on inferior right hepatic veins

    Institute of Scientific and Technical Information of China (English)

    Xue Xing; Hong Li; Wei-Guo Liu

    2007-01-01

    BACKGROUND:Many small veins are called accessory, short hepatic veins in addition to the right, middle and left hepatic veins. The size of these veins varied from a pinhole to 1 cm; the size of inferior right hepatic veins (IRHVs) is thicker than that of short hepatic veins or more than 1 cm occasionally. Adults have a higher incidence rate of the IRHV. DATA SOURCES:A literature search of the PubMed database was conducted and research articles were reviewed. RESULTS:The size of IRHVs is related to the size of the right hepatic vein, i.e. the larger the diameter of the right hepatic vein, the smaller the diameter of the IRHVs, and vice versa. The IRHVs are divided into superior, medial and inferior groups, separately named the superior, medial and inferior right hepatic veins according to the position of the IRHV entering the inferior vena cava. The superior right hepatic vein mainly drains the superior part of segmentⅦ, and the medial right hepatic vein drains the middle part of segmentⅦ. A thicker IRHV mainly drains segmentⅥ and the inferior part of segmentⅦ and a thinner IRHV drains the inferior part of segmentⅤ. CONCLUSIONS:The clinical signiifcance of these studies on IRHVs is varied: (1) Hepatic caudate lobe resection could be introduced after study on the veins of that lobe. (2) It is very important to identify the draining region of the IRHV for guiding hepatic segmentectomy. The postero-inferior area of the right lobe can be preserved along with the hypertrophic IRHV even if the entire main right hepatic vein is resected during segmentectomy ofⅦ andⅧwith right hepatic vein resection for patients with primary liver cancer. (3) The ligation of the major hepatic vein for the treatment of juxtahepatic vein injury is recommended because of severe hemorrhagic shock and dififculty in

  2. The novel phenylpropiophenone derivates induced relaxation of isolated rat aorta.

    Science.gov (United States)

    Ivković, B; Vladimirov, S; Novaković, R; Cupić, V; Heinle, H; Gojković-Bukarica, L

    2012-07-01

    Our aim was to define how different chemical properties of newly developed phenylpropiophenone derivates (PhPds) influenced their potency and efficacy to relax rat aorta. A contribution of ion channels in the PhPds and propafenone mechanism of vasodilatation was tested. PhPds were syntethysed by substitution in the benzyl moiety with -F, -CH3 or -CF3 groups on the ortho or para position. The vasodilatation by PhPds was examined on the rings of rat aorta precontracted with phenylephrine. In order to test involvement of voltage-gated Na+ and K+ channels and L-type Ca2+ channels in a mechanism of action of PhPds, we used their blockers: lidocaine, nifedipine and 4-aminopiridine, respectively. Aorta was more sensitive to 5-ortho-trifluoromethyl derivate than to propafenone and other PhPds. The 5-para-methyl derivate had lower potency and efficacy than propafenone and other PhPds. Lidocaine did not influenced relaxation induced by PhPds, but slightly inhibited the effect of propafenone. The 4-aminopiridine only inhibited relaxation induced by 5-para-methyl derivate. Nifedipine inhibited relaxation of the rat aorta induced by 5-ortho-trifluoromethyl derivate and by propafenone. Introduction of 5-ortho-trifluoromethyl and 5-para-methyl group in the benzyl moiety of propafenone molecule changed its potency, efficacy and mechanism of action in the rat aorta. The 4-aminopiridine- and nifedipine sensitive ion channels are involved in mechanism of action of 5-para-methyl and 5-ortho-trifluoromethyl derivate. The introduction of other tested groups in the benzyl moiety does not affect pharmacological properties of the PhPds in relation to propafenone.

  3. Who Is at Risk for Varicose Veins?

    Science.gov (United States)

    ... may raise your risk for varicose veins. The normal wear and tear of aging may cause the valves in your veins to weaken and not work well. Gender Women tend to get varicose veins more often than men. Hormonal changes that occur during puberty, pregnancy, and menopause (or ...

  4. Cephalic veins in coronary artery bypass surgery

    DEFF Research Database (Denmark)

    Licht, P; Jakobsen, Erik; Lerbjerg, G

    1996-01-01

    Various alternative conduits for aortocoronary bypass grafting have been suggested when the saphenous vein quality is inadequate. During a 10-year period we have used the cephalic vein in 39 patients. Eighteen entered an angiographic follow-up study. A total of 31 arm vein grafts were used with 4...

  5. Radiological aspects of portal vein embolization

    NARCIS (Netherlands)

    van Lienden, K.P.

    2012-01-01

    This thesis deals with liver regeneration after portal vein embolization (PVE) or portal vein ligation (PVL). Several aspects of these portal vein occlusion techniques are evaluated in clinical and experimental studies. In addition, the role of dynamic liver function tests and CT-volumetry in risk a

  6. Cephalic veins in coronary artery bypass surgery

    DEFF Research Database (Denmark)

    Licht, P; Jakobsen, Erik; Lerbjerg, G;

    1996-01-01

    Various alternative conduits for aortocoronary bypass grafting have been suggested when the saphenous vein quality is inadequate. During a 10-year period we have used the cephalic vein in 39 patients. Eighteen entered an angiographic follow-up study. A total of 31 arm vein grafts were used with 4...

  7. Serial Measurements of Splanchnic Vein Diameters in RatsUsing High-Frequency Ultrasound

    Directory of Open Access Journals (Sweden)

    Bridget M Seitz

    2016-05-01

    Full Text Available The purpose of this study was to investigate serial ultrasound imaging in rats as a fully non-invasive method to 1 quantify the diameters of splanchnic veins in real time as an indirect surrogate for the capacitance function of those veins, and 2 assess the effects of drugs on venous dimensions. A 21 MHz probe was used on anesthetized male Sprague-Dawley rats to collect images containing the portal vein (PV, superior mesenteric vein (SMV, abdominal inferior vena cava (IVC, and splenic vein (SpV; used as a landmark in timed studies and the abdominal aorta (AA. Stable landmarks were established that allowed reproducible quantification of cross-sectional diameters within an animal. The average diameters of vessels measured every 5 minutes over 45 minutes remained within 0.75±0.15% (PV, 0.2±0.09% (SMV, 0.5±0.12% (IVC and 0.38±0.06% (AA of baseline (PV: 2.0±0.12 mm; SMV: 1.7±0.04 mm; IVC: 3.2±0.1 mm; AA: 2.3±0.14 mm. The maximal effects of the vasodilator sodium nitroprusside (SNP; 2 mg/kg, i.v. bolus on venous diameters were determined 5 minutes post SNP bolus; the diameters of all noted veins were significantly increased by sodium nitroprusside, while mean arterial pressure decreased 29±4 mmHg. By contrast, administration of the venoconstrictor sarafotoxin (S6c; 5 ng/kg, i.v. bolus significantly decreased PV and SpV, but not IVC, SMV or AA, diameters 5 minutes post S6c bolus; mean arterial pressure increased by 6±2 mmHg. In order to determine if resting splanchnic vein diameters were stable over much longer periods of time, vessel diameters were measured every two weeks for 8 weeks. Measurements were found to be highly reproducible within animals over this time period. Finally, to evaluate the utility of vein imaging in a chronic condition, images were acquired from 4-week deoxycorticosterone acetate salt (DOCA-salt hypertensive and normotensive (SHAM control rats. All vessel diameters increased from baseline while mean arterial pressure

  8. Posterior Nutcracker Syndrome with Left Renal Vein Duplication: A Rare Cause of Haematuria in a 12-Year-Old Boy

    Directory of Open Access Journals (Sweden)

    J. Preza Fernandes

    2012-01-01

    Full Text Available The nutcracker syndrome (NCS is a rare cause of haematuria. It embraces an extended nonpathognomonic spectrum of symptoms that imply a difficult diagnosis. Ultimately it may be associated with substantial morbidity and even life-threatening events. We report a rare cause if a 12-year-old boy who presented with a history of frequent intermittent episodes of painless constant haematuria. The cystoscopy showed a bloody urine ejaculate from the left ureter meatus. The Doppler ultrasonography showed turbulent pattern of venous blood flow of the posterior renal vein branch behind the aorta. The abdominopelvic computer tomography (apCT revealed left renal vein (LRV duplication with a dilated retroaortic branch, entrapped between the aorta and the vertebral column, promoting the renal nutcracker syndrome. The patient was initially hospitalized and managed with oral iron supplements and continuous saline bladder irrigation, not requiring additional treatment. The child is currently asymptomatic, with haemoglobin value returning to normal and therefore proposed to conservative management with close followup. The authors present a case report of episodic haematuria caused by a rare entity—posterior nutcracker syndrome with renal vein duplication.

  9. CFU-S(11) activity does not localize solely with the aorta in the aorta-gonad-mesonephros region

    NARCIS (Netherlands)

    M.F.T.R. de Bruijn (Marella); M.C. Peeters (Marian); T. Luteijn; P. Visser (Pim); N.A. Speck; E.A. Dzierzak (Elaine)

    2000-01-01

    textabstractThe aorta-gonad-mesonephros (AGM) region is a potent hematopoietic site in the midgestation mouse conceptus and first contains colony-forming units-spleen day 11 (CFU-S(11)) at embryonic day 10 (E10). Because CFU-S(11) activity is present in the AGM region b

  10. Physical description of the blood flow from the internal jugular vein to the right atrium of the heart: new ultrasound application perspectives

    CERN Document Server

    Sisini, Francesco

    2016-01-01

    This is a self-published methodological note distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The note contains an original reasoning of mine and the goal to share thoughts and methodologies, not results. Therefore before using the contents of these notes, everyone is invited to verify the accuracy of the assumptions and conclusions.

  11. [An accidental puncture of a small artery behind the internal jugular vein in real-time ultrasound-guided pediatric central venous cannulation].

    Science.gov (United States)

    Kayashima, Kenji

    2013-02-01

    A baby girl, 15-month-old, 75.6 cm in height, and 7.5 kg in weight, was scheduled to undergo ventricular septal defect repair. The right IJV, 3.0 mm in thickness and 7.0 mm in depth, was punctured to place a central venous catheter with a 19-mm-long 24G puncture needle. Non-pulsatile bright red blood appeared during the 15.8-mm-long needle insertion and dark red blood appeared during the 14.7-mm-long needle insertion. The vertebral artery, 3.9 mm in width, lay 14.1 mm in depth. The 15.8-mm-long needle inserted at a 45-degree angle could reach about 11.3 mm deep perpendicularly from the skin surface. The 14.7-mm-long needle inserted at a 45-degree angle reached about 10.4 mm, which is near the posterior wall of the IJV It seemed that a small artery behind the IJV was punctured mistakenly. In withdrawing blood from a cyanotic patient, it may be difficult to judge if the blood was arterial because it was non-pulsatile when it appeared. We should be careful to know the existence of small arteries behind IJVs and to confirm which vessels the returned blood comes from.

  12. Hemodynamic effects of spiral ePTFE prosthesis compared with standard arteriovenous graft in a carotid to jugular vein porcine model

    NARCIS (Netherlands)

    Jahrome, Ommid Kh; Hoefer, Imo; Houston, Graeme J.; Stonebridge, Peter A.; Blankestijn, Peter J.; Moll, Frans L.; de Borst, Gert J.

    2011-01-01

    Introduction: The primary patency rate of arteriovenous (AV) grafts is limited by distal venous anastomosis stenosis or occlusion due to intimal hyperplasia associated with distal graft turbulence. The normal blood flow in native arteries is spiral laminar flow. Standard vascular grafts do not produ

  13. Classification of hypervascular liver lesions based on hepatic artery and portal vein blood supply coefficients calculated from triphasic CT scans.

    Science.gov (United States)

    Boas, F Edward; Kamaya, Aya; Do, Bao; Desser, Terry S; Beaulieu, Christopher F; Vasanawala, Shreyas S; Hwang, Gloria L; Sze, Daniel Y

    2015-04-01

    Perfusion CT of the liver typically involves scanning the liver at least 20 times, resulting in a large radiation dose. We developed and validated a simplified model of tumor blood supply that can be applied to standard triphasic scans and evaluated whether this can be used to distinguish benign and malignant liver lesions. Triphasic CTs of 46 malignant and 32 benign liver lesions were analyzed. For each phase, regions of interest were drawn in the arterially enhancing portion of each lesion, as well as the background liver, aorta, and portal vein. Hepatic artery and portal vein blood supply coefficients for each lesion were then calculated by expressing the enhancement curve of the lesion as a linear combination of the enhancement curves of the aorta and portal vein. Hepatocellular carcinoma (HCC) and hypervascular metastases, on average, both had increased hepatic artery coefficients compared to the background liver. Compared to HCC, benign lesions, on average, had either a greater hepatic artery coefficient (hemangioma) or a greater portal vein coefficient (focal nodular hyperplasia or transient hepatic attenuation difference). Hypervascularity with washout is a key diagnostic criterion for HCC, but it had a sensitivity of 72 % and specificity of 81 % for diagnosing malignancy in our diverse set of liver lesions. The sensitivity for malignancy was increased to 89 % by including enhancing lesions that were hypodense on all phases. The specificity for malignancy was increased to 97 % (p = 0.039) by also examining hepatic artery and portal vein blood supply coefficients, while maintaining a sensitivity of 76 %.

  14. A New Multimodal Biometric System Based on Finger Vein and Hand Vein Recognition

    OpenAIRE

    Randa Boukhris Trabelsi; Alima Damak Masmoudi; Dorra Sellami Masmoudi

    2013-01-01

    As a reliable and robust biological characteristic, the vein pattern increases more and more the progress in biometric researches. Generally, it was shown that single biometric modality recognition is not able to meet high performances. In this paper, we propose a new multimodal biometric system based on fusion of both hand vein and finger vein modalities. For finger vein recognition, we employ the Monogenic Local Binary Pattern (MLBP), and for hand vein recognitionan Improved Gaussian Matche...

  15. Application of intravenous electrocardiography for insertion of central veins dialysis catheters

    Directory of Open Access Journals (Sweden)

    Beigi Ali

    2009-01-01

    Full Text Available One fifth of the inserted dialysis catheters in the internal jugular or subclavian veins may be misplaced. Appropriate positioning of the catheter tip is sometimes difficult. We attempted to use intravenous electrocardiography (ECG to guide catheter tip positioning in 30 hemodialysis patients (17 (57% were men, and the mean age was 43 ± 12 years. who required vascular accesses for dialysis by insertion of double lumen temporary catheters via the jugular veins. Before cathe-terization, standard ECG on the long lead D II was performed and P-wave height was recorded. P-wave voltage was also measured via the blue (venous and red (arterial lumens, using the guide wire as an electrical conductor. After confirmation of the appropriate position of the catheter tip at the superior vena cava (SVC-right atrial junction using chest radiography, the ECG lead corres-ponding to the right hand was connected to the guide wire lodged inside the lumen of the blue catheter. P-wave height in the long lead D II was recorded. The guide wire was withdrawn so as to bring its tip tangent to the tip of the red catheter. ECG was performed on the long lead D II in a similar manner, and the P-wave height was recorded. The mean P-wave voltage in normal ECG and intravenous ECG (red and blue catheter tips measured 1.27 ± 0.38 mm, 3.10 ± 0.95 mm, and 5.42 ± 1.76 mm, respectively. The difference between the mean P-wave voltages measured in standard and intravenous ECG (blue and red catheter tips was statistically significant (P< 0.05. We conclude that the dialysis catheter tip can be positioned appropriately via the measurement of the P-wave height by intravenous ECG and using the sinoatrial node as an accurate landmark. This method can complement the chest radiography in the appropriate placement of the central vein catheters.

  16. Recurrence of superficial vein thrombosis in patients with varicose veins.

    Science.gov (United States)

    Karathanos, Christos; Spanos, Konstantinos; Saleptsis, Vassileios; Tsezou, Aspasia; Kyriakou, Despina; Giannoukas, Athanasios D

    2016-08-01

    To investigate which factors other than history of superficial vein thrombosis (SVT) are associated with recurrent spontaneous SVT episodes in patients with varicose veins (VVs). Patients with a history of spontaneous SVT and VVs were followed up for a mean period of 55 months. Demographics, comorbidities, and thrombophilia screening test were analyzed. Patients were grouped according to the clinical-etiology-anatomy-pathophysiology classification. A multiple logistic regression analysis with the forward likelihood ratio method was undertaken. Thirteen patients out of 97 had a recurrence SVT episode during the follow-up period. All those patients were identified to have a thrombophilia defect. Protein C and S, antithrombin, and plasminogen deficiencies were more frequently present in patients without recurrence. Gene mutations were present in 38% in the nonrecurrence group and 77% in the recurrence group. After logistic regression analysis, patients with dislipidemia and mutation in prothrombin G20210A (FII) had an increased risk for recurrence by 5.4-fold and 4.6-fold, respectively. No deep vein thrombosis or pulmonary embolism occurred. Dislipidemia and gene mutations of F II are associated with SVT recurrence in patients with VVs. A selection of patients may benefit from anticoagulation in the short term and from VVs intervention in the long term. © The Author(s) 2015.

  17. Direction of the J-tip of the guidewire, in seldinger technique, is a significant factor in misplacement of subclavian vein catheter: a randomized, controlled study.

    Science.gov (United States)

    Tripathi, Mukesh; Dubey, Prakash K; Ambesh, Sushil P

    2005-01-01

    Misplacement of central venous catheters, predisposing to poor functioning including inability to aspirate blood, is common with the subclavian approach. In this prospective study we sought to determine whether the direction of the guidewire J-tip influenced the catheter tip placement during right subclavian catheterization. In this randomized, double-blind clinical study, we observed the placement of catheters via the right subclavian vein while keeping the J-tip directed either caudad in Group 1 (n=147) or cephalad in Group 2 (n=148) patients. The majority of catheters (97% and 57%) in Groups 1 and 2 respectively entered the superior vena cava/right atrium (P <0.05). The incidence of catheter misplacement into the ipsilateral internal jugular vein was 2% and 40% in Groups 1 and 2, respectively (P = <0.01). Subsequent experimental study confirmed that the direction of the J-tip was retained inside a model of vascular tubes and its tip led the guidewire into the tubing on the same side even at the acute angulation formed between tubings representing the subclavian, internal jugular, and superior vena cava junction complex. The authors conclude that the simple measure of keeping the guidewire J-tip directed caudad increased correct placement of central venous catheters towards the right atrium during right subclavian catheterization.

  18. Reverse Regulatory Pathway (H2S / PGE2 / MMP in Human Aortic Aneurysm and Saphenous Vein Varicosity.

    Directory of Open Access Journals (Sweden)

    Ingrid Gomez

    Full Text Available Hydrogen sulfide (H2S is a mediator with demonstrated protective effects for the cardiovascular system. On the other hand, prostaglandin (PGE2 is involved in vascular wall remodeling by regulating matrix metalloproteinase (MMP activities. We tested the hypothesis that endogenous H2S may modulate PGE2, MMP-1 activity and endogenous tissue inhibitors of MMPs (TIMP-1/-2. This regulatory pathway could be involved in thinning of abdominal aortic aneurysm (AAA and thickening of saphenous vein (SV varicosities. The expression of the enzyme responsible for H2S synthesis, cystathionine-γ-lyase (CSE and its activity, were significantly higher in varicose vein as compared to SV. On the contrary, the endogenous H2S level and CSE expression were lower in AAA as compared to healthy aorta (HA. Endogenous H2S was responsible for inhibition of PGE2 synthesis mostly in varicose veins and HA. A similar effect was observed with exogenous H2S and consequently decreasing active MMP-1/TIMP ratios in SV and varicose veins. In contrast, in AAA, higher levels of PGE2 and active MMP-1/TIMP ratios were found versus HA. These findings suggest that differences in H2S content in AAA and varicose veins modulate endogenous PGE2 production and consequently the MMP/TIMP ratio. This mechanism may be crucial in vascular wall remodeling observed in different vascular pathologies (aneurysm, varicosities, atherosclerosis and pulmonary hypertension.

  19. Reverse Regulatory Pathway (H2S / PGE2 / MMP) in Human Aortic Aneurysm and Saphenous Vein Varicosity.

    Science.gov (United States)

    Gomez, Ingrid; Ozen, Gulsev; Deschildre, Catherine; Amgoud, Yasmine; Boubaya, Lilia; Gorenne, Isabelle; Benyahia, Chabha; Roger, Thomas; Lesèche, Guy; Galardon, Erwan; Topal, Gokce; Jacob, Marie-Paule; Longrois, Dan; Norel, Xavier

    2016-01-01

    Hydrogen sulfide (H2S) is a mediator with demonstrated protective effects for the cardiovascular system. On the other hand, prostaglandin (PG)E2 is involved in vascular wall remodeling by regulating matrix metalloproteinase (MMP) activities. We tested the hypothesis that endogenous H2S may modulate PGE2, MMP-1 activity and endogenous tissue inhibitors of MMPs (TIMP-1/-2). This regulatory pathway could be involved in thinning of abdominal aortic aneurysm (AAA) and thickening of saphenous vein (SV) varicosities. The expression of the enzyme responsible for H2S synthesis, cystathionine-γ-lyase (CSE) and its activity, were significantly higher in varicose vein as compared to SV. On the contrary, the endogenous H2S level and CSE expression were lower in AAA as compared to healthy aorta (HA). Endogenous H2S was responsible for inhibition of PGE2 synthesis mostly in varicose veins and HA. A similar effect was observed with exogenous H2S and consequently decreasing active MMP-1/TIMP ratios in SV and varicose veins. In contrast, in AAA, higher levels of PGE2 and active MMP-1/TIMP ratios were found versus HA. These findings suggest that differences in H2S content in AAA and varicose veins modulate endogenous PGE2 production and consequently the MMP/TIMP ratio. This mechanism may be crucial in vascular wall remodeling observed in different vascular pathologies (aneurysm, varicosities, atherosclerosis and pulmonary hypertension).

  20. Hemodialysis catheter implantation in the axillary vein by ultrasound guidance versus palpation or anatomical reference

    Directory of Open Access Journals (Sweden)

    Restrepo Valencia CA

    2013-10-01

    Full Text Available Cesar A Restrepo Valencia,1 Carlos A Buitrago Villa,1 Jose A Chacon Cardona21Internal Medicine, Nephrology, 2Epidemiology, Caldas University, Manizales, ColombiaBackground: We compared the results of four different methods of hemodialysis catheter insertion in the medial segment of the axillary vein: ultrasound guidance, palpation, anatomical reference, and prior transient catheter.Methods: All patients that required acute or chronic hemodialysis and for whom it was determined impossible or not recommended either to place a catheter in the internal jugular vein (for instance, those patients with a tracheostomy, or to practice arteriovenous fistula or graft; it was then essential to obtain an alternative vascular access. When the procedure of axillary vein catheter insertion was performed in the Renal Care Facility (RCF, ultrasound guidance was used, but in the intensive care unit (ICU, this resource was unavailable, so the palpation or anatomical reference technique was used.Results: Two nephrologists with experience in the technique performed 83 procedures during a period lasting 15 years and 8 months (from January 1997–August 2012: 41 by ultrasound guidance; 19 by anatomical references; 15 by palpation of the contiguous axillary artery; and 8 through a temporary axillary catheter previously placed. The ultrasound-guided patients had fewer punctures than other groups, but the value was not statistically significant. Arterial punctures were infrequent in all techniques. Analyzing all the procedure-related complications, such as hematoma, pneumothorax, brachial-plexus injury, as well as the reasons for catheter removal, no differences were observed among the groups. The functioning time was longer in the ultrasound-guided and previous catheter groups. In 15 years and 8 months of surveillance, no clinical or image evidence for axillary vein stenosis was found.Conclusion: The ultrasound guide makes the procedure of inserting catheters in the

  1. Evaluation of a Jugular Venipuncture Alpaca Model to Teach the Technique of Blood Sampling in Adult Alpacas.

    Science.gov (United States)

    Rousseau, Marjolaine; Beauchamp, Guy; Nichols, Sylvain

    2017-05-23

    The effectiveness of teaching aids in veterinary medical education is not often assessed rigorously. The objective in the present study was to evaluate the effectiveness of a commercially available jugular venipuncture alpaca model as a complementary tool to teach veterinary students how to perform venipuncture in adult alpacas. We hypothesized that practicing on the model would allow veterinary students to draw blood in alpacas more rapidly with fewer attempts than students without previous practice on the model. Thirty-six third-year veterinary students were enrolled and randomly allocated to the model (group M; n=18) or the control group (group C; n=18). The venipuncture technique was taught to all students on day 0. Students in group M practiced on the model on day 2. On day 5, an evaluator blinded to group allocation evaluated the students' venipuncture skills during a practical examination using live alpacas. Success was defined as the aspiration of a 6-ml sample of blood. Measured outcomes included number of attempts required to achieve success (success score), total procedural time, and overall qualitative score. Success scores, total procedural time, and overall scores did not differ between groups. Use of restless alpacas reduced performance. The jugular venipuncture alpaca model failed to improve jugular venipuncture skills in this student population. Lack of movement represents a significant weakness of this training model.

  2. Management of varicose veins and venous insufficiency.

    Science.gov (United States)

    Hamdan, Allen

    2012-12-26

    Chronic venous disease, reviewed herein, is manifested by a spectrum of signs and symptoms, including cosmetic spider veins, asymptomatic varicosities, large painful varicose veins, edema, hyperpigmentation and lipodermatosclerosis of skin, and ulceration. However, there is no definitive stepwise progression from spider veins to ulcers and, in fact, severe skin complications of varicose veins, even when extensive, are not guaranteed. Treatment options range from conservative (eg, medications, compression stockings, lifestyle changes) to minimally invasive (eg, sclerotherapy or endoluminal ablation), invasive (surgical techniques), and hybrid (combination of ≥1 therapies). Ms L, a 68-year-old woman with varicose veins, is presented. She has had vein problems over the course of her life. Her varicose veins recurred after initial treatment, and she is now seeking guidance regarding her current treatment options.

  3. [ENDOVENOUS LASER TREATMENT FOR VARICOSE VEINS].

    Science.gov (United States)

    Tezuka, Masahiro; Kanaoka, Yuji; Ohki, Takao

    2015-05-01

    Varicose veins are a common condition attecting approximately 10 million patients in Japan. The main cause of varicose veins is reflux of the saphenous vein, and conventional treatment for several decades was stripping the affected saphenous vein and phlebectomy. Endovenous laser treatment (EVLT) is a less-invasive treatment method in which the saphenous vein is ablated with a laser under local anesthesia. EVLT has been approved by the Japanese Ministry of Health, Labor and Welfare since 2011, and we have performed EVLT on 5,160 legs with saphenous insufficiency with no severe complications including deep vein thrombosis except for one case of arteriovenous fistula. EVLT appears to be a safe, effective treatment option for varicose veins with saphenous insufficiency.

  4. Deep vein thrombosis in pregnancy.

    Science.gov (United States)

    Colman-Brochu, Stephanie

    2004-01-01

    This article provides a review of the incidence, pathophysiology, and treatment of deep vein thrombosis (DVT) in pregnancy, a rare but serious complication of pregnancy. The incidence of DVT in pregnancy varies widely, but it is a leading cause of maternal morbidity in both the United States and the United Kingdom. Risk factors during pregnancy include prolonged bed rest or immobility, pelvic or leg trauma, and obesity. Additional risk factors are preeclampsia, Cesarean section, instrument-assisted delivery, hemorrhage, multiparity, varicose veins, a previous history of a thromboembolic event, and hereditary or acquired thrombophilias such as Factor V Leiden. Heparin is the anticoagulant of choice to treat active thromboembolic disease or to administer for thromboprophylaxis, but low molecular-weight heparin is being used with increasing frequency in the pregnant woman. Perinatal nurses should be aware of the symptoms, diagnostic tools, and treatment options available to manage active thrombosis during pregnancy and in the intrapartum and postpartum periods.

  5. FINGER-VEIN RECOGNITION SYSTEMS

    Directory of Open Access Journals (Sweden)

    A.Haritha Deepthi

    2015-10-01

    Full Text Available As the Person‟s/Organization‟s Private information‟s are becoming very easy to access, the demand for a Simple, Convenient, Efficient, and a highly Securable Authentication System has been increased. In considering these requirements for data Protection, Biometrics, which uses human physiological or behavioral system for personal Identification has been found as a solution for these difficulties. However most of the biometric systems have high complexity in both time and space. So we are going to use a Real time Finger-Vein recognition System for authentication purposes. In this paper we had implemented the Finger Vein Recognition concept using MATLAB R2013a. The features used are Lacunarity Distance, Blanket Dimension distance. This has more accuracy when compared to conventional methods.

  6. Extra corporeal membrane oxygenation in newborns : implications for brain and lung

    NARCIS (Netherlands)

    Heijst, Adrianus Franciscus Jacobus van

    2004-01-01

    Extracorporeal membrane oxygenation (ECMO) is a rescue treatment for newborns with severe respiratory insufficiency. In veno-arterial ECMO, venous blood is drained from the right atrium, oxygenated in an artificial lung and reinfused in the aorta. For vascular access the right internal jugular vein

  7. Effect of cerebral blood flow on consciousness and outcome after head injury. Assessment by jugular bulb venous metabolism and IMP-SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Imaizumi, Shigeki; Onuma, Takehide; Motohashi, Osamu; Kameyama, Motonobu; Ishii, Kiyoshi [Sendai City Hospital (Japan)

    2002-10-01

    This study was performed to elucidate the therapeutical value of arteriojugularvenous oxygen difference (AVDO{sub 2}) in the ultra-emergent period after head injury. Rational therapeutic strategy after severe head injury needs information concerning the dynamical change of cerebral blood flow (CBF) and metabolism. We monitored the cerebral venous metabolism within 6 hours after head injury until the day IMP-SPECT was performed. Whole brain cerebral blood flow detected by IMP-SPECT and AVDO{sub 2} at the same day was compared, which restored to the period within 6 hours after head injury. From this procedure, we could outline cerebral blood flow conditions by only AVDO{sub 2} without IMP-SPECT in the ultra-emergent period. Eighty-six patients with head injury who were carried to our emergency center in the period of recent 2 years aged ranging from 15 to 94 years were the subjects. They all performed jugular bulb cannulation within 6 hours after the accident (Martin's phase I: day 0) to know saturation of jugular vein (SjO{sub 2}), AVDO{sub 2} and AVL. They were monitored until the day IMP-SPECT was performed (Martin's phase II; day 1-3 or phase III; day 4-15). The correlation between CBF and AVDO{sub 2}. The effect of CBF and cerebral venous metabolism on consciousness and outcome was also analyzed. CBF and AVDO{sub 2} in phase II and III were reversely correlated (p<0.0001). Normal CBF corresponded with 5.0 vol% in AVDO{sub 2}. AVDO{sub 2} in all cases changed 6.2 vol% at phase I, 4.5 vol% at phase II and 5.1 vol% at phase III. Glasgow comascale (GCS) on admission under 8 (n=47) and over 9 (n=39) significantly differed in AVDO{sub 2} and CBF in the period of II and III. The patients with favorable consciousness showed low AVDO{sub 2} and hyperemia afterwards. Dead cases in phase I (n=19) showed high AVDO{sub 2} and low SjO{sub 2}. The patients with severe disability (SD) (n=13) showed high AVDO{sub 2} and low CBF and the patients with good recovery (GR

  8. Mortality after portal vein embolization

    Science.gov (United States)

    Lee, Eung Chang; Park, Sang-Jae; Han, Sung-Sik; Park, Hyeong Min; Lee, Seung Duk; Kim, Seong Hoon; Lee, In Joon; Kim, Hyun Beom

    2017-01-01

    Abstract Portal vein embolization (PVE) is increasingly performed worldwide to reduce the possibility of liver failure after extended hepatectomy, by inducing future liver remnant (FLR) hypertrophy and atrophy of the liver planned for resection. The procedure is known to be very safe and to have few procedure-related complications. In this study, we described 2 elderly patients with Bismuth–Corlette type IV Klatskin tumor who underwent right trisectional PVE involving the embolization of the right portal vein, the left medial sectional portal branch, and caudate portal vein. Within 1 week after PVE, patients went into sepsis combined with bile leak and died within 1 month. Sepsis can cause acute liver failure in patients with chronic liver disease. In this study, the common patient characteristics other than sepsis, that is, trisectional PVE; chronic alcoholism; aged >65 years; heart-related comorbidity; and elevated serum total bilirubin (TB) level (7.0 mg/dL) at the time of the PVE procedure in 1 patient, and concurrent biliary procedure, that is, percutaneous transhepatic biliary drainage in the other patient might have affected the outcomes of PVE. These cases highlight that PVE is not a safe procedure. Care should be taken to minimize the occurrence of infectious events because sepsis following PVE can cause acute liver failure. Additionally, prior to performing PVE, the extent of PVE, chronic alcohol consumption, age, comorbidity, long-lasting jaundice, concurrent biliary procedure, etc. should be considered for patient safety. PMID:28178122

  9. Japanese case of Budd-Chiari syndrome due to hepatic vein thrombosis successfully treated with liver transplantation.

    Science.gov (United States)

    Iwasaki, Tomohiro; Kawai, Hirokazu; Oseki, Koushi; Togashi, Tadayuki; Shioji, Kazuhiko; Yamamoto, Satoshi; Sato, Yoshinobu; Suzuki, Kenji; Toba, Ken; Nomoto, Minoru; Hatakeyama, Katsuyoshi; Aoyagi, Yutaka

    2012-02-01

    A 22-year-old Japanese woman was found to have severe esophageal varices and then suffered from hepatic encephalopathy. She was diagnosed with Budd-Chiari syndrome (BCS) due to hepatic vein (HV) thrombosis accompanied by portal vein thrombosis without inferior vena cava (IVC) obstruction. Latent myeloproliferative neoplasm (MPN) lacking the JAK2-V617F mutation was considered to be the underlying disease. Liver transplantation was strikingly effective for treating the clinical symptoms attributable to portal hypertension. Although thrombosis of the internal jugular vein occurred due to thrombocythemia, which manifested after transplantation despite anticoagulation therapy with warfarin, the thrombus immediately disappeared with the addition of aspirin. Neither thrombosis nor BCS has recurred in more than 4 years since the amelioration of the last thrombotic event, and post-transplant immunosuppression with tacrolimus has not accelerated the progression of MPN. In Japan, IVC obstruction, which was a predominant type of BCS, is suggested to have decreased in incidence with recent improvements in hygiene. The precise diagnosis of BCS and causative underlying diseases should be made with attention to the current trend of the disease spectrum, which fluctuates with environmental sanitation levels. Because the stepwise strategy, including liver transplantation, has been proven effective for patients with pure HV obstruction in Western countries, this strategy should also be validated for utilization in Japan and in developing countries where HV obstruction potentially predominates.

  10. THE COURSE OF DISSECTING ANEURYSM OF THE AORTA

    Directory of Open Access Journals (Sweden)

    N. A. Kosheleva

    2016-01-01

    Full Text Available Research objective. To define features of a course of dissecting aortic aneurysm now.Materials and methods. 11 clinical records of the patients with the established diagnosis of dissecting aortic aneurysm who have come to Regional clinical hospital of Saratov for 2015 are analysed.Results. Along with traditional risk factors, such as the male, existence of arterial hypertension are revealed also additional risk factors, in particular, regular heavy lifting. Gender features in localization of dissecting aortic aneurysm are defined: at men more often of dissecting aortic aneurysm of an aorta is localized in the abdominal aorta, at women in the thoracic region.Conclusions. Additional risk factor of stratification of dissecting aortic aneurysm in the thoracic region at women is the systematic raising of weights.

  11. The AORTA Reasoning Framework - Adding Organizational Reasoning to Agents

    DEFF Research Database (Denmark)

    Jensen, Andreas Schmidt

    is a practical component (founded in logic) that enriches intelligent agents with organizational reasoning capabilities. We take the agent’s perspective by devising a component that integrates with the agent’s usual reasoning capabilities in a non-intrusive way. This results in agents that are both organization...... a generic framework that allows different kinds of agents to reason about different kinds of organizations. We present our results in three main parts. In the first part, we present the theoretical foundations for the AORTA framework, which consists of semantics of norms, an organizational metamodel......, and the AORTA reasoning component. The reasoning component is characterized by being completely decoupled from the cognitive agent, by its automated reasoning about norms and organizational options, and by the reasoning rules specified by the designer to act upon norms and options. We specify the reasoning...

  12. Mycotic aneurysm of the thoracic aorta presenting as pneumonia

    Energy Technology Data Exchange (ETDEWEB)

    Mengozzi, E. [Dept. of Radiology, Maggiore Hospital, Bologna (Italy); Sartoni Galloni, S. [Dept. of Radiology, San Salvatore Hospital, Bologna (Italy); Giovannini, G. [Dept. of Paediatrics, Maggiore Hospital, Bologna (Italy); Bronzetti, G. [Dept. of Paediatric Cardiology, Sant' Orsola-Malpighi University Medical Centre, Bologna (Italy)

    2001-07-01

    Mycotic aneurysms of the thoracic aorta rarely occur in children. We report an unusual case of a mycotic aneurysm of the descending aorta in a 4-year-old boy presenting with respiratory tract infection, which was rapidly complicated by atelectasis of the left lung. The patient's mycotic aortic aneurysm was diagnosed by contrast-enhanced spiral CT, whereas conventional chest radiographs did not detect its presence. An unsuspected mild aortic coarctation was also diagnosed at the time of admission. This case demonstrates that an aortic aneurysm may clinically and radiologically manifest itself with respiratory tract infection and atelectasis and that contrast-enhanced spiral CT is a fast and powerful tool for establishing the diagnosis. (orig.)

  13. Contractile reaction of isolated frog aorta after X-irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Michailov, M.C.; Prechter, I.; Greimel, H.; Welscher, U.E.

    1983-07-01

    The action of X-rays (50 kV, filtered by 0.3 mm Al) on helical strip of frog aorta (rana esculenta) has been investigated. The isolated preparations have a stable basal tone and are radio-sensitive to X-rays which induce reversible, dose-dependent, contractile responses. After repeated irradiational tachyphylaxis appears. The threshold doses are about 250 R at 3 to 6 kR/min, antiadrenergic (phentolamine, propranolol), anticholinergic (atropin), antihistaminic (Neo-Bridal) and serotoninergic (Deseril) drugs have no visible influence on the X-ray induced reaction, i.e. these action mechanisms of the irradiation-induced contraction do not seem probable. Theophylline and cAMP inhibit the X-ray contraction probably non-specifically. Indometacin also inhibits the X-ray contraction: this suggests participation of prostaglandin-mechanism on the contraction of frog aorta after irradiation.

  14. Novel Treatment Approach to Ascending Aorta Pseudoaneurysms: A Case Report

    Directory of Open Access Journals (Sweden)

    Seyed Ebrahim Kassaian

    2017-06-01

    Full Text Available The pseudoaneurysm of the aorta is rarely due to trauma and infection but usually is a late complication of previous surgical procedures like coronary artery bypass graft surgery. We describe a 65-year-old woman with the pseudoaneurysm of the ascending aorta due to coronary artery bypass graft surgery. It was revealed in coronary artery angiography after nonspecific symptoms. It was confirmed by multidetector computed tomographic angiography. The patient refused open cardiac surgery, so we decided to use an atrial septal defect occluder device in off-label way to seal the pseudoaneurysm orifice. In a hybrid operating room setting, the procedure was done successfully and patient’s hospitalization course was eventless. In multidetector computed tomographic angiography after 3 months, the device was in the appropriate position without endoleak and in the yearly visit the patient was asymptomatic and healthy.

  15. Emergent treatment of patients with traumatic aorta ruptures

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xiao-ying; DI Dong-mei; JIANG Nan-qing; QIAN Yong-xiang; ZHAN Xiang-hong

    2007-01-01

    Objective: To discuss our experience on the diagnosis and treatment of thoracic aorta rupture (TAR) that is one of the main common causes of death in the victims under blunt chest trauma.Methods: Between July 2001 and March 2006, 9 patients (6 men and 3 women, aged from 20 to 54 years) suffering from acute traumatic aorta rupture after motor vehicle accidents received emergent surgical treatments in our hospital. Based on our experience in the rescue of the first TAR patient we introduced a practical procedure on the diagnosis and treatment of TAR in our department. All the other patients generally followed this procedure. Eight patients received contrast material enhanced helical computerized tomography scan before the operation. The leakage of constrast medium from the aorta isthmus was found, and diagnosis of TAR was confirmed. Seven patients underwent immediate operation within 14 hours after accidents. One patient was treated on the 5th day of the accident because of delayed diagnosis of aortic rupture. All patients received general anesthesia with double lumen endotracheal tube and normothermic femoro-femoral partial cardiopulmonary bypass, with beating heart and aortic clamping. One patient received simple repair, and others received partial replacement of thoracic aorta with artificial vascular graft.Results: Seven TAR patients were successfully salvaged. Three patients combined brain injury as well as extremitiy hemiplegia before operation. After treatments one was fully and two partially recovered without paraplegia. Conclusions: Proper practical protocol is emphasized for the surgical repair of TAR because it will reduce the mortality of severe blunt chest injury.

  16. Intrapericardial bronchogenic cyst adherent to ascending aorta in young patient

    Directory of Open Access Journals (Sweden)

    Reddy Atipo-Galloye

    2014-06-01

    Full Text Available Bronchogenic cysts arise from an abnormal budding of the ventral diverticulum of the foregut or the thracheobronchial tree during embryogenesis. An intrapericardial location is an extremely rare finding. Symptoms are related to cardiac structure compression, but in most case they remain asymptomatic. We present a case of intrapericardial bronchogenic cyst in a young patient, resected entirely with repair of right lateral proximal ascending aorta with PTFE graft.

  17. [Resistant arterial hypertension and coarctation of the aorta].

    Science.gov (United States)

    Martínez-Quintana, Efrén; Rossique-Delmas, Pilar; Rodríguez-González, Fayna

    2014-01-01

    Coarctation of the aorta accounts for around 5 percent of all congenital heart defects. Many of these patients develop arterial hypertension, and occasionally resistant arterial hypertension, despite adequate correction. This may lead to potentially fatal complications such as heart failure, aortic dissection, cerebrovascular events, or myocardial infarction. Therefore, a correct diagnosis must be made and an appropriate treatment started to reduce arterial hypertension, arteriosclerotic vascular disease, as well as the increased risk of cardiovascular morbidity and mortality.

  18. Descending thoracic aorta dissection associated with esophageal carcinoma

    Directory of Open Access Journals (Sweden)

    Kaushik Saha

    2013-01-01

    Full Text Available The association of aortic dissection with a malignancy is a rare finding and previous reports are usually those of primary aortic sarcomas. A 45-year-old male presented to us with chest pain and dysphagia for 1 month with a background history of obstructive airway disease and uncontrolled hypertension. In this report we present a case of typical descending aorta dissection with associated esophageal carcinoma.

  19. Surgical treatment of penetrating atherosclerotic ulcer of the descending aorta

    OpenAIRE

    Kovačević Pavle; Velicki Lazar; Popović Dušan; Ivanović Vladimir; Mojašević Renata

    2013-01-01

    Introduction. The term “penetrating atherosclerotic ulcer” (PAU) of the aorta describes the condition in which ulceration of an aortic atherosclerotic lesion penetrates the internal elastic lamina into media. PAU is a high-risk lesion due to its deleterious effects on the integrity of aortic wall, with potentially fatal outcome. Case report. A patient with intensive, sharp chest pain irradiating to the back but with no signs of myocardial ischemia on an electrocardiogram was referred to...

  20. Aberrant vertebral artery originating from the descending aorta

    Energy Technology Data Exchange (ETDEWEB)

    Stoesslein, F.; Porstmann, W.; Schueler, F.; Schoepke, W.

    1982-05-01

    A so far unknown case of a combination of coarctation and a right vertebral artery originating isolatedly from the thoracic aorta is reported, presenting the embryological hypothesis of the development of this anomalous course. The haemodynamic action of the coarctation produces a steal effect so that the vascular segments existing cranially of the stenosis are connected with the poststenotic zone via the vertebral circulation and the anomalous right vertebral artery.

  1. Hemodynamics of patient-specific aorta-pulmonary shunt configurations

    OpenAIRE

    Pekkan, Kerem; Pişkin, Senol; Altın, H. Fırat; Yıldız, Okan; Bakır, İhsan

    2017-01-01

    Optimal hemodynamics in aorta-pulmonary shunt reconstruction is essential for improved post-operative recovery of the newborn congenital heart disease patient. However, prior to in vivo execution, the prediction of post-operative hemodynamics is extremely challenging due to the interplay of multiple confounding physiological factors. It is hypothesized that the post-operative performance of the surgical shunt can be predicted through computational blood flow simulations that consider patient ...

  2. Analysis of human aorta using fluorescence lifetime imaging microscopy (FLIM)

    Science.gov (United States)

    Vieira-Damiani, Gislaine; Adur, J.; Ferro, D. P.; Adam, R. L.; Pelegati, V.; Thomáz, A.; Cesar, C. L.; Metze, K.

    2012-03-01

    The use of photonics has improved our understanding of biologic phenomena. For the study of the normal and pathologic architecture of the aorta the use of Two-Photon Excited Fluorescence (TPEF) and Second Harmonic Generation showed interesting details of morphologic changes of the elastin-collagen architecture during aging or development of hypertension in previous studies. In this investigation we tried to apply fluorescence lifetime imaging (FLIM) for the morphologic analysis of human aortas. The aim of our study was to use FLIM in non-stained formalin-fixed and paraffin-embedded samples of the aorta ascendants in hypertensive and normotensive patients of various ages, examining two different topographical regions. The FLIM-spectra of collagen and elastic fibers were clearly distinguishable, thus permitting an exact analysis of unstained material on the microscopic level. Moreover the FLIM spectrum of elastic fibers revealed variations between individual cases, which indicate modifications on a molecular level and might be related to FLIM age or diseases states and reflect modifications on a molecular level.

  3. Elastic characteristics of aorta in patients with epilepsy

    Directory of Open Access Journals (Sweden)

    Yılmaz Cingozbay

    2011-02-01

    Full Text Available Aim To investigate elastic characteristics of the aorta in patientswith epilepsy.Methods Seventy five patients with a diagnosis of epilepsy through clinical and EEG findings and age and sex matched, 50 healthy controls were included. Systolic and diastolic blood pressures plus systolic and diastolic diameter of the aortic root was measured. Aortic strain (AS and aortic distensibility (AD and aortic distensibility index (BSI were calculated. Results The average age of the epilepsy group was 23.8.8 ± 8.2 years, and of the control group it was 24.1± 6.2 years (p>0.05. AS and AD were lower in the epileptic group while the aortic stiffness index was higher (10.4± 4.2 vs 16.9±0.2, p: 0.001, for AS; 8.7± 4.0 vs 17.2±0.1, p: 0.001, for AD and 20.1±0.1 vs 3.5±1.2, p: 0.001 for BSI. Conclusion Elastic characteristics of the aorta change in epileptic patients, with a decrease of the distensibility of the aorta and an increaseof the stiffness. After this preliminary study, new controlledstudies are needed.

  4. CT and MR imaging of the thoracic aorta

    Directory of Open Access Journals (Sweden)

    Di Cesare Ernesto

    2016-01-01

    Full Text Available At present time, both CT and MRI are valuable techniques in the study of the thoracic aorta. Nowadays, CT represents the most widely employed technique for the study of the thoracic aorta. The new generation CTs show sensitivities up to 100% and specificities of 98-99%. Sixteen and wider row detectors provide isotropic pixels, mandatory for the ineludible longitudinal reconstruction. The main limits are related to the X-ray dose expoure and the use of iodinated contrast media. MRI has great potential in the study of the thoracic aorta. Nevertheless, if compared to CT, acquisition times remain longer and movement artifact susceptibility higher. The main MRI disadvantages are claustrophobia, presence of ferromagnetic implants, pacemakers, longer acquisition times with respect to CT, inability to use contrast media in cases of renal insufficiency, lower spatial resolution and less availability than CT. CT is preferred in the acute aortic disease. Nevertheless, since it requires iodinated contrast media and X-ray exposure, it may be adequately replaced by MRI in the follow up of aortic diseases. The main limitation of MRI, however, is related to the scarce visibility of stents and calcifications.

  5. The umbilical and paraumbilical veins of man.

    Science.gov (United States)

    Martin, B F; Tudor, R G

    1980-03-01

    During its transit through the umbilicus structural changes occur in the thick wall of the extra-abdominal segment of the umbilical vein whereby the components of the intra-abdominal segment acquire an essentially longitudinal direction and become arranged in fibro-elastic and fibro-muscular zones. The vein lumen becomes largely obliterated by asymmetrical proliferation of loose subendothelial conective tissue. The latter forms a new inner zone within which a small segment of the lumen persists in an eccentric position. This residual lumen transmits blood to the portal system from paraumbilical and systemic sources, and is retained in the upper part of the vein, even in old age. A similar process of lumen closure is observed in the ductus venosus. In early childhood the lower third of the vein undergoes breakdown, with fatty infiltration, resulting in its complete division into vascular fibro-elastic strands, and in old age some breakdown occurs in the outermost part of the wall of the upper two thirds. The paraumbilical veins are thick-walled and of similar structure to the umbilical vein. Together they constitute an accessory portal system which is confined between the layers of the falciform ligament and is in communication with the veins of the ventral abdominal wall. The constituents form an ascending series, namely, Burow's veins, the umbilical vein, and Sappey's inferior and superior veins. The main channel of Sappey's inferior veins may be the remnant of the right umbilical vein since it communicates with the right rectus sheath and often communicates directly with the portal system within the right lobe of the liver. The results are of significance in relation to clinical usage of the umbilical vein.

  6. Gamma Knife radiosurgery for glomus jugulare tumors: a single-center series of 75 cases.

    Science.gov (United States)

    Ibrahim, Ramez; Ammori, Mohannad B; Yianni, John; Grainger, Alison; Rowe, Jeremy; Radatz, Matthias

    2017-05-01

    OBJECTIVE Glomus jugulare tumors are rare indolent tumors that frequently involve the lower cranial nerves (CNs). Complete resection can be difficult and associated with lower CN injury. Gamma Knife radiosurgery (GKRS) has established its role as a noninvasive alternative treatment option for these often formidable lesions. The authors aimed to review their experience at the National Centre for Stereotactic Radiosurgery, Sheffield, United Kingdom, specifically the long-term tumor control rate and complications of GKRS for these lesions. METHODS Clinical and radiological data were retrospectively reviewed for patients treated between March 1994 and December 2010. Data were available for 75 patients harboring 76 tumors. The tumors in 3 patients were treated in 2 stages. Familial and/or hereditary history was noted in 12 patients, 2 of whom had catecholamine-secreting and/or active tumors. Gamma Knife radiosurgery was the primary treatment modality in 47 patients (63%). The median age at the time of treatment was 55 years. The median tumor volume was 7 cm(3), and the median radiosurgical dose to the tumor margin was 18 Gy (range 12-25 Gy). The median duration of radiological follow-up was 51.5 months (range 12-230 months), and the median clinical follow-up was 38.5 months (range 6-223 months). RESULTS The overall tumor control rate was 93.4% with low CN morbidity. Improvement of preexisting deficits was noted in 15 patients (20%). A stationary clinical course and no progression of symptoms were noted in 48 patients (64%). Twelve patients (16%) had new symptoms or progression of their preexisting symptoms. The Kaplan-Meier actuarial tumor control rate was 92.2% at 5 years and 86.3% at 10 years. CONCLUSIONS Gamma Knife radiosurgery offers a risk-versus-benefit treatment option with very low CN morbidity and stable long-term results.

  7. Volume reduction of the jugular foramina in Cavalier King Charles Spaniels with syringomyelia

    Directory of Open Access Journals (Sweden)

    Schmidt Martin

    2012-09-01

    Full Text Available Abstract Background Understanding the pathogenesis of the chiari-like malformation in the Cavalier King Charles Spaniel (CKCS is incomplete, and current hypotheses do not fully explain the development of syringomyelia (SM in the spinal cords of affected dogs. This study investigates an unconventional pathogenetic theory for the development of cerebrospinal fluid (CSF pressure waves in the subarachnoid space in CKCS with SM, by analogy with human diseases. In children with achondroplasia the shortening of the skull base can lead to a narrowing of the jugular foramina (JF between the cranial base synchondroses. This in turn has been reported to cause a congestion of the major venous outflow tracts of the skull and consequently to an increase in the intracranial pressure (ICP. Amongst brachycephalic dog breeds the CKCS has been identified as having an extremely short and wide braincase. A stenosis of the JF and a consequential vascular compromise in this opening could contribute to venous hypertension, raising ICP and causing CSF jets in the spinal subarachnoid space of the CKCS. In this study, JF volumes in CKCSs with and without SM were compared to assess a possible role of this pathologic mechanism in the development of SM in this breed. Results Computed tomography (CT scans of 40 CKCSs > 4 years of age were used to create three-dimensional (3D models of the skull and the JF. Weight matched groups (7–10 kg of 20 CKCSs with SM and 20 CKCSs without SM were compared. CKCSs without SM presented significantly larger JF -volumes (median left JF: 0.0633 cm3; median right JF: 0.0703 cm3; p 3; median right JF: 0.0434 cm3; p Conclusion A stenosis of the JF and consecutive venous congestion may explain the aetiology of CSF pressure waves in the subarachnoid space, independent of cerebellar herniation, as an additional pathogenetic factor for the development of SM in this breed.

  8. Ultrasonic quantitative detection of elasticity of jugular vessel wall of female pilots and its application value

    Directory of Open Access Journals (Sweden)

    Long-fang ZHANG

    2011-11-01

    Full Text Available Objective To observe the elasticity of the jugular vessel wall of female aerotransport pilots on active duty,provide a reference for the selection of female pilots,and the prevention and therapy of cardiovascular diseases in female pilots.Methods Using the Echo-Tracking technique,the elastic parameters of the carotid artery were quantitatively detected in nineteen female pilots who were first selected as female astronauts.Twenty male pilots who were selected as astronauts were randomly chosen as the control group.No statistical difference in age and blood pressure between the two groups was found.No history of cardiovascular diseases was recorded,and no abnormal signs were revealed in the results of the physical examination.Electrocardiogram,chest radiography,hepatic and kidney function,and biochemical examination showed normal results.The factors affecting the elasticity of the artery could possibly be avoided for the male pilots except for the fighter pilots or the smokers.Results No statistical difference was found in the clinical and biochemical data between the pilot groups(P > 0.05.As for carotid artery elastic parameters,no statistical difference between the left and right sides of the artery was indicated.The elastic modulus,arterial stiffness index,and pulse wave velocity of the carotid artery wall of the female pilots were significantly lower than those of the male pilots(P < 0.05,and the arterial compliance was significantly higher than that of the male pilots(P < 0.05.Conclusion All of the elastic parameters of the vessel wall of female pilots were better than those of the male pilots.

  9. Palm Vein Verification Using Gabor Filter

    Directory of Open Access Journals (Sweden)

    Ali Mohsin Al-Juboori

    2013-01-01

    Full Text Available Palm vein authentication is one of the modern biometric techniques, which employs the vein pattern in the human palm to verify the person. The merits of palm vein on classical biometric (e.g. fingerprint, iris, face are a low risk of falsification, difficulty of duplicated and stability. In this research, a new method is proposed for personal verification based on palm vein features. In the propose method, the palm vein images are firstly enhanced and then the features are extracted by using bank of Gabor filters. Then Fisher Discriminated Analysis (FDA is used to reduce the dimension of the features vectors. For vein pattern verification, this work uses Nearest Neighbors method. The EER of the proposed method is 0.2335%.

  10. Preduodenal portal vein: its surgical significance.

    Science.gov (United States)

    Makey, D A; Bowen, J C

    1978-11-01

    Preduodenal portal vein is a rare anatomical variant which may be one of many anomalies in the neonate with duodenal "atresia." Preduodenal portal vein also may be an occasional finding in an adult undergoing biliary, gastric, or pancreatic surgery. Awareness and recognition of the anomaly are essential for the avoidance of injury during such operations. We report here a symptomless patient whose preduodenal portal vein was discovered at cholecystectomy.

  11. Small hepatic veins Budd-Chiari syndrome.

    Science.gov (United States)

    Riggio, Oliviero; Marzano, Chiara; Papa, Alessia; Pasquale, Chiara; Gasperini, Maria Ludovica; Gigante, Antonietta; Valla, Dominique Charles; Plessier, Aurélie; Amoroso, Antonio

    2014-05-01

    Budd-Chiari syndrome is a rare disorder characterized by hepatic venous outflow obstruction at any level from the small hepatic veins to the atrio-caval junction, in the absence of heart failure or constrictive pericarditis. Various imaging modalities are available for investigating the gross hepatic vascular anatomy but there are rare forms of this disease where the obstruction is limited to the small intrahepatic veins, with normal appearance of the large hepatic veins at imaging. In this cases only a liver biopsy can demonstrate the presence of a small vessels outflow block. We report two cases of small hepatic veins Budd-Chiari syndrome.

  12. Leiomyosarcoma of the external iliac vein.

    Science.gov (United States)

    Fukuda, Wakako; Taniguchi, Satoshi; Fukuda, Ikuo

    2012-06-01

    Leiomyosarcoma of the iliac vein is an uncommon tumor. We report a case of a 63-year-old Japanese woman with leiomyosarcoma of the right external iliac vein. The patient complained of right inguinal pain and swelling. Computed tomography demonstrated a mass surrounding the right external iliac artery and vein. Metastases in the lungs and liver were found. Complete resection of the tumor along with the involved vessels was performed. Polytetrafluoroethylene grafts were used to reconstruct the vessels. Pathological examination revealed leiomyosarcoma of the external iliac vein. Although the prognosis of leiomyosarcoma is poor, en bloc tumor resection is the treatment of choice.

  13. Sonographic Findings in Fetal Renal Vein Thrombosis.

    Science.gov (United States)

    Gerber, Rebecca E; Bromley, Bryann; Benson, Carol B; Frates, Mary C

    2015-08-01

    We present the sonographic findings of fetal renal vein thrombosis in a series of 6 patients. The mean gestational age at diagnosis was 31.2 weeks. Four cases were unilateral, and 2 were bilateral. The most common findings were renal enlargement and intrarenal vascular calcifications, followed by increased renal parenchymal echogenicity. Inferior vena cava thrombosis was found in 4 patients and common iliac vein thrombosis in 2. Fetal renal vein thrombosis is an uncommon diagnosis with characteristic sonographic findings. The presence of these findings should prompt Doppler interrogation of the renal vein and inferior vena cava to confirm the diagnosis.

  14. Embolia pulmonar séptica secundária à tromboflebite jugular: um caso de síndrome de Lemierre Septic pulmonary embolism secondary to jugular thrombophlebitis: a case of Lemierre's syndrome

    Directory of Open Access Journals (Sweden)

    Denise Rossato Silva

    2008-12-01

    Full Text Available A síndrome de Lemierre é caracterizada pela infecção aguda da orofaringe, complicada por trombose venosa jugular interna secundária à tromboflebite séptica, e por infecções metastáticas a vários órgãos distantes-mais freqüentemente os pulmões. Relatamos um caso de síndrome de Lemierre em uma mulher de 56 anos que se apresentou com massa cervical à direita e febre. Trombose venosa jugular interna foi demonstrada na ecografia. A tomografia computadorizada de tórax revelou múltiplas opacidades em ambos os pulmões. Uma biópsia pulmonar cirúrgica foi realizada por suspeita de metástases pulmonares. O exame anatomopatológico revelou êmbolos sépticos em parênquima pulmonar. Retrospectivamente, a paciente relatou história de faringite duas semanas antes da hospitalização. Após o diagnóstico, foi tratada com antibióticos de amplo espectro (cefuroxima por 7 dias e azitromicina por 5 dias e, posteriormente, devido à persistência de febre, cefepime por 7 dias. A tomografia computadorizada de tórax, realizada um mês após, mostrou resolução das opacidades.Lemierre's syndrome is characterized by acute oropharyngeal infection, complicated by internal jugular venous thrombosis secondary to septic thrombophlebitis, and by metastatic infections in various distant organs-most commonly in the lungs. We report a case of Lemierre's syndrome in a 56-year-old female who presented with right-sided neck mass and fever. Right internal jugular venous thrombosis was demonstrated on an ultrasound. A computed tomography scan of the chest revealed multiple opacities throughout both lungs. An open surgical biopsy was performed due to suspicion of pulmonary metastases. Anatomopathological examination revealed septic emboli in lung parenchyma. Retrospectively, the patient reported a history of pharyngitis two weeks prior to hospitalization. After the diagnosis had been made, the patient was treated with broad-spectrum antibiotics (cefuroxime

  15. phenoVein - A tool for leaf vein segmentation and analysis

    OpenAIRE

    Bühler, J.; Rishmawi, L.; Pflugfelder, D.; Huber, G; Scharr, H.; Hülskamp, M; Koornneef, M.; Schurr, U; Jahnke, S.

    2015-01-01

    Precise measurements of leaf vein traits are an important aspect of plant phenotyping for ecological and genetic research. Here, we present a powerful and user-friendly image analysis tool named phenoVein. It is dedicated to automated segmenting and analyzing of leaf veins in images acquired with different imaging modalities (microscope, macrophotography, etc.), including options for comfortable manual correction. Advanced image filtering emphasizes veins from the background and compensates f...

  16. False aneurysm on distal part of coarctation of the aorta in a parous Turner syndrome patient.

    Science.gov (United States)

    Oi, Keiji; Yoshida, Tetsuya; Takeshita, Masashi; Tsuruta, Goro

    2013-09-01

    False aneurysm associated with untreated coarctation of the aorta (CoA) is an uncommon vascular complication. We present a 41-year-old woman with mosaic Turner syndrome who had CoA complicated with a small false aneurysm on descending aorta just distal to the coarctation. The patient had not been diagnosed with Turner syndrome despite several physical characteristics of the syndrome because she had histories of natural childbirth. The false aneurysm was resected with the coarctation through a thoracotomy and proximal aorta was directly anastomosed to distal aorta. Endovascular therapy has become preferred method in recent years in treatment for coarctation of the aorta. However, careful consideration should be given to the irregularities on the aorta with the coarctation for diagnosis of false aneurysm.

  17. Os ramos colaterais da aorta abdominal em jaguatirica (Leopardus pardalis

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    Luane L. Pinheiro

    2014-05-01

    Full Text Available A jaguatirica (Leopardus pardalis é uma das espécies de felino silvestre que pouco foi investigada quanto a sua morfologia. Assim, o estudo objetivou detalhar a origem e distribuição dos ramos colaterais da aorta abdominal deste animal. Avaliou-se dois exemplares, sendo um macho e uma fêmea, jovens, provenientes de Paragominas-PA, doados ao Laboratório de Pesquisa Morfológica Animal (LaPMA da Universidade Federal Rural da Amazônia (UFRA. O sistema arterial foi preenchido com látex pigmentado de vermelho e os cadáveres foram preservados com solução de formaldeído tamponado a 10%. A aorta abdominal do L. pardalis teve origem entre T12 e L1, sendo a artéria celíaca o primeiro ramo visceral no sentido crânio-caudal, resultando nas artérias hepática, gástrica esquerda e esplênica. A artéria mesentérica cranial surgiu como segundo ramo da aorta abdominal, originando as artérias jejunais. Na sequência localizamos artéria pancreáticoduodenal caudal, artérias ileais, artérias ileocólicas, artérias renais direita e esquerda, artérias adrenais direita e esquerda e artérias ováricas ou testiculares direita e esquerda. Parietalmente, a aorta abdominal originou em média seis ramos lombares, bem como a artéria frenicoabdominal, as artérias circunflexas ilíacas profundas e artérias ilíacas externa e interna. A aorta abdominal gerou ainda a artéria mesentérica caudal, a qual dividiu-se em artérias cólica esquerda e retal cranial. A artéria cólica esquerda seguiu cranialmente paralela ao cólon descendente irrigando-o, originando em média 18 ramos, e anastomosando-se com a artéria cólica média. A artéria retal cranial seguiu em direção caudal distribuindo oito ramos à porção final do cólon descendente e ao reto, e uniu-se com a artéria retal média. Por fim, a aorta abdominal emitiu como ramo terminal a artéria sacral mediana. A vascularização arterial abdominal desta espécie é bastante semelhante ao

  18. Delphi Method Validation of a Procedural Performance Checklist for Insertion of an Ultrasound-Guided Internal Jugular Central Line.

    Science.gov (United States)

    Hartman, Nicholas; Wittler, Mary; Askew, Kim; Manthey, David

    2016-01-01

    Placement of ultrasound-guided central lines is a critical skill for physicians in several specialties. Improving the quality of care delivered surrounding this procedure demands rigorous measurement of competency, and validated tools to assess performance are essential. Using the iterative, modified Delphi technique and experts in multiple disciplines across the United States, the study team created a 30-item checklist designed to assess competency in the placement of ultrasound-guided internal jugular central lines. Cronbach α was .94, indicating an excellent degree of internal consistency. Further validation of this checklist will require its implementation in simulated and clinical environments.

  19. Treatment of traumatic rupture of the thoracic aorta

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    Davidović Lazar

    2008-01-01

    Full Text Available INTRODUCTION Interest for traumatic thoracic aorta rupture stems from the fact that its number continually increases, and it can be rapidly lethal. OBJECTIVE The aim of this study is to present early and long term results as well as experiences of our team in surgical treatment of traumatic thoracic aorta rupture. METHOD Our retrospective study includes 12 patients with traumatic thoracic aorta rupture treated between 1985 and 2007. There were 10 male and two female patients of average age 30.75 years (18-74. RESULTS In six cases, primary diagnosis was established during the first seven days days after trauma, while in 6 more than one month later. In 11 cases, classical open surgical procedure was performed, while endovascular treatment was used in one patient. Three (25% patients died, while two (16.6% had paraplegia. Nine patients (75% were treated without complications, and are in good condition after a mean follow-up period of 9.7 years (from one month to 22 years. CONCLUSION Surgical treatment requires spinal cord protection to prevent paraplegia, using cardiopulmonary by-pass (three of our cases or external heparin-bonded shunts (five of our cases. Cardiopulmonary by-pass is followed with lower incidence of paraplegia, however it is not such a good solution for patients with polytrauma because of hemorrhage. The endovascular repair is a safe and feasible procedure in the acute phase, especially because of traumatic shock and polytrauma which contributes to higher mortality rate after open surgery. On the other hand, in chronic postrauamatic aortic rupture, open surgical treatment is connected with a lower mortality rate and good long-term results. There have been no published data about long-term results of endovascular treatment in the chronic phase.

  20. Acceptability of virtual unenhanced CT of the aorta as a replacement for the conventional unenhanced phase

    Energy Technology Data Exchange (ETDEWEB)

    Shaida, N., E-mail: nadeem.shaida@addenbrookes.nhs.uk [Department of Radiology, Addenbrooke' s Hospital, Cambridge (United Kingdom); Bowden, D.J.; Barrett, T.; Godfrey, E.M.; Taylor, A.; Winterbottom, A.P.; See, T.C. [Department of Radiology, Addenbrooke' s Hospital, Cambridge (United Kingdom); Lomas, D.J. [Department of Radiology, University of Cambridge, Addenbrooke' s Hospital, Cambridge (United Kingdom); Shaw, A.S. [Department of Radiology, Addenbrooke' s Hospital, Cambridge (United Kingdom)

    2012-05-15

    Aim: To evaluate whether virtual unenhanced (VU) computed tomography (CT) images generated of the aorta were of sufficient quality to replace the conventional unenhanced (CU) images. Materials and methods: Forty-nine patients undergoing examination of the thoracic or abdominal aorta were examined using a dual-energy protocol. VU images were generated from the arterial phase images and compared to the CU images. Objective analysis was performed by drawing paired regions of interest (ROIs) within the thoracic and abdominal aorta and measuring the radiodensity in Hounsfield units attenuation within the ROIs. Subjective analysis was performed by two experienced readers evaluating the VU images in terms of noise, quality, calcium loss, and overall acceptability. Results: The attenuation was significantly higher in the VU images compared to the CU images within the thoracic aorta (p < 0.01) but not within the abdominal aorta (p = 0.15). Overall the VU images of the abdominal aorta were deemed acceptable as replacements for the CU images in 93% of cases. For the thoracic aorta, the VU images were deemed acceptable in only 12% of cases, primarily due to pulsation artefact. Conclusion: VU images of the abdominal aorta are acceptable as replacements for the CU images in the vast majority of cases; however, they are not suitable as replacements for the CU images of the thoracic aorta.

  1. Cannulation in the diseased aorta: a safe approach using the Seldinger technique.

    Science.gov (United States)

    Khoynezhad, Ali; Plestis, Konstadinos A

    2006-01-01

    The Seldinger technique is a method of femoral cannulation that has been used to establish cardiopulmonary bypass. Reports of cannulation of the ascending aorta for antegrade perfusion using the Seldinger method are anecdotal. To the best of our knowledge, the approach described herein for direct cannulation of the ascending aorta with use of the Seldinger technique for antegrade perfusion has not been previously described in the English-language medical literature. This method is helpful when the surgeon is treating a patient who has a calcified ascending aorta, complicated aortic dissection, calcified femoral vessels, or a diseased thoracoabdominal aorta. In such cases, retrograde perfusion has been associated with severe complications as a result of atheromatous embolization from the descending thoracic aorta. Herein, we describe our approach to cannulation for cardiopulmonary bypass, which entails insertion of an aortic cannula into the ascending aorta by means of the Seldinger technique. A soft-tip guidewire is inserted through an arterial entry catheter that has been used to puncture a hole in the wall of the vessel. Then the aortic cannula is introduced into the vessel, sliding along the guidewire. Guided by transesophageal echocardiography, the tip of the cannula is positioned carefully and is then advanced into the descending aorta. This positioning of the cannula decreases the chance of arterial embolization, thereby improving cerebral protection. If cannulation of the ascending aorta is not feasible, the transverse aortic arch or proximal descending aorta can be used.

  2. [Comparison of 2 systems for continuous intraoperative monitoring of oxygen saturation in the jugular bulb].

    Science.gov (United States)

    García del Valle, S; Bartolomé, A; Menéndez, B; Azofra, J; Requejo, M D

    1996-02-01

    To compare accuracy, precision and stability of two jugular venous blood catheters for continuous monitoring of oxygen saturation during surgery, in a nonrandom, prospective sample. We studied 47 patients requiring continuous monitoring of SjvO2 during a variety of neurosurgical procedures. Swan-Ganz pediatric 5.5F catheters (Opticath P575-EH) were used in 27 patients; neonatal umbilical artery 4F catheters (Opticath U425C) were used in 20. Both catheters were equipped with a fiberoptic system for continuous monitoring of hemoglobin oxygen saturation. After checking correct placement, readings transmitted were compared with co-oximetry readings for a sample taken from the distal end of the catheter. We also compared time spent placing the catheters and stability of SjvO2 reading during surgery. Insertion time (+/- SD) was 10.3 +/- 2.5 minutes for the 4F catheter and 15.9 +/- 5.5 minutes for the 5.5F model (p < 0.01). Although both systems tended to overestimate, the 5.5F catheters were more accurate: the mean differences were -6.8% for the 4F catheter and -1.2% for the 5.5F. These results made it necessary to calibrate the 4F catheters after placement and before use, a procedure not needed if the 5.5F catheters are used. Stability of SjvO2 readings during surgery was significantly greater (p < 0.01) for the 5.5F catheters, such that only 25.9% were considered clinically useful based on this parameter. However, 70% of the 5.5F catheters provided acceptable SjvO2 readings. Intracranial pressure during insertion and removal of the SjvO2 catheters was measured in only 5 patients; there were no changes greater than 1 mmHg. Although the 5.5F pediatric catheters take longer to put into position, their greater accuracy, precision and stability makes them preferable to the 4F catheters for continuous monitoring of SjvO2. Long-term vascular effects must be studied further.

  3. Gamma Knife surgery for patients with jugular foramen schwannomas: a multiinstitutional retrospective study in Japan.

    Science.gov (United States)

    Hasegawa, Toshinori; Kato, Takenori; Kida, Yoshihisa; Sasaki, Ayaka; Iwai, Yoshiyasu; Kondoh, Takeshi; Tsugawa, Takahiko; Sato, Manabu; Sato, Mitsuya; Nagano, Osamu; Nakaya, Kotaro; Nakazaki, Kiyoshi; Kano, Tadashige; Hasui, Koichi; Nagatomo, Yasushi; Yasuda, Soichiro; Moriki, Akihito; Serizawa, Toru; Osano, Seiki; Inoue, Akira

    2016-10-01

    OBJECTIVE This study aimed to explore the efficacy and safety of stereotactic radiosurgery in patients with jugular foramen schwannomas (JFSs). METHODS This study was a multiinstitutional retrospective analysis of 117 patients with JFSs who were treated with Gamma Knife surgery (GKS) at 18 medical centers of the Japan Leksell Gamma Knife Society. The median age of the patients was 53 years. Fifty-six patients underwent GKS as their initial treatment, while 61 patients had previously undergone resection. At the time of GKS, 46 patients (39%) had hoarseness, 45 (38%) had hearing disturbances, and 43 (36%) had swallowing disturbances. Eighty-five tumors (73%) were solid, and 32 (27%) had cystic components. The median tumor volume was 4.9 cm(3), and the median prescription dose administered to the tumor margin was 12 Gy. Five patients were treated with fractionated GKS and maximum and marginal doses of 42 and 21 Gy, respectively, using a 3-fraction schedule. RESULTS The median follow-up period was 52 months. The last follow-up images showed partial remission in 62 patients (53%), stable tumors in 42 patients (36%), and tumor progression in 13 patients (11%). The actuarial 3- and 5-year progression-free survival (PFS) rates were 91% and 89%, respectively. The multivariate analysis showed that pre-GKS brainstem edema and dumbbell-shaped tumors significantly affected PFS. During the follow-up period, 20 patients (17%) developed some degree of symptomatic deterioration. This condition was transient in 12 (10%) of these patients and persistent in 8 patients (7%). The cause of the persistent deterioration was tumor progression in 4 patients (3%) and adverse radiation effects in 4 patients (3%), including 2 patients with hearing deterioration, 1 patient with swallowing disturbance, and 1 patient with hearing deterioration and hypoglossal nerve palsy. However, the preexisting hoarseness and swallowing disturbances improved in 66% and 63% of the patients, respectively

  4. The AORTA Architecture: Integrating Organizational Reasoning in Jason

    DEFF Research Database (Denmark)

    Jensen, Andreas Schmidt; Dignum, Virginia; Villadsen, Jørgen

    2014-01-01

    the expected behavior of the agents. Agents need to be able to reason about the regulations, so that they can act within the expected boundaries and work towards the objectives of the organization. In this paper, we describe the AORTA (Adding Organizational Reasoning to Agents) architecture for making agents...... organization-aware. It is designed such that it provides organizational reasoning capabilities to agents implemented in existing agent programming languages without being tied to a specific organizational model. We show how it can be integrated in the Jason agent programming language, and discuss how...

  5. Pseudo-dissection of ascending aorta in inferior myocardial infarction.

    Directory of Open Access Journals (Sweden)

    Grahame K. Goode

    2011-06-01

    Full Text Available Acute aortic dissection is a cardiac emergency which can present as inferior myocardial infarction. It has high morbidity and mortality requiring prompt diagnosis and treatment. Rapid advances in noninvasive imaging modalities have facilitated the early diagnosis of this condition and in ruling out this potentially catastrophic illness. We report an interesting case of a 57 year- old -man who presented with inferior myocardial infarction requiring thrombolysis and temporary pacing wire for complete heart block. An echocardiogram was highly suspicious of aortic dissection. CT scan confirmed that the malposition of the temporary pacing wire through the aorta mimicked aortic dissection.

  6. Nanoparticle-Mediated Local Delivery of an Antisense TGF-β1 Construct Inhibits Intimal Hyperplasia in Autogenous Vein Grafts in Rats

    Science.gov (United States)

    Sun, Da-Xin; Liu, Zhen; Tan, Xiao-Dong; Cui, Dong-Xu; Wang, Bao-Sheng; Dai, Xian-Wei

    2012-01-01

    Background Intimal hyperplasia is one of the most important causes of vascular graft failure. Numerous studies have correlated transforming growth factor-β1 (TGF-β1) with extracellular matrix (ECM) deposition, a hallmark of intimal thickening. Principal Findings In the present study, we performed immunohistochemistry, RT-PCR, and Western blot to examine the dynamic expression of TGF-β1, TGF-β1 receptor type I (TGF-β RI), matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) during intimal hyperplasia in grafted veins of a rat model generated by grafting a portion of the right internal jugular vein to the ipisiliary caroid artery. Additionally, we determined whether nanoparticle-mediated delivery of a TGF-β1 antisense-expressing construct prevented TGF-β1 expression and intimal hyperplasia in grafted veins. In grafted veins, the expression of TGF-β1 significantly increased on day 3 after transplantation, peaked on day 7, slightly decreased on day 14, and returned to baseline levels on day 28. The positive expression of TGF-β RI in grafted veins remarkably increased on day 7, peaked on day 14, and decreased thereafter. MMP-1 expression decreased significantly, while TIMP-1 expression increased, significantly on days 14 and 28. Nanoparticle-mediated delivery of a TGF-β1 antisense-expressing construct down-regulated TGF-β1 expression and inhibited intimal hyperplasia in grafted veins. Conclusions Our findings provide further evidence that TGF-β1 plays an integral role in the development of intimal hyperplasia after vascular injury. Nanoparticle-mediated delivery of a TGF-β1 antisense-expressing construct is a feasible strategy to target TGF-β1-induced intimal thickening. PMID:22860019

  7. Early growth response gene-1 decoy oligonucleotides inhibit vascular smooth muscle cell proliferation and neointimal hyperplasia of autogenous vein graft in rabbits.

    Science.gov (United States)

    Wang, Xisheng; Mei, Yunqing; Ji, Qiang; Feng, Jing; Cai, Jianzhi; Xie, Shiliang

    2015-07-01

    The excess proliferation of vascular smooth muscle cells (VSMCs) and the development of intimal hyperplasia is a hallmark of vein graft failure. This study aimed to verify that a single intraoperative transfection of early growth response gene-1 (Egr-1) decoy oligonucleotide (ODN) can suppress vein graft proliferation of VSMCs and intimal hyperplasia. In a rabbit model, jugular veins were treated with Egr-1 decoy ODN, scrambled decoy ODN, Fugene6, or were left untreated, then grafted to the carotid artery. The vein graft samples were obtained 48 h, 1, 2 or 3 weeks after surgery. The thickness of the intima and intima/media ratio in the grafts was analysed by haematoxylin-eosin (HE) staining. The expression of the Egr-1 decoy ODN transfected in the vein was analysed using fluorescent microscopy. Egr-1 mRNA was measured using reverse transcription-polymerase chain reaction. The expression of Egr-1 protein was analysed by Western blot and immunohistochemistry. Transfection efficiency of the ODN was confirmed by 4', 6-diamidino-2-phenylindole staining. In the grafts treated with Egr-1 decoy ODN, our study achieved statistically significant inhibition of intimal hyperplasia by ∼58% at 3 weeks. Transfection of Egr-1 decoy ODNs decreased the protein expression of Egr-1 and Egr-1 mRNA. We confirmed that gene therapy using in vivo transfection of an Egr-1 decoy ODN significantly inhibits proliferation of VSMC and intimal hyperplasia of vein grafts in a rabbit model. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  8. Trombosis yugular interna bilateral asociada a trombofilia después de la inducción ovárica por infertilidad Bilateral internal jugular thrombosis associated with thrombophilia after ovarian induction for infertility

    Directory of Open Access Journals (Sweden)

    Fernando Vázquez

    2002-08-01

    Full Text Available Los eventos tromboembólicos son complicaciones poco frecuentes del tratamiento hormonal de la infertilidad y generalmente están asociados al síndrome de hiperestimulación ovárico (SHO. La trombosis venosa yugular es infrecuente y ante su presencia se debería sospechar la existencia de algún factor predisponente. Describimos una paciente de 31 años, sin antecedentes de importancia, no fumadora, a la cual se le realizó un único ciclo de estimulación hormonal para fertilización in vitro por esterilidad primaria con factor masculino. Durante la octava semana de embarazo gemelar desarrolló una trombosis yugular interna bilateral, en ausencia de SHO u otros factores predisponentes aparentes. En la evaluación para trombofilia se detectó la presencia del Factor V Leiden y la mutación del gen de la protrombina G 20210, que junto con el estímulo hormonal, se interpretaron como los factores predisponentes. Se anticoaguló con heparina de bajo peso molecular. No está recomendado el rastreo sistemático de trombofilia antes del tratamiento hormonal, pero podría ser considerado en pacientes de alto riesgo o en quienes desarrollan trombosis en ausencia de un factor predisponente claro.Thromboembolic events are an infrequent complication of hormonal treatment for infertility and are generally related to the hyperstimulated ovarian syndrome (HOS. Jugular vein thrombosis is an unusual site of thrombosis and when present one should look for a predisposing factor. We describe a 31-year-old woman, with no previous medical history, non-smoker, who received a single cycle of hormonal stimulation for in vitro fertilisation due to primary infertility. During her eighth week of a twin pregnancy, she consulted the emergency room where the diagnosis of bilateral jugular thrombosis was confirmed, in absence of HOS or any known predisposing factor. In subsequent studies, the presence of Factor V Leyden and a mutation of G 20210 prothrombin were found

  9. In vitro contractility of normal and aneurysmal abdominal aorta muscle coat sections in human and animal material.

    Science.gov (United States)

    Gnus, Jan; Czerski, Albert; Zawadzki, Wojciech; Witkiewicz, Wojciech; Hauzer, Willy; Rusiecka, Agnieszka; Ferenc, Stanisław

    2012-01-01

    The objective of the study was to demonstrate spontaneous contractile activity of the smooth muscle coat of the aorta in human and animal material. Spontaneous contractility of smooth muscle tissue, or tonus, is essential for the proper function of many internal organs as observed in the many types of muscle cells which make up the internal structures. The spontaneous contractile activity of the muscle tissue in blood vessels is particularly marked in resistance vessels, regulating circulation within organs or tissues. It can also be observed in large blood vessels such as arteries and veins. The contractile activity of muscular tissue isolated from arteries is the result of a number of factors, including endogenous paracrine substances, neurotransmitters released at postganglionic endings (mostly within the sympathetic system), cells capable of spontaneously generation of functional potentials (pacemaking cells) and the vascular endothelium. Pacemaking cells present in the aortic wall are an important factor in the development of the spontaneous contractility of the muscular coat of the aorta. They are capable of generating functional potentials, resulting in the constant tonus of the smooth muscular coat (comprising the aortic wall) due to tonic contraction. In vitro studies were carried out on abdominal aortic sections collected from 30 New Zealand rabbits with a body mass of 3-4 kilograms each and also on aneurysmal abdominal aortic sections collected during elective aneurysm repair procedures in humans (10 abdominal aortic sections). The 1.5 cm-long sections were mounted in chambers of an automated water bath. The sections were oriented in a transverse and longitudal fashion in order to compare contractility. The incubation medium consisted of Krebs-Henseleit buffer. Spontaneous contractile activity was observed during the study, characterized by rhythmic contractions of the muscular layer of the aorta. The contractile tension within the sections was 0.15 m

  10. Generating and analyzing synthetic finger vein images

    NARCIS (Netherlands)

    Hillerström, Fieke; Kumar, Ajay; Veldhuis, Raymond

    2014-01-01

    Abstract: The finger-vein biometric offers higher degree of security, personal privacy and strong anti-spoofing capabilities than most other biometric modalities employed today. Emerging privacy concerns with the database acquisition and lack of availability of large scale finger-vein database have

  11. PORTAL VEIN THROMBOSIS-ULTRASOUND IMAGING

    Directory of Open Access Journals (Sweden)

    Trajkovska Meri

    2016-07-01

    Full Text Available Portal venous system, apart from the main portal vein, includes its tributaries: superior and inferior mesenteric vein, as well as splenic vein, so the term portal venous thrombosis encompasses a broad spectrum of pathological conditions. Usually, one or more causative factors can be recognized, either local endothelial/ flow disturbances, or systemic inherited /acquired conditions. Portal vein thrombosis can be associated with benign or malignant disorders. Weather we are speaking about acute or chronic thrombosis, the clinical presentation is different. Acute thrombosis can be presented in a wide range, from mild abdominal discomfort to a state of intestinal ischemia and life-threatening infarction. Chronic thrombosis is usually recognized when variceal bleeding or other symptoms of portal hypertension express. Fast and accurate diagnosis sometimes is a life-saving procedure, especially in acute vascular alterations. Recently, due to the improvement of imaging procedures the number of patients with diagnosed portal vein thrombosis is increasingly growing. With a negative predictive value of 98% color Doppler ultrasound is considered as imaging modality of choice in detecting portal vein thrombosis. Based on large studies it is presumed that overall risk of getting portal vein thrombosis during lifetime is 1% in general population, but much bigger 5%-15% in cirrhotic patients. Existence of specific ultrasound criteria, if fulfilled, has ensured that diagnosis of portal vein thrombosis is fast and non-invasive. Procedure is convenient for the patient and healthcare providers, and above all, allows prompt treatment preventing further deterioration.

  12. Endovenous laser therapy for varicose veins

    NARCIS (Netherlands)

    Disselhoff, B.C.V.M.

    2008-01-01

    This thesis describes the technique of endovenous laser ablation and the outcome of various series of patients with varicose veins due to reflux in the great saphenous vein, treated by endovenous laser ablation or cryostripping in a single-centre study. This study has shown clear advantages of endov

  13. Vein of foramen caecum: imaging findings.

    Science.gov (United States)

    Tutar, Onur; Kandemirli, Sedat Giray; Yildirim, Duzgun; Memis, Emine Sebnem; Bakan, Selim

    2016-07-01

    Vein of foramen caecum has been classically described as a vein that connects nasal mucosa to the superior sagittal sinus in classic anatomy textbooks. However, its existence is controversial in literature. Herein, we demonstrated computed tomography and contrast enhanced magnetic resonance imaging findings of a tubular vascular structure extending to nasal mucosa and superior sagittal sinus.

  14. Improving the management of varicose veins.

    Science.gov (United States)

    Onida, Sarah; Lane, Tristan R A; Davies, Alun H

    2013-01-01

    Up to 30% of the UK population are affected by varicose veins. They are a manifestation of increased venous pressure in the lower limb caused by impaired venous return. Primary varicosities result from poor drainage from the superficial to the deep venous system. Secondary varicosities arise as a result of underlying pathology impeding venous drainage, such as deep venous thrombosis or increased intra-abdominal pressure caused by a mass, pregnancy or obesity. Patients with bleeding varicose veins should be referred to a vascular service immediately. Referral is also indicated in the following cases: symptomatic primary or recurrent varicose veins; lower limb skin changes thought to be caused by chronic venous insufficiency; superficial vein thrombosis and suspected venous incompetence; a venous leg ulcer or healed venous leg ulcer. Imaging is crucial in the assessment of the superficial and deep venous system to enable assessment of venous competence. The gold standard imaging technique is colour duplex ultrasonography. Duplex ultrasound should be used to confirm the diagnosis of varicose veins and the extent of truncal reflux, and to plan treatment for patients with suspected primary or recurrent varicose veins. Superficial vein ligation, phlebectomy and stripping have been the mainstay of treatment. In recent years, new techniques have been developed that are minimally invasive, enabling treatment of superficial venous incompetence with reduced morbidity. NICE recommends that endothermal ablation, in the form of radiofrequency or laser treatment, should be offered as treatment for patients with confirmed varicose veins and truncal reflux.

  15. Retinal vein occlusion: pathophysiology and treatment options

    OpenAIRE

    Niral Karia

    2010-01-01

    Niral KariaDepartment of Ophthalmology, Southend Hospital, Prittlewell Chase, Westcliff on Sea, Essex, United KingdomAbstract: This paper reviews the current thinking about retinal vein occlusion. It gives an overview of its pathophysiology and discusses the evidence behind the various established and emerging treatment paradigms.Keywords: central, hemispheric, branch, retinal vein occlusion, visual loss

  16. Assessment and management of patients with varicose veins.

    Science.gov (United States)

    Allen, Louise

    Varicose veins are enlarged superficial veins found in the legs. This article explores the anatomy and physiology of the venous system to assist nurses to assess, manage and treat patients with varicose veins.

  17. AN EXCEPTIONAL CASE OF QUADRUPLE RENAL ARTERIES & T WIN RENAL VEINS WITH CROWDED HILAR ANATOMY

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    Sreekanth

    2013-02-01

    Full Text Available ABSTRACT: The renal vasculature was always a subject of varia tions both in the number and pattern of portal of entry into kidney and Perihilar placement of the artery, vein and pelvis. Good anatomical insight is an essential prerequisite besides the surgical expertise. The cadaveric dissection revealed a Right Kidney supplied by Quadruple renal arteries & Drained by two renal veins. The main renal artery (MRA was arising from antero lateral aspect and the accessory renal artery was arising from anterior as pect of aorta 1cm distal to the former vessel. Only the MRA showed Fork Pattern Branching with fou r anterior segmental arteries and one posterior segmental artery in the pre hilar region. T he first and fourth segmental arteries showed a small subsidiary branch and a large tortuo us subsidiary branch respectively. The later along with the branch running downwards and lateral from lower renal artery formed a common trunk and pierced the capsule and entered int o the substance of the kidney anteriorly about 2cm lateral to the hilum, thus forming an abe rrant artery. The upper polar artery was seen arising from the lower supra renal artery. The main renal vein (MRV, was formed by two formative tributaries of which one is larger and ot her being smaller. The later was seen just anterior to the third anterior segmental branch of MRA. Accessory renal vein was formed by only one tributary encircled by the fourth anterior segmental artery and posterior segmental artery. There was crowding of structures seen with altered hilar anatomy in both vertical and horizontal disposition. Such a rare combination of extra renal multiple arterio-venous variation is of worth concern to the urologists harvesting ki dneys from the live donors for performing transplantation procedures. Partial nephrectomies for the hilar tumors and for Radiologists during interpretation of the angiograms.

  18. Branches of the abdominal aorta in Aotus azarae infulatus

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    Bianca Mendonça Faria

    2016-05-01

    Full Text Available 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.

  19. Elastin aging and lipid oxidation products in human aorta

    Directory of Open Access Journals (Sweden)

    Kamelija Zarkovic

    2015-04-01

    Full Text Available Vascular aging is associated with structural and functional modifications of the arteries, and by an increase in arterial wall thickening in the intima and the media, mainly resulting from structural modifications of the extracellular matrix (ECM components. Among the factors known to accumulate with aging, advanced lipid peroxidation end products (ALEs are a hallmark of oxidative stress-associated diseases such as atherosclerosis. Aldehydes generated from the peroxidation of polyunsaturated fatty acids (PUFA, (4-hydroxynonenal, malondialdehyde, acrolein, form adducts on cellular proteins, leading to a progressive protein dysfunction with consequences in the pathophysiology of vascular aging. The contribution of these aldehydes to ECM modification is not known. This study was carried out to investigate whether aldehyde-adducts are detected in the intima and media in human aorta, whether their level is increased in vascular aging, and whether elastin fibers are a target of aldehyde-adduct formation. Immunohistological and confocal immunofluorescence studies indicate that 4-HNE-histidine-adducts accumulate in an age-related manner in the intima, media and adventitia layers of human aortas, and are mainly expressed in smooth muscle cells. In contrast, even if the structure of elastin fiber is strongly altered in the aged vessels, our results show that elastin is not or very poorly modified by 4-HNE. These data indicate a complex role for lipid peroxidation and in particular for 4-HNE in elastin homeostasis, in the vascular wall remodeling during aging and atherosclerosis development.

  20. Ebstein's anomaly with coarctation of the aorta. An unusual association

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    Munir Ebaid

    1999-08-01

    Full Text Available Ebstein's anomaly with coarctation of the aorta is an extremely unusual condition. In this report, the clinical and surgical features of 3 male patients, aged 7 months, 4 years and 14 years, are discussed. All patients were in situs solitus. The first 2 patients had atrioventricular and ventriculoarterial discordance and progressed to heart failure in the neonatal period. The third had atrioventricular and ventriculoarterial concordance, as well as Wolf-Parkinson-White syndrome, with frequent episodes of paroxysmal tachycardia. The 3 patients underwent surgery for correction of the coarctation of the aorta. The patient with atrioventricular and ventriculoarterial concordance underwent tricuspid valvuloplasty using a DeVega-like technique. In addition, ablation of 2 anomalous pathways (Kent bundle, which were detected by the electrophysiologic study, was also subsequently performed. The 3 patients showed a good postoperative outcome for 2 years, although, in those with discordance, the surgical procedure did not influence the dysplasia of the tricuspid valve, because this valve showed light to moderate dysfunction.

  1. Coarctation of the aorta: Management from infancy to adulthood.

    Science.gov (United States)

    Torok, Rachel D; Campbell, Michael J; Fleming, Gregory A; Hill, Kevin D

    2015-11-26

    Coarctation of the aorta is a relatively common form of congenital heart disease, with an estimated incidence of approximately 3 cases per 10000 births. Coarctation is a heterogeneous lesion which may present across all age ranges, with varying clinical symptoms, in isolation, or in association with other cardiac defects. The first surgical repair of aortic coarctation was described in 1944, and since that time, several other surgical techniques have been developed and modified. Additionally, transcatheter balloon angioplasty and endovascular stent placement offer less invasive approaches for the treatment of coarctation of the aorta for some patients. While overall morbidity and mortality rates are low for patients undergoing intervention for coarctation, both surgical and transcatheter interventions are not free from adverse outcomes. Therefore, patients must be followed closely over their lifetime for complications such as recoarctation, aortic aneurysm, persistent hypertension, and changes in any associated cardiac defects. Considerable effort has been expended investigating the utility and outcomes of various treatment approaches for aortic coarctation, which are heavily influenced by a patient's anatomy, size, age, and clinical course. Here we review indications for intervention, describe and compare surgical and transcatheter techniques for management of coarctation, and explore the associated outcomes in both children and adults.

  2. Coarctation of the aorta:Management from infancy to adulthood

    Institute of Scientific and Technical Information of China (English)

    Rachel; D; Torok; Michael; J; Campbell; Gregory; A; Fleming; Kevin; D; Hill

    2015-01-01

    Coarctation of the aorta is a relatively common form of congenital heart disease, with an estimated incidence of approximately 3 cases per 10000 births. Coarctation is a heterogeneous lesion which may present across all age ranges, with varying clinical symptoms, in isolation, or in association with other cardiac defects. The first surgical repair of aortic coarctation was described in 1944, and since that time, several other surgical techniques have been developed and modified. Additionally, transcatheter balloon angioplasty and endovascular stent placement offer less invasive approaches for the treatment of coarctation of the aorta for some patients. While overall morbidity and mortality rates are low for patients undergoing intervention for coarctation, both surgical and transcatheter interventions are not free from adverse outcomes. Therefore, patients must be followed closely over their lifetime for complications such as recoarctation, aortic aneurysm, persistent hypertension, and changes in any associated cardiac defects. Considerable effort has been expended investigating the utility and outcomes of various treatment approaches for aortic coarctation, which are heavily influenced by a patient’s anatomy, size, age, and clinical course. Here we review indications for intervention, describe and compare surgical and transcatheter techniques for management of coarctation, and explore the associated outcomes in both children and adults.

  3. Comparison of Two Kinds of Application of Puncture Approach Ways of Central Vein Catheterization in Critically Ill Patients%两种穿刺入路方式中心静脉置管术在危重症抢救中的应用比较

    Institute of Scientific and Technical Information of China (English)

    谢德东; 周莉娟; 陈力; 戴领

    2014-01-01

    Objective To compare two kinds of puncture approach ways of central vein catheterization in the critically ill rescue application, in the way of central vein to seek for optimal rescue critically ill patients. Methods A retrospective analysis from 2008 March to 2013 year in March 900 cases of critically ill patients in our center of central venous catheterization patients clinical data, which take the internal jugular vein puncture approach in 420 cases, puncture of subclavian vein approach in 480 cases, based on the two kinds of puncture approach ways of central vein catheterization occurred in quick puncture success rate and puncture related complications rate analysis. Results The success rate of puncture of internal jugular vein puncture ap-proach: 336 cases (80% ); puncture of subclavian vein approach in 456 cases (95% ); the incidence rate of puncture related complications: internal jugular vein puncture approach in 69 cases (16. 4% ), puncture of subclavian vein in 20 cases (4. 2% ). Conclusion In critically ill patients subclavian vein puncture approach ways of central vein catheterization rate is better than that of internal jugular vein puncture approach in fast puncture success rate and puncture related complications.%目的:比较两种穿刺入路方式中心静脉置管术在危重症抢救中的应用,寻求适用于危重症患者抢救中最优的中心静脉置管入路方式。方法回顾性分析2008年3月至2013年3月我中心900例危重抢救患者中心静脉置管术临床资料,其中采取颈内静脉穿刺入路方式420例,锁骨下静脉穿刺入路方式480例,通过对两种穿刺入路方式中心静脉置管术在快速穿刺成功率及穿刺相关并发症发生率方面进行分析比较。结果一针穿刺成功率:颈内静脉穿刺入路方式336例(80%);锁骨下静脉穿刺入路方式456例(95%);穿刺相关并发症发生率:颈内静脉穿刺入路方式69例(16.4%),锁

  4. First clinical experience in applying XperGuide in embolization of jugular paragangliomas by direct intratumoral puncture

    Energy Technology Data Exchange (ETDEWEB)

    Spelle, Laurent; Moret, Jacques [Fondation Rothschild Hospital, Interventional Neuroradiology Department, Paris (France); Ruijters, Daniel; Babic, Drazenko; Homan, Robert; Mielekamp, Peter; Guillermic, Jeremy [Philips Healthcare, Cardio/Vascular Innovation, Best (Netherlands)

    2009-11-15

    The purpose of this study is to introduce a novel image-guided technique utilized in the embolization of jugular paraganglioma tumors, using preoperative diagnostic scans and planning together with perioperative X-ray fluoroscopy in a combined image. A lesion center and a skin entry point on the patient are selected and connected with a straight line, which resembles the most ideal lesion access trajectory to be followed during the needle insertion. The skin entry point and the corresponding line location are selected such that it avoids the impenetrable bones and vital anatomical structures. Two viewing incidence angles are defined to guide the cranial needle insertion: the entry view tangent to the planned trajectory, and the progression view perpendicular to the path. The proposed method was applied in two patients with jugular paragangliomas in order to navigate needles to the lesion location and subsequently embolize the tumors. The perioperative registration took less than 8 s. Using this method, it was possible to guide the needle within 5 mm of the planned path. The fluoroscopic needle navigation, overlaid on the corresponding soft tissue of the underlying anatomy, combined with a planned path, has been shown to be an accurate and efficient tool for needle guidance. The patient pose varied between the preoperative data and the fluoroscopy guided intervention, but this did not hinder the procedure. (orig.)

  5. JUGULAR CENTRAL VENOUS CATHETER PLACEMENT THROUGH A MODIFIED SELDINGER TECHNIQUE FOR LONG-TERM VENOUS ACCESS IN CHELONIANS.

    Science.gov (United States)

    Pardo, Mariana A; Divers, Stephen

    2016-03-01

    Long-term or repeated venous access in chelonians is difficult to obtain and manage, but can be critically important for administration of medications and blood sampling in hospitalized patients. Jugular catheterization provides the most rapid and secure route for vascular access, but catheters can be difficult to place, and maintaining catheter patency may be challenging. Long multilumen polyurethane catheters provide flexibility and sampling access, and minimize difficulties, such as catheter displacement, that have been encountered with traditional over-the-needle catheters. We describe placement of 4 Fr. 13-cm polyurethane catheters in three chelonians with the use of a modified Seldinger technique. Venous access was obtained with the use of an over-the-needle catheter, which allowed placement of a 0.018-in.-diameter wire, over which the polyurethane catheter was placed. Indwelling time has ranged between 1 and 4 mo currently. All tortoises were sedated for this procedure. Polyurethane central catheters provide safe, long-term venous access that allows clinicians to perform serial blood sampling as well as intravenous administration of medications, anesthetic agents, and fluids. A jugular catheter can also allow central venous pressure measurement. Utilization of central line catheters was associated with improvements in diagnostic efficiency and therapeutic case management, with minimal risks and complications.

  6. Percutaneous closure of huge patent ductus arterious associated with anomalous inferior vein cava drainage and dextrocardia with muscular ventricular septal defect occluder

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    @@ Transcatheter occlusion of patent ductus arterious (PDA) using various occluders and coils has been a well-established method1-5 since Porstmann and colleagues6 reported the first case in 1967. However, when patients associated with anomalous inferior vein cava drainage or/and huge high pulmonary artery pressure ductus (HPAP-PDA), the method is not suitable. First, it is unfeasible to carry out the procedure via femoral vein. Second, in the presence of high pulmonary artery pressure such devices including the Amplatzer ductu occluder carry the risk of embolising into the aorta.7 The muscular ventricular septal defect occluder (MVSDO), which is a device for transcatheter closure of muscular ventricular septal defect, may be more suitable for using with HPAP-PDA as its double disk tends to anchor the device, preventing embolisation into the aorta. We present a patient, who is suffering from huge PDA associated with anomalous inferior vein cava drainage and dextrocardia, in whom percutaneous closure of PDA using MVSDO was successfully accomplished via transjugular approach.

  7. Ropivacaine-Induced Contraction Is Attenuated by Both Endothelial Nitric Oxide and Voltage-Dependent Potassium Channels in Isolated Rat Aortae

    Directory of Open Access Journals (Sweden)

    Seong-Ho Ok

    2013-01-01

    Full Text Available This study investigated endothelium-derived vasodilators and potassium channels involved in the modulation of ropivacaine-induced contraction. In endothelium-intact rat aortae, ropivacaine concentration-response curves were generated in the presence or absence of the following inhibitors: the nonspecific nitric oxide synthase (NOS inhibitor Nω-nitro-L-arginine methyl ester (L-NAME, the neuronal NOS inhibitor Nω-propyl-L-arginine hydrochloride, the inducible NOS inhibitor 1400W dihydrochloride, the nitric oxide-sensitive guanylyl cyclase (GC inhibitor ODQ, the NOS and GC inhibitor methylene blue, the phosphoinositide-3 kinase inhibitor wortmannin, the cytochrome p450 epoxygenase inhibitor fluconazole, the voltage-dependent potassium channel inhibitor 4-aminopyridine (4-AP, the calcium-activated potassium channel inhibitor tetraethylammonium (TEA, the inward-rectifying potassium channel inhibitor barium chloride, and the ATP-sensitive potassium channel inhibitor glibenclamide. The effect of ropivacaine on endothelial nitric oxide synthase (eNOS phosphorylation in human umbilical vein endothelial cells was examined by western blotting. Ropivacaine-induced contraction was weaker in endothelium-intact aortae than in endothelium-denuded aortae. L-NAME, ODQ, and methylene blue enhanced ropivacaine-induced contraction, whereas wortmannin, Nω-propyl-L-arginine hydrochloride, 1400W dihydrochloride, and fluconazole had no effect. 4-AP and TEA enhanced ropivacaine-induced contraction; however, barium chloride and glibenclamide had no effect. eNOS phosphorylation was induced by ropivacaine. These results suggest that ropivacaine-induced contraction is attenuated primarily by both endothelial nitric oxide and voltage-dependent potassium channels.

  8. Donor lung assessment using selective pulmonary vein gases.

    Science.gov (United States)

    Costa, Joseph; Sreekanth, Sowmyashree; Kossar, Alex; Raza, Kashif; Lederer, David J; Robbins, Hilary; Shah, Lori; Sonett, Joshua R; Arcasoy, Selim; D'Ovidio, Frank

    2016-11-01

    Standard donor lung assessment relies on imaging, challenge gases and subjective interpretation of bronchoscopic findings, palpation and visual assessment. Central gases may not accurately represent true quality of the lungs. We report our experience using selective pulmonary vein gases to corroborate the subjective judgement. Starting, January 2012, donor lungs have been assessed by intraoperative bronchoscopy, palpation and visual judgement of lung collapse upon temporary disconnection from ventilator, central gases from the aorta and selective pulmonary vein gases. Partial pressure of oxygen (pO2) <300 mmHg on FiO2 of 1.0 was considered low. The results of the chest X-ray and last pO2 in the intensive care unit were also collected. Post-transplant primary graft dysfunction and survival were monitored. To date, 259 consecutive brain-dead donors have been assessed and 157 transplants performed. Last pO2 in the intensive care unit was poorly correlated with intraoperative central pO2 (Spearman's rank correlation rs = 0.29). Right inferior pulmonary vein pO2 was associated (Mann-Whitney, P < 0.001) with findings at bronchoscopy [clean: median pO2 443 mmHg (25th-75th percentile range 349-512) and purulent: 264 mmHg (178-408)]; palpation [good: 463 mmHg (401-517) and poor: 264 mmHg (158-434)] and visual assessment of lung collapse [good lung collapse: 429 mmHg (320-501) and poor lung collapse: 205 mmHg (118-348)]. Left inferior pulmonary pO2 was associated (P < 0.001) with findings at bronchoscopy [clean: 419 mmHg (371-504) and purulent: 254 mmHg (206-367)]; palpation [good: 444 mmHg (400-517) and poor 282 mmHg (211-419)] and visual assessment of lung collapse [good: 420 mmHg (349-496) and poor: 246 mmHg (129-330)]. At 72 h, pulmonary graft dysfunction 2 was in 21/157 (13%) and pulmonary graft dysfunction 3 in 17/157 (11%). Ninety-day and 1-year mortalities were 6/157 (4%) and 13/157 (8%), respectively. Selective pulmonary vein gases provide corroborative objective

  9. The Inhibitory Effect of Astilbin on the Arteriosclerosis of Murine Thoracic Aorta Transplant

    Institute of Scientific and Technical Information of China (English)

    Jinping ZHAO; Ping LI; Yunfeng ZHANG; Xianguo WANG; Qilin AO; Sihai GAO

    2009-01-01

    The inhibitory effect of astilbin on transplant arteriosclerosis in murine model of thoracic aorta transplantation was examined.Model of rat thoracic aorta transplantation was established.Ninety rats were divided into three groups.In isograft group,the thoracic aorta of Brown Norway (BN) rat was anastomosed with the abdominal aorta of another BN rat.In allograft group,the thoracic aorta of BN rat was anastomosed with the abdominal aorta of Lewis rat.In astilbin group,the rats receiving allo-transplantation were given astiibin 5 mg/kg per day for a time of 28 days.The donor thoracic aorta and the recipient abdominal aorta were anastomosed by means of a polyethylene cannula (inner diameter:1.5 mm,length:3 mm length).The grafts were histologically examined for structural changes.The areas of arterial lumen and endatrium were calculated.Our results showed that,in the allograft group,28 days after aliografting,conspicuous proliferation of smooth muscles and infiltration with a great number of inflammatory cells were found in the tunica intima and tunica media.Astilbin significantly inhibited the proliferation of smooth muscles and ameliorated the infiltration of inflammatory cells thereyby prevent against the development of transplant arteriosclerosis.It is concluded that asltilbin can effectively prevent the development of arteriosclerosis in allotrausplant by inhibiting the proliferation of smooth muscles and inhibit the proliferation of smooth muscles in tunica of intima and media and reducing infiltration of the inflammatory cells.

  10. Improved protein extraction and protein identification from archival formalin-fixed paraffin-embedded human aortas.

    Science.gov (United States)

    Fu, Zongming; Yan, Kun; Rosenberg, Avraham; Jin, Zhicheng; Crain, Barbara; Athas, Grace; Heide, Richard S Vander; Howard, Timothy; Everett, Allen D; Herrington, David; Van Eyk, Jennifer E

    2013-04-01

    Evaluate combination of heat and elevated pressure to enhance protein extraction and quality of formalin-fixed (FF), and FF paraffin-embedded (FFPE) aorta for proteomics. Proteins were extracted from fresh frozen aorta at room temperature (RT). FF and FFPE aortas (3 months and 15 years) were extracted at RT, heat alone, or a combination of heat and high pressure. Protein yields were compared, and digested peptides from the extracts were analyzed with MS. Combined heat and elevated pressure increased protein yield from human FF or FFPE aorta compared to matched tissues with heat alone (1.5-fold) or at RT (8.3-fold), resulting in more proteins identified and with more sequence coverage. The length of storage did adversely affect the quality of proteins from FF tissue. For long-term storage, aorta was preserved better with FFPE than FF alone. Periostin and MGF-E8 were demonstrated suitable for MRM assays from FFPE aorta. Combination of heat and high pressure is an effective method to extract proteins from FFPE aorta for downstream proteomics. This method opens the possibility for use of archival and often rare FFPE aortas and possibly other tissues available to proteomics for biomarker discovery and quantification. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  11. Extraanatomic reconstruction for isolated thoracic aorta coarctation in an adult patient.

    Science.gov (United States)

    Lee, Seung Hyun; Kim, Jae Bum; Park, Nam Hee; Keum, Dong Yoon; Choi, Sea Young

    2012-10-01

    A 42-year-old male patient with no medical history except hypertension presented with intermittent chest pain radiating to the left shoulder. From coronary computed tomography, a coarctation of proximal descending thoracic aorta was found demonstrating near aortic occlusion. From various available surgical options for this condition, we chose extraanatomic bypass from the left subclavian artery to the descending aorta.

  12. Intima-media thickness of the descending aorta in patients with bicuspid aortic valve

    Directory of Open Access Journals (Sweden)

    Johan Petrini

    2016-06-01

    Conclusions: Intima-media thickness of the descending aorta is not affected by aortic valve morphology (BAV/TAV; age is the main determinant of AoIMT. Genetic markers (SNPs known to influence IMT in the carotid artery seem to correlate to IMT in the descending aorta only in patients with TAV.

  13. Pressure-volume characteristics of aortas of harbor and Weddell seals.

    Science.gov (United States)

    Rhode, E A; Elsner, R; Peterson, T M; Campbell, K B; Spangler, W

    1986-07-01

    The mechanical properties of the radially enlarged proximal segment of the aorta of diving marine mammals was studied on 15 excised aortas of harbor seals and five aortas of Weddell seals. This was done by recording static pressure-volume relationships for the whole thoracic aorta, the aortic bulb, and the descending thoracic aorta and passive length-tension measurements of aortic strips. Aortic bulb volume distensibility was found to be much greater than that of the descending thoracic aorta or of an equivalent aortic segment of terrestrial mammals. The consequences were that the total potential energy and volume that may be stored within the aortic bulb is very large, with a capacity for storage of the stroke work of more than two normal heart beats and a volume of more than three times normal stroke volume. The aortic bulb has an average radius and wall thickness twice that of the descending aorta, but at any level of distension the wall stress (g/cm2) is the same throughout. The static mechanical properties of aortic strips from the bulb and descending thoracic aortas were not markedly different, so that the differences in the pressure-volume relationships are explained by differences in geometry of the two sections. The expanded aortic bulb functions through energy and volume storage actions and through uncoupling actions to maintain arterial pressures and stroke volume at near predive levels during a dive.

  14. Radiological features of azygous vein aneurysm.

    Science.gov (United States)

    Choudhary, Arabinda Kumar; Moore, Michael

    2014-04-01

    Mediastinal masses are most commonly associated with malignancy. Azygous vein aneurysm is a very rare differential diagnosis of mediastinal mass. We report here three cases of azygous vein aneurysm including children and adult patients. In the pediatric patient it was further complicated by thrombosis and secondary pulmonary embolism. We describe the radiological features on CXR, MRI, CT, PET-CT, US and angiogram and their differential diagnosis. Imaging findings of continuity with azygous vein, layering of contrast medium on enhanced CT and dynamic MRA showing filling of the mass at the same time as the azygous vein without prior enhancement will be strongly suggestive of azygous vein aneurysm with transtracheal ultrasound being the definitive test in these patients. It is important to keep a vascular origin mass in the differential diagnosis of mediastinal masses. Also, in young healthy patients with pulmonary embolism, a vascular etiology such as azygous vein aneurysm should be carefully evaluated. This article will help the clinicians to learn about the imaging features of azygous vein aneurysm on different imaging modalities.

  15. Portal vein gas in emergency surgery

    Directory of Open Access Journals (Sweden)

    Mahmood Hind

    2008-07-01

    Full Text Available Abstract Background Portal vein gas is an ominous radiological sign, which indicates a serious gastrointestinal problem in the majority of patients. Many causes have been identified and the most important was bowel ischemia and mesenteric vascular accident. The presentation of patients is varied and the diagnosis of the underlying problem depends mainly on the radiological findings and clinical signs. The aim of this article is to show the clinical importance of portal vein gas and its management in emergency surgery. Methods A computerised search was made of the Medline for publications discussing portal vein gas through March 2008. Sixty articles were identified and selected for this review because of their relevance. These articles cover a period from 1975–2008. Results Two hundreds and seventy-five patients with gas in the portal venous system were reported. The commonest cause for portal vein gas was bowel ischemia and mesenteric vascular pathology (61.44%. This was followed by inflammation of the gastrointestinal tract (16.26%, obstruction and dilatation (9.03%, sepsis (6.6%, iatrogenic injury and trauma (3.01% and cancer (1.8%. Idiopathic portal vein gas was also reported (1.8%. Conclusion Portal vein gas is a diagnostic sign, which indicates a serious intra-abdominal pathology requiring emergency surgery in the majority of patients. Portal vein gas due to simple and benign cause can be treated conservatively. Correlation between clinical and diagnostic findings is important to set the management plan.

  16. Surgical Microanatomy of the Posterior Condylar Emissary Vein and its Anatomical Variations for the Transcondylar Fossa Approach.

    Science.gov (United States)

    Ota, Nakao; Tanikawa, Rokuya; Yoshikane, Tsutomu; Miyama, Masataka; Miyazaki, Takanori; Kinoshita, Yu; Matsukawa, Hidetoshi; Yanagisawa, Takeshi; Sakakibara, Fumihiro; Suzuki, Go; Saito, Norihiro; Miyata, Shiro; Noda, Kosumo; Tsuboi, Toshiyuki; Takeda, Rihei; Kamiyama, Hiroyasu; Tokuda, Sadahisa; Kamada, Kyousuke

    2017-06-01

    It is essential to identify and be aware of the anatomy of the posterior condylar emissary vein (PCEV) for achieving an adequate operative field for the transcondylar fossa approach (TCFA). To describe the variations in the drainage patterns of PCEVs and the technical issues encountered in such cases. This was a retrospective analysis of the anatomy of PCEVs in 104 sides in 52 cases treated by the TCFA. Preoperative findings of multidetector-row computed tomography (CT) and CT venography (CTV) were compared with the intraoperative findings. The drainage patterns were classified as 5 types: the sigmoid sinus (SS), jugular bulb (JB), occipital sinus (OS), anterior condylar emissary vein (ACEV), and marginal sinus (MS). The SS, JB, ACEV, and OS types were observed in 33 (31.7%), 42 (40.3%), 8 (7.7%), and 1 (1.0%) side(s), respectively. One side (1.0%) each had combined drainage from MS and JB, and ACEV and JB, respectively. In 17 sides (16.3%), the PCEVs and posterior condylar canals could not be identified on CT and CTV. Preoperative CT and CTV findings correlated well with the intraoperative findings. To make a sufficient operative field for TCFA, PCEVs should be appropriately dealt with based on the preoperative knowledge of their running course, pattern, and origin.

  17. Hand vein recognition based on orientation of LBP

    Science.gov (United States)

    Bu, Wei; Wu, Xiangqian; Gao, Enying

    2012-06-01

    Vein recognition is becoming an effective method for personal recognition. Vein patterns lie under the skin surface of human body, and hence provide higher reliability than other biometric traits and hard to be damaged or faked. This paper proposes a novel vein feature representation method call orientation of local binary pattern (OLBP) which is an extension of local binary pattern (LBP). OLBP can represent the orientation information of the vein pixel which is an important characteristic of vein patterns. Moreover, the OLBP can also indicate on which side of the vein centerline the pixel locates. The OLBP feature maps are encoded by 4-bit binary values and an orientation distance is developed for efficient feature matching. Based on OLBP feature representation, we construct a hand vein recognition system employing multiple hand vein patterns include palm vein, dorsal vein, and three finger veins (index, middle, and ring finger). The experimental results on a large database demonstrate the effectiveness of the proposed approach.

  18. Protective effect of zingerone on increased vascular contractility in diabetic rat aorta.

    Science.gov (United States)

    Ghareib, Salah A; El-Bassossy, Hany M; Elberry, Ahmed A; Azhar, Ahmad; Watson, Malcolm L; Banjar, Zainy M; Alahdal, Abdulrahman M

    2016-06-05

    The aim of the present study was to investigate the effect and possible mechanism of action of zingerone, the main constituent of ginger, on vascular reactivity in isolated aorta from diabetic rats. The results show that incubation of aortae with zingerone alleviates the exaggerated vasoconstriction of diabetic aortae to phenylephrine, as well as the impaired relaxatory response to acetylcholine in a concentration-dependent manner. Furthermore, Zingerone directly relax phenylephrine-precontracted aortae. The vasorelaxatory response is significantly attenuated by the nitric oxide synthase inhibitor Nω-nitro-l-arginine methyl ester hydrochloride and the guanylate cyclase inhibitor methylene blue but no effect of either the potassium channels blocker tetraethylammonium chloride, or the cyclooxygenase inhibitor indomethacin was observed. Zingerone had no effect on advanced glycation end product formation as well. In conclusion, zingerone ameliorates enhanced vascular contraction in diabetic aortae which may be mediated by its vasodilator effect through NO- and guanylate cyclase stimulation.

  19. Ventriculoatrial shunting via the azygos vein.

    Science.gov (United States)

    Balasubramaniam, C; DuBois, J J; Laurent, J P; Pokorny, W J; Harberg, F J; Cheek, W R

    1990-06-01

    The treatment of hydrocephalus has evolved through many stages but the "cure" is still elusive. It is not unusual for the neurosurgeon to find that the commonly used routes for catheter placement or sites for drainage of cerebrospinal fluid (CSF) cannot be employed. The azygos vein was used to gain access to the right atrium when the CSF could not be drained into the peritoneal cavity, nor could the neck veins be used to place the catheter into the right atrium. The azygos vein is a convenient and safe route to reach the right atrium in selected patients.

  20. Portal Decompression Using the Inferior Mesenteric Vein

    Directory of Open Access Journals (Sweden)

    Paolo Gorini

    1998-01-01

    Full Text Available We report five patients with variceal hemorrhage, in three cases secondary to diffuse thrombosis of the portal, superior mesenteric and splenic veins. Mesenteric angiography demonstrated patency of the inferior mesenteric vein (IMV in each, and successful portal decompression by anastomosis of the IMV to the left renal vein (n=4 or the inferior vena cava (n=1 was accomplished. Bleeding was permanently controlled: four patients have survived from one to eight years post-operatively. Because shunt procedures utilizing the IMV are technically straightforward, subtotally decompress the portal system and avoid the right upper quadrant, they may be advantageous in certain clinical settings.