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Sample records for superficial radial artery

  1. Applied anatomy of the superficial branch of the radial nerve.

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    Robson, A J; See, M S; Ellis, H

    2008-01-01

    The superficial branch of the radial nerve (SBRN) is highly vulnerable to trauma and iatrogenic injury. This study aimed to map the course of the SBRN in the context of surgical approaches and identify a safe area of incision for de Quervain's tenosynovitis. Twenty-five forearms were dissected. The SBRN emerged from under brachioradialis by a mean of 8.31 cm proximal to the radial styloid (RS), and remained radial to the dorsal tubercle of the radius by a mean of 1.49 cm. The nerve divided into a median of four branches. The first branch arose a mean of 4.92 cm proximal to the RS, traveling 0.49 cm radial to the first compartment of the extensor retinaculum, while the main nerve remained ulnar to it by 0.64 cm. All specimens had branches underlying the traditional transverse incision for de Quervain's release. A 2.5-cm longitudinal incision proximal from the RS avoided the SBRN in 17/25 cases (68%). In 20/25 specimens (80%), the SBRN underlay the cephalic vein. In 18/25 (72%), the radial artery was closely associated with a sensory nerve branch near the level of the RS (SBRN 12/25, lateral cutaneous nerve of the forearm (LCNF) 6/25.) A longitudinal incision in de Quervain's surgery may be preferable. Cannulation of the cephalic vein in the distal third of the forearm is best avoided. The close association between the radial artery and first branch of the SBRN or the LCNF may explain the pain often experienced during arterial puncture. Particular care should be taken during radial artery harvest to avoid nerve injury.

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

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

    2016-01-01

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

  3. Superficial Temporal Artery Pseudoaneurysm: A Case Report

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    Younus, Syed Muneeb; Imran, Muhammad; Qazi, Rabia

    2015-01-01

    Pseudoaneurysms of the superficial temporal artery are an uncommon vascular lesion of the external carotid system and most often the result of blunt head trauma. The frequency of pseudoaneurysms of the superficial temporal artery developing after craniotomy is exceedingly low and only a few cases have been reported. We present a case of pseudoaneurysm of this type in a 45-year-old male who underwent craniotomy for excision of meningioma. One month postoperatively, the craniotomy flap exhibited an enormous diffuse pulsate swelling. The suspected diagnosis of pseudoaneurysm arising from superficial temporal artery was confirmed on angiography. Surgical excision was done and no recurrences of the tumor or aneurysm were noted on subsequent follow up. PMID:26501064

  4. Countercurrent aortography via radial artery

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    Sohn, Hyung Kuk; Lee, Young Chun; Lee, Seung Chul; Jeon, Seok Chol; Joo, Kyung Bin; Lee, Seung Ro; Kim, Soon Yong [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

    1987-06-15

    Countercurrent aortography via radial artery was performed for detection of aortic arch anomalies in 4 infants with congenital heart disease. Author's cases of aortic arch anomalies were 3 cases of PDA, 1 case of coarctation of aorta, and 1 case of occlusion of anastomosis site on subclavian artery B-T shunt. And aberrant origin of the right SCA, interrupted aortic arch, hypoplastic aorta, anomalous origin of the right pulmonary artery from the ascending aorta can be demonstrated by this method. Countercurrent aortography affords an safe and simple method for detection of aortic arch anomalies without retrograde arterial catheterization, especially in small infants or premature babies.

  5. Trifurcation of superficial brachial artery: a rare case with its clinico-embryological implications.

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    Gupta, N; Anshu, A; Dada, R

    2014-01-01

    Literatures on vasculature of upper limbs are crammed with reports of distinctly deviant version of normally prevalent vessels having modified origins, altered branching and odd courses. A unique anatomical variation in vascular pattern was observed during routine dissection of right upper limb in gross anatomy laboratory, AIIMS, New Delhi, India. The brachial artery was placed superficial to median nerve in the arm and therefore it was called superficial brachial artery. In the cubital fossa, 2.8 cm distal to intercondylar line of elbow joint, this superficial brachial artery terminated by trifurcation into radial, common interosseous and ulnar branches. Strikingly the ulnar branch, after its origin ran superficially over the median nerve and epitrochlear superficial flexor group of muscles of forearm in succession for the initial third of its course in the forearm, consequently it was addressed as superficial ulnar artery. The existence of superficial brachial artery in place of normal brachial artery, its termination by trifurcation into radial, common interosseous and superficial ulnar arteries with remarkably different courses, leads to confusing disposition of structures in the arm, cubital fossa and in the forearm and collectively makes this myriad of anatomical variations even rarer. The clinico-embryological revelations for combination of these unconventional observations, apprises and guides the specialized medical personnel attempting blind and invasive procedures in brachium and ante-brachium. This case report depicts the anatomical perspective and clinical implications on confronting a rare variant vasculature architecture pattern of upper limb.

  6. Differences in excitability between median and superficial radial sensory axons.

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    Fujimaki, Yumi; Kanai, Kazuaki; Misawa, Sonoko; Shibuya, Kazumoto; Isose, Sagiri; Nasu, Saiko; Sekiguchi, Yukari; Ohmori, Shigeki; Noto, Yu-ichi; Kugio, Yumiko; Shimizu, Toshio; Matsubara, Shiro; Lin, Cindy S Y; Kuwabara, Satoshi

    2012-07-01

    The aim of this study was to investigate differences in excitability properties of human median and superficial radial sensory axons (e.g., axons innervating the glabrous and hairy skin in the hand). Previous studies have shown that excitability properties differ between motor and sensory axons, and even among sensory axons between median and sural sensory axons. In 21 healthy subjects, threshold tracking was used to examine excitability indices such as strength-duration time constant, threshold electrotonus, supernormality, and threshold change at the 0.2 ms inter-stimulus interval in latent addition. In addition, threshold changes induced by ischemia for 10 min were compared between median and superficial radial sensory axons. Compared with radial sensory axons, median axons showed shorter strength-duration time constant, greater threshold changes in threshold electrotonus (fanning-out), greater supernormality, and smaller threshold changes in latent addition. Threshold changes in both during and after ischemia were greater for median axons. These findings suggest that membrane potential in human median sensory axons is more negative than in superficial radial axons, possibly due to greater activity of electrogenic Na(+)/K(+) pump. These results may reflect adaptation to impulses load carried by median axons that would be far greater with a higher frequency. Biophysical properties are not identical in different human sensory axons, and therefore their responses to disease may differ. Copyright © 2011 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  7. A morphological study of variations in the branching pattern and termination of the radial artery.

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    Gupta, C; Ray, B; Dsouza, A S; Nair, N; Pai, S R; Manju, M

    2012-03-01

    Coronary artery bypass grafting is an established means of treating advanced coronary artery disease. In recent years, there has been an increased interest in the radial artery as an entry route during coronary angiography. Accurate knowledge of the branching pattern of this artery and its relation to surrounding structures is of great importance in the care of surgical patients. This study was conducted on 75 formalin-fixed upper limbs in order to note the variations in the branching pattern and termination of the radial artery. The radial artery divided into three branches in 2.7% of cases and into two branches in 52.0% of cases. The radial recurrent artery originated from the brachial artery instead of the radial artery in 12.0% of cases. The radial recurrent artery, palmar carpal artery, first dorsal metacarpal artery and superficial palmar artery were absent in 1.3%, 26.7%, 9.3% and 5.3% of cases, respectively. 6.7% of cases had a high origin of the superficial palmar artery. The rich photographic documentation of the variation of branching pattern and termination of radial artery is not only of academic interest but also useful to surgeons and radiologists working in the same area.

  8. A CASE REPORT ON HIGH ORIGIN OF RADIAL ARTERY

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    Vaishali Bondage

    2014-09-01

    Full Text Available Background: The use of radial artery (RA as an access to heart and for other procedures and surgeries make it significant. The context and purpose: The RA is a common access port for coronary angiography (CAG, percutaneous coronary intervention (PCI, and coronary artery bypass graft Surgery (CABG, RA cannulation, along with others. Results: In this case report, we want to present a case of unilateral high origin of RA arising as branch of brachial artery in the proximal 1/3rd of arm. Conclusions, brief summary and potential implications: Misdiagnosis, complications during medical procedures and increased possibility of injury are the most common dangers of having a superficial RA.

  9. PERSISTENT MEDIAN ARTERY ASSOCIATED WITH SUPERFICIA L RADIAL ARTERY AT THE WRIST- A CASE REPORT

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    Jayasabarinathan

    2013-02-01

    Full Text Available ABSTRACT: Vascular variations are usually the result of deve lopmental anomaly during the formation of blood vessels in any respective part of the body. In this case a rare unilateral variation was found on the left upper limb during rou tine dissection in the Department of Anatomy. Brachial artery divided into radial artery and a common trunk. The common trunk in turn divided into ulnar, median and common inteross eous artery. The median artery was palmar type, had two proper palmar digital branches in t he palm. The radial artery had normal course in the forearm till the junction between upper two third and lower one third where it turned dorsally and reached the anatomical snuff bo x and ran superficial to the abductor pollicis longus, extensor carpi radialis brevis and extensor carpi radialis longus along the cephalic vein medially and superficial branch of radial nerve late rally. The median artery, arose from the common trunk, had pierced the median nerve about 4cm from its origin then ran along the median nerve in the forearm thereby reached the palm where it gave off two common palmar digital branches but did not anastomose with the ul nar artery hence formed incomplete superficial palmar arch. But on the right side no suc h variations found. These vascular variations have been studied in detail and their cl inical implications and embryological significance are emphasized.

  10. Traumatic aneurysm of superficial temporal artery. CT demonstration

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    Sharma, A.; Tyagi, G.; Sahai, A.; Baijal, S.S. (G.B. Pant Hospital and M.A. Medical Coll., New Delhi (India). Dept. of Neurosurgery G.B. Pant Hospital and M.A. Medical Coll., New Delhi (India). Dept. of Radiology)

    1991-12-01

    A case of traumatic pseudo-aneurysm of the superficial temporal artery documented on Computed tomography (CT) and angiography is described in a 55-year-old female, who was treated by surgical excision. Computed tomographic appearance of this lesion is illustrated. This represents, to our knowledge, the first CT demonstration of traumatic aneurysm of superficial temporal artery within a large subgaleal haematoma. (orig.).

  11. The superficial ulnar artery: development and clinical significance Artéria ulnar superficial: desenvolvimento e relevância clínica

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    Srinivasulu Reddy

    2007-09-01

    Full Text Available The principal arteries of the upper limb show a wide range of variation that is of considerable interest to orthopedic surgeons, plastic surgeons, radiologists and anatomists. We present here a case of superficial ulnar artery found during the routine dissection of right upper limb of a 50-year-old male cadaver. The superficial ulnar artery originated from the brachial artery, crossed the median nerve anteriorly and ran lateral to this nerve and the brachial artery. The superficial ulnar artery in the arm gave rise to a narrow muscular branch to the biceps brachii. At the elbow level the artery ran superficial to the bicipital aponeurosis where it was crossed by the median cubital vein. It then ran downward and medially superficial to the forearm flexor muscles, and then downward to enter the hand. At the palm, it formed the superficial and deep palmar arches together with the branches of the radial artery. The presence of a superficial ulnar artery is clinically important when raising forearm flaps in reconstructive surgery. The embryology and clinical significance of the variation are discussed.As principais artérias do membro superior apresentam uma ampla variação, que é relativamente importante a cirurgiões ortopédicos e plásticos, radiologistas e anatomistas.Apresentamosumcaso de artéria ulnar superficial encontrada durante dissecção de rotina de membro superior direito de um cadáver masculino de 50 anos de idade.Aartéria ulnar superficial originava-se da artéria braquial, cruzava o nervo mediano anteriormente e percorria lateralmente esse nervo e a artéria braquial. A artéria ulnar superficial no braço deu origem a um ramo muscular estreito do músculo bíceps braquial. Ao nível do cotovelo, a artéria percorria superficialmente a aponeurose bicipital, onde era cruzada pela veia cubital mediana. Percorria, então, em sentido descendente e medialmente superficial aos músculos flexores do antebraço, e então descendia para

  12. ESTUDIO ANATÓMICO DE LA RAMA SUPERFICIAL DEL NERVIO RADIAL. IMPLICACIONES QUIRÚRGICAS Superficial branch of radial nerve: an anatomical study and its surgical implications

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    Enrique Vergara-Amador; José Luis Nieto

    2010-01-01

    Antecedentes. Conocer la anatomía de la rama superficial del nervio radial, es indispensable para la adecuada práctica de cirugías que involucran la mano y la muñeca. Objetivo. Determinar las relaciones del nervio radial y sus ramas con el tubérculo de Lister, la apófisis estiloides del radio y la distribución en el dorso de la mano. Material y métodos. Se disecaron 25 piezas de cadáveres frescos. Se identificó la rama superficial del nervio radial y se midió la distancia entre la salida del ...

  13. ESTUDIO ANATÓMICO DE LA RAMA SUPERFICIAL DEL NERVIO RADIAL. IMPLICACIONES QUIRÚRGICAS Superficial branch of radial nerve: an anatomical study and its surgical implications

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    Enrique Vergara-Amador

    2010-07-01

    Full Text Available Antecedentes. Conocer la anatomía de la rama superficial del nervio radial, es indispensable para la adecuada práctica de cirugías que involucran la mano y la muñeca. Objetivo. Determinar las relaciones del nervio radial y sus ramas con el tubérculo de Lister, la apófisis estiloides del radio y la distribución en el dorso de la mano. Material y métodos. Se disecaron 25 piezas de cadáveres frescos. Se identificó la rama superficial del nervio radial y se midió la distancia entre la salida del nervio y la apófisis estiloides del radio. Se identificaron las ramas del nervio en el antebrazo distal y en la muñeca y se midieron respecto a la apófisis estiloides y al tubérculo de Lister. Resultados. La rama superficial del nervio radial emergió en la región dorsal y radial del tercio distal del antebrazo entre el músculo braquiradialis y el extensor carpis radialis longus, a una distancia de 8,45 cm proximal a la apófisis estiloides. Su primera rama de división discurrió palmar a la apófisis estiloides radial a una distancia promedio de 0,74 cm respecto a la misma. El tronco principal se dividió en varias ramas terminales así: proximal a la apófisis estiloides del radio (28%, a nivel de la misma (12% y distal (60%. El patrón de distribución de las ramas nerviosas en la base de los dedos más frecuente fue el del primero, segundo y el lado radial del tercer dedo (56%. Discusión. Este estudio mostró la gran variabilidad de la rama superficial del nervio radial en el dorso de la mano y la alta probabilidad de daño del mismo durante los procedimientos abiertos, artroscópicos o procedimientos percutáneos en la muñeca.Background. The anatomy of the superficial branch of radial nerve is essential for the proper practice of surgery involving the hand and wrist. Objetive. Determine relationship between the superficial radial nerve and his branches with the radial styloid process level, Lister’s tubercle and the distribution of

  14. Porcine radial artery decellularization by high hydrostatic pressure.

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    Negishi, Jun; Funamoto, Seiichi; Kimura, Tsuyoshi; Nam, Kwangoo; Higami, Tetsuya; Kishida, Akio

    2015-11-01

    Many types of decellularized tissues have been studied and some have been commercially used in clinics. In this study, small-diameter vascular grafts were made using HHP to decellularize porcine radial arteries. One decellularization method, high hydrostatic pressure (HHP), has been used to prepare the decellularized porcine tissues. Low-temperature treatment was effective in preserving collagen and collagen structures in decellularized porcine carotid arteries. The collagen and elastin structures and mechanical properties of HHP-decellularized radial arteries were similar to those of untreated radial arteries. Xenogeneic transplantation (into rats) was performed using HHP-decellularized radial arteries and an untreated porcine radial artery. Two weeks after transplantation into rat carotid arteries, the HHP-decellularized radial arteries were patent and without thrombosis. In addition, the luminal surface of each decellularized artery was covered by recipient endothelial cells and the arterial medium was fully infiltrated with recipient cells.

  15. Estudio anatómico de la rama superficial del nervio radial, implicaciones quirúrgicas

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    Vergara Amador, Enrique; Nieto, José Luis

    2010-01-01

    Antecedentes. Conocer la anatomía de la rama superficial del nervio radial, es indispensable para la adecuada práctica de cirugías que involucran la mano y la muñeca. Objetivo. Determinar las relaciones del nervio radial y sus ramas con el tubérculo de Lister, la apófisis estiloides del radio y la distribución en el dorso de la mano. Material y métodos. Se disecaron 25 piezas de cadáveres frescos. Se identificó la rama superficial del nervio radial y se midió la distancia entre la sali...

  16. Selective use of superficial temporal artery cannulation in infants undergoing cardiac surgery

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    Pradeep Bhaskar

    2015-01-01

    Full Text Available Arterial cannulation is routinely performed in children undergoing cardiac surgery to aid the intraoperative and intensive care management. Most commonly cannulated peripheral site in children is radial artery, and alternatives include posterior tibial, dorsalis pedis, and rarely superficial temporal artery (STA. Two specific situations in cardiac surgery where STA cannulation and monitoring was useful during the surgical procedure are reported. To our knowledge, such selective use of STA pressure monitoring has not been reported in the literature previously. Our experience suggests that STA monitoring can be useful and reliable during repair of coarctation of aorta or administration of anterograde cerebral perfusion in patients having associated aberrant origin of the right subclavian artery.

  17. A new noninvasive device for continuous arterial blood pressure monitoring in the superficial temporal artery.

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    Chin, K Y; Panerai, R B

    2013-04-01

    Continuous recording of arterial blood pressure (ABP) has many applications in cardiovascular physiology, but existing alternatives rely on measurements performed in the fingers or radial artery. Peripheral recordings have significant differences from central ABP regarding the pattern of the waveform and corresponding systolic and diastolic values. To address the need for noninvasive measurements closer to the ascending aorta, a new device was constructed to measure ABP in the superficial temporal artery (STA) using photoplethysmography and the arterial volume clamping technique. The optoelectronic circuitry to generate the photoplethysmogram is contained in a specially designed probe placed over the STA and kept in place with a head frame. The prototype (STAbp) also includes original designs for the pneumatic, electronic, signal processing, control and display sub-systems. A self-calibration feature regularly updates the photoplethysmogram operating point to improve accuracy. The performance of the STAbp was compared against the Finapres in 19 healthy subjects. At rest, the bias (SDd) was -23.1 (15.05), -10.8 (13.83) and -12.4 (12.93) mmHg for systolic, mean and diastolic pressures respectively, without significant differences in drift between the two devices. The 99% bandwidth (SD) for the spectral distribution of ABP waveforms was 5.3 (1.46) Hz for STAbp and 6.8 (0.73) Hz for the Finapres (p < 0.01). Handgrip manoeuvre showed a very similar response to the Finapres, including the rapid return to baseline on release. The new STAbp device has considerable potential as a new tool for clinical and research applications where continuous recording of more central ABP is advantageous compared to peripheral alternatives.

  18. Revascularization using satellite vein after radial artery harvested for coronary artery bypass grafting.

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    Gon, Shigeyoshi; Yoshida, Shigehiko; Sanae, Tsutomu; Takahashi, Tamami; Inada, Eiichi

    2006-06-01

    The radial artery has been increasingly used for coronary artery bypass grafting and has excellent long-term patency rates. Hand claudication is one of the adverse effects after radial artery harvest. We reconstructed a radial artery using the satellite vein to prevent hand claudication. Pulsating blood flow at 35 cm/sec was evaluated using color Doppler echocardiography three months after surgery. This method makes it possible to use a radial artery in patients with a positive Allen test.

  19. Anomalous superficial radial nerve: a patient with probable autosomal dominant inheritance of the anomaly.

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    Kuruvilla, Abraham; Laaksonen, Satu; Falck, Björn

    2002-11-01

    The sensory symptoms due to lesions of the superficial branch of the radial nerve are usually limited to the dorsolateral area of the hand. We describe a 40-year-old woman who presented with numbness of the dorsomedial aspect of the right hand following arthroplasty of the wrist. Clinically, the sensory loss suggested a lesion of the dorsal branch of the ulnar nerve. However, nerve conduction studies showed that the sensory loss was due to a lesion of a branch of the superficial branch of the radial nerve. The patient had bilateral, anomalous innervation of the dorsum of the hand-the dorsal branch of the ulnar nerve could not be demonstrated with nerve conduction techniques and the superficial branch of the radial nerve innervated most of the dorsum of the hand. Antidromic stimulation of the dorsal branch of the ulnar nerve and superficial branch of the radial nerve with paired surface recording of sensory nerve action potentials from the dorsolateral (radial side) and dorsomedial (ulnar side) hand is useful for evaluating this anomaly. Our patient had two children, one of them with a similar anomaly. This suggests an autosomal dominant inheritance of the anomaly.

  20. Percutaneous transluminal angioplasty of the superficial femoral artery by retrograde catheterization via the popliteal artery

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    Tønnesen, K H; Sager, P; Karle, A;

    1988-01-01

    We report the results of 50 angioplasty procedures via the popliteal artery. A 3-year follow-up including control of blood pressures at ankle and toe levels show results comparable to reports in the literature. This new approach for angioplasty of the superficial femoral artery and eventually...

  1. A rare variant of the superficial ulnar artery, and its clinical implications: a case report

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    Senanayake Kithsiri J

    2007-11-01

    Full Text Available Abstract The superficial ulnar artery is a rare variation of the upper limb arterial system that arises from the brachial or axillary artery and runs superficial to the muscles arising from the medial epicondyle 123. The incidence is about 0.7 to 7% 145. In our routine dissections we found a superficial ulnar artery, which crossed the cubital fossa superficial to the bicipital aponeurosis making it highly vulnerable to intra-arterial injection. This is a rare variation that every medical and nursing staff member should know about.

  2. Kinesio tape management for superficial radial nerve entrapment: a case report.

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    Anandkumar, Sudarshan

    2013-04-01

    This case report describes a 41-year-old female who presented with complaints of pain in the lower lateral one-third of the right radius extending into the first web space. Tinel's sign reproducing the patient's symptoms was elicited 8.2 cm above the radial styloid process. Physical diagnosis for superficial radial nerve entrapment was made based on a positive upper limb neural tension test 2a along with symptom reproduction during resisted isometrics to brachioradialis and wrist extensors. A potential first time successful conservative Kinesio tape (KT) management for entrapment of the superficial radial nerve is described in this report. An immediate improvement in grip strength and functional activities along with a reduction in pain and swelling was noted in this patient after the first treatment session, which was maintained at a 6 month follow-up. A model is proposed describing the mechanism by which KT application could be used to intervene for nerve entrapment interfaces.

  3. Radial artery pseudo aneurysm after percutaneous cannulation using Seldinger technique

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    Anil Ranganath

    2011-01-01

    Full Text Available Cannulation of a peripheral artery in a patient allows for continuous blood pressure (BP monitoring and facilitates frequent arterial blood gas (ABG analysis. Complications include thrombosis, embolism risk, haemorrhage, sepsis, and formation of pseudo aneurysms. A 75-year-old male admitted via casualty with a collapse secondary to seizures. Patient was intubated and mechanically ventilated for 7 days. A right radial artery catheter was inserted on admission to casualty. The arterial catheter remained in situ for 7 days. Five days following its removal, the skin site appeared inflamed and a wound swab grew methicillin resistant Staphylococcus aureus (MRSA. Eight days later a distinct bulging of the radial artery was noticed. An ultrasound was done and it showed radial artery pseudoaneurysm, the diagnosis was confirmed by angiogram. Delayed radial artery pseudoaneurysm formation has only been reported in association with infection, and less than twenty of these cases have been reported in the literature.

  4. Radial artery pseudo aneurysm after percutaneous cannulation using Seldinger technique.

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    Ranganath, Anil; Hanumanthaiah, Deepak

    2011-05-01

    Cannulation of a peripheral artery in a patient allows for continuous blood pressure (BP) monitoring and facilitates frequent arterial blood gas (ABG) analysis. Complications include thrombosis, embolism risk, haemorrhage, sepsis, and formation of pseudo aneurysms. A 75-year-old male admitted via casualty with a collapse secondary to seizures. Patient was intubated and mechanically ventilated for 7 days. A right radial artery catheter was inserted on admission to casualty. The arterial catheter remained in situ for 7 days. Five days following its removal, the skin site appeared inflamed and a wound swab grew methicillin resistant Staphylococcus aureus (MRSA). Eight days later a distinct bulging of the radial artery was noticed. An ultrasound was done and it showed radial artery pseudoaneurysm, the diagnosis was confirmed by angiogram. Delayed radial artery pseudoaneurysm formation has only been reported in association with infection, and less than twenty of these cases have been reported in the literature.

  5. Immediate Bilateral Breast Reconstruction with Unilateral Deep Superior Epigastric Artery and Superficial Circumflex Iliac Artery Flaps

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    Keith S. Hansen

    2016-09-01

    Full Text Available Autologous breast reconstruction utilizing a perforator flap is an increasingly popular method for reducing donor site morbidity and implant-related complications. However, aberrant anatomy not readily visible on computed tomography angiography is a rare albeit real risk when undergoing perforator flap reconstruction. We present an operative case of a patient who successfully underwent a bilateral breast reconstruction sourced from a unilateral abdominal flap divided into deep superior epigastric artery and superficial circumflex iliac artery flap segments.

  6. Radial arterial compliance measurement by fiber Bragg grating pulse recorder.

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    Sharath, U; Shwetha, C; Anand, K; Asokan, S

    2014-12-01

    In the present work, we report a novel, in vivo, noninvasive technique to determine radial arterial compliance using the radial arterial pressure pulse waveform (RAPPW) acquired by fiber Bragg grating pulse recorder (FBGPR). The radial arterial compliance of the subject can be measured during sphygmomanometric examination by the unique signatures of arterial diametrical variations and the beat-to-beat pulse pressure acquired simultaneously from the RAPPW recorded using FBGPR. This proposed technique has been validated against the radial arterial diametrical measurements obtained from the color Doppler ultrasound. Two distinct trials have been illustrated in this work and the results from both techniques have been found to be in good agreement with each other.

  7. Superficial Circumflex Iliac Artery Perforator Flap for Dorsalis Pedis Reconstruction.

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    Tashiro, Kensuke; Yamashita, Shuji

    2017-04-01

    Reconstruction of dorsalis pedis with soft tissue is challenging because it needs to preserve thin structure to ensure that the patient will be able to wear shoes. Here, we report the use of a thin superficial circumflex iliac artery perforator (SCIP) flap in dorsalis pedis reconstruction. A 67-year-old man presented with a third-degree burn, which exposed his extensor tendons. A thin SCIP flap from the left inguinal region measuring 15 × 4 cm was transferred to the dorsalis pedis region. Postoperatively, no major cosmetic or functional problems were observed. Because the invasiveness of the donor site is nearly same between SCIP flap and skin graft from inguinal region, SCIP flap is better solution in point of textural qualities for dorsalis pedis reconstruction.

  8. Radial artery pseudoaneurysm: A rare complication after a single arterial puncture for blood-gas analysis.

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    Patel, Kajal Nitin; Gandhi, Shruti P; Sutariya, Harsh C

    2016-10-01

    With a reported incidence of 0.048%, radial artery pseudoaneurysm (PA) is a rare but serious complication of arterial cannulation. We report a case of PA developing after a single puncture of the right radial artery for arterial blood-gas analysis diagnosed by Doppler ultrasound in young male patient. The development of PA after puncture of radial artery for continuous blood pressure monitoring and serial blood-gas analysis has been reported in the past; however, to the best of our knowledge, there is only one case report of development of PA after a single arterial puncture for blood-gas analysis is reported in the past.

  9. Radial artery pseudoaneurysm: A rare complication after a single arterial puncture for blood-gas analysis

    OpenAIRE

    Kajal Nitin Patel; Shruti P Gandhi; Sutariya, Harsh C.

    2016-01-01

    With a reported incidence of 0.048%, radial artery pseudoaneurysm (PA) is a rare but serious complication of arterial cannulation. We report a case of PA developing after a single puncture of the right radial artery for arterial blood-gas analysis diagnosed by Doppler ultrasound in young male patient. The development of PA after puncture of radial artery for continuous blood pressure monitoring and serial blood-gas analysis has been reported in the past; however, to the best of our knowledge,...

  10. Endoscopic versus open radial artery harvest and mammario-radial versus aorto-radial grafting in patients undergoing coronary artery bypass surgery

    DEFF Research Database (Denmark)

    Carranza, Christian L; Ballegaard, Martin; Werner, Mads U

    2014-01-01

    , it is unknown whether the endoscopic technique results in fewer complications or a graft patency comparable to open harvest. When the radial artery has been harvested, there are two ways to use the radial artery as a graft. One way is sewing it onto the aorta and another is sewing it onto the mammary artery......) mammario-radial open surgery group; and (4) aorto-radial open surgery group.The hand function will be assessed by a questionnaire, a clinical examination, the change in cutaneous sensibility, and the measurement of both sensory and motor nerve conduction velocity at 3 months postoperatively. All...... the postoperative complications will be registered, and we will evaluate muscular function, scar appearance, vascular supply to the hand, and the graft patency including the patency of the central radial artery anastomosis. A patency evaluation by multi-slice computer tomography will be done at one year...

  11. Branch facial nerve trauma after superficial temporal artery biopsy: a case report

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    Rison Richard A

    2011-01-01

    Full Text Available Abstract Introduction Giant cell arteritis is an emergency requiring prompt diagnosis and treatment. Superficial temporal artery biopsy is the gold diagnostic standard. Complications are few and infrequent; however, facial nerve injury has been reported, leaving an untoward cosmetic outcome. This case report is to the best of our knowledge only the fourth one presented in the available literature so far regarding facial nerve injury from superficial temporal artery biopsy. Case presentation A 73-year-old Caucasian woman presented for neurological evaluation regarding eyebrow and facial asymmetry after a superficial temporal artery biopsy for presumptive giant cell arteritis-induced cephalalgia. Conclusion Damage to branches of the facial nerve may occur after superficial temporal artery biopsy, resulting in eyebrow droop. Although an uncommon and sparsely reported complication, all clinicians of various specialties involved in the care of these patients should be aware of this given the gravity of giant cell arteritis and the widespread use of temporal artery biopsy.

  12. A Case Report of Radial Artery Spasm during Anesthesia

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    M Masoudifar

    2010-01-01

    Full Text Available Introduction & objective: One of the most important drawbacks of radial artery is its tendency toward spasm and one of the rare etiologies of that is recurrent blood sampling of the artery. Other causes are injection of drugs in artery in spite of vein, or using radial artery in cardiopulmonary bypass. Papaverine is a useful drug in vasospasm, but it must be used with special caution to avoid it's complications such as arrhythmia. Case: The patient was a 72 year old man with intestinal gangrene and peritonitis whom was operated in Al-Zahra hospital in 2008. During Laparatomy surgery, because of severe acidosis, blood sampling was done 3 times for blood gas analysis. After being taken to the recovery ward, no radial pulse was detectable in the patient's right hand and severe cyanosis in the same hand was seen. After inserting the arterial catheter in brachial artery, treatment with Papaverine, indications of recovery were seen. Conclusion: Despite the rarity of radial artery spasm during anesthesia, it is very dangerous situation, and anesthesiologist must try to prohibit and be able to manage this problem and have suitable drugs in the operation room.

  13. Radial artery applanation tonometry for continuous non-invasive arterial pressure monitoring in intensive care unit patients: comparison with invasively assessed radial arterial pressure.

    Science.gov (United States)

    Meidert, A S; Huber, W; Müller, J N; Schöfthaler, M; Hapfelmeier, A; Langwieser, N; Wagner, J Y; Eyer, F; Schmid, R M; Saugel, B

    2014-03-01

    Radial artery applanation tonometry technology can be used for continuous non-invasive measurement of arterial pressure (AP). The purpose of this study was to evaluate this AP monitoring technology in intensive care unit (ICU) patients in comparison with invasive AP monitoring using a radial arterial catheter. In 24 ICU patients (German university hospital), AP values were simultaneously recorded on a beat-to-beat basis using radial artery applanation tonometry (T-Line system; Tensys Medical, San Diego, CA, USA) and a radial arterial catheter (contralateral arm). The primary endpoint of the study was to investigate the accuracy and precision of the non-invasively assessed AP measurements with the Bland-Altman method based on averaged 10 beat AP epochs (n=2993 10 beat epochs). For mean AP (MAP), systolic AP (SAP), and diastolic AP (DAP), we observed a bias (±standard deviation of the bias; 95% limits of agreement; percentage error) of +2 mm Hg (±6; -11 to +15 mm Hg; 15%), -3 mm Hg (±15; -33 to +27 mm Hg; 23%), and +5 mm Hg (±7; -9 to +19 mm Hg; 22%), respectively. In ICU patients, MAP and DAP measurements obtained using radial artery applanation tonometry show clinically acceptable agreement with invasive AP determination with a radial arterial catheter. While the radial artery applanation tonometry technology also allows SAP measurements with high accuracy, its precision for SAP measurements needs to be further improved.

  14. Radial Artery Approach to Salvage Nonmaturing Radiocephalic Arteriovenous Fistulas

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    Hsieh, Mu-Yang; Lin, Lin; Tsai, Kuei-Chin; Wu, Chih-Cheng, E-mail: chihchengwumd@gmail.com [National Taiwan University Hospital, Department of Cardiology (China)

    2013-08-01

    PurposeTo evaluate the usefulness of an approach through the radial artery distal to the arteriovenous anastomosis for salvaging nonmaturing radiocephalic arteriovenous fistulas.MethodsProcedures that fulfilled the following criteria were retrospectively reviewed: (1) autogenous radiocephalic fistulas, (2) fistulas less than 3 months old, (3) distal radial artery approach for salvage. From 2005 to 2011, a total of 51 patients fulfilling the above criteria were enrolled. Outcome variables were obtained from angiographic, clinical and hemodialysis records, including the success, complication, and primary and secondary patency rates.ResultsThe overall anatomical and clinical success rates for the distal radial artery approach were 96 and 94 %, respectively. The average procedure time was 36 {+-} 19 min. Six patients (12 %) experienced minor complications as a result of extravasations. No arterial complication or puncture site complication was noted. The postinterventional 6-month primary patency rate was 51 %, and the 6-month secondary patency rate was 90 %. When the patients were divided into a stenosed group (20 patients) and an occluded group (31 patients), there were no differences in the success rate, complication rate, or primary and secondary patency rates.ConclusionAn approach through the radial artery distal to the arteriovenous anastomosis is an effective and safe alternative for the salvage of nonmaturing radiocephalic arteriovenous fistulas, even for occluded fistulas.

  15. De quervain disease: Ibri technique to avoid superficial radial nerve injury.

    Science.gov (United States)

    Suresh, Saraswathivilasam S; Zaki, Hosam

    2009-06-01

    Tenosynovitis of the first dorsal compartment of the wrist, commonly known as de Quervain disease, is most of the time amenable to conservative treatment in form of splinting and injection of steroids into the compartment. Resistant cases need surgical release of the compartment but with high incidence of incomplete release owing to tendon anomalies and damage to the superficial branch of the radial nerve (SBRN). Many techniques evolved for a period of years, techniques using longitudinal, transverse, and oblique incisions, but damage to SBRN still remains unsolved. The authors describe a technique they have been using since 2004 and, so far, operated on 17 wrists without a single incidence of damage to the SBRN.

  16. Unexpected motor axons in the distal superficial radial and posterior interosseous nerves: a cadaver study.

    Science.gov (United States)

    Okwueze, Martina I; Cardwell, Nancy L; Wolfort, Sean L; Nanney, Lillian B

    2007-10-01

    The prevalence of motor variations in the nerves supplying muscles of the first web space was evaluated by a visual dissection and immunohistochemical analysis from 56 cadaver hands. By microscopic visualization, 30% of the superficial radial nerves (SRNs) sent branches into muscles of the first web space. Since these unexpected penetrating branches were expected to be sensory or proprioceptive, markers of sensory and motor axons were used for confirmation. Positive identifications of motor axons (as identified by positive immunostaining for choline acetyltransferase) were made in 30% of SRNs and in 28.5% of posterior interosseous nerves. Classical teachings that the SRNs and PINs are exclusively sensory have been brought into question. Our data are in agreement with the rare clinical finding that motor function occasionally persists following devastating injury to both the ulnar and median nerves. Anatomic prevalence for this variation appears much higher than previous descriptions have indicated.

  17. Total Arterial Revascularization with Internal Mammary Artery or Radial Artery Graft Configuration

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    To investigate the clinical use of π graft in total arterial revascularization and its outcomes, a retrospective analysis of 23 patients out of 1000 patients undergoing total arterial coronary bypass surgery with a π graft between September 1994 and December 2004 was performed. In the selected patients for the management of triple vessel disease with middle diagonal/intermediate ramus disease such that a skip with the left internal mammary artery (LIMA) or radial artery (RA),the main stem of π graft, to the left anterior descending coronary artery (LAD) will not work and the right internal mammary artery (RIMA) or right gastroepiploic artery (RGEA) cannot pick up the diagonal/intermediate ramus, hence the LAD and diagonal/intermediate ramus were grafted with a mini Y graft using the distal segment of LIMA, RIMA, RA or RGEA, together with the bilateral internal mammary artery (BIMA) or LIMA-RA T graft to compose π graft. Twenty-three patients (18 males, 5 females) underwent the π graft procedure. There were no deaths or episodes of myocardial infarction, stroke, and deep sternal wound infection. One patient required reopening for controlling bleeding. Until the end of 2004, during a mean follow-up of 81.0 ±28.4 months, no angina needing re-intervention or operative therapy or coronary related death occurred. In conclusion, in patients with specific coronary artery anatomy/stenosis, the BIMA (sometimes LIMA with RA or RGEA) π graft can be successfully performed for total arterial revascularization with good midterm outcomes.

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

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    Satoru Takeuchi

    2015-01-01

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

  19. Endoscopic radial artery harvesting: patient satisfaction and complications.

    Science.gov (United States)

    Nishida, Satoru; Kikuchi, Yujiro; Watanabe, Go; Takata, Munehisa; Ito, Shigeki; Kawachi, Kenji

    2008-01-01

    Endoscopic radial artery harvesting was recently introduced to reduce the morbidity associated with conventional open harvesting and improve cosmetic outcomes. From January 2004 through December 2006, 25 radial arteries were harvested endoscopically from 25 patients using the VasoView endoscopic system. Bilateral radial arteries were harvested from 6 patients by both the endoscopic and open techniques, and postoperative patient satisfaction was assessed using a visual analogue scale. Mean harvesting time was 61.9 +/- 16.0 min (range, 44-105 min), and mean harvested conduit length was 16.8 +/- 2.0 cm (range, 15-19 cm). Objective dorsal thenar numbness remained in 2 patients (8%); none complained of forearm numbness. All patients expressed marked satisfaction with the endoscopic technique and the small incision. Patient satisfaction was significantly higher with the endoscopic technique than with the open technique (visual analogue scale of 9 vs 5). Postoperative angiography revealed occlusion of a graft that had been anastomosed to a small diagonal branch. The overall graft patency was 96.6%. Endoscopic radial artery harvesting can be performed safely with infrequent complications. This method results in excellent patient satisfaction, particularly regarding the cosmetic outcome.

  20. VARIACIÓN DE LA DUREZA SUPERFICIAL DE LOS RODILLOS RADIALES DE TRANSPORTADORES YACOBI.

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    Benigno Leyva de la Cruz

    2014-06-01

    Full Text Available Uno de los problemas medulares que ha afectado la productividad de las empresas en general, es el deterioro de las piezas de sus equipamientos tecnológicos por desgastes. En tal sentido, el estudio del comportamiento de la dureza superficial de dichos componentes durante su vida útil es de vital importancia, para poder recomendar una estructura eficiente, en cuanto al material y tratamiento a seleccionar. En este trabajo se realizó un estudio sobre la variación de la dureza superficial que experimentan los rodillos radiales de transportadores yacobi durante su período de explotación. Se determinó la influencia que tienen sobre la dureza el efecto combinado de la temperatura, la fuerza, el número de revoluciones, y el régimen de enfriamiento en el acero AISI 1045, laminado y templado. Se efectuó la determinación de la dureza superficial de 12 rodillos antes y después de la puesta en explotación con un durómetro portátil modelo 316 con rango de medición de 20 – 65 HRC y apreciación 1,5 puntos, asegurando la condición de normalidad para un nivel de confianza del 95 %. Los resultados obtenidos indicarón que la dureza de los rodillos son 47,5 HRC y 41,67 HRC antes y después de la explotación respectivamente. Además, el análisis de variancia efectuado refiere que existe diferencia significativa entre los valores de la dureza superficial antes y después de la puesta en explotación, lo que indicó la necesidad de realizar un análisis minucioso de las causas que están provocando dicha variación para mejorar la calidad del proceso.

  1. RADIAL ARTERY ANOMALIES IN THE MACEDONIAN POPULATION DURING TRANSRADIAL ANGIOGRAPHY PROCEDURES

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    Zafirovska Biljana

    2016-07-01

    Full Text Available Objective: To assess the incidence of arterial anomalies of the radial artery in the Macedonian population registered during transradial access (TRA angiography procedures in a large series of patients. Background: Transradial angiography (TRA is now the recommended access for percutaneous coronary intervention, but technically is a more challenging approach for angiography procedures mostly due to the anatomic anomalies on the radial artery, which may influence the success rate of transradial angiographic procedures. Methods: All consecutive 19292 patients from our Center, in the period from March 2011 until December 2014 were examined. Preprocedural radial artery angiography was performed in all patients. Clinical and procedure characteristics, type and incidence of vascular anatomy variants and access site complications were analyzed. Results: Anatomical variants were present in 1625 (8.8% patients. The most frequent was high-bifurcating radial artery origin from the axillary and brachial arteries in 1017(5.5% patients, 227 (1.2% had extreme radial artery tortuosity, 176(0.95% had a full radial loop, 32(0.17% with hypoplastic radial artery and 173(0.9% had tortuous brachial, subclavian and axillary arteries. Radial artery spasm was very common in patients with present radial artery anomalies. Conclusion: Radial artery anomalies are very common in the general population. Knowing the anatomy of the radial artery helps the interventional cardiologist in successfully planning and performing this procedure. Radial artery angiography is strongly encouraged in every patient before the begining of the transradial angiography procedures.

  2. Iliac Artery Stent Placement Relieves Claudication in Patients with Iliac and Superficial Femoral Artery Lesions

    Energy Technology Data Exchange (ETDEWEB)

    Ichihashi, Shigeo, E-mail: shigeoichihashi@yahoo.co.jp; Higashiura, Wataru; Itoh, Hirofumi; Sakaguchi, Shoji; Kichikawa, Kimihiko [Nara Medical University, Department of Radiology (Japan)

    2013-06-15

    Purpose. To evaluate the efficacy of iliac artery stent placement for relief of claudication in patients with both iliac and superficial femoral artery (SFA) lesions. Methods. Stent placement for only iliac artery occlusive disease was performed in 94 limbs (74 patients) with both iliac and SFA occlusive disease on the same limb. All procedures were performed because intermittent claudication did not improve after continuation of antiplatelet medication therapy and home-based exercise for 3 months. Rutherford classification was 2 in 20 limbs and 3 in 74 limbs. Patients with critical limb ischemia were excluded. Median duration of follow-up was 40 months. Primary patency rates of the iliac stent, clinical improvement rates, and risk factors for requiring additional SFA procedures were evaluated. Results. Primary patency rates of the iliac stent at 1, 3, 5, and 7 years were 97, 93, 79, and 79 %, respectively. The initial clinical improvement rate was 87 %. Continued clinical improvement rates at 1, 3, 5, and 7 years were 87, 81, 69, and 66 %, respectively. SFA Trans-Atlantic Inter-Society Consensus (TASC) II C/D lesion was a significant risk factor for requiring additional SFA procedures. Conclusion. Intermittent claudication was relieved by iliac stent placement in most patients with both iliac and SFA lesions. Thus, the indications for treatment of the SFA intended for claudicants should be evaluated after treatment of the iliac lesion.

  3. The feasibility of left radial artery approach for coronary angiography

    Institute of Scientific and Technical Information of China (English)

    Liangbo Chen; Can Chen; Shian Huang

    2008-01-01

    Objective:To study the feasibility of the left radial approach for coronary angiography. Methods:195 patients diagnosed with coronary atherosclerotic heart disease were randomly divided for coronary angiography(CAG) into a left radial artery approach group(98 cases) and a fight radial artery approach group(97 cases) from Jan 2006 to Dec 2006. Selective coronary angiographies were performed with 5F TIG catheters. The time of puncturing, duration under X-ray fluoroscopy and of the operation, successful rates of puncturing and coronary angiography were recorded. Results:There was no difference in the time of puncturing(2.25 -F 1.58 min vs 2.19±1.62 min), duration under X-ray fluoroscopy(3.12±1.53 min vs 3.21±1.49 min) and the duration of the operation(12.87±2.52 rain vs 12.98±2.85 min), nor in the success rates of puncturing(95.91% vs 95.87%) and coronary angiography(94.90% vs 94.85%). Conclusion: Coronary angiography can be accomplished via the left radial artery approach, indicating that this is a worthwhile clinical approach.

  4. A Case of Urethral Reconstruction Using a Superficial Circumflex Iliac Artery

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    Kun-Woon Yoo

    2012-05-01

    Full Text Available A radial forearm free flap has been conventionally used for urethral reconstruction. However, aesthetic and functional complications occur frequently at the donor site. The use of a superficial circumflex iliac artery perforator (SCIP flap can resolve these disadvantages. Here, we report our case with a review of literature. A 69-year-old man visited our hospital with multiple contusions of the abdomen and genital amputation. After necrotic tissue debridement, the length of the residual corpus carvernosum was 1.5 cm and that of the corpus spongiosum and urethra was 1 cm. For the reconstruction of the penis, a SCIP flap and anterolateral thigh free flap was performed. The primary closure was performed at the donor site. Three weeks postoperatively, the patient had a urethral foley catheter removed. The neourethra was functioning well without stricture. Four months postoperatively, the patient had no complications such as urethral stricture. A good recovery was also achieved with no aesthetic deficits at the donor site. SCIP flap is appropriate for urethral reconstruction. Because of its proximity to the recipient sites, it makes surgical preparation easier and the primary closure at the donor site available. It is also advantageous in that its location is almost unnoticeable.

  5. New puncture needle (Seldinger technique) for easy antegrade catheterization of the superficial femoral artery

    Energy Technology Data Exchange (ETDEWEB)

    Saltzmann, J.; Probst, P.

    1987-02-01

    Mainly for anatomical reasons a guide-wire or a catheter has a tendency to turn into the deep femoral artery during antegrade catheterization of the lower limb. To overcome this problem a curved puncture needle has been designed which allows positioning of the guide-wire in an anterior direction. Antegrade catheterization of the superficial femoral artery was achieved in 25 patients without lengthy manipulations or complications. With this technique the rate of complications at antegrade catheterization will probably be reduced.

  6. Primary temporal region squamous cell carcinoma diagnosed by a superficial temporal artery biopsy

    DEFF Research Database (Denmark)

    Andersen, S A W; Kiss, K

    2015-01-01

    BACKGROUND: Superficial temporal artery biopsy is a frequent procedure performed in the diagnosis of giant cell arteritis. METHODS AND RESULTS: An otherwise healthy 69-year-old man presented with 2months complaint of right temporal region pain. Giant cell arteritis was suspected and a temporal ar...

  7. Intramuscular myxoid lipoma in the proximal forearm presenting as an olecranon mass with superficial radial nerve palsy: a case report

    OpenAIRE

    Hildebrand Kevin A; Medlicott Shaun AC; Lewkonia Peter

    2011-01-01

    Abstract Background Extremity lipomas may occur in any location, including the proximal forearm. We describe a case of a patient with an intramuscular lipoma presenting as an unusual posterior elbow mass. Case presentation We discuss the case of a 57-year-old Caucasian man who presented with a tender, posterior elbow mass initially diagnosed as chronic olecranon bursitis. A minor sensory disturbance in the distribution of the superficial radial nerve was initially thought to be unrelated, but...

  8. The anatomy of the superficial external pudendal artery: a quantitative study Anatomia da artéria pudenda superficial externa: estudo quantitativo

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    Osvaldir Lanzoni La Falce

    2006-10-01

    Full Text Available The importance of the superficial external pudendal artery in cases of lower limb obstructive arteriopathies has been established, and a perfect knowledge of its anatomy is desirable for the creation of successful flaps involving it. However, little information is available on the morphometry of this artery. PURPOSE: In this study, we conducted a quantitative investigation of the superficial external pudendal artery as the basis for skin grafts. METHOD: Twenty-five right and left sides of the inguinal region of male cadavers were dissected. After retracting the skin at the inguinal region, the femoral vessels and the sapheno-femoral junction were exposed. The following aspects were then analyzed: 1 the presence of the superficial external pudendal artery, 2 the place of origin of the superficial external pudendal artery and the common trunk, 3 the duplication of the superficial external pudendal artery, 4 the distance from the superficial external pudendal artery or the common trunk to the inguinal ligament, and 5 the diameter of the superficial external pudendal artery. RESULTS: The results were the following: 1 superficial external pudendal arteries were found in 46 of 50 sides (92%; 2 they originated from the femoral artery in 45 cases and from the deep femoral artery in only 1 case; 3 the arteries were found duplicated in 21 cases (46%, as a common trunk in 11 cases (24%, and as a single artery in 14 cases (30%; 4 the distance from the superficial external pudendal artery to the inguinal ligament ranged from 0.8 cm to 8.5 cm; from the common trunk, it ranged from 3.5 cm to 6.7 cm; 5 the diameter of the superficial external pudendal artery ranged from 1.2 mm to 3.8 mm; and 6 the diameter of the common trunk ranged from 1.35 mm to 5.15 mm. CONCLUSION: The results show that the superficial external pudendal artery generally originates from the femoral artery. It was found as a common trunk, duplicated, or as a single artery. There was a great

  9. Incidence, risk factors, treatment and prognosis of popliteal artery embolization in the superficial femoral artery interventions.

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    Weiwei Wu

    Full Text Available OBJECTIVE: Percutaneous transluminal angioplasty and stenting (PTA + stent has gained acceptance as a primary treatment modality for the superficial femoral artery (SFA diseases. Popliteal artery embolization (PAE is a severe complication in SFA interventions. The purpose of this study was to evaluate the incidence, risk factors, treatment and prognosis of PAE in primary SFA PTA + stent. METHODS: Chronic SFA arteriosclerosis cases that underwent primary PTA + stent were reviewed from a retrospectively maintained database. Runoff vessels were evaluated in all cases before and after the interventions for PAE detection. The primary patency, secondary patency and limb salvage rates were calculated using Kaplan-Meier analysis and compared using log-rank analysis. Cox multivariate regression was performed to evaluate predictors of patency and limb salvage rates. RESULTS: There were 436 lesions treated in 388 patients with 10 PAE events (2.3% in total. PAE rate was significantly higher in Transatlantic Inter-Society Consensus (TASC C/D group compared with TASC A/B group (OR = 8.91, P = .002, in chronic total occlusion (CTO lesions compared with stenotic lesions (P<.0001, and in group with history of cerebral ischemic stroke (OR = 6.11, P = .007. PAE rates were not significantly affected by age, sex, smoking, hypertension, diabetes, hyperlipidemia and runoff status. The binary logistic regression showed that only the TASC C/D was an independent predictor of PAE (P = .031. The 12-month and 24-month primary patency, secondary patency and limb salvage rates in PAE group showed no significant differences comparing with non-PAE group. CONCLUSIONS: PAE is a rare event in primary SFA PTA + stent. TASC C/D lesion, CTO and cerebral ischemic stroke history are risk factors for PAE. PAE is typically reversible by comprehensive techniques. If the popliteal flow is restored in time, PAE has no significant effect on long-term patency and limb

  10. Coronary bypass revascularization with radial artery and internal mammary artery grafts

    Institute of Scientific and Technical Information of China (English)

    甄文俊; 佟宏峰; 王永忠; 孙耀光; 黄文; 马玉健; 田家政; 吴良洪

    2002-01-01

    Objective To evaluate radial artery (RA) and internal mammary artery (IMA) grafts in coronary artery bypass and the use of color Doppler ultrasound in the peri-operative evaluation of IMA and radial-ulnar collateral circulation.Methods From June 1998 to June 2000, sixty cases of coronary bypass revascularization with RA and IMA were performed. Preoperatively, the radial-ulnar collateral circulation was evaluated with the modified Allen's test, color Doppler ultrasound and noninvasive oxygen saturation measurement. The IMA lumen and blood flow were measured at the first intercostal space with color Doppler ultrasound preoperatively and postoperatively.Results One patient (1.7%) died of serious cardiac arrhythmia on the fourth postoperative day. There were no arterial graft harvest related complications. Before harvesting, the ulnar artery blood flow was 30.78±9.71?ml/min, and it increased to 43.36±13.98?ml/min (40.87% increase, P0.05), but the systolic/diastolic flow ratio markedly decreased from 8.57±3.98?ml/min to 3.41±4.87?ml/min (P<0.01).Conclusions Arterial grafts can be safely used for coronary bypass revascularization with good results. The ulnar artery blood flow can increase compensatively after RA harvesting. The diastolic blood flow of grafted IMA markedly increased postoperatively. Color Doppler ultrasound was very helpful both in evaluating the radial-ulnar collateral circulation before RA harvesting and in assessing the patency of the grafted IMA after coronary artery bypass grafting (CABG).

  11. Neurological Study of Radial Nerve Conduction During Endoscopic Radial Artery Harvesting:An Intra‐Operative Evaluation

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    Gianluigi Bisleri

    2014-08-01

    Full Text Available Endoscopic radial artery harvesting (ERAH is a feasible and attractive minimally invasive approach for conduit procurement, however there have been concerns about a potential neurological damage occurring at the harvest limb site secondary to injury of the radial nerve during endoscopic harvesting. We present a case of ERAH in which we evaluated intraoperatively the characteristics of radial nerve conduction by means of electroneuromyography (ENM during harvesting. No pathological changes of nerve conduction were detected at the harvest limb site during surgery and postoperatively, thereby supporting the benefits of the endoscopic approach in terms of neurological outcomes following radial artery procurements with a less invasive approach.

  12. Micromorphology of Skeletonized and Pedicled Internal Thoracic and Radial Arteries.

    Science.gov (United States)

    Mamchur, Sergey; Bokhan, Nikita; Vecherskii, Yuri; Malyshenko, Egor

    2015-01-01

    The objective of the study was to estimate the internal thoracic arteries (ITA) and radial arteries (RA) micromorphologic features by light microscopy after harvesting them using the skeletonization and pedicled methods in patients undergoing coronary artery bypass grafting. The micromorphologic characteristics of ITA and RA were studied by luminous microscopy in 61 patients undergoing coronary artery bypass grafting. A total of 122 ITA and RA segments harvested during surgery, fixed in formalin, and stained with hematoxiline and eosin were evaluated. The mean intima-media thickness of ITA was 9.2 and 134.7 µm and that of RA was 9.1 and 334.2 µm, respectively. In the distal segment of ITA the media-intima relation was 1.5 times bigger than in the proximal segment. None of ITA specimens contained atherosclerotic plaques or lipid inclusions. Atherosclerotic plaques were found in 3 (5%) RA specimens. Other degenerative changes were detected in 30%-74.2% of the specimens: splitting of internal elastic lamina, reduced tortuosity of the internal elastic lamina, and thickening and detachment of the intima; their incidence was associated with the skeletonization of the vessels. In conclusion, the incidence of ITA and RA degenerative changes varies from 30%-74.2% and its increase is associated with the skeletonization of the vessels, which is statistically significant. The media of the RA is 2.5 times thicker than that of the ITA (P < 0.01). This fact shows that RA has higher spasmogenic potential than that of ITA. The distal segment of the ITA has 1.5 times bigger media-intima relation than the proximal segment. Therefore, in case of enough graft length, it is recommended to avoid the distal segment and cut it off.

  13. Systematic comparison of the effectiveness of radial artery and saphenous vein or right internal thoracic artery coronary bypass grafts in non-left anterior descending coronary arteries

    Institute of Scientific and Technical Information of China (English)

    Xiang HU; Qiang ZHAO

    2011-01-01

    Coronary artery bypass grafting surgery is increasingly being carried out on patients with multi-vessel coronary artery disease, but the best grafting candidate for non-left antetior descending coronary arteries is unclear.This research sought to systematically compare the efficacies and safeties of coronary bypass with radial artery and other available grafts. A systematic literature retrieval was performed for all clinical trials comparing the outcomes of coronary artery bypass surgery with radial artery and other grafts in PubMed, EMBASE, and the Cochrane Library.Seven eligible clinical studies, comparing radial artery and great saphenous vein grafts, were found between 1966 and 2010: one prospective non-randomized and six prospective randomized trials. The pooling analysis obtained a relative risk of 0.507 (P<0.05) of graft occlusion in radial arteries compared with great saphenous veins. There was a significantly lower infection rate in arms (i.e., harvest sites for radial arteries) relative to legs (harvest sites for veins), with a pooled relative risk of 0.140 (P<0.05). From the reports on mortality after follow-up ranging from one year to six years,there was no significant difference in mortality between the two graft types (P=0.927). In addition, four cohort controlled trials for radial and right internal thoracic artery grafts were included. The radial graft was associated with less cardiac related events relative to the right intemal thoracic artery graft (P=0.014), but with comparable mortality and comparable rates of repeat percutaneous transluminal coronary angioplasty. Subjects with radial arteries seemed to have a lower occlusion rate and a lower graft harvest site infection rate than those with great saphenous veins. Moreover there were fewer cardiac related events with radial arteries relative to the right internal thoracic artery grafts. More studies are needed to confirm these findings concerning the favorable outcomes of coronary artery

  14. Surgery Averted Using a Novel, Minimally Invasive Approach to Treat Very Severe Radial Artery Spasm

    Directory of Open Access Journals (Sweden)

    Anthony A. Cochet

    2017-01-01

    Full Text Available A 42-year-old male admitted with a non-ST elevation myocardial infarction was referred for invasive angiographic assessment. Based on preprocedural assessment, the right radial artery approach was selected. Despite possessing none of the consensus risk factors for radial artery spasm, in addition to receiving standard arterial spasm prophylaxis and conscious sedation, the patient suffered very severe radial artery spasm with initial catheter placement, resulting in entrapment of a 5 Fr pigtail catheter within the left ventricle. After exhausting traditional methods for resolution of radial artery spasm, surgical intervention appeared to be the only remaining option for removal of the entrapped catheter. Prior to committing to surgery, use of an axillary nerve block to hinder sympathetic vascular tone was suggested and attempted. This intervention resulted in atraumatic catheter removal. We present a case of very severe radial artery spasm refractory to customary interventions, alleviated with a novel, minimally invasive technique, which spared surgical intervention.

  15. Surgery Averted Using a Novel, Minimally Invasive Approach to Treat Very Severe Radial Artery Spasm.

    Science.gov (United States)

    Cochet, Anthony A; Bellin, Daniel A

    2017-01-01

    A 42-year-old male admitted with a non-ST elevation myocardial infarction was referred for invasive angiographic assessment. Based on preprocedural assessment, the right radial artery approach was selected. Despite possessing none of the consensus risk factors for radial artery spasm, in addition to receiving standard arterial spasm prophylaxis and conscious sedation, the patient suffered very severe radial artery spasm with initial catheter placement, resulting in entrapment of a 5 Fr pigtail catheter within the left ventricle. After exhausting traditional methods for resolution of radial artery spasm, surgical intervention appeared to be the only remaining option for removal of the entrapped catheter. Prior to committing to surgery, use of an axillary nerve block to hinder sympathetic vascular tone was suggested and attempted. This intervention resulted in atraumatic catheter removal. We present a case of very severe radial artery spasm refractory to customary interventions, alleviated with a novel, minimally invasive technique, which spared surgical intervention.

  16. Incidence and outcome of radial artery occlusion following transradial artery coronary angioplasty.

    Science.gov (United States)

    Stella, P R; Kiemeneij, F; Laarman, G J; Odekerken, D; Slagboom, T; van der Wieken, R

    1997-02-01

    Coronary angioplasty with 6F guiding catheters via the radial artery is associated with a minimal risk for major entry site-related complications. Although the incidence of radial artery occlusion (RAO) in the literature is approximately 30% after prolonged cannulations, little is known about the incidence and its clinical consequences of RAO following transradial percutaneous coronary angioplasty. In a prospective study, 563 patients with a normal Allen test were evaluated on patency and function of the radial artery after transradial angioplasty, by physical and ultrasound examination at discharge, and at 1 month follow-up. At discharge, 30 patients (5.3%) had clinical evidence of RAO. At follow-up, persistent RAO was found in 16 patients (2.8%). In this study we found a low incidence of RAO after transradial percutaneous coronary angioplasty. None of the patients with temporary or persistent RAO had any major clinical symptoms. Therefore, the occurrence of RAO can be considered a minor complication in patients with a previously good double blood supply to the hand.

  17. Intramuscular myxoid lipoma in the proximal forearm presenting as an olecranon mass with superficial radial nerve palsy: a case report

    Directory of Open Access Journals (Sweden)

    Hildebrand Kevin A

    2011-07-01

    Full Text Available Abstract Background Extremity lipomas may occur in any location, including the proximal forearm. We describe a case of a patient with an intramuscular lipoma presenting as an unusual posterior elbow mass. Case presentation We discuss the case of a 57-year-old Caucasian man who presented with a tender, posterior elbow mass initially diagnosed as chronic olecranon bursitis. A minor sensory disturbance in the distribution of the superficial radial nerve was initially thought to be unrelated, but was likely caused by mass effect from the lipoma. No pre-operative advanced imaging was obtained because the diagnosis was felt to have already been made. At the time of surgery, a fatty mass originating in the volar forearm muscles was found to have breached the dorsal forearm fascia and displaced the olecranon bursa. Tissue diagnosis was made by histopathology as a myxoid lipoma with no aggressive features. Post-operative recovery was uneventful. Conclusion We present a case of an unusual elbow mass presenting with symptoms consistent with chronic olecranon bursitis, a relatively common condition. The only unexplained pre-operative finding was the non-specific finding of a transient superficial radial nerve deficit. We remind clinicians to be cautious when diagnosing soft tissue masses in the extremities when unexplained physical findings are present.

  18. Radial artery applanation tonometry for continuous noninvasive arterial blood pressure monitoring in the cardiac intensive care unit.

    Science.gov (United States)

    Langwieser, Nicolas; Prechtl, Luisa; Meidert, Agnes S; Hapfelmeier, Alexander; Bradaric, Christian; Ibrahim, Tareq; Laugwitz, Karl-Ludwig; Schmid, Roland M; Wagner, Julia Y; Saugel, Bernd

    2015-06-01

    Hemodynamic monitoring plays a pivotal role in the treatment of patients in the cardiac intensive care unit (CICU). The innovative radial artery applanation tonometry technology allows for continuous noninvasive arterial blood pressure (AP) measurement. By closing the gap between continuous invasive AP monitoring (arterial catheter) and intermittent noninvasive AP monitoring (oscillometry) this technology might improve CICU patient monitoring. We therefore aimed to evaluate the measurement performance of radial artery applanation tonometry in comparison with a radial arterial catheter in CICU patients. In this prospective method comparison study, we simultaneously recorded AP noninvasively with radial artery applanation tonometry (T-line 200 pro device; Tensys Medical Inc., San Diego, CA, USA) and invasively with an arterial catheter (criterion standard) in 30 patients treated in the CICU of a German university hospital. We statistically analyzed 7,304 averaged 10-beat epochs of measurements of mean AP, systolic AP, and diastolic AP by using Bland-Altman analysis for repeated measurements. Our study revealed a mean difference ± standard deviation (95% limits of agreement; percentage error) between radial artery applanation tonometry and the criterion standard method (radial arterial catheter) of +2 ± 6 mmHg (-10 to +14 mmHg; 17%) for mean AP, -6 ± 11 mmHg (-28 to +15 mmHg; 20%) for systolic AP, and +4 ± 7 mmHg (-9 to +17 mmHg; 23%) for diastolic AP. In CICU patients, continuous noninvasive measurement of AP using radial artery applanation tonometry is feasible. The technology showed reasonable accuracy and precision in comparison with radial arterial catheter-derived AP values.

  19. Profunda Anchor Technique for Ipsilateral Antegrade Approach in Endovascular Treatment of Superficial Femoral Artery Ostial Occlusion

    Energy Technology Data Exchange (ETDEWEB)

    Pua, Uei, E-mail: druei@yahoo.com [Tan Tock Seng Hospital, Department of Diagnostic Radiology (Singapore)

    2015-04-15

    Endovascular treatment of the superficial femoral artery (SFA) is challenging in the presence of flush ostial occlusion. One of the main challenges is the availability of access sites for intervention. Contralateral retrograde femoral access followed by cross-over and antegrade intervention while commonly used, may not be feasible in cases of altered iliac anatomy (e.g. kissing iliac stents). Ipsilateral antegrade intervention using common femoral artery (CFA) access in these instances while possible is typically challenging due to inadequate working length of the CFA for interrogation of the SFA ostium, compounded by the lack of sheath stability. The “profunda anchor” technique uses a buddy wire in the profunda femoris artery (PFA) to stabilize the sheath and allow catheter manipulation for antegrade intervention at the level of the SFA ostium. The PFA is further used as a conduit for deployment of closure device to avoid interference with the treated SFA.

  20. A histological, ultrastructural and immunohistochemical study of superficial temporal arteries and middle meningeal arteries in moyamoya disease.

    Science.gov (United States)

    Li, B; Wang, C C; Zhao, Z Z; Hu, Y; Aihara, K; Ghazizadeh, M; Sasaki, Y; Yang, S Y; Pan, J

    1991-07-01

    Pathologic changes in superficial temporal arteries (STA) and middle meningeal arteries (MMA) biopsied from 15 patients with moyamoya disease (MD) who had undergone cerebro-temporal arterio-synangiosis were studied histologically, ultrastructurally and immunohistochemically. The main pathologic features were: proliferation of smooth muscle cells (SMCs) and thickening of the intima, degeneration and destruction of SMCs in the media and intima, and the presence of condensed organelles in necrosed SMCs or the interstitium among SMCs, or both outside and within the elastica interna (EI). The EI had become thin, porous, fragmented and was even absent in some segments. These changes are different from those of other forms of angiopathy, but identical with those at the ends of internal carotid arteries (ICA) reported by us previously, being pathognomonic for MD. These changes in the STA and MMA reveal that MD involves not only the ICA but also the intra- and extracranial branches of external carotid arteries. The medial necrosis of SMCs seems to be the primary injury of the arterial wall in MD. STA tissue blocks from two cases of MD were stained immunohistochemically. By electron microscopy, IgG-, IgM-, and C3-positive granules were observed on the ER of endothelial and intimal cells. Further studies on more cases are needed to determine whether an immunoreaction has occurred in these arteries.

  1. French multicenter experience with the GORE TIGRIS Vascular Stent in superficial femoral and popliteal arteries.

    Science.gov (United States)

    Sibé, Maxime; Kaladji, Adrien; Boirat, Claire; Cardon, Alain; Chaufour, Xavier; Bossavy, Jean-Pierre; Saint-Lebes, Bertrand

    2017-05-01

    Preliminary results in small single-center studies after stenting with the GORE TIGRIS Vascular Stent (W. L. Gore & Associates, Flagstaff, Ariz) show promising short-term primary patency rates, but larger, multicenter studies are needed. This study therefore investigated the performance of the GORE TIGRIS Vascular Stent at three different centers in France in patients with symptomatic peripheral artery disease. This retrospective, single-arm, multicenter cohort study included 215 patients with peripheral artery disease (Rutherford-Becker category 2-6) who were treated with the GORE TIGRIS Vascular Stent, a dual-component stent consisting of a nitinol wire frame combined with a fluoropolymer-interconnecting structure. The efficacy end point was primary patency defined by freedom from binary restenosis as derived by duplex ultrasound imaging until 2 years after the intervention. Primary, secondary, and primary assisted patency rates at 3, 6, 12, 18, and 24 months were estimated by Kaplan-Meier analysis. The GORE TIGRIS Vascular Stent was used to successfully treat 239 lesions, of which 141 lesions were located in the superficial femoral artery and 98 in the popliteal artery. Patients were a mean age of 74 ± 12 years. Mean lesion length was 86.8 ± 44.7 mm. After 12 and 24 months, the overall primary patency rates were 81.5% and 67.2%, respectively, and primary assisted patency was 94.9% and 84.8%. Secondary patency was achieved in 99.1% at 24 months. Our multicenter experience with the GORE TIGRIS Vascular Stent demonstrates continued good results at 2 years for endovascular treatment of challenging obstructive superficial femoral artery and popliteal artery disease. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  2. [Percutaneous treatment of a superficial femoral artery aneurysm using an intravascular stent-prosthesis].

    Science.gov (United States)

    Michel, C; Laffy, P Y; Leblanc, G; Riou, J Y; Chaloum, S; Maklouf, M; Le Guen, O

    1999-05-01

    One case of superficial femoral aneurysm treated percutaneously by endovascular stent graft (Passager Boston) is reported. The initial radiographic evaluation included arteriography and color doppler sonography which enable analysis of the flow path, the extent of the wall thrombus, the choice of stended graft size. The procedure of implantation was technically trouble free. The post-procedure 3D CT and arteriography demonstrated occlusion of the aneurysm and resaturation of normal flow path. The six and twelve month check confirmed the stability of the results locally and the integrity of run off vessels. In weakened and specially elderly patient percutaneous treatment of superficial femoral artery aneurysm can be carried out easily. The contribution of 3D CT is essential in follow up to ensure an optimal result and to detect any complication.

  3. Multiple digital gangrene after a radial artery penetrating injury: a case report.

    Science.gov (United States)

    Lin, Ting-Lung; Huang, Faye; Chen, Chien-Chung; Shih, Hsiang-Shun; Hsieh, Ching-Hua

    2007-05-01

    We describe the case of a young female patient who sustained a radial artery penetration injury from broken glass after falling and was managed only by external compression without arterial repair. Although the patient did not have any reported predisposing factors and the radial artery was normal as well as patent in the angiographic examination, she developed progressive multiple digital ischemia and required subsequent amputation of the gangrenous fingers. The possible mechanism might be an occlusion of the digital arteries originating from the injured radial artery by dispersion of thrombembolic particles distally during the injury as there was sparing of involvement of the ring finger, which wore a ring that restricted the thromboembolic particles from passing distally during the accident. This case revealed that particular attention should be paid to those patients with a radial artery penetration injury to facilitate early detection and implementation of therapy for possible finger ischemia and subsequent gangrene.

  4. A 6-year experience with radial artery conduit for myocardial revascularization

    Directory of Open Access Journals (Sweden)

    A Sadeghpour-Tabaee

    2007-07-01

    Full Text Available Background: Excellent long-term patencies of arterial grafts are considered, superior to those of vein grafts. In this study, we present our 6 years experience in using radial artery as a conduit for myocardial revascularization. The aim of the present study was to assess the safety and early and mid term results of using radial artery in coronary artery bypass graft. Methods: The radial artery used as a conduit in 308 cases was evaluated during past 6 years, and the results obtained were processed and analyzed. Results: The operative morbidity comprised re-operation for bleeding in 3.2%, MI in 5%, with paresthesis and stitch abscess of the hand in 10% in and 3.5% respectively. Hospital mortality included 2 patients, one case being directly due to complication of harvesting radial artery.Conclusion: The results of present study were satisfactory with acceptable morbidity and mortality and favored the application of this conduit to CABG patients.

  5. Endoscopic versus open radial artery harvest and mammario-radial versus aorto-radial grafting in patients undergoing coronary artery bypass surgery: protocol for the 2 × 2 factorial designed randomised NEO trial.

    Science.gov (United States)

    Carranza, Christian L; Ballegaard, Martin; Werner, Mads U; Hasbak, Philip; Kjær, Andreas; Kofoed, Klaus F; Lindschou, Jane; Jakobsen, Janus Christian; Gluud, Christian; Olsen, Peter Skov; Steinbrüchel, Daniel A

    2014-04-23

    Coronary artery bypass grafting using the radial artery has, since the 1990s, gone through a revival. Observational studies have indicated better long-term patency when using radial arteries. Therefore, radial artery might be preferred especially in younger patients where long time patency is important. During the last 10 years different endoscopic techniques to harvest the radial artery have evolved. Endoscopic radial artery harvest only requires a small incision near the wrist in contrast to open harvest, which requires an incision from the elbow to the wrist. However, it is unknown whether the endoscopic technique results in fewer complications or a graft patency comparable to open harvest. When the radial artery has been harvested, there are two ways to use the radial artery as a graft. One way is sewing it onto the aorta and another is sewing it onto the mammary artery. It is unknown which technique is the superior revascularisation technique. The NEO Trial is a randomised clinical trial with a 2 × 2 factorial design. We plan to randomise 300 participants into four intervention groups: (1) mammario-radial endoscopic group; (2) aorto-radial endoscopic group; (3) mammario-radial open surgery group; and (4) aorto-radial open surgery group.The hand function will be assessed by a questionnaire, a clinical examination, the change in cutaneous sensibility, and the measurement of both sensory and motor nerve conduction velocity at 3 months postoperatively. All the postoperative complications will be registered, and we will evaluate muscular function, scar appearance, vascular supply to the hand, and the graft patency including the patency of the central radial artery anastomosis. A patency evaluation by multi-slice computer tomography will be done at one year postoperatively.We expect the nerve conduction studies and the standardised neurological examinations to be able to discriminate differences in hand function comparing endoscopic to open harvest of the

  6. Aneurisma idiopático de artéria radial: relato de caso Idiopathic radial artery aneurysm: case report

    Directory of Open Access Journals (Sweden)

    Luiz Ernani Meira Jr.

    2011-12-01

    Full Text Available Os aneurismas da artéria radial são extremamente raros. Em sua maioria, consistem de pseudoaneurismas pós-traumáticos. Os aneurismas da artéria radial verdadeiros podem ser idiopáticos, congênitos, pós-estenóticos ou associados a patologias, tais como vasculites e doenças do tecido conjuntivo. Foi relatado um caso de aneurisma idiopático de artéria radial em uma criança de três anos, que, após completa investigação diagnóstica complementar, foi submetida à ressecção cirúrgica.Radial artery aneurysms are extremely rare. Post-traumatic pseudoaneurysms are the vast majority. True radial artery aneurysms can be idiopathic, congenital, poststenotic, or associated with some pathologies, such as vasculitis and conjunctive tissue diseases. We report a case of an idiopathic aneurysm of the radial artery in a three-year-old child who was submitted to surgical resection after a complete diagnostic approach.

  7. [Use of autologous superficial femoral artery in surgery for aortic prosthesis infection].

    Science.gov (United States)

    da Gama, A Dinis; Rosa, António; Soares, Mário; Moura, Carlos

    2003-01-01

    The surgical management of the aortic prosthesis infection still remains an enormous challenge for the vascular surgeon and a critical issue for the patient's integrity and life. Several techniques for its management have been devised and employed, along the years, but none of them revealed itself as totally satisfactory. This stimulates the creation of new alternatives. We present the clinical case of an infected aortic prosthesis in a 41 year old man, complicated by duodenal and ureteral erosion, in whom the autologous superficial femoral artery was employed successfully in the treatment of this most demanding situation.

  8. Symptomatic radial artery thrombosis successfully treated with endovascular approach via femoral access route

    Energy Technology Data Exchange (ETDEWEB)

    Pasha, Ahmed Khurshid [Department of Internal Medicine, University of Arizona (United States); Elder, Mahir D. [Heart and Vascular Institute, Detroit, MI (United States); Division of Cardiology, Wayne State University, Detroit, MI (United States); Malik, Umer Ejaz [Department of Internal Medicine, Texas Tech University Health Science Center at Permian Basin, TX (United States); Khalid, Abdullah Mian [Department of Internal Medicine, University of Pittsburg Medical Center, Mercy Hospital, Pittsburg, PA (United States); Noor, Zeeshan [Department of Internal Medicine, St. Joseph Mercy Hospital, Ann Arbor, MI (United States); Movahed, Mohammad Reza, E-mail: rmova@aol.com [Department of Internal Medicine, University of Arizona (United States); Sarver Heart Center, University of Arizona (United States); CareMore HealthCare, AZ (United States)

    2014-09-15

    Radial access has been increasingly utilized for coronary intervention due to higher safety profile in comparison to femoral access site with lower bleeding rate. Radial artery occlusion is not uncommon with radial access site. This usually does not lead to any harm due to ulnar artery collaterals that are sufficient to prevent hand ischemia and is usually left alone. However, in the case of significant hand ischemia, treatment is often necessary. We are reporting an interesting case of symptomatic radial artery thrombosis leading to arm ischemia that was successfully treated percutaneously using femoral access. Using femoral access for radial artery intervention has not been reported previously. This case is followed by review of the literature.

  9. Simulations of piezoelectric pressure sensor for radial artery pulse measurement

    Energy Technology Data Exchange (ETDEWEB)

    Joshi, Abhay B. [Department of Electronic Science, University of Pune, Pune 411 007 (India); Kalange, Ashok E. [Department of Electronic Science, University of Pune, Pune 411 007 (India); Tuljaram Chaturchand College, Baramati 413 102 (India); Bodas, Dhananjay, E-mail: dhananjay.bodas@gmail.co [Center for Nanobio Sciences, Agharkar Research Institute, Pune 411 004 (India); Gangal, S.A. [Department of Electronic Science, University of Pune, Pune 411 007 (India)

    2010-04-15

    A radial artery pulse is used to diagnose human body constitution (Prakruti) in Ayurveda. A system consisting of piezoelectric sensor (22 mm x 12 mm), data acquisition card and LabView software was used to record the pulse data. The pulse obtained from the sensor was noisy, even though signal processing was done. Moreover due to large sized senor accurate measurements were not possible. Hence, a need was felt to develop a sensor of the size of the order of finger tip with a resonant frequency of the order of 1 Hz. A micromachined pressure sensor based on piezoelectric sensing mechanism was designed and simulated using CoventorWare. Simulations were carried out by varying dimensions of the sensor to optimize the resonant frequency, stresses and voltage generated as a function of applied pressure. All simulations were done with pressure ranging of 1-30 kPa, which is the range used by Ayurvedic practitioners for diagnosis. Preliminary work on fabrication of such a sensor was carried out successfully.

  10. Measurement of radial artery spasm using an automatic pullback device.

    Science.gov (United States)

    Kiemeneij, F; Vajifdar, B U; Eccleshall, S C; Laarman, G; Slagboom, T; van der Wieken, R

    2001-12-01

    Current evaluation of radial artery spasm (RAS), a frequent finding during the transradial approach for coronary angiography and angioplasty (TRA), is subjective. A quantitative measure of RAS will help in evaluation and comparison of management strategies. The objectives of the study were to assess the feasibility and safety of using an automatic pullback device (APD) for removal of transradial introducer sheaths and to establish a parameter to quantify RAS. In 50 consecutive transradial procedures, the APD was used to measure the force required for sheath removal. The mean maximal pullback force (MPF) was 0.53 +/- 0.52 kg (range, 0.1-3.0 kg). In 48 (96%) cases, the MPF was reached within the first 5 sec of pullback. All patients with clinical RAS (n = 4) had an MPF greater than 1.0 kg, while the remaining had an MPF less than 1.0 kg. All patients with severe pain during sheath removal (n = 3) had an MPF greater than 1.0 kg, while no patient with an MPF less than 1.0 kg had severe pain. It is feasible and safe to remove transradial introducer sheaths using the APD. The MPF is achieved within the first 5 sec of pullback and is a reliable parameter to quantify RAS. An MPF more than 1.0 kg correlates with clinical RAS and is associated with severe pain during sheath removal.

  11. Punciones repetidas de la arteria radial para cateterismo cardíaco Repeated radial artery puncture for cardiac catheterization

    Directory of Open Access Journals (Sweden)

    Eduardo Magariños

    2007-06-01

    Full Text Available La punción percutánea de la arteria radial para la realización de procedimientos por cateterismo ha ganado aceptación debido a una eficacia similar a la obtenida con el acceso femoral. En el presente trabajo evaluamos los resultados obtenidos con la punción repetida de esta arteria. En un total de 182 accesos radiales se realizaron 17 punciones repetidas, y mediante ellas, 20 procedimientos (9 coronariografías y 11 angioplastias. Se obtuvo éxito del acceso en 15 punciones repetidas (88.2% y éxito del procedimiento en todos los casos cuando logramos éxito del acceso. Si bien el grupo es pequeño es suficiente para mostrar que la punción repetida de la arteria radial es factible y permite una alta tasa de éxito de los procedimientos con una disminución ostensible de las complicaciones locales.The radial artery approach for percutaneous cardiac interventions has gained worldwide acceptance due to the similar results obtained by the femoral artery access. In this paper, we report our experience with repeated puncture of the radial artery. One hundred and eighty two radial artery access procedures were performed, in 17 interventions the puncture was repeated once or twice, with a total of 20 therapeutic catheterizations (9 coronary angiographies, 11 angioplasties. There was no therapeutic failure through the radial approach but, we successfully gained access in 88.2% (15/17 of the re-interventions cases. Although an experience with a low number of cases, we had a very high successful therapeutic rate, and also a remarkable lowering of local complications, this shows the feasibility and potential of this technique.

  12. CT perfusion assessment of Moyamoya syndrome before and after direct revascularization (superficial temporal artery to middle cerebral artery bypass)

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Yueqin [Hospital of Qingdao University, Department of Radiology, Qingdao (China); Hospital of Jining Medical College, CT Department, Jining (China); Xu, Wenjian [Hospital of Qingdao University, Department of Radiology, Qingdao (China); Guo, Xiang; Shi, Zhitao; Sun, Zhanguo; Wang, Jiehuan [Hospital of Jining Medical College, CT Department, Jining (China); Gao, Lingyun [Hospital of Jining Medical College, MR Department, Jining (China); Jin, Feng [Hospital of Jining Medical College, Department of Neurosurgery, Jining (China); Chen, Weijian; Yang, Yunjun [Hospital of Wenzhou Medical University, Department of Radiology, Wenzhou (China)

    2016-01-15

    To evaluate the utility of CT perfusion (CTP) for the assessment of superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis in patients with Moyamoya syndrome (MMS). Twenty-four consecutive MMS patients, who underwent unilateral STA-MCA bypass surgery, received CTP before and after surgery. The relative perfusion parameter values of surgical hemispheres before treatment were compared with post-treatment values. All patients underwent CT angiography (CTA) before and after surgery in order to confirm the patency of bypass. The follow-up CTA after surgery clearly demonstrated 20 (20/24, 83.3 %) bypass arteries, whereas four (16.7 %) bypass arteries were occluded or very small. Postoperative rMTT and rTTP values (P < 0.05) of the surgical side were significantly lower than pre-operation. In patients (n = 20) with bypass patency, postoperative rCBF, rMTT and rTTP values (P < 0.05) of the surgical side were significantly improved. However, the differences of all parameters were not significant (P > 0.05) in the patients (n = 4) without bypass patency after revascularization. This study demonstrates that CTP can provide a crucial quantitative assessment of cerebral haemodynamic changes in MMS before and after STA-MCA anastomosis. (orig.)

  13. Anatomic Study of Different Way to Cutting Superficial Radial Nerve Transplanting to Repair Peripheral Nerve Defection and Functional Reconstruction of Donor Site%桡神经浅支的功能解剖学观察

    Institute of Scientific and Technical Information of China (English)

    李高峰; 田德虎; 董海涛; 刁雪鸥; 于光辉; 梁立伟

    2011-01-01

    Objective In order to provide anatomic basis for clinic using of different way of cutting superficial radial nerve transplantation and reconstructing the function of the donor site. Methods We have investigated 30 adult cadaveric upper limbs (left 15 and right 15) that fixed by Formaldehyde. Then measured the data following:the length of the superficial radial nerve ,the length of deep the superficial radial nerve ,the vertical dimension from bifurcation of superficial radial nerve to lateral antebrachial cutaneous nerve and the vertical dimension to the median nerve. Eight fresh cadaveric upper limbs were selected to perform HE staining to count nerve-tract numbers of the same horizontal of cutaneous antebrachii lateralis nerve and median nerve under a microscope. 8 cephalic vein of fresh cadaveric upper limbs were perfused with polyvinyl chloride cyclohexanone solution,then the relation of little branches of cephalic vein and superficial radial nerve was observed. Red emulsion was perfused to arteries of 8 upper limb specimen,then the length and blood supply of median nerve were observed. Results The length of radial deep the superficial radial nerve is (124.89+10. 52) mm,the length of the superficial radial nerve is (31.87+12.54) mm ,The vertical dimension from bifurcation of superficial radial nerve is to lateral antebrachial cutaneous nerve is (5. 99+1.50) mm. and the vertical dimension to the median nerve is (35.66+2.82) mm. Conclusion The superficial radial nerve not only using free grafting with blood vessel or not with blood vessel,but also using to rebuild aesthema of operating antebrachial flap. After cutting superficial radial nerve ,we can reconstruct sensory function of the donor by way of end-to-side anastomosis between far broken ends of superficial radial nerve and median nerve or and lateral antebrachial cutaneous nerve. The superficial radial nerve is a better donator nerve for curing neurologic defect.%目的 对桡神经浅支进行功能解

  14. Continuous Right Radial Arterial Pressure Monitoring as a Guide to Dissection of a Thoracic Inlet Neurofibroma.

    Science.gov (United States)

    Ravindra, Madhavi Nishtala

    2015-09-01

    Excision of tumors in the thoracic inlet entail a risk of injury to subclavian vessels due to their close proximity. A right radial artery line can sensitively and continuously monitor the occurrence of right subclavian artery compression and warn the surgeon of its proximity and prevent injury. We describe a case of thoracic inlet tumor in a 12-year-old child, wherein the use of radial artery pressure monitoring guided the surgeon to separate the subclavian artery from the tumor to which it was adherent. © The Author(s) 2015.

  15. Role of radial artery in total arterial myocardial revascularization in coronary bypass surgery

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Background Total arterial revascularization (TAR) was widely utilized in coronary artery bypass grafting (CABG) as a result of its better long-term effect compared with vein grafts.Of the arterial conduits,radial artery (RA) gained popularity for its easy availability and reported long-term patency.Thus,the objective of this study was to investigate the effect of RA in TAR in CABG.Methods From January 2000 to December 2006,85 patients (56 male and 29 female) at a mean age of 57.0±5.2 years,underwent TAR in CABG RA and left internal mammary artery (LIMA) with composite Y or T and seauential grafting techniques were used.Post-operative complications were recorded and follow-up was performed.Results Eighty-five LIMA and 149 RA grafts including 21 single and 64 bilateral RA were collected.A total of 87 distal anastomoses were done with the LIMA and another 152 were done with the RA,with the mean number of diStal anastOmosis per patient of 2.81±0.47.The proximal RA ends were anastomsed directly to the aorta in 140 grafts with Y or T graft off in situ LIMA in 9,Yor T graft off Rain 9.The distal end was anastomsed to right coronary artery system in 92,to Obtuse margma in 46,to diagonal in 19 and to ramous intermedius in 5.Nine sequential anastomoses were Derformed with RA.Nine composite Y or T grafts were constructed with RA and LIMA while another 9 were constructed with RA and RA.One (1.2%) patient died,3 patients (3.5%) experienced acute renal failure and 2 (2.4%) developed stroke.All patienfs were still alive and no patient had evidences of newly occurred myocardial infarction or angina after a mean tollow-up of 36.5±4.1 months (6-67 months).Postoperatively at 6 month,mean left ventricular ejective fraction was increased to 0.49±0.09,compared with that of 0.43±0.11 preoperatively (P=0.027).Postoperative mean New York Heart Association class was 2.5±0.5,compared with that of 3.0±0.4 preoperatively (P=0.003).Conclusions TAR with arterial conduits of which RA was

  16. A unique variation of superficial palmar arch

    Directory of Open Access Journals (Sweden)

    Jiji PJ

    2009-09-01

    Full Text Available We present a unique variation in the arterial pattern of superficial palmar arch in which it was completed by one of the large terminal branches of radial artery. The origin of the arteria radialis indicis was also peculiar that it was arising from the communicating branch of the radial artery and further reinforced by the first dorsal metacarpal artery that joined it after reaching the volar aspect. Pertinent anatomical knowledge regarding the variations of the palmar arch is significant for the purposes of microvascular repairs and re-implantations.

  17. Superficial temporal artery-middle cerebral artery bypass combined with encephalo-duro-myo-synangiosis in treating moyamoya disease: surgical techniques, indications and midterm follow-up results

    Institute of Scientific and Technical Information of China (English)

    XU Bin; SONG Dong-lei; MAO Ying; GU Yu-xiang; XU Hong; LIAO Yu-jun; LIU Chuang-hong; ZHOU Liang-fu

    2012-01-01

    Background Surgical interventions for moyamoya disease include direct and indirect revascularizations.This study aimed to evaluate the therapeutic effect of superficial temporal artery-middle cerebral artery bypass combined with an indirect revascularization procedure,encephalo-duro-myo-synangiosis,in the treatment of moyamoya disease.Methods From October 2005 to November 2009,we performed this combined revascularization procedure in 111 patients with different types and stages of moyamoya disease.The superficial temporal artery,middle meningeal artery and the deep temporal artery were evaluated for individualized surgical planning in these cases.The integrity of the deep temporal artery and the middle meningeal artery network,and the pre-existing spontaneous anastomoses of the distal branches of the external carotid artery with the cortical arteries were well preserved.The mean follow-up time was 72.5 months,all clinical and radiological data were retrospectively reviewed.Results A total of 198 stomas were performed in 122 hemispheres,all remaining patent until the last follow-up.The encephalo-duro-myo-synangiosis resulted in extensive anastomoses of the deep temporal artery (100%),the middle meningeal artery (90.9%),and the sphenopalatine artery (39.8%) with the cortical arteries,respectitvely.The superficial temporal artery,deep temporal artery,and the middle meningeal artery were significantly thickened in 88 patients as determined by digital subtraction angiography at follow-up.The relative cerebral blood flow increased significantly within one week after the operation.At 6 months post the operation,the relative cerebral blood flow was further increased by 15.5% from the gradual formation of anastomoses as a result of indirect revascularization.Transient ischemic attacks were effectively reduced or totally arrested.The neurological deficits significantly improved in 37 patients,with the National Institutes of Health Stroke Scale scores lowered by 2

  18. Late Complication after Superficial Femoral Artery (SFA) Aneurysm: Stent-graft Expulsion Outside the Skin

    Energy Technology Data Exchange (ETDEWEB)

    Pecoraro, Felice, E-mail: felicepecoraro@libero.it; Sabatino, Ermanno R.; Dinoto, Ettore; Rosa, Giuliana La; Corte, Giuseppe; Bajardi, Guido [University of Palermo, Vascular Surgery Unit (Italy)

    2015-10-15

    A 78-year-old man presented with a 7-cm aneurysm in the left superficial femoral artery, which was considered unfit and anatomically unsuitable for conventional open surgery for multiple comorbidities. The patient was treated with stent-graft [Viabhan stent-graft (WL Gore and Associates, Flagstaff, AZ)]. Two years from stent-graft implantation, the patient presented a purulent secretion and a spontaneous external expulsion through a fistulous channel. No claudication symptoms or hemorrhagic signs were present. The pus and device cultures were positive for Staphylococcus aureus sensitive to piperacillin/tazobactam. Patient management consisted of fistula drainage, systemic antibiotic therapy, and daily wound dressing. At 1-month follow-up, the wound was closed. To our knowledge, this is the first case of this type of stent-graft complication presenting with external expulsion.

  19. Partial breast reconstruction with mini superficial inferior epigastric artery and mini deep inferior epigastric perforator flaps.

    Science.gov (United States)

    Spiegel, Aldona J; Eldor, Liron

    2010-08-01

    In this study, partial breast reconstruction was undertaken after breast conservation therapy using mini abdominal free flaps on both an immediate and delayed basis.Patient demographics, oncologic status, reconstructive data, and complications were collected from medical records.Twelve patients (age range 39-60) were included in this study with a mean follow-up time of 5 years. Ten mini superficial inferior epigastric artery flaps and 2 mini deep inferior epigastric perforator flaps were used (7 immediate and 5 delayed reconstructions). No flap lost, 1 minor abdominal wound dehiscence, and no local or distant recurrences were noted. Good to excellent results were reported by 91% of the women.In properly selected patients with high motivation toward breast conservation, tailored abdominal mini-free flaps can safely and satisfactorily be implemented for the reconstruction of partial mastectomy defects. Patients should be comprehensively educated on the potential future implications of using the abdominal donor site for partial breast reconstruction.

  20. Osler's nodes, pseudoaneurysm formation, and sepsis complicating percutaneous radial artery cannulation.

    Science.gov (United States)

    Cohen, A; Reyes, R; Kirk, M; Fulks, R M

    1984-12-01

    Percutaneous arterial cannulation is useful for hemodynamic monitoring and frequent arterial blood gas determinations in selected intensive care patients. However, this procedure is not without risk. We report a case of localized Osler node formation, distal to a radial artery catheter, associated with sepsis, pseudoaneurysm formation, and thrombosis at the site of catheterization. Complications of this technique require aggressive medical and, in selected cases, surgical intervention.

  1. The role of superficial femoral artery endoluminal bypass in long de novo lesions and in-stent restenosis.

    NARCIS (Netherlands)

    Doomernik, D.E.; Golchehr, B.; Lensvelt, M.M.A.; Reijnen, M.M.P.J.

    2012-01-01

    AIM: Results of endovascular treatment for long de novo lesions of the superficial femoral artery (SFA) are limited by in-stent restenosis (ISR). Polytetrafluoroethylene (PTFE) covered stents are developed to reduce the incidence of ISR. This study was conducted to summarize available data on the us

  2. The Effect of Light Therapy on Superficial Radial Nerve Conduction Using a Clustered Array of Infrared Super luminous Diodes and Red Light Emitting Diodes

    Science.gov (United States)

    Telemeco, Todd Allen; Schrank, Edward Carl

    2013-01-01

    Introduction: Lasers, light emitting diodes (LEDs) and super luminous diodes (SLDs) are widely used to treat selected musculoskeletal, integumentary and neurological conditions.The mechanisms underlying the reported treatment effects of light therapy are unclear and the physiologic effect of light on a variety of tissues, particularly neurological, is mostly unknown. A few researchers have reported on the effects of lasers and to a lesser extent infrared LEDs on nerve conduction in superficial nerves, but there is little evidence of the effects of SLDs and red LEDs on conduction parameters of peripheral nerves. The purpose of this study was to examine the effects of a light therapy generated by cluste rprobe containing an array of infrared super luminous and red light emitting diodes on superficial radial nerve conduction. Methods: This was a single blind, randomized controlled trial conducted in an academic clinical laboratory. Thirty-two healthy participants (mean age = 25 years) were randomized to a treatment group or a placebo group. The treatment group received light irradiation through the application of a cluster probe containing 32 infrared (880nm) SLDs and 4 red (660nm) LEDs for 30 seconds at a dose of 6 J/cm2 to each of the two 5 cm2 segments of skin overlying the superficial radial nerve. The placebo group received identical set-up without the application of light irradiation. Negative peak latency (NPL) and conduction velocity (NCV) for the superficial radial nerve were measured before treatment and for 10-minutes following treatment at 2-minute intervals. Skin temperature was monitored throughout. Results: No significant differences between groups and over time for NPL, NCV, or temperature difference scores were identified. However, a significant increase in skin temperature was measured over time at each time point compared to baseline. Conclusion: Light irradiation using a cluster probe containing infrared super luminous and red light emitting diodes

  3. PTA and stent placement distal to the superficial femoral artery; PTA und Stent distal der AFS

    Energy Technology Data Exchange (ETDEWEB)

    Rand, T.; Stadler, A.; Schoder, M.; Kettenbach, J. [Medizinische Universitaet Wien, Klinische Abteilung fuer Angiographie und Interventionelle Radiologie, Wien (Austria); Haumer, M. [Klinik fuer Innere Medizin II des Universitaetsklinikums Wien, Klinische Abteilung fuer Angiologie, Wien (Austria)

    2006-11-15

    Although angioplasty and stent applications in the iliac vessels and the superficial femoral artery have become routine procedures, their usefulness for the treatment of lesions of the popliteal artery and the lower leg arteries is still under discussion. For the popliteal artery, limitations are mainly due to the high mechanical stress in this area, causing high traction forces. Moreover, beyond the occlusive atherosclerotic changes, specific pathological entities such as aneurysms, emboli, entrapment syndromes, and cystic adventitial disease have to be differentiated. There is hope that the development of innovative stent designs with high flexibility might overcome the limitations. For lesions of the lower leg arteries treatment with percutaneous transluminal angioplasty (PTA) has become the method of choice. However, stent designs as used for cardiac interventions have been adapted for their application below the knee, and first encouraging results may help to justify their broad use in the future. Regarding PTA, innovative equipment and techniques for the treatment of arterial lesions below the knee include dedicated, long, and very flexible balloons, cutting balloon cryoplasty, and laser angioplasty. Regarding stents, bare metal stents, stents with passive or active coatings, and bioabsorbable stents have all been successfully used. (orig.) [German] Waehrend Angioplastie (PTA) und Stentbehandlung im Bereich der Beckengefaesse sich zu etablierten interventionellen Standardverfahren entwickelt haben, ist die endovaskulaere Behandlung von Laesionen der A. poplitea und auch der Unterschenkelgefaesse noch in Diskussion. Gruende hierfuer sind bei der A. poplitea v. a. die unguenstigen mechanischen Faktoren, die hohe Traktionskraefte am Gefaess wirken lassen und besonders die Gefaesspathologien, die neben der stenosierenden Atherosklerose auch andere spezifische Auspraegungen wie Aneurysmen, Embolien, Entrapmentsyndrome und die zystische Adventitianekrose umfassen

  4. Acoustic hemostasis of porcine superficial femoral artery: Simulation and in-vivo experimental studies

    Science.gov (United States)

    Zeng, Xiaozheng; Mitchell, Stuart; Miller, Matthew; Barnes, Stephen; Hopple, Jerry; Kook, John; Moreau-Gobard, Romain; Hsu, Stephen; Ahiekpor-Dravi, Alexis; Crum, Lawrence A.; Eaton, John; Wong, Keith; Sekins, K. Michael

    2012-10-01

    In-vivo focused ultrasound studies were computationally simulated and conducted experimentally with the aim of occluding porcine superficial femoral arteries (SFA) via thermal coagulation. A multi-array HIFU applicator was used which electronically scanned multiple beam foci around the target point. The spatio-temporally averaged acoustic and temperature fields were simulated in a fluid dynamics and acousto-thermal finite element model with representative tissue fields, including muscle, vessel and blood. Simulations showed that with an acoustic power of 200W and a dose time of 60s, perivascular tissue reached 91°C; and yet blood reached a maximum 59°C, below the coagulation objective for this dose regime (75°C). Per simulations, acoustic-streaming induced velocity in blood reached 6.1cm/s. In in-vivo experiments, several arteries were treated. As simulated, thermal lesions were observed in muscle surrounding SFA in all cases. In dosing limited to 30 to 60 seconds, it required 257W to provide occlusion (one complete and one partial occlusion). Angiography and histology showed evidence of thrombogenesis and collagen shrinkage-based vessel constriction at these doses.

  5. Pre-ejection period by radial artery tonometry supplements echo doppler findings during biventricular pacemaker optimization

    Directory of Open Access Journals (Sweden)

    Qamruddin Salima

    2011-07-01

    Full Text Available Abstract Background Biventricular (Biv pacemaker echo optimization has been shown to improve cardiac output however is not routinely used due to its complexity. We investigated the role of a simple method involving computerized pre-ejection time (PEP assessment by radial artery tonometry in guiding Biv pacemaker optimization. Methods Blinded echo and radial artery tonometry were performed simultaneously in 37 patients, age 69.1 ± 12.8 years, left ventricular (LV ejection fraction (EF 33 ± 10%, during Biv pacemaker optimization. Effect of optimization on echo derived velocity time integral (VTI, ejection time (ET, myocardial performance index (MPI, radial artery tonometry derived PEP and echo-radial artery tonometry derived PEP/VTI and PEP/ET indices was evaluated. Results Significant improvement post optimization was achieved in LV ET (286.9 ± 37.3 to 299 ± 34.6 ms, p Conclusion An acute shortening of PEP by radial artery tonometry occurs post Biv pacemaker optimization and correlates with improvement in hemodynamics by echo Doppler and may provide a cost-efficient approach to assist with Biv pacemaker echo optimization.

  6. Morphological Assessment of Cadaveric Radial, Brachial and Subclavian Arteries: A Neurointerventional Approach

    Science.gov (United States)

    Yilmaz, Ali; Ozkul, Ayca; Shin, Dong Seong; Im, Soo-Bin; Yoon, Seok-Mann

    2015-01-01

    Objective The transradial catheterization (TRC) is becoming widespread, primarily for neurointerventions. Therefore, the evaluation of radial artery puncture in clinical practice and a better understanding of the anatomy are important to improve the safety of neuroendovascular surgery. Methods Ten formalin-fixed adult Korean cadavers were dissected to expose radial artery (RA), brachial artery (BrA) and subclvian artery (ScA), bilaterally. Vessel lengths and diameters were meaured using a caliper and distance between the specific point of vessels and the anatomical landmarks including the radial styloid process, the medial epicondyle of the humerus, the sternoclavicular joint, and the vertebral artery orifice were also measured. Results The average length between the radial (RAPS) and the BrA puncture sites (BrAPS) and between the vertebral artery orifice (VAO) and the BrA bifurcation (BrAB) did not differ between sides (p>0.05). The average length between the radial styloid process (RSP) and the RAPS was 13.41±2.19 mm, and the RSP was 26.85±2.47 mm from the median nerve (MN). The mean length between the medial epicondyle (ME) and the BrAPS as 44.23±5.47 mm, whereas the distance between the ME and the MN was 42.23±4.77 mm. The average VAO-ScA angle was 70.94±6.12°, and the length between the ScA junction (SCJ) and the VAO was 60.30±8.48 mm. Conclusion This study provides basic anatomical information about the radial artery and the brachial route and can help improving new techniques, selection of size and shape of catheters for TRC. This can help neurointerventionists who adopt a transradial neuroendovascular approach and offers comprehensive and safe care to their patients. PMID:26819682

  7. Evaluation of a spasmolytic cocktail to prevent radial artery spasm during coronary procedures.

    Science.gov (United States)

    Kiemeneij, Ferdinand; Vajifdar, Bhavesh U; Eccleshall, Simon C; Laarman, GertJan; Slagboom, Ton; van der Wieken, Ron

    2003-03-01

    Radial artery spasm is a frequent complication of the transradial approach for coronary angiography and angioplasty. Recently, we have been able to quantify spasm using the automatic pullback device. The objective of this study was to assess the efficacy of an intra-arterial vasodilating cocktail in reducing the incidence and severity of radial artery spasm. A hundred patients undergoing coronary procedures via the radial artery were divided into two groups of 50 each. Patients in group A received intra-arterial cocktail (5 mg of verapamil plus 200 micro g nitroglycerine in 10 ml of normal saline), while patients in group B did not receive any vasodilating drug. The pullback device was used for sheath removal at the end of the procedure. Seven (14%) patients in group A experienced pain (i.e., pain score of III-V) during automatic sheath removal, as compared to 17 (34%) in group B (P = 0.019). The mean pain score was significantly lower in group A than in group B (1.7 +/- 0.94 vs. 2.08 +/- 1.07; P = 0.03). The maximal pullback force (MPF) was also significantly lower for group A (0.53 +/- 0.52 kg; range, 0.10-3.03 kg) as compared to group B (0.76 +/- 0.45 kg; range, 0.24-1.99 kg; P = 0.013). Only 4 (8%) patients in group A had an MPF value greater than 1.0 kg, suggesting the presence of significant radial artery spasm, as opposed to 11 (22%) in group B (P = 0.029). Administration of an intra-arterial vasodilating cocktail prior to sheath insertion reduces the occurrence and severity of radial artery spasm.

  8. Intra-arterial vasodilators to prevent radial artery spasm: a systematic review and pooled analysis of clinical studies

    Energy Technology Data Exchange (ETDEWEB)

    Kwok, Chun Shing, E-mail: shingkwok@doctors.org.uk [Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent (United Kingdom); Rashid, Muhammad [St. Helens & Knowsley Teaching Hospital (NHS) Trust, Whiston Hospital, Prescot (United Kingdom); Fraser, Doug [Manchester Heart Centre, Manchester Royal Infirmary (United Kingdom); Nolan, James [University Hospital of North Midlands, Stoke-on-Trent (United Kingdom); Mamas, Mamas [Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent (United Kingdom); Farr Institute, Institute of Population Health, University of Manchester, Manchester (United Kingdom)

    2015-12-15

    Objectives: The aim of this study is to review the available literature on the efficacy and safety of agents used for prevention of RAS. Background: Different vasodilator agents have been used to prevent radial artery spasm (RAS) in patients undergoing transradial cardiac catheterization. Methods: We included studies that evaluated any intra-arterial drug administered in the setting cardiac catheterization that was undertaken through the transradial access site (TRA). We also compared studies for secondary outcomes of major bleeding, procedure time, and procedure failure rate in setting of RAS prevention, patent hemostasis and radial artery occlusion. Results: 22 clinical studies met the inclusion criteria. For placebo, RAS rate was 12% (4 studies, 638 participants), which was similar to 2.5 mg of verapamil 12% (3 studies, 768 participants) but greater than 5 mg of verapamil (4%, 2 studies, 497 participants). For nicorandil, there was a much higher RAS rate compared to placebo (16%, 3 studies, 447 participants). The lowest rates of RAS was found for nitroglycerin at both 100 μg (4%) and 200 μg (2%) doses, isosorbide mononitrate (4%) and nicardipine (3%). We found no information regarding the procedure failure rates, patent hemostasis, and radial artery occlusion in these studies. Conclusions: In this largest and up-to-date review on intra-arterial vasodilators use to reduce RAS, we have found that the verapamil at a dose of 5 mg or verapamil in combination with nitroglycerine are the best combinations to reduce RAS. - Highlights: • Radial artery spasm (RAS) causes procedural failure in transradial catheterization. • RAS may complicate 10–15% procedures undertaken through the radial approach. • We reviewed the efficacy of vasodilators that have been used to minimize RAS. • The pooled RAS rate was lowest with 5 mg of verapamil (4%) compared to placebo (12%). • The best combination of drugs to minimize RAS is nitroglycerine and verapamil.

  9. Severe atherosclerosis of the radial artery in a free radial forearm flap precluding its use.

    NARCIS (Netherlands)

    Bree, de R.; Quak, J.J.; Kummer, J.A.; Simsek, S.; Leemans, C.R.

    2004-01-01

    The free radial forearm flap is the most frequently used free flap for head and neck reconstructions. Survival of free flaps is dependent on adequate blood supply. A 69-year old woman was scheduled for excision of a T3N0M0 oropharyngeal carcinoma, neck dissections and reconstruction with a free vasc

  10. Superficial temporal artery-middle cerebral artery bypass surgery in a pediatric giant intracranial aneurysm presenting as migraine-like episodes.

    Science.gov (United States)

    Goedee, H S; Depauw, P R A M; vd Zwam, B; Temmink, A H

    2009-02-01

    Aneurysms of the intracranial arteries in the pediatric population are reportedly rare. There is a male predominance, association with connective tissue disorders, as well as bacterial, mycotic infections, and trauma. Common sites of presentation are the internal carotid artery bifurcation, posterior circulation, and distal segment of middle cerebral artery. Clinical manifestations can vary from seizures and subarachnoidal hemorrhage to headache, irritability, lethargy, vomiting, or focal motor deficits. Current treatment modalities encompass endovascular or surgical approach. We present a case report on an 11-year-old girl with migraine-like episodes due to an underlying giant fusiform middle cerebral artery aneurysm treated successfully with two superficial temporal artery-middle cerebral artery bypasses.

  11. The value of arterial pressure waveform cardiac output measurements in the radial and femoral artery in major cardiac surgery patients

    NARCIS (Netherlands)

    van Drumpt, A.; J. van Bommel (Jasper); S.E. Hoeks (Sanne); F. Grüne (Frank); T. Wolvetang (Timothy); J.A. Bekkers (Jos); M. Horst, ter (Maarten)

    2017-01-01

    textabstractBackground: A relatively new uncalibrated arterial pressure waveform cardiac output (CO) measurement technique is the Pulsioflex-ProAQT® system. Aim of this study was to validate this system in cardiac surgery patients with a specific focus on the evaluation of a difference in the radial

  12. Radial artery cannulation. Potential hazard in patients with acromegaly.

    Science.gov (United States)

    Campkin, T V

    1980-10-01

    Using Allen's test, impaired ulnar artery circulation to one or both hands was detected pre-operatively in five out of ten acromegalic patients scheduled for transphenoidal hypophysectomy. Three of these patients also had symptoms of compression of the median nerve at the wrist (carpal tunnel syndrome). If ulnar flow is considered to be inadequate cannulation of a dorsalis pedis artery provides one possible alternative route for continuous measurement of the blood pressure during induced hypotension. In the three patients in this report in whom this vessel was cannulated no ischaemic complications in the foot were seen.

  13. Successful Treatment of Two Cases of Squamous Cell Carcinoma on the Ear with Intra-Arterial Administration of Peplomycin through a Superficial Temporal Artery

    Directory of Open Access Journals (Sweden)

    Takahiro Haga

    2014-09-01

    Full Text Available Cutaneous squamous cell carcinoma (SCC is the second most common non-melanoma skin cancer and tends to develop in sun-exposed cosmetic areas, including the ear. In this report, we describe two cases of SCC on the ear successfully treated with intra-arterial administration of peplomycin through a superficial temporal artery. In addition to this selective chemotherapy, we administered oral tegafur, which achieved complete remission of the tumor. These findings suggest that intra-arterial administration of peplomycin with tegafur is one of the optimal therapies for the treatment of SCC developing on the ear.

  14. Twelve months follow-up after retrograde recanalization of superficial femoral artery chronic total occlusion

    Directory of Open Access Journals (Sweden)

    Joanna Wojtasik-Bakalarz

    2017-03-01

    Full Text Available Introduction : Fifty percent of cases of peripheral artery disease are caused by chronic total occlusion (CTO of the superficial femoral artery (SFA. Ten–fifteen percent of percutaneous SFA recanalization procedures are unsuccessful. In those cases the retrograde technique can increase the success rate of the procedure, but the long-term follow-up of such procedures is still unknown. Aim : To assess the efficacy and clinical outcomes during long-term follow-up after retrograde recanalization of the SFA. Material and methods: We included patients after at least one unsuccessful percutaneous antegrade recanalization of the SFA. Patients were evaluated for the procedural and clinical follow-up of mean time 13.9 months. Results: The study included 17 patients (7 females, 10 males who underwent percutaneous retrograde recanalization of the SFA from June 2011 to June 2015. The mean age of patients was 63 ±7 years. Retrograde puncture of the distal SFA was successful in all cases. A retrograde procedure was performed immediately after antegrade failure in 4 (23.5% patients and after a previously failed attempt in 13 (76.5% patients. The procedure was successful in 15 (88.2% patients, and unsuccessful in 2 (11.8% patients. Periprocedural complications included 1 peripheral distal embolization (successfully treated with aspiration thrombectomy, 1 bleeding event from the puncture site and 7 puncture site hematomas. During follow-up the all-cause mortality rate was 5.8% (1 patient, non-cardiac death. The primary patency rate at 12 months was 88.2% and secondary patency 100%. Conclusions : The retrograde SFA puncture seems to be a safe and successful technique for CTO recanalization and is associated with a low rate of perioperative and long-term follow-up complications.

  15. In vivo imaging of superficial femoral artery (SFA) stents for deformation analysis

    Science.gov (United States)

    Ganguly, A.; Schneider, A.; Keck, B.; Bennett, N. R.; Fahrig, R.

    2008-03-01

    A high-resolution (198 μm) C-arm CT imaging system (Axiom Artis dTA, Siemens Medical Solutions, Forchheim, Germany) was optimized for imaging superficial femoral artery (SFA) stents in humans. The SFA is susceptible to the development of atherosclerotic lesions. These are typically treated with angioplasty and stent deployment. However, these stents can have a fracture rate as high as 35%. Fracture is usually accompanied by restenosis and reocclusion. The exact cause of breakage is unknown and is hypothesized to result from deforming forces due to hip and knee flexion. Imaging was performed with the leg placed in both straight and bent positions. Projection images obtained during 20 s scans with ~200° of rotation of the C-arm were back-projected to obtain 3D volumes. Using a semi-automatic software algorithm developed in-house, the stent centerlines were found and ellipses were fitted to the slice normals. Image quality was adequate for calculations in 11/13 subjects. Bending the leg was found to shorten the stents in 10/11 cases with the maximum change being 9% (12 mm in a 133 mm stent), and extend the stent in one case by 1.6%. The maximum eccentricity change was 36% with a bend angle of 72° in a case where the stent extended behind the knee.

  16. Drug-coated balloons are replacing the need for nitinol stents in the superficial femoral artery.

    Science.gov (United States)

    Kitrou, Panagiotis; Karnabatidis, Dimitrios; Katsanos, Konstantinos

    2016-08-01

    Amassed evidence from several randomized controlled trials and high quality meta-analyses clearly support the primary use of paclitaxel-coated balloons (PCB) in the superficial femoral artery over traditional plain balloon angioplasty or primary bare nitinol stenting with significantly lower vascular restenosis, less need for repeat procedures, improved quality of life and potential cost savings for the healthcare system. Stents may be reserved for bail-out in case of a suboptimal dilatation result, and for selected more complex lesions, or in case of critical limb ischemia in order to eliminate vessel recoil and maximize immediate hemodynamic gain. Debulking atherectomy remains unproven, but holds a lot of promise in particular in combination with PCBs, in order to improve compliance of the vessel wall by plaque removal, allow for a better angioplasty result and optimize drug transfer and bioavailability. The present overview summarizes and discusses current evidence about femoropopliteal PCB angioplasty compared to the historical standard of plain old balloon angioplasty and bare nitinol stents. Available evidence is appraised in the context of clinically meaningful results, relevant unresolved issues are highlighted, and future trends are discussed.

  17. PROLONGED RADIAL ARTERY SPASM IN THE CATHETERIZATION LABORATORY - RELIEF BY PHARMACOLOGICAL INTERVENTION

    Directory of Open Access Journals (Sweden)

    Krishna Kumar

    2010-11-01

    Full Text Available Radial spasm is often very prolonged and painful to the patient. Here, we describe a novel way to deal with the same. The total spasm lasted over 4 hours. A 3.4 6 JR catheter was introduced via the femoral route and papav arine one ampoule was injected directly into the right subclavian artery. After about 10 min we were able to pull out the radial catheter. Radial angiography is a simple procedure with reportedly less complications 1,2. How ever ,it has one major complication radial spasm. We describe here a patient with radial spasm that persisted for more than 2 hours and how we dealt with it.

  18. Arterial Myocardial Revascularization Using Bilateral Radial Arte 17 Years after Right Pneumonectomy

    Science.gov (United States)

    Erdil, Nevzat; Nisanoglu, Vedat; Toprak, Huseyin Ilksen; Erdil, Feray Akgul; Kuzucu, Akin; Battaloglu, Bektas

    2004-01-01

    We report the case of a 51-year-old man who underwent arterial myocardial revascularization with the use of bilateral radial arteries, 17 years after undergoing a right pneumonectomy. We used a fast-track anesthesia protocol for the procedure. There was no perioperative complication, and postoperative recovery was uneventful. The patient was discharged from the hospital 5 days after the operation. PMID:15061636

  19. Brachiomedian artery (arteria brachiomediana revisited: a comprehensive review

    Directory of Open Access Journals (Sweden)

    David Kachlik

    2016-03-01

    Full Text Available This article reviews in detail the superficial brachiomedian artery (arteria brachiomediana superficialis, a very rare variant of the main arterial trunks of the upper limb. It branches either from the axillary artery or the brachial artery, descends superficially in the arm (similar to the course of the superficial brachial artery and continues across the cubital fossa, runs superficially in the forearm, approaches the median nerve and enters the carpal canal to reach the hand. It usually terminates in the superficial palmar arch. The first drawing was published, in 1830, and the first description was published, in 1844. Altogether, to our knowledge, only 31 cases of a true, superficial brachiomedian artery have been reported (Some cases are incorrectly reported as superficial brachioradiomedian artery or superficial brachioulnomedian artery. Based on a meta-analysis of known, available studies, the incidence is 0.23% in Caucasians and 1.48% in Mongolians. Knowing whether or not this arterial variant is present is important in clinical medicine and relevant for: The catheterization via the radial or ulnar artery; harvesting the vascular pedicle for a forearm flap based on the radial, ulnar or superficial brachiomedian arteries; the possible collateral circulation in cases of the arterial closure; and the surgical management of carpal tunnel syndrome. Its presence can elevate the danger of an injury to the superficially located variant artery or of an accidental injection.

  20. Single stage reconstruction of ruptured tendoachilles tendon with skin cover using distally based superficial sural artery flap.

    Science.gov (United States)

    Abhyankar, Suhas V; Kulkarni, Ananta; Agarwal, Naveen Kumar

    2009-10-01

    Ruptured tendoachilles along with skin defect is a complex problem to reconstruct. Both things require a priority. Single stage reconstruction of ruptured tendoachilles tendon with skin cover using distally based superficial sural arterial flap allows us to perform both. This procedure gives excellent result, shortens the stay, thereby reducing the cost. This method is a simple solution to the complex problem like ruptured tendoachilles with skin defect. In this study, 6 patients with rupture of tendoachilles tendon due to penetrating injury, with skin defect are presented. The repair was done using aponeurotic part of tendoachilles tendon, taken from proximal part of tendoachilles in the midline measuring around 2 to 2.5 cm in width and 8 to 10 cm in length, with intact distal attachment. The tendon was turned upside down by 180 degrees and sutured to the distal stump of the tendoachilles tendon without tension. The skin defect was covered using distally based superficial sural artery flap in the same sitting. The follow-up period was 9 to 30 months. All patients showed good results. In one patient there was distal necrosis of 1.5 cm of the distally based superficial sural artery flap, which healed satisfactorily with conservative treatment. Single stage tendoachilles reconstruction can be used with good functional result and patient satisfaction.

  1. Elastic properties and structure of the radial artery in patients with type 2 diabetes.

    Science.gov (United States)

    Catalano, M; Scandale, G; Minola, M; Carzaniga, G; Carotta, M; Perilli, E; Dimitrov, G; Cortellazzo, A; Cinquini, M

    2009-10-01

    Alterations of elastic properties may contribute to the accelerated atherosclerosis in patients with T2D. Little is known, however, about radial artery distensibility in this patient group. A total of 19 patients with T2D and 19 controls were investigated.An echotracking system coupled to a plethysmograph was used to assess the morphologic and elastic properties of radial artery. Distensibility and compliance were evaluated using Langewouters' equations. Distensibility and compliance did not differ significantly in patients with diabetes compared with controls. In contrast, radial IMT and WCSA were significantly higher in patients with T2D than in controls. Multiple regression analyses revealed a significant association between SBP and IMT (r(2) = 0.40, p<0.001) as well as WCSA (r = 0.54; r(2) = 0.30; p<0.001 ) in individuals with diabetes. In conclusion, distensibility and compliance of the radial artery are not reduced in patients with T2D. In contrast, radial IMT and WCSA are significantly higher in patients with T2D than in controls.These modifications are chiefly and positively related to SBP.

  2. A Neural Network for Estimation of Aortic Pressure from the Radial Artery Pressure Pulse

    Science.gov (United States)

    2001-10-25

    from periphery to artery: a model based study, American Journal of Physiology, 1998,274:43, pp H1386-92 [9] C. Chen, E. Nevo , B Fetics, P Pak, F, Yin, L...36. [10] B Fetics, E Nevo , C. Chen, D Kass, Parametric model derivation of transfer function for noninvasive estimation of aortic pressure by radial

  3. Percutaneous radial intervention for complex bilateral renal artery stenosis using paclitaxel eluting stents.

    Science.gov (United States)

    Granillo, Gastón A Rodriguez; van Dijk, Lukas C; McFadden, Eugène P; Serruys, Patrick W

    2005-01-01

    Techniques used in the coronary circulation may be useful in peripheral intervention. We report a case of bilateral renal artery stenosis treated via a radial approach by direct stenting with distal protection at a right ostial lesion and modified crush stenting at a left renal bifurcation lesion using paclitaxel-eluting stents.

  4. Development of a Tonometric Sensor with a Decoupled Circular Array for Precisely Measuring Radial Artery Pulse.

    Science.gov (United States)

    Jun, Min-Ho; Kim, Young-Min; Bae, Jang-Han; Jung, Chang Jin; Cho, Jung-Hee; Jeon, Young Ju

    2016-05-26

    The radial artery pulse is one of the major diagnostic indices used clinically in both Eastern and Western medicine. One of the prominent methods for measuring the radial artery pulse is the piezoresistive sensor array. Independence among channels and an appropriate sensor arrangement are important for effectively assessing the spatial-temporal information of the pulse. This study developed a circular-type seven-channel piezoresistive sensor array using face-down bonding (FDB) as one of the sensor combination methods. The three-layered housing structure that included independent pressure sensor units using the FDB method not only enabled elimination of the crosstalk among channels, but also allowed various array patterns to be created for effective pulse measurement. The sensors were arranged in a circular-type arrangement such that they could estimate the direction of the radial artery and precisely measure the pulse wave. The performance of the fabricated sensor array was validated by evaluating the sensor sensitivity per channel, and the possibility of estimating the blood vessel direction was demonstrated through a radial artery pulse simulator. We expect the proposed sensor to allow accurate extraction of the pulse indices for pulse diagnosis.

  5. CryoPlasty therapy of the superficial femoral and popliteal arteries: a single center experience.

    Science.gov (United States)

    Samson, Russell H; Showalter, David P; Lepore, Michael R; Ames, Scott

    Long-term patency remains a significant hurdle in the minimally invasive treatment of arteriosclerosis in the superficial femoral and popliteal arteries. New technologies designed to address the sources of restenosis have recently been introduced. CryoPlasty therapy (Boston Scientific, Natick, Mass) is a new approach designed to significantly reduce injury, elastic recoil, stent implantation, neointimal hyperplasia, and constrictive remodeling. The technique combines the dilatation forces of percutaneous transluminal angioplasty with cold thermal energy applied to the plaque and vessel wall. The cumulative effect of limiting the sources of restenosis with CryoPlasty therapy was shown to demonstrate longer term patency in a prospective, multicenter, Investigational Device Exemption study of the PolarCath Peripheral Dilatation System. The CryoPlasty therapy experience of 1 center is reported, in which 47 lesions in 32 consecutive patients (34 procedures, 33 limbs) were treated. The technical success rate was 96%. There were no type 3 flow-limiting dissections, and only 4 (8.5%) lesions were stented. There were no unanticipated adverse events, specifically no thrombus, acute occlusions, distal embolizations, aneurysms, or groin complications. With an average follow-up of 12 months, only 5 lesions have recurred, 4 requiring re-intervention. The 12-month freedom from restenosis for lesions and limbs treated was 82.2% and 84.4%, respectively. These results are similar to the findings of the Investigational Device Exemption study and are encouraging. CryoPlasty therapy appears to be a viable endovascular therapeutic option to achieve longer term patency without compromising options for future interventions. The lack of early occlusions may be due to a low rate of spiral dissection that may be a particular benefit of this form of angioplasty.

  6. Anatomical variants of the superficial temporal artery in patients with microtia: a pilot descriptive study

    Science.gov (United States)

    Yong, Chong Kong; Das, Srijit; Huei, Yap Lok

    2016-01-01

    Superficial temporal artery (STA) based pedicled fascial flap plays a pivotal role in ear reconstruction for microtia patients. There is paucity of literature on the anatomy of the STA in microtia patients. The present study aimed to describe any possible anatomical variations seen in the STA of patients afflicted with microtia. Pre-operative carotid computer tomographic angiography images of patients under the microtia database of Plastic and Reconstructive Surgery Unit at a tertiary medical centre were selected and 3-dimensionally reconstructed. Measurements were made on the 3D reconstructed computed tomographic angiography images of the STA on both the sides of the microtic ear and the non-microtic ear to assess its various anatomical parameters. We managed to obtain a total of 39 computed tomographic angiography images of STAs for analysis. There was a significant difference in the number of main branches of STA between the two groups (P=0.006). The proportion of ears with 2 main branches was higher in the non-microtia group (89.5%) compared to the microtia group (45.0%). A significant difference was found in the STA diameter between the two groups (P=0.012). The mean diameter of STA in the non-microtia group was larger by 0.4 mm. Furthermore, the median angle of STA was larger on the side of the non-microtic ears compared to that of microtic ears by 24.5°, with a P-value of 0.011. The results of the study may be of clinical importance while planning and performing ear reconstructive surgeries using STA based pedicled fascial flaps. PMID:28127502

  7. UNILATERAL INCOMPLETE SUPERFICIAL PALMAR ARCH: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Subhankar Chakraborty

    2015-12-01

    Full Text Available The functional importance of hand is revealed by its rich vascularity contributed by superficial and deep palmar arches (SPA and DPA.Superficial palmar arch is located superficial to flexor tendons, and deep palmar arch deep to lumbrical muscles. Variations are found more often in SPA than DPA, later being more or less constant. During routine undergraduate dissection, we observed, unilateral incomplete SPA being formed by superficial palmar branches of ulnar and radial artery in the right hand of a male cadaver. These two arteries remained independent without anastomosis forming incomplete arch (SPA.The superficial branch of ulnar artery entered hand superficial to flexor retinaculum and supplied middle, ring and little finger by three branches. The superficial branch of radial artery via its two branches supplied index finger and thumb. Classical SPA formation was seen on left side. The presence of an incomplete SPA as in this case is a potential danger in RA harvesting for CABG.Variations in SPA play a pivotal role in microvascular surgical procedures of hand, RAinterventions and arterial graft applications.

  8. A Case of Urethral Reconstruction Using a Superficial Circumflex Iliac Artery

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    Kun-Woon Yoo

    2012-05-01

    Full Text Available A radial forearm free flap has been conventionally used for urethral reconstruction. However,aesthetic and functional complications occur frequently at the donor site. The use of asuperficial circumflex iliac artery perforator (SCIP flap can resolve these disadvantages.Here, we report our case with a review of literature. A 69-year-old man visited our hospitalwith multiple contusions of the abdomen and genital amputation. After necrotic tissuedebridement, the length of the residual corpus carvernosum was 1.5 cm and that of thecorpus spongiosum and urethra was 1 cm. For the reconstruction of the penis, a SCIP flap andanterolateral thigh free flap was performed. The primary closure was performed at the donorsite. Three weeks postoperatively, the patient had a urethral foley catheter removed. Theneourethra was functioning well without stricture. Four months postoperatively, the patienthad no complications such as urethral stricture. A good recovery was also achieved withno aesthetic deficits at the donor site. SCIP flap is appropriate for urethral reconstruction.Because of its proximity to the recipient sites, it makes surgical preparation easier and theprimary closure at the donor site available. It is also advantageous in that its location isalmost unnoticeable.

  9. Randomized Trial of the SMART Stent versus Balloon Angioplasty in Long Superficial Femoral Artery Lesions: The SUPER Study

    Energy Technology Data Exchange (ETDEWEB)

    Chalmers, Nicholas, E-mail: nicholas.chalmers@cmft.nhs.uk [Manchester Royal Infirmary, Department of Radiology (United Kingdom); Walker, Paul T. [James Cook University Hospital, Department of Radiology (United Kingdom); Belli, Anna-Maria [St. George' s Healthcare NHS Trust, Department of Radiology (United Kingdom); Thorpe, Anthony P. [Aberdeen Royal Infirmary, Department of Radiology (United Kingdom); Sidhu, Paul S. [King' s College Hospital, Department of Radiology (United Kingdom); Robinson, Graham [Hull Royal Infirmary, Department of Radiology (United Kingdom); Ransbeeck, Mariella van [Johnson and Johnson Medical NV/SA, Cordis (Belgium); Fearn, Steven A. [Johnson and Johnson Medical Ltd., Cordis (United Kingdom)

    2013-04-15

    To determine whether primary stenting reduces the rate of restenosis compared with balloon angioplasty alone in the endovascular treatment of long superficial femoral artery lesions; and to assess the effect of treatment on quality of life. A total of 150 patients with superior femoral artery occlusion or severe stenosis of 5-22 cm length from 17 UK centers were randomized to either primary stenting with the SMART stent or balloon angioplasty (i.e., percutaneous transluminal angioplasty, PTA). Bailout stent placement was permitted in case of inadequate result from PTA. The primary end point was restenosis measured by duplex ultrasound at 1 year. Quality-of-life assessments were performed by the EuroQol (EQ)-5D questionnaire. Mean lesion length was 123.0 mm in the stent group and 116.8 mm in the PTA group. A total of 140 (93.3 %) of 150 had total occlusions. At 12 months' follow-up, restenosis measured by Duplex ultrasound was not significantly different between the stent and PTA groups by intention-to-treat or as-treated analyses: 47.2 versus 43.5 % (p = 0.84) and 40.8 versus 46.7 % (p = 0.68), respectively. There were fewer target lesion revascularizations in patients randomized to stenting, but this did not reach statistical significance (12.5 vs. 20.8 %, p = 0.26). There was no difference in the rate of amputation. Patients in both groups reported improved quality of life. Primary stenting of long lesions in predominantly occluded superficial femoral arteries does not reduce the rate of binary restenosis compared with balloon angioplasty and bailout stenting. Both treatment strategies conferred a meaningful and sustained improvement to the quality of life of patients with severe superficial femoral artery disease.

  10. Patent haemostasis prevents radial artery occlusion in patients with an acute coronary syndrome.

    Science.gov (United States)

    Wilson, Simon J; Mitchell, Andrew; Gray, Timothy J M; Loh, Hoe Jun; Cruden, Nick L

    2017-08-01

    A haemostatic technique that maintains radial artery flow ("patent haemostasis") following transradial catheterization reduces rates of radial artery occlusion (RAO) in patients with stable coronary disease. It is unclear whether this benefit extends to patients with an acute coronary syndrome (ACS). Patients undergoing inpatient transradial catheterization for an ACS were prospectively enrolled in a consecutive cohort study (n=300). Radial haemostasis was obtained using standard radial compression (cohort 1; n=150) or patent haemostasis (cohort 2; n=150). An end-of-case activated clotting time (ACT) was recorded and radial artery patency assessed within 24 hours of sheath removal by reverse Barbeau's test. The incidence of RAO was 16.0% following standard radial compression and 5.3% following patent haemostasis (p=0.003). Univariate predictors of RAO were patent haemostasis (OR 0.30; [0.13-0.68], p=0.004), hyperlipidaemia (OR 0.46; [0.21-0.98], p=0.04), history of current smoking (OR 2.86; [1.3-6.0], p=0.015) and longer procedure times (OR 1.03/additional minute; [1.01-1.05], p=0.003). There was no association between the end-of-case ACT and RAO (OR 1.00; [0.9-1.01] p=1.00). After adjusting for covariates, patent haemostasis reduced the risk of RAO by 70% compared to standard compression (OR 0.30; [0.12-0.77], p=0.12). The c-statistic for model discrimination was 0.79 (95% CI [0.71-0.86], ppatent haemostasis as an independent predictor of reduced RAO (OR 0.38 [0.15-0.95], p=0.039). Patent haemostasis is highly effective in preventing early RAO in patients with ACS. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Features and variations of a radial artery approach in southern Chinese populations and their clinical significance in percutaneous coronary intervention

    Institute of Scientific and Technical Information of China (English)

    LI Lang; ZENG Zhi-yu; ZHONG Ji-ming; WU Xiang-hong; ZENG Shu-yi; TANG Er-wen; CHEN Wei

    2013-01-01

    Background More and more percutaneous coronary intervention were done from radial artery approach.But the great limitation of radial artery approach and main failure cause of transradial coronary intervention is smaller size and more variations of a radial artery approach.The aim of the study is to explore the features and variations of a radial artery approach in southern Chinese populations and their clinical significance in percutaneous coronary intervention.Methods A total of 1400 patients who underwent scheduled first time transradial coronary angiography between July 2007 and September 2010 were enrolled.Radial arteriography was performed in all patients to detect the anatomical variations of this vessel.All patients' radial and ulnar artery inner diameters were measured using a computer assisted quantification method.A detailed patient history was recorded.Multivariate Logistic regression analysis was performed to evaluate the predictive value of variables (including age,gender,ethnicity,height,weight,body mass index,smoking,diabetes,hypertension and dyslipidemia) in arterial tortuosities and variations of this vessel.Results In southern Chinese populations,there were no significant differences in the diameters of the forearm arteries:the mean radial artery inner diameter was (3.04±0.43) mm in ethnic Han Chinese and (3.05±0.42) mm in ethnic Zhuang Chinese,P >0.05),the mean ulnar artery inner diameter was (3.03±0.38) mm in Han Chinese and (3.05±0.36) mm in Zhuang Chinese,P >0.05).It was estimated that the inner diameter of the radial artery was not smaller than a 6F Cordis sheath in 86.1% of male patients and in 57.0% of female patients,and not smaller than a 7F Cordis sheath in 59.3% of male patients and 24.9% of female patients.The factors found to positively affect the size of the radial artery were sex (bj=0.309,P <0.01),weight (bj=0.103,P <0.01),and diabetes mellitus (bj=-0.088,P <0.01) was found to negatively affect radial artery

  12. Intraoperative radial nerve injury during coronary artery surgery – report of two cases

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    Tsivgoulis Georgios

    2006-12-01

    Full Text Available Abstract Background Peripheral nerve injury and brachial plexopathy are known, though rare complications of coronary artery surgery. The ulnar nerve is most frequently affected, whereas radial nerve lesions are much less common accounting for only 3% of such intraoperative injuries. Case presentations Two 52- and 50-year-old men underwent coronary artery surgery. On the first postoperative day they both complained of wrist drop on the left. Neurological examination revealed a paresis of the wrist and finger extensor muscles (0/5, and the brachioradialis (4/5 with hypoaesthesia on the radial aspect of the dorsum of the left hand. Both biceps and triceps reflexes were normoactive, whereas the brachioradialis reflex was diminished on the left. Muscles innervated from the median and ulnar nerve, as well as all muscles above the elbow were unaffected. Electrophysiological studies were performed 3 weeks later, when muscle power of the affected muscles had already begun to improve. Nerve conduction studies and needle electromyography revealed a partial conduction block of the radial nerve along the spiral groove, motor axonal loss distal to the site of the lesion and moderate impairment in recruitment with fibrillation potentials in radial innervated muscles below the elbow and normal findings in triceps and deltoid. Electrophysiology data pointed towards a radial nerve injury in the spiral groove. We assume external compression as the causative factor. The only apparatus attached to the patients' left upper arm was the sternal retractor, used for dissection of the internal mammary artery. Both patients were overweight and lying on the operating table for a considerable time might have caused the compression of their left upper arm on the self retractor's supporting column which was fixed to the table rail 5 cm above the left elbow joint, in the site where the radial nerve is directly apposed to the humerus. Conclusion Although very uncommon, external

  13. Revascularização do miocárdio com a artéria radial Radial artery for coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    Luís Alberto Dallan

    1995-06-01

    éria submetida a endarterectomia. A artéria radial parece constituir uma alternativa de grande importância na revascularização do miocárdio, especialmente após o advento dos bloqueadores dos canais de cálcio. Entretanto, é necessário maior número de estudos e o seguimento a longo prazo dos pacientes, para conclusões definitivas.The radial artery (RA was used as a conduit for coronary artery bypass many years ago. Some years later, the graft was abandoned due to of a high incidence of narrowing or occlusion. The advent of new antispastic drugs led us to reinvestigate the use of the RA for coronary artery bypass grafting. Since May 1994,30 patients underwent myocardial revascularization using 31 RA grafts (1 patient received 2 grafts at our Service. The left internal thoracic artery (LITA was concomitantly used in all (100% patients, the right internal thoracic artery (RITA in 9 (30% patients and a saphenous vein graft in 24 (80% cases. A mean of 3.5 graft per patient was performed. The RA was anastomosed to the diagonal (n=10/33,3%, circunflex (n=8/26.6%, right coronary (n=8/26.6%, diagonalis (n=4/13.3% and anterior interventricular artery (n=1/3.3%. Two (6.6% patients presented for redo coronary surgery and 14 (46% had prior myocardial infarction. Two patients underwent associated ventricular aneurismectomy and 3 coronary endarterectomy. The left RA was used in 28 (93.4% patients, and the right RA in the 2 (6.6% remaining. The RA was used as a free graft. The proximal end of the RA was directly anastomosed to the ascending aorta using a 7-0 Polypropylene suture. After complete, the aortic clamp was removed and the blood flow throught the RA was tested. The distal anastomosis was then performed using a running 7-0 Polypropylene suture. All patientes received diltiazem started intraoperatively and continued at the follow-up period, when the AAS was associated. There was no mortality in this series. Angiographic controls were obtained in 7 (23.3% patients before the

  14. Long-term results of open and endovascular revascularization of superficial femoral artery occlusive disease

    Science.gov (United States)

    Scali, Salvatore T.; Rzucidlo, Eva M.; Bjerke, Aja A.; Stone, David H.; Walsh, Daniel B.; Goodney, Philip P.; Chang, Catherine K.; Powell, Richard J.

    2017-01-01

    Background First-line treatment for patients with superficial femoral arterial (SFA) occlusive disease has yet to be determined. This study compared long-term outcomes between primary SFA stent placement and primary femoral-popliteal bypass. Periprocedural patient factors were examined to determine their effect on these results. Methods All femoral-popliteal bypasses and SFA interventions performed in consecutive patients with symptoms Rutherford 3 to 6 between 2001 and 2008 were reviewed. Time-dependent outcomes were analyzed using the Kaplan-Meier method and log-rank test. Cox proportional hazards were performed to determine predictors of graft patency. Multivariate analysis was completed to identify patient covariates most often associated with the primary therapy. Results A total of 152 limbs in 141 patients (66% male; mean age, 66 ± 22 years) underwent femoral-popliteal bypass, and 233 limbs in 204 patients (49% male; mean age, 70 ± 11 years) underwent SFA interventions. Four-year primary, primary-assisted, and secondary patency rates were 69%, 78%, and 83%, respectively, for bypass patients and 66%, 91%, and 95%, respectively, for SFA interventions. Six-year limb salvage was 80% for bypass vs 92% for stenting (P = .04). Critical limb ischemia (CLI) and renal insufficiency were predictors of bypass failure. Claudication was a predictor of success for SFA stenting. Three-year limb salvage rates for CLI patients undergoing surgery and SFA stenting were 83%. Amputation-free survival at 3 years for CLI patients was 55% for bypass and 59% for SFA interventions. Multivariate predictors (odds ratios and 95% confidence intervals) of covariates most frequently associated with first-line SFA stenting were TransAtlantic Inter-Society Consensus II A and B lesions (5.9 [3.4-9.1], P 70 years (2.1 [1.4-3.1], Ppatients were more likely to have nondiabetic status (5.6 [3.3-9.4], P patient-specific covariates, and anatomic lesion classification have significant association

  15. Colgajos de perforantes de las arterias epigástricas inferiores profunda y superficial Deep and superficial inferior epigastric artery perforator flaps

    Directory of Open Access Journals (Sweden)

    A. R. Gagnon

    2006-12-01

    Full Text Available Con el desarrollo de los colgajos miocutáneos de recto abdominal (TRAM, el abdomen inferior ha sido reconocido como la principal área dadora de tejidos autólogos de alta calidad, especialmente útiles en reconstrucción mamaria. Más recientemente la habilidad para obtener componentes adiposocutáneos similares sin sacrificar el músculo recto ha revolucionado el campo de la Cirugía Reconstructiva. El advenimiento de los colgajos de perforantes ha permitido a los cirujanos plásticos lograr los mismos buenos resultados estéticos que con los colgajos miocutáneos tradicionales, pero con un considerable descenso en la morbilidad del área donante. Con los colgajos de perforantes de la arteria epigástrica inferior profunda (DIEP y de la arteria epigástrica inferior superficial (SIEA, los pacientes han incrementado sus opciones de reconstrucción. Este artículo revisa la anatomía quirúrgica de la pared abdominal relativa a los colgajos SIEA y DIEP. Se explican detalladamente los pasos principales para la preparación preoperatoria, la técnica quirúrgica y los cuidados postoperatorios. Se discuten las ventajas y desventajas y se presen- tan los trucos técnicos que pueden ayudar a mejorar el resultado final. Además se ilustran con ayuda de casos clínicos las indicaciones típicas y atípicas.Following the development of the transverse rectus abdominis myocutaneous (TRAM flap, the lower abdomen has been recognized as a prime source of high quality autogenous tissue, especially useful in breast reconstruction. More recently, the ability to harvest a similar adipocutaneous component without sacrifice of the rectus muscle has revolutionized the field of reconstructive surgery. The advent of perforator flaps has allowed plastic surgeons to achieve the same highly esthetic results as with the former myocutaneous flaps while significantly decreasing the donor site morbidity. With the deep inferior epigastric artery perforator (DIEP flap and

  16. Variation in the Branching Pattern of the Superficial Palmar Arch

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    Sumalatha S

    2016-05-01

    Full Text Available In this article we describe a rare variation in the superficial palmar arch (SPA encountered during routine cadaveric dissection. SPA was formed by the superficial branches of ulnar and radial arteries which provided a proper digital branch to the ulnar side of the little finger and three common palmar digital branches to the medial four digits. Additionally a first common digital artery was seen to emerge from the radial side of SPA which further divided into the arteria princeps pollicis and arteria radialis indicis. We also found a small communicating branch between the arteria princeps pollicis and the radial artery in the anatomical snuff box. Such arterial variations in the palm due to alteration in the developmental sequence remains a crucial issue in the reconstructive hand surgeries, especially while dealing with the innovative microsurgical procedures, where these varied patterns act as pivotal points around which successful results of various advanced surgical procedures revolve.

  17. Incidence and predictors of radial artery spasm during transradial coronary angiography and intervention

    Institute of Scientific and Technical Information of China (English)

    JIA De-an; HU Bin; YAN Zhen-xian; CHEN Yi; GAO Fei; ZHOU Yu-jie; SHI Dong-mei; LIU Yu-yang; WANG Jian-long; LIU Xiao-li; WANG Zhi-jian; YANG Shi-wei; GE Hai-long

    2010-01-01

    Background Radial artery spasm (RAS) is the most common complication in transradial coronary angiography and intervention. In this study, we designed to investigate the incidence of RAS during transradial procedures in Chinese, find out the independent predictors through multiple regression, and analyze the clinical effect of RAS during follow-up. Methods Patients arranged to receive transradial coronary angiography and intervention were consecutively enrolled. The incidence of RAS was recorded. Univariate analysis was performed to find out the influence factors of RAS, and logistic regression analysis was performed to find out the independent predictors of RAS. The patients were asked to return 1 month later for the assessment of the radial access.Results The incidence of RAS was 7.8% (112/1427) in all the patients received transradial procedure. Univariate analysis indicates that young (P=0.038), female (P=0.026), small diameter of radial artery (P 3) (P=0.048), rapid baseline heart rate (P=0.032) and long operation time (P=0.021) were associated with RAS. Logistic regression showed that female (OR=1.745, 95% CI: 1.148-3.846, P=0.024), small radial artery diameter (OR=4.028, 95%CI: 1.264-12.196, P=0.008), diabetes (OR= 2.148, 95%CI: 1.579-7.458, P=0.019) and unsuccessful access at first attempt (OR=1.468, 95%CI: 1.212-2.591, P=0.032) were independent predictors of RAS. Follow-up at (28±7) days after the procedure showed that, compared with non-spasm patients, the RAS patients had higher portion of pain (11.8% vs. 6.2%, P=0.043). The occurrences of hematoma (7.3% vs. 5.6%, P=0.518) and radial artery occlusion (3.6% vs. 2.6%, P=0.534) were similar. Conclusions The incidence of RAS during transradial coronary procedure was 7.8%. Logistic regression analysis showed that female, small radial artery diameter, diabetes and unsuccessful access at first attempt were the independent predictors of RAS.

  18. The second best arterial graft: a propensity analysis of the radial artery versus the free right internal thoracic artery to bypass the circumflex coronary artery.

    Science.gov (United States)

    Tranbaugh, Robert F; Dimitrova, Kamellia R; Lucido, David J; Hoffman, Darryl M; Dincheva, Gabriela R; Geller, Charles M; Balaram, Sandhya K; Ko, Wilson; Swistel, Daniel G

    2014-01-01

    We sought to determine if the radial artery (RA) or the free right internal thoracic artery (RITA) is the better conduit to bypass the circumflex coronary artery during coronary artery bypass grafting (CABG) using the left internal thoracic artery (LITA). Propensity matching was performed on 2488 CABG-LITA patients from 2 affiliated centers, resulting in 528 pairs who received either a RA at one center or a free RITA at the other center to bypass the circumflex coronary artery from 1995 to 2009. Kaplan Meier estimated 1-, 5-, 10-, and 15-year survival rates were 99%, 95%, 85%, and 76% for RA patients, respectively, and 97%, 92%, 80%, and 71% for RITA patients, respectively (P = .060). Major adverse events (MAEs) were fewer in the RA group (7.6% vs 14.0%; P = .001) and use of the RA was a significant predictor of reduced MAEs (odds ratio [OR], 0.48; P = .002) in all patients and especially in diabetic (OR, 0.32; P = .003), older (OR, 0.40; P = .009), obese (OR, 0.15; P < .001), and chronic obstructive pulmonary disease (COPD) (OR, 0.05; P = .016) patients. However, survival was better with RA only in COPD (hazard ratio, 0.49; P = .045) and older (hazard ratio, 0.71; P = .050) patients. Overall RA patency (83.9%) was similar to RITA patency (87.4%) at a mean of 5.1 ± 3.8 years (P = .155). Long-term survival is similar in CABG-LITA patients using either a RA or free RITA graft to bypass the circumflex coronary artery. RA grafting has fewer MAEs, a similar patency to RITA, and improves survival in older and COPD patients. The choice of the second arterial conduit should be guided by patient profiles and surgeon preferences. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  19. Three-dimensional computed tomography angiography for the investigation of superficial temporal artery pseudoaneurysms--two case reports--.

    Science.gov (United States)

    Higashino, Takuya; Kawashima, Masatou; Mannoji, Hiromichi

    2005-03-01

    An 89-year-old man and a 60-year-old man presented with superficial temporal artery (STA) pseudoaneurysms which developed secondary to trauma. Conventional cerebral angiography and three-dimensional computed tomography (3D CT) angiography clearly demonstrated the STA pseudoaneurysms. The patients underwent surgical excision of the aneurysms based on the conventional cerebral angiography findings in one patient and 3D CT angiography findings in other patient. 3D CT angiography is an excellent noninvasive diagnostic method for detecting extracranial aneurysms such as STA pseudoaneurysm, especially the relationship between the aneurysm and surrounding structures, including the calvarium.

  20. An improved technique for gaining radial artery access in endovascular interventions.

    Science.gov (United States)

    Rigatelli, Gianluca; Magro, Beatrice; Maronati, Lorenza; Tranquillo, Milan; Oliva, Laura; Panin, Stefano; Bedendo, Emiliano

    2006-01-01

    We present a simple technique to avoid time loss and potential dangerous maneuvers for catheterization of the radial artery in endovascular interventions. If any difficulties are encountered when advancing the guide wire after the arterial puncture using standard transradial kits, we found it useful to routinely use a 60-mm polyethylene radial pressure line catheter like the Leader Cath (Vygon, Ecquen, France), which is more flexible and less traumatic than short catheters and are usually available in the standard hydrophilic transradial kit. With the 20-gauge needle within the arterial lumen, it is sufficient to advance the guide wire 3 or 4 cm, followed by the insertion of the radial pressure line catheter for administering a vasodilator cocktail. The contrast injection through the catheter is safer than through the needle, and visualization of the underling problems may avoid any time loss and complications. The standard sheath insertion is facilitated by the pressure line catheter that acts as a dilator. This technique, especially when performing coronary or peripheral interventions in which large introducers are needed, may avoid potentially dangerous vascular complications and improve the success rate.

  1. Distally based superficial sural artery flap for soft tissue coverage in the distal 2/3 of leg and foot

    Directory of Open Access Journals (Sweden)

    Kamath B

    2005-01-01

    Full Text Available Background: Skin coverage for defects in the lower 2/3 of leg, ankle region and posterior heel has always been a difficult challenge for reconstructive surgeon. Methods: We describe our experience with the distally based superficial sural artery flap coverage in 48 patients with moderate sized defects in these difficult areas. Results: One out of 48 flaps (in 48 patients was lost totally and 3 suffered marginal necrosis which did not require any secondary procedure. These complications could have been avoided by proper selection of cases and refining technical skills. Conclusion: This simple procedure could be an important and versatile tool for any reconstructive surgeon in providing skin coverage in the distal leg and proximal foot. Preservation of major arteries of the lower limb, minimal donor defect, relatively uninjured donor area in compound fracture or poly trauma involving distal leg are some of the advantages of the flap.

  2. Critical evaluation of stents in the peripheral arterial disease of the superficial femoral artery – focus on the paclitaxel eluting stent

    Directory of Open Access Journals (Sweden)

    Litsky J

    2014-05-01

    Full Text Available Jason Litsky,1 Arijit Chanda,2 Erik Stilp,1 Alexandra Lansky,1 Carlos Mena11Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA; 2Section of Cardiology, Department of Internal Medicine, Bridgeport Hospital, Bridgeport, CT, USAAbstract: The endovascular management of obstructive disease of the superficial femoral artery (SFA is challenging due to unique anatomical and biomechanical forces. Obstructive lesions of the SFA make up the largest proportion of lesions leading to symptomatic peripheral arterial disease. Accordingly, endovascular treatment of SFA disease is becoming increasingly common and, in many cases, is the preferred initial therapy. The use of self-expanding nitinol stents have proven superior to percutaneous transluminal balloon angioplasty in the treatment of intermediate length SFA stenosis. However, achieving durable results, as well as attaining adequate therapy for long occlusions typically seen in clinical practice, remains problematic. Newer technologies, such as paclitaxel eluting stents, seem promising in improving outcomes.Keywords: Zilver PTX, self-expanding stent, atherosclerotic disease, superficial femoral artery

  3. Comparison of how well conscious cats tolerate blood pressure measurement from the radial and coccygeal arteries.

    Science.gov (United States)

    Cannon, Martha J; Brett, Jo

    2012-12-01

    Hypertension is a common condition of older cats and acquiring clinically relevant and repeatable blood pressure (BP) measurements in conscious cats is important in its diagnosis and management. The most common sites for indirect BP measurement in the cat are the radial artery (RA) and the coccygeal artery (CA) but, to date, there are no published data comparing how conscious cats tolerate BP measurements from these sites. A high-definition oscillometric BP monitor was used to measure BP in 30 cats admitted to a cat-only veterinary clinic for reasons other than hypertension. Systolic arterial pressure (SAP), mean arterial pressure (MAP) and diastolic arterial pressure (DAP) were measured using the RA and CA, alternating which site was used first. The number of failed attempts and total time to achieve six measurements was recorded. Measurement of BP using the CA was better tolerated than the RA, resulting in fewer failures and shorter total time required. SAP measurements were slightly higher from the CA compared with the RA, irrespective of which site was used first. There were no significant differences in MAP and DAP. The coccygeal artery appears to be the more appropriate site to use when measuring BP in conscious cats using this oscillometric machine. Further studies are required using alternative BP monitors, including Doppler machines, to establish whether this is a consistent finding. When measuring BP in cats the site used should be recorded and the same site used for all subsequent measurements from the same cat.

  4. Emergency Percutaneous Coronary Intervention Through the Left Radial Artery is Associated with Less Vascular Complications than Emergency Percutaneous Coronary Intervention Through the Femoral Artery.

    Science.gov (United States)

    Qi, Guoqing; Sun, Qi; Xia, Yue; Wei, Liye

    2017-01-01

    To compare the advantages and disadvantages of emergency percutaneous coronary intervention through the left radial artery with those of emergency percutaneous coronary intervention through the femoral artery. A total of 206 patients with acute myocardial infarction who required emergency percutaneous coronary intervention and were admitted to our hospital between January 2011 and August 2013 were divided into the following two groups: a group that underwent percutaneous coronary intervention through the left radial artery and a group that underwent percutaneous coronary intervention through the femoral artery. The times required for angiographic catheter and guiding catheter placement, the success rate of the procedure and the incidence of vascular complications in the two groups were observed. There was no significant difference in catheter placement time or the ultimate success rate of the procedure between the two groups. However, the left radial artery group showed a significantly lower incidence of vascular complications than the femoral artery group (pEmergency percutaneous coronary intervention through the left radial artery is associated with less vascular complications than emergency percutaneous coronary intervention through the femoral artery and is thus potentially advantageous for patients.

  5. Ulnar Artery Compression: A Feasible and Effective Approach to Prevent the Radial Artery Occlusion after Coronary Intervention

    Institute of Scientific and Technical Information of China (English)

    Jun Tian; Yu-Shun Chu; Jing Sun; Tie-Min Jiang

    2015-01-01

    Background:Radial artery (RA) occlusion (RAO) is not rare in patients undergoing coronary intervention by transradial approach (TRCI).Predictors of and prevention from RAO have not been systematically studied.This study aimed to analyze the risk factors of the weakness of RA pulsation (RAP) and its predictive value for RAO after TRCI,and simultaneously to describe a feasible and effective approach to maintain RA patency.Methods:Between June 2006 and March 2010,all patients who underwent TRCI were classified according to the weakness of RAP after removing compression bandage with confirmation by Doppler ultrasound for the first 30 consecutive patients.Among a total of 2658 patients studied,187 (7%) patients having a weaker RAP were prospectively monitored.At 1 h after bandage removal,the ulnar artery in puncture side of all patients was blocked with manual compression to favor brachial and collateral artery blood flow through the RA until a good RAP was restored.The primary analysis was the occurrence of RAO.Results:Doppler ultrasound demonstrated the significant reduction of both systolic velocity (61.24 ± 3.95 cm/s vs.72.31 ± 3.57 cm/s)and diastolic velocity (1.83 ± 0.32 cm/s vs.17.77 ± 3.97 cm/s) in RA at access side as compared to the contralateral RA (all P < 0.001),but these velocities in ipsilateral ulnar artery (81.2 ± 2.16 cm/s and 13.1 ± 2.86 cm/s,respectively) increased profoundly.The average time of ulnar artery compression was 4.1 ± 1.2 h (ranged 2.5-6.5 h).There were two patients experienced persistent RAO with a success rate of 98.9% and RAO in 0.075% of patients after ulnar artery compression was applied.The pulsation of the ulnar artery after compression was removed had not been influenced by the compression.Conclusions:After intervention using TRCI approach,the presence of a weaker RAP is an indicator of imminent RAO.The continuing compression of ipsilateral ulnar artery is an effective approach to maintain RA patency.

  6. Ulnar Artery Compression: A Feasible and Effective Approach to Prevent the Radial Artery Occlusion after Coronary Intervention

    Directory of Open Access Journals (Sweden)

    Jun Tian

    2015-01-01

    Full Text Available Background: Radial artery (RA occlusion (RAO is not rare in patients undergoing coronary intervention by transradial approach (TRCI. Predictors of and prevention from RAO have not been systematically studied. This study aimed to analyze the risk factors of the weakness of RA pulsation (RAP and its predictive value for RAO after TRCI, and simultaneously to describe a feasible and effective approach to maintain RA patency. Methods: Between June 2006 and March 2010, all patients who underwent TRCI were classified according to the weakness of RAP after removing compression bandage with confirmation by Doppler ultrasound for the first 30 consecutive patients. Among a total of 2658 patients studied, 187 (7% patients having a weaker RAP were prospectively monitored. At 1 h after bandage removal, the ulnar artery in puncture side of all patients was blocked with manual compression to favor brachial and collateral artery blood flow through the RA until a good RAP was restored. The primary analysis was the occurrence of RAO. Results: Doppler ultrasound demonstrated the significant reduction of both systolic velocity (61.24 ± 3.95 cm/s vs. 72.31 ± 3.57 cm/s and diastolic velocity (1.83 ± 0.32 cm/s vs. 17.77 ± 3.97 cm/s in RA at access side as compared to the contralateral RA (all P < 0.001, but these velocities in ipsilateral ulnar artery (81.2 ± 2.16 cm/s and 13.1 ± 2.86 cm/s, respectively increased profoundly. The average time of ulnar artery compression was 4.1 ± 1.2 h (ranged 2.5-6.5 h. There were two patients experienced persistent RAO with a success rate of 98.9% and RAO in 0.075% of patients after ulnar artery compression was applied. The pulsation of the ulnar artery after compression was removed had not been influenced by the compression. Conclusions: After intervention using TRCI approach, the presence of a weaker RAP is an indicator of imminent RAO. The continuing compression of ipsilateral ulnar artery is an effective approach to

  7. Determination of the luminal diameter of the radial artery in man by high frequency ultrasound

    DEFF Research Database (Denmark)

    Nielsen, T H; Iversen, Helle Klingenberg; Tfelt-Hansen, P

    1990-01-01

    measurements. By comparing the diameter of the reference object either filled with water or blood at 37 degrees C, the ultrasound velocity in human blood at 37 degrees C was calculated to be 1605 m/s. The intraobserver repeatability coefficients of in-vivo measurements of the radial artery in man were...... in the same range, whether measurements were repeated after 30 min (14%) or from day to day (12%). The interobserver repeatability coefficient was acceptable (15%) when the site of measurements was marked, whereas measurements without a mark resulted in a repeatability coefficient of 24%. The intravenous...

  8. Noninvasive continuous beat-to-beat radial artery pressure via TL-200 applanation tonometry.

    Science.gov (United States)

    Dueck, Ron; Goedje, Oliver; Clopton, Paul

    2012-04-01

    The Tensys TL-200(®) noninvasive beat-to-beat blood pressure (BP) monitor displays continuous radial artery waveform as well as systolic, mean and diastolic BP from a pressure sensor directly over the radial artery at the wrist. It locates the site of maximal radial pulse signal, determines mean BP from maximal pulse waveform amplitude at optimal artery compression and then derives systolic and diastolic BP. We performed a cross-sectional study of TL-200 BP comparisons with contralateral invasive radial artery (A-Line) BP values in 19 subjects during an average 2.5 h of general anesthesia for a wide range of surgical procedures. Two hundred and fifty random sample pairs/patient resulted in 4,747 systolic, mean and diastolic BP pairs for analysis. A-Line BP ranged from 29 mm Hg diastolic to 211 mm Hg systolic, and heart rate varied between 38 and 210 beats/min. Bland-Altman analysis showed an average 2.3 mm Hg TL-200 versus A-Line systolic BP bias and limits of agreement (1.96 SD) were ± 15.3 mm Hg. Mean BP showed a 2.3 mm Hg TL-200 bias and ± 11.7 mm Hg limits of agreement, while diastolic BP showed a 1.7 mm Hg bias and ± 12.3 mm Hg limits of agreement. Coefficients of determination for TL-200 and A-Line BP regression were r² = 0.86 for systolic, r² = 0.86 for mean, and r² = 80 for diastolic BP, respectively, with no apparent change in correlation at low or high BP. Bland-Altman analysis suggested satisfactory agreement between TL-200 noninvasive beat-to-beat BP and invasive A-Line BP. Paired TL-200/A-Line BP comparisons showed a high coefficient of determination.

  9. Ambulatory instrument for monitoring indirect beat-to-beat blood pressure in superficial temporal artery using volume-compensation method.

    Science.gov (United States)

    Tanaka, S; Yamakoshi, K

    1996-11-01

    A portable instrument, based on a volume-compensation technique, is designed for ambulatory monitoring of indirect beat-to-beat blood pressure (BP) in the superficial temporal artery. The instrument consists of a small disc-type cuff and a portable unit carried by the subject. Several components are integrated in the cuff for applying counter-pressure to the artery, i.e. a reflectance-type photo-plethysmographic sensor for arterial volume detection, a pressure sensor for cuff pressure Pc measurement and a nozzle flapper-type- electro-pneumatic convertor for controlling Pc. The portable unit includes volume servo control circuitry and a microprocessor-based signal-processing and recording unit. This automatically performs all the necessary measurement procedures and stores into a memory IC element the processed systolic, mean and diastolic blood pressure data, together with pulse intervals on a beat-to-beat basis from the servo-controlled Pc (indirectly measured BP waveform). With this instrument, momentary changes in BP during ambulatory situations such as bicycle ergometer exercise and daily activities including motorway driving are successfully recorded. From the results of simultaneous measurement of the subject's posture changes, the effect of posture change on blood pressure, e.g. baroreceptor-cardiac reflex, is also clearly demonstrated.

  10. A Randomized Controlled Trial on the Effect of Needle Gauge on the Pain and Anxiety Experienced during Radial Arterial Puncture.

    Directory of Open Access Journals (Sweden)

    Maxime Patout

    Full Text Available Arterial punctures for assessment of arterial blood-gases can be a painful procedure. Lidocaine can be used to reduce pain prior to needle insertion but it is not a widely accepted practice. The purpose of this study was to determine whether a large size needle induces more pain compared to a smaller size needle for radial arterial puncture and to assess the anxiety associated with radial arterial punctures.We conducted a prospective, double-blind, randomized, controlled, monocentric study including all outpatients who had a planned assessment of arterial blood gas analysis. Patients were randomized to have the arterial puncture performed with a 23 or a 25 G needle. The main judgement criteria was pain during arterial puncture. Visual analogue scale for pain (VAS-P and visual analogue scale for anxiety (VAS-A were used to assess pain and anxiety during radial arterial puncture.Two hundred consecutive patients were randomized. The 25 G needle was as painful as the 23 G needle (6.63 mm [0-19 mm] vs. 5.21 mm [0-18.49 mm], respectively, p = 0.527. Time for arterial puncture was longer with the 25 G needle than with the 23 G needle (42 s [35-55 s] vs. 33 s [24.5-35 s], respectively, p = 0.002. There was a correlation between the level of anxiety prior to the arterial puncture and the pain experienced by the patients (p: 0.369, p<0.0001. There was a correlation between the pain experienced by patients and the anxiety experienced in anticipation of another arterial puncture (p: 0.5124, p<0.0001.The use of 23 G needle allows quicker arterial sampling and is not associated with increased pain and symptoms. Anxiety was correlated with the pain experienced by patients during arterial punctures.Clinicaltrials.gov: NCT02320916.

  11. Investigation of the agreement of a continuous non-invasive arterial pressure device in comparison with invasive radial artery measurement.

    Science.gov (United States)

    Ilies, C; Bauer, M; Berg, P; Rosenberg, J; Hedderich, J; Bein, B; Hinz, J; Hanss, R

    2012-02-01

    Arterial pressure (AP) monitoring should be accurate, easy to use, free of risks, and ideally continuous. The continuous non-invasive arterial pressure (CNAP) device is non-invasive and provides continuous pressure readings. This study was performed to compare the agreement of CNAP and invasive AP monitoring. Ninety patients undergoing surgery under general anaesthesia were enrolled. Invasive pressure monitoring was established at the radial artery. CNAP monitoring using a finger sensor recording was begun before induction of anaesthesia. Statistical analysis was conducted with the Bland-Altman method for comparisons of repeated measures. We obtained 16 843 valid pressure readings from 85 patients. Mean (sd) bias during maintenance of anaesthesia was: systolic AP: 4.2 (16.5) mm Hg; mean AP (MAP): -4.3 (10.4) mm Hg; and diastolic AP: -5.8 (6) mm Hg. The results of a subgroup analysis of patients who had a mean intra-arterial pressure of pressure: -0.3 (9.7) mm Hg; mean pressure: -6.8 (7.6) mm Hg; and diastolic pressure: -7.9 (7.2) mm Hg. Bias and percentage error during the induction period were greater in both the main and subgroup analyses, probably due to recalibration being omitted after induction. The CNAP monitor showed an acceptable agreement and was interchangeable with invasive pressure monitoring for MAP during normotensive conditions. During induction of anaesthesia and when the AP was low, the agreement was less good and interchangeability was not achieved. These results suggest that CNAP is not statistically equivalent to invasive monitoring during all periods of anaesthesia but may be a useful additional AP monitor.

  12. Measuring the Pressure in the Superficial Inferior Epigastric Vein to Monitor for Venous Congestion in Deep Inferior Epigastric Artery Perforator Breast Reconstructions : A Pilot Study

    NARCIS (Netherlands)

    Smit, Jeroen M.; Audolfsson, Thorir; Whitaker, Iain S.; Werker, Paul M. N.; Acosta, Rafael; Liss, Anders G.

    2010-01-01

    During deep inferior epigastric artery perforator (DIEP) flap dissection, we noted that in many cases the superficial vein on the ipsilateral side of the flap was engorged and tense, and in others, it was empty. This led us to believe that the pressure is increased as the result of preferential outf

  13. Improvement in cerebral hemodynamic parameters and outcomes after superficial temporal artery-middle cerebral artery bypass in patients with severe stenoocclusive disease of the intracranial internal carotid or middle cerebral arteries.

    Science.gov (United States)

    Low, Shiong Wen; Teo, Kejia; Lwin, Sein; Yeo, Leonard L L; Paliwal, Prakash R; Ahmad, Aftab; Sinha, Arvind K; Teoh, Hock Luen; Wong, Lily Y H; Chong, Vincent F; Seet, Raymond C S; Chan, Bernard P L; Yeo, Tseng Tsai; Chou, Ning; Sharma, Vijay K

    2015-09-01

    Both the older and the recent extracranial-intracranial (EC-IC) bypass trials for symptomatic carotid occlusion failed to demonstrate a reduction in stroke recurrence. However, the role of superficial temporal artery (STA)-middle cerebral artery (MCA) bypass in patients with symptomatic intracranial stenoocclusive disease has been rarely evaluated. The authors evaluated serial changes in various cerebral hemodynamic parameters in patients with severe stenoocclusive disease of the intracranial internal carotid artery (ICA) or middle cerebral artery (MCA) and impaired cerebral vasodilatory reserve (CVR), treated by STA-MCA bypass surgery or medical treatment. Patients with severe stenoocclusive disease of the intracranial ICA or MCA underwent transcranial Doppler (TCD) ultrasonography and CVR assessment using the breath-holding index (BHI). Patients with impaired BHI (hemodynamic parameters and reduction in stroke recurrence.

  14. The Use of ExoSeal Vascular Closure Device for Direct Antegrade Superficial Femoral Artery Puncture Site Hemostasis

    Energy Technology Data Exchange (ETDEWEB)

    Rimon, Uri, E-mail: rimonu@sheba.health.gov.il; Khaitovich, Boris, E-mail: borislena@012.net.il [Tel-Aviv University, Diagnostic and Interventional Imaging Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel); Yakubovich, Dmitry, E-mail: Dmitry.Yakubovitch@sheba.health.gov.il [Tel-Aviv University, Vascular Surgery Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel); Bensaid, Paul, E-mail: paulbensaid@hotmail.com; Golan, Gil, E-mail: gilgolan201@gmail.com [Tel-Aviv University, Diagnostic and Interventional Imaging Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel); Silverberg, Daniel, E-mail: Daniel.Silverberg@sheba.health.gov.il [Tel-Aviv University, Vascular Surgery Department, Chaim Sheba Medical Center, Tel-Hashomer, Affiliated to the Sackler School of Medicine (Israel)

    2015-06-15

    PurposeThis study was designed to assess the efficacy and safety of the ExoSeal vascular closure device (VCD) to achieve hemostasis in antegrade access of the superficial femoral artery (SFA).MethodsWe retrospectively reviewed the outcome of ExoSeal VCD used for hemostasis in 110 accesses to the SFA in 93 patients between July 2011 and July 2013. All patients had patent proximal SFA based on computer tomography angiography or ultrasound duplex. Arterial calcifications at puncture site were graded using fluoroscopy. The SFA was accessed in an antegrade fashion with ultrasound or fluoroscopic guidance. In all patients, 5–7F vascular sheaths were used. The ExoSeal VCD was applied to achieve hemostasis at the end of the procedure. All patients were clinically examined and had ultrasound duplex exam for any puncture site complications during the 24 h postprocedure.ResultsIn all procedures, the ExoSeal was applied successfully. We did not encounter any device-related technical failure. There were four major complications in four patients (3.6 %): three pseudoaneurysms, which were treated with direct thrombin injection, and one hematoma, which necessitated transfusion of two blood units. All patients with complications were treated with anticoagulation preprocedure or received thrombolytic therapy.ConclusionsThe ExoSeal VCD can be safely used for antegrade puncture of the SFA, with a high procedural success rate (100 %) and a low rate of access site complications (3.6 %)

  15. Lower extremity computed tomography angiography can help predict technical success of endovascular revascularization in the superficial femoral and popliteal artery.

    Science.gov (United States)

    Itoga, Nathan K; Kim, Tanner; Sailer, Anna M; Fleischmann, Dominik; Mell, Matthew W

    2017-09-01

    Preprocedural computed tomography angiography (CTA) assists in evaluating vascular morphology and disease distribution and in treatment planning for patients with lower extremity peripheral artery disease (PAD). The aim of the study was to determine the predictive value of radiographic findings on CTA and technical success of endovascular revascularization of occlusions in the superficial femoral artery-popliteal (SFA-pop) region. Medical records and available imaging studies were reviewed for patients undergoing endovascular intervention for PAD between January 2013 and December 2015 at a single academic institution. Radiologists reviewed preoperative CTA scans of patients with occlusions in the SFA-pop region. Radiographic criteria previously used to evaluate chronic occlusions in the coronary arteries were used. Technical success, defined as restoration of inline flow through the SFA-pop region with technical failure (P = .014). Longer lengths of occlusion were also associated with technical failure (P = .042). Multiple occlusions (P = .55), negative remodeling (P = .69), vessel runoff (P = .56), and percentage of vessel calcification (P = .059) were not associated with failure. On multivariable analysis, 100% calcification remained the only significant predictor of technical failure (odds ratio, 9.0; 95% confidence interval, 1.8-45.8; P = .008). Analysis of preoperative CTA shows 100% calcification as the best predictor of technical failure of endovascular revascularization of occlusions in the SFA-pop region. Further studies are needed to determine the cost-effectiveness of obtaining preoperative CTA for lower extremity PAD. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  16. Invasive evaluation of plaque morphology of symptomatic superficial femoral artery stenoses using combined near-infrared spectroscopy and intravascular ultrasound.

    Science.gov (United States)

    Zacharias, Sibin K; Safian, Robert D; Madder, Ryan D; Hanson, Ivan D; Pica, Mark C; Smith, James L; Goldstein, James A; Abbas, Amr E

    2016-08-01

    The purpose of this study is to characterize the plaque morphology of severe stenoses in the superficial femoral artery (SFA) employing combined near-infrared spectroscopy and intravascular ultrasound (NIRS-IVUS). Atherosclerosis is the most common cause of symptomatic peripheral arterial disease. Plaque composition of SFA stenoses has been characterized as primarily fibrous or fibrocalcific by non-invasive and autopsy studies. NIRS has been validated to detect lipid-core plaque (LCP) in the coronary circulation. We imaged severe SFA stenoses with NIRS-IVUS prior to revascularization in 31 patients (46 stenoses) with Rutherford claudication ⩾ class 3. Angiographic parameters included lesion location and stenosis severity. IVUS parameters included plaque burden and presence of calcium. NIRS images were analyzed for LCP and maximum lipid-core burden index in a 4-mm length of artery (maxLCBI4mm). By angiography, 38 (82.6%) lesions were calcified and 9 (19.6%) were chronic total occlusions. Baseline stenosis severity and lesion length were 86.0 ± 11.0% and 36.5 ± 46.5 mm, respectively. NIRS-IVUS identified calcium in 45 (97.8%) lesions and LCP in 17 (37.0%) lesions. MaxLCBI4mm was 433 ± 244. All lesions with LCP also contained calcium; there were no non-calcified lesions with LCP. In conclusion, this is the first study of combined NIRS-IVUS in patients with PAD. NIRS-IVUS demonstrates that nearly all patients with symptomatic severe SFA disease have fibrocalcific plaque, and one-third of such lesions contain LCP. These findings contrast with those in patients with acute coronary syndromes, and may have implications regarding the pathophysiology of atherosclerosis in different vascular beds.

  17. Effects of various factors on Doppler ultrasonographic measurements of radial and coccygeal arterial blood pressure in privately owned, conscious cats.

    Science.gov (United States)

    Whittemore, Jacqueline C; Nystrom, Michael R; Mawby, Dianne I

    2017-04-01

    OBJECTIVE To assess the effects of age, body condition score (BCS), and muscle condition score (MCS) on radial and coccygeal systolic arterial blood pressure (SAP) in cats. DESIGN Prospective randomized trial. ANIMALS 66 privately owned cats enrolled between May and December 2010. PROCEDURES BCS and MCS of cats were assessed by 2 investigators; SAP was measured via Doppler ultrasonic flow detector, with cats positioned in right lateral or sternal recumbency for measurements at the radial or coccygeal artery, respectively, with order of site randomized. Associations among variables were assessed through correlation coefficients, partial correlation coefficients, and ANCOVA. RESULTS Interrater reliability for BCS and MCS assessment was high (correlation coefficients, 0.95 and 0.83, respectively). No significant effect was identified for order of SAP measurement sites. Coccygeal and radial SAP were positively correlated (ρ = 0.45). The median difference in coccygeal versus radial SAP was 19 mm Hg, but differences were not consistently positive or negative. Radial SAP was positively correlated with age (ρ = 0.48) and negatively correlated with MCS (ρ = -0.30). On the basis of the correlation analysis, the association between radial SAP and MCS reflected the confounding influence of age. Coccygeal SAP was not significantly correlated with age, BCS, or MCS. CONCLUSIONS AND CLINICAL RELEVANCE Use of the coccygeal artery is recommended to reduce the confounding effects of age and sarcopenia on Doppler ultrasonographic SAP measurements in cats. Additionally, monitoring for changes in MCS is recommended for cats undergoing serial SAP measurement.

  18. Large-diameter compression arteries as a possible facilitating factor for trigeminal neuralgia: analysis of axial and radial diffusivity

    OpenAIRE

    2016-01-01

    Background Neurovascular compression (NVC) of the trigeminal nerve is associated with trigeminal neuralgia (TN). Some arteries that compress the trigeminal nerve are large, while others are small. This study evaluated the influence of diameter of compression arteries (DCA) on NVC with and without TN using axial diffusivity (AD) and radial diffusivity (RD) of magnetic resonance (MR) imaging. Methods Fifty TN patients with unilateral NVC, 50 asymptomatic patients with unilateral NVC, and 50 hea...

  19. Intrapericardial denervation - Radial artery blood flow and heart rate responses to LBNP

    Science.gov (United States)

    Mckeever, Kenneth H.; Skidmore, Michael G.; Keil, Lanny C.; Sandler, Harold

    1990-01-01

    The effects of intrapericardial denervation on the radial artery blood flow velocity (RABFV) and heart rate (HR) responses to LBNP in rhesus monkeys were investigated by measuring the RABFV transcutaneously by a continuous-wave Doppler ultrasonic flowmeter in order to derive an index of forearm blood flow response to low (0 to -20 mm Hg) and high (0 to -60 mm Hg) ramp exposures during supine LBNP. Four of the eight subjects were subjected to efferent and afferent cardiac denervation. It was found that, during low levels of LBNP, monkeys with cardiac denervation exhibited no cardiopulmonary baroreceptor-mediated change in the RABFV or HR, unlike the intact animals, which showed steady decreases in RABFV during both high- and low-pressure protocols. It is suggested that forearm blood flow and HR responses to low-level LBNP, along with pharmacological challenge, are viable physiological tests for verifying the completeness of atrial and cardiopulmonary baroreceptor denervation.

  20. Pedicled Supraclavicular Artery Island Flap Versus Free Radial Forearm Flap for Tongue Reconstruction Following Hemiglossectomy.

    Science.gov (United States)

    Zhang, Senlin; Chen, Wei; Cao, Gang; Dong, Zhen

    2015-09-01

    This study investigated the tongue function and donor-site morbidity of patients with malignant tumors who had undergone immediate flap reconstruction surgery. Twenty-seven patients who had undergone immediate reconstruction after hemiglossectomy were observed. Twelve patients were reconstructed using the pedicled supraclavicular artery island flap (PSAIF) and 15 patients using the free radial forearm flap (FRFF). Flap survival, speech and swallowing function, and donor-site morbidity at the 6-month follow-up were evaluated. All the flaps were successfully transferred. No obvious complications were found in either the transferred flaps or donor regions. Age, sex, defect extent, speech and swallowing function were comparable between the 2 groups. Donor-site complications were less frequent with PSAIF reconstruction than FRFF reconstruction. The PSAIF is reliable and well suited for hemiglossectomy defect. It has few significant complications, and allows preservation of oral function.

  1. Effects of Purge-Flow Rate on Microbubble Capture in Radial Arterial-Line Filters.

    Science.gov (United States)

    Herbst, Daniel P

    2016-09-01

    The process of microbubble filtration from blood is complex and highly dependent on the forces of flow and buoyancy. To protect the patient from air emboli, arterial-line filters commonly use a micropore screen, a large volume housing with purpose-built shape, and a purge port to trap, separate, and remove circulating microbubbles. Although it has been proposed that an insufficient buoyancy force renders the purge port ineffective at removing microbubbles smaller than 500 μm, this research attempts to investigate the purge flow of an arterial-line filter to better understand the microbubble removal function in a typical radial filter design. As its primary objective, the study aims to determine the effect of purge-flow rate on bubble capture using air bolus injections from a syringe pump with 22-gauge needle and Doppler ultrasound bubble detection. The measureable bubble size generated in the test circuit ranged between 30 and 500 μm, while purge flow was varied between .1 and .5 L/min for testing. Statistical analysis of the test data was handled using a repeated measures design with significance set at p purge flows yielded higher bubble counts, but the effect of purge-flow rate on bubble capture decreased as bubble size increased. Results also showed that purge flow from the test filter was capable of capturing all bubble sizes being generated over the entire flow range tested, and confirms utility of the purge port in removing microbubbles smaller than 500 μm. By analyzing bubble counts in the purge flow of a typical radial-filter design, this study demonstrates that currently available micropore filter technology is capable of removing the size range of bubbles that commonly pass through modern pump-oxygenator systems and should continue to be considered during extracorporeal circulation as a measure to improve patient safety.

  2. Intraoperative dexmedetomidine and postoperative cerebral hyperperfusion syndrome in patients who underwent superficial temporal artery-middle cerebral artery anastomosis for moyamoya disease

    Science.gov (United States)

    Seo, Hyungseok; Ryu, Ho-Geol; Son, Je Do; Kim, Jeong-Soo; Ha, Eun Jin; Kim, Jeong-Eun; Park, Hee-Pyoung

    2016-01-01

    Abstract Dexmedetomidine, a selective α2-agonist, reduces cerebral blood flow and has neuroprotective effects against cerebral ischemia/reperfusion injury in experimental animals. We examined whether intraoperative dexmedetomidine would reduce the incidence of postoperative cerebral hyperperfusion syndrome (CHS) after superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis in patients with moyamoya disease. The electronic medical records of 117 moyamoya patients who underwent STA-MCA anastomosis were reviewed retrospectively. The patients were divided into 2 groups: 48 patients received intraoperative dexmedetomidine (Group D), while 69 patients did not (Group ND). The incidence (primary outcome), onset, and duration of postoperative CHS were noted. The incidence of postoperative CHS was 45.8% and 40.6% in groups D and ND, respectively (P = 0.708). The duration of postoperative CHS was shorter in group D than in group ND (median [Q1–Q3], 5 [3–7] vs 8 [5–10] days, P = 0.021). There was no significant difference in the onset of CHS between group D and group ND (0 [0–2] vs 1 [0–3] days, P = 0.226). In conclusion, intraoperative dexmedetomidine did not reduce the incidence of postoperative CHS, although it reduced the duration of CHS, in patients who had undergone direct revascularization surgery for moyamoya disease. PMID:28033272

  3. Long-term patency of superficial temporal artery to middle cerebral artery bypass for cerebral atherosclerotic disease: factors determining the bypass patent.

    Science.gov (United States)

    Matano, Fumihiro; Murai, Yasuo; Tateyama, Kojiro; Tamaki, Tomonori; Mizunari, Takayuki; Matsukawa, Hideoshi; Teramoto, Akira; Morita, Akio

    2016-10-01

    Long-term patency of superficial temporal artery to middle cerebral artery (STA-MCA) bypass surgery for atherosclerotic disease and associated risk factors for loss of patency have rarely been discussed. We retrospectively analyzed long-term patency following STA-MCA bypass and evaluated various demographic and clinical factors to identify the ones predictive of postsurgical loss of patency using records of 84 revascularization procedures (58 patients, 45 males; mean age at surgery 63.6 years, range 31-78 years). Bypass patency was diagnosed based on magnetic resonance angiography or three-dimensional computed tomography. The mean follow-up period was 24.7 months (range 6-63 months). Decreased bypass patency was observed in 4 of 58 patients (6.9 %) who collectively underwent 6 bypasses (7.1 %) of 84. All cases of decreased bypass patency were first detected within 6 months of surgery. Bypass patency was not correlated with age, sex, number of anastomoses, postoperative cerebral infarction, or control of postoperative diabetes mellitus. We found a significant association of bypass patency with hyperperfusion (p = 0.01) and postoperative smoking (p = 0.0036). Furthermore, we found a significant association of hyperperfusion with STA diameter (p bypass patency in cerebral atherosclerotic disease patients. Careful monitoring of patency to prevent hyperperfusion and cessation of smoking are recommended, particularly within 6 months of the surgery.

  4. Drug-eluting stents in superficial femoral artery treatment: could they be the standard of care?

    Science.gov (United States)

    Bosiers, Marc; Deloose, Koen; Callaert, Joren; Peeters, Patrick; Bosiers, Michel

    2016-12-01

    Endovascular techniques have improved markedly over the past several decades. Plain old balloon angioplasty can only reach patencies around 40% after 1 year. Scaffolding stents have resulted in improved short-term results but encountered limitations for longer-term durability. With the introduction of drug-eluting technologies the process of intimal hyperplasia might be slowed, resulting in improved long-term patency results. At first, limus-eluting technologies were not able to transfer the enthusiasm from the coronaries to the infrainguinal vascular bed. However, the newer generation paclitaxel-eluting technologies perform significantly better in femoropopliteal arteries than their non-eluting or non-coated counterparts. The results of a prospective randomized trial comparing DES versus DCB is eagerly awaited. For the moment there seems, based on the meta-analysis, no difference between the two treatment modalities. Although, we need to keep in mind that DCB perform worse in long calcified lesions.

  5. Quantitative cerebral perfusion assessment using microscope-integrated analysis of intraoperative indocyanine green fluorescence angiography versus positron emission tomography in superficial temporal artery to middle cerebral artery anastomosis

    Directory of Open Access Journals (Sweden)

    Shinya Kobayashi

    2014-01-01

    Full Text Available Background: Intraoperative qualitative indocyanine green (ICG angiography has been used in cerebrovascular surgery. Hyperperfusion may lead to neurological complications after superficial temporal artery to middle cerebral artery (STA-MCA anastomosis. The purpose of this study is to quantitatively evaluate intraoperative cerebral perfusion using microscope-integrated dynamic ICG fluorescence analysis, and to assess whether this value predicts hyperperfusion syndrome (HPS after STA-MCA anastomosis. Methods: Ten patients undergoing STA-MCA anastomosis due to unilateral major cerebral artery occlusive disease were included. Ten patients with normal cerebral perfusion served as controls. The ICG transit curve from six regions of interest (ROIs on the cortex, corresponding to ROIs on positron emission tomography (PET study, was recorded. Maximum intensity (I MAX , cerebral blood flow index (CBFi, rise time (RT, and time to peak (TTP were evaluated. Results: RT/TTP, but not I MAX or CBFi, could differentiate between control and study subjects. RT/TTP correlated (|r| = 0.534-0.807; P < 0.01 with mean transit time (MTT/MTT ratio in the ipsilateral to contralateral hemisphere by PET study. Bland-Altman analysis showed a wide limit of agreement between RT and MTT and between TTP and MTT. The ratio of RT before and after bypass procedures was significantly lower in patients with postoperative HPS than in patients without postoperative HPS (0.60 ± 0.032 and 0.80 ± 0.056, respectively; P = 0.017. The ratio of TTP was also significantly lower in patients with postoperative HPS than in patients without postoperative HPS (0.64 ± 0.081 and 0.85 ± 0.095, respectively; P = 0.017. Conclusions: Time-dependent intraoperative parameters from the ICG transit curve provide quantitative information regarding cerebral circulation time with quality and utility comparable to information obtained by PET. These parameters may help predict the occurrence of postoperative

  6. Feasibility and Safety of Vascular Closure Devices in an Antegrade Approach to Either the Common Femoral Artery or the Superficial Femoral Artery

    Energy Technology Data Exchange (ETDEWEB)

    Gutzeit, Andreas, E-mail: andreas.gutzeit@ksw.ch; Schie, Bram van, E-mail: Bram.vanschie@hotmail.com; Schoch, Eric, E-mail: eric.schoch@ksw.ch [Cantonal Hospital Winterthur, Department of Radiology (Switzerland); Hergan, Klaus, E-mail: k.hergan@salk.at [Paracelsus Medical University Salzburg, Department of Radiology (Austria); Graf, Nicole, E-mail: graf@biostatistics.ch; Binkert, Christoph A., E-mail: christoph.binkert@ksw.ch [Cantonal Hospital Winterthur, Department of Radiology (Switzerland)

    2012-10-15

    Introduction: The purpose of the present study was to analyze complications following antegrade puncture of the common femoral artery (CFA) and the superficial femoral artery (SFA) using vascular closure systems (VCS). Methods: A single-center, retrospective study was performed after obtaining approval from the institutional review board and informed consent from all patients. At our center, the CFA or SFA are used for arterial access. All patients were evaluated clinically on the same day. If there was any suspicion of an access site problem, Duplex ultrasound was performed. Results: Access location was the CFA in 50 patients and the SFA in 130 patients. The sheath size ranged from 4F to 10F. Two patients had to be excluded because of lack of follow-up. Successful hemostasis was achieved in 162 of 178 cases (91 %). The following complications were observed in 16 patients (8.9 %): 4 pseudoaneurysms (2.2 %), 11 hematomas (6.2 %), and 1 vascular occlusion (0.5 %). The two pseudoaneurysms healed spontaneously, in one case an ultrasound-guided thrombin injection was performed, and one aneurysm was compressed manually. No further medical therapy was needed for the hematomas. The one vascular occlusion was treated immediately with angioplasty using a contralateral approach. No significant difference was noted between the CFA and the SFA group with respect to complications (p = 1.000). Conclusions: The use of closure devices for an antegrade approach up to 10F is feasible and safe. No differences in low complication rates were observed between CFA and SFA.

  7. Neurological Complications Comparing Endoscopically vs. Open Harvest of the Radial Artery

    Science.gov (United States)

    2016-07-05

    Complications Due to Coronary Artery Bypass Graft; Coronary Artery Disease; Myocardial Ischemia; Coronary Disease; Heart Diseases; Cardiovascular Diseases; Arteriosclerosis; Arterial Occlusive Diseases; Vascular Diseases

  8. Thermochemoradiation Therapy Using Superselective Intra-arterial Infusion via Superficial Temporal and Occipital Arteries for Oral Cancer With N3 Cervical Lymph Node Metastases

    Energy Technology Data Exchange (ETDEWEB)

    Mitsudo, Kenji, E-mail: mitsudo@yokohama-cu.ac.jp [Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama (Japan); Koizumi, Toshiyuki; Iida, Masaki; Iwai, Toshinori; Oguri, Senri [Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama (Japan); Yamamoto, Noriyuki [Department of Oral and Maxillofacial Surgery, Nagoya University Graduate School of Medicine, Nagoya (Japan); Itoh, Yoshiyuki [Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya (Japan); Kioi, Mitomu; Hirota, Makoto; Tohnai, Iwai [Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama (Japan)

    2012-08-01

    Purpose: To evaluate the therapeutic results and histopathological effects of treatment with thermochemoradiation therapy using superselective intra-arterial infusion via the superficial temporal and occipital arteries for N3 cervical lymph node metastases of advanced oral cancer. Methods and Materials: Between April 2005 and September 2010, 9 patients with N3 cervical lymph node metastases of oral squamous cell carcinoma underwent thermochemoradiation therapy using superselective intra-arterial infusion with docetaxel (DOC) and cisplatin (CDDP). Treatment consisted of hyperthermia (2-8 sessions), superselective intra-arterial infusions (DOC, total 40-60 mg/m{sup 2}; CDDP, total 100-150 mg/m{sup 2}) and daily concurrent radiation therapy (total, 40-60 Gy) for 4-6 weeks. Results: Six of 9 patients underwent neck dissection 5-8 weeks after treatment. In four of these 6 patients, all metastatic lymph nodes, including those at N3, were grade 3 (non-viable tumor cells present) or grade 4 (no tumor cells present) tumors, as classified by the system by Shimosato et al (Shimosato et al Jpn J Clin Oncol 1971;1:19-35). In 2 of these 6 patients, the metastatic lymph nodes were grade 2b (destruction of tumor structures with a small amount of residual viable tumor cells). The other 3 patients did not undergo neck dissection due to distant metastasis after completion of thermochemoradiation therapy (n=2) and refusal (n=1). The patient who refused neck dissection underwent biopsy of the N3 lymph node and primary sites and showed grade 3 cancer. During follow-up, 5 patients were alive without disease, and 4 patients died due to pulmonary metastasis (n=3) and noncancer-related causes (n=1). Five-year survival and locoregional control rates were 51% and 88%, respectively. Conclusions: Thermochemoradiation therapy using intra-arterial infusion provided good histopathologic effects and locoregional control rates in patients with N3 metastatic lymph nodes. However, patients with N3

  9. Endothelial dysfunction and the occurrence of radial artery spasm during transradial coronary procedures: The ACRA-Spasm study

    NARCIS (Netherlands)

    Van Der Heijden, D.J. (Dirk J.); M.A.H. van Leeuwen (Maarten); G.N. Janssens (Gladys N.); Hermie, J. (Jailen); M.J. Lenzen (Mattie); M.J.P.F. Ritt; P.M. van de Ven (Peter); F. Kiemeneij (Ferdinand); N. van Royen (Niels)

    2016-01-01

    textabstractAims: The aim of this study was to analyse the relation between endothelial dysfunction (ED) and the occurrence of radial artery spasm (RAS) during transradial coronary procedures. Methods and results: From May 2014 to June 2015, endothelial function was assessed by EndoPAT and FMD befor

  10. An ultrasound-based method for determining pulse wave velocity in superficial arteries.

    Science.gov (United States)

    Rabben, Stein Inge; Stergiopulos, Nikos; Hellevik, Leif Rune; Smiseth, Otto A; Slørdahl, Stig; Urheim, Stig; Angelsen, Bjørn

    2004-10-01

    In this paper, we present a method for estimating local pulse wave velocity (PWV) solely from ultrasound measurements: the area-flow (QA) method. With the QA method, PWV is estimated as the ratio between change in flow and change in cross-sectional area (PWV = dQ/dA) during the reflection-free period of the cardiac cycle. In four anaesthetized dogs and 21 human subjects (age 23-74) we measured the carotid flow and cross-sectional area non-invasively by ultrasound. As a reference method we used the Bramwell-Hill (BH) equation which estimates PWV from pulse pressure and cross-sectional area. Additionally, we therefore measured brachial pulse pressure by oscillometry in the human subjects, and central aortic pulse pressure by micro-manometry in the dogs. As predicted by the pressure dependency of arterial stiffness, the estimated PWV decreased when the aortic pressure was lowered in two of the dogs. For the human subjects, the QA and BH estimates were correlated (R=0.43, pBH method increased with age (pBH method, indicating different precisions for the two methods. This study illustrates that the simple equation PWV = dQ/dA gives estimates correlated to the PWV of the reference method. However, improvements in the basic measurements seem necessary to increase the precision of the method.

  11. Evaluation of the radial artery applanation tonometry technology for continuous noninvasive blood pressure monitoring compared with central aortic blood pressure measurements in patients with multiple organ dysfunction syndrome.

    Science.gov (United States)

    Meidert, Agnes S; Huber, Wolfgang; Hapfelmeier, Alexander; Schöfthaler, Miriam; Müller, Johannes N; Langwieser, Nicolas; Wagner, Julia Y; Schmid, Roland M; Saugel, Bernd

    2013-12-01

    We compared blood pressure (BP) measurements obtained using radial artery applanation tonometry with invasive BP measurements using a catheter placed in the abdominal aorta through the femoral artery in patients with multiple organ dysfunction syndrome (MODS). In 23 intensive care unit patients with MODS, we simultaneously assessed BP values for 15 minutes per patient using radial artery applanation tonometry (T-Line TL-200 pro device; Tensys Medical Inc, San Diego, Calif) and the arterial catheter (standard-criterion technique). A total of 2879 averaged 10-beat epochs were compared using Bland-Altman plots. The mean difference ± SD (with corresponding 95% limits of agreement) between radial artery applanation tonometry-derived BP and invasively assessed BP was +1.0 ± 5.5 mm Hg (-9.9 to +11.8 mm Hg) for mean arterial pressure, -3.3 ± 11.2 mm Hg (-25.3 to +18.6 mm Hg) for systolic arterial pressure, and +4.9 ± 7.0 mm Hg (-8.8 to +18.6 mm Hg) for diastolic arterial pressure, respectively. In intensive care unit patients with MODS, mean arterial pressure and diastolic arterial pressure can be determined accurately and precisely using radial artery applanation tonometry compared with central aortic values obtained using a catheter placed in the abdominal aorta through the femoral artery. Although systolic arterial pressure could also be derived accurately, wider 95% limits of agreement suggest lower precision for determination of systolic arterial pressure. © 2013.

  12. Differences in perioperative femoral and radial arterial blood pressure in neonates and infants undergoing pediatric cardiac surgery requiring cardiopulmonary bypass.

    Science.gov (United States)

    Cho, Hwa Jin; Lee, Sang Hoon; Jeong, In Seok; Yoon, Nam Sik; Ma, Jae Sook; Ahn, Byoung Hee

    2017-08-30

    Several reports claim that blood pressure (BP) in the radial artery may underestimate the accurate BP in critically ill patients. Here, the authors evaluated differences in mean blood pressure (MBP) between the radial and femoral artery during pediatric cardiac surgery to determine the effectiveness of femoral arterial BP monitoring. The medical records of children under 1 year of age who underwent open-heart surgery between 2007 and 2013 were retrospectively reviewed. Radial and femoral BP were measured simultaneously, and the differences between these values were analyzed at various times: after catheter insertion, after the initiation of cardiopulmonary bypass (CPB-on), after aortic cross clamping (ACC), after the release of ACC, after weaning from CPB, at arrival in the intensive care unit (ICU), and every 6h during the first day in the ICU. A total of 121 patients who underwent open-heart surgery met the inclusion criteria. During the intraoperative period, from the beginning to the end of CPB, radial MBPs were significantly lower than femoral MBPs at each time-point measured (p60min, odds ratio: 7.47) was a risk factor for lower radial pressure. However, discrepancies between these two values disappeared after arrival in the ICU. There was no incidence of ischemic complications associated with the catheterization of both arteries. The authors suggest that femoral arterial pressure monitoring can be safely performed, even in neonates, and provides more accurate BP values during CPB-on periods, and immediately after weaning from CPB, especially when CPB time was greater than 60min. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  13. Assessment of the efficacy of phentolamine to prevent radial artery spasm during cardiac catheterization procedures: a randomized study comparing phentolamine vs. verapamil.

    Science.gov (United States)

    Ruiz-Salmerón, Rafael J; Mora, Ramón; Masotti, Mónica; Betriu, Amadeo

    2005-10-01

    The objective of this study was to evaluate phentolamine as radial artery spasmolytic in transradial catheterization procedures. Radial artery spasm is a relatively frequent complication during transradial approach, causing patient discomfort or even making it impossible to continue the procedure. As radial artery spasm is mediated by the stimulation of alpha-adrenoreceptors, the use of the alpha-blocker phentolamine could make sense as spasmolytic. We designed a randomized double-blind study to compare phentolamine vs. verapamil, the standard spasmolytic agent. Five hundred patients (250 in each arm) submitted to a transradial cardiac catheterization were consecutively included and randomly assigned to receive 2.5 mg of verapamil or 2.5 mg of phentolamine after sheath insertion. Both vasodilator agents induced a significant radial artery diameter increase (from 2.22 +/- 0.53 to 2.48 +/- 0.57 mm, P phentolamine). However, verapamil was more efficacious to prevent radial artery spasm (13.2% compared with 23.2% in phentolamine-treated patients; P = 0.004). Follow-up (20 +/- 18 days) evaluation of the radial artery patency by plestismography and pulse oximetry showed no differences between the two groups in the rate of radial occlusion (3.0% vs. 3.2% in verapamil and phentolamine treated patients, respectively). Phentolamine was an effective radial vasodilator agent, although it showed less ability to prevent radial artery spasm than verapamil. Radial artery occlusion rate was almost identical for both vasodilators. Thus, phentolamine could be a valid alternative to verapamil as a radial artery spasmolytic agent.

  14. Estudio neurofisiológico de la inervación sensitiva de la porción dorsomedial de la mano por parte de la rama superficial del nervio radial como variante de la normalidad.

    OpenAIRE

    Parra Escorihuela, Silvia

    2015-01-01

    La inervación sensitiva del dorso de la mano depende fundamentalmente del nervio cubital dorsal que se encarga de la porción dorsomedial de la mano y del nervio radial superficial que inerva la porción dorsolateral. Se ha descrito la inervación de la porción dorsomedial de la mano por parte del nervio radial como variante de la normalidad, si bien los artículos publicados son muy escasos y difieren en la frecuencia observada e incluso en su existencia. Su conocimiento es fundamental para un c...

  15. Successful Endovascular Repair of an Iatrogenic Perforation of the Superficial Femoral Artery Using Self-Expanding Nitinol Supera Stents in a Patient with Acute Thromboembolic Limb Ischemia

    Directory of Open Access Journals (Sweden)

    Tom Eisele

    2016-01-01

    Full Text Available The treatment of acute thromboembolic limb ischemia includes well-established surgical thrombectomy procedures and, in recent times, also percutaneous rotational thrombectomy using Straub Rotarex® system. This modality not only enables efficient treatment of such thrombotic occlusion but also in rare cases may imply the risk of perforation of the occluded artery. Herein, we report the case of a perforation of the superficial femoral artery (SFA in an elderly female patient with thromboembolic limb ischemia. The perforation was successfully treated by implantation of self-expanding nitinol Supera stents and without the need for implantation of a stent graft.

  16. The Efficacy of Single Barrel Superficial Temporal Artery-middle Cerebral Artery Bypass in Treatment of Adult Patients with Ischemic-type Moyamoya Disease

    Science.gov (United States)

    Ha, Mahnjeong; Choi, Chang Hwa; Lee, Jae Il; Cha, Seung Heon; Lee, Sang Weon

    2016-01-01

    Objective So far, there is no study answering the question of which type of surgical technique is practically the most useful in the treatment of adult patients with ischemic type moyamoya disease (MMD). We evaluated the efficacy of single barrel superficial temporal artery (STA)-middle cerebral artery (MCA) bypass in the treatment of adult patients with ischemic type MMD by retrospectively collecting clinical and radiological data. Materials and Methods A retrospective review identified 31 adult patients who underwent 43 single barrel STA-MCA bypass procedures performed for treatment of ischemic-type MMD between 2006 and 2014. The male to female ratio was 17:14 and the mean age was 41 years (range, 21-65 years). Peri-operative complications, angiographic and clinical outcomes were analyzed retrospectively. Results The permanent neurological morbidity and mortality rates were 2.3% and 0%, respectively. During the observation period of a mean of 35 months (range, 12-73 months), 29 patients (93.5%) had no further cerebrovascular events and transient ischemic attack occurred in two patients (6.5%), resulting in an annual stroke risk of 2.2%. Follow-up computed tomography perfusion (CTP) (mean, 18.4 months after surgery) documented improved cerebral hemodynamics in the revascularized hemispheres (p < 0.001). Post-operative patency was clearly verified in 38 bypasses (88.4%) of 43 bypasses on follow-up imaging (mean, 16.5 months). Conclusion Our results suggest that single barrel STA-MCA bypass with wide dural opening is safe and durable method of cerebral revascularization in adult patients with ischemic type MMD and can be considered as a potential treatment option for adult patients with ischemic type MMD. PMID:27847768

  17. Laser Doppler flowmeter study on regional cerebral blood flow in early stage after standard superficial temporal artery-middle cerebral artery bypass surgery for moyamoya disease

    Institute of Scientific and Technical Information of China (English)

    GESANG Dun-zhu; ZHANG Dong; ZHAO Ji-zong; WANG Shuo; ZHAO Yuan-li; WANG Rong; SUN Jian-jun; MENG Ze

    2009-01-01

    Background Standard superficial temporal artery-middle cerebral artery (STA-MCA) bypass surgery is an effective treatment for moyamoya disease, but recent evidence suggests that postoperative cerebral hyperperfusion can occur. In this study, the trendline of changes in regional cerebral blood flow (rCBF) after surgery were continually monitored near the site of anastomosis in order to investigate both the efficacy of the procedure for improving rCBF and the possible riskof hyperperfusion.Methods Standard STA-MCA bypass surgery was performed on 13 patients, rCBF was measured continually using laser Doppler flowmetry (LDF) until the 5th day after the operation with the LDF probe implanted adjacent to the area of the anastomosis. The trendline of rCBF changes postoperatively was recorded for the analysis performed using SPSS 13.0.Results The baseline LDF value of cortical rCBF was (84.68±14.39) perfusion unit (PU), which was linear relative to absolute perfusion volume before anastomosis and (88.90±11.26) PU immediately after anastomosis (P >0.05). The value changed significantly from before to after anastomosis (P 0.05).Conclusions STA-MCA anastomosis improves the cerebral blood supply significantly in the early stage after surgery,however, the risk of symptomatic hyperperfusion may exist, which may possibly occur on the 1st day and 5th day after surgery. A LDF is useful for postoperative monitoring for both the efficacy of bypass and possible risk of neurologic deterioration or bleeding from hyperperfusion.

  18. Ultrasonic Measurement of Transient Change in Stress-Strain Property of Radial Arterial Wall Caused by Endothelium-Dependent Vasodilation

    Science.gov (United States)

    Ikeshita, Kazuki; Hasegawa, Hideyuki; Kanai, Hiroshi

    2008-05-01

    The endothelial dysfunction is considered to be an initial step of atherosclerosis. Additionally, it was reported that the smooth muscle, which constructs the media of the artery, changes its characteristics owing to atherosclerosis. Therefore, it is essential to develop a method for assessing the regional endothelial function and mechanical property of the arterial wall. There is a conventional technique of measuring the transient change in the diameter of the brachial artery caused by flow-mediated dilation (FMD) after the release of avascularization. For more sensitive and regional evaluation, we developed a method of measuring the change in the elasticity of the radial artery due to FMD. In this study, the transient change in the mechanical property of the arterial wall was further revealed by measuring the stress-strain relationship during each heartbeat. The minute change in the thickness (strain) of the radial arterial wall during a cardiac cycle was measured by the phased tracking method, together with the waveform of blood pressure which was continuously measured with a sphygmometer at the radial artery. The transient change in stress-strain relationship during a cardiac cycle was obtained from the measured changes in wall thickness and blood pressure to show the transient change in instantaneous viscoelasticity. From the in vivo experimental results, the stress-strain relationship shows the hysteresis loop. The slope of the loop decreased owing to FMD, which shows that the elastic modulus decreased, and the increasing area of the loop depends on the ratio of the loss modulus (depends on viscosity) to the elastic modulus when the Voigt model is assumed. These results show a potential of the proposed method for the thorough analysis of the transient change in viscoelasticity due to FMD.

  19. Twelve-month experience with the GORE® TIGRIS® Vascular Stent in the superficial femoral and popliteal arteries.

    Science.gov (United States)

    Piorkowski, M; Freitas, B; Steiner, S; Botsios, S; Bausback, Y; Scheinert, D; Schmidt, A

    2015-02-01

    The aim of this paper was to report the continued mid-term follow-up of the first patients world-wide treated with the GORE(®) TIGRIS(®) Vascular Stent, a dual component stent consisting of a nitinol wire frame combined with a fluoropolymer-interconnecting structure. From December 2011 until November 2012, 32 consecutive patients (20 men, mean age 72.8 years) with 40 atherosclerotic femoropopliteal lesions (5% occlusions) underwent angioplasty and implantation of a GORE(®) TIGRIS(®) Vascular Stent. The patients were scheduled for follow-up at 3, 6 and 12 months after stent implantation for duplex ultrasound and assessment of Rutherford-Becker class (RBC) and Ankle-Brachial Index (ABI). Here we report the completed 6-month follow-up and, for the first time, a 12-month follow-up. The median follow-up was 418 days. During the 12-month follow-up 4 patients died. Restenosis or reocclusion of the stent in this time period was observed in 5 lesions (12.5%), resulting in a cumulative primary patency rate of 85.5±6.0%. The ABI increased pre-interventionally from 0.65±0.18 to 0.91±0.18 (PGORE(®) TIGRIS(®) Vascular Stent showed promising results with high 12-month primary patency rates after femoropopliteal endovascular interventions. These first clinical data are very promising compared to other stent concepts in the superficial femoral and popliteal artery.

  20. Assessment of Hyperperfusion by Brain Perfusion SPECT in Transient Neurological Deterioration after Superficial Temporal Artery-Middle Cerebral Artery Anastomosis Surgery

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Won; Kim, Yu Kyeong; Lee, Sang Mi; Eo, Jae Sun; Oh, Chang Wan; Lee, Won Woo; Paeng, Jin Chul; Kim, Sang Eun [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2008-08-15

    Transient neurological deterioration (TND) is one of the complications after extracranial-intracranial bypass surgery, and it has been assumed to be caused by postoperative transient hyperperfusion. This study was performed to evaluate the relationship between TND and preoperative and postoperative cerebral perfusion status on brain perfusion SPECT following superficial temporal artery.middle cerebral artery (STA-MCA) anastomosis surgery. A total of 60 STA-MCA anastomosis surgeries of 56 patients (mean age: 50{+-}16 yrs; M:F=29:27; atherosclerotic disease: 33, moyamoya disease: 27) which were done between September 2003 and July 2006 were enrolled. The resting cerebral perfusion and cerebral vascular reserve (CVR) after acetazolamide challenge were measured before and 10 days after surgery using 99mTc-ethylcysteinate dimer (ECD) SPECT. Moreover, the cerebral perfusion was measured on the third postoperative day. With the use of the statistical parametric mapping and probabilistic brain atlas, the counts for the middle cerebral artery (MCA) territory were calculated for each image, and statistical analyses were performed. In 6 of 60 cases (10%), TND occurred after surgery. In all patients, the preoperative cerebral perfusion of affected MCA territory was significantly lower than that of contralateral side (p=0.002). The cerebral perfusion on the third and tenth day after surgery was significantly higher than preoperative cerebral perfusion (p=0.001, p=0.02). In TND patients, basal cerebral perfusion and CVR on preoperative SPECT were significantly lower than those of non-TND patients (p=0.01, p=0.05). Further, the increases in cerebral perfusion on the third day after surgery were significant higher than those in other patients (p=0.008). In patients with TND, the cerebral perfusion ratio of affected side to contralateral side on third postoperative day was significantly higher than that of other patients (p=0.002). However, there was no significant difference of

  1. Awkward defects around the elbow: The radial recurrent artery flap revisited

    Directory of Open Access Journals (Sweden)

    Maksud M Devale

    2016-01-01

    Full Text Available Background: Soft tissue defects on the posterior aspect of the elbow are commonly seen in patients treated with internal fixation for fractures around the elbow joint. An axial flap based on the radial recurrent artery (RRA is very useful for such defects, especially if a posterior midline arm incision has been taken for skeletal fixation. The aim of this study is to describe the usefulness of RRA flap (based on the RRA in the management of such defects. Materials and Methods: We present a retrospective analysis of 4 cases managed with the RRA flap for soft tissue reconstruction of defects around the elbow joint at our institute from January 2015 to August 2016. All the patients were males with a history of exposed implant following internal fixation of olecranon/distal humerus fracture. The size of defects ranged from 4 cm × 4 cm to 7 cm × 5 cm. Results of the analysis are presented here. Results: All flaps survived completely. There was no infection, hematoma or distal neurovascular deficit. There was minimal donor site morbidity. Conclusion: The RRA flap is a useful, simple flap for defects around the elbow joint in select patients providing one stage, reliable, cosmetically acceptable coverage.

  2. Free superficial peroneal artery perforator flap free transplantation for wound coverage in the hand%腓浅动脉穿支皮瓣游离移植修复手部创面

    Institute of Scientific and Technical Information of China (English)

    杨晓东; 刘杨武; 杨锦; 张根福; 丁茂超; 梅劲; 唐茂林

    2014-01-01

    目的 探讨应用腓浅动脉穿支皮瓣游离移植修复手部创面的临床效果.方法 2008年3月至2012年3月,应用腓浅动脉穿支皮瓣游离移植修复手部创面共9例,其中手掌侧创面4例,虎口区创面1例,手指侧方创面1例,手背创面3例;缺损面积为3.0 cm×4.5 cm~ 5.0 cm×10.0 cm.其中4例与受区桡动脉头静脉吻合,4例与指总动脉浅静脉吻合,1例与尺动脉贵要静脉吻合.5例供区直接缝合,4例供区创面植皮修复.结果 本组9例皮瓣全部存活,未出现血管危象.术后随访3~ 12个月,原缺损部位外形及功能恢复满意,供区外形功能无明显影响.结论 应用腓浅动脉穿支皮瓣游离移植修复手部创面,临床效果满意,值得推广应用.%Objective To investigate the clinical outcomes of repairing wound in the hand with free superficial peroneal artery perforator flap transplantation.Methods From March 2008 to March 2012,9 cases of wound in the hand were treated with free superficial peroneal artery perforator flap transplantation.There were 4 cases of volar defects,1 case of first web space wound,1 case of lateral finger defect and 3 cases of dorsal defects.The size of the wounds ranged from 3.0 cm× 4.5 cm to 5.0 cm × 10.0 cm.The perforator flap vascular pedicle was anastomosed to the radial artery and cephalic vein of the recipient area in 4 cases,to the proper digital artery and superficial vein in 4 cases,and to the ulnar artery and basilic vein in 1 case.The donor site was closed directly in 5 cases and covered with skin graft in 4 cases.Results All of the 9 flaps survived completely.No vascular crisis occurred.Postoperative follow-up ranged from 3 to 12 months.The appearance and function of the repaired sites were satisfactory.Conclusion Free superficial peroneal artery perforator flap transfer for coverage of wound in the hand can lead to satisfactory clinical results.It is an effective method that is worth wide clinical application.

  3. Does vitamin C or its combination with vitamin E improve radial artery endothelium-dependent vasodilatation in patients awaiting coronary artery bypass surgery?

    OpenAIRE

    Uzun, Alper; Yener, Umit; Cicek, Omer Faruk; Yalcinkaya, Adnan; Diken, Adem; Ozkan, Turgut; Ulas, Mahmut; Yener, Ozlem; Turkvatan, Aysel

    2013-01-01

    Background We evaluated the vasodilatory effects of two antioxidants, vitamins C (ascorbic acid) and E (α-tocopherol), on radial artery and endothelium-dependent responses in patients awaiting coronary artery bypass surgery. Methods The study was performed in three groups. The first group took 2 g of vitamin C orally (n = 31, vitamin C group), the second group took 2 g of vitamin C with 600 mg of vitamin E orally (n = 31, vitamins C + E group), and the third group took no medication (n = 31, ...

  4. Superficial Temporal Artery Monitor

    Science.gov (United States)

    1986-03-01

    patient lying on such a " mattress " would eliminate the need for attachment of sensors and would be completely non-obstructive to medical personnel...are useful but not applicable to the cockpit environment because of their sensitivity to vibration , narrow beamwidth, and precise positioning

  5. The association of lesion eccentricity with plaque morphology and components in the superficial femoral artery: a high-spatial-resolution, multi-contrast weighted CMR study

    Directory of Open Access Journals (Sweden)

    Zhao Xihai

    2010-07-01

    Full Text Available Abstract Background Atherosclerotic plaque morphology and components are predictors of subsequent cardiovascular events. However, associations of plaque eccentricity with plaque morphology and plaque composition are unclear. This study investigated associations of plaque eccentricity with plaque components and morphology in the proximal superficial femoral artery using cardiovascular magnetic resonance (CMR. Methods Twenty-eight subjects with an ankle-brachial index less than 1.00 were examined with 1.5T high-spatial-resolution, multi-contrast weighted CMR. One hundred and eighty diseased locations of the proximal superficial femoral artery (about 40 mm were analyzed. The eccentric lesion was defined as [(Maximum wall thickness- Minimum wall thickness/Maximum wall thickness] ≥ 0.5. The arterial morphology and plaque components were measured using semi-automatic image analysis software. Results One hundred and fifteen locations were identified as eccentric lesions and sixty-five as concentric lesions. The eccentric lesions had larger wall but similar lumen areas, larger mean and maximum wall thicknesses, and more calcification and lipid rich necrotic core, compared to concentric lesions. For lesions with the same lumen area, the degree of eccentricity was associated with an increased wall area. Eccentricity (dichotomous as eccentric or concentric was independently correlated with the prevalence of calcification (odds ratio 3.78, 95% CI 1.47-9.70 after adjustment for atherosclerotic risk factors and wall area. Conclusions Plaque eccentricity is associated with preserved lumen size and advanced plaque features such as larger plaque burden, more lipid content, and increased calcification in the superficial femoral artery.

  6. Impaired Fasting Glucose and Diabetes as Predictors for Radial Artery Calcification in End Stage Renal Disease Patients

    Directory of Open Access Journals (Sweden)

    Katarzyna Janda

    2013-01-01

    Full Text Available Objective. The objective of the study was to assess the relationship between selected clinical and biochemical parameters of end stage renal disease (ESRD patients and arterial calcification. Materials and Methods. The study comprised 59 stage 5 chronic kidney disease patients (36 hemodialyzed and 23 predialysis. The examined parameters included common carotid artery intima-media thickness (CCA-IMT, BMI, incidence of diabetes and impaired fasting glucose (IFG, dyslipidemia, hypertension, and 3-year mortality. Plasma levels asymmetric dimethylarginine (ADMA, osteopontin (OPN, osteoprotegerin (OPG, and osteocalcin (OC were also measured. Fragments of radial artery obtained during creation of hemodialysis access were stained for calcifications using von Kossa method and alizarin red. Results. Calcification of radial artery was significantly associated with higher prevalence of IFG and diabetes (P=0.0004 and older age (P=0.003, as well as higher OPG (P=0.014 and ADMA concentrations (P=0.022. Fasting glucose >5.6 mmol/l (IFG and diabetes significantly predicted vascular calcification in multiple logistic regression. The calcification was also associated with higher CCA-IMT (P=0.006 and mortality (P=0.004; OR for death 5.39 [1.20–24.1] after adjustment for dialysis status and age. Conclusion. Combination of renal insufficiency and hyperglycemic conditions exerts a synergistic effect on vascular calcification and increases the risk of death.

  7. An innovative method to measure the peripheral arterial elasticity: spring constant modeling based on the arterial pressure wave with radial vibration.

    Science.gov (United States)

    Wei, Ching-Chuan

    2011-11-01

    In this study, we propose an innovative method for the direct measurement of the peripheral artery elasticity using a spring constant model, based on the arterial pressure wave equation, vibrating in a radial direction. By means of the boundary condition of the pressure wave equation at the maximum peak, we can derive the spring constant used for evaluating peripheral arterial elasticity. The calculated spring constants of six typical subjects show a coincidence with their proper arterial elasticities. Furthermore, the comparison between the spring constant method and pulse wave velocity (PWV) was investigated in 70 subjects (21-64 years, 47 normotensives and 23 hypertensives). The results reveal a significant negative correlation for the spring constant vs. PWV (correlation coefficient = -0.663, p constant method to assess the arterial elasticity is carefully verified, and it is shown to be effective as well as fast. This method should be useful for healthcare, not only in improving clinical diagnosis of arterial stiffness but also in screening subjects for early evidence of cardio-vascular diseases and in monitoring responses to therapy in the future.

  8. [Approaches to radial shaft].

    Science.gov (United States)

    Bartoníček, J; Naňka, O; Tuček, M

    2015-10-01

    In the clinical practice, radial shaft may be exposed via two approaches, namely the posterolateral Thompson and volar (anterior) Henry approaches. A feared complication of both of them is the injury to the deep branch of the radial nerve. No consensus has been reached, yet, as to which of the two approaches is more beneficial for the proximal half of radius. According to our anatomical studies and clinical experience, Thompson approach is safe only in fractures of the middle and distal thirds of the radial shaft, but highly risky in fractures of its proximal third. Henry approach may be used in any fracture of the radial shaft and provides a safe exposure of the entire lateral and anterior surfaces of the radius.The Henry approach has three phases. In the first phase, incision is made along the line connecting the biceps brachii tendon and the styloid process of radius. Care must be taken not to damage the lateral cutaneous nerve of forearm.In the second phase, fascia is incised and the brachioradialis identified by the typical transition from the muscle belly to tendon and the shape of the tendon. On the lateral side, the brachioradialis lines the space with the radial artery and veins and the superficial branch of the radial nerve running at its bottom. On the medial side, the space is defined by the pronator teres in the proximal part and the flexor carpi radialis in the distal part. The superficial branch of the radial nerve is retracted together with the brachioradialis laterally, and the radial artery medially.In the third phase, the attachment of the pronator teres is identified by its typical tendon in the middle of convexity of the lateral surface of the radial shaft. The proximal half of the radius must be exposed very carefully in order not to damage the deep branch of the radial nerve. Dissection starts at the insertion of the pronator teres and proceeds proximally along its lateral border in interval between this muscle and insertion of the supinator

  9. Evaluación de hipertensos en base a registros de variación de diámetro arterial radial Evaluation of hypertensive patients by radial arterial diameter variation recording

    Directory of Open Access Journals (Sweden)

    Fernando M. Clara

    2006-12-01

    Full Text Available Se utilizó la técnica de análisis del registro incruento de las variaciones de diámetro de arteria radial para evaluar el deterioro arterial y el riesgo cardiovascular en pacientes hipertensos. El transductor utilizado consistió en un sensor de movimiento apoyado sobre la zona de palpación del pulso radial. Se efectuó la determinación del índice de aumentación radial, un parámetro que cuantifica la magnitud de las reflexiones de la onda de presión en la región aórtica, sobre un conjunto de 47 hipertensos, y se lo comparó con otro estudio similar efectuado sobre 81 normotensos sanos. Estos últimos presentaron menores valores de dicho índice, pero al avanzar la edad los valores de ambos grupos tendieron a coincidir. Esto fue confirmado al comparar morfológicamente los registros de ambos grupos, hallándose que los registros de ancianos normotensos sanos e hipertensos de edades similares resultaron visiblemente parecidos. Se halló también que determinados hipertensos jóvenes presentaron ciertas características morfológicas similares a las de normotensos de la misma edad, indicando que aún conservaban las características elásticas propias de su grupo etario. Los resultados fueron similares a los logrados sobre registros de presión arterial radial obtenidos mediante tonometría de aplanación, utilizándose una tecnología disponible en nuestro medio y de menor costo.A blood less analysis technique of the diameter variation signal at radial artery was used to evaluate the arterial disease and the cardiovascular risk in hypertensive patients. A movement transducer was used to record the wrist pulse. A radial augmentation index was proposed to quantify the magnitude of the pressure wave reflections in the aortic region. The experiment was carried out with a group of 47 hypertensive men and compared with a similar study performed on 81 normotensive healthy men. The last ones presented smaller values of this index, but as age

  10. Randomized Controlled Trial on the Effect of Channa striatus Extract on Measurement of the Uterus, Pulsatility Index, Resistive Index of Uterine Artery and Superficial Skin Wound Artery in Post Lower Segment Caesarean Section Women.

    Directory of Open Access Journals (Sweden)

    Mohd Rizal Abu Bakar

    Full Text Available To compare the mean of anteroposterior (AP measurements of the uterus in longitudinal and oblique transverse planes, and the pulsatility index (PI and resistive index (RI of the uterine artery and superficial skin wound artery between patients taking Channa striatus and placebo.Channa striatus, also known as haruan, is a fresh water snakehead fish consumed in many parts of Southeast Asia. Channa striatus is also normally consumed by women postpartum to promote wound healing as well as to reduce post-operative pain.This study is a randomised, double blind, placebo-controlled study conducted in women after Lower Segment Caesarean Section (LSCS. Subjects were randomised to either a Channa striatus or a placebo group and were given a daily dosage of 500 mg of Channa striatus extract or 500 mg maltodextrin, respectively, for six weeks post LSCS. The anteroposterior measurements of the uterus in the longitudinal and oblique transverse planes, and the pulsatility index (PI and resistive index (RI of the uterine and superficial skin wound arteries were assessed using pelvic Gray-scale ultrasound and Doppler ultrasound at baseline (Day 3 and at two weeks, four weeks and six weeks post-operatively.Sixty-six subjects were randomised into the study with 33 in the Channa striatus group and 33 in the placebo group. No significant differences were detected in terms of the pulsatility index (PI and the resistive index (RI of the uterine and superficial skin wound arteries between the Channa striatus and placebo groups. However, in the Channa striatus group, the AP measurements of the uterus on the longitudinal and oblique transverse planes were significantly lower compared to the placebo group (p<0.05 and p<0.001, respectively.Daily intake of Channa striatus extract results in marked differences compared to placebo in terms of uterine involution and recovery in women post LSCS.www.isrctn.com 11960786.

  11. Randomized Controlled Trial on the Effect of Channa striatus Extract on Measurement of the Uterus, Pulsatility Index, Resistive Index of Uterine Artery and Superficial Skin Wound Artery in Post Lower Segment Caesarean Section Women

    Science.gov (United States)

    Abdul Karim, Ahmad Helmy; Nik Hussain, Nik Hazlina; Mohd Noor, Norhayati; Omar, Julia; Bin Bai @ Bae, Saringat; Wan Mahmood, Wan Haslindawani; Abdul Razak, Asrenee; Yunus, Rohaizan

    2015-01-01

    Aim To compare the mean of anteroposterior (AP) measurements of the uterus in longitudinal and oblique transverse planes, and the pulsatility index (PI) and resistive index (RI) of the uterine artery and superficial skin wound artery between patients taking Channa striatus and placebo. Background Channa striatus, also known as haruan, is a fresh water snakehead fish consumed in many parts of Southeast Asia. Channa striatus is also normally consumed by women postpartum to promote wound healing as well as to reduce post-operative pain. Methodology This study is a randomised, double blind, placebo-controlled study conducted in women after Lower Segment Caesarean Section (LSCS). Subjects were randomised to either a Channa striatus or a placebo group and were given a daily dosage of 500 mg of Channa striatus extract or 500 mg maltodextrin, respectively, for six weeks post LSCS. The anteroposterior measurements of the uterus in the longitudinal and oblique transverse planes, and the pulsatility index (PI) and resistive index (RI) of the uterine and superficial skin wound arteries were assessed using pelvic Gray-scale ultrasound and Doppler ultrasound at baseline (Day 3) and at two weeks, four weeks and six weeks post-operatively. Results Sixty-six subjects were randomised into the study with 33 in the Channa striatus group and 33 in the placebo group. No significant differences were detected in terms of the pulsatility index (PI) and the resistive index (RI) of the uterine and superficial skin wound arteries between the Channa striatus and placebo groups. However, in the Channa striatus group, the AP measurements of the uterus on the longitudinal and oblique transverse planes were significantly lower compared to the placebo group (p<0.05 and p<0.001, respectively). Conclusion Daily intake of Channa striatus extract results in marked differences compared to placebo in terms of uterine involution and recovery in women post LSCS. Trial Registration www.isrctn.com 11960786

  12. Noninvasive cardiac output determination using applanation tonometry-derived radial artery pulse contour analysis in critically ill patients

    DEFF Research Database (Denmark)

    Compton, Friederike; Wittrock, Marc; Schaefer, Juergen-Heiner

    2008-01-01

    Conventional thermodilution cardiac output (CO) monitoring is limited mainly to intensive care units and operating rooms because it requires the use of invasive techniques. To reduce the potential for complications and to broaden the applicability of hemodynamic monitoring, noninvasive methods...... for CO determination are being sought. Applanation tonometry allows noninvasive CO estimation through pulse contour analysis, but the method has not been evaluated in critically ill patients. We therefore performed noninvasive radial artery applanation tonometry in 49 critically ill medical intensive...... care unit patients and compared CO estimates to invasive CO measurements obtained using a pulmonary artery catheter or the PiCCO transpulmonary thermodilution system. One-hundred-sixteen measurements were performed, and patients were receiving vasopressor support during 78 measurements. When the data...

  13. A case's root cause analysis of osteofascial compartment syndrome induced by radial artery puncture and its defensive strategy

    Institute of Scientific and Technical Information of China (English)

    Feng-Ying Kang; Yang Yang; Yu-Ping Tong; Ya-Li Hu; Ning-Ning Xue

    2016-01-01

    Objective: The objective of this study was to reduce or avoid the occurrence of the cases of osteofascial compartment syndrome induced by a radial artery puncture for arterial blood gas analysis. Methods: We analyzed an adverse event using cheese model analysis, “fish bone” analysis, root cause analysis, and other methods. Results: There are three root causes leading to an adverse event:operation technique, assessment of the disease, and informing patient families. However, there are many reasons to promote the occurrence and development of the event. Conclusions: We should analyze and manage the adverse events in patients from the point of view of a system. Developing the measures of a system defense can enhance patient safety and create a good safety culture.

  14. Renal Arteries: Isotropic, High-Spatial-Resolution, Unenhanced MR Angiography with Three-dimensional Radial Phase Contrast1

    Science.gov (United States)

    Lum, Darren P.; Johnson, Kevin M.; Landgraf, Benjamin R.; Bley, Thorsten A.; Reeder, Scott B.; Schiebler, Mark L.; Grist, Thomas M.; Wieben, Oliver

    2011-01-01

    Purpose: To prospectively compare a new three-dimensional (3D) radial phase-contrast magnetic resonance (MR) angiographic method with contrast material–enhanced MR angiography for anatomic assessment of the renal arteries. Materials and Methods: An institutional review board approved this prospective HIPAA-compliant study. Informed consent was obtained. Twenty-seven subjects (mean age, 52.6 years ± 20.5 [standard deviation]) were imaged with respiratory-gated phase-contrast vastly undersampled isotropic projection reconstruction (VIPR) prior to contrast-enhanced MR angiographic acquisition with a 3.0-T clinical system. The imaging duration for phase-contrast VIPR was 10 minutes and provided magnitude and complex difference (“angiographic”) images with 3D volumetric (320 mm) coverage and isotropic high spatial resolution (1.25 mm3). Quantitative analysis consisted of comparing vessel diameters between the two techniques. Qualitative assessment included evaluation of the phase-contrast VIPR and contrast-enhanced MR angiographic techniques for artifacts, noise, and image quality. Bland-Altman analysis was used for comparison of quantitative measurements, and the Wilcoxon signed rank test was used for comparison of qualitative scores. Results: Phase-contrast VIPR images were successfully acquired in all subjects. The vessel diameters measured with phase-contrast VIPR were slightly greater than those measured with contrast-enhanced MR angiography (mean bias = 0.09 mm). Differences in mean artifact, quality scores for the proximal renal arteries, and overall image quality scores between phase-contrast VIPR and contrast-enhanced MR angiographic techniques were not statistically significant (P = .31 and .29, .27 and .39, and .43 and .69 for readers 1 and 2, respectively). The quality scores for the segmental renal arteries were higher for phase-contrast VIPR than for contrast-enhanced MR angiography (P contrast-enhanced MR angiography and were statistically

  15. Use of the Stingray Re-Entry System in Two Complex Cases of Occluded Superficial Femoral Arteries

    OpenAIRE

    Galbraith, Erin M.; Marc Del Rosario; Khusrow Niazi

    2011-01-01

    Totally occluded infrainguinal arterial disease presents formidable challenges to endovascular revascularization. A variety of devices have been made available to make the crossing of these lesions more amenable to endovascular techniques. We discuss the novel use of a device that has been developed for crossing occluded coronary arteries, the Stingray Re-Entry System.

  16. Use of the Stingray Re-Entry System in Two Complex Cases of Occluded Superficial Femoral Arteries

    Directory of Open Access Journals (Sweden)

    Erin M. Galbraith

    2011-01-01

    Full Text Available Totally occluded infrainguinal arterial disease presents formidable challenges to endovascular revascularization. A variety of devices have been made available to make the crossing of these lesions more amenable to endovascular techniques. We discuss the novel use of a device that has been developed for crossing occluded coronary arteries, the Stingray Re-Entry System.

  17. High Residual Collagen-Induced Platelet Reactivity Predicts Development of Restenosis in the Superficial Femoral Artery After Percutaneous Transluminal Angioplasty in Claudicant Patients

    Energy Technology Data Exchange (ETDEWEB)

    Gary, Thomas, E-mail: thomas.gary@medunigraz.at [Medical University of Graz, Division of Angiology, Department of Internal Medicine (Austria); Prüller, Florian, E-mail: florian.prueller@klinikum-graz.at; Raggam, Reinhard, E-mail: reinhard.raggam@klinikum-graz.at [Medical University of Graz, Clinical Institute of Medical and Chemical Laboratory Diagnostics (Austria); Mahla, Elisabeth, E-mail: elisabeth.mahla@medunigraz.at [Medical University of Graz, Department of Anesthesiology and Intensive Care Medicine (Austria); Eller, Philipp, E-mail: philipp.eller@medunigraz.at; Hafner, Franz, E-mail: franz.hafner@klinikum-graz.at; Brodmann, Marianne, E-mail: marianne.brodmann@medunigraz.at [Medical University of Graz, Division of Angiology, Department of Internal Medicine (Austria)

    2016-02-15

    PurposeAlthough platelet reactivity is routinely inhibited with aspirin after percutaneous angioplasty (PTA) in peripheral arteries, the restenosis rate in the superficial femoral artery (SFA) is high. Interaction of activated platelets and the endothelium in the region of intervention could be one reason for this as collagen in the subendothelium activates platelets.Materials and MethodsA prospective study evaluating on-site platelet reactivity during PTA and its influence on the development of restenosis with a total of 30 patients scheduled for PTA of the SFA. Arterial blood was taken from the PTA site after SFA; platelet function was evaluated with light transmission aggregometry. After 3, 6, 12, and 24 months, duplex sonography was performed and the restenosis rate evaluated.ResultsEight out of 30 patients developed a hemodynamically relevant restenosis (>50 % lumen narrowing) in the PTA region during the 24-month follow-up period. High residual collagen-induced platelet reactivity defined as AUC >30 was a significant predictor for the development of restenosis [adjusted odds ratio 11.8 (9.4, 14.2); P = .04].ConclusionsHigh residual collagen-induced platelet reactivity at the interventional site predicts development of restenosis after PTA of the SFA. Platelet function testing may be useful for identifying patients at risk.

  18. Estimated aortic blood pressure based on radial artery tonometry underestimates directly measured aortic blood pressure in patients with advancing chronic kidney disease staging and increasing arterial stiffness

    DEFF Research Database (Denmark)

    Carlsen, Rasmus K; Peters, Christian D; Khatir, Dinah S;

    2016-01-01

    we compared invasive aortic systolic BP (SBP) with estimated central SBP obtained by radial artery tonometry and examined the influence of renal function and arterial stiffness on this relationship. We evaluated 83 patients with stage 3 to 5 CKD (mean estimated glomerular filtration rate [eGFR] 30 ml......% confidence interval -14.9 to -11.4) mm Hg. Arterial stiffness was evaluated by carotid-femoral pulse wave velocity (cf-PWV) and was significantly increased in CKD patients compared with (versus) control patients (mean 10.7 vs. 9.3 m/s). The difference in BP significantly increased 1.0 mm Hg for every 10 ml....../min decrease in eGFR and by 1.6 mm Hg per 1 m/s increase in cfPWV. Using multivariate regression analysis including both eGFR and cfPWV, the difference between estimated central and invasive aortic SBP was significantly increased by 0.7 mm Hg. For the entire cohort brachial SBP significantly better reflected...

  19. A STUDY ON SUPERFICIAL PALMAR ARCH AND IT’S VARIATIONS

    Directory of Open Access Journals (Sweden)

    Venkateswara Rao

    2015-03-01

    Full Text Available INTRODUCTION: Knowledge of the frequency of anatomical variations of arterial pattern of hand is crucial for safe and successful hand surgical approach, diagnostic and therapeutic procedures. The superficial pal mar arch is a major blood supply to the hand. Various ano malous patterns in the superficial arch of hand are reported. The superficial pal mar arch is formed predominantly by ulnar artery with a contribution from superficial branch of radial artery. OBSERVATIONS: Superficial palmar arch is dissected within the p alm and observed from its origin to termination. Variations in its origin, branches were observed. A classic superficial palmar arch was found in 10% [5/50]. O ut of dissected specimens complete arch found in 67% and incomplete arch was 33%. Incomplete arch is formed by ulnar artery alone. It supply four and half fingers and give five branches. Majority of arches is supplied by three and half fingers and gives four branches. DISCUSSION: Many attempts have been made to classify these variations. A complex cla ssification of superficial pal mar arch by Coleman & Anson [1961]. S ince then, many other classification have been suggested by different authors [Karlsson & N iechajev, 1982; al - Turk & Metcalf, 1984; Doscher et al. 1985; Ruengsakulrachh et al. 2001;] provi des simplest understanding of distribution of the arches. Although the classical pattern of the arch occurs in frequently, anatomical presence of a complete superficial palmar arch varies from 84% to 66% [Coleman & Anson]. This incidence was lower in the c urrent study and might be a reflection of sample size [52 hands]. The median artery was found in 10% of the hands, similar frequency to that reported by McCormack et al. [1953].

  20. Randomized control study of the outback LTD reentry catheter versus manual reentry for the treatment of chronic total occlusions in the superficial femoral artery.

    Science.gov (United States)

    Gandini, Roberto; Fabiano, Sebastiano; Spano, Sergio; Volpi, Tommaso; Morosetti, Daniele; Chiaravalloti, Antonio; Nano, Giovanni; Simonetti, Giovanni

    2013-09-01

    To assess the efficacy and safety of the Outback device in patients with a chronic total occlusion (CTO) of the superficial femoral artery and evaluate its impact on fluoroscopy and procedural times. From October 2006 to March 2007, 52 patients affected by TASC II-D superficial femoral artery CTO were treated with subintimal recanalization. Clinical indications for endovascular recanalization were: claudication, tissue loss, and at rest leg pain with critical limb ischemia. In 26 patients the manual reentry technique was used and in 26 the OUTBACK(®) LTD Re-Entry Catheter was used. Total procedure time, fluoroscopy time and precision in targeting the expected reentry site have been compared. Technical success was achieved in all cases (100%). In group 2, the planned in-target re-entry was achieved in 11/26 cases (42.3%). The procedure was performed with a traditional antegrade approach in 23/26 (88.4%) cases and in three cases (11.6%) a combined antegrade/retrograde approach was necessary. In group 1, the in-target re-entry was achieved in 26/26 cases (100%). In group 2, the mean procedural time was 55.4 ± 14.2 min with a mean fluoroscopy time 39.6 ± 13.9 min compared to 36.0 ± 9.4 min and 29.8 ± 8.9 min, respectively, of group 1 (P < 0.0001). In our experience, the use of this device is very useful for the revascularization of chronic femoral occlusions, even calcific, in which an accurate re-entry cannot be achieved with the conventional subintimal technique. In these cases, the Outback device grants high technical success rates and a significant reduction of procedural and fluoroscopy times. Copyright © 2013 Wiley Periodicals, Inc.

  1. Continuous blood pressure monitoring via non-invasive radial artery applanation tonometry and invasive arterial catheter demonstrates good agreement in patients undergoing colon carcinoma surgery.

    Science.gov (United States)

    Sun, Jing; Chen, Hanjian; Zheng, Jun; Mao, Bin; Zhu, Shengmei; Feng, Jingyi

    2016-12-20

    Radial artery applanation tonometry (RAAT) has been developed and utilized for continuous arterial pressure monitoring. However, evidence is lacking to clinically verify the RAAT technology and identify appropriate patient groups before routine clinical use. This study aims to evaluate the RAAT technology by comparing systolic blood pressure (SBP), mean blood pressure (MBP) and diastolic blood pressure (DBP) values in patients undergoing colon carcinoma surgery. Blood Pressure (BP) values obtained via RAAT (TL-300, Tensys Medical Inc., San Diego, CA, USA) and conventional arterial catheterization from 30 colon carcinoma surgical patients were collected and compared via Bland-Atman method, linear regression and 4-quadrant plot concordance analysis. For SBPs, MBPs and DBPs, means of the differences (±standard deviation; 95% limits of agreement) were -0.9 (±7.6; -15.7 to 13.9) mmHg, 3.1 (±6.5; -9.6 to 15.8) mmHg and 4.3 (±7.4; -10.3 to 18.8) mmHg, respectively. Linear regression coefficients of determination were 0.8706 for SBPs, 0.8353 for MBPs and 0.6858 for DBPs. Four-quadrant concordance correlation coefficients were 0.8740, 0.8522 and 0.7108 for SBPs, MBPs and DBPs, respectively. A highly selected patient collective undergoing colon carcinoma surgery was studied. BP measurements obtained via the TL-300 had clinically acceptable agreement with that acquired invasively using an arterial catheter. For use in clinical routine, it is necessary to take measures for improvement regarding movement artifacts and dilution of noise. A large sample size of patients under various conditions is also needed to further evaluate the RAAT technology before clinically routine use.

  2. 经桡动脉冠状动脉支架植入术后的护理%Nursing after via radial artery coronary artery stent implantation

    Institute of Scientific and Technical Information of China (English)

    李少晶

    2016-01-01

    Objective:To explore the postoperative nursing of via radial artery coronary artery stent implantation in the treatment of coronary heart disease.Methods:215 patients with coronary heart disease were given via radial artery coronary artery stent implantation.The postoperative nursing situation was observed.Results:215 patients were successfully completed surgery.2 cases occurred complications after operation,including 1 case of acute myocardial ischemia and 1 case of false aneurysm.They were treated in a timely manner.The patients recovered and discharged.Conclusion:Nursing staff should enhance the understanding,pay attention to the postoperative observation and nursing,systemly master the clinical features,timely find out various problems,report to the doctor,so that they can give timely effective treatment.Through actively taking comprehensive nursing measures is conducive to the patient's recovery as soon as possible,reduce the complications.%目的:探讨经桡动脉冠状动脉内支架植入术治疗冠心病的术后护理。方法:对215例冠心病患者给予经桡动脉冠状动脉内支架植入术,观察术后护理情况。结果:215例患者皆顺利完成手术治疗,术后出现并发症2例,包括急性心肌缺血1例及假性动脉瘤1例,均得到及时处理,患者康复出院。结论:护理人员应提高认识,重视术后的观察及护理,系统掌握其临床特点,及时发现各种问题,报告医生,以便及时、有效地处理,通过积极采取综合护理措施,有利于患者的尽快康复,减少并发症。

  3. Clinical research of retention radial nerve superficial branch vascular fasciocutaneous pedicle flap%保留桡神经浅支的血管筋膜蒂皮瓣的临床研究

    Institute of Scientific and Technical Information of China (English)

    王夫平; 陈康察; 丘日升; 林戈亮; 石惠文; 冷树立

    2013-01-01

    目的 观察保留桡神经浅支的血管筋膜蒂皮瓣进行转位修复手部创面的可行性及临床效果.方法 临床应用前臂远端保留桡神经浅支的血管筋膜蒂皮瓣修复手腕部软组织缺损7例,皮瓣切取面积7 cm×4 cm~12 cm×7 cm.结果 7例皮瓣中4例完全成活,3例出现静脉回流障碍,其中1例表皮脱落,皮瓣全部成活,质地良好;1例远端皮肤有宽约1.5cm坏死区,经植皮愈合;另1例皮瓣远端有3 cm×2 cm斑片状坏死,经换药瘢痕愈合.术后5例桡神经浅支支配区皮肤感觉正常;2例有麻木感,术后4周恢复正常.经术后3~20个月随访,7例患者对皮瓣修复效果均表示满意,2例对皮瓣部分坏死后的局限性瘢痕及前臂植皮瘢痕有整形愿望.结论 保留桡神经浅支的血管筋膜蒂皮瓣对保留手部皮肤感觉有实用价值,进一步改善静脉回流是防止皮瓣部分坏死的关键因素.%Objective To observe the retention radial nerve superficial branch vascular fasciocutaneous pedicle flap's feasibility, method, indication and clinical effect in hand trauma. Methods 7 patients with soft tissue defects in hand and wrist wound were treated with forearm retention radial nerve superficial branch vascular fasciocutaneous pedicle flap, the flap area was 7 cm×4 cm~12 cm×7 cm, and the clinical outcome were observed. Results The flaps in 4 cases survived successfully, however the other 3 cases developed venous flow obstruction: skin flap distal side had a necrotic area width of 1.5 cm in 1 case, and healed by skin grafting; 1/4 distal skin flap zone had patchy necrosis in 1 case, and healed with contractile scar; the epidermis of the flap was necrotic in 1 case, but the flap's appearance was good. The skin feeling was normal in the area, arranged by superficial branch of the radial nerve in 5 case; 2 cases had numbness, but the depth of pain feeling existed and recovered normal 4 weeks later. After 3~20 months following-up, all these

  4. Randomized trial of Legflow® paclitaxel eluting balloon and stenting versus standard percutaneous transluminal angioplasty and stenting for the treatment of intermediate and long lesions of the superficial femoral artery (RAPID trial): Study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    A. Karimi; S.W. de Boer (Sanne W.); D.A.F. Van Den Heuvel; B. Fioole (Bram); D. Vroegindeweij (Dammis); J.M.M. Heyligers (Jan); P.N.M. Lohle (Paul N.M.); O.E. Elgersma (Otto E.); R.P.T. Nolthenius (Rudolf ); J.A. Vos (Jan Albert); J.-P.P.M. de Vries (Jean-Paul)

    2013-01-01

    textabstractBackground: Restenosis after percutaneous transluminal angioplasty (PTA) of the superficial femoral artery (SFA) may occur in 45% of patients at 2 years follow-up. Paclitaxel-coated balloons have been found to reduce neointimal hyperplasia, and thus reduce restenosis. Recently, the Legfl

  5. Anatomic study of branches-chain base on the superficial peroneal artery%腓浅动脉皮支链的应用解剖

    Institute of Scientific and Technical Information of China (English)

    秦向征; 刘鹏; 许东元; 刘环宇; 金昱; 延光海; 方今女; 丁自海

    2015-01-01

    Objective To definite the specific area and morphology of the branches-chain base on the superficial peroneal artery,provide the Anatomical information for Taking the branches-chain flap.Methods From October,2012 to September,2013,a total of 15 fresh adult cadaveric lower limb were used in the research:which were 3 females and 12 males.There was no history of trauma and surgery.Thirteen specimens were perfused with red latex for microanatomy to observe linking form of the the cutaneous perforators,measuring the outer diameter of perforators at the deep fascia.2 specimens were perfused with self-curing denture acrylic to be vascular cast mold.Results A total of 61 cutaneous branches issued fom the chain of the superficial peroneal nerve nutrient vessels,each side was (4.38 ± 0.77) cutaneous branches,which were the diameter of wearing the deep fascia was (0.57 ± 0.14) mm; Fibula length was (347.76 ± 17.78) mm,The number of cutaneous branches participating the branches-chain was 28,averaged on each side of (2.15 ± 0.38).The diameter was (0.45 ± 0.13) mm,and the area of cutaneous branches-chain of the superficial peroneal artery was (45.95 ± 13.08)% to (76.91 ± 8.71)%.Conclusion Taking the dislocation or free cutaneous flap is safe with branches-chain base on the superficial peroneal artery as the axis in the medium and lower segment of anterolateral of crus.%目的 明确腓浅动脉皮支链形成的区域和形态,为临床切取小腿前外侧皮支链皮瓣提供解剖学基础. 方法 2012年10月-2013年9月,解剖新鲜成年尸体标本下肢15侧,女性3侧,男性12侧,皮肤观察无外伤及手术史.13侧下肢经股动脉灌注红色乳胶,手术显微镜下精细解剖,显示各皮支来源、链状吻合部位和形态,于穿深筋膜处测量各皮支的外径.2侧下肢制做动脉铸型标本. 结果 腓浅动脉皮支共61支,每侧(4.38±0.77)支,各皮支穿过深筋膜处的直径为(0.57±0.14)mm;参与构成腓浅

  6. Fundamental Basis of Scalp Layering Techniques to Protect Against Wound Infection: A Comparative Study Between Conventional and In-to-Out Dissection of the Superficial Temporal Artery.

    Science.gov (United States)

    Chung, Yeongu; Lee, Sung Ho; Choi, Seok Keun

    2017-01-01

    Superficial temporal artery (STA) to middle cerebral artery (MCA) bypass is associated with several surgical problems. Despite the vascular patency and hemodynamic changes after the anastomosis, wound problems can be a major surgical complication. In a review of 41 surgical cases of STA-MCA bypass for moyamoya disease or cerebral occlusive vascular disease, we compared the conventional (out-to-in) dissection method for STA (n = 23) with the in-to-out (ITO) dissection method (n = 18) and evaluated the surgical results with respect to wound problems. The incidence of skin maceration was significantly higher in the conventional dissection group than the ITO dissection group (34.8% vs. 5.5%; P dissection group (39.1%) than the ITO group (22.2%). These data suggest that the simple layering technique of the ITO dissection method can protect against contamination from bacteria and reduce postoperative surgical wound problems. Sealing of the galea aponeurotica (first protective barrier), including fibrous septa and loose areolar tissues, including the periosteal layer (second protective barrier), is an important factor to decrease the rate of scalp wound infection. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Pulsatility Index of Blood Echogenicity of the Human Radial and Common Carotid Arteries: Relation with Age and Stroke

    Energy Technology Data Exchange (ETDEWEB)

    Bok, Tae Hoon; Kong, Qi; Nam, Kweon Ho; Choi, Jay Chol; Paeng, Dong Guk [Department of Ocean System Engineering, Jeju National University, Jeju (Korea, Republic of)

    2012-10-15

    In the present paper, the ultrasound blood images were measured at both the human radial artery(RA) and common carotid artery(CCA), depending on the age, and the pulsatility index of blood echogenicity(PIBE) was analyzed. In addition, the ultrasound blood images were measured at both RA and CCA of both the stroke patients and the control group, and PIBE was compared. PIBE of RA for the young group was similar with that for the old group (0.13{+-}0.21 and 0.16{+-}0.03). PIBE of CCA for the young group, however, was larger than that for the old group (0.70{+-}0.21 and 0.32{+-}0.01), and was more variable depending on the subject. Similarly, the fibrinogen concentrations of the patients (336{+-}61 and 340{+-}126 mg/dl) were more than that of the control group (264{+-}38 and 43 mg/dl), for both RA and CCA. The results indicate the possibility of the ultrasonic test on the correlation between erythrocyte aggregation and stroke, and it is expected that the in-vivo EA measurement would be clinically useful.

  8. Loss of bifurcation patency after cross-over stenting of ostial lesions in superficial femoral artery: possible causes, prevention and reintervention

    Institute of Scientific and Technical Information of China (English)

    Jiang Junhao; Chen Bin; Dong Zhihui; Shi Yun; Li Weimiao; Yue Jianing

    2014-01-01

    Background Crossover stenting across the origin of the profunda femoral artery (PFA) and occasionally into the common femoral artery (CFA) is commonly used after suboptimal balloon angioplasty of ostial occlusive lesions of the superficial femoral artery (SFA) involving the bifurcation.Late stent occlusion at the bifurcation is not rare and results in severe lower extremity ischemia.Therefore,we tried to assess its possible causes,prevention and reintervention.Methods Using a prospectively maintained single-center database,12-month femoral bifurcation patency was retrospectively compared and lesion and procedural predictors of stent occlusion were determined among 63 patients (64 lesions) who between July 2011 and February 2013 underwent crossover (36 non-jailed and 15 jailed SFA,and 12 distal and 1 complete CFA) stenting of de novo ostial SFA lesions.Results Twelve-month overall patency rate at the femoral bifurcation was 88%,with no significant difference between jailed-ostial SFA (80%) and distal CFA (67%) stenting (P=0.731),and significant differences between either and non-jailed ostial stenting (100%,P=0.035 and 0.002).When PFA ostium was jailed by the stent,patients with preexisting CFA or PFA lesions had a 12-month bifurcation patency rate of 20%,significantly lower than those with simple ostial SFA lesions (83%,P=0.015).Stent induced intimal hyperplasia caused bifurcation occlusion in 6 surgical reintervention cases.Conclusions In crossover stenting of ostial lesions in SFA,bifurcation patency loss was significantly higher in distal CFA and jailed ostial SFA stenting than non-jailed ostial SFA stenting.Preexisting CFA or PFA lesion is a significant risk factor for bifurcation patency loss when PFA ostium is jailed by crossover stenting.

  9. Quadruple-component superficial circumflex iliac artery perforator (SCIP) flap: A chimeric SCIP flap for complex ankle reconstruction of an exposed artificial joint after total ankle arthroplasty.

    Science.gov (United States)

    Yamamoto, Takumi; Saito, Takafumi; Ishiura, Ryohei; Iida, Takuya

    2016-09-01

    Total ankle arthroplasty (TAA) is becoming popular in patients with rheumatoid arthritis (RA)-associated ankle joint degeneration. However, ankle wound complications can occur after TAA, which sometimes requires challenging reconstruction due to anatomical complexity of the ankle. Superficial circumflex iliac artery (SCIA) perforator (SCIP) flap has been reported to be useful for various reconstructions, but no case has been reported regarding a chimeric SCIP flap for complex ankle reconstruction. We report a case of complex ankle defect successfully reconstructed with a free quadruple-component chimeric SCIP flap. A 73-year-old female patient with RA underwent TAA, and suffered from an extensive ankle soft tissue defect (13 × 5 cm) with exposure of the implanted artificial joint and the extensor tendons. A chimeric SCIP flap was raised based on the deep branch and the superficial branch of the SCIA, which included chimeric portions of the sartorius muscle, the deep fascia, the inguinal lymph node (ILN), and the skin/fat. The flap was transferred to the recipient ankle. The sartorius muscle was used to cover the artificial joint, the deep fascia to reconstruct the extensor retinaculum, the ILN to prevent postoperative lymphedema, and the adiposal tissue to put around the extensor tendons for prevention of postoperative adhesion. Postoperatively, the patient could walk by herself without persistent leg edema or bowstringing of the extensor tendons, and was satisfied with the concealable donor scar. Although further studies are required to confirm efficacy, multicomponent chimeric SCIP has a potential to be a useful option for complex defects of the ankle.

  10. The phosphodiesterase 3 inhibitor cilostazol dilates large cerebral arteries in humans without affecting regional cerebral blood flow

    DEFF Research Database (Denmark)

    Birk, Steffen; Kruuse, Christina Rostrup; Petersen, Kenneth A;

    2004-01-01

    in the middle cerebral arteries (VMCA) was measured with transcranial Doppler, and the superficial temporal and radial arteries diameters were measured with ultrasonography. During the 4-hour observation period, there was no effect on systolic blood pressure (P = 0.28), but diastolic blood pressure decreased...

  11. Nitric oxide-induced headache may arise from extracerebral arteries as judged from tolerance to isosorbide-5-mononitrate

    DEFF Research Database (Denmark)

    Christiansen, Ingelise; Iversen, Helle Klingenberg; Olesen, Jes

    2008-01-01

    in different cranial arteries over more than 24 h are lacking. We compared the vascular changes of the middle cerebral, superficial temporal and radial arteries during oral administration of isosorbide-5-mononitrate (5-ISMN) 30 mg three times daily for 7 days in 11 healthy subjects in a double...

  12. Nitric oxide-induced headache may arise from extracerebral arteries as judged from tolerance to isosorbide-5-mononitrate3

    DEFF Research Database (Denmark)

    Christiansen, I.; Iversen, H.K.; Olesen, Jes

    2008-01-01

    in different cranial arteries over more than 24 h are lacking. We compared the vascular changes of the middle cerebral, superficial temporal and radial arteries during oral administration of isosorbide-5-mononitrate (5-ISMN) 30 mg three times daily for 7 days in 11 healthy subjects in a double...

  13. Redundant Vasodilator Pathways Underlying Radial Artery Flow-Mediated Dilation Are Preserved in Healthy Aging

    Directory of Open Access Journals (Sweden)

    Kevin D. Ballard

    2014-01-01

    Full Text Available Background. Blocking nitric oxide (NO and vasodilator prostanoids (PN does not consistently reduce flow-mediated dilation (FMD in young adults. The impact of aging on the contribution of NO and PG to FMD is unknown. Methods. FMD was measured in older adults (n=10, 65±3 y after arterial infusion of saline, N(G-monomethyl-L-arginine (L-NMMA, and ketorolac + L-NMMA. Data were compared to published data in young adults. Results. L-NMMA reduced FMD in older adults (8.9±3.6 to 5.9±3.7% although this was not statistically significant (P=0.08 and did not differ (P=0.74 from the reduction observed in young adults (10.0±3.8 to 7.6±4.7%; P=0.03. Blocking PN did not affect FMD in young or older adults. In older adults, L-NMMA reduced (n=6; range = 36–123% decrease, augmented (n=3; 10–122% increase, or did not change FMD (n=1; 0.4% increase. After PN blockade, FMD responses were reduced (n=2, augmented (n=6, or unaffected (n=1. Conclusions. NO or PN blockade did not consistently reduce FMD in healthy older adults, suggesting the existence of redundant vasodilator phenotypes as observed previously in young adults.

  14. Cutting-Balloon Angioplasty Versus Balloon Angioplasty as Treatment for Short Atherosclerotic Lesions in the Superficial Femoral Artery: Randomized Controlled Trial

    Energy Technology Data Exchange (ETDEWEB)

    Poncyljusz, Wojciech, E-mail: wponcyl@poczta.onet.pl; Falkowski, Aleksander, E-mail: bakhis@hot.pl [Pomeranian Medical University, Department of Interventional Radiology (Poland); Safranow, Krzysztof, E-mail: chrissaf@mp.pl; Rac, Monika, E-mail: carmon@pum.edu.pl [Pomeranian Medical University, Department of Biochemistry and Medical Chemistry (Poland); Zawierucha, Dariusz, E-mail: dariusz13@yahoo.com [Interventional Radiology, Sacred Heart Medical Center, River Bend (United States)

    2013-12-15

    Purpose: To evaluate the treatments of a short-segment atherosclerotic stenosis in the superficial femoral arteries with the cutting balloon angioplasty (CBA) versus conventional balloon angioplasty [percutaneous transluminal angioplasty (PTA)] in a randomized controlled trial. Material and Methods: The study group comprised 60 patients (33 men, 27 women; average age 64 years) with a short ({<=}5 cm) focal SFA de novo atherosclerotic stenosis associated with a history of intermittent claudication or rest pain. The primary end point of this study was the rate of binary restenosis in the treated segment 12 months after the intervention. All patients were evenly randomized to either the PTA or CBA treatment arms. Follow-up angiograms and ankle-brachial index (ABI) measurements were performed after 12 months. The evaluation of the restenosis rates and factors influencing its occurrence were calculated by logistic regression analysis. Results: In the intention-to-treat analysis, restenosis rates after 2-month follow-up were 9 of 30 (30 %) in the PTA group and 4 of 30 (13 %) in the CBA group (p = 0.117). In the actual treatment analysis, after exclusion of patients who required nitinol stent placement for a suboptimal result after angioplasty alone (5 patients in the PTA group and none in the CBA group), restenosis rates were 9 of 25 (36 %) and 4 of 30 (13 %), respectively (p = 0.049). In the intention-to-treat analysis there were also significant differences in ABI values between the PTA and CBA groups at 0.77 {+-} 0.11 versus 0.82 {+-} 0.12, respectively (p = 0.039), at 12 months. Conclusion: Based on the presented results of the trial, CBA seems to be a safer and more effective than PTA for treatment of short atherosclerotic lesions in the superior femoral artery.

  15. Non-invasive continuous arterial pressure measurement based on radial artery tonometry in the intensive care unit: a method comparison study using the T-Line TL-200pro device.

    Science.gov (United States)

    Saugel, B; Meidert, A S; Hapfelmeier, A; Eyer, F; Schmid, R M; Huber, W

    2013-08-01

    The T-Line TL-200pro (TL-200pro) device (Tensys Medical, Inc., San Diego, CA, USA), based on radial artery tonometry, provides an arterial pressure (AP) waveform and beat-to-beat values of systolic arterial pressure (SAP), mean arterial pressure (MAP), and diastolic arterial pressure (DAP). The aim of the study was to evaluate this non-invasive technique for continuous AP monitoring in medical intensive care unit (ICU) patients. Arterial pressure measurements obtained using the TL-200pro technology were compared using Bland-Altman analysis with values measured directly from a femoral arterial catheter in 34 ICU patients. Arterial pressure values were analysed and compared in 4502 averaged 10-beat epochs. A bias of +0.72 mm Hg (95% limits of agreement -9.37 to +10.82 mm Hg) was observed for MAP. For SAP and DAP, there was a mean difference of -1.39 mm Hg (95% limits of agreement -18.74 to +15.96 mm Hg) and +4.36 mm Hg (95% limits of agreement -8.66 to +17.38 mm Hg), respectively. The percentage error for MAP, SAP, and DAP was 12%, 14%, and 21%, respectively. Arterial pressure measurement based on radial artery tonometry using the TL-200pro technology is feasible in medical ICU patients. The TL-200pro system is capable of providing MAP values with high accuracy (low mean difference) and precision (narrow limits of agreement) compared with MAP measured invasively using a femoral arterial catheter. The TL-200pro technology is promising for the measurement of SAP and DAP but further development is necessary to improve accuracy and precision.

  16. The effect of the superficial temporal to middle cerebral artery bypass based on the data of motor activation single photon emission computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Kawaguchi, Shoichiro; Uranishi, Ryunosuke; Morimoto, Tetsuya; Sakaki, Toshisuke; Imai, Teruhiko; Ohishi, Hajime [Nara Medical Univ., Kashihara (Japan)

    1999-07-01

    We evaluated and analyzed the effect of the superficial temporal to middle cerebral artery (STA-MCA) bypass for the pure motor function in the ischemic cerebrovascular diseases (CVDs) using the motor activation single photon emission computed tomography (SPECT). Motor activation SPECT was performed on the 25 cases with ischemic CVD treated with STA-MCA bypass. Motor activation SPECT studies using the finger opposition task on the affected side were performed before surgery, at 1 month, and at 3 months after the bypass. The result of the motor activation SPECT was expressed as negative and positive by the visual inspection. During the follow-up period (mean; 2.2 years), there has been no recurrent or worsening clinical symptom. Before bypass, 10 cases were positive in the motor activation SPECT. The other 15 cases were negative. At one month after bypass, 14 cases were positive in the motor activation SPECT. At three months after bypass, 23 cases were positive in the motor activation SPECT. Twenty-two cases showed the improvement of the resting CBF. STA-MCA bypass is useful for pure motor function in the ischemic CVDs based on the motor activation SPECT coupling with their clinical symptoms. (author)

  17. p21-Activated Kinase 4 Promotes Intimal Hyperplasia and Vascular Smooth Muscle Cells Proliferation during Superficial Femoral Artery Restenosis after Angioplasty

    Directory of Open Access Journals (Sweden)

    Liangxi Yuan

    2017-01-01

    Full Text Available The aim of this study is to explore the function of p21-activated kinase 4 (PAK4 in intimal hyperplasia (IH and vascular smooth muscle cells (VSMCs proliferation. We choose vascular samples from patients undergoing angioplasty in superficial femoral artery (SFA as the experimental group and vascular samples from donors without clinical SFA restenosis as the control group, respectively. We draw from the results that both levels of mRNA and protein of PAK4 in the experimental group increased dramatically compared with the control group. IH arose from angioplasty of SFA. Moreover, overexpression of PAK4 dramatically contributed to cell proliferation of VSMCs and promoted cell cycle progression from G0/G1 phase (71.12±0.69% versus 58.77±0.77%, P<0.001 into S phase (23.99±0.21% versus 31.35±0.33%, P<0.001. Besides, PAK4 downregulated the level of p21 and enhanced the activity of Akt as well. And we conclude that PAK4 acts as a regulator of cell cycle progression of VSMC by mediating Akt signaling and controlling p21 levels, which further modulate IH and VSMCs’ proliferation.

  18. Combined stent placement and high dose PGE1 drip infusion for chronic occlusion of the superficial femoral artery as a modality to salvage chronic critical limb ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Ikushima, Ichiro [Department of Radiology, Miyakonojo Medical Association Hospital, 5822-3 Oiwadacho, Miyakonojo 885-0062 (Japan)], E-mail: iku-i@fk.enjoy.ne.jp; Hirai, Toshinori [Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University (Japan); Ishii, Akihiko [Department of Radiology, Miyakonojo Medical Association Hospital, 5822-3 Oiwadacho, Miyakonojo 885-0062 (Japan); Yamashita, Yasuyuki [Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University (Japan)

    2008-04-15

    Purpose: To assess the initial effect, short-term patency, and limb salvage rates of combined stent placement and high-dose prostaglandin E-1 (PGE1) drip infusion for chronic occlusion of the superficial femoral artery (SFA). Materials and methods: A total of 15 arteriosclerotic occlusive lesions of the SFA were treated in 11 consecutive patients (mean age: 78.4 years old). All cases were of category 4 or 5, based on the criteria of the Society of Vascular Surgery and Intermittent Society for Cardiovascular Surgery (SVC/ISCVS). In all cases a self-expandable stainless steel stent was implanted. PGE1 treatment was started 3-5 days before stent placement and continued for 7-10 days after the intervention. The technical success, limb salvage outcomes, patency rates, and complications were examined. Results: In all cases, the technical success rate of the procedure was 100%. After stent implantation, the clinical status of all cases was improved by at least +2, and major amputation was not required in any cases. The 12-month primary, secondary patency rates, and limb salvage rate were 57%, 100%, and 100%, respectively. Conclusion: Combined stent placement and high-dose PGE1 drip infusion is a treatment of choice for salvaging the lower limb of a patient with chronic critical ischemia.

  19. PERSISTENT MEDIAN ARTERY IN THE CARPAL TUNNEL

    Directory of Open Access Journals (Sweden)

    Raviprasanna.K.H

    2014-09-01

    Full Text Available Introduction: Persistent median artery originates from the anterior interosseous artery in proximal one-third of the forearm and accompanies median nerve. Median artery may regress in the forearm or enter palm through the carpal tunnel deep to flexor retinaculum of wrist and supply palm by anastomosing with the superficial palmar arch. Objective: In present study the objective was to study presence of persistent median artery accompanying median nerve and its termination Materials and Methods: The study included 50 human cadaver upper limb specimens at the Department of Anatomy, Mysore Medical College & Research Institute, Mysore during 2011-13. These specimens fixed in 10% formalin were finely dissected and persistent median artery was traced from origin to termination. Results: Out of 50 human cadaver specimens, persistent median artery was present in 4 specimens (8%. All the 4 median arteries originated from anterior interosseous artery and were of palmar type which reached palm. Out of 4 median arteries, 3 median arteries (6% took part in completion of superficial palmar arch, supplying the distal aspect of palm and 1 median artery (2% directly supplied radial two and half fingers without forming arch. Conclusion: Knowledge of unusual variations helps in proper treatment of disorders of the median nerve. Presence of persistent median artery usually will be asymptomatic but may cause symptoms of carpal tunnel syndrome or pronator teres syndrome when subjected to compression. Rarely this artery can be taken for reconstruction

  20. Arterial responses during migraine headache

    DEFF Research Database (Denmark)

    Iversen, Helle Klingenberg; Nielsen, T H; Olesen, J

    1990-01-01

    The superficial temporal artery has been thought to be the main focus of pain during migraine attacks, but its diameter has never been measured directly. The use of a new, high-resolution ultrasound machine to measure arterial size in 25 migraine patients with unilateral head pain showed...... that the lumen was wider on the painful than on the non-painful side during a migraine attack. The diameters of both radial arteries and the temporal artery on the non-painful side were smaller during than between attacks. The generalised vasoconstriction was not shared by the temporal artery on the affected...... side, which suggests a local vasodilatory response. The findings suggest that cephalic arteries may play a role in migraine pathogenesis....

  1. Superficial and deep sternal wound infection after more than 9000 coronary artery bypass graft (CABG: incidence, risk factors and mortality

    Directory of Open Access Journals (Sweden)

    Abbasi Kyomars

    2007-09-01

    Full Text Available Abstract Background Sternal wound infection (SWI is an uncommon but potentially life-threatening complication of cardiac surgery. Predisposing factors for SWI are multiple with varied frequencies in different studies. The purpose of this study was to assess the incidence, risk factors, and mortality of SWI after coronary artery bypass grafting (CABG at Tehran Heart Center. Methods This study prospectively evaluated multiple risk factors for SWI in 9201 patients who underwent CABG at Tehran Heart Center between January 2002 and February 2006. Cases of SWI were confirmed based on the criteria of the Centers for Disease Control and Prevention. Deep SWI (bone and mediastinitis was categorized according to the Oakley classification. Results In the study period, 9201 CABGs were performed with a total SWI rate of 0.47 percent (44 cases and deep SWI of 0.22 percent (21 cases. Perioperative (in-hospital mortality was 9.1% for total SWI and about 14% for deep SWI versus 1.1% for non-SWI CABG patients. Female gender, preoperative hypertension, high functional class, diabetes mellitus, obesity, prolonged intubation time (more than 48 h, and re-exploration for bleeding were significant risk factors for developing SWI (p = 0.05 in univariate analysis. In multivariate analysis, hypertension (OR = 10.7, re-exploration (OR = 13.4, and female gender (OR = 2.7 were identified as significant predictors of SWI (p Conclusion Rarely reported previously, the two risk factors of hypertension and the female gender were significant risk factors in our study. Conversely, some other risk factors such as cigarette smoking and age mentioned as significant in other reports were not significant in our study. Further studies are needed for better documentation.

  2. Utilização da artéria radial como segundo enxerto arterial em pacientes acima de 70 anos The use of the radial artery as the second choice for arterial graft in patients over 70 years of age

    Directory of Open Access Journals (Sweden)

    Joseph Fredric Whitaker

    2005-03-01

    Full Text Available OBJETIVO: Estudo retrospectivo para avaliar a morbi-mortalidade e a evolução hospitalar em pacientes com idade superior a 70 anos, submetidos à operação de revascularização do miocárdio com utilização da artéria radial como segundo enxerto arterial. MÉTODO: No período de agosto de 1994 a dezembro de 2002, foram realizadas 2487 cirurgias de revascularização do miocárdio no Instituto do Coração de Juiz de Fora. Dentre os pacientes operados, 476 tinham idade superior a 70 anos, sendo que em 36 (Grupo II foi utilizada a artéria radial como 2º enxerto arterial. O mesmo tipo de cirurgia foi realizado em 142 pacientes com idade inferior a 70 anos (Grupo I. Não foram incluídas neste estudo reoperações, cirurgias sem CEC ou com procedimentos associados. RESULTADOS: A média de idade do Grupo II foi 72,5 anos, a mortalidade hospitalar neste grupo de pacientes foi 6,0%, a incidência de complicações também foi baixa, comparável à observada no mesmo tipo de operação realizada em pacientes com idade inferior a 70 anos. CONCLUSÃO: Diante destes resultados, os autores acreditam que a artéria radial possa ser usada com segurança como 2º enxerto arterial em pacientes acima de 70 anos, criteriosamente selecionados, apesar do maior risco de co-morbidades associadas nesta faixa etária.OBJECTIVE: Retrospective study eveluating the morbid-mortality and hospital behaviour in patients over 70-years -od patients submitted to myocardial revascularization involving the radial artery as the second arterial graft. METHOD: During the period of August 1994 to December 2002, 2487 cases of myocardial revascularization were performed by the group of the Juiz de Fora Heart Institute, 476 of whom were 70 years of age or older and 36 (Group II received the radial artery as the second arterial graft. The same type of surgery was performed in 142 patients under 70-year-old (Group I. Reoperations, off-pump operations (OPCAB or associated procedures

  3. [Osteo-cutaneous Mycobacterium marinum infection of the elbow and reconstruction with radial collateral artery perforator-based propeller flap].

    Science.gov (United States)

    Gabert, P-E; Lievain, L; Vallée, A; Joly, P; Auquit Auckbur, I

    2016-08-01

    Mycobacterium marinum is an atypical and non-tuberculosis mycobacterium that mainly leads to cutaneous infections. Infections occur through inoculation of the organism through injury to the skin in the presence of contaminated water or fish. The patient often presents with unspecific symptoms and the evolution, in the absence of adequate treatment, is characterized by an expansion of the cutaneous lesion and a spread to deep structures. Infections of tendon sheaths and joints are described, rarely osteomyelitis. Sure diagnosis is hard to obtain and is established from the medical history and microbiological examination. There are no specific therapeutic guidelines. Double or triple antibiotherapy is often effective and should be continued several months after complete resolution of clinical signs. Surgical debridement is required in cases of invasive or resistant infections. We report the case of a young immunocompetent fishmonger with a rare osteocutaneous M. marinum infection of the elbow. Treatment included large surgical excision of infected skin and bone areas and a triple antibiotics administration. Reconstruction have been ensured by a radial collateral artery perforator-based propeller flap, satisfying appropriates functional and cosmetical concerns of this anatomical region. Surgery and appropriate antibiotics treatment were effective and allowed healing of an invasive cutaneous and bone M. marinum infection.

  4. Aneurisma sacular da artéria radial: a propósito de um caso clínico Sacular aneurysm of the radial artery: a case report

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    Nádia Duarte

    2011-06-01

    Full Text Available Os aneurismas da artéria radial são raros e esporádicos, sendo que os pseudoaneurismas são mais frequentes do que os aneurismas verdadeiros e maioritariamente de configuração sacular. A etiologia é variada e diferenciam-se de outros diagnósticos pela pulsação e frémito. Raramente se complicam de ruptura, sendo a trombose e embolização as principais complicações. Dos casos publicados sobre aneurismas verdadeiros da artéria radial, apenas um está descrito como sendo secundário a lesão ocupacional repetitiva, sendo a maioria de causa idiopática. Os autores descrevem um caso de uma mulher de 63 anos, referenciada à consulta de Cirurgia Vascular por crescimento de massa pulsátil na tabaqueira anatómica da mão esquerda. O estudo por eco-doppler e angiografia, confirmaram o diagnóstico de aneurisma sacular da artéria radial, com 20 mm de maior eixo, arcada palmar permeável e sem sinais de embolização distal. Foi submetida a aneurismectomia parcial com laqueação dupla proximal e distal e endoaneurismorrafia. A cirurgia e pós-operatório decorreram sem complicações, nomeadamente complicações isquémicas. A propósito desde caso clínico, discute-se a abordagem diagnóstica e opções terapêuticas.Radial artery aneurysms are sporadic and rare, pseudoaneurysms are more common than true aneurysms, mainly in saccular configuration. The etiology is varied and difference from other diagnostics is done by the presence of pulse and thrill. Thrombosis and embolization are the main complications, while rupture is rare. From the reported cases of true aneurysms of the radial artery, only one is described as being secondary to repetitive occupational injury, the majority being idiopathic. The authors describe the case of a 63 year old woman, referred to a Vascular Surgery consultation because of a growing pulsatile mass in the anatomical snuffbox of the left hand. The Doppler and Angiography studies confirmed the diagnosis of

  5. Estudio de la variación del acabado superficial del cilindro en función de la presión de diseño en los hidromotores de pistones radiales. // Cylinder superficial finish variation study in function of design pressure in radial pistons hydromotors.

    Directory of Open Access Journals (Sweden)

    G. Morejón Vizcaino

    2003-01-01

    Full Text Available En este artículo se realiza un estudio teórico de la tendencia del comportamiento de la rugosidad superficial en los cilindrosde los motores hidráulicos tipo estrella para mantener constante la eficiencia volumétrica ante un incremento de la presiónde trabajo. Con el objetivo de determinar la tendencia de como influye la presión de diseño en la tecnología de construccióndel motor. La tendencia moderna es construir hidromotores con presión de diseño elevada para alcanzar altas densidades depotencia, para este empeño se utiliza la ley de Poiseuille para establecer el modelo de fuga entre cilindro y pistón. Elmodelo de la holgura se establece a partir de suponer lineal el comportamiento descrito en la literatura consultada, seobtienen resultados de rugosidad del cilindro contra presión para mantener la eficiencia volumétrica constante. Quedademostrado que el ensayo, para inferir los valores necesarios para el cálculo a realizar, se realiza sobre un cilindro similar alcilindro del motor.Palabras claves: Eficiencia volumétrica, algoritmo, motores hidráulicos, acabado superficial, fugas.____________________________________________________________________________Abstract.In this article is carried out a theoretical study of the tendency of superficial ruggedness behavior in cylinders of hydraulicmotors (star type to maintain constant the volumetric efficiency when is applied an increment of working pressure withthe objective of determining the tendency of how the design pressure influences in the motor construction technology.Since the modern tendency is to build hydromotors with risen design pressure in order to reach high power densities, forthis engagement the law of Poiseuille is used to establish the fugue pattern between cylinder and piston.The looseness model is stated starting from supposing lineal the behavior described in the consulted literature, results of thecylinder ruggedness against pressure are obtained to maintain

  6. A coincidental variation of the axillary artery: the brachioradial artery and the aberrant posterior humeral circumflex artery passing under the tendon of the latissimus dorsi muscle

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    Marek Konarik

    2014-09-01

    Full Text Available A case of anomalous terminal branching of the axillary artery was encountered and described in a left upper limb of a male cadaver. A series of 214 upper limbs of Caucasian race was dissected. A variant artery, stemming from the very end of the axillary artery followed a superficial course distally. It passed the cubital fossa, ran on the lateral side of the forearm as usual radial artery, crossed ventrally to the palm and terminated in the deep palmar arch. This vessel is a case of the brachioradial artery (incorrectly termed as the “radial artery with high origin”. Moreover, it was associated with another variation, concerning the aberrant posterior humeral circumflex artery passing under the tendon of the latissimus dorsi muscle. The anatomical knowledge of the axillary region is essential for radiodiagnostic, surgical and traumatologic procedures. The superficially located artery brings an elevated danger of heavy bleeding in all unexpected situations, its variant branching can cause problems in radial catheterization procedures and the anomalously coursing other arterial variant poses an elevated danger in surgical procedures concerning the surgical neck of humerus.

  7. Index finger radial digital proper artery transfer and sleeve anastomosis to treat thumb digital artery defect%食指桡侧指固有动脉转位套入法治疗拇指断指

    Institute of Scientific and Technical Information of China (English)

    姚阳; 李崇杰

    2014-01-01

    Objective To investigate the effect of index finger radial digital proper artery transfer and sleeve anastomosis on treatment of thumb digital artery defect. Methods 10 cases of complete or incomplete thumb amputation with digital artery defect, but without tendon or nerve defect, were replanted by index finger radial digital proper artery transfer and sleeve anastomosis to thumb ulnar digital proper artery. Results All of 10 cases survived after operation, finger pulp was plump, color and lustre was florid. The patients were followed up for 10 months to 2 years, the hand function has obtained satisfactory recovery, and extrinsic feature was natural. Conclusion Index finger radial digital proper artery transfer and sleeve anastomosis is especially adaptive to the treatment of thumb digital artery defect.%目的:探讨食指桡侧指固有动脉转位套入法治疗拇指断指的疗效。方法对10例指动脉缺损而无肌腱神经缺损的拇指完全或不完全离断病例,采用食指桡侧指固有动脉转位与拇指尺侧指固有动脉行套入吻合法修复动脉,再植拇指。结果本组10例再植拇指均成活,指腹饱满,色泽红润,经6~24个月随访,患者手部功能恢复满意,外观自然,2例出现虎口狭窄,经手术改善。结论食指桡侧指固有动脉转位套入法适用于单纯拇指指动脉缺损的再植治疗。

  8. An evaluation of radial and ulnar artery flow characteristics in diabetic patients with carpal tunnel syndrome and the diagnostic value of ultrasonography in these patients

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    Ahmet Boyacı

    2014-06-01

    Full Text Available Objectives: This study aimed to research the value of ultrasonography in the diagnosis of carpal tunnel syndrome (CTS in patients with diabetes mellitus (DM and to examine the flow characteristics of the radial and ulnar arteries in diabetic patients with CTS. Methods: A total of 23 diabetic hands diagnosed with CTS from electrophysiological evaluation (DM-CTS, 47 asymptomatic diabetic hands (DM and 50 healthy hands (C as the control group were evaluated with high resolution ultrasonography. The median nerve was measured in the cross-sectional area (CSA, flattening ratio (FR and at the level of the carpal tunnel inlet [proximal (p] and the wrist crease [distal (d]. The radial and ulnar arteries were evaluated with both hands in a neutral position. Results: In the DM-CTS group, the CSA-p and CSA-d values were statistically signficantly greater compared to the DM and C groups (p0.05. The radial artery diameter was determined to be statistically significantly greater in the DM-CTS group than the C group (p<0.05. Conclusion: The median nerve CSA is significantly greater in diabetic CTS patients compared to patients with diabetes only and healthy controls. In the evaluation of CTS in diabetic patients, CSA measured with ultrasonography may be a diagnostic tool. J Clin Exp Invest 2014; 5 (2: 179-185

  9. Comparação da perviedade entre artéria radial e veia safena em pacientes em pós-operatório de cirurgia de revascularização miocárdica com retorno dos sintomas Comparison of patency between radial artery and saphenous vein in a coronary artery bypass grafting post operative with return of the symptoms

    Directory of Open Access Journals (Sweden)

    Herbert Coelho Hortmann

    2010-06-01

    Full Text Available OBJETIVO: Comparar a perviedade da artéria radial e veia safena em pacientes com retorno dos sintomas após cirurgia de revascularização do miocárdio (CRVM. MÉTODOS: Estudo retrospectivo. No período de janeiro de 1998 a dezembro de 2005, foram realizadas 469 CRVMs com o uso da artéria radial dentre os enxertos, no Hospital Vera Cruz, em Belo Horizonte/MG. Destes, 94 pacientes apresentaram alterações isquêmicas no pós-operatório recente ou tardio e foram reestudados com cineangiocoronariografia. Os enxertos foram divididos em três grupos: artéria torácica interna (ATI, artéria radial (AR e veia safena (VS, e foram estratificados segundo a gravidade das lesões: sem lesão grave (OBJECTIVE: To compare the radial artery and saphenous vein's patency in patients with recurrence of symptoms in a coronary artery bypass grafting (CABG. METHODS: Retrospective study. From January 1998 to December 2005, 469 CABGs were performed using the radial artery as a graft, in Vera Cruz Hospital in Belo Horizonte/ MG. Among the patients who underwent those surgeries, 94 presented ischemic changes in early or late postoperative period, which led them to be re-evaluated by coronary angiography. The grafts were divided in three groups: internal thoracic artery (ITA, radial artery (RA and saphenous vein (SV, and they were stratified according to the severity of injury: uninjured or patent (< 70%, severe obstruction (70 to 99% and occlusion. RESULTS: For the 94 patients in the study, 86 grafts of ITA, 94 of RA and 111 of SV were used. For the 86 ITA grafts, 73 (84.88% were found patent. For the 94 RA grafts, 55 (58.51% were found patent, and for the 111 SV grafts, 73 (65.76% were uninjured. A statistically significant difference (P= 0.001 was found between RA and SV grafts, with a higher patency found for VS graft. For the RA grafts, women presented a worse result concerning the RA patency (65.7% and 40.7%, with P = 0.006. Concerning coronary

  10. Arterial endothelial function measurement method and apparatus

    Energy Technology Data Exchange (ETDEWEB)

    Maltz, Jonathan S; Budinger, Thomas F

    2014-03-04

    A "relaxoscope" (100) detects the degree of arterial endothelial function. Impairment of arterial endothelial function is an early event in atherosclerosis and correlates with the major risk factors for cardiovascular disease. An artery (115), such as the brachial artery (BA) is measured for diameter before and after several minutes of either vasoconstriction or vasorelaxation. The change in arterial diameter is a measure of flow-mediated vasomodification (FMVM). The relaxoscope induces an artificial pulse (128) at a superficial radial artery (115) via a linear actuator (120). An ultrasonic Doppler stethoscope (130) detects this pulse 10-20 cm proximal to the point of pulse induction (125). The delay between pulse application and detection provides the pulse transit time (PTT). By measuring PTT before (160) and after arterial diameter change (170), FMVM may be measured based on the changes in PTT caused by changes in vessel caliber, smooth muscle tone and wall thickness.

  11. Authentication of Radial Versus Femoral Arterial Pressure Waveform-Derived Cardiac Output With Transesophageal Echocardiography-Derived Cardiac Output Measurements in Patients Undergoing On-Pump Coronary Bypass Surgery.

    Science.gov (United States)

    Maddali, Madan Mohan; Waje, Niranjan Dilip; Sathiya, Panchatcharam Murthi

    2017-08-01

    The aim of this study was to ascertain if arterial waveform-derived cardiac output measurements from radial and femoral cannulation sites were reliable as compared with transesophageal echocardiography (TEE)-derived cardiac output (CO) values, and which of the CO measurements derived from radial and the femoral arterial pressure waveforms closely tracked simultaneously measured TEE-derived CO values. This study also aimed to ascertain if cardiopulmonary bypass (CPB) would impact the accuracy of arterial pressure-derived CO values from either of the 2 sites. A prospective observational study. Tertiary care cardiac center. Cardiac surgical patients undergoing on-pump primary coronary artery bypass surgery. Waveform-derived CO monitoring through radial and femoral artery cannulation using a FloTrac/Vigileo system. Twenty-seven consecutive cardiac surgical patients undergoing on-pump primary coronary artery bypass surgery were included in the study. Cardiac output was measured sequentially by the arterial pressure waveform analysis method from radial and femoral arterial sites and compared with simultaneously measured TEE-derived CO. Cardiac output data were obtained in triplicate at 6 predefined time intervals: before and after sternotomy, 5, 15, and 30 minutes after separation from CPB and prior to shifting the patient out of the operating room. The overall bias of the study was 0.11 and 0.27, the percentage error was 19.31 and 18.45, respectively, for radial and femoral arterial waveform-derived CO values as compared with TEE-derived CO measurements. The overall precision as compared with the TEE-derived CO values was 16.94 and 15.95 for the radial and femoral cannulation sites, respectively. The bias calculated by the Bland-Altman method suggested that CO measurements from the radial arterial site were in closer agreement with TEE-derived CO values at all time periods, and the relation was not affected by CPB. However, percentage error and precision calculations

  12. Radial Artery Catheterization

    Science.gov (United States)

    ... Search Donate Circulation My alerts Sign In Join Facebook Twitter Home About this Journal Editorial Board General Statistics Circulation Doodle → Blip the Doodle Information for Advertisers Author Reprints Commercial Reprints Customer Service and Ordering ...

  13. Threshold Setting for Likelihood Function for Elasticity-Based Tissue Classification of Arterial Walls by Evaluating Variance in Measurement of Radial Strain

    Science.gov (United States)

    Tsuzuki, Kentaro; Hasegawa, Hideyuki; Kanai, Hiroshi; Ichiki, Masataka; Tezuka, Fumiaki

    2008-05-01

    Pathologic changes in arterial walls significantly influence their mechanical properties. We have developed a correlation-based method, the phased tracking method [H. Kanai et al.: IEEE Trans. Ultrason. Ferroelectr. Freq. Control 43 (1996) 791], for measurement of the regional elasticity of the arterial wall. Using this method, elasticity distributions of lipids, blood clots, fibrous tissue, and calcified tissue were measured in vitro by experiments on excised arteries (mean±SD: lipids 89±47 kPa, blood clots 131 ±56 kPa, fibrous tissue 1022±1040 kPa, calcified tissue 2267 ±1228 kPa) [H. Kanai et al.: Circulation 107 (2003) 3018; J. Inagaki et al.: Jpn. J. Appl. Phys. 44 (2005) 4593]. It was found that arterial tissues can be classified into soft tissues (lipids and blood clots) and hard tissues (fibrous tissue and calcified tissue) on the basis of their elasticity. However, there are large overlaps between elasticity distributions of lipids and blood clots and those of fibrous tissue and calcified tissue. Thus, it was difficult to differentiate lipids from blood clots and fibrous tissue from calcified tissue by simply thresholding elasticity value. Therefore, we previously proposed a method by classifying the elasticity distribution in each region of interest (ROI) (not a single pixel) in an elasticity image into lipids, blood clots, fibrous tissue, or calcified tissue based on a likelihood function for each tissue [J. Inagaki et al.: Jpn. J. Appl. Phys. 44 (2006) 4732]. In our previous study, the optimum size of an ROI was determined to be 1,500 µm in the arterial radial direction and 1,500 µm in the arterial longitudinal direction [K. Tsuzuki et al.: Ultrasound Med. Biol. 34 (2008) 573]. In this study, the threshold for the likelihood function used in the tissue classification was set by evaluating the variance in the ultrasonic measurement of radial strain. The recognition rate was improved from 50 to 54% by the proposed thresholding.

  14. Drug-Eluting Nitinol Stent Treatment of the Superficial Femoral Artery and Above-the-Knee Popliteal Artery (The Zilver PTX Single-Arm Clinical Study): A Comparison Between Diabetic and Nondiabetic Patients

    Energy Technology Data Exchange (ETDEWEB)

    Fanelli, Fabrizio, E-mail: fabrizio.fanelli@uniroma1.it [Sapienza University of Rome, Vascular and Interventional Radiology Unit, Department of Radiological Sciences (Italy); Primo, Massimiliano Di [Hopital Europeen Georges Pompidou, University Paris Descartes (France); Boatta, Emanuele [Sapienza University of Rome, Vascular and Interventional Radiology Unit, Department of Radiological Sciences (Italy); Johnston, Krystal, E-mail: kjohnston@medinst.com [MED Institute, Inc (United States); Sapoval, Marc, E-mail: marc.sapoval2@egp.aphp.fr [Hopital Europeen Georges Pompidou, University Paris Descartes (France)

    2013-10-15

    Purpose: To describe the 1-year results of drug-eluting nitinol stent placement in the femoropopliteal artery of diabetic and nondiabetic patients. Materials and Methods: All patients enrolled in this prospective, multicenter study underwent paclitaxel-eluting stent placement for de novo or restenotic lesions of the superficial femoral and/or popliteal artery. Baseline and follow-up walking impairment questionnaire (WIQ) scores, Rutherford classifications, and ankle-brachial index (ABI) measurements were obtained. Follow-up was completed at 1, 6, and 12 months. Results: There were 285 diabetic patients and 502 nondiabetic patients treated. There were no significant differences in mean lesion length or lesion calcification between patient groups. Procedural success in both treatment groups was >97 %. There were no significant differences between diabetic and nondiabetic groups in Kaplan-Meier estimates of patency, event-free survival (EFS), or freedom from target lesion revascularization (TLR) at 6 and 12 months. Both groups experienced a significant increase in ABI and WIQ values after treatment, and these improvements were sustained to 12-month follow-up; however, nondiabetic patients had significantly greater 6- and 12-month WIQ scores compared with diabetic patients. Based on covariate analysis, the only factors shown to be significant and to negatively influence patency were longer lesion length (p = 0.009), higher Rutherford classification (p = 0.02), and lack of hypertension (p = 0.02); diabetic status was not found to be a significant factor. Conclusion: Diabetic and nondiabetic patients had similar estimates of primary patency, EFS, and freedom from TLR; however, diabetic patients showed less improvement in WIQ scores compared with nondiabetic patients.

  15. Breast reconstruction with superficial inferior epigastric artery flap%腹壁浅动脉蒂游离腹壁皮瓣乳房再造术的初步临床应用

    Institute of Scientific and Technical Information of China (English)

    穆大力; 栾杰; 穆兰花; 严义坪

    2010-01-01

    Objective To present a method for breast reconstruction with the superficial inferior epigastric artery (S1EA) flap and to summarize the operative experiences. Methods The diameter and distribution were evaluated with multipledetector-row computed tomography (MDCT) angiography and doppler perfusion flowmeter. Bipedicle superficial inferior epigastric artery flap was designed below umbilicus. Superficial inferior epigastric artery and vein were anastomosed to the internal mammary artery and vein. Results Since 2007, we have used the superficial inferior epigastric artery flap in 4 cases of breast reconstruction. Four flaps survived completely. With the follow-up of 6-12 months, the reconstructed breasts were well-shaped and there were no complications such as abdominal hernia, bulge and weakness in donor sites. Conclusions Breast reconstruction using the superficial inferior epigastric artery flaps can not only preserve the advantages of the traditional method using the deep inferior epigastric perforator flaps, but also retain the maximal function of the fascia and the rectus abdominal muscle and prevent the occurrence of abdominal weakness and hernia. It is an ideal alternative method of breast reconstruction on condition that definitive preoperative assessment of vessels and skilled surgical technique are provided.%目的 探讨采用腹壁浅动脉(superficial inferior epigastric artery,SIEA)蒂游离腹壁皮瓣乳房再造术方法 、特点及适应证.方法 术前采用多层螺旋CT(multipledetector-row computed tomography,MDCT)三维血管造影及多普勒血流探测仪检查SIEA的直径、走行及分布,于脐与阴阜上缘之间设计皮瓣,采用单蒂或双蒂SIEA,与胸廓内动,静脉吻合,腹部供区直接拉拢缝合.结果 4例乳房再造病例皮瓣全部存活,皮瓣和腹部供区无脂肪液化、坏死、切口裂开、腹壁薄弱及腹壁疝等并发症的出现,再造乳房外形效果满意.结论 SIEA蒂游离腹壁皮瓣与腹

  16. First clinical experience with the Innova versus the Protege EverFlex self-expanding bare metal stents in superficial femoral artery occlusions.

    Science.gov (United States)

    Gabrielli, Roberto; Rosati, Maria Sofia; Chiappa, Roberto; Millarelli, Massimiliano; Marcuccio, Luigi; Siani, Andrea; Caselli, Giovanni

    2015-03-01

    To evaluate outcomes of superficial femoral artery (SFA) stenting with Boston Scientific Innova stent system (Boston Scientific Corporation Place, Natick, Massachusetts, United States) compared with ev3 Protege stent system (Endovascular, Inc., Plymouth, Minnesota, United States) in terms of safety and effectiveness and to identify factors predictive of restenosis. From March 2012 to January 2013, 71 patients with SFA TASC (Trans Atlantic Inter-Societal Consensus)-II B and C occlusive lesions were treated by percutaneous transluminal angioplasty with stenting (30 patients in the Innova group and 41 cases in the Protege group) and were evaluated by retrospective observational data analysis. Chi-square tests for categorical data and time to event provided two-sided p values with a level of significance at 0.05 and 95% confidence intervals (CIs). Survival curves for primary patency were plotted using the Kaplan-Meier method. Univariate analysis for diabetes, hypercholesterolemia, smoking, hypertension, and critical limb ischemia was performed according to the Cox proportional hazards model. The mean follow-up was 14 months (range 1-18 months). The occlusive lesions treated were ≤15 cm in length. The 12-month primary patency rate was significantly higher in the Protege group (81.5%; 31/38) than the Innova group (43.3%; 13/30; hazard ratio [HR] 3.0; 95% CI: 1.38-6.8; p = 0.005. The secondary patency was similar to the primary comparison data and showed a significant advantage for the Protege stent (HR 2.9; 95% CI: 1.21-6.99; p = 0.01). Univariate analysis demonstrated that diabetes and smoking were significantly related to patency failure in both groups. SFA stenting is generally a safe procedure, but the effectiveness and patency rates are significantly lower for Innova than Protege. Furthermore, preoperative diabetes and smoking continue to be associated with low primary patency rate. These preliminary data suggest that Innova stent is not the treatment of choice

  17. A CASE REPORT OF MULTIPLE ARTERIAL ANOMALIES IN A CADAVE R

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    Anbumani

    2015-03-01

    Full Text Available During routine dissection in our department, multiple arterial variations were observed in a cadaver. The following arterial variations are present. They are, superficial brachioulnar artery, which originated at the level of junction of upper and middle th ird of arm. It runs a superficial course anterior to median nerve in the arm and terminates in the formation of superficial palmar arch. The brachial artery terminated as radial and common interosseous artery. Subscapular artery and circumflex humeral arte ry arose as a common trunk from the third part of axillary artery. The circumflex humeral artery later divides into anterior circumflex humeral and posterior circumflex humeral arteries. The right common carotid artery bifurcated into internal carotid arte ry anteromedially and external carotid artery posterolaterally at the level of upper lamin a of th yroid cartilage. A proper knowledge of variations in the arterial pattern is a must for a good treatment outcome, especially in the fields like vascular surge ry, reconstructive surgery, cardiac surgery, angiogram, arterial cannulation, arterio - venous fistula for renal dialysis. etc.

  18. Salvage of critical limb ischemia with the "trellis reserve'' of subintimal superficial femoral-popliteal artery occlusion: a new modality in managing critical limb ischemia--a case report.

    LENUS (Irish Health Repository)

    Sultan, Sherif

    2005-01-01

    Subintimal angioplasty is a safe, effective, but nondurable procedure in treating long superficial femoral artery occlusions in patients with severe lower limb ischemia. The authors report a case of acute thrombosis that presented 16 weeks after subintimal angioplasty. The ;;Trellis\\'\\' percutaneous thrombolytic infusion system permitted a controlled site-specific infusion of recombinant tissue-type plasminogen activator (rtPA). The unique design of the ;;Trellis\\'\\' allowed complete aspiration of thrombus and avoiding regional and systemic thrombolytic side effects. The ;;Trellis\\'\\' system is effective in percutaneous management of thrombotic lesions; however, intimal dissection may need to be addressed.

  19. Estimated aortic blood pressure based on radial artery tonometry underestimates directly measured aortic blood pressure in patients with advancing chronic kidney disease staging and increasing arterial stiffness.

    Science.gov (United States)

    Carlsen, Rasmus K; Peters, Christian D; Khatir, Dinah S; Laugesen, Esben; Bøtker, Hans Erik; Winther, Simon; Buus, Niels H

    2016-10-01

    Central blood pressure (BP) can be assessed noninvasively based on radial tonometry and may potentially be a better predictor of clinical outcome than brachial BP. However, the validity of noninvasively obtained estimates has never been examined in patients with chronic kidney disease (CKD). Here we compared invasive aortic systolic BP (SBP) with estimated central SBP obtained by radial artery tonometry and examined the influence of renal function and arterial stiffness on this relationship. We evaluated 83 patients with stage 3 to 5 CKD (mean estimated glomerular filtration rate [eGFR] 30 ml/min/1.73 m(2)) and 41 controls without renal disease undergoing scheduled coronary angiography. BP in the ascending aorta was measured through the angiography catheter and simultaneously estimated using radial tonometry. The mean difference between estimated central and aortic SBP was -13.2 (95% confidence interval -14.9 to -11.4) mm Hg. Arterial stiffness was evaluated by carotid-femoral pulse wave velocity (cf-PWV) and was significantly increased in CKD patients compared with (versus) control patients (mean 10.7 vs. 9.3 m/s). The difference in BP significantly increased 1.0 mm Hg for every 10 ml/min decrease in eGFR and by 1.6 mm Hg per 1 m/s increase in cfPWV. Using multivariate regression analysis including both eGFR and cfPWV, the difference between estimated central and invasive aortic SBP was significantly increased by 0.7 mm Hg. For the entire cohort brachial SBP significantly better reflected invasive SBP than estimated SBP. Thus, tonometry-based estimates of central BP progressively underestimate invasive central SBP with decreasing renal function and increasing arterial stiffness in CKD patients.

  20. Teste de força de preensão manual: estudo da fadiga mioelétrica do flexor radial do carpo e flexor superficial dos dedos

    Directory of Open Access Journals (Sweden)

    Marco Tulio Baptista

    2013-09-01

    Full Text Available Um protocolo de força de preensão manual (FPM em degraus de intensidade foi empregado para estudo da fadiga dos músculos flexor radial do carpo (FRC e flexor superficial dos dedos (FSD por meio do registro da força de preensão sustentada. Foi feita a análise do sinal eletromiográfico de superfície destes músculos no domínio do tempo e da frequência de 2kHz. Foi utilizado um dinamômetro eletrônico e um conversor analógico-digital de 16 bits. Participaram deste estudo 12 indivíduos saudáveis, ativos e destros, com média de idade 21,53 ± 1,26 anos, percentual de gordura 7,76 ± 3,53%, peso corporal 74,9 ± 10,36 kg e estatura 180,69 ± 7,14 cm. Os indivíduos realizaram o teste de contração isométrica voluntária máxima (CIVM da mão dominante seguido do protocolo de degraus submáximos em 20%, 40% e 60% da CIVM por 10 segundos cada. O processamento dos sinais envolveu a filtragem passa banda e o cálculo dos valores de raiz média quadrática (RMS e frequência mediana (FM em cada degrau de contração submáxima. A análise de variância "two-way" foi aplicada para os valores de RMS e FM. O teste proposto não gerou queda do rendimento de força nos degraus submáximos estabelecidos e a instauração do processo de fadiga do FSD. Por outro lado, o FRC apresentou sinais de fadiga mioelétrica sugerindo o processo de falência da FPM. Estes dados sugerem que a fadiga mioelétrica dos flexores dos dedos durante a FPM é um processo tardio à fadiga dos estabilizadores do punho. O protocolo em degrau de 60% parece desencadear o processo de fadiga mioelétrica do músculo FRC, mas não do FSD, baseado na análise da ativação muscular nos domínios do tempo e frequência.

  1. Recanalização da artéria femoral superficial com stents Zilver: técnica padronizada e análise retrospectiva de 3 anos Superficial femoral artery recanalization with Zilver stents: standard technique and 3-year retrospective analysis

    Directory of Open Access Journals (Sweden)

    Marcelo Ferreira

    2006-12-01

    Full Text Available OBJETIVOS: Descrever a técnica de recanalização endovascular da artéria femoral superficial e fazer uma análise retrospectiva dos 3 primeiros anos da técnica. MÉTODOS: Análise retrospectiva dos pacientes tratados entre 2001 e 2004, visando obter as taxas de perviedade das recanalizações. A amostra considerada neste estudo consta de 79 artérias femorais superficiais recanalizadas em 61 pacientes, nos quais foram utilizados exclusivamente a técnica descrita e o mesmo modelo de stent de nitinol auto-expansível (Zilver, COOK. RESULTADOS: Dos 61 pacientes, 8% possuíam isquemia crítica de membro inferior e 92% apresentavam claudicação incapacitante refratária ao tratamento clínico. A melhora clínica foi observada e referida pelos pacientes numa relação direta à perviedade das recanalizações. A análise estatística demonstrou taxas acumuladas de perviedade primária assistida de 98, 91 e 84% em 12, 24 e 37 meses, respectivamente. As taxas de perviedade, entendida como fluxo continuado nas recanalizações, foram de 96, 93 e 93% em 12, 24 e 37 meses, respectivamente. CONCLUSÕES: Consideramos a técnica da recanalização da artéria femoral superficial um método ao mesmo tempo pouco invasivo, com reduzidas complicações e de consideráveis taxas de sucesso anatômico e perviedade, que, em conjunto, são capazes de proporcionar satisfação e qualidade de vida aos pacientes portadores de doença arterial obstrutiva periférica.OBJECTIVES: To describe the endovascular recanalization technique of the superficial femoral artery and perform a 3-year retrospective analysis of the technique. METHODS: Retrospective analysis of the patients treated between 2001 and 2004, with the aim of obtaining the patency rates of the recanalizations. The sample consisted of 79 recanalized superficial femoral arteries in 61 patients, exclusively using the described technique and the same nitinol self-expanding stent model (Zilver, COOK. RESULTS

  2. Mycotic aneurysm of the popliteal artery as a complication of intravesical BCG therapy for superficial bladder cancer. Case report and literature review.

    NARCIS (Netherlands)

    Witjes, J.A.; Vriesema, J.L.J.; Brinkman, K.; Bootsma, G.P.; Barentsz, J.O.

    2003-01-01

    A 67-year-old man was treated with maintenance intravesical BCG for superficial bladder cancer. As a culture-proven complication of this therapy, he developed general malaise, high fever, granulomatous hepatitis and a mycotic aneurysm in his left knee. All complications were treated successfully wit

  3. Establishment of Drug Sensitive Model for Radial Artery ill vitro%桡动脉体外药物敏感模型的建立

    Institute of Scientific and Technical Information of China (English)

    祝岩; 王辉山; 李新民; 汪曾炜

    2011-01-01

    目的 利用组织浴槽的方法 体外模拟在体桡动脉,摸索建立体外桥血管药物敏感模型,研究单一因素改变对血管舒缩状态的影响.方法 取成年男性桡动脉,4℃Krebs-Ringer保存液中切割成3~4 mm宽、内膜完好的血管环,两端分别牵引,在10 ml麦式组织浴槽中水浴,并连接至换能器、生理记录仪和适度的前负荷上,待血管环状态稳定后记录初长度及静息张力.分别用终浓度为0.06 mol/L的K+和20 μmol/L的乙酰胆碱评估内膜组织的完整性和证实血管环舒张、收缩活性.取内膜完整且舒缩活性良好的血管环分别用不同终浓度的苯肾上腺素作用作为刺激因素,观测血管环收缩程度的变化.绘制在不同半对数克分子浓度苯肾上腺素作用下,血管环收缩静息张力变化曲线.结果 所有血管环在水浴槽中均能很快达到稳定状态.对KCl和乙酰胆碱的反应敏感,提示血管环内膜完整及收缩、舒张功能良好.苯肾上腺素半对数克分子浓度与血管环静息张力呈正相关.结论 利用组织浴槽建立药物敏感模型在方法 上是可行的.血管环可以很好的模拟桥血管在体内的状态,可将实验所得苯肾上腺素浓度一静息张力曲线中的半对数克分子浓度作为后续实验中刺激血管收缩的标准浓度.%Objective To establish a drug sensitive model for radial artery in vitro by utilizing the organ bath to mimic radial artery in vivo, and to study the unifactor which affects the systolic and diastolic state of the radial artery. Methods The radial arteries were harvested from adult male and cut into 3 to 4 mm vessel rings with intima intact in the Krebs-Rubger hquid at 4 ℃. The vessel ring was pulled with proper preload at both ends and connected to the pressure transducer and physilogical recorder in the organ bath. The initial length and resting tension were recorded after stabilization of the radial artery. The 0.06 mol/L KCL

  4. In-line positioning of ultrasound images using wireless remote display system with tablet computer facilitates ultrasound-guided radial artery catheterization.

    Science.gov (United States)

    Tsuchiya, Masahiko; Mizutani, Koh; Funai, Yusuke; Nakamoto, Tatsuo

    2016-02-01

    Ultrasound-guided procedures may be easier to perform when the operator's eye axis, needle puncture site, and ultrasound image display form a straight line in the puncture direction. However, such methods have not been well tested in clinical settings because that arrangement is often impossible due to limited space in the operating room. We developed a wireless remote display system for ultrasound devices using a tablet computer (iPad Mini), which allows easy display of images at nearly any location chosen by the operator. We hypothesized that the in-line layout of ultrasound images provided by this system would allow for secure and quick catheterization of the radial artery. We enrolled first-year medical interns (n = 20) who had no prior experience with ultrasound-guided radial artery catheterization to perform that using a short-axis out-of-plane approach with two different methods. With the conventional method, only the ultrasound machine placed at the side of the head of the patient across the targeted forearm was utilized. With the tablet method, the ultrasound images were displayed on an iPad Mini positioned on the arm in alignment with the operator's eye axis and needle puncture direction. The success rate and time required for catheterization were compared between the two methods. Success rate was significantly higher (100 vs. 70 %, P = 0.02) and catheterization time significantly shorter (28.5 ± 7.5 vs. 68.2 ± 14.3 s, P method as compared to the conventional method. An ergonomic straight arrangement of the image display is crucial for successful and quick completion of ultrasound-guided arterial catheterization. The present remote display system is a practical method for providing such an arrangement.

  5. Vascular Effects of Advanced Glycation End-Products: Content of Immunohistochemically Detected AGEs in Radial Artery Samples as a Predictor for Arterial Calcification and Cardiovascular Risk in Asymptomatic Patients with Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Katarzyna Janda

    2015-01-01

    Full Text Available Objectives. Our aim was to determine whether vascular deposition of advanced glycation end-products (AGEs is associated with arterial calcification and cardiovascular mortality in chronic kidney disease (CKD patients and to assess the relationships between vascular content of AGEs and selected clinical and biochemical parameters. Materials and Methods. The study comprised 54 CKD patients (33 hemodialyzed, 21 predialyzed. Examined parameters included BMI, incidence of diabetes, plasma fasting glucose, AGEs, soluble receptor for AGEs and 2,2-diphenyl-1-picrylhydrazyl (DPPH scavenging, serum C-reactive protein (hsCRP, plasminogen activator inhibitor-1 (PAI-1, and fetuin-A. Fragments of radial artery obtained during creation of hemodialysis access were stained for calcifications using alizarin red. AGEs deposits were identified immunohistochemically and their relative content was quantified. Results. Vascular content of AGEs was positively correlated with BMI, hsCRP, fetuin-A, PAI-1, and DPPH scavenging in simple regression; only fetuin-A was an independent predictor in multiple regression. There was a significant positive trend in the intensity of AGEs immunostaining among patients with grades 1, 2, and 3 calcifications. AGEs immunostaining intensity predicted 3-year cardiovascular mortality irrespective of patient’s age. Conclusions. The present study demonstrates an involvement of AGEs in the development of medial arterial calcification and the impact of arterial AGE deposition on cardiovascular mortality in CKD patients.

  6. 颞浅动脉岛状皮瓣修复重度感染性义眼座暴露%The repair surgery of severe infectious orbital implants exposure with superficial temporal artery island flaps

    Institute of Scientific and Technical Information of China (English)

    杨鸿斌; 刘素芝; 包俊辉; 刘萍

    2013-01-01

    Objective To discuss the method and efficacy of repairment of large severely infectious orbital implants exposure with superficial temporal artery island flaps.Methods To analyse retrospectively the clinical data in ophthalmology department of Xinjiang Hospital of Occupational Disease:6 eyes from 6 cases,with exposure of diameters over 10 mm or concurrent infections in orbital implants.Results After partial penetration and flush for infection control,the patient' s ipsilateral superficial temporal artery island flaps were implanted into the ocular prosthesis to repair the large defect of the conjunctiva sac all at once.All the flaps of 6 cases survived,with stable blood supply,good wear resistance and smooth union with the conjunctiva sac tissues.The ocular prosthesis moved smoothly in all quadrants.Except for the long hair after surgery in 2 cases,no other postoperative complications appeared in the follow-up of 1 to 5 years,with good effect of the treatment.Conclusion The effective partial anti-inflammatory therapy,combined with the superficial temporal artery island flap,is a feasible and effective surgery procedure to repair severe ocular prosthesis exposure and the co-infection.%目的 探讨颞浅动脉岛状皮瓣一次性修复感染性义眼座大面积暴露的方法和效果.方法 新疆职业病医院眼科6例(6眼)义眼座暴露直径>10 mm或合并感染的回顾性分析.结果 经过局部贯穿并冲洗控制感染,取同侧颞浅动脉岛状皮瓣,植入义眼一次性修复大面积结膜囊缺损,6例全部成活,皮瓣血供稳定,耐磨性良好,与结膜囊内组织愈合平整.安装义眼各象限活动自如.术后2例出现毛发过长,需修剪,未见其它术后并发症,随访1~5年,手术效果良好.结论 局部有效抗炎结合颞浅动脉岛状皮瓣,一次性修复严重义眼座暴露合并感染,是可行有效的手术方式.

  7. Free superficial iliac circumflex artery skin flap : the clinical application and management of donor site defects%旋髂浅动脉游离皮瓣的临床应用及供瓣区处理

    Institute of Scientific and Technical Information of China (English)

    韩军涛; 谢松涛; 陶克; 张万福; 计鹏; 胡大海

    2013-01-01

    Objective To investigate the clinical application of free superficial iliac circumflex artery skin flaps,as well as the management of donor site defects.Methods 17 free superficial iliac circumflex artery skin flaps were applied for the traumatic defects or deformities on face,neck,foot,hand,ankle and lower leg,respectively.The donor site defects were closed directly or covered by paraumbilical island flaps.Results The 17 flap size ranged from 5 cm× 3 cm to 19 cm × 14 cm.16 flaps survived completely except 1 flap with partial necrosis,which was closed by free skin graft.The donor site defects were closed directly in 10 cases,and covered by paraumbilical island flaps in 7 flaps without no flap necrosis.The abdomen had a good appearance.Conclusions Good appearance can be achieved with free superficial iliac circumflex artery skin flaps for the dcfects on face,neck,foot,hand,ankle and lower leg.Paraumbilical island flap can be used for the donor site defects.%目的 探讨旋髂浅动脉皮瓣游离移植的临床适应证及供瓣区的修复方法.方法 根据创面大小设计旋髂浅动脉皮瓣,并分别游离移植修复17例面颈部、足踝部及小腿等处创伤及畸形,对供瓣区无法直接拉拢缝合者,设计同侧脐旁岛状皮瓣转移进行修复.结果 17例旋髂浅动脉游离皮瓣,最大面积19 cm×14 cm,最小5 cm×3 cm,16例术后成活良好,1例皮瓣部分坏死,术后2周移植皮片修复.10例供瓣区直接缝合,7例行脐旁岛状皮瓣转移修复,皮瓣全部成活,术后经3个月至2年随访,腹部外形良好.结论 旋髂浅动脉皮瓣游离移植,对于面颈部及手足等处具有良好的修复效果,而同侧脐旁岛状皮瓣亦可使供瓣区得到良好的修复.

  8. Small arteries can be accurately studied in vivo, using high frequency ultrasound

    DEFF Research Database (Denmark)

    Nielsen, T H; Iversen, Helle Klingenberg; Tfelt-Hansen, P

    1993-01-01

    We have validated measurements of diameters of the superficial temporal artery and other small arteries in man with a newly developed 20 MHz ultrasound scanner with A, B and M-mode imaging. The diameter of a reference object was 1.202 mm vs. 1.205 mm as measured by stereomicroscopy (nonsignifican......-gauge plethysmography (nonsignificant). Pulsations were 4.6% in the radial artery. We conclude that high frequency ultrasound provides an accurate and reproducible measure of the diameter of small and medium sized human arteries in vivo....

  9. Nursing of patients with bone fascia compartment syndrome after radial artery coronary artery intervention%经桡动脉冠状动脉介入术后并发骨筋膜间室综合征的护理

    Institute of Scientific and Technical Information of China (English)

    陆月兰; 孟丽华; 高文君

    2015-01-01

    目的:总结经桡动脉冠状动脉介入术后患者发生骨筋膜间室综合征的护理对策。方法对2009年1月~2014年12月经桡动脉冠状动脉介入术后并发骨筋膜间室综合征8例患者的临床资料进行回顾性分析,总结护理对策,包括密切观察病情、肿胀的观察和护理、用药护理、疼痛护理和凝血功能监测。结果所有患者出现疼痛,穿刺前臂明显肿胀、变硬,其中6例桡动脉搏动减弱,1例手指牵拉痛,1例肌力减退,1例右上肢无力,经对症治疗后缓解。结论骨筋膜间室综合征的早期观察至关重要,高度重视患者的主诉,针对并发症产生的原因及时采取有效的护理对策,争取内科保守治疗时间,可减少患者痛苦,促进患者早日康复。%Objective To explore the causes of bone fascia compartment syndrome after radial artery coronary artery intervention and sum up the nursing experience. Method The clinical data of 8 patients with bone fascia compartment syndrome after radial artery coronary artery intervention from January 2009 to December 2014 were analyzed retrospectively to summarize the nursing countermeasures, including close observation of illness, swelling and pain nursing, medication and blood and monitoring of coagulation functions. Result The forearm of all patients were painful, swollen and enlarged, 6 of them with radial pulse abating,1 with finger pulling pain, 2 with muscle decreasing. Conclusions The early observation and treatment of bone fascia compartment syndrome are critical. Great importance to the complaints of patients should be attached in view of the causes of complications so that effective nursing strategy can be taken to save time of conservative treatment, alleviate the patients'pains and promote their early recovery.

  10. Popliteal artery local technique in superficial femoral artery antegrade subintimal recanalization%腘动脉局域超选技术用于股浅动脉内膜下顺行开通

    Institute of Scientific and Technical Information of China (English)

    裴轶飞; 刘广钦; 包俊敏

    2012-01-01

    Objective To evaluate popliteal artery local technique in superficial femoral artery antegrade subintimal recanalization.Methods From January 2009 to Dec 2011,550 limbs in 476 TASC (Trans-Atlantic Inter-Society Consensus) Ⅱ C/D cases underwent endo-therapy at our department.The success rate、operation time、symptom progress and follow up were analyzed retrospectively.Results In the 550 limbs,62 limbs received popliteal artery local technique directly.There was 9 technical failures.Procedures succeeded in 53 limbs(85.5% ).The average operation time was (69 ±24) min,(1.8 ±0.6) stents were used and the main covered length was ( 33 ± 6) cm.Symptoms of 46 limbs was improved and unchanged in 6,amputation needed to be done in one limb.One year follow up accomplished for 39 limb.The 6 and 12 months patence rate was 87.1% and 69.2%.For 488 limbs using traditional approach 378 achieved anti-grade recanalization,the average operation time was ( 89 ± 30) min,average (2.1 ± 0.6) stents were used and the main covered length is (31 ± 13) cm.Symptom in 300 limbs improved.The half and one year patence rate in 292 limbs was 92.1% and 61.0%.Conclusions The popliteal artery local technique is as effective as with traditional approach and is time saving.%目的 研究腘动脉局域超选法在完成股浅动脉顺向内膜下开通中的作用.方法 2009年1月至2011年12月对467例患者(550条肢体)行腔内治疗,病变均为泛大西洋协作组(Trans-Atlantic Inter-Society Consensus,TASC)定义的ⅡC/D级股腘动脉闭塞.统计其中直接应用腘动脉局域超选技术和传统真腔超选方法的62条肢体,观察其手术成功率、手术时间、症状改善和随访情况.结果 在550条肢体中,62条肢体直接应用了腘动脉局域超选技术,其中9条肢体未能顺向返回真腔操作.53条肢体(85.5%)完成手术,平均手术时间(69 ±24) min,平均支架应用数(1.8±0.6)枚,平均覆盖长度(33 ±6) cm.46条肢体(86.8

  11. Micro-computed tomographic analysis of the radial geometry of intrarenal artery-vein pairs in rats and rabbits: Comparison with light microscopy.

    Science.gov (United States)

    Ngo, Jennifer P; Le, Bianca; Khan, Zohaib; Kett, Michelle M; Gardiner, Bruce S; Smith, David W; Melhem, Mayer M; Maksimenko, Anton; Pearson, James T; Evans, Roger G

    2017-08-10

    We assessed the utility of synchrotron-radiation micro-computed tomography (micro-CT) for quantification of the radial geometry of the renal cortical vasculature. The kidneys of nine rats and six rabbits were perfusion fixed and the renal circulation filled with Microfil. In order to assess shrinkage of Microfil, rat kidneys were imaged at the Australian Synchrotron immediately upon tissue preparation and then post fixed in paraformaldehyde and reimaged 24 hours later. The Microfil shrank only 2-5% over the 24 hour period. All subsequent micro-CT imaging was completed within 24 hours of sample preparation. After micro-CT imaging, the kidneys were processed for histological analysis. In both rat and rabbit kidneys, vascular structures identified in histological sections could be identified in two-dimensional (2D) micro-CT images from the original kidney. Vascular morphology was similar in the two sets of images. Radial geometry quantified by manual analysis of 2D images from micro-CT was consistent with corresponding data generated by light microscopy. However, due to limited spatial resolution when imaging a whole organ using contrast-enhanced micro-CT, only arteries ≥100 and ≥60 μm in diameter, for the rat and rabbit respectively, could be assessed. We conclude that it is feasible and valid to use micro-CT to quantify vascular geometry of the renal cortical circulation in both the rat and rabbit. However, a combination of light microscopic and micro-CT approaches are required to evaluate the spatial relationships between intrarenal arteries and veins over an extensive range of vessel size. © 2017 John Wiley & Sons Australia, Ltd.

  12. Elective vs non-elective radial artery grafts: comparing midterm results through 64-Slice computed tomography Enxertos de artéria radial eletivos vs emergência: comparando resultados em seguimento a médio prazo

    Directory of Open Access Journals (Sweden)

    Roberto Rocha-e-Silva

    2007-01-01

    Full Text Available BACKGROUND: Left internal thoracic artery to left anterior descending artery (LITA-LADA grafting has become a fundamental part of the coronary artery bypass graft procedure (CABG. This grafting in turn has led to an increased use of other arterial conduits, of which the radial artery (RA is most popular. Whether RA grafting can be used in the emergency patient is controversial. METHODS: 47 patients with critical stenosis (>70% in all target vessels underwent CABG with LITA and RA grafts from 1996 to 2003. Patients were divided into elective (23 patients and non-elective groups (24 patients with LITA and RA grafts per patient being similar in both groups. Of these 47 patients, 5 died from non-cardiac complications and 12 were unavailable. Thus, 30 patients (71% of survivors were studied by multidetector computed tomography. A total of 36 LITA and 64 RA grafts were studied. RESULTS: The RA patency rate for elective and non-elective grafts were 82% (31/38 and 85% (22/26, respectively (p=0.75. The RA had a similar patency rate for all target vessels ranging from 73% to 100%. Only one patient had a redo CABG and 29 (97% are free from angina or re-intervention. LITA-LADA had a 92% (11/12 and 100% (10/10 patency rate for elective and non-elective groups, respectively (p=0.37. The sequential LITA-diagonal-LADA in the elective group had a 50% (03/06 patency rate, which was significantly lower than the 100% (08/08 patency rate of the non-elective group (p=0.02. CONCLUSION: Radial Artery grafts can be used in both elective and non-elective patients with excellent results.INTRODUÇÃO: A anastomose da artéria torácica interna esquerda com a artéria descendente anterior (ATIE-DA se tornou parte fundamental da cirurgia de revascularização do miocárdio (RM. Esta técnica levou ao aumento de utilização de outros enxertos arteriais, entre os quais, a artéria radial (AR é muito usasa. Na literatura há controvérsia se a AR pode ser usada em pacientes

  13. 切割球囊扩张在股浅动脉长段闭塞治疗中的作用%Angioplasty with cutting balloon in patient with long segmental obstruction of superficial femoral artery

    Institute of Scientific and Technical Information of China (English)

    王爱林; 徐恒; 刘军; 韩圣辉

    2012-01-01

    Objective To compare the technical success rate and midterm results of cutting balloon angioplasty (CBA) to conventional balloon angioplasty (BA) for treatment of long segmental obstruction of the superficial femoral artery. Methods Between March 2009 and May 2010, 33 patients with long segmental obstruction of the superficial femoral artery treated with conventional angioplasty underwent cutting angioplasty. Follow-up consisted clinical examination and computed tomographic angiography at interval of one year. Results After conventional angioplasty there were still severe stenoses in the treated segments of the superficial femoral artery among the 33 selected patients. The stenosis rate decreased from 60% -95% (average 78%) post-conventional angioplasty to 15% -45% (average 36%) after cutting balloon angioplasty. Three patients complicated minor vessel dissection without other major complication. The one year patency of the cutting balloon angioplasty was 66% , which is better than the patency of the conventional balloon angioplasty ( 37% ) . Conclusion Cutting balloon angioplasty provides better vessel patency additional to balloon angioplasty in the treatment of the long segmental obstruction of the superficial femoral artery.%目的 分析评价在常规球囊扩张基础上加用切割球囊治疗股浅动脉长段闭塞的治疗效果和中期通畅率.方法 应用了切割球囊扩张治疗33例股浅动脉长段闭塞患者,导丝通过闭塞段后,首先应用常规球囊进行扩张后,进行动脉造影,对常规球囊扩张后仍有明显狭窄部位进行切割球囊扩张,再次动脉造影评价切割球囊扩张效果.术后对经过治疗的24例患者进行1年的中期随访,并与前期完成的24例单纯常规球囊扩张的1年通畅率进行比较,总结分析两者的中期通畅率、再狭窄的病变特点.结果 在股浅动脉长段闭塞部位进行常规球囊扩张后,均存在不同部位的短段重度狭窄,狭窄部位位于

  14. Ultrasound speckle tracking for radial, longitudinal and circumferential strain estimation of the carotid artery--an in vitro validation via sonomicrometry using clinical and high-frequency ultrasound.

    Science.gov (United States)

    Larsson, Matilda; Heyde, Brecht; Kremer, Florence; Brodin, Lars-Åke; D'hooge, Jan

    2015-02-01

    Ultrasound speckle tracking for carotid strain assessment has in the past decade gained interest in studies of arterial stiffness and cardiovascular diseases. The aim of this study was to validate and directly contrast carotid strain assessment by speckle tracking applied on clinical and high-frequency ultrasound images in vitro. Four polyvinyl alcohol phantoms mimicking the carotid artery were constructed with different mechanical properties and connected to a pump generating carotid flow profiles. Gray-scale ultrasound long- and short-axis images of the phantoms were obtained using a standard clinical ultrasound system, Vivid 7 (GE Healthcare, Horten, Norway) and a high-frequency ultrasound system, Vevo 2100 (FUJIFILM, VisualSonics, Toronto, Canada) with linear-array transducers (12L/MS250). Radial, longitudinal and circumferential strains were estimated using an in-house speckle tracking algorithm and compared with reference strain acquired by sonomicrometry. Overall, the estimated strain corresponded well with the reference strain. The correlation between estimated peak strain in clinical ultrasound images and reference strain was 0.91 (pspeckle tracking demonstrates that carotid strain assessment by ultrasound speckle tracking is feasible. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

  15. Anatomic study on the superficial radial nerve transplanting in repairing peripheral nerve defect and functional reconstruction of donor site%桡神经浅支作为供体神经功能重建的解剖学研究

    Institute of Scientific and Technical Information of China (English)

    李高峰; 田德虎; 董海涛; 刁雪鸥; 于光辉; 梁立伟

    2011-01-01

    Objective To provide anatomic basis after cutting superficial radial nerve to repair peripheral nerve defect and functional reconstruction of donor site. Methods 30 adult cadaveric upper limbs ( 15 left limbs and 15 right limbs) were fixed by formaldehyde. The vertical dimension from bifurcation of superficial radial nerve to lateral antebrachial cutaneous nerve and the vertical dimension to the median nerve were measured. The six fresh cadaveric upper limbs were made pathological section to count nerve-tract numbers of the same horizontal of cutaneous antebrachii lateralis nerve and median nerve under microscope. Results The vertical dimension from bifurcation of ramus superficial radial nerve to lateral antebrachial cutaneous nerve was ( 6.0 ± 1.5 ) mm, and the vertical dimension to the median nerve was ( 35.7 ± 2.8 ) mm. At the same horizontal, the nerve-tract counts of superficial radial nerve were 6 ~ 10;cutaneous antebrachii lateralis nerve was 1 ~3;median nerve was 19 ~27.Conclusion The sensory function of the donor by wayof end-to-side anastomosis between far broken ends of superficial radial nerve and median nerve or lateral antebrachial cutaneous nerve can be reconstructed.%目的 为桡神经浅支切取后供区功能重建提供解剖学基础.方法 成人前臂防腐标本30侧,测量桡神经浅支分支点与前臂外侧皮神经及正中神经尺侧缘的垂直距离;取6侧新鲜尸体与此水平分别将上述神经作病理切片,观察神经束数目.结果 桡神经浅支浅段分支点到前臂外侧皮神经及正中神经尺侧的垂直距离分别为(6.0±1.5) mm及(35.7±2.8) mm.其在此平面附近桡神经浅支内有6~10个神经束;前臂外侧皮神经神经束数目为1~3束;正中神经神经束数目为19~27束.结论 可通过端侧吻合的方式将桡神经浅支远断端与正中神经或前臂外侧皮神经吻合,以重建供区的感觉功能.

  16. Radial forces of stents used in thoracic endovascular aortic repair and bare self-expanding nitinol stents measured ex vivo - Rapid rescue for obstruction of the innominate artery using bare self-expanding nitinol stents.

    Science.gov (United States)

    Matsumoto, Takuya; Inoue, Kentaro; Tanaka, Shinichi; Aoyagi, Yukihiko; Matsubara, Yutaka; Matsuda, Daisuke; Yoshiya, Keiji; Yoshiga, Ryosuke; Ohkusa, Tomoko; Maehara, Yoshihiko

    2017-02-01

    Purpose Our objective was to compare the radial forces of several stents ex vivo to identify stents suitable for rescue of the unexpected coverage of aortic arch branches in thoracic endovascular aortic repair. Methods We measured the radial forces of two types of self-expanding bare nitinol stents (E-luminexx and Epic) used singly or as double-walled pairs, and of three endoprostheses used in thoracic endovascular aortic repair (TEVAR, Gore c-TAG, Relay, and Valiant) by compressing the stent using an MTS Instron universal testing machine (model #5582). We also examined the compressive effects of the TEVAR endoprostheses and the bare nitinol stents on each other. Results The radial force was greater in the center than at the edge of each stent. In all stents tested, the radial force decreased incrementally with increasing stent diameter. The radial force at the center was two times greater when using two stents than with a single stent. In the compression test, only E-luminexx used as a pair was not compressed after compressing a Relay endoprosthesis by 12 mm. Conclusion Two E-luminexx stents are appropriate to restore the blood flow if a TEVAR endoprosthesis covers the innominate artery following innominate-carotid-left subclavian arterial bypass.

  17. Viabahn腔内人工血管治疗股浅动脉狭窄闭塞性病变%Primary effectiveness of the GORE (R) Viabahn endoprosthesis in stenosed or obliterated superficial femoral artery

    Institute of Scientific and Technical Information of China (English)

    郝良玉; 庄百溪; 张童; 马鲁波; 于春利; 杨淼; 石波

    2014-01-01

    Objective To observe the primary clinical results of Gore (R) Viabahn endoprosthesis for atherosclerotic stenosis or occlusion in superficial femoral artery (SFA).Methods From March 2013 to November 2013,45 consecutive patients (54 limbs) who had ischemic symptom due to stenosis or occlusion of superficial femoral artery were treated by endovascular deployment of Gore (R) Viabahn endoprosthesis.We observed patency rate,improvement of Rutherford classification and ankle-brachial index,limb salvage rate and survival rate after 1,3 and 6 months.Results 43 patients (52 limbs)were followed-up,among which 32 patients(38 limbs)belonged to TASC Ⅱ type C or type D lesion.The mean (± SD) length of treated segment in 52 limbs was(19 ±4)cm.The rate of postoperative patency on duplex ultrasonography:one month,3 months and 6 months were 96.15% (50 limbs),92.31% (48 limbs)and 90.38% (47 limbs) ; Ankle-brachial index increased from(0.32 ±0.20)to(0.68 ±0.18) (t =3.180,P < 0.005) after 6 months ; at 6 months limb salvage rate was 96.08 percent (49 limbs),and survival rate was 97.67% (42 patients).Conclusions Implantation of Gore (R) Viabahn endoprosthesis in atherosclerotic stenotic or occluded superficial femoral artery safely achieves a definite primary clinical effectiveness.%目的 总结分析股浅动脉粥样硬化狭窄闭塞病变置入Viabahn腔内人工血管的初期疗效.方法 回顾性分析2013年3-11月收治的因症状性股浅动脉硬化狭窄或闭塞而置入Viabahn腔内人工血管45例患者(54条肢体)临床资料,观察术后l、3、6个月的通畅率、临床分级改善程度、踝肱比变化、保肢率及生存率.结果 最终完成43例患者(52条肢体)的随访数据收集,其中TASCⅡC型及D型病变32例(38条肢体).52条肢体治疗段长度为13.3~32.5cm,平均长度为(19±4) cm;血管超声随访通畅率:术后1、3、6个月分别为96.15%(50条肢体)、92.31%(48条肢体)和90.38%(47条肢

  18. 颞浅动脉顶支扩张岛状皮瓣在修复头皮缺损中的应用%Application of the parietal branches of superficial temporal artery island flap in complex scalp defects

    Institute of Scientific and Technical Information of China (English)

    王楷; 李爱林; 赵月强; 余墨声; 罗定安; 吴晓蔚

    2013-01-01

    Objective To investigate the application of the parietal branches of superficial temporal artery island flap in the complex scalp defects.Methods A parietal branches of superficial temporal artery island flap on the ectatic scalp flap was designed to repair the complex scalp defects in 25cases and the repairing effect was observed.Results The island flaps were survived completely in 24patients,in which 1 patient had partial necrosis because of the flap tension was too large,but healed after local dressing and debridement.After followed up 6~ 12 months,the color and texture of the flap were the same to the surrounding normal scalp,and the shape was satisfactory.The flap donor site of hair growth was good,with well healing and no obvious complications.Conclusions The parietal branches of superficial temporal artery island flap can repair the complex scalp defects with the flexible flap design and movement.The flap survives well and the repair area is large.The flap and the surrounding scalp connects good.Therefore,it is a good method strongly recommended for small area complex scalp defects repair in clinics.%目的 探讨颞浅动脉顶支扩张岛状皮瓣在修复复杂头皮缺损中的应用.方法 通过在扩张头皮瓣上设计以颞浅动脉顶支为蒂的岛状皮瓣,转移修复复杂头皮缺损25例,并观察其愈合和修复效果.结果 25例患者,24例皮瓣完全存活,1例患者因皮瓣张力过大出现部分坏死,但通过清创及换药后愈合.术后随访6~12个月,头皮缺损修复部位与周围皮肤色泽、质地相似,外形恢复满意,皮瓣供受区毛发生长良好,创面愈合良好,无并发症发生.结论 应用颞浅动脉顶支为蒂的岛状扩张皮瓣修复复杂头皮缺损,皮瓣存活良好,皮瓣设计、转移灵活,修复范围较大,皮瓣与周边头皮衔接良好,是修复复杂头皮缺损的一种良好方法,值得应用和推广.

  19. Modified superficial peroneal neurocutaneous flap pedicled with lateral supramalleolar artery arising from peroneal artery for forefoot defect%跨区供血腓动脉外踝上穿支蒂腓浅神经营养血管皮瓣修复足前部缺损

    Institute of Scientific and Technical Information of China (English)

    陈雪松; 肖茂明; 王元山; 管力; 张黎明; 江珉

    2010-01-01

    Objective To report the operative techniques and clinical results of modified distally based superficial peroneal neuroeutaneous flap for skin defect of the forefoot. Methods A reversed superficial peroneal nerocutaneous flap pedicled with the lateral superamalleolar perforating artery or its descending branch, which vascularized the flap through the nutrient vessel chain of the nerve, which linked vascular territories of superamalleolar perforating artery, cutaneous branches of the anterior tibial artery and superficial peroneal artery, was designed to repair skin defects in the forefoot. Results The modified flaps were applied in 17 cases. All flaps were survived successfully with no complication. The largest size of the flap was 20 cm × 8 cm. The flap could reach as far as the proximal end of the second and third toes or weight-bearing areas under the fifth metatarsal caput. Conclusions The modified flap has reliable blood supply with a relatively large size and long rotation are. It is a simple and safe for covering medium to large defects in the forefoot.%目的 探讨改良腓浅神经营养血管皮瓣修复足前部缺损的手术方法及临床效果.方法 对足前部皮肤软组织缺损创面,设计切取以外踝上穿支或其降支为蒂,经其升支、胫前动脉皮穿支及腓浅动脉跨区供血的腓浅神经营养血管皮瓣修复.结果 2005年2月至2008年2月,于临床应用17例,最远修复至第2、3趾基底部及第5跖骨头负重区,最大切取面积20 cm×8 cm;皮瓣均全部成活,术后随访6~12个月,皮瓣质地优良,外形与足踝功能恢复满意.结论 该皮瓣神经血管丛粗大而丰富,蒂部供血确切,旋转修复距离可达足趾,适用于涉及足前部的足背中、大面积皮肤软组织缺损的修复.

  20. Airport and superficial femoral artery obstruction due to a wandering coronary stent: the possibility of airport detection of modern implant metals.

    Science.gov (United States)

    Teijink, J A W; van Herwaarden, J A; van den Berg, J C; Overtoom, T C; Moll, F L

    2004-06-01

    In the treatment of coronary artery disease, peripheral loss of a coronary stent is an unusual complication. We present the case of a patient who suggested that his right leg claudication was caused by a slipped coronary stent 2 years previously. The patient was convinced about this unusual finding based on an airport security check. Examination proved him to be right. However, the ability to detect an object using eddy currents is dependent on the object's permeability and its conductivity. Ferrous (iron) content is not the critical factor. Modern implant materials and processing techniques result in implants that are difficult to magnetize i.e. their permeability is very low. In addition their conductivity is very low. This enables modern implants to escape detection at airports. For this reason the event at the airport, as described by our patient, is considered coincidental.

  1. Correlation Study of Ankle Brachial Index,Superficial Femoral Artery Intima-media Thickness and the Coronary Heart Disease%踝臂指数及股浅动脉内中-膜厚度与冠心病相关性研究

    Institute of Scientific and Technical Information of China (English)

    应卫华; 李浙成; 胡智星; 童跃锋

    2012-01-01

    目的 探讨踝臂指数(ABI)及股浅动脉内-中膜厚度(IMT)与冠心病相关性.方法 对132例入选对象行冠状动脉造影检查、超声测定股浅动脉IMT及用全自动动脉硬化检测仪检测ABI,并调查年龄、性别、吸烟、血压、家族史、体质指数(BMI)等.用冠状动脉病变血管的数量和GAS积分评价冠脉病变的程度,分析、对比不同病变程度下股浅动脉IMT及ABI.结果 冠心病组股浅动脉IMT明显大于非冠心病组,冠心病组ABI明显小于非冠心病组,差异存在统计学意义,P值均小于0.05;股浅动脉IMT随着冠状动脉病变程度的加重而增加,但冠心病各组间比较无显著差异;ABI随着冠状动脉病变程度的加重而降低,且ABI值在各组间比较,P<0.05,差异具有统计学意义.结论 股浅动脉IMT及ABI与冠心病显著相关.对于冠心病患者,对比股浅动脉IMT与ABI,ABI是更能间接反映冠状动脉病变严重程度的良好指标.%Objective To discuss correlation of the superficial femoral artery intima-media thickness (IMT),ankle brachial index (ABI) and coronary heart disease. Methods .132 cases of hospitalized patients were selected to performed coronary artery angiography and ultrasound measurement of superficial femoral artery intima-media thickness (IMT) and automatic arteriosclerosis detection instrument of ankle brachial index (ABI),and the age, sex,smoking, blood pressure,family history,body weight index (BMI) etc were investigated. With coronary artery lesion volume and GAS integral evaluation of coronary lesion extent,the different extent of lesions of the superficial femoral artery intima-media thickness and ankle brachial index (ABI) were analysed. Results The superficial femoral artery intima-media thickness of coronary heart disease group was significantly greater than that of non-CHD group; ankle brachial index (ABI)was significantly lower than that of non-CHD group,there were statistically significant difference

  2. 颞浅动脉组织瓣修复儿童头面部畸形%REPAIRING DEFORMITY OF THE HEAD AND FACE WITH TISSUE FLAP PEDICLED WITH THE SUPERFICIAL TEMPORAL ARTERY IN CHILDREN

    Institute of Scientific and Technical Information of China (English)

    傅跃先; 向代理; 张显文; 邱林; 唐毅; 王珊

    2001-01-01

    目的 评价颞浅动脉组织瓣在修复儿童头面部畸形中的作用。方法 1986年10月~1996年12月,采用颞浅动脉组织瓣修复13例儿童头面部畸形,其中先天性畸形9例,烧伤瘢痕3例,感染后瘢痕1例。采用颞部皮瓣1例,颞部毛发皮瓣3例,额部皮瓣1例,耳后浅筋膜瓣与皮瓣8例。组织瓣大小为5.0 cm×1.2 cm~10.0 cm×5.0 cm,皮瓣蒂长5~8 cm。结果 术后组织瓣均Ⅰ期愈合。术后10例获得随访,时间6个月~12年,皮瓣色泽似邻近皮肤,质地柔软,厚薄适中,毛发瓣毛发生长良好,耳后浅筋膜瓣与皮瓣满足耳再造需要。所有病例术后切口瘢痕隐蔽,外观获明显改善。结论 颞浅动脉组织瓣血供丰富,邻近受区,易操作且形态良好,适用于儿童头面部多种畸形的修复。%Objective To evaluate the effect of tissue flap pedicled with the superficial temporal artery in repairing deformity of the head and face in children. Methods From October 1986 to December 1996, 13 children with deformity of the head and face were repaired by this tissue flap. Among them, there were congenital deformity in 9 cases, burned scar in 3 cases and infection scar in 1 case. Among the flaps, 1 was temporal skin flap, 3 were temporal flap with hairbearing scalp, 1 was frontal skin flap, and 8 were posterio-uricular superficial fascia flap and skin flap. The area of tissue flap was ranged from 5.0 cm×1.2 cm to 10.0 cm×5.0 cm. The length of the pedicle was 5~8 cm. Results All tissue flaps healed with first intention. Followed up for 6 months to 12 years, the appearance and function of tissue flaps were satisfactory. Conclusion The tissue flap pedicled with the superficial temporal artery is suitable to repair many kinds of deformities of the head and face in children. It has the advantages of good blood supply, closely acceptor area, easy operation and satisfactory appearance.

  3. Radial volumetric imaging breath-hold examination (VIBE) with k-space weighted image contrast (KWIC) for dynamic gadoxetic acid (Gd-EOB-DTPA)-enhanced MRI of the liver: advantages over Cartesian VIBE in the arterial phase

    Energy Technology Data Exchange (ETDEWEB)

    Fujinaga, Yasunari; Ohya, Ayumi; Tokoro, Hirokazu; Yamada, Akira; Ueda, Kazuhiko; Kadoya, Masumi [Shinshu University School of Medicine, Department of Radiology, Matsumoto (Japan); Ueda, Hitoshi; Kitou, Yoshihiro; Adachi, Yasuo; Shiobara, Aya; Tamaru, Naomichi [Radiology Division of Shinshu University Hospital, Matsumoto (Japan); Nickel, Marcel D. [Siemens AG Healthcare Sector, H IM MR PI TIO Oncology, Erlangen (Germany); Maruyama, Katsuya [Siemens Japan. K. K., Imaging and Therapy Systems Division, Shinagawa, Tokyo (Japan)

    2014-06-15

    To compare radial volumetric imaging breath-hold examination with k-space weighted image contrast reconstruction (r-VIBE-KWIC) to Cartesian VIBE (c-VIBE) in arterial phase dynamic gadoxetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (DCE-MRI) of the liver. We reviewed 53 consecutive DCE-MRI studies performed on a 3-T unit using c-VIBE and 53 consecutive cases performed using r-VIBE-KWIC with full-frame image subset (r-VIBE{sub full}) and sub-frame image subsets (r-VIBE{sub sub}; temporal resolution, 2.5-3 s). All arterial phase images were scored by two readers on: (1) contrast-enhancement ratio (CER) in the abdominal aorta; (2) scan timing; (3) artefacts; (4) visualisation of the common, right, and left hepatic arteries. Mean abdominal aortic CERs for c-VIBE, r-VIBE{sub full}, and r-VIBE{sub sub} were 3.2, 4.3 and 6.5, respectively. There were significant differences between each group (P < 0.0001). The mean score for c-VIBE was significantly lower than that for r-VIBE{sub full} and r-VIBE{sub sub} in all factors except for visualisation of the common hepatic artery (P < 0.05). The mean score of all factors except for scan timing for r-VIBE{sub sub} was not significantly different from that for r-VIBE{sub full}. Radial VIBE-KWIC provides higher image quality than c-VIBE, and r-VIBE{sub sub} features high temporal resolution without image degradation in arterial phase DCE-MRI. circle Radial VIBE-KWIC minimised artefact and produced high-quality and high-temporal-resolution images. circle Maximum abdominal aortic enhancement was observed on sub-frame images of r-VIBE-KWIC. (orig.)

  4. Artéria radial na ampliação do uso de enxertos arteriais para revascularização do miocárdio: considerações anatômicas e tática cirúrgica Radial artery for a wider arterial myocardial revascularization: microscopical anatomy and surgical technique

    Directory of Open Access Journals (Sweden)

    Luís Alberto Dallan

    1996-06-01

    lateral do ventrículo esquerdo. A anastomose do coto proximal é realizada na ATIe que, por sua vez, é habitualmente anastomosada ao ramo interventricular anterior (RIA. As artérias AGEd e ATId in situ ou, como enxerto livre, têm complementado o procedimento. Dentre 64 pacientes operados nos últimos 3 meses com a utilização da AR, 62 (96,9% receberam pelo menos 2 enxertos arteriais, 27 (42,2% receberam pelo menos 3 enxertos arteriais e 8 (12,5% pacientes receberam 4 ou 5 enxertos arteriais. Em 29 (45,3% deles a AR foi anastomosada à ATIe ou ATId. Acreditamos que essa técnica reduza a excessiva pressão conseqüente à anastomose direta da AR na aorta e que o maior fluxo decorrente das anastomoses seqüenciais auxilie na manutenção da perviabilidade da AR. A despeito de considerarmos o enxerto pediculado da ATIe o principal método de revascularização do miocárdio, os resultados preliminares indicam que a AR constitui uma excelente via complementar na busca da revascularização completa do miocárdio com enxertos arteriais.The aim of our study is to determine the microscopical anatomy imunohistochemistry and electronical scanning analysis of the radial artery (RA; 269 patients underwent myocardial revascularization with a RA graft were studied, performing 319 RA anatomoses; 80.7% patients were male and 93.7% Caucasians. The left internal thoracic artery (LITA was used in 246 patients at the present surgery and 17 LITA were used before (redo-operation, performing 97.8%. LITA conduits employed altogether. The patients received another additional conduits: 59 (21.9% right internal thoracic arteries (RITA; 17 (6.3% right gastroepiploic arteries (RGEA; 161 (59.8% saphenous vein grafts. An average of 3.4 anastomoses/patient were constructed. There was no post-operative complications such as ischemia or infection envolving the hand with interruption of the RA supply. The RA immunohistochemistry and electronical scanning microscopy showed that the internal elastic

  5. Observation of the curative effect immediate technique of the catheterization of the superficial temporal artery for retrograde intra-artery chemotherapy on postoperative chemotherapy administration in patients with oral squamous cell carcinomas%即刻行颞浅动脉逆行置管化疗技术对口腔鳞癌患者术后化疗的疗效观察

    Institute of Scientific and Technical Information of China (English)

    倪鑫; 赵洪伟; 冯驰; 季平; 邱丽华; 李勇; 高翔; 刘平; 王涛

    2015-01-01

    目的:对口腔鳞癌患者采用不同化疗给药途径并观察奈达铂(nedaplatin,NDP)和5‐氟尿嘧啶(5‐fluorouracil,5‐Fu)的疗效和不良反应。方法将64例口腔鳞癌患者分为术后普通静脉化疗组(IV组,32例)和术中即刻行颞浅动脉逆行置管化疗组(IA组,32例),两组化疗方案都为DNP和5‐Fu,其中IA组剂量为IV组的1/3,观察疗效和不良反应。结果IA组疗效优于IV组(P<0.05),同时IA组在骨髓抑制、胃肠道反应及口腔黏膜炎等化疗后并发症较IV组轻,差异有统计学意义(P<0.05)。结论术中IA疗效明显,不良反应轻且安全,适合临床推广。%Objective Treat patients with oral squamous cell carcinomas with different chemotherapy administration route ,and observe the effects and adverse reaction of Nedaplatin (NDP) and 5‐Fluorouracil (5‐Fu) .Methods Sixty four patients with oral squamous cell carcinomas were randomly divided into two groups which included intravenous chemotherapy group (IV)(with 32 ca‐ses) and intra‐artery infusion via the superficial temporal artery group (IA)(with 32 cases) .Each group was treated with NDP and 5‐Fu .The dose of the IA group was one third of that of the IV group .Efficacy and side effect had been observed .Results Efficacy of the IA group was better than that of the IV group (P<0 .05) .Complications including bone marrow suppression ,gastrointestinal reactions and oral mucositis of the IA group was lighter than that of the IV group ,which was significantly different (P<0 .05) . Conclusion The retrograde intra‐arterial chemotherapy via the superficial temporal artery during the surgery is safe ,effective and useful ,and it is worth of further clinical application .

  6. Recanalization of superficial femoral artery occlusions with Outback LTD catheter%股浅动脉闭塞性病变中Outback LTD导管的应用分析

    Institute of Scientific and Technical Information of China (English)

    张宏鹏; 郭伟; 刘小平; 尹太; 贾鑫; 王立军; 熊江; 马晓辉

    2012-01-01

    目的 探讨股浅动脉慢性完全闭塞性病变(CTO)中应用Outback LTD导管内膜下成形术治疗技术的近中期结果.方法 2010年1月至2011年5月,30例股浅动脉CTO的35条肢体应用Outback LTD导管进行治疗.其中男性20例,女性10例,平均年龄68岁.重度间歇性跛行10条肢体(Rutherford 3级,28.6%),静息痛13条肢体(Rutherford 4级,37.1%),小面积溃疡12条肢体(Rutherford 5级,34.3%).所有患者术中应用常规的导管和导丝技术无法顺行从内膜下返回真腔.统计技术成功率、相关并发症及操作时间.随访中计算支架通畅率和治疗结果.结果 平均病变长度为(210±15)mm,操作技术成功率为97.1% (34/35),无操作相关的并发症发生.平均随访时间(7.2±0.3)个月.随访3、6、12个月支架一期通畅率分别为90.9%、84.8%和50.6%.重度缺血病变中,3条肢体行截趾术,1条行膝关节以下的截肢术.结论 Outback LTD导管在股浅动脉CTO内膜下成形术中能够安全、有效地辅助导丝返回真腔,缩短射线暴露时间,提高技术成功率.%Objective To evaluate immediate- and median-term outcomes from subintimal recanalization of superficial femoral arteries (SFA) chronic total occlusions (CTO) with the Outback LTD catheter.Methods From January 2010 to May 2011,35 legs in 30 patients with CTO of the SFA and proximal popliteal artery were treated by Outback LTD catheter.There were 20 male and 10 female patients.The mean age of the patients was 68 years. Clinical presentation was severe intermittent claudication (Rutherford category 3,10/35,28.6% ),rest pain (Rutherford category 4,13/35,37.1% ),and minor ulceration (Rutherford category 5,12/35,34.3% ).In all cases,the true lumen could not be entered by using standard antegrade catheter and guide wire techniques.Technical success,complications,procedure times,clinical outcomes and cumulative patency rates in follow-up were evaluated.Results Median lesion length was

  7. Transradial artery coronary angioplasty.

    Science.gov (United States)

    Kiemeneij, F; Laarman, G J; de Melker, E

    1995-01-01

    This study explored the feasibility and safety of percutaneous coronary balloon angioplasty (PTCA) with miniaturized PTCA equipment via the radial artery. Coronary angioplasty (PTCA) via the femoral or brachial arteries may be associated with rare vascular complications such as bleeding and damage to the artery and adjacent structures. It was postulated that PTCA via the radial artery with miniaturized angioplasty equipment is feasible and that no major puncture site-related complications occur because hemostasis is obtained easily and because no major structures are near the radial artery. With double blood supply to the hand, radial artery occlusion is well tolerated. In 100 patients with collateral blood supply to the right hand, PTCA was attempted with 6F guiding catheters and rapid-exchange balloon catheters for exertional angina (87 patients) or nonexertional angina (13 patients). Angioplasty was attempted in 122 lesions (type A n = 67 [55%], Type B n = 37 [30%], and type C n = 18 [15%]). Pre- and post-PTCA computerized quantitative coronary analysis was performed. Radial artery function and structure were assessed clinically and with Doppler and two-dimensional ultrasound on the day of discharge. Coronary catheterization via the radial artery was successful in 94 patients (94%). The 6 remaining patients had successful PTCA via the femoral artery (n = 5) or the brachial artery (n = 1). Procedural success (120 of 122 lesions) was achieved in 92 patients (98%) via the radial artery and in 98 patients of the total study population.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. The Predictive Value of Combining Umbilical Arterial and Radial Arterial pH for Neonatal Hypoxic Ischemic Encephalopathy%脐带血联合动脉血pH值对新生儿缺血缺氧性脑病的预测价值

    Institute of Scientific and Technical Information of China (English)

    郭晓辉; 李华英; 夏俊霞; 沙文琼; 陈淑芳

    2011-01-01

    目的 探讨脐带血联合动脉血pH值对新生儿缺血缺氧性脑病(HIE)的预测价值.方法 选取2009年4月至2011年1月在深圳市人民医院分娩的无严重畸形的7 456例活产婴儿作为研究对象,对其脐动脉血pH值与新生儿缺血缺氧性脑病的相关性进行分析,并随机选择481例新生儿于出生后1h行桡动脉血气分析.结果 7 456例脐动脉血pH为7.10~7.42.以脐带血pH<7.10为指标预测新生儿HIE的阳性预测值为35.57%,敏感性42.06%.脐带血联合出生后1h动脉血pH值预测HIE的敏感性为60.00%,阳性预测值71.79%.联合检测与单项检测临床符合率比较,差异有统计学意义(P<0.01).结论 脐带血pH<7.10且出生1h动脉血pH<7.3对新生儿缺血缺氧性脑病有预测意义.脐动脉血pH<7.10的新生儿应常规于出生后复查桡动脉血pH值.%Objective To study the predictive value of combining radial arterial blood and umbilical arterial blood gas analysis for hypoxic ischemic encephalopathy (HIE). Methods 7 456 neonates without severe deformity,bom in Shenzhen People's Hospital from April 2009 to January 2011, were recruited into our research. The correlation between umbilical arterial blood gas analysis and neonatal hypoxic ischemic encephalopathy were analyzed. 481 cases were randomly selected for radial arterial blood gas analysis an hour after birth. Results The pH values of umbilical arterial blood ranged from 7.10 to 7.42. There was a significant correlation between HIE and the pH value of umbilical arterial blood (P < 0.05). Taken pH<7.10 as an indicator to assess neonatal HIE,the positive predictive value and sensitivity were 35.5% and 42.06%, respectively. The positive predictive value and sensitivity of combining radial arterial with umbilical arterial blood gas analysis were 71.79% and 60.00%, respectively. The difference in clinical coincidence rates between combined test and single test was statistically significant (P < 0

  9. Superficies de segundo orden

    OpenAIRE

    Salazar Salazar, Luis Álvaro

    1987-01-01

    Este trabajo se propone poner al alcance de estudiantes de primeros semestres de carreras de aplicación de la matemática, un algoritmo proporcionado por el álgebra lineal, para tratar con mas generalidad, agilidad y libertad unos objetos de la geometría analítica de no fácil manipulación por otros métodos y que se conocen como superficies de segundo orden o superficies cuádricas. En este orden de ideas, el autor considera importante que con este tratamiento se incluya este tema en una asignat...

  10. Dedicated radial ventriculography pigtail catheter

    Energy Technology Data Exchange (ETDEWEB)

    Vidovich, Mladen I., E-mail: miv@uic.edu

    2013-05-15

    A new dedicated cardiac ventriculography catheter was specifically designed for radial and upper arm arterial access approach. Two catheter configurations have been developed to facilitate retrograde crossing of the aortic valve and to conform to various subclavian, ascending aortic and left ventricular anatomies. The “short” dedicated radial ventriculography catheter is suited for horizontal ascending aortas, obese body habitus, short stature and small ventricular cavities. The “long” dedicated radial ventriculography catheter is suited for vertical ascending aortas, thin body habitus, tall stature and larger ventricular cavities. This new design allows for improved performance, faster and simpler insertion in the left ventricle which can reduce procedure time, radiation exposure and propensity for radial artery spasm due to excessive catheter manipulation. Two different catheter configurations allow for optimal catheter selection in a broad range of patient anatomies. The catheter is exceptionally stable during contrast power injection and provides equivalent cavity opacification to traditional femoral ventriculography catheter designs.

  11. Prevention of radial artery spasm with a lidocaine gauze swab during transradial coronary angiography/intervention%应用利多卡因外擦导管减少桡动脉痉挛的临床观察

    Institute of Scientific and Technical Information of China (English)

    沈迎; 朱天奇; 张奇; 张瑞岩; 沈卫峰

    2012-01-01

    目的:桡动脉痉挛是经桡动脉路径冠状动脉造影(CAG)和(或)介入治疗(PCI)的常见并发症之一.本研究旨在观察应用利多卡因外擦动脉鞘和造影导管,减少桡动脉痉挛的临床疗效.方法:将连续237例接受经桡动脉路径CAG/PCI的患者随机分为两组,分别于动脉鞘和造影/导引导管插入前应用2%利多卡因溶液(118例,利多卡因组)或0.9%氯化钠溶液(119例,对照组)外擦其表面.主要观察终点:严重桡动脉痉挛(导管推进或操作困难并伴前臂疼痛、桡动脉造影示管腔内径狭窄>70%)发生率.次要终点:前臂出血或血肿、患者不适程度以及操作成功率.结果:利多卡因组5例(4.2%)和对照组16例(13.4%)发生严重桡动脉痉挛(P=0.013);利多卡因组中无一例发生前臂出血或血肿,但对照组中3例前臂轻度出血(表现为造影剂外渗)和1例局部血肿形成,均经局部加压包扎后好转;利多卡因组因疼痛引起的重度不适减少;两组CAG/PCI均成功.结论:CAG/PCI时,应用2%利多卡因溶液外擦动脉鞘和造影/导引导管可能是一种减少严重桡动脉痉挛及其相关并发症的简易方法.%Objective: Radial artery spasm is one of the most common complications during transradial coronary angiography and/or percutaneous coronary intervention (CAG/PCI). This study investigated whether direct wiping of arterial sheath and angiographic catheters with a lidocaine gauze swab before insertion could reduce the occurrence of severe radial artery spasm. Method: Two hundred and thirty-seven consecutive patients undergoing transradial CAG/PCI were randomly divided into 2 groups. Before inserting into radial artery, the arterial sheath and angiographic catheters were wiped with a gauze swab of lidocaine (n=118; lidocaine group) or normal saline (71= 119; control group). The primary endpoint was the rate of severe radial artery spasm defined as difficulties in pushing and manipulating the

  12. Avaliação do gradiente pressórico aorto-radial em pacientes submetidos à intervenção cirúrgica com circulação extracorpórea Evaluación del gradiente presórico aorto-radial en pacientes sometidos a la intervención quirúrgica con circulación extracorpórea Evaluation of the aorta-to-radial artery pressure gradient in patients undergoing surgery with cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Maria José Carvalho Carmona

    2007-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Diversos estudos têm demonstrado diferença significativa entre a pressão aórtica e a pressão radial em pacientes submetidos à circulação extracorpórea (CEC. Os objetivos deste estudo foram avaliar o comportamento da diferença entre pressão arterial radial e a pressão aórtica durante revascularização do miocárdio (RM com CEC e sua correlação com resistência vascular sistêmica. MÉTODO: Após aprovação pelo Comitê de Ética Hospitalar, 16 pacientes submetidos à RM com CEC hipotérmica foram estudados. Pressões sistólica, diastólica e média foram obtidas na raiz da aorta e na artéria radial, através de cateteres específicos. Débito cardíaco foi obtido com o uso de cateter de artéria pulmonar ou diretamente da máquina de CEC e resistência vascular sistêmica indexada (RVSi foi calculada nos momentos pré-CEC, início da CEC, após a última RM, no fim da CEC e pós-CEC. A análise estatística foi realizada por meio de Análise de Variância para medidas repetidas e correlação de ordem de Spearman e o nível de significância foi fixado em 0,05. RESULTADOS: Após o início da CEC, a pressão arterial radial foi sistematicamente menor que a pressão aórtica em 3 a 5 mmHg. Foi observada correlação significativa entre o gradiente médio de pressão aorto-radial e a RVSi somente após a última RM, correspondendo ao aquecimento do paciente (Rho = 0,67, p = 0,009. CONCLUSÕES: A medida de pressão na arterial radial subestimou sistematicamente a pressão arterial na raiz da aorta após a CEC e a RVSi não forneceu estimativa acurada da magnitude do gradiente de pressão aorto-radial.JUSTIFICATIVA Y OBJETIVOS: Diversos estudios han demostrado diferencia significativa entre la presión aórtica y la presión radial en pacientes sometidos a la circulación extracorpórea (CEC. Los objetivos de este estudio fueron evaluar el comportamiento de la diferencia entre presión arterial radial y la

  13. Common Superficial Bursitis.

    Science.gov (United States)

    Khodaee, Morteza

    2017-02-15

    Superficial bursitis most often occurs in the olecranon and prepatellar bursae. Less common locations are the superficial infrapatellar and subcutaneous (superficial) calcaneal bursae. Chronic microtrauma (e.g., kneeling on the prepatellar bursa) is the most common cause of superficial bursitis. Other causes include acute trauma/hemorrhage, inflammatory disorders such as gout or rheumatoid arthritis, and infection (septic bursitis). Diagnosis is usually based on clinical presentation, with a particular focus on signs of septic bursitis. Ultrasonography can help distinguish bursitis from cellulitis. Blood testing (white blood cell count, inflammatory markers) and magnetic resonance imaging can help distinguish infectious from noninfectious causes. If infection is suspected, bursal aspiration should be performed and fluid examined using Gram stain, crystal analysis, glucose measurement, blood cell count, and culture. Management depends on the type of bursitis. Acute traumatic/hemorrhagic bursitis is treated conservatively with ice, elevation, rest, and analgesics; aspiration may shorten the duration of symptoms. Chronic microtraumatic bursitis should be treated conservatively, and the underlying cause addressed. Bursal aspiration of microtraumatic bursitis is generally not recommended because of the risk of iatrogenic septic bursitis. Although intrabursal corticosteroid injections are sometimes used to treat microtraumatic bursitis, high-quality evidence demonstrating any benefit is unavailable. Chronic inflammatory bursitis (e.g., gout, rheumatoid arthritis) is treated by addressing the underlying condition, and intrabursal corticosteroid injections are often used. For septic bursitis, antibiotics effective against Staphylococcus aureus are generally the initial treatment, with surgery reserved for bursitis not responsive to antibiotics or for recurrent cases. Outpatient antibiotics may be considered in those who are not acutely ill; patients who are acutely ill

  14. SUPERFICIAL CERVICAL PLEXUS BLOCK

    Directory of Open Access Journals (Sweden)

    Komang Mega Puspadisari

    2014-01-01

    Full Text Available Superficial cervical plexus block is one of the regional anesthesia in  neck were limited to thesuperficial fascia. Anesthesia is used to relieve pain caused either during or after the surgery iscompleted. This technique can be done by landmark or with ultrasound guiding. The midpointof posterior border of the Sternocleidomastoid was identified and the prosedure done on thatplace or on the level of cartilage cricoid.

  15. A rare variant route of the ulnar artery does not contraindicate the creation of a fistula in the wrist of a diabetic patient with end-stage renal disease

    Directory of Open Access Journals (Sweden)

    Mirosław Banasik

    2011-10-01

    Full Text Available A superficial variant route of the ulnar artery is a rare variation of the arterial system of the wrist. The route of the arteries in that region is extremely important for patients with end-stage renal disease due to the necessity to create an arteriovenous fistula for hemodialysis. It is thought that the vascular access is too often achieved by catheters or vascular prostheses because of that each possibility to create a fistula in the wrist region should be utilized. In our patient a rare variant route of the ulnar artery was observed in the wrist region. Instead of a deep route between the muscles the artery did not only run superficially, but, also untypically, first laterally and then medially. A variation of the ulnar artery’s route may evoke a fear of hand ischemia after creation arteriovenous fistula for hemodialysis. The fear may be connected with blood supply throw the palmar arch which is created by radial and ulnar artery. This fear of the doctor may result in avoiding the attempt to create an arteriovenous fistula on the wrist. The authors demonstrate that the variant route of the ulnar artery is not a contraindication to the creation of a fistula on the wrist using the radial artery because of a fear of hand ischemia.

  16. Detecting Carotid Artery and Radial Artery of Chronic Kidney Disease Patients by Echo-tracking Technique%血管回声跟踪技术检测慢性肾脏病患者颈总动脉及桡动脉弹性变化

    Institute of Scientific and Technical Information of China (English)

    郭卫东; 白亚玲; 张晓玲; 赵刚; 徐金生; 杨漪

    2011-01-01

    Objective To investigate the value of echo-tracking technique detecting carotid artery and radial artery elasticity of CKD patients. Methods Carotid artery and radial artery elasticity changes of 100 chronic kidney disease patients and normal control group were detected by ultrasound echo-tracking(ET) technique. The elasticity of different arteries and changing laws of chronic kidney patients were analyzed. Results (l)With the progression of disease course, Stiffness parameter (β) of ET technique, vascular pressure-strain elasticty modulus (Ep), one-point pulse wave velocity (PWVβ) gradually increased. Arterial compliance( AC) showed a decreasing tendency. (2)There were statistical differences (P<0. 05) in β, Ep, PWVβ, AC changes of RA in the mild group and moderate group. Only PWVβ of CCA in the moderate group and the mild group had statistical difference (P<0. 05). Β, Ep、 AC had, statistical differences (P<0. 05) only in the severe group. Conclusions ET technique can accurately detect early changes in arterial elasticity of CKD patients. RA have significant changes in the moderate group (CKD3), which occurs earlier than CCA parameters. It is indicated that muscular peripheral artery may be the sensitive indicators in reflecting the early changes of arterial elasticity.%目的 探讨血管回声跟踪技术检测慢性肾脏病(chronic kidney disease,CKD)患者颈总动脉(common carotid artery,CCA)和桡动脉(radial artery,RA)弹性的意义.方法 应用超声血管回声跟踪(echo-tracking,ET)技术检测100例各期CKD患者CCA及RA弹性的变化,并与正常对照组比较,分析不同部位动脉间弹性变化的差异,以及评价CKD患者的变化规律.结果 (1)随患者病程发展,参数僵硬度指数(stiffness parameter,β),血管压力-应变弹性系数(pressure-strain elastictymodulus,Ep),点脉搏波传导速度(one-point pulse wave velocity,PWVβ)呈逐渐增大变化,顺应性(arterial compliance,AC)呈逐渐减小趋势.(2)按照

  17. Radial pseudoaneurysm following diagnostic coronary angiography

    Directory of Open Access Journals (Sweden)

    Shankar Laudari

    2015-06-01

    Full Text Available The radial artery access has gained popularity as a method of diagnostic coronary catheterization compared to femoral artery puncture in terms of vascular complications and early ambulation. However, very rare complication like radial artery pseudoaneurysm may occur following cardiac catheterization which may give rise to serious consequences. Here, we report a patient with radial pseudoaneurysm following diagnostic coronary angiography. Adequate and correct methodology of compression of radial artery following puncture for maintaining hemostasis is the key to prevention.DOI: http://dx.doi.org/10.3126/jcmsn.v10i3.12776 Journal of College of Medical Sciences-Nepal, 2014, Vol-10, No-3, 48-50

  18. The effect of sumatriptan on cephalic arteries

    DEFF Research Database (Denmark)

    Amin, Faisal Mohammad; Asghar, Mohammad Sohail; Ravneberg, Julie W;

    2013-01-01

    AIM: To explore a possible differential effect of sumatriptan on extracerebral versus cerebral arteries, we examined the superficial temporal (STA), middle meningeal (MMA), extracranial internal carotid (ICAextra), intracranial internal carotid (ICAintra), middle cerebral (MCA) and basilar arteries...

  19. Superficies de placer

    OpenAIRE

    Delli Gatti, Romina

    2012-01-01

    La presente tesis cuenta con 28 pinturas en distintos formatos y tama- ños a través de los cuales la artista investiga diferentes objetos de su entorno cotidiano que le resultan agradables y pueden llegar a transformar anímicamente. De esta manera se van construyendo superficies ideales, relacionadas principalmente con lo cotidiano y lo intimo, lo orgánico, lo industrial, el diseño textil y lo abstracto. Es un intento por generar o prolongar una sensación visual de agrado y placer a tra...

  20. Interventional therapy for atherosclerotic occlusive disease of the superficial femoral artery%介入治疗股浅动脉硬化闭塞19例分析

    Institute of Scientific and Technical Information of China (English)

    祝慧鹏; 周艺琳; 冯翔; 李鸣; 包俊敏; 景在平

    2009-01-01

    Objective To explore the methods and mid-term results of interventional therapy for atherosclerotic occlusive disease of the superficial femoral artery(SFA).Methods From January 2005 to August 2008,Nineteen cases with 22 diseased lower limbs were admitted.According to Fontaine stage system,there were 6 stage Ⅱb limbs(moderate to severe intermittent claudication),8 stage Ⅲ limbs(rest pain),and 8 stage Ⅳ limbs(6 with ulcer and 2 with gangrene).The mean lesion length was 8.8 cm(5~13 cm).On the basis of the TransAtlantic Inter-Society Consensus(TASC)femoropopliteal classification,the lesions were classified as type B in 4 limbs,type C in 17,and D in 1.Follow up examinations with color duplex ultrasound and/or arteriography were carried out to determine the patency.The improvement of clinical symptoms after operation was analyzed.Results 17 limbs were revascularization successfully,2 limbs were turned to bypass operation,3 limbs were judged untreatable.The technical success rate is 77.3%,and the clinical improvement of symptoms was achieved in 100% of the 17 limbs on which the procedure was successful.The 17 limbs were followed up for a mean of 12.5 months(range 3-33 months).One patient died of cardia infarction one month postoperatively.SFA occlusion happened in 4 limbs.At one year postoperatively,the patency rate was 75%(13/17)after primary operation.Conclusions Primary endovascular treatment of SFA occlusion diseases is a safe,minimally invasive,and effective method.%目的 探讨股浅动脉硬化闭塞介入治疗的方法和疗效.方法 回顾性分析2005年1月至2008年8月介入治疗的19例(22条下肢)股浅动脉硬化闭塞症患者的临床资料.其中Fontaine Ⅱb期(中、重度间歇跛行)6条,Ⅲ期(静息痛)8条,Ⅳ期(组织缺损)8条(其中足部溃疡6条,足趾坏疽2条).股浅动脉病变的平均长度8.8 cm(5.0~13 cm).病变TASC分型B型4条,C型17条,D型1条.通过彩色血管超声和(或)动脉造影观察病变段动脉

  1. 桡动脉肌间隙远、近段皮支链皮瓣的解剖学基础%The radial artery cutaneous branches-chain flap:anatomy and clinical application

    Institute of Scientific and Technical Information of China (English)

    孙超; 徐聪; 张伟; 李宏亮; 谭为; 丁自海

    2012-01-01

    目的 为桡动脉肌间隙远、近段皮支链皮瓣带蒂转位修复腕部及肘部小范围组织缺损提供解剖学基础.方法 选用新鲜男尸正常上肢标本12侧:10侧乳胶灌注显微解剖,2侧制作铸型标本研究桡动脉从肱桡肌与桡侧腕屈肌肌间隙发出皮支的解剖形态学特点.以桡骨茎突至外上髁连线中点为分界划分前臂远、近两段.结果 (1)桡动脉发出肌间隙皮支9.1支,其中前臂远段发出皮支6.8支,直径(0.45±0.14)mm,蒂长(1.2±0.48 )cm;前臂近段发出皮支2.3支,直径(0.68±0.12)mm,蒂长(1.9±0.53 )cm.桡动脉在前臂远、近两段发出的肌间隙皮支的参数差异比较均有统计学意义(P<0.05);(2)在桡骨茎突近端(3.0±0.67)cm和肱骨外上髁远端(9.01 ±1.74)cm,分别有直径(0.59±0.08)mm,蒂长(1.41±0.26)cm和直径(0.67±).09)mm,蒂长(1.87±0.62 )cm恒定粗大皮支从肌间隙穿出;(3)相邻皮支穿深筋膜后,其终末支间形成与肌间隙长轴平行的血管链.结论 以桡动脉肌间隙远、近段皮支设计带蒂转位皮支链皮瓣可用于修复腕部及肘部小范围软组织损伤,避免了其主干动脉的破坏.%Objective To provide anatomic information for repairing small tissue defects in hands and forearm with cutaneous branches-chain flaps pedicled with radial and ulnar arteries. Methods A total of 12 male cadaveric specimens were included in the study: 10 underwent latex perfusion for microanatomy, 2 were made into vessel cast for morphologic observation of cutaneous branch of radial artery passed between the brachioradialis muscle and the flexor carpi radialis muscle. Forearm was divided into proximal and distal segments by the midpoint between the radial styloid and the lateral epicondyle. Results ①A total of 9.1 intermuscular cutaneous branches issued from radial artery, of which, 6.8 from the distal forearm and 2.3 from the proximal end, with the diameter of (0.45±0.14) mm and pedicle length of (1.2±0

  2. 经桡动脉行冠心病介入治疗的护理道德要求%Ethical Requirements in the Nursing of Percutaneous Radial Artery Approach for Coronary Intervention

    Institute of Scientific and Technical Information of China (English)

    任云霞; 周明利

    2011-01-01

    冠心病介入治疗的广泛应用对临床护理道德提出了新的要求.实践证明:通过护理诊断、实施医嘱做好术前护理,术中配合医生做好全面护理,术后密切观察穿刺局部及全身情况并做好出院指导等,对提高经桡动脉穿刺行冠心病介入治疗的成功率,减少并发症,提高病人生命质量等均具有重要的作用.结合我科2006年5月~2010年5月对经桡动脉穿刺行冠心病介入治疗的300例患者护理实际,总结了经桡动脉行冠心病介入治疗的护理道德要求.%The extensive application of coronary intervention has brought patients more hope, while it has also set novel demand in the field of clinical nursing ethics. It has been proved by clinical practice that comprehensive and appropriate nursing measures contribute to increase the success rate of percutaneous radial artery approach for coronary intervention, reduce operational complications, and enhance the patients'living quality. Recommended nursing measures include pre - operational nursing care based on the nursing diagnosis and strict performance of medical orders, overall nursing care during the operational process under the direction of operating doctors, careful observation of patients puncturation region and overall physical condition, and detailed discharge guidance. In this paper, the authors summarized the ethical requirements of nursing in the percutaneous radial artery approach for coronary intervention, based on the nursing practice from the 300 cases from May, 2006 to May, 2010 in the authors'hospital.

  3. Study on repairing high ulnar nerve injury by low end-to-side anastomosis of superficial branch of radial nerve%桡神经浅支端侧吻合修复尺神经高位损伤的研究

    Institute of Scientific and Technical Information of China (English)

    梁斌; 李荣祝; 韦绍仁; 刘勇; 韦爱仙; 莫冰峰; 楚野

    2014-01-01

    included in the experiment and the upper limbs were studied , with the 12 limbs randomized into 3 groups ( 4 limbs in each group ) . Group A(experimental group):The ulnar nerve was cut at the upper segment of the upper limb , with end-to-end an-astomosis followed .The superficial branch of radial nerve was cut at the distal end and the end-to-side anastomosis was performed by transferring the superficial branch of radial nerve to the wrist segment ( fenestration was made in the outer membrane).Group B(control group):3 cm of the ulnar nerve was cut at the upper segment of the upper limb and folding ligation was made from both ends .Treatment at the wrist segment was the same as in group A .Group C ( Control group ):Treatment at the unlar nerve of the upper was the same as in group A .But no transferring was made at the wrist segment .The atrophy of intrinsic muscle controlled by ulnar nerve was observed after surgery .The intrin-sic muscle at the end-to-side anastomosis , neural stem distal to end-to-side anastomosis and hypothenar muscle were collected at 1M, 3M, 6M and 12M after surgery and the tissues collected were made into sections to observe the changes under microscope .Results The intrinsic muscle of the macaques in group A restored autonomic activity 12 months after surgery and no obvious atrophy in intrinsic muscle of the operated side was observed .Atrophy in intrinsic muscle of the operated side was observed in group B and group C , but with more obvious atrophy observed in group C.Histological observation revealed that the number and density of nerve fibres increased as the time went on in group A.While in group B, the number and density of nerve fibres kept stable after increase to certain degree , but no necrosis was observed .In group C, the number of nerve fibres decreased significantly as time went on .The number of muscle fibres also decreased significantly and besides atrophy , hyalinization , interstitial hemorrhage and formation of granulation tissue

  4. Variations in the usage and composition of a radial cocktail during radial access coronary angiography procedures.

    LENUS (Irish Health Repository)

    Pate, G

    2011-10-01

    A survey was conducted of medication administered during radial artery cannulation for coronary angiography in 2009 in Ireland; responses were obtained for 15 of 20 centres, in 5 of which no radial access procedures were undertaken. All 10 (100%) centres which provided data used heparin and one or more anti-spasmodics; verapamil in 9 (90%), nitrate in 1 (10%), both in 2 (20%). There were significant variations in the doses used. Further work needs to be done to determine the optimum cocktail to prevent radial artery injury following coronary angiography.

  5. 高龄骨科患者持续桡动脉压力监测的"集束化护理"%Cluster-based care on old osteology patient with continued radial artery pressure monitoring

    Institute of Scientific and Technical Information of China (English)

    陆翠玲; 张瑞甫; 张玉想; 王宇

    2011-01-01

    Objective:To observe effect of cluster based care on old osteology patient with continued radial artery pressure monitoring and role of catheterization complications. Method:Patients were randomly divided into control group and treatment group. Artery catheterization success rate and complications were compared between the control group and cluster based care group. Result:The artery catheterization success rate was higher (P<0. 05) in treatment group. While the incidence of catheter complications was significantly lower in treatment group (P <0. 01). Conclusion:①Cluster-based care is an effective method of clinical care of critically ill patients, but also a reflection of the quality management philosophy. ②"Cluster-based care" can improve the success rate and decrease complications of catheterization in old osteology patients.③Cluster-based care benefits for bothe patients and doctors.%目的:探讨入住ICU的高龄骨科患者持续桡动脉压力监测"集束化护理"对其穿刺置管成功率及并发症的预防护理措施.方法:随机选择患者,设立对照组,观察实施此护理方法前、后动脉穿刺置管成功率、并发症发生情况等指标的变化.结果:以上各指标经对照研究,"集束化护理"组桡动脉穿刺置管成功率高于对照组(P<0.05),置管后并发症发生率也较对照组显著下降(P<0.01).结论:①"集束化护理"是一种有效的危重患者临床护理方法,同时也是危重症护理质量管理理念的一种体现;②"集束化护理"能够提高高龄骨科患者桡动脉置管的成功率及降低置管后并发症的发生,有利于观察患者病情;③"集束化护理"有益于保护医、患双方,切实将人文管理融入到危重患者的护理之中.

  6. 孕妇桡动脉血流图对预测子痫前期的价值%The value of radial artery rheography in the prediction of pre-eclampsia in pregnant women

    Institute of Scientific and Technical Information of China (English)

    王群

    2015-01-01

    Objective To explore the value of umbilical artery flow index in the prediction of pre-eclampsia. Methods Puerpera who delivered in the department of obstetrics in our hospital from January 2011 to January 2014 were selected, and were assigned to the prediction group and the control group. The control group was regularly given antenatal care without the intervention of radial artery rheography. The prediction group was regularly given antenatal care combined with the intervention of radial artery rheography.①The incidence rate of pregnancy induced hypertension was compared between the prediction group and the control group. ②Morbidity degree of the pregnant women was compared between the prediction group and the control group. ③The prediction of pre-eclampsia in different gestational weeks via MP monitoring system was compared. ④Growth restriction of newborns delivered by the two groups of pregnant women was compared. Results ①The incidence rate of pregnancy induced hypertension in the prediction group was significantly lower than that in the control group, and the difference was statistically significant(P<0.05). ②There were statistical differences of the data of mild pre-eclampsia, severe pre-eclampsia and eclampsia between the prediction group and the control group (P<0.05).③The accordance rate of pre-eclampsia predicted by the MP monitoring system in the pre-diction group was gradually increased according to the increase of gestational weeks.④There was significant difference of neonatal body weight between the prediction group and the control group(x2=9.52, P<0.01). Conclusion After the in-tervention of eclampsia via radial artery rheogaphy for the pregnant women with positive prediction, it is able to signifi-cantly reduce the incidence rate of pregnancy induced hypertension in pregnant women.%目的 探讨脐动脉血流指数对预测子痫前期的价值. 方法 收集2011年1月~2014年1月我院产科分娩的产妇,分为预测组和对

  7. Hypothenar hammer syndrome: Distal ulnar artery reconstruction with autologous inferior epigastric artery.

    Science.gov (United States)

    Smith, Hadley E; Dirks, Marco; Patterson, Robert B

    2004-12-01

    Digital artery embolization and ulnar artery thrombosis are consequences of repetitive trauma and can lead to digit loss and debility from ischemia and cold intolerance. We postulate that an arterial autograft is a theoretically superior conduit to traditional saphenous vein, and report reconstruction with inferior epigastric artery. Three adult male smokers, ages 39 to 49 years, had severe digital ischemia and cold-induced vasospasm. Arteriograms confirmed occlusion of the distal ulnar artery without direct perfusion of the superficial palmar arch, distal digital artery embolization, and normal proximal vasculature. All reconstructions were performed from the distal most patent ulnar artery at the wrist to the superficial palmar arch (1 patient) or sequentially to the involved common digital arteries (2 patients), with inferior epigastric artery. Handling characteristics and size match between the arterial autografts and bypassed arteries was excellent. Patency has been confirmed with duplex scanning at follow-up of 8 to 24 months, with resolution of cold intolerance and successful digital preservation.

  8. Bilateral high radial nerve compressions: a case report.

    Science.gov (United States)

    Chuangsuwanich, A; Muangsombut, S; Sangruchi, T

    2000-06-01

    A 40-year-old woman with bilateral high radial nerve compressions by non-traumatic cause was reported. It occurred first at the right radial nerve which was explored after a period of investigation and conservative treatment. Two constricted sites 2.0 cm apart of the right radial nerve crossed by branches of the radial collateral artery beneath the lateral head of the triceps were found. The constricted sites including tissue in between was resected and replaced with a sural nerve graft. One year later the patient had the same episode on the left side. The operative finding was the same as the previous one. Sural nerve graft was performed after neurolysis had failed. The patient's normal radial nerve function returned in one year. This is the first reported case in the literature of bilateral high radial nerve compressions by branches of the radial collateral artery.

  9. 带腓动脉的腓浅神经营养血管皮瓣修复前足软组织缺损%Reconstruction of forefoot soft tissue defect with superficial peroneal neurotropphic vascular flap with peroneal artery

    Institute of Scientific and Technical Information of China (English)

    李俊明; 李艳华; 易先达; 李智浩; 黄贺军; 李道选; 代彭威; 贺喜顺

    2013-01-01

    Objective To observe the clinical effect of retrograde transferring of Superficial peroneal nerve nutrition vessel flap for repairing the soft tissue defect of forefoot.Methods From January 2007 to December 2011,twelve patients with soft tissue defect in forefoot were treated with superficial peroneal nerve nutrition vessel flap by retrograde transfer repair.The flap ranged in size from 6 cm × 4 cm to 18 cm × 12 cm.Results Only 1 flap appeared blood stasis and swelling,and the distal end of skin flap became effusion under the epidermis.Considering it may because we sew it up too tight,we removed sort of suture timely.The flap became ruddy and survived.And the others smoothly survived without special handling.Eight patients had our follow-up visit and they were satisfied with the shape of their flaps,the flap was wear-resisting.Five cases get followed-up of the 7 patients which had neural anastomosis surgery,the 2PD was 10-14 mm of the flap.Conclusion With a good shape,this type of flap supplying with plentiful blood,easily chipped,transferred with a strong randomness,is one of the ideal methods to repair the rather large area skin soft tissue defect in the forefoot.%目的 总结带腓动脉的腓浅神经营养血管皮瓣逆行转位修复前足皮肤软组织缺损的临床效果. 方法 2007年1月至2011年12月,应用带腓动脉的腓浅神经营养血管皮瓣逆行转移对12例前足皮肤软组织缺损进行修复,皮瓣切取面积为6cm×4cm~18cm×12cm. 结果 仅1例术后36 h出现皮瓣瘀血肿胀,皮瓣远端出现表皮下积液,与蒂部缝合过紧有关,及时拆除蒂部部分缝线,皮瓣转红润,顺利成活,其余皮瓣均顺利成活.8例得到3个月~3年的随访,皮瓣外形满意,耐磨.吻合神经的7例中有5例得到随访,皮瓣两点辨别觉在10 ~ 14 mm. 结论 带腓动脉的腓浅神经营养血管皮瓣血供丰富,切取简便,随意转移性强,外观好,是修复前足较大面积皮肤软组织缺损理想的方法之一.

  10. 口服葡萄糖对新生儿桡动脉采血疼痛的影响%Effect of oral glucose on neonatal pain during blood sampling through radial artery

    Institute of Scientific and Technical Information of China (English)

    张昆珍; 韦琴; 李小容; 孙俭凤

    2012-01-01

    Objective To explore the effect of 10% and 25% oral glucose on neonatal pain during blood sampling through radial artery.Methods 90 newborns were randomly divided into group A,B and C,each group with 30 cases.2 min before the blood sampling,group A was offered 2ml 10% oral glucose,group B was offered 2ml 25% oral glucose,and group C was offered 2ml plain boiled water by oral intake.Pain was evaluated based on Neonatal Facial Coding System (NFCS),Neonatal Infant Pain Scale(NIPS),raise of heart rate and crying cases.Results The scores of NIPS during puncture,the scores of NFCS and NIPS after puncture,the raise of heart rate and crying cases were significantly different between three groups.Group B were lower than group A and group C,while differences between group A and group C had no statistical significance.Conclusions During blood sampling through radial artery,offering newboms 2ml 25% oral glucose can reduce the pain,while 2ml 10% oral glucose was ineffective.%目的 探讨2种浓度葡萄糖对新生儿桡动脉采血所致疼痛的影响.方法 采用随机分组原则,将90例新生儿随机分成A、B、C3组各30例,于桡动脉采血前2 min,A组新生儿予口服10%葡萄糖2 ml,B组新生儿予口服25%葡萄糖2 ml,C组新生儿予口服白开水2ml.采用新生儿面部编码系统(NFCS)、新生儿疼痛量表(NIPS)、心率上升幅度和啼哭例数作为观测指标.结果 3组新生儿疼痛评分(包括穿刺时的NIPS评分、结束时的NFCS评分和NIPS评分)分值、心率上升幅度以及啼哭例数比较差异明显,B组明显低于A、C组,而A、C2组间比较差异无统计学意义.结论 桡动脉采血时予口服25%葡萄糖2 ml可以明显缓解新生儿疼痛,而10%葡萄糖2ml无显著镇痛作用.

  11. de secador de flujo radial

    Directory of Open Access Journals (Sweden)

    Néstor Durango

    2005-01-01

    Full Text Available En este artículo se presentan los resultados obtenidos en la investigación realizada para establecer la influencia e importancia de las variables cantidad de yuca, relación superficie a volumen del material de los pedazos de yuca, velocidad del ventilador y temperatura del aire de recirculación, en el proceso de secado de yuca en un modelo de secador de flujo radial. La metodología experimental utilizada fue el diseño de experimentos factoriales, la cual, mediante una serie de análisis estadísticos, posibilitó la caracterización del proceso para un tiempo de secado de tres horas y la obtención de un modelo matemático que describe su comportamiento.

  12. Revascularização do miocárdio com emprego da artéria radial: estudo clínico e angiográfico seqüencial Myocardial revascularization with the radial artery: clinical and sequential angiographic study

    Directory of Open Access Journals (Sweden)

    Francisco Diniz Affonso da Costa

    1995-12-01

    Full Text Available De 8/4/94 a 28/2/95,32 pacientes foram submetidos a revascularização do miocárdio (RM com a utilização da artéria radial (RA como parte do procedimento. Esse número representou 17,3% da experiência global com RM neste período. Vinte e três pacientes eram masculinos e a média de idades foi de 56,8 anos (41 a 74 anos. A RA foi utilizada para revascularizar o território do ramo interventricular anterior (RIA ou Dg em 7 casos, da coronária direita em 7 e o da circunflexa em 18. A mortalidade hospitalar foi de 2 (6% casos, sendo ambos de causa não cardíaca. Reestudo angiográfico antes da alta hospitalar foi realizado em todos os pacientes que sobreviveram, demonstrando enxertos patentes em 96% (46/48. Dois enxertos exibiram espasmo moderado relacionado à ponta do cateter, um apresentou espasmo acentuado e dois demonstraram a presença de string sign. Oito pacientes com evolução pós-operatória tardia superior a 6 meses foram submetidos a reestudo angiográfico seqüencial, com enxertos pérvios em 100%, sem nenhuma anormalidade detectável. Uma paciente que apresentou string sign no pós-operatório imediato foi reestudada no 4º mês de pós-operatório, com progressão do processo. Os resultados aqui obtidos nos permitem afirmar que a RA pode ser uma excelente opção para pacientes com varizes dos MMII ou ausência de veias safenas. O seguimento clínico mais prolongado nos ajudará a determinar o real valor da RA como enxerto aorto-coronário.From 4/8/94 thru 2/28/95, 32 patients were submitted to myocardial revascularization utilizing the radial artery graft (RA as part of the procedure. This represented 17.3% of our coronary bypass surgery experience during that period. Twenty three patients were male and mean age was 56.8 years (41-74. The RA was used to graft the anterior interventricular area in 7 cases, right coronary artery in 7 cases and circunflex in 18 cases. Two patients died, for a hospital mortality of 6%, being

  13. Reverse flow first dorsal metacarpal artery flap for covering the defect of distal thumb.

    Science.gov (United States)

    Checcucci, Giuseppe; Galeano, Mariarosaria; Zucchini, Maura; Zampetti, Pier Giuseppe; Ceruso, Massimo

    2014-05-01

    Reconstruction of distal thumb injuries still remains a challenge for hand surgeons. Surgical treatment includes the use of local, regional, and free flaps. The purpose of this report is to present the results of the use of a sensitive reverse flow first dorsal metacarpal artery (FDMA) flap. The skin flap was designed on the radial side of the proximal phalanx of the index finger based on the ulnar and radial branch of the FDMA and a sensory branch of the superficial radial nerve. This neurovascular flap was used in five patients to cover distal soft-tissue thumb defects. All flaps achieved primary healing except for one patient in whom superficial partial necrosis of the flap occurred, and the defect healed by second intention. All patients maintained the thumb original length and were able to return to their previous daily activities. The reverse flow FDMA flap is a reliable option to cover immediate and delayed defects of distal thumb, offering acceptable functional and cosmetic outcomes in respect to sensibility, durability, and skin-match.

  14. Superficial Priming in Episodic Recognition

    Science.gov (United States)

    Dopkins, Stephen; Sargent, Jesse; Ngo, Catherine T.

    2010-01-01

    We explored the effect of superficial priming in episodic recognition and found it to be different from the effect of semantic priming in episodic recognition. Participants made recognition judgments to pairs of items, with each pair consisting of a prime item and a test item. Correct positive responses to the test item were impeded if the prime…

  15. The effect of propranolol on glyceryltrinitrate-induced headache and arterial response

    DEFF Research Database (Denmark)

    Tvedskov, Jesper; Thomsen, L L; Thomsen, L L

    2004-01-01

    Prophylactic drug trials in migraine are long-lasting and expensive and require long-term toxicology information. A human migraine model would therefore be helpful in testing new drugs. Immediate headache and delayed migraine after glyceryltrinitrate (GTN) has been well characterized. We have...... was administered on a study day at the end of both pretreatment periods. Headache was registered for 12 h after GTN infusions. Its intensity was scored on a numerical verbal rating scale from 0 to 10. Fulfilment of International Headache Society (HIS) criteria was recorded for 24 h. Radial and superficial temporal...... artery diameters and blood velocity of both middle cerebral arteries were measured. All migraine subjects developed headache after GTN. No reduction of overall peak headache was found after propranolol (median 5, range 0-7) compared with placebo (median 5, range 0-10) (P = 0.441). Eight of the 14...

  16. Major Superficial White Matter Abnormalities in Huntington's Disease

    Science.gov (United States)

    Phillips, Owen R.; Joshi, Shantanu H.; Squitieri, Ferdinando; Sanchez-Castaneda, Cristina; Narr, Katherine; Shattuck, David W.; Caltagirone, Carlo; Sabatini, Umberto; Di Paola, Margherita

    2016-01-01

    Background: The late myelinating superficial white matter at the juncture of the cortical gray and white matter comprising the intracortical myelin and short-range association fibers has not received attention in Huntington's disease. It is an area of the brain that is late myelinating and is sensitive to both normal aging and neurodegenerative disease effects. Therefore, it may be sensitive to Huntington's disease processes. Methods: Structural MRI data from 25 Pre-symptomatic subjects, 24 Huntington's disease patients and 49 healthy controls was run through a cortical pattern-matching program. The surface corresponding to the white matter directly below the cortical gray matter was then extracted. Individual subject's Diffusion Tensor Imaging (DTI) data was aligned to their structural MRI data. Diffusivity values along the white matter surface were then sampled at each vertex point. DTI measures with high spatial resolution across the superficial white matter surface were then analyzed with the General Linear Model to test for the effects of disease. Results: There was an overall increase in the axial and radial diffusivity across much of the superficial white matter (p < 0.001) in Pre-symptomatic subjects compared to controls. In Huntington's disease patients increased diffusivity covered essentially the whole brain (p < 0.001). Changes are correlated with genotype (CAG repeat number) and disease burden (p < 0.001). Conclusions: This study showed broad abnormalities in superficial white matter even before symptoms are present in Huntington's disease. Since, the superficial white matter has a unique microstructure and function these abnormalities suggest it plays an important role in the disease. PMID:27242403

  17. Major Superficial White Matter Abnormalities in Huntington disease

    Directory of Open Access Journals (Sweden)

    Owen Robert Phillips

    2016-05-01

    Full Text Available BackgroundThe late myelinating superficial white matter at the juncture of the cortical gray and white matter comprising the intracortical myelin and short-range association fibers has not received attention in Huntington’s disease. It is an area of the brain that is late myelinating and is sensitive to both normal aging and neurodegenerative disease effects. Therefore, it may be sensitive to Huntington’s disease processes. MethodsStructural MRI data from 25 Pre-symptomatic subjects, 24 Huntington’s disease patients and 49 healthy controls was run through a cortical pattern-matching program. The surface corresponding to the white matter directly below the cortical gray matter was then extracted. Individual subject’s Diffusion Tensor Imaging (DTI data was aligned to their structural MRI data. Diffusivity values along the white matter surface were then sampled at each vertex point. DTI measures with high spatial resolution across the superficial white matter surface were then analyzed with the General Linear Model to test for the effects of disease. ResultsThere was an overall increase in the axial and radial diffusivity across much of the superficial white matter (p < 0.001 in Pre-symptomatic subjects compared to controls. In Huntington’s disease patients increased diffusivity covered essentially the whole brain (p < 0.001. Changes are correlated with genotype (CAG repeat number and disease burden (p < 0.001.ConclusionsThis study showed broad abnormalities in superficial white matter even before symptoms are present in Huntington’s disease. Since the superficial white matter has a unique microstructure and function these abnormalities suggest it plays an important role in the disease.

  18. 旋髂浅动脉穿支嵌合骨皮瓣修复四肢骨与软组织缺损%Transplantation of the chimerical osteocutaneous perforator flap with superficial circumflex iliac artery for repair of bone and skin defect in limbs

    Institute of Scientific and Technical Information of China (English)

    潘朝晖; 蒋萍萍; 薛山; 刘学胜; 李洪飞; 赵玉祥

    2010-01-01

    目的 探讨旋髂浅动脉穿支嵌合骨皮瓣修复四肢骨与软组织缺损的应用特点.方法 2008年2月至2009年4月应用旋髂浅动脉穿支嵌合骨皮瓣修复四肢骨与软组织缺损5例,男4例,女1例;年龄22~44岁,平均31.2岁.车祸伤3例,机器挤压伤2例.掌骨2例,足2例,腓骨1例.皮肤缺损面积5 cm×2 cm~16 cm×5 cm.骨瓣切取范围2 cm×1 cm×0.8 cm~8 cm×2 cm×0.5 cm,皮瓣切取范围6cm×3 cm~18 cm×6 cm.血管吻合除1例动脉端侧吻合外,均采用端端吻合方式.骨瓣以钢板螺钉固定4例,克氏针固定1例.结果 1例术后第2天出现动脉危象,探查后发生皮瓣边缘浅表性坏死,经植皮愈合,其余皮瓣全部存活.供区伤口8~27 d愈合.全部患者随访8~19个月,皮瓣外观满意,无须特殊保护.骨愈合时间3~6个月.髋部外形轮廓未改变,无髋区疼痛,无瘢痕增生.修复手部缺损者患手恢复握持功能,基本恢复对掌功能;修复下肢缺损者患肢可负重,无疼痛.结论 旋髂浅动脉穿支嵌合骨皮瓣供区损伤小,是修复小面积骨缺损,尤其是合并较大范围软组织缺损的一种较好方法.%Objective To investigate the applied methods and effects of the chimerical osteocuta-neous perforator flap with superficial circumflex iliac artery for reconstruction of bone and skin defect in limbs. Methods From February 2008 to April 2009, five patients in whom bone and skin defect in limbs were reconstructed with free chimerical osteocutaneous perforator flaps using superficial circumflex iliac vessel, in-cluding 4 males and 1 female with an average age of 31.2 years. Of 5 patients, 2 were used for the recon-struction of composite metacarpal bone and soft-tissue defects, 2 for foot reconstruction, and 1 for fibula re-construction. The area of cutaneous deficiency was about 5 cm×2 cm to 16 cm×5 cm. The size of osseous flaps ranged from 2 cm×1 cm×0.8 cm to 8 cm×2 cm×0.5 cm, and the size of cutaneous flaps ranged

  19. Estudio de la vascularización arterial del músculo flexor digitorum superficialis Anatomical study of the arterial vascularization of the flexor digitorum superficialis muscle

    Directory of Open Access Journals (Sweden)

    N. Comellas Melero

    2010-03-01

    Full Text Available El objetivo de nuestro estudio es describir la distribución de la vascularización del músculo flexor digitorum superficialis para optimizar sus indicaciones en Cirugía Reconstructiva de miembro superior. Disecamos 15 antebrazos fijados según el método Thiel y coloreados mediante la inyección de látex en los vasos femorales. Centramos nuestro estudio en la disección del músculo flexor digitorum superficialis, seleccionando únicamente los pedículos vasculares que superan los 2 mm, valorando los resultados en función de sus relaciones anatómicas y de su longitud. El número total hallado de arterias nutrientes del vientre muscular fue de 219, localizándose en mayor porcentaje en el tercio medio del antebrazo. De los resultados obtenidos de nuestro estudio podemos deducir que las arterias cubital y cubital recurrente aportan la vascularización dominante. Medialmente, el músculo recibe ramas de la arteria cubital y cubital recurrente, en la parte profunda del vientre muscular. Lateral y proximalmente, recibe ramas de la arteria mediana, mientras que lateral y distalmente recibe ramas de la arteria radial, que penetran en la superficie del músculo.We present an anatomical study that describes the distribution of the muscular perforators of the flexor digitorum superficialis muscle. In this study we dissected 15 forearms fixed according to Thiel method and coloured latex injection in the femoral vessels.The study was centered on the flexor digitorum superficialis muscle. Only muscular perforator arteries with diameters over 2mm were selected. The vascular origin and length were also studied. In all cases, measurements were taken from the bicondyle line. The total number of arteries obtained from the muscle belly was 219, with the greatest percentage located in the half of the forearm. The principal vascular origin of the perforator arteries was the cubital artery. From the results obtained in our work, we can deduce that the ulnar and

  20. Superficie

    OpenAIRE

    Corna, Pablo María

    2015-01-01

    En la época posclásica del derecho romano se buscó, por parte del Estado y ciudadanos, utilizar ciertos terrenos que formaban parte de su patrimonio para arrendarlos por largo término —y a veces a perpetuidad— a personas que tenían el derecho de edificar o plantar mediante el pago de un precio llamado pensio o solárium. En el siglo II de nuestra era ya era utilizado para asentar tribus romanizadas en la frontera del imperio como para el cultivo de vid y los olivos que demoran varios...

  1. Superficie

    OpenAIRE

    Corna, Pablo María

    2015-01-01

    En la época posclásica del derecho romano se buscó, por parte del Estado y ciudadanos, utilizar ciertos terrenos que formaban parte de su patrimonio para arrendarlos por largo término —y a veces a perpetuidad— a personas que tenían el derecho de edificar o plantar mediante el pago de un precio llamado pensio o solárium. En el siglo II de nuestra era ya era utilizado para asentar tribus romanizadas en la frontera del imperio como para el cultivo de vid y los olivos que demoran varios años e...

  2. Correlation of invasive central arterial pressure with peripheral arterial pressure and coronary sclerosis

    Institute of Scientific and Technical Information of China (English)

    吴琪

    2013-01-01

    Objective To study the consistency among non-invasive and invasive brachial artery pressure,radial artery pressure and invasive central arterial pressure,and to explore the correlation between the severe degree of coronary artery disease and invasive central aortic pressure.

  3. Aneurysm of the superficial palmar arch: a case report.

    Science.gov (United States)

    Estrella, Emmanuel P; Lee, Ellen Y

    2008-01-01

    Aneurysms of the hand are uncommon lesions. The most common location is the ulnar artery. We present a case of a young female who consulted us for a hand mass with a history of trauma to the hand. Pre-operative arteriogram showed a superficial palmar arch aneurysm. The mass was excised and the arch was reconstructed using a reversed Y-shaped vein graft. Fourteen months after surgery, there was no recurrence of the aneurysm and the patient only reported occasional cold intolerance.

  4. Balloon-Assisted Tracking to Overcome Radial Spasm during Transradial Coronary Angiography: A Case Report

    OpenAIRE

    Verouden, N. J. W.; Kiemeneij, F.

    2014-01-01

    Spasm of the radial artery is the most important cause of failure to perform coronary angiography via the transradial approach. Spasmolytic cocktail may prevent radial artery spasm but is relatively contraindicated in patients with aortic stenosis or diminished left ventricular function. In this case report we describe a recently published technique to overcome severe radial spasm during transradial coronary angiography in a patient with moderate aortic valve stenosis.

  5. Balloon-Assisted Tracking to Overcome Radial Spasm during Transradial Coronary Angiography: A Case Report.

    Science.gov (United States)

    Verouden, N J W; Kiemeneij, F

    2014-01-01

    Spasm of the radial artery is the most important cause of failure to perform coronary angiography via the transradial approach. Spasmolytic cocktail may prevent radial artery spasm but is relatively contraindicated in patients with aortic stenosis or diminished left ventricular function. In this case report we describe a recently published technique to overcome severe radial spasm during transradial coronary angiography in a patient with moderate aortic valve stenosis.

  6. Balloon-Assisted Tracking to Overcome Radial Spasm during Transradial Coronary Angiography: A Case Report

    Directory of Open Access Journals (Sweden)

    N. J. W. Verouden

    2014-01-01

    Full Text Available Spasm of the radial artery is the most important cause of failure to perform coronary angiography via the transradial approach. Spasmolytic cocktail may prevent radial artery spasm but is relatively contraindicated in patients with aortic stenosis or diminished left ventricular function. In this case report we describe a recently published technique to overcome severe radial spasm during transradial coronary angiography in a patient with moderate aortic valve stenosis.

  7. Massive cerebral arterial air embolism following arterial catheterization

    Energy Technology Data Exchange (ETDEWEB)

    Yang, C.W. [Northwestem University Feinberg School of Medicine, Department of Radiology, Chicago, IL (United States); Yang, B.P. [Northwestern University Feinberg School of Medicine, Department of Neurological Surgery, Chicago, IL (United States)

    2005-12-01

    Microscopic cerebral arterial air embolism (CAAE) has been described in many patients undergoing cardiac surgery as well as other invasive diagnostic and therapeutic procedures. However, massive CAAE is rare. We report a 42-year-old woman who initially presented with thalamic and basal ganglia hemorrhages. Shortly after a radial arterial catheter was inserted, the patient suffered a generalized seizure and CT demonstrated intra-arterial air in bilateral cerebral hemispheres. (orig.)

  8. Residual strains in conduit arteries.

    Science.gov (United States)

    Rachev, A; Greenwald, S E

    2003-05-01

    Residual strains and stresses are those that exist in a body when all external loads are removed. Residual strains in arteries can be characterized by the opening angle of the sector-like cross-section which arises when an unloaded ring segment is radially cut. A review of experimental methods for measuring residual strains and the main results about the variation of the opening angle with arterial localization, age, smooth muscle activity, mechanical environment and certain vascular pathologies are presented and discussed. It is shown that, in addition to their well-established ability to homogenize the stress field in the arterial wall, residual strains make arteries more compliant and thereby improve their performance as elastic reservoirs and ensure more effective local control of the arterial lumen by smooth muscle cells. Finally, evidence that, in some cases, residual strains remain in arteries even after they have been cut radially is discussed.

  9. A Rare Variant of the Ulnar Artery with Important Clinical Implications: a Case Report

    OpenAIRE

    Casal Diogo; Pais Diogo; Toscano Tiago; Bilhim Tiago; Rodrigues Luís; Figueiredo Inês; Aradio Sónia; Angélica-Almeida Maria; Goyri-O’Neill João

    2012-01-01

    Abstract Background Variations in the major arteries of the upper limb are estimated to be present in up to one fifth of people, and may have significant clinical implications. Case presentation During routine cadaveric dissection of a 69-year-old fresh female cadaver, a superficial brachioulnar artery with an aberrant path was found bilaterally. The superficial brachioulnar artery originated at midarm level from the brachial artery, pierced the brachial fascia immediately proximal to the elb...

  10. Late sequelae of superficial irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Hood, I.C.; Young, J.E.

    1984-10-01

    Superficial irradiation results in well recognized late sequelae including not only sclerosis and atrophy of skin and subcutaneous tissue, but also the development of benign and malignant tumors of skin and adjacent structures. The long latency between irradiation and its late effects allowed the early uncontrolled use of radiation treatment for benign conditions. The subsequent recognition of the causal relationship between tumors and previous irradiation has restricted its use to more appropriate purposes, although it is possible that it is still overused in some areas of dermatologic practice. Clinicians need to be aware of the time interval between irradiation and the development of its late sequelae, and the incidence of these sequelae. Appropriate irradiation exposure history should be a part of the evaluation of every patient.

  11. Radial heat transport in packed beds at elevated pressures

    NARCIS (Netherlands)

    Wijngaarden, R.J.; Westerterp, K.R.

    1992-01-01

    Values were measured for the effective radial heat conductivity λeff, r and the heat transfer coefficient at the wall αw in a packed bed. This was done for superficial velocities of 5 – 70 cm s−1 and at pressures from 1 – 10 bar. Values for λeff, r and αw were obtained by simultaneous fitting of

  12. Superficial siderosis in the central nervous system

    Energy Technology Data Exchange (ETDEWEB)

    Pythinen, J. [Oulu Univ. (Finland). Dept. of Diagnostic Radiology; Paeaekkoe, E. [Oulu Univ. (Finland). Dept. of Diagnostic Radiology; Ilkko, E. [Oulu Univ. (Finland). Dept. of Diagnostic Radiology

    1995-02-01

    We describe a rare entity, superficial siderosis of the central nervous system, due to multiple small episodes of subarachnoid haemorrhage from any source. Non-specific neurological findings are associated with deposition of iron-containing pigments in the leptomeninges and superficial layers of the cortex. T2-weighted magnetic resonance imaging demonstrates characteristic low signal in the meninges. (orig.)

  13. Constriction of collateral arteries induced by "head-up tilt" in patients with occlusive arterial disease of the legs

    DEFF Research Database (Denmark)

    Agerskov, K; Henriksen, O; Tønnesen, K H

    1981-01-01

    . Relative change in blood flow in the leg during tilt was estimated by changes in arterio-venous oxygen differences and by the indicator dilution technique in nine patients. Head-up tilt caused a decrease in leg blood flow of 36% corresponding to an increase in total vascular resistance of 57%. Tilt did......The effect of head-up tilt on leg blood flow and segmental arterial blood pressures was studied in 21 patients with occlusion or severe stenosis of the common or superficial femoral artery. Arterial pressure was measured directly in the brachial artery, common femoral artery and popliteal artery...... not change the pressure gradient from femoral to popliteal artery in the patients with occlusion of the superficial femoral artery, indicating that the flow resistance offered by the collateral arteries had increased. In a bilateral sympathectomised patient the increase in collateral resistance was almost...

  14. Radial heat flux transformer

    Science.gov (United States)

    Basiulis, A.; Buzzard, R. J.

    1971-01-01

    Unit moves heat radially from small diameter shell to larger diameter shell, or vice versa, with negligible temperature drop, making device useful wherever heating or cooling of concentrically arranged materials, substances, and structures is desired.

  15. 慢性肾脏病5期患者桡动脉gremlin表达与血管钙化的关系%Association of vascular calcification and gremlin expression in radial arteries of patients with stage 5 of chronic kidney disease

    Institute of Scientific and Technical Information of China (English)

    龚立峰; 卢景奎; 唐卫刚; 姜维; 马桂香

    2011-01-01

    目的 探讨慢性肾脏病(CKD)5期患者桡动脉中骨形态发生蛋白(BMP)拮抗剂gremlin表达与血管钙化的关系.方法 40例CKD5期患者为试验组,于行首次动静脉内瘘术时取桡动脉标本;38例单纯外伤性脾破裂患者为对照组,取其脾小梁动脉标本.用钙盐特异性染色法( von Kossa)对动脉进行钙化染色;用免疫组化法检测动脉gremlin、BMP-2、-7的表达,并用ELISA法检测血清中3者浓度;用病理图像分析系统(IPP6.0)对组织切片进行半定量化图像分析;用SPSS 19.0统计分析软件进行数据处理.结果 试验组12例(30%)钙盐染色显著阳性,位于中膜的平滑肌细胞层,而对照组无显著钙盐染色.试验组钙盐染色显著阳性的桡动脉均有gremlin、BMP-2显著表达,位于中膜的平滑肌细胞层,且2者的表达量与钙盐染色程度均呈正相关.试验组BMP-7的表达量显著低于对照组.结论 gremlin、BMP-2均可能参与了CKD5期患者桡动脉平滑肌细胞向成骨样细胞表型转化这一过程,而BMP-7可能阻止此过程的进展.%Objective To study the association of the expression of bone morphogenetic protein (BMP) antagonist gremlin and vascular calcification in radial arteries of patients with stage 5 of chronic kidney disease (CKD).Methods Radial arteries of 40 patients with stage 5 of CKD were collected as specimens of the study group,which were trimmed off during arterial venous fistula operations.Splenic trabecular arteries were collected as specimens of the control group,which were removed from 38 patients with simple traumatic splenic rupture.All the arteries were examined histologically for calcification with yon Kossa stain.Expressions of gremlin and BMP-2,-7were detected by immunohistochemistry and their serum concentrations were detected by ELISA.Images of histological sections were semi-quantitatively analyzed by Image-Pro Plus 6.0.SPSS 19.0software was used to perform statistical analysis

  16. Cochlear implantation in superficial siderosis.

    Science.gov (United States)

    Kim, Chong-Sun; Song, Jae-Jun; Park, Min-Hyun; Kim, Young Ho; Koo, Ja-Won

    2006-08-01

    Superficial siderosis (SS) of the central nervous system has been thought to be a rare condition that generates progressive hearing loss, ataxia, pyramidal signs, and dementia. The main cause of hearing loss by SS is thought to be neuronal. Because there is no histopathologic report of the human temporal bone in SS, there is a debate about the possibility of cochlear involvement. We present a 25-year-old man who was investigated for bilateral progressive sensorineural hearing loss and vestibular failure after head trauma. On brain MRI, SS of the central nervous system was detected. Distortion product otoacoustic emission (DPOAE) and auditory brainstem response (ABR) showed no response on both sides. However, integrity of the eighth nerve was proved by the electrical ABR test on the right side and the patient benefited significantly from cochlear implantation. The sensorineural hearing loss in SS seems to be related to cochlear damage as well as neuronal damage. So, cochlear implantation would be a hearing rehabilitation modality for the sensorineural hearing loss caused by SS.

  17. Silicon superficial texturing bypulsed laser

    Directory of Open Access Journals (Sweden)

    Ponce, L.

    1998-04-01

    Full Text Available Texturing of silicon surfaces with pulsed laser is made. The method is based on the formation of laser- induced periodic surface structure (LIPSS. The process is temporary characterized through the dynamic reflectance, thus determining the formation threshold of the structure. Relation between the different textures and the spectral reflectance of the samples before and after the treatment is also characterized. The mean value of spectral reflectance decreases up to a 6 %.

    Se realiza el texturado de superficies de silicio con un láser pulsado mediante la formación de una estructura periódica inducida por láser (LIPSS. Se caracteriza el proceso mediante reflectancia dinámica, determinándose el umbral de formación de la estructura. Se caracteriza el nivel de texturado midiendo la reflectancia espectral de las muestras antes y después del tratamiento. El valor medio de la reflectancia espectral disminuye hasta el 6 %.

  18. 纵向、径向及周向二维应变评价冠心病患者左心室局部收缩功能异常%Longitudinal, radial and circumferential 2-dimensional strain for quantitative analysis of regional left ventricular systolic dysfunction in patients with coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    李燕; 胡莉君; 李薇玢; 吕清; 王新房; 谢明星; 张静; 丁尚伟; 陈明; 王静; 贺林

    2009-01-01

    Objective To assess longitudinal, radial and circumferential systolic strain of regional myocardium in patients with coronary artery disease by 2-dimensional strain echocardiography, and to explore stenosis of coronary artery impacting on regional left ventricular systolic dysfunction in quietscent condition. Methods Twenty-six patients with coronary artery disease were entrolled into this study and 26 healthy volenteers in the control group. The two-dimensional loop-einec were obtained in apical 4-chamber view,apical 2-chamber view and long axis view of left venricular, and three levels of the short axis views (mitral valve,papillary muscle and cardiac apex). According to left ventricle 18 segments divla, there were 194 affected myocardiums in 26 cases. According to stenosis degrees of coronary artery, the affected myocardiums were divided into two groups: group A (coronary stenosis degree≤70%) and group B (coronary stenosis degree>70%). Longitudinal, radial and circumferential systolic strain (SL, SR, SC) from regional myocardium were analyzed. Results Group A had 90 segments. Compared with control group,SL was decreased significantly from control group (P 0.05). Group B had 104 segments. Compared with control group, SL, SC and SR were decreased significantly in group B(P 70%供血的心肌.结果 A组共90个节段.其纵向收缩期峰值应变(SL)明显低于对照组(P0.05);B组共104个节段,其SL、SR和SC均明显低于对照组(P<0.05),A组和B组之间SL、SC和SR的差异有统计学意义(P<0.05).结论 二维应变超声心动图能准确评价冠心病患者左室局部收缩功能异常,局部心肌SL、SR和SC的变化町反映冠脉狭窄严重程度.

  19. Pedal arteries of monkeys, with special reference to the plantar metatarsal arteries.

    Directory of Open Access Journals (Sweden)

    Hinenoya,Hitoshi

    1987-12-01

    Full Text Available In the Japanese, Formosan and crab-eating monkeys, the dorsal metatarsal arteries and their lateral distal perforating branches were well developed and supplied, directly or via the catella plantaris distalis, the plantar digital arteries. In the black ape, the plantar digital arteries arose from the medial plantar artery. The plantar metatarsal arteries of these monkeys, including the black ape, arose from the catella plantaris proximalis or deep plantar arch and were classified into the superficial plantar metatarsal (sM, superficial plantar intermetatarsal (sI, deep plantar metatarsal (dM and deep plantar intermetatarsal (dI arteries in relation to the interosseous muscles and metatarsal bones. This classification largely coincides with that of the human hand and foot (Murakami, 1969, 1971 and the monkey hand (Nakai et al., 1987.

  20. Radial tunnel syndrome. Findings and treatment in 17 patients

    Directory of Open Access Journals (Sweden)

    Gustavo Alberto Breglia

    2015-05-01

    Full Text Available Backround Radial tunnel syndrome is a condition secondary to the intermittent entrapment of the posterior interosseous nerve between superficial and deep mass of short supinator adjacent structures, such as vessels and fascias. The purpose of this study was to identify the anatomical structures that produce the eventual compression, to establish and communicate the differences in the subjective pain perception before and after the release of the posterior interosseous nerve in the radial tunnel. Method Between 2009 and 2014, 17 patients underwent surgical treatment by posterior interosseous nerve release. We used the approach between the first external radial and brachioradialis. Patients were assessed by visual analogue scale for pain intensity before surgery and at week 6, and according to the Roles and Maudsley functional criteria. Results The causes of posterior interosseous nerve compression were fibrous band of short supinator (arcade of Frohse (7 cases, recurrent vessels (4 cases, compression by the mass of the superficial portion of the short supinator muscle (2 cases and secondary compression by extensor carpi radialis brevis tendon (4 cases. Results were excellent (4 patients, good (10 patients and fair (3 patients. Patients treated through the Labor Risk Insurance had worse outcomes than those who were not covered by this system. Conclusions Radial tunnel syndrome is a condition that must be taken into account when there is refractory lateral epicondylalgia. This disease has a marked effect in patients with labor conflict, which may bias the outcome of treatment.

  1. Subintimal Arterial Flossing with Antegrade-Retrograde Intervention for Subintimal Recanalization in Treatment of Superficial Femoral Artery Long Segment Occlusion in 16 Patients%双向内膜下血管成形术治疗股浅动脉长段硬化性闭塞疾病16例分析

    Institute of Scientific and Technical Information of China (English)

    徐树彬; 梁志会; 李亮; 刘晶磊; 李佳; 崔进国; 赵红恩; 谢永伟

    2014-01-01

    目的 探讨经双向内膜下血管成形术(subintimal arterial flossing with antegrade retrograde intervention,SAFARI)治疗股浅动脉长段硬化性闭塞疾病的临床效果和应用价值.方法 选择2011年5月—2013年8月收治的经内膜下血管成形术治疗失败的股浅动脉长段硬化性闭塞疾病16例,经SAFARI开通,采用经皮穿刺腔内血管成形术(PTA)联合内支架(stent)置入.结果 全组治疗技术成功率为100%,无严重并发症发生;术后平均随访10(3 ~18)个月,一期通畅率为93.75%(15/16),二期通畅率为100%.踝肱指数由术前的0.25±0.15增加至术后的0.89±0.19(P <0.05).结论 SAFARI是治疗股浅动脉长段硬化性闭塞所致慢性严重肢体缺血的安全有效的方法.

  2. Scanning electron microscopy of superficial white onychomycosis*

    Science.gov (United States)

    de Almeida Jr., Hiram Larangeira; Boabaid, Roberta Oliveira; Timm, Vitor; Silva, Ricardo Marques e; de Castro, Luis Antonio Suita

    2015-01-01

    Superficial white onychomycosis is characterized by opaque, friable, whitish superficial spots on the nail plate. We examined an affected halux nail of a 20-year-old male patient with scanning electron microscopy. The mycological examination isolated Trichophyton mentagrophytes. Abundant hyphae with the formation of arthrospores were found on the nail's surface, forming small fungal colonies. These findings showed the great capacity for dissemination of this form of onychomycosis. PMID:26560225

  3. Treatment of superficial mycoses: review - part II

    OpenAIRE

    2013-01-01

    Superficial fungal infections of the hair, skin and nails are a major cause of morbidity in the world. Choosing the right treatment is not always simple because of the possibility of drug interactions and side effects. The first part of the article discusses the main treatments for superficial mycoses - keratophytoses, dermatophytosis, candidiasis, with a practical approach to the most commonly-used topical and systemic drugs , referring also to their dosage and duration of use. Promising new...

  4. Treatment of superficial mycoses: review - part II*

    OpenAIRE

    2013-01-01

    Superficial fungal infections of the hair, skin and nails are a major cause of morbidity in the world. Choosing the right treatment is not always simple because of the possibility of drug interactions and side effects. The first part of the article discusses the main treatments for superficial mycoses - keratophytoses, dermatophytosis, candidiasis, with a practical approach to the most commonly-used topical and systemic drugs , referring also to their dosage and duration of use. Promising new...

  5. Radial wedge flange clamp

    Science.gov (United States)

    Smith, Karl H.

    2002-01-01

    A radial wedge flange clamp comprising a pair of flanges each comprising a plurality of peripheral flat wedge facets having flat wedge surfaces and opposed and mating flat surfaces attached to or otherwise engaged with two elements to be joined and including a series of generally U-shaped wedge clamps each having flat wedge interior surfaces and engaging one pair of said peripheral flat wedge facets. Each of said generally U-shaped wedge clamps has in its opposing extremities apertures for the tangential insertion of bolts to apply uniform radial force to said wedge clamps when assembled about said wedge segments.

  6. Radial pulse (image)

    Science.gov (United States)

    ... heart. The arteries are the vessels with the "pulse", a rhythmic pushing of the blood in the ... a refilling of the heart chamber. To determine heart rate, one feels the beats at a pulse point ...

  7. Continuous blood gas monitoring in femoral arteries

    Science.gov (United States)

    Schlain, Les A.; Spar, Steven M.; Dellinger, Bart

    1995-05-01

    Continuous intra-arterial blood gas monitoring is a potentially valuable tool in the surgical and intensive care arenas. Patient oxygenation and acid base status can change rapidly and without warning. The ability to monitor pHa, PaCO2 and PaO2 in arterial blood will be a major medical advance for the anesthesiologist and intensivist. Intra-arterial blood gas sensors are typically placed in radial arteries. In certain patient populations accurate monitoring is not possible in radial arteries due to arterial environmental factors such as hypotension, vasoconstriction and atherosclerotic disease. These same factors can make radial cannulation difficult resulting in traumatic catheter insertion, thereby further compromising flow conditions. In situations where radial artery flow is expected to be compromised, selecting a large vessel for sensor placement is desirable. We report an initial feasibility study of our blood gas monitoring system using the femoral artery as the sensing site. Clinical results are presented as well as potential advantages and disadvantages associated with monitoring in the femoral artery.

  8. 指脉氧监测协助下提高桡动脉穿刺成功率并减少并发症%Improve the success rate of radial artery puncture and reduce complications with the help of the pulse oximeter

    Institute of Scientific and Technical Information of China (English)

    邵振鸿; 冀琳琳; 金慧燕

    2016-01-01

    目的:探讨指脉氧监测协助下是否可以提高桡动脉穿刺成功率并减少并发症。方法选取2012年7月至2013年3月桡动脉径路行冠脉介入诊治Allen试验阳性患者96例,Allen试验的同时给予指脉氧监测,记录Allen试验开始前、阳性结果判断时患者指脉氧饱和度分数变化,同时记录Allen试验结束后指脉氧饱和度分数恢复时间、穿刺成功率、穿刺时间、压迫时间以及穿刺血管并发症。结果指脉氧饱和度分数在Allen试验前和阳性结果判断时差异无统计学意义(P>0.05);指脉氧饱和度分数下降分数和恢复时间差异无统计学意义(P>0.05);各组穿刺成功率、穿刺时间、压迫时间和并发症差异无统计学意义(P>0.05)。结论虽然未观测到各项指标的统计学差异,但指脉氧监测可以更加直观的观测到患者的桡动脉和尺动脉侧支血供的通畅情况,提高桡动脉的穿刺成功率并减少并发症。%Objective To explore if the pulse oximeter can help improve the success rate of radial artery puncture and reduce complications.Methods Allen test was positive in 96 patients from July 2012 to March 2013, give pulse oximeter and then record the oxygen saturation saturation before the Allen test; after the Allen test, then record the oxygen saturation saturation, the recovery time, the success rate of puncture, puncture time, oppression time, and complications.Results The pulse oxygen saturation before and afterthe Allen test was not significantly different(P>0.05); the decreased scores and recovery time of oxygen saturation saturation was not significantly different(P>0.05); no significant differences was found in success rate of puncture, puncture time, oppression time, and complications(P>0.05).Conclusion pulse oximeter can be a more intuitive observation to the collateral blood supply of radial artery and ulnar artery, it also improve the success rate of radial artery

  9. Radial Halbach Magnetic Bearings

    Science.gov (United States)

    Eichenberg, Dennis J.; Gallo, Christopher A.; Thompson, William K.

    2009-01-01

    Radial Halbach magnetic bearings have been investigated as part of an effort to develop increasingly reliable noncontact bearings for future high-speed rotary machines that may be used in such applications as aircraft, industrial, and land-vehicle power systems and in some medical and scientific instrumentation systems. Radial Halbach magnetic bearings are based on the same principle as that of axial Halbach magnetic bearings, differing in geometry as the names of these two types of bearings suggest. Both radial and axial Halbach magnetic bearings are passive in the sense that unlike most other magnetic bearings that have been developed in recent years, they effect stable magnetic levitation without need for complex active control. Axial Halbach magnetic bearings were described in Axial Halbach Magnetic Bearings (LEW-18066-1), NASA Tech Briefs, Vol. 32, No. 7 (July 2008), page 85. In the remainder of this article, the description of the principle of operation from the cited prior article is recapitulated and updated to incorporate the present radial geometry. In simplest terms, the basic principle of levitation in an axial or radial Halbach magnetic bearing is that of the repulsive electromagnetic force between (1) a moving permanent magnet and (2) an electric current induced in a stationary electrical conductor by the motion of the magnetic field. An axial or radial Halbach bearing includes multiple permanent magnets arranged in a Halbach array ("Halbach array" is defined below) in a rotor and multiple conductors in the form of wire coils in a stator, all arranged so the rotary motion produces an axial or radial repulsion that is sufficient to levitate the rotor. A basic Halbach array (see Figure 1) consists of a row of permanent magnets, each oriented so that its magnetic field is at a right angle to that of the adjacent magnet, and the right-angle turns are sequenced so as to maximize the magnitude of the magnetic flux density on one side of the row while

  10. Improved Lattice Radial Quantization

    CERN Document Server

    Brower, Richard C; Fleming, George T

    2014-01-01

    Lattice radial quantization was proposed in a recent paper by Brower, Fleming and Neuberger[1] as a nonperturbative method especially suited to numerically solve Euclidean conformal field theories. The lessons learned from the lattice radial quantization of the 3D Ising model on a longitudinal cylinder with 2D Icosahedral cross-section suggested the need for an improved discretization. We consider here the use of the Finite Element Methods(FEM) to descretize the universally-equivalent $\\phi^4$ Lagrangian on $\\mathbb R \\times \\mathbb S^2$. It is argued that this lattice regularization will approach the exact conformal theory at the Wilson-Fisher fixed point in the continuum. Numerical tests are underway to support this conjecture.

  11. The ARCS radial collimator

    OpenAIRE

    Stone M.B.; Niedziela J.L.; Overbay M.A.; Abernathy D.L.

    2015-01-01

    We have designed, installed, and commissioned a scattered beam radial collimator for use at the ARCS Wide Angular Range Chopper Spectrometer at the Spallation Neutron Source. The collimator has been designed to work effectively for thermal and epithermal neutrons and with a range of sample environments. Other design considerations include the accommodation of working within a high vacuum environment and having the ability to quickly install and remove the collimator from the scattered beam. W...

  12. Perceived radial translation during centrifugation

    NARCIS (Netherlands)

    Bos, J.E.; Correia Grácio, B.J.

    2015-01-01

    BACKGROUND: Linear acceleration generally gives rise to translation perception. Centripetal acceleration during centrifugation, however, has never been reported giving rise to a radial, inward translation perception. OBJECTIVE: To study whether centrifugation can induce a radial translation percepti

  13. Treatment of superficial mycoses: review - part II*

    Science.gov (United States)

    Dias, Maria Fernanda Reis Gavazzoni; Bernardes-Filho, Fred; Quaresma-Santos, Maria Victória Pinto; Amorim, Adriana Gutstein da Fonseca; Schechtman, Regina Casz; Azulay, David Rubem

    2013-01-01

    Superficial fungal infections of the hair, skin and nails are a major cause of morbidity in the world. Choosing the right treatment is not always simple because of the possibility of drug interactions and side effects. The first part of the article discusses the main treatments for superficial mycoses - keratophytoses, dermatophytosis, candidiasis, with a practical approach to the most commonly-used topical and systemic drugs , referring also to their dosage and duration of use. Promising new, antifungal therapeutic alternatives are also highlighted, as well as available options on the Brazilian and world markets. PMID:24474103

  14. Treatment of superficial mycoses: review. Part II.

    Science.gov (United States)

    Dias, Maria Fernanda Reis Gavazzoni; Bernardes-Filho, Fred; Quaresma-Santos, Maria Victória Pinto; Amorim, Adriana Gutstein da Fonseca; Schechtman, Regina Casz; Azulay, David Rubem

    2013-01-01

    Superficial fungal infections of the hair, skin and nails are a major cause of morbidity in the world. Choosing the right treatment is not always simple because of the possibility of drug interactions and side effects. The first part of the article discusses the main treatments for superficial mycoses - keratophytoses, dermatophytosis, candidiasis, with a practical approach to the most commonly-used topical and systemic drugs , referring also to their dosage and duration of use. Promising new, antifungal therapeutic alternatives are also highlighted, as well as available options on the Brazilian and world markets.

  15. Radial artery perforator flap for repair of soft tissue defect after palm postoperative scar contracture%桡动脉穿支皮瓣逆行转移修复手掌瘢痕挛缩术后软组织缺损

    Institute of Scientific and Technical Information of China (English)

    王刚; 姚有榕; 邓盼; 张一智; 徐云钦; 申屠刚

    2016-01-01

    Objective To explore the clinical effect of the radial artery perforator flap on repairing soft tissue defect after palm postoperative scar contracture. Methods Eighteen patients with palm scar contracture were selected. The palm soft tissue defect was repaired by radial artery perforator flap after the operation of scar removal and soft tissue release. The areas of soft tissue ranged from 5 cm × 3 cm to 8 cm × 5 cm. The area of donor flap exceeds 20%of the wounds area, and wounds were repaired by free skin grafting. Six months after operation, the hand function was compared with that before operation. Results All the patients were followed up for 6-15 months (mean 10.8 months), all flaps survived with good shape, and flap donor site wounds were healed by skin grafting. The patients were evaluated 6 months after operation according to the Chinese Medical Hand Surgery Society of upper part of functional assessment criteria: excellent in 11 cases, good in 5 cases and general in 2 cases, but preoperative functional evaluation was excellent 0 case, good in 3 cases, general in 7 cases and poor in 8 cases. Compared with that before operation, the postoperative function was significantly improved. Conclusions It is a commendable approach of repairing soft tissue defect after postoperative palm scar contracture by radial artery perforator flap, because it can provide reliable blood supply, and significantly improve hand function with exactly clinical effect.%目的 探讨桡动脉穿支皮瓣逆行转移修复手掌瘢痕挛缩术后软组织缺损的临床疗效.方法 选取手掌瘢痕挛缩患者18例,均行瘢痕切除、软组织松解,缺损创面予以桡动脉穿支皮瓣逆行转移修复,缺损创面面积5cm×3cm~8cm×5cm,皮瓣供区创面放大20%切取,创面均予以游离植皮修复.术后6个月随访比较术前、术后手功能变化.结果 所有患者均获得随访,随访时间为6~15个月(平均10.8个月),所有皮瓣均完全成活,皮瓣供

  16. Antiproton compression and radial measurements

    Science.gov (United States)

    Andresen, G. B.; Bertsche, W.; Bowe, P. D.; Bray, C. C.; Butler, E.; Cesar, C. L.; Chapman, S.; Charlton, M.; Fajans, J.; Fujiwara, M. C.; Funakoshi, R.; Gill, D. R.; Hangst, J. S.; Hardy, W. N.; Hayano, R. S.; Hayden, M. E.; Humphries, A. J.; Hydomako, R.; Jenkins, M. J.; Jørgensen, L. V.; Kurchaninov, L.; Lambo, R.; Madsen, N.; Nolan, P.; Olchanski, K.; Olin, A.; Page, R. D.; Povilus, A.; Pusa, P.; Robicheaux, F.; Sarid, E.; El Nasr, S. Seif; Silveira, D. M.; Storey, J. W.; Thompson, R. I.; van der Werf, D. P.; Wurtele, J. S.; Yamazaki, Y.

    2008-08-01

    Control of the radial profile of trapped antiproton clouds is critical to trapping antihydrogen. We report detailed measurements of the radial manipulation of antiproton clouds, including areal density compressions by factors as large as ten, achieved by manipulating spatially overlapped electron plasmas. We show detailed measurements of the near-axis antiproton radial profile, and its relation to that of the electron plasma. We also measure the outer radial profile by ejecting antiprotons to the trap wall using an octupole magnet.

  17. Vascularization of the facial bones by facial artery: implications for full face allotransplantation

    OpenAIRE

    Rampazzo, Antonio

    2014-01-01

    Background-The maxillary artery is recognized as the main vascular supply of the facial bones; nonetheless clinical evidence supports a co-dominant role for the facial artery. This study explores the extent of the facial skeleton within a facial allograft that can be harvested based on the facial artery. Methods-Twenty-three cadaver heads were used in this study. In 12 heads, the right facial, superficial temporal and maxillary arteries were injected. In 1 head, facial artery angiography w...

  18. 桡动脉感染性假性动脉瘤切除并内瘘成型术的围手术期护理%Perioperative care of a radial artery infective pseudoaneurysm excision and internal fistula plastic operation

    Institute of Scientific and Technical Information of China (English)

    黄春丽; 张雪燕; 刘莲清

    2014-01-01

    目的:总结桡动脉感染性假性动脉瘤切除并内瘘成型术的围手术期护理方法。方法:选择我院2008年1月~2013年12月治疗的桡动脉感染性假性动脉瘤患者46例,总结临床治疗和护理方法。结果:术后平均随访12个月,46例瘤切除并Ⅰ期内瘘成型术,46例均内瘘成熟后血流能满足血液透析需要。结论:术前强调规范的心理护理和预防瘤体破裂,术后加强并发症的观察并进行护理干预和指导,保证内瘘通畅,让患者在瘤切除同时行Ⅰ期内瘘成型术,可有效使用内瘘行血液透析从而提高患者的生活质量和生存率。%Objective:To discuss the effective care method of preoperative anti-fracturing of radial artery infective pseudoaneurysm and internal fistula plas-tic unblocking of postoperative maintenance Phase I. Methods:46 radial artery infective pseudoaneurysm patients received tumor excision and internal fistula plastic operation Phase I from January 2008 to December 2013 were selected for retrospective analysis of perioperative care. Results:Within the average fol-low-up visit period of 12 months after operation,in the 46 patients after maturity of internal fistula could meet the demand of hematodialysis. Conclusion:The regulated psychological care and prevention of tumor body fracturing were emphasized operation,the observation of complication was strengthened and care interference and guidance were made after operation to guarantee the unblocking of internal fistula and make the best efforts to make the patients receive tumor excision wile receiving internal fistula plastic operation Phase I,and the blood vessel available for the hematodialysis could effectively improve the pa-tients′life quality and survival rate.

  19. Arterial Wall Properties and Womersley Flow in Fabry Disease

    Directory of Open Access Journals (Sweden)

    Dimitriadis Emilios

    2002-01-01

    Full Text Available Abstract Background Fabry disease is an X-linked recessive lysosomal storage disease resulting in the cellular accumulation of globotriaosylceramide particularly globotriaosylceramide. The disease is characterized by a dilated vasculopathy with arterial ectasia in muscular arteries and arterioles. Previous venous plethysomographic studies suggest enhanced endothelium-dependent vasodilation in Fabry disease indicating a functional abnormality of resistance vessels. Methods We examined the mechanical properties of the radial artery in Fabry disease, a typical fibro-muscular artery. Eight control subjects and seven patients with Fabry disease had a right brachial arterial line placed allowing real time recording of intra-arterial blood pressure. Real time B-mode ultrasound recordings of the right radial artery were obtained simultaneously allowing calculation of the vessel wall internal and external diameter, the incremental Young's modulus and arterial wall thickness. By simultaneously measurement of the distal index finger-pulse oximetry the pulse wave speed was calculated. From the wave speed and the internal radial artery diameter the volume flow was calculated by Womersley analysis following truncation of the late diastolic phase. Results No significant difference was found between Fabry patients and controls for internal or external arterial diameters, the incremental Young's modulus, the arterial wall thickness, the pulse wave speed and the basal radial artery blood flow. Further, no significant difference was found for the radial artery blood flow in response to intra-arterial acetylcholine or sodium nitroprusside. Both drugs however, elevated the mean arterial flow. Conclusions The current study suggests that no structural or mechanical abnormality exists in the vessel wall of fibro-muscular arteries in Fabry disease. This may indicate that a functional abnormality downstream to the conductance vessels is the dominant feature in

  20. Superficial Urothelial Cancer in the Prostatic Urethra

    Directory of Open Access Journals (Sweden)

    Ziya Kirkali

    2006-01-01

    Full Text Available Transitional cell carcinoma (TCC is a multifocal disease of the urinary tract that can also involve the prostatic urethra (PU. The exact incidence of superficial involvement of the PU in patients with bladder TCC is not well known. Bladder TCC may involve the prostate in 12—40% of the patients and the degree of involvement can include urethral mucosa, ducts, acini, and stroma of the gland, which has been shown to affect the outcome. Risk factors for superficial urothelial cancer in the PU are high-grade, multifocal bladder TCC and presence of carcinoma in situ (CIS in the bladder. While visible tumors are easy to detect and resect, controversy still exists regarding the optimal technique to identify prostatic involvement by TCC. Prostatic urethral sampling by a transurethral resection biopsy or a cold-cup biopsy, particularly in the high-risk group of bladder cancer patients, has been recommended for detecting prostatic urethral involvement. Management of superficial prostatic involvement by TCC is also unclear. Currently, there is increasing recognition of the value of conservative treatment options with intravesical agents when there is superficial involvement of the PU. Particularly, intravesical bacillus Calmette-Guèrin (BCG seems to be an effective treatment alternative in the management of superficial involvement of the PU by TCC. Close follow-up by cystoscopy and PU biopsy at 3-month intervals, particularly in intermediate and high-risk patients who respond to intravesical therapy and in whom cystectomy is appropriate, is recommended in order to detect persistent tumor, recurrences, or progression.

  1. Superficial urothelial cancer in the prostatic urethra.

    Science.gov (United States)

    Kirkali, Ziya; Canda, A Erdem

    2006-02-28

    Transitional cell carcinoma (TCC) is a multifocal disease of the urinary tract that can also involve the prostatic urethra (PU). The exact incidence of superficial involvement of the PU in patients with bladder TCC is not well known. Bladder TCC may involve the prostate in 12-40% of the patients and the degree of involvement can include urethral mucosa, ducts, acini, and stroma of the gland, which has been shown to affect the outcome. Risk factors for superficial urothelial cancer in the PU are high-grade, multifocal bladder TCC and presence of carcinoma in situ (CIS) in the bladder. While visible tumors are easy to detect and resect, controversy still exists regarding the optimal technique to identify prostatic involvement by TCC. Prostatic urethral sampling by a transurethral resection biopsy or a cold-cup biopsy, particularly in the high-risk group of bladder cancer patients, has been recommended for detecting prostatic urethral involvement. Management of superficial prostatic involvement by TCC is also unclear. Currently, there is increasing recognition of the value of conservative treatment options with intravesical agents when there is superficial involvement of the PU. Particularly, intravesical bacillus Calmette-Guèrin (BCG) seems to be an effective treatment alternative in the management of superficial involvement of the PU by TCC. Close follow-up by cystoscopy and PU biopsy at 3-month intervals, particularly in intermediate and high-risk patients who respond to intravesical therapy and in whom cystectomy is appropriate, is recommended in order to detect persistent tumor, recurrences, or progression.

  2. The ARCS radial collimator

    Directory of Open Access Journals (Sweden)

    Stone M.B.

    2015-01-01

    Full Text Available We have designed, installed, and commissioned a scattered beam radial collimator for use at the ARCS Wide Angular Range Chopper Spectrometer at the Spallation Neutron Source. The collimator has been designed to work effectively for thermal and epithermal neutrons and with a range of sample environments. Other design considerations include the accommodation of working within a high vacuum environment and having the ability to quickly install and remove the collimator from the scattered beam. We present here characterization of the collimator's performance and methodologies for its effective use.

  3. The ARCS radial collimator

    Science.gov (United States)

    Stone, M. B.; Niedziela, J. L.; Overbay, M. A.; Abernathy, D. L.

    2015-01-01

    We have designed, installed, and commissioned a scattered beam radial collimator for use at the ARCS Wide Angular Range Chopper Spectrometer at the Spallation Neutron Source. The collimator has been designed to work effectively for thermal and epithermal neutrons and with a range of sample environments. Other design considerations include the accommodation of working within a high vacuum environment and having the ability to quickly install and remove the collimator from the scattered beam. We present here characterization of the collimator's performance and methodologies for its effective use.

  4. Radial reflection diffraction tomography

    Energy Technology Data Exchange (ETDEWEB)

    Lehman, Sean K.

    2012-12-18

    A wave-based tomographic imaging method and apparatus based upon one or more rotating radially outward oriented transmitting and receiving elements have been developed for non-destructive evaluation. At successive angular locations at a fixed radius, a predetermined transmitting element can launch a primary field and one or more predetermined receiving elements can collect the backscattered field in a "pitch/catch" operation. A Hilbert space inverse wave (HSIW) algorithm can construct images of the received scattered energy waves using operating modes chosen for a particular application. Applications include, improved intravascular imaging, bore hole tomography, and non-destructive evaluation (NDE) of parts having existing access holes.

  5. Radial Reflection diffraction tomorgraphy

    Energy Technology Data Exchange (ETDEWEB)

    Lehman, Sean K

    2013-11-19

    A wave-based tomographic imaging method and apparatus based upon one or more rotating radially outward oriented transmitting and receiving elements have been developed for non-destructive evaluation. At successive angular locations at a fixed radius, a predetermined transmitting element can launch a primary field and one or more predetermined receiving elements can collect the backscattered field in a "pitch/catch" operation. A Hilbert space inverse wave (HSIW) algorithm can construct images of the received scattered energy waves using operating modes chosen for a particular application. Applications include, improved intravascular imaging, bore hole tomography, and non-destructive evaluation (NDE) of parts having existing access holes.

  6. One-year results of total arterial revascularization vs. conventional coronary surgery: CARRPO trial

    DEFF Research Database (Denmark)

    Damgaard, Sune; Wetterslev, Jørn; Lund, Jens T

    2009-01-01

    AIMS: To investigate clinical and angiographic outcomes after coronary surgery using total arterial revascularization (TAR). METHODS AND RESULTS: We randomized 331 patients with multivessel or isolated left main disease to TAR [internal thoracic (ITA) and radial arteries] vs. conventional...

  7. Flash fluorescence with indocyanine green videoangiography to identify the recipient artery for bypass with distal middle cerebral artery aneurysms: operative technique.

    Science.gov (United States)

    Rodríguez-Hernández, Ana; Lawton, Michael T

    2012-06-01

    Distal middle cerebral artery (MCA) aneurysms frequently have nonsaccular morphology that necessitates trapping and bypass. Bypasses can be difficult because efferent arteries lie deep in the opercular cleft and may not be easily identifiable. We introduce the "flash fluorescence" technique, which uses videoangiography with indocyanine green (ICG) dye to identify an appropriate recipient artery on the cortical surface for the bypass, enabling a more superficial and easier anastomosis. Flash fluorescence requires 3 steps: (1) temporary clip occlusion of the involved afferent artery; (2) videoangiography demonstrating fluorescence in uninvolved arteries on the cortical surface; and (3) removal of the temporary clip with flash fluorescence in the involved efferent arteries on the cortical surface, thereby identifying a recipient. Alternatively, temporary clips can occlude uninvolved arteries, and videoangiography will demonstrate initial fluorescence in efferent arteries during temporary occlusion and flash fluorescence in uninvolved arteries during reperfusion. From a consecutive series of 604 MCA aneurysms treated microsurgically, 22 (3.6%) were distal aneurysms and 11 required a bypass. The flash fluorescence technique was used in 3 patients to select the recipient artery for 2 superficial temporal artery-to-MCA bypasses and 1 MCA-MCA bypass. The correct recipient was selected in all cases. The flash fluorescence technique provides quick, reliable localization of an appropriate recipient artery for bypass when revascularization is needed for a distal MCA aneurysm. This technique eliminates the need for extensive dissection of the efferent artery and enables a superficial recipient site that makes the anastomosis safer, faster, and less demanding.

  8. Radial Velocities with PARAS

    Science.gov (United States)

    Roy, Arpita; Mahadevan, S.; Chakraborty, A.; Pathan, F. M.; Anandarao, B. G.

    2010-01-01

    The Physical Research Laboratory Advanced Radial-velocity All-sky Search (PARAS) is an efficient fiber-fed cross-dispersed high-resolution echelle spectrograph that will see first light in early 2010. This instrument is being built at the Physical Research laboratory (PRL) and will be attached to the 1.2m telescope at Gurushikhar Observatory at Mt. Abu, India. PARAS has a single-shot wavelength coverage of 370nm to 850nm at a spectral resolution of R 70000 and will be housed in a vacuum chamber (at 1x10-2 mbar pressure) in a highly temperature controlled environment. This renders the spectrograph extremely suitable for exoplanet searches with high velocity precision using the simultaneous Thorium-Argon wavelength calibration method. We are in the process of developing an automated data analysis pipeline for echelle data reduction and precise radial velocity extraction based on the REDUCE package of Piskunov & Valenti (2002), which is especially careful in dealing with CCD defects, extraneous noise, and cosmic ray spikes. Here we discuss the current status of the PARAS project and details and tests of the data analysis procedure, as well as results from ongoing PARAS commissioning activities.

  9. Revascularização cirúrgica do miocárdio com enxerto composto de artérias torácica interna esquerda e radial: comparação do fluxo sangüíneo para artéria coronária esquerda com a técnica convencional Coronary artery bypass grafting with composite grafts: comparison of blood flow to the left coronary artery with the conventional technique

    Directory of Open Access Journals (Sweden)

    Josué V. Castro Neto

    2004-12-01

    Full Text Available INTRODUÇÃO: Os enxertos compostos têm sido freqüentemente utilizados na cirurgia de revascularização do miocárdio (RM. Entretanto, permanece indefinido se essa técnica é capaz de oferecer o mesmo fluxo sangüíneo (Q aos ramos da artéria coronária esquerda (CE que a técnica convencional. O objetivo é comparar o Q total aos ramos revascularizados pelas artérias torácica interna esquerda (ATIE e radial (AR nas técnicas compostas e convencional. MÉTODO: Estudamos 42 pacientes distribuídos, aleatoriamente, conforme a técnica de RM utilizada. Grupo A ou ATIE e AR composta em Y(n=14. Grupo B ou ATIE e AR composta modificada [enxerto intercoronariano com AR e anastomose da ATIE sobreposta a AR ao nível da artéria interventricular anterior (DA, n=14]. Grupo C ou ATIE pediculada para DA e AR em posição aorto-coronariana (n=14. Trinta e um pacientes foram submetidos a fluxometria (Fx com cateter-guia doppler de 12-MHz (0,014 polegada, Flowire, Jometrics Inc., no pós-operatório imediato. A reserva de fluxo coronariano (RFC foi calculada pela determinação da média da velocidade de pico (APV em hiperemia após administração de adenosina. RESULTADOS: A APV em repouso no início da ATIE foi, no grupo A, 28,4±4,8 cm/s; no grupo B, 34,4±7,9 cm/s (p=0,0384 x C e, no grupo C, 25,8± 8,6 cm/s. A RFC foi de 2,1 ± 0,4, 2 ± 0,3 e 2±0,4 nos grupos A, B e C, (p=0,7208. O Q total distribuído aos ramos da CE revascularizados foi, no grupo A, 110±30 ml/min, no grupo B, 145±59 ml/min e, no grupo C, 133±58 ml/min (p=0,3232 A, B x C. CONCLUSÕES: Não houve diferença significativa do Q total oferecido ao território da CE revascularizado pelas técnicas de EC e convencional. A RFC da ATIE nos grupos compostos foi satisfatória.BACKGROUND: Composite grafting techniques for coronary artery bypass grafts (CABG have been widely used. However, it remains unclear whether this technique provides similar blood flow to the left coronary artery

  10. ISR Radial Field Magnet

    CERN Multimedia

    1983-01-01

    There were 37 (normal) + 3 (special) Radial Field magnets in the ISR to adjust vertically the closed orbit. Gap heights and strengths were 200 mm and .12 Tm in the normal magnets, 220 mm and .18 Tm in the special ones. The core length was 430 mm in both types. Due to their small length as compared to the gap heights the end fringe field errors were very important and had to be compensated by suitably shaping the poles. In order to save on cables, as these magnets were located very far from their power supplies, the coils of the normal type magnets were formed by many turns of solid cpper conductor with some interleaved layers of hollow conductor directly cooled by circulating water

  11. Outcome of 1470nm laser diode ablation for superficial venous insufficiency

    Directory of Open Access Journals (Sweden)

    Gilberto do Nascimento Galego

    2015-06-01

    Full Text Available BACKGROUND: Endovenous laser ablation is a minimally invasive procedure that can be used to treat superficial venous insufficiency. We believe that using a longer wavelength will reduce the frequency of the most common adverse effects associated with the use of shorter wavelengths.OBJECTIVES: To report the results of an initial series of patients with chronic superficial venous insufficiency treated using a 1470 nanometer diode laser and to compare results using linear and radial laser fibers.METHODS: We conducted an observational cohort study. Seventy-four patients, for whom at least two postoperative Doppler ultrasonography scans were available, were recruited with a total of 121 saphenous veins treated (92 great and 29 small saphenous veins. There were 57 patients in Group A (treated with the linear fiber and 17 in Group B (radial fiber. Follow-up ideally comprised clinical consultation and Doppler ultrasonography at 1 month, 6 months and 12 months after the procedure. Success was defined as total occlusion of the venous segment that had been treated.RESULTS: Success rates at mean follow-up of 13.4 months (range 7 - 27 were 83% for great saphenous veins and 89% for small saphenous veins. Patients treated with the radial fiber required less energy to achieve occlusion of the small saphenous vein and exhibited fewer adverse reactions, with statistical significance.CONCLUSIONS: Treatment of great and small saphenous vein insufficiency using the 1470 nm diode laser is safe and effective. The radial fiber was associated with fewer intercurrent conditions than the linear fiber, although success rates were similar.

  12. Radial Reflection Diffraction Tomography

    Energy Technology Data Exchange (ETDEWEB)

    Lehman, S K; Norton, S J

    2003-10-10

    We develop a wave-based tomographic imaging algorithm based upon a single rotating radially outward oriented transducer. At successive angular locations at a fixed radius, the transducer launches a primary field and collects the backscattered field in a ''pitch/catch'' operation. The hardware configuration, operating mode, and data collection method is identical to that of most medical intravascular ultrasound (IVUS) systems. IVUS systems form images of the medium surrounding the probe based upon ultrasonic B-scans, using a straight-ray model of sound propagation. Our goal is to develop a wave-based imaging algorithm using diffraction tomography techniques. Given the hardware configuration and the imaging method, we refer to this system as ''radial reflection diffraction tomography.'' We consider two hardware configurations: a multimonostatic mode using a single transducer as described above, and a multistatic mode consisting of a single transmitter and an aperture formed by multiple receivers. In this latter case, the entire source/receiver aperture rotates about the fixed radius. Practically, such a probe is mounted at the end of a catheter or snaking tube that can be inserted into a part or medium with the goal of forming images of the plane perpendicular to the axis of rotation. We derive an analytic expression for the multimonostatic inverse but ultimately use the new Hilbert space inverse wave (HSIW) algorithm to construct images using both operating modes. Applications include improved IVUS imaging, bore hole tomography, and non-destructive evaluation (NDE) of parts with existing access holes.

  13. What factors control superficial lava dome explosivity?

    Science.gov (United States)

    Boudon, Georges; Balcone-Boissard, Hélène; Villemant, Benoît; Morgan, Daniel J.

    2015-09-01

    Dome-forming eruption is a frequent eruptive style and a major hazard on numerous volcanoes worldwide. Lava domes are built by slow extrusion of degassed, viscous magma and may be destroyed by gravitational collapse or explosion. The triggering of lava dome explosions is poorly understood: here we propose a new model of superficial lava-dome explosivity based upon a textural and geochemical study (vesicularity, microcrystallinity, cristobalite distribution, residual water contents, crystal transit times) of clasts produced by key eruptions. Superficial explosion of a growing lava dome may be promoted through porosity reduction caused by both vesicle flattening due to gas escape and syn-eruptive cristobalite precipitation. Both processes generate an impermeable and rigid carapace allowing overpressurisation of the inner parts of the lava dome by the rapid input of vesiculated magma batches. The relative thickness of the cristobalite-rich carapace is an inverse function of the external lava dome surface area. Explosive activity is thus more likely to occur at the onset of lava dome extrusion, in agreement with observations, as the likelihood of superficial lava dome explosions depends inversely on lava dome volume. This new result is of interest for the whole volcanological community and for risk management.

  14. HISTOPATHOLOGY OF MARGINAL SUPERFICIAL PERIODONTIUM AT MENOPAUSE

    Directory of Open Access Journals (Sweden)

    A. Georgescu

    2012-03-01

    Full Text Available Premises: Sexual hormones may affect the general health condition of women, as early as puberty, continuing during pregnancy and also after menopause. Variations of the hormonal levels may cause different – either local or general – pathological modifications. Sexual hormones may also affect periodontal status, favourizing gingival inflammations and reducing periodontal resistance to the action of the bacterial plaque. Scope: Establishment of the correlations between the debut or the manifestation of menopause and the modifications produced in the superficial periodontium. Materials and method: Clinical and paraclinical investigations were performed on female patients with ages between 45 and 66 years, involving macroscopic, microscopic and radiological recording of the aspect of the superificial periodontium (gingiva. Results: Analysis of the histological sections evidenced atrophic and involutive modifications in the marginal superficial periodontium of female patients at menopause. Conclusions: Sexual hormones intervene in the histological equilibrium of the marginal superficial periodontium, influencing the periodontal health status, which explains the correlation between the subjective symptomatology specific to menopause and the histopatological aspect at epithelial level.

  15. Antiproton compression and radial measurements

    CERN Document Server

    Andresen, G B; Bowe, P D; Bray, C C; Butler, E; Cesar, C L; Chapman, S; Charlton, M; Fajans, J; Fujiwara, M C; Funakoshi, R; Gill, D R; Hangst, J S; Hardy, W N; Hayano, R S; Hayden, M E; Humphries, A J; Hydomako, R; Jenkins, M J; Jorgensen, L V; Kurchaninov, L; Lambo, R; Madsen, N; Nolan, P; Olchanski, K; Olin, A; Page R D; Povilus, A; Pusa, P; Robicheaux, F; Sarid, E; Seif El Nasr, S; Silveira, D M; Storey, J W; Thompson, R I; Van der Werf, D P; Wurtele, J S; Yamazaki, Y

    2008-01-01

    Control of the radial profile of trapped antiproton clouds is critical to trapping antihydrogen. We report detailed measurements of the radial manipulation of antiproton clouds, including areal density compressions by factors as large as ten, achieved by manipulating spatially overlapped electron plasmas. We show detailed measurements of the near-axis antiproton radial profile, and its relation to that of the electron plasma. We also measure the outer radial profile by ejecting antiprotons to the trap wall using an octupole magnet.

  16. Arterial Patterns of the Face in Perissodactyla.

    Science.gov (United States)

    Kowalczyk, Karolina; Frąckowiak, Hieronim

    2017-09-01

    Considerable consistency in the arterial pattern of the head has been observed in species of Artiodactyla, but few studies have examined the order Perissodactyla. Here, we describe arteries supplying the intermandibular, mental, masseteric, buccal, labial, and nasal regions in eight perissodactylans, including representing of all families comprising this order. Observations were made on a total of 45 preparations of head arteries, obtained by injection of arteries with acetone-dissolved stained vinyl superchloride or stained latex LBS3060. In the Equidae species alone it was found that the facial artery descends from the linguofacial trunk. In tapirs and rhinos the facial artery branches off directly from the main arteries of the head. In tapirs alone it was found that the inferior alveolar artery gives off the buccal and sublingual arteries, and then extends into the mental artery. In the rhino a specific feature of the arterial pattern of the head was the exit of the occipital artery from the superficial temporal artery. In all equines studied, the transverse facial artery gave off a larger blood vessel to the masseter muscle and ran along the facial crest, while in tapirs and rhinos the transverse facial artery fanned out branches in the masseteric fossa. The variations observed can be considered in future studies on the origin of Perissodactyla. In this context, we note that the most similar patterns of exit and course of the facial, mental, transverse facial and infraorbital arteries exist in tapirs and rhinos (Ceratomorpha suborder), at least among the perissodactylans studied here. Anat Rec, 300:1529-1534, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  17. A rare variant of the ulnar artery with important clinical implications: a case report

    Directory of Open Access Journals (Sweden)

    Casal Diogo

    2012-11-01

    Full Text Available Abstract Background Variations in the major arteries of the upper limb are estimated to be present in up to one fifth of people, and may have significant clinical implications. Case presentation During routine cadaveric dissection of a 69-year-old fresh female cadaver, a superficial brachioulnar artery with an aberrant path was found bilaterally. The superficial brachioulnar artery originated at midarm level from the brachial artery, pierced the brachial fascia immediately proximal to the elbow, crossed superficial to the muscles that originated from the medial epicondyle, and ran over the pronator teres muscle in a doubling of the antebrachial fascia. It then dipped into the forearm fascia, in the gap between the flexor carpi radialis and the palmaris longus. Subsequently, it ran deep to the palmaris longus muscle belly, and superficially to the flexor digitorum superficialis muscle, reaching the gap between the latter and the flexor carpi ulnaris muscle, where it assumed is usual position lateral to the ulnar nerve. Conclusion As far as the authors could determine, this variant of the superficial brachioulnar artery has only been described twice before in the literature. The existence of such a variant is of particular clinical significance, as these arteries are more susceptible to trauma, and can be easily confused with superficial veins during medical and surgical procedures, potentially leading to iatrogenic distal limb ischemia.

  18. In vivo adaptive response of the peripheral conduit artery in patients with borderline systolic hypertension

    Institute of Scientific and Technical Information of China (English)

    陶军; 靳亚非; 王礼春; 唐安丽; 廖新学; 杨震; 马虹

    2003-01-01

    Objective To investigate elastic changes of the radial artery, a medium-sized muscular peripheral conduit artery, in patients with borderline systolic hypertension. Methods Using a non-invasive high-resolution echo-tracking device coupled to a photoplethysmography (Finapres system) allowing simultaneous arterial diameter and finger blood pressure monitoring, we measured radial artery elastic parameters of 20 patients with borderline systolic hypertension and 20 normal subjects according to Langewouters model.Results The diameter of the radial artery of control subjects and those with borderline systolic hypertension at the isobaric level of 100 mmHg and mean arterial pressure was similar, but the compliance and distensibility at similar conditions in patients with borderline systolic hypertension did not further reduced and even increased. Conclusion In patients with borderline systolic hypertension, the adaptive responses of the radial artery compliance and distensibility to increased pressure were directed to maintain its elasticity, contributing to the homeostasis of the cardiovascular system.

  19. Turbine with radial acting seal

    Energy Technology Data Exchange (ETDEWEB)

    Eng, Darryl S; Ebert, Todd A

    2016-11-22

    A floating brush seal in a rim cavity of a turbine in a gas turbine engine, where the floating brush seal includes a seal holder in which the floating brush seal floats, and a expandable seal that fits within two radial extending seal slots that maintains a seal with radial displacement of the floating brush seal and the seal holder.

  20. Radial gas turbine design

    Energy Technology Data Exchange (ETDEWEB)

    Krausche, S.; Ohlsson, Johan

    1998-04-01

    The objective of this work was to develop a program dealing with design point calculations of radial turbine machinery, including both compressor and turbine, with as few input data as possible. Some simple stress calculations and turbine metal blade temperatures were also included. This program was then implanted in a German thermodynamics program, Gasturb, a program calculating design and off-design performance of gas turbines. The calculations proceed with a lot of assumptions, necessary to finish the task, concerning pressure losses, velocity distribution, blockage, etc., and have been correlated with empirical data from VAT. Most of these values could have been input data, but to prevent the user of the program from drowning in input values, they are set as default values in the program code. The output data consist of geometry, Mach numbers, predicted component efficiency etc., and a number of graphical plots of geometry and velocity triangles. For the cases examined, the error in predicted efficiency level was within {+-} 1-2% points, and quite satisfactory errors in geometrical and thermodynamic conditions were obtained Examination paper. 18 refs, 36 figs

  1. Estructura electrónica de superficies: estados de superficie y estados resonantes del calcio

    OpenAIRE

    H. Herrera; César Mora

    2006-01-01

    En este artículo presentamos un estudio detallado de la estructura electrónica de bandas de superficies orientadas (001) y (110) de cristales cúbicos centrados en la cara del Ca. Para nuestro estudio utilizamos la aproximación de enlace fuerte y el método de acoplamiento de la función de Green de superficie. Primero, construimos hamiltonianos de enlace fuerte en el formalismo de Slater Koster (SK). Utilizamos una base ortogonal de nueve orbitales atómicos (spd) por átomo en la celda unitaria....

  2. Musculocutaneous nerve substituting for the distal part of radial nerve: A case report and its embryological basis

    Directory of Open Access Journals (Sweden)

    A S Yogesh

    2011-01-01

    Full Text Available In the present case, we have reported a unilateral variation of the radial and musculocutaneous nerves on the left side in a 64-year-old male cadaver. The radial nerve supplied all the heads of the triceps brachii muscle and gave cutaneous branches such as lower lateral cutaneous nerve of the arm and posterior cutaneous nerve of forearm. The radial nerve ended without continuing further. The musculocutaneous nerve supplied the brachioradialis, extensor carpi radialis longus and extensor carpi radialis brevis muscles. The musculocutaneous nerve divided terminally into two branches, superficial and deep. The deep branch of musculocutaneous nerve corresponded to usual deep branch of the radial nerve while the superficial branch of musculocutaneous nerve corresponded to usual superficial branch of the radial nerve. The dissection was continued to expose the entire brachial plexus from its origin and it was found to be normal. The structures on the right upper limb were found to be normal. Surgeons should keep such variations in mind while performing the surgeries of the upper limb.

  3. Transradial artery intervention: an alternative approach for renal artery stent implantation?

    Institute of Scientific and Technical Information of China (English)

    LUO Jian-fang; WANG Hui-yong; HUANG Wen-hui; LIU Yuan; LI Guang; ZHOU Ying-ling; CHEN Ji-yan

    2012-01-01

    Background Transfemoral artery access is the main approach for the interventional treatment of renal artery stenosis (RAS).This study aimed to investigate the technical feasibility of a transradial interventional (TRI) treatment of renal artery stenosis.Methods A series of 23 patients who underwent transradial renal artery stenting from October 2010 to October 2011 were studied.Radial sheath system (Terumo,Japan) was used to get access to the radial artery.Radial tourniquet (Terumo) was used to stop bleeding.A 5Fr MPA (COOK,USA) was used to perform selective renal arteriography.Percutaneous renal artery stent systems were used to perform renal artery stenting.Results Renal artery angiography showed that 15 patients had unilateral renal artery stenosis and eight patients had bilateral renal artery stenosis.The descending aorta could not be catheterized in one patient because of the type Ⅲ aortic arch.Twenty-two patients successfully underwent transradial renal artery angiography and the technical success rate was 95.7%.There was no puncture site hematoma or pseudoaneurysm.Mean procedure time was (38.4±7.2) minutes,the mean amount of contrast agent used was (93.2±6.3) ml,and the mean postprocedure bleeding time was (3.2±1.9) minutes.Conclusion Transradial renal artery intervention is technically reliable with less invasion,rapid recovery,fewer complications and may become an alternative intervention approach for the treatment of renal artery stenosis.

  4. Perforator anatomy of the radial forearm free flap versus the ulnar forearm free flap for head and neck reconstruction

    NARCIS (Netherlands)

    Hekner, D.D.; Roeling, TAP; van Cann, EM

    2016-01-01

    The aim of this study was to investigate the vascular anatomy of the distal forearm in order to optimize the choice between the radial forearm free flap and the ulnar forearm free flap and to select the best site to harvest the flap. The radial and ulnar arteries of seven fresh cadavers were injecte

  5. Clinical usefulness of the second peak of radial systolic blood pressure for estimation of aortic systolic blood pressure.

    Science.gov (United States)

    Kohara, K; Tabara, Y; Tomita, H; Nagai, T; Igase, M; Miki, T

    2009-08-01

    Central aortic blood pressure (BP), obtained from radial arterial waveform using the transfer function method (TFM), has been shown to have prognostic value independently of brachial BP. In this study, the relationship between peripheral systolic BP (SBP) and aortic SBP was evaluated. We further investigated whether TFM-derived aortic SBP can be estimated by information obtained from the radial waveform. The radial waveform was analysed to obtain the first peak of radial SBP (SBP1), second peak of radial SBP (SBP2), radial augmentation index (AI) (radial (SBP2-DBP)/(SBP1-DBP) x 100 and aortic SBP and AI using TFM in 233 subjects in the supine position. Measurements were repeated after changing position to the prone position. The constructed equation was validated in 149 community residents with different backgrounds. Radial SBP2 was closer to TFM-derived aortic SBP compared with brachial SBP. TFM-derived aortic SBP was approximated by the equation: aortic SBP=18.9-radial SBP2-0.03 x HR-0.214 x radial AI (r2=0.992). The equation was also applicable to predicting aortic SBP in the prone position as well as in different populations (mean difference between predicted aortic SBP and TFM-derived aortic SBP: -0.01+/-1.34 and 1.05+/-1.47 mm Hg, respectively). Radial arterial waveform analysis can be used for estimation of TFM-derived aortic SBP.

  6. Radial forearm free flap morbidity: A rare case of a normal preoperative arteriogram and acute intraoperative hand ischemia

    OpenAIRE

    Bruner, Terrence W.; Hanasono, Matthew M.; Skoracki, Roman J

    2011-01-01

    The radial forearm free flap is ideal for reconstructive microsurgery due to its thin, pliable fasciocutaneous tissue, reliable anatomy and ease and simplicity of flap elevation. However, one of the major complications is hand ischemia due to sacrifice of the radial artery, although it is a rare occurrence. A case involving a 73-year-old man who developed intraoperative hand ischemia after elevation of a radial forearm free flap is presented.

  7. 经桡动脉路径介入治疗时应用经皮冠状动脉介入治疗导丝和球囊辅助指引导管成功跨越痉挛段33例分析%Feasibility study of guiding catheter passing through spasmodic vess els during percutaneous coronary intervention via radial artery access by the aid of PCI guiding wire and balloon

    Institute of Scientific and Technical Information of China (English)

    倪祝华; 迟永辉; 张大鹏; 邓俊萍; 王益民; 刘广军; 张小良; 赵建红; 张继强; 刘佳胜; 祁树莹; 王乐丰; 杨新春; 王红石; 徐立; 李惟铭; 夏昆; 刘宇; 何冀芳

    2016-01-01

    目的:探讨经桡动脉路径行经皮冠状动脉介入治疗( percutaneous coronary intervention , PCI)血管通路痉挛应用PCI导丝和球囊辅助跨越痉挛段血管的安全性和可行性。方法回顾性分析2014年1月至2015年6月首都医科大学附属北京朝阳医院、临汾市人民医院、晋城心脑血管病医院、临汾市第二人民医院和烟台海港医院经桡动脉路径PCI伴有桡动脉和(或)肱动脉痉挛应用PCI导丝和球囊辅助成功越过痉挛段的33例冠心病患者( A组),并与同期其他术者用常规方法处理痉挛的38例患者( B组)进行比较。观察两种方法指引导管通过痉挛段的成功率以及并发症的发生率等指标,以了解两种方法的优劣。结果两组患者痉挛部位比较,差异无统计学意义( P=0.150),但肱动脉痉挛的发生率均较桡动脉高。 A组指引导管通过率显著高于B组[33例(100.0%)比15例(39.5%),P=0.000];对于指引导管成功通过痉挛段的两组患者,A组较B组所需时间更短( P=0.000),A、B组指引导管通过时间≤5 min的患者分别为30例(90.9%)和2例(13.3%),5~15 min的患者分别为3例(9.1%)和7例(46.7%),>15 min的患者分别为0和6例(40.0%)。 A组患者前臂血肿发生率较B组降低[(2例(6.1%)比7例(18.4%)],但差异无统计学意义( P=0.113)。结论经桡动脉路径PCI血管痉挛应用PCI导丝和球囊辅助可非常安全有效地使指引导管跨越痉挛和(或)夹层段,较应用抗痉挛药物这一常规方法更为安全可行。%Objective To explore the safety and feasibility of guiding catheter passing through spasmodic vessels in patients undergoing percutaneous coronary intervention (PCI) via radial artery access by the aid of PCI guiding wire and balloon .Methods The clinical data of 33 coronary artery disease (CAD

  8. Superficial microcirculation flow measurement using polarized light

    Science.gov (United States)

    Wu, Jiwei; Morgan, S. P.; Xiao, Yunshi

    2008-12-01

    Depth discrimination of polarized light is used in investigating laser Doppler measurement of the superficial microcirculation in tissue. Using polarization Monte Carlo simulation, temporal point spread function and power spectral distribution of backscattered polarization remaining light firstly are used to prove polarized light to be valid in measuring moving blood cell perfusion and mean flow velocity. Then simulation of layered medium model demonstrate that relationships between blood flow perfusion and mean frequency shift are linear to medium flowing velocity, and the Doppler shift information in polarization remaining light mainly comes from lower layer medium up to about 14 times of mean free path (MFP) of medium investigated and can be considered that Doppler effects come only from lower layer of the medium. Simulations in three-layer tissue model show that moving blood cell perfusion and mean blood cell moving velocity calculated from polarization remaining are much more sensitive to lower layer flow velocity variation, and more irrelevant to deeper layer flow rate fluctuations, that further confirms Doppler measurement from polarization remaining light to be effective for superficial microcirculation in tissue. Factors affecting Laser Doppler measurement like medium absorption, percentage of moving particles in blood detector size are discussed.

  9. Superficial white matter: effects of age, sex, and hemisphere.

    Science.gov (United States)

    Phillips, Owen R; Clark, Kristi A; Luders, Eileen; Azhir, Ramin; Joshi, Shantanu H; Woods, Roger P; Mazziotta, John C; Toga, Arthur W; Narr, Katherine L

    2013-01-01

    Structural and diffusion imaging studies demonstrate effects of age, sex, and asymmetry in many brain structures. However, few studies have addressed how individual differences might influence the structural integrity of the superficial white matter (SWM), comprised of short-range association (U-fibers), and intracortical axons. This study thus applied a sophisticated computational analysis approach to structural and diffusion imaging data obtained from healthy individuals selected from the International Consortium for Brain Mapping (ICBM) database across a wide adult age range (n=65, age: 18-74 years, all Caucasian). Fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD) were sampled and compared at thousands of spatially matched SWM locations and within regions-of-interest to examine global and local variations in SWM integrity across age, sex, and hemisphere. Results showed age-related reductions in FA that were more pronounced in the frontal SWM than in the posterior and ventral brain regions, whereas increases in RD and AD were observed across large areas of the SWM. FA was significantly greater in left temporoparietal regions in men and in the posterior callosum in women. Prominent leftward FA and rightward AD and RD asymmetries were observed in the temporal, parietal, and frontal regions. Results extend previous findings restricted to the deep white matter pathways to demonstrate regional changes in the SWM microstructure relating to processes of demyelination and/or to the number, coherence, or integrity of axons with increasing age. SWM fiber organization/coherence appears greater in the left hemisphere regions spanning language and other networks, while more localized sex effects could possibly reflect sex-specific advantages in information strategies.

  10. Measurement of Blood Flow in an Intracranial Artery Bypass From the Internal Maxillary Artery by Intraoperative Duplex Sonography.

    Science.gov (United States)

    Yu, Zaitao; Shi, Xiang'en; Brohi, Shams Raza; Qian, Hai; Liu, Fangjun; Yang, Yang

    2017-02-01

    This study explored the hemodynamic characteristics of a subcranial-intracranial bypass from the internal maxillary artery by measuring blood flow on intraoperative duplex sonography. The hemodynamic parameters of the internal maxillary artery (n = 20), radial artery (n = 20), internal maxillary artery-middle cerebral artery bypass (n = 42), and internal maxillary artery-posterior cerebral artery bypass (n = 9) were measured by intraoperative duplex sonography. There was no significant difference in the internal diameters of the internal maxillary and radial arteries (mean ± SD, 2.51 ± 0.34 versus 2.56 ± 0.22 mm; P = .648). The mean radial artery graft length for subcranial-intracranial bypasses was 88.5 ± 12.78 mm (95% confidence interval [CI], 80.8-90.2 mm). Internal maxillary artery-middle cerebral artery bypasses required a shorter radial artery graft than internal maxillary artery-posterior cerebral artery bypasses (77.8 ± 2.47 versus 104.8 ± 4.77 mm; P = .001). The mean flow volumes were 85.3 ± 18.5 mL/min (95% CI, 76.6-93.9 mL/min) for the internal maxillary artery, 72.6 ± 26.4 mL/min (95% CI, 64.3-80.9 mL/min) for internal maxillary artery-middle cerebral artery bypasses, and 45.4 ± 6.7 mL/min (95% CI, 40.7-50.0 mL/min) for internal maxillary artery-posterior cerebral artery bypasses. All grafts were opened after the success of the salvage procedures had been established, and the early patency rates (1 month after the operation) were 95% for internal maxillary artery-middle cerebral artery bypasses and 100% the internal maxillary artery-posterior cerebral artery bypasses. Measurement of blood flow by intraoperative sonography can be helpful in decision making and predicting graft patency and success after neurosurgical bypass procedures.

  11. Lattice radial quantization by cubature

    CERN Document Server

    Neuberger, Herbert

    2014-01-01

    Basic aspects of a program to put field theories quantized in radial coordinates on the lattice are presented. Only scalar fields are discussed. Simple examples are solved to illustrate the strategy when applied to the 3D Ising model.

  12. Acute arterial occlusion - kidney

    Science.gov (United States)

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

  13. 桡动脉返支骨瓣移植治疗手舟骨AO-B型陈旧性骨折%Application of bone flap pedicled on retrograde branch of radial artery for treatment of old scaphoid bone fractures of type AO-B

    Institute of Scientific and Technical Information of China (English)

    孙庆鹏

    2015-01-01

    目的:探讨应用桡动脉茎突返支骨瓣治疗手舟骨AO-B型陈旧性骨折的临床疗效。方法:2007年10月到2011年10月采用桡动脉返支骨瓣移植术治疗41例陈旧性手舟骨骨折患者,男26例,女15例;年龄16~43岁,平均(27.3±4.5)岁;手术前病程6~22个月,平均11个月。均属于AO分型的B型,即手舟骨腰部陈旧性骨折。术前及术后6个月复查时对所有患者腕部功能依据Cooney腕关节评分系统评分,同时在随访过程中注意观察患者骨愈合情况。结果:36例患者获完整随访,随访时间4~15个月,平均(8.3±2.4)个月。所用患者手术切口愈合良好,无感染等并发症发生。随访过程中影像学证实骨折均完全愈合,患者Cooney腕关节评分由术前53.61±13.97提高到术后的81.81±8.71(P<0.01)。末次随访时疗效优13例,良8例,中15例。结论:桡动脉返支骨瓣移植术是一有效治疗陈旧性手舟骨骨折的方法,其治疗方法科学、疗效确切,具有较高的临床应用价值。%Objective:To investigate application of the bone flap pedicled on the retrograde branch of radial artery for treatment of old scaphoid bone fractures of type AO-B. Methods:From October 2007 to October 2011,41 patients with old scaphoid bone fractures of type AO-B were treated by transplantation of the bone flap pedicled on the retrograde branch of ra⁃dial artery including 26 males and 15 females with an average of(27.3 ± 4.5)years old ranging from 16 to 43 years old. The courses before operation ranged from 6 to 22 months with an average of 11 months. All fractures belonged to the type B of AO classification,that is old wrist fracture of scaphoid bone. All patients' wrist function(pain,function,motion,grip strength) were evaluated by Cooney's modified wrist scoring system before and 6 months after operation,and the conditions of bone heal⁃ing were observed during the follow up time. Results

  14. Effect of Stent Radial Force on Stress Pattern After Deployment: A Finite Element Study

    Science.gov (United States)

    Borghi, Alessandro; Murphy, Olive; Bahmanyar, Reza; McLeod, Chris

    2014-07-01

    The present article presents a method for assessing the radial stiffness of nitinol stents. An idealized stent model was created, and its radial stiffness was calculated by means of finite element modeling. The calculations were validated against experimental measurements. The variation of radial stiffness with geometrical dimensions was calculated, and the effect of increasing radial stiffness on endovascular deployment was analyzed. Peak tensile and compressive stresses as well as stent penetration were calculated in the case of an idealized pulmonary artery model having realistic dimensions as well as stiffness. The results of stress calculations were compared with a second set of simulations, where an idealized behavior of the stent (uniform expansion to a theoretical contact diameter) was modeled. The results show how in reality nitinol stents behave in a non-ideal way, having a non-uniform expansion and exerting non-uniform pressure on the contact areas with the artery. Such non-ideality decreases though with the increase in radial stiffness. The radial force alone may be insufficient in describing the stent-artery interaction, and numerical modeling proves to be necessary for capturing such complexity.

  15. Metabolomic change precedes apple superficial scald symptoms.

    Science.gov (United States)

    Rudell, David R; Mattheis, James P; Hertog, Maarten L A T M

    2009-09-23

    Untargeted metabolic profiling was employed to characterize metabolomic changes associated with 'Granny Smith' apple superficial scald development following 1-MCP or DPA treatment. Partial least-squares discriminant analyses were used to link metabolites with scald, postharvest treatments, and storage duration. Models revealed metabolomic differentiation between untreated controls and fruit treated with DPA or 1-MCP within 1 week following storage initiation. Metabolic divergence between controls and DPA-treated fruit after 4 weeks of storage preceded scald symptom development by 2 months. alpha-Farnesene oxidation products with known associations to scald, including conjugated trienols, 6-methyl-5-hepten-2-one, and 6-methyl-5-hepten-2-ol, were associated with presymptomatic as well as scalded control fruit. Likewise, a large group of putative triterpenoids with mass spectral features similar to those of ursolic acid and beta-sitosterol were associated with control fruit and scald. Results demonstrate that extensive metabolomic changes associated with scald precede actual symptom development.

  16. Condiciones de la superficie deslizamiento con falla

    Directory of Open Access Journals (Sweden)

    María Cecilia Sierra B.

    2011-06-01

    Full Text Available Se modelan seis (6 taludes can diferentes ángulos de inclinación y peso unitario de 1.8 ton/m3, módulo de Young de 500 ton/m2 y relación de Poisson de 0.45. En cada uno de estos taludes se calculan los esfuerzos a través del talud y se determinan los puntos que están sometidos a mayores esfuerzos cortantes, correspondiendo estos a los estados de esfuerzos mas críticos, La ubicación de estos puntos es por donde comenzará y terminará la superficie de falla. Se obtiene un gráfico de diseño que permite obtener la pendiente máxima que debe tener un talud para que no se presente falla local en ningún punto.

  17. RECONSTRUCCIÓN TRIDIMENSIONAL DE ROSTROS A PARTIR DE IMÁGENES DE RANGO POR MEDIO DE FUNCIONES DE BASE RADIAL DE SOPORTE COMPACTO TRI-DIMENSIONAL RECONSTRUCTION OF FACES FROM RANGE IMAGES THROUGH COMPACT SUPPORT RADIAL BASIS FUNCTIONS

    Directory of Open Access Journals (Sweden)

    Jaime A. Echeverri A.

    2007-07-01

    Full Text Available En este trabajo se muestra la utilización de funciones de base radial de soporte compacto para la reconstrucción tridimensional de rostros. En trabajos anteriores se habían explorado diferentes técnicas y diferentes funciones de base radial para reconstrucción de superficies; ahora presentamos los algoritmos y los resultados de la utilización de funciones de base radial de soporte compacto las cuales presentan ventajas comparativas en términos del tiempo de construcción de un interpolante para la reconstrucción. Se presentan comparaciones con técnicas ampliamente utilizadas en este campo y se detalla el proceso global de reconstrucción de superficies.In previous works, we have explored several radial basis techniques and functions for the reconstruction of surfaces. We now present the use of compact support radial basis functions for the tri-dimensional reconstruction of human faces. Therefore, we present algorithms and results coming from the application of compact support radial basis functions which have revealed comparative advantages in terms of the amount of time needed for the construction of an interpolant to be used in the reconstruction. We are also presenting some comparisons with techniques widely used in this field and we explain in detail the global process for the surfaces reconstruction.

  18. The Clinical Application of Styloid Process of Periosteal Flap Pedicled of Retrograde Branch of Radial Artery Transposition for Repairing Old Scaphoid Fracture%逆行桡动脉返支的桡骨茎突骨膜瓣移植转位修复腕舟骨陈旧性骨折

    Institute of Scientific and Technical Information of China (English)

    牛常英; 谭慎兴; 曹哲; 曹松丽; 唐胜建; 梁晓琴

    2015-01-01

    Objective To investigate the clinical curative effect of styloid process of radius periosteal flap pedicled of recurrent branch of radial artery retrograde transposition grafting repair old nonunion of scaphoid fracture . Methods From May 2013 to March 2015 ,admitted to the wrist of old scaphoid nonunion 9 patients ,were used to trans-position periosteal flap repair ,while at the fracture section implants BMP complexes induce osteogenesis .During operation cut periosteal flap that ranging from about 1.0cm ×0.5cm~1.2cm ×0.6cm,which was curl implanted to the set bone groove .Limb function spaces immobilization and early rehabilitation after the operation .Assessing the wrist function re-covery according to Krimmer clinical scoring system consist of pain ,the range of motion and grip strength .Results The group follow up 3 to 16 months postoperatively ,CT revealed that the fractures were anatomic reduction and bone healing time of about 3 months to 6 months,an average of about 4 months.There is no infection,nonunion,traumatic arthritis and other complications;and Krimmer clinical scoring system assessment:excellent in 6 cases,good in 2 cases,medium in 1case ,good rate of 89%.Conclusion The use of radial styloid periosteal flap vascularized repair old scaphoid nonunion , improves the healing rate ,has reliable curative effect and obtains satisfactory results .%目的 探讨以逆行桡动脉返支为蒂的桡骨茎突骨膜瓣移植转位修复腕舟骨陈旧性骨折不愈合的临床疗效. 方法 2013年5月~2015年3月,对收治的腕舟骨陈旧性骨折不愈合的9例患者,均采用以逆行桡动脉返支为蒂的桡骨茎突骨膜瓣移植转位修复骨折不愈合,同时于骨折端植入BMP复合物诱导成骨. 术中切取预定骨膜瓣大小,将其卷曲植入设定骨槽内,骨膜瓣面积范围约1.0cm ×0.5cm~1.2cm ×0.6cm. 术后患肢功能位外固定制动,早期康复训练;按Krimmer临床评分系统对腕部的疼痛情况、关节活动

  19. Femoral artery recanalisation with percutaneous angioplasty and segmentally enclosed plasminogen activator

    DEFF Research Database (Denmark)

    Jørgensen, B; Tønnesen, K H; Bülow, J;

    1989-01-01

    To establish whether re-occlusion of the femoral artery could be prevented, in 6 consecutive patients undergoing percutaneous transluminal angioplasty (PTA) for superficial femoral artery occlusion the recanalised segment was isolated, with a 7-French double-balloon catheter. 5 mg recombined human...

  20. Personalized Antiplatelet Therapy Following Endovascular Revascularization in Peripheral Artery Occlusive Disease : A Novel Concept

    NARCIS (Netherlands)

    Peeters Weem, S. M O; Leunissen, T. C.; Teraa, M.; Vonken, E. J.; De Borst, G. J.; Moll, F. L.

    2015-01-01

    Case A 73 year old patient with a longstanding history of peripheral artery occlusive disease (PAOD) presented with an acute on chronic progression of symptoms, based on a long occlusion of the superficial femoral artery (SFA), which was treated by thrombosuction, percutaneous transluminal

  1. Chemotherapy using new superselective intra-arterial infusion for advanced oral cancer

    Institute of Scientific and Technical Information of China (English)

    Iwai Tohnai; Kenji Mitsudo; Takefumi Fukui; Toshinori Iwai; Kei Watanuki; Yoshiro Matsui

    2008-01-01

    @@ Purpose: We developed a new method of superselective intra-arterial infusion via the superficial temporal artery (HFT method: Hattori, Fuwa and Tohnai reported) and preoperatively performed daily concurrent radiotherapy and chemotherapy with docetaxel (DOC) and cisplatin (CDDP) using this method for 46 patients with stage Ⅲ, Ⅳ oral cancer.

  2. The arterial blood supply of the temporomandibular joint: an anatomical study and clinical implications

    Energy Technology Data Exchange (ETDEWEB)

    Cuccia, Antonino Marco; Caradonna, Carola; Caradonna, Domenico [Dept. of Surgical and Oncological Disciplines, University of Palermo, Palermo (Italy); Anastasi, Giuseppe; Milardi, Demetrio; Favaloro, Angelo; Caradonna, Luigi; Cutroneo, Giuseppina [Biomorphology and Biotechnologies, University of Messina, Messina (Italy); De Pietro, Anita; Angileri, Tommaso Maurizio [Villa Santa Teresa, Diagnostica per Immagini, Palermo (Italy)

    2013-03-15

    The aim of this study was to analyze three-dimensional images of the arterial supply to the temporomandibular joint. Ten patients (five men and five women, mean age 36 years) without signs or symptoms of temporomandibular disorders, who underwent contrast-enhanced computed tomographic (CT) scanning with intravenous contrast, were studied. The direct volume rendering technique of CT images was used, and a data set of images to visualize the vasculature of the human temporomandibular joint in three dimensions was created. After elaboration of the data through post-processing, the arterial supply of the temporomandibular joint was studied. The analysis revealed the superficial temporal artery, the anterior tympanic artery, the deep temporal artery, the auricular posterior artery, the transverse facial artery, the middle meningeal artery, and the maxillary artery with their branches as the main arterial sources for the lateral and medial temporomandibular joint. The direct volume rendering technique was found to be successful in the assessment of the arterial supply to the temporomandibular joint. The superficial temporal artery and maxillary artery ran along the lateral and medial sides of the condylar neck, suggesting that these arteries are at increased risk during soft-tissue procedures such as an elective arthroplasty of the temporomandibular joint.

  3. Volumetric and superficial characterization of carbon activated; Caracterizacion volumetrica y superficial de carbon activado

    Energy Technology Data Exchange (ETDEWEB)

    Carrera G, L.M.; Garcia S, I.; Jimenez B, J.; Solache R, M.; Lopez M, B.; Bulbulian G, S.; Olguin G, M.T. [Departamento de Quimica, Gerencia de Ciencias Basicas, Instituto Nacional de Investigaciones Nucleares, A.P. 18-1027, 11801 Mexico D.F. (Mexico)

    2000-07-01

    The activated carbon is the resultant material of the calcination process of natural carbonated materials as coconut shells or olive little bones. It is an excellent adsorbent of diluted substances, so much in colloidal form, as in particles form. Those substances are attracted and retained by the carbon surface. In this work is make the volumetric and superficial characterization of activated carbon treated thermically (300 Centigrade) in function of the grain size average. (Author)

  4. Radial head dislocation during proximal radial shaft osteotomy.

    Science.gov (United States)

    Hazel, Antony; Bindra, Randy R

    2014-03-01

    The following case report describes a 48-year-old female patient with a longstanding both-bone forearm malunion, who underwent osteotomies of both the radius and ulna to improve symptoms of pain and lack of rotation at the wrist. The osteotomies were templated preoperatively. During surgery, after performing the planned radial shaft osteotomy, the authors recognized that the radial head was subluxated. The osteotomy was then revised from an opening wedge to a closing wedge with improvement of alignment and rotation. The case report discusses the details of the operation, as well as ways in which to avoid similar shortcomings in the future.

  5. Radial lean direct injection burner

    Science.gov (United States)

    Khan, Abdul Rafey; Kraemer, Gilbert Otto; Stevenson, Christian Xavier

    2012-09-04

    A burner for use in a gas turbine engine includes a burner tube having an inlet end and an outlet end; a plurality of air passages extending axially in the burner tube configured to convey air flows from the inlet end to the outlet end; a plurality of fuel passages extending axially along the burner tube and spaced around the plurality of air passage configured to convey fuel from the inlet end to the outlet end; and a radial air swirler provided at the outlet end configured to direct the air flows radially toward the outlet end and impart swirl to the air flows. The radial air swirler includes a plurality of vanes to direct and swirl the air flows and an end plate. The end plate includes a plurality of fuel injection holes to inject the fuel radially into the swirling air flows. A method of mixing air and fuel in a burner of a gas turbine is also provided. The burner includes a burner tube including an inlet end, an outlet end, a plurality of axial air passages, and a plurality of axial fuel passages. The method includes introducing an air flow into the air passages at the inlet end; introducing a fuel into fuel passages; swirling the air flow at the outlet end; and radially injecting the fuel into the swirling air flow.

  6. Risk factors associated with acquiring superficial fungal infections in ...

    African Journals Online (AJOL)

    school children in South Western Nigeria: a comparative study. Olaide Oke Olutoyin1, Olaniyi ... Keywords: Risk factors, school children, skin, superficial fungal infections. ..... study with poor hygiene, malnutrition, overcrowding and poor general social ... cial determinants of health that influence the presence of superficial ...

  7. ON WALL SHEAR STRESS OF ARTERY

    Institute of Scientific and Technical Information of China (English)

    Liu Zhao-rong; Liu Bao-yu; Qin Kai-rong

    2003-01-01

    In this paper, a method was proposed that the wall shear stress of artery could be determined by measuring the centerline axial velocity and radial motion of arterial wall simultaneously.The method is simple in application and can get higher precision when it is used to determine the shear stress of arterial wall in vivo.As an example, the shear stress distribution in periodic oscillatory flow of human carotid was calculated and discussed.The computed results show that the shear stress distribution at any given instant is almost uniform and will be zero at the centerline and tends to maximum at the vessel wall.

  8. Percutaneous transradial artery approach for coronary stent implantation.

    Science.gov (United States)

    Kiemeneij, F; Laarman, G J

    1993-10-01

    A new approach for implantation of Palmaz Schatz coronary stents is reported. We describe the technique and rationale of coronary stenting with miniaturized angioplasty equipment via the radial artery. This technique is illustrated in three patients. One patient underwent Palmaz Schatz stent implantation for a saphenous vene coronary bypass graft stenosis, the second patient for a restenosis in the anterior descending coronary artery after atherectomy, and the third patient for a second restenosis after balloon angioplasty in the circumflex coronary artery.

  9. Radial propagators and Wilson loops

    CERN Document Server

    Leupold, S; Leupold, Stefan; Weigert, Heribert

    1996-01-01

    We present a relation which connects the propagator in the radial (Fock-Schwinger) gauge with a gauge invariant Wilson loop. It is closely related to the well-known field strength formula and can be used to calculate the radial gauge propagator. The result is shown to diverge in four-dimensional space even for free fields, its singular nature is however naturally explained using the renormalization properties of Wilson loops with cusps and self-intersections. Using this observation we provide a consistent regularization scheme to facilitate loop calculations. Finally we compare our results with previous approaches to derive a propagator in Fock-Schwinger gauge.

  10. Detonation in supersonic radial outflow

    KAUST Repository

    Kasimov, Aslan R.

    2014-11-07

    We report on the structure and dynamics of gaseous detonation stabilized in a supersonic flow emanating radially from a central source. The steady-state solutions are computed and their range of existence is investigated. Two-dimensional simulations are carried out in order to explore the stability of the steady-state solutions. It is found that both collapsing and expanding two-dimensional cellular detonations exist. The latter can be stabilized by putting several rigid obstacles in the flow downstream of the steady-state sonic locus. The problem of initiation of standing detonation stabilized in the radial flow is also investigated numerically. © 2014 Cambridge University Press.

  11. CONGENITAL RADIAL DYSPLASIA: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Venkatram Reddy

    2015-08-01

    Full Text Available Congenital radial dysplasia, also referred to as radial club hand , means deficiency along the preaxial or radial side of the extremity. It ranges from hypoplasia of the thumb to variou s degrees of radial hypoplasia. We present one such rare case of type 4 congenital unilateral isolated radial dysplasia with carpel anomaly , reported to our department in SVS medical C ollege, Mahabubanagar, Telangana state

  12. Efficiency in supercritical fluid chromatography with different superficially porous and fully porous particles ODS bonded phases.

    Science.gov (United States)

    Lesellier, E

    2012-03-09

    The chromatographic efficiency, in terms of plate number per second, was dramatically improved by the introduction of sub-two microns particles with ultra-high pressure liquid chromatography (UHPLC). On the other hand, the recent development of superficially porous particles, called core-shell or fused-core particles, appears to allow the achievement of the same efficiency performances at higher speed without high pressure drops. CO₂-based mobile phases exhibiting much lower viscosities than aqueous based mobile phases allow better theoretical efficiencies, even with 3-5 μm particles, but with relative low pressure drops. They also allow much higher flow rates or much longer columns while using conventional instruments capable to operate below 400 bar. Moreover, the use of superficially porous particles in SFC could enhance the chromatographic performances even more. The kinetic behavior of ODS phases bonded on these particles was studied, with varied flow rates, outlet (and obviously inlet) pressures, temperatures, by using a homologous series (alkylbenzenes) with 10% modifier (methanol or acetonitrile) in the carbon dioxide mobile phase. Results were also compared with classical fully porous particles, having different sizes, from 2.5 to 5 μm. Superior efficiency (N) and reduced h were obtained with these new ODS-bonded particles in regards to classical ones, showing their great interest for use in SFC. However, surprising behavior were noticed, i.e. the increase of the theoretical plate number vs. the increase of the chain length of the compounds. This behavior, opposite to the one classically reported vs. the retention factor, was not depending on the outlet pressure, but on the flow rate and the temperature changes. The lower radial trans-column diffusion on this particle types could explain these results. This diffusion reduction with these ODS-bonded superficially porous particles seems to decrease with the increase of the residence time of compounds.

  13. [Alterations in arterial compliance of dyslipidemic patients].

    Science.gov (United States)

    Clara, Fernando Mario; Corral, Pablo; Blanco, Gustavo Hector; Scandurra, Adriana Graciela; Meschino, Gustavo Javier

    2015-01-01

    We studied the alteration on the distensibility of the arterial walls caused by dyslipidemia LDLc dependent, along the decades of life, by means of a study of the radial artery pulse wave. We made an analysis of the radial artery pulse wave records acquired by means a movement displacement sensor, placed on radial palpation area. We recruited 100 dyslipidemic men without other cardiovascular risk factors, between the 3rd and the 6th decade. We identified the reflected wave in the records and we computed the augmentation index in order to quantify its amplitude and position. This index is useful to assess the endothelial dysfunction. Besides, we defined a velocity coefficient as the ratio between the size of the individuals and the delay time between the peak of the systolic wave and the arrival of the reflected wave. Results were compared against those obtained in a group of 161 healthy volunteers. We found that dyslipidemic patients presented augmentation index values similar to controls until the fourth decade, increasing thereafter with significant differences only in the 6th decade. No significant differences were found in the velocity index in any of the ages studied. We conclude that alterations produced by dyslipidemia take decades to manifest, and they begin affecting the mechanism of vasodilation of distal arteries with highest proportion of smooth muscle, without altering the proximal conduit arteries with more elastin content. Copyright © 2013 Sociedad Española de Arteriosclerosis. Published by Elsevier España. All rights reserved.

  14. A Case of Persistent Sciatic Artery Aneurysm Accompanied by a Persistent Sciatic Vein

    OpenAIRE

    Tadakoshi, Masao; Ohta, Takashi; Ishibashi, Hiroyuki; Sugimoto, Ikuo; Iwata, Hirohide; Yamada, Tetsuya; Hida, Noriyuki; Orimoto, Yuki

    2010-01-01

    A persistent sciatic artery is a rare anomaly. On the other hand, a persistent sciatic vein is frequently associated with Klippel-Trenaunay syndrome. In a 71-year-old female with a complete-type persistent sciatic artery aneurysm, we performed aneurysmectomy and right femoropopliteal bypass surgery. The right popliteal vein drained into the femoral vein via a lower-type persistent sciatic vein and the deep femoral vein. The superficial femoral artery and vein were hypoplastic. Since only 4 ca...

  15. Tachoastrometry: astrometry with radial velocities

    CERN Document Server

    Pasquini, L; Lombardi, M; Monaco, L; Leão, I C; Delabre, B

    2014-01-01

    Spectra of composite systems (e.g., spectroscopic binaries) contain spatial information that can be retrieved by measuring the radial velocities (i.e., Doppler shifts) of the components in four observations with the slit rotated by 90 degrees in the sky. By using basic concepts of slit spectroscopy we show that the geometry of composite systems can be reliably retrieved by measuring only radial velocity differences taken with different slit angles. The spatial resolution is determined by the precision with which differential radial velocities can be measured. We use the UVES spectrograph at the VLT to observe the known spectroscopic binary star HD 188088 (HIP 97944), which has a maximum expected separation of 23 milli-arcseconds. We measure an astrometric signal in radial velocity of 276 \\ms, which corresponds to a separation between the two components at the time of the observations of 18 $\\pm2$ milli-arcseconds. The stars were aligned east-west. We describe a simple optical device to simultaneously record p...

  16. Zygomatico-orbital artery as a recipient vessel for microsurgical head and neck reconstruction.

    Science.gov (United States)

    Higashino, Takuya; Sawamoto, Naoya; Hirai, Rintaro; Arikawa, Masaki

    2013-07-01

    The selection of recipient vessels in head and neck reconstruction is one of the key factors influencing its difficulty and outcome. We report a case of a microsurgical scalp reconstruction using the zygomatico-orbital artery as a recipient vessel.A 71-year-old woman had intractable skin ulcers on her head after neurosurgeries. Computed tomography angiography findings showed that the superficial temporal artery was obstructed and that the zygomatico-orbital artery ran forward and upward. She underwent scalp reconstruction using a free anterior lateral thigh flap. The zygomatico-orbital artery was dissected distally, cut, and turned over cranially. The diameter of the zygomatico-orbital artery was 1.2 mm. The blood flow through the zygomatico-orbital artery was sufficient. The thinned scalp area was excised, and some of the titanium devices and infectious tissues were removed. An anterior lateral thigh flap measuring 20 × 9 cm was harvested and transferred to the defect in the head. The discrepancy in calibers was within double, and the zygomatico-orbital artery fit the descending branch of the lateral circumflex femoral artery. The flap was transferred successfully.The zygomatico-orbital artery is one of the branches from the external carotid artery and supports the suprazygomatic territory. The zygomatico-orbital artery is present in 78% to 92% of people and originates from the superficial temporal artery and sometimes from the frontal branch of superficial temporal artery. The mean diameter of the zygomatico-orbital artery at origin is reported to be 1.20 mm. The zygomatico-orbital artery is another option as a recipient vessel in head and neck reconstruction.

  17. Adventitial cystic disease of the axillary artery.

    Science.gov (United States)

    Elster, Eric A; Hewlett, Stanley; DeRienzo, Damian P; Donovan, Sean; Georgia, Jeff; Yavorski, Chester C

    2002-01-01

    Adventitial cystic disease (ACD) is an extremely rare cause of arterial and venous insufficiency, with only 317 reported cases in the world literature. These lesions have been previously described in the popliteal fossa, external iliac artery, and distal brachial, radial, and ulnar arteries as well as in the proximal saphenous vein at the ankle. We describe here the first reported case of this disease in a proximal vessel, the axillary artery. A 33-year-old man was evaluated for upper extremity arterial insufficiency and was diagnosed with ACD on the basis of physical examination and radiographic findings, which was confirmed by pathological assessment. The patient was treated by excision of the lesion and interposition vein bypass. As this represents the first case of ACD in the proximal vasculature, it demonstrates that these lesions can occur in axial blood vessels.

  18. Prevalence of superficial siderosis following singular, acute aneurysmal subarachnoid hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Lummel, N.; Bochmann, K. [Ludwig-Maximilian-University, Department of Neuroradiology, Klinikum Grosshadern, Munich (Germany); Bernau, C. [Leibniz-Rechenzentrum, Munich (Germany); Thon, N. [Ludwig-Maximilian-University, Department of Neurosurgery, Klinikum Grosshadern, Munich (Germany); Linn, J. [Technical University, Department of Neuroradiology, Klinikum Dresden, Dresden (Germany)

    2015-04-01

    Superficial siderosis is presumably a consequence of recurrent bleeding into the subarachnoid space. The objective of this study was to assess the prevalence of superficial siderosis after singular, aneurysmal subarachnoid hemorrhage (SAH) in the long term. We retrospectively identified all patients who presented with a singular, acute, aneurysmal SAH at our institution between 2010 and 2013 and in whom a magnetic resonance imaging (MRI) including T2*-weighted imaging was available at least 4 months after the acute bleeding event. MRI scans were judged concerning the presence and distribution of superficial siderosis. Influence of clinical data, Fisher grade, localization, and cause of SAH as well as the impact of neurosurgical interventions on the occurrence of superficial siderosis was tested. Seventy-two patients with a total of 117 MRIs were included. Mean delay between SAH and the last available MRI was 47.4 months (range 4-129). SAH was Fisher grade 1 in 2 cases, 2 in 4 cases, 3 in 10 cases, and 4 in 56 cases. Superficial siderosis was detected in 39 patients (54.2 %). In all patients with more than one MRI scan, localization and distribution of superficial siderosis did not change over time. Older age (p = 0.02) and higher degree of SAH (p = 0.03) were significantly associated with the development of superficial siderosis. Superficial siderosis develops in approximately half of patients after singular, aneurysmal SAH and might be more common in patients with an older age and a greater amount of blood. However, additional factors must play a role in whether a patient is prone to develop superficial siderosis or not. (orig.)

  19. Comportamiento hidráulico de los sistemas de riego por goteo superficial y sub superficial

    OpenAIRE

    2011-01-01

    Para su evaluación el sistema de riego fue montado con un diseño experimental completamente aleatorizado, con cuatro tratamientos, uno con el sistema de riego por goteo superficial y tres con sistemas de riego por goteo sub superficiales con emisores soterrados a 15, 30 y 45 centímetros de profundidad. Se realizaron evaluaciones de laboratorio y de campo de los principales parámetros hidráulicos del sistema, al inicio de la primera campaña de riego y al final de la tercera, obteniéndose en el...

  20. Heart transplantation and arterial elasticity

    Directory of Open Access Journals (Sweden)

    Colvin-Adams M

    2013-12-01

    Full Text Available Monica Colvin-Adams,1 Nonyelum Harcourt,1 Robert LeDuc,2 Ganesh Raveendran,1 Yassir Sonbol,3 Robert Wilson,1 Daniel Duprez11Cardiovascular Division, University of Minnesota, Minneapolis, MN, USA; 2Division of Biostatistics University of Minnesota, Minneapolis, MN, USA; 3Cardiovascular Division, St Luke's Hospital System, Sugar Land, TX, USAObjective: Arterial elasticity is a functional biomarker that has predictive value for cardiovascular morbidity and mortality in nontransplant populations. There is little information regarding arterial elasticity in heart transplant recipients. This study aimed to characterize small (SAE and large (LAE artery elasticity in heart transplant recipients in comparison with an asymptomatic population free of overt cardiovascular disease. A second goal was to identify demographic and clinical factors associated with arterial elasticity in this unique population.Methods: Arterial pulse waveform was registered noninvasively at the radial artery in 71 heart transplant recipients between 2008 and 2010. SAEs and LAEs were derived from diastolic pulse contour analysis. Comparisons were made to a healthy cohort of 1,808 participants selected from our prevention clinic database. Multiple regression analyses were performed to evaluate associations between risk factors and SAE and LAE within the heart transplant recipients.Results: LAE and SAE were significantly lower in heart transplant recipients than in the normal cohort (P <0.01 and P < 0.0001, respectively. Female sex and history of ischemic cardiomyopathy were significantly associated with reduced LAE and SAE. Older age and the presence of moderate cardiac allograft vasculopathy were also significantly associated with reduced SAE. Transplant duration was associated with increased SAE.Conclusion: Heart transplants are associated with peripheral endothelial dysfunction and arterial stiffness, as demonstrated by a significant reduction in SAE and LAE when compared with a

  1. Superficial cervicovaginal myofibroblastoma: report of four cases and literature review

    Institute of Scientific and Technical Information of China (English)

    WANG Qi-feng; WU Yu-yu; WANG Jian

    2010-01-01

    @@ In 2001, Laskin et al~1 firstly described a series of 14 seemly distinctive mesenchymal tumors that occurred exclusively in the superficial lamina propria of the vagina and cervix of middle to old-aged women. They proposed the term "superficial cervicovaginal myofibroblastoma (SCVM)" to highlight the unique features of this tumor: the superficial subepithelial location and myofibroblastic differentiation of the tumor cells. SCVM appears less well recognized with only three additional reports have been documented in the English literatures.~(2-4) In this study, we described four new cases of SCVM to further characterize the clinical and pathological features of this rare entity.

  2. Superficial Fibromatosis Mimicking Glomus Tumor of the Second Toe.

    Science.gov (United States)

    Jo, Hyang Jeong; Chae, Soo Uk; Kim, Gang Deuk; Kim, Yeung Jin; Choi, Deok Hwa; Park, Jae In

    2015-09-01

    Various types of tumor can occur in the subungual space, including glomus tumors, subungual exostosis, hemangioma, epidermal cysts, and malignant tumors. While fibromatosis can occur at various sites throughout the body, it is very rarely seen in the toe. Here, we are the first to report a case of superficial fibromatosis mimicking a glomus tumor in the subungual space of the second toe. The presentation of this condition shows the possibility of encountering uncommon superficial fibromatosis in the distal phalanx of the toe, and suggests that superficial fibromatosis should be included in the differential diagnosis of a glomus tumor in the toe.

  3. Revisión sobre modelado de superficies complejas

    Directory of Open Access Journals (Sweden)

    Juan D. Osorio

    2004-01-01

    Full Text Available Este artículo presenta una revisión de las técnicas más empleadas para la obtención de modelos computacionales de superficies complejas. Estas representaciones están siendo utilizadas en diversas áreas de la industria mediante procedimientos de ingeniería reversa. Las tres principales categorías son las superficies funcionales (implícitas, paramétricas y las superficies complejas simplicial (mallas triangulares. Se realiza un paralelo entre estos métodos y se exponen las ventajas y las desventajas de cada una de estas representaciones.

  4. Low level termination of external carotid artery and its clinical significance: A case report

    Directory of Open Access Journals (Sweden)

    Surekha Devadasa Shetty

    2015-09-01

    Full Text Available The external carotid arterial system is a complex vascular system providing nourishment to the territorial areas of the head and neck. The branches of the external carotid artery are the key landmarks for adequate exposure and appropriate placement of cross-clamps on the carotid arteries during carotid endarterectomy. Knowledge of anatomical variation of the external carotid artery is important in head and neck surgeries. Variations in the branching pattern of the external carotid artery are well known and documented. We report a rare case of low-level termination of the external carotid artery. It terminated by dividing into maxillary and superficial temporal arteries deep into the posterior belly of the digastric muscle, one inch below the angle of the mandible. The occipital and posterior auricular arteries arose from a common trunk given off by the external carotid artery. [Arch Clin Exp Surg 2015; 4(3.000: 160-163

  5. Antibody conjugate radioimmunotherapy of superficial bladder cancer

    Directory of Open Access Journals (Sweden)

    Alan Perkins

    2002-09-01

    Full Text Available The administration of antibody conjugates for cancer therapy is now proving to be of clinical value. We are currently undertaking a programme of clinical studies using the monoclonal antibody C595 (IgG3 which reacts with the MUC1 glycoprotein antigen that is aberrantly expressed in a high proportion of bladder tumours. Radioimmunoconjugates of the C595 antibody have been produced with high radiolabelling efficiency and immunoreactivity using Tc-99m and In-111 for diagnostic imaging, and disease staging and the cytotoxic radionuclides Cu-67 and Re-188 for therapy of superficial bladder cancer. A Phase I/II therapeutic trail involving the intravesical administration of antibody directly into the bladder has now begun.A administração de anticorpos conjugados para o tratamento do câncer está agora provando ser de valor clínico. Nós estamos atualmente realizando um programa de estudos clínicos usando o anticorpo monoclonal C595 (IgG3 que reage com a glicoproteína MUC1 que está aberrantemente expressa numa alta proporção de tumores de bexiga. Tem sido produzidos radioimunoconjugados do anticorpo C595, com alta eficiência de radiomarcação e a imunoreatividade, usando-se o Tc-99m e In-111, para o diagnóstico por imagem e estagiamento de doenças. Tem sido produzidos, também, radionuclídeos citotóxicos (Cu-67 e Re-188 para o tratamento de cânceres superficiais de bexiga. A fase terapêutica I/II já se iniciou, envolvendo a administração intravesical do anticorpo diretamente na bexiga.

  6. Hemipelvic irradiation for superficial bladder cancer

    Energy Technology Data Exchange (ETDEWEB)

    Tashiro, Kazuya; Machida, Toyohei; Ooishi, Yukihiko; Ueda, Masataka; Kido, Akira; Wada, Tetsuro; Yoshigoe, Fukuo; Yamashita, Takashi; Mochizuki, Sachio

    1985-02-01

    In 15 patients with superficial bladder cancer hemipelvic irradiation was performed for prevention of relapse of cancer and decrease in side effects with following results. All patients received TUR-Bt at our department during the six years period from 1978 to 1983. As to stages, one was classified as Ta, 11 as T 1 and 3 as T 2, and pathologic diagnosis was transitional epithelial carcinoma of grade 1 in 1 case, grade 2 in 8 cases and grade 3 in 6 cases. Irradiation was started from the 7 th to 14 th day after TUR-Bt. At first, hemipelvic anterior and posterior field including the field from the affected pelvis to 1 to 2 cm beyond the midline toward the contralateral side and from the aortic bifurcation to the prostatic urethra were irradiated at a dose of 45 Gy. Then, whole bladder field was given an additional rotation irradiation of 20 Gy. The mean observation period was 43 months (ranging from 12 to 79 months) and relapse of cancer was observed in 6 cases out of 15 cases (40%). The site of relapse was in the irradiated site in 2 cases, contralateral site in 3 cases and both side in 1 cases. However, in all of the relapsed cases no aggravation in differential degree or progression in stage was observed. As the side effects, radiation cystitis developed as a delayed damage in 1 case. Thus, although no efficacy for prevention of relapse which we had expected was not seen, this irradiation method effectively inhibited the progression of lesion and development of delayed damage. (author).

  7. [Should biopsy be done on the sensory branch of the radial nerve in leprosy patients? Apropos of 112 cases].

    Science.gov (United States)

    Grauwin, M Y; Dieye, M; Mane, I; Cartel, J L

    1997-01-01

    Biopsies of the superficial sensory branch of the radial nerve are contested. Some authors mention it to be simple and without harm, but others are formally against this procedure. At ILAD, 274 biopsies were made between 1986 to 1992. We present a review of 112 leprosy patients for whom biopsy was done. On 112 reexamined patients, we observed 2 benign neuroma, hence 2%. The comparison of nerve function before biopsy and after, of 63 of the 112 patients, reexamination shows no significant modification of the functional score. Given even the occurrence of benign neuroma in only 2% of the cases, the authors do not recommend the biopsy of the superficial sensory branch of the radial nerve. For research purposes on neuritis in leprosy, as well as to assure diagnosis in primary neuritic leprosy, we propose the biopsy of the sensory branch of the musculo cutaneous nerve at elbow level.

  8. Acoustic detection of coronary artery disease.

    Science.gov (United States)

    Semmlow, John; Rahalkar, Ketaki

    2007-01-01

    Coronary artery disease (CAD) occurs when the arteries to the heart (the coronary arteries) become blocked by deposition of plaque, depriving the heart of oxygen-bearing blood. This disease is arguably the most important fatal disease in industrialized countries, causing one-third to one-half of all deaths in persons between the ages of 35 and 64 in the United States. Despite the fact that early detection of CAD allows for successful and cost-effective treatment of the disease, only 20% of CAD cases are diagnosed prior to a heart attack. The development of a definitive, noninvasive test for detection of coronary blockages is one of the holy grails of diagnostic cardiology. One promising approach to detecting coronary blockages noninvasively is based on identifying acoustic signatures generated by turbulent blood flow through partially occluded coronary arteries. In fact, no other approach to the detection of CAD promises to be as inexpensive, simple to perform, and risk free as the acoustic-based approach. Although sounds associated with partially blocked arteries are easy to identify in more superficial vessels such as the carotids, sounds from coronary arteries are very faint and surrounded by noise such as the very loud valve sounds. To detect these very weak signals requires sophisticated signal processing techniques. This review describes the work that has been done in this area since the 1980s and discusses future directions that may fulfill the promise of the acoustic approach to detecting coronary artery disease.

  9. Emerging Stent and Balloon Technologies in the Femoropopliteal Arteries

    Directory of Open Access Journals (Sweden)

    Georgios Pastromas

    2014-01-01

    Full Text Available Endovascular procedures for the management of the superficial femoral (SFA and popliteal artery disease are increasingly common. Over the past decade, several stent technologies have been established which may offer new options for improved clinical outcomes. This paper reviews the current evidence for SFA and popliteal artery angioplasty and stenting, with a focus on randomized trials and registries of nitinol self-expanding stents, drug-eluting stents, dug-coated balloons, and covered stent-grafts. We also highlight the limitations of the currently available data and the future routes in peripheral arterial disease (PAD stent and balloon technology.

  10. Arterial Catheterization

    Science.gov (United States)

    ... way of keeping the blood pressure up. The arterial catheter allows accurate, second-to-second measurement of the blood pressure; repeated meas- urement is called monitoring. ■ High blood pressure (hypertension)— In some sit- uations, ...

  11. Compression of the radial nerve at the elbow by a ganglion: two case reports

    Directory of Open Access Journals (Sweden)

    Jou I-Ming

    2009-06-01

    Full Text Available Abstract Introduction Radial nerve compression by a ganglion in the radial tunnel is not common. Compressive neuropathies of the radial nerve in the radial tunnel can occur anywhere along the course of the nerve and may lead to various clinical manifestations, depending on which branch is involved. We present two unusual cases of ganglions located in the radial tunnel and requiring surgical excision. Case presentation A 31-year-old woman complained of difficulty in fully extending her fingers at the metacarpophalangeal joint for 2 weeks. Before her first visit, she had noticed a swelling and pain in her right elbow over the anterolateral forearm. The extension muscle power of the metacarpophalangeal joints at the fingers and the interphalangeal joint at the thumb had decreased. Sonography and magnetic resonance imaging of the elbow revealed a cystic lesion located at the area of the arcade of Frohse. A thin-walled ovoid cyst was found against the posterior interosseous nerve during surgical excision. Pathological examination was compatible with a ganglion cyst. The second case involved a 36-year-old woman complaining of numbness over the radial aspect of her hand and wrist, but without swelling or tumor in this area. The patient had slightly decreased sensitivity in the distribution of the sensory branch of the radial nerve. There was no muscle weakness on extension of the fingers and wrist. Surgical exposure defined a ganglion cyst in the shoulder of the division of the radial nerve into its superficial sensory and posterior interosseous components. There has been no disease recurrence after following both patients for 2 years. Conclusion Compression of nerves by extraneural soft tissue tumors of the extremities should be considered when a patient presents with progressive weakness or sensory changes in an extremity. Surgical excision should be promptly performed to ensure optimal recovery from the nerve palsy.

  12. Peripheral arterial blood pressure versus central crterial blood pressure monitoring in critically ill patients after Cardio-pulmonary Bypass.

    Science.gov (United States)

    Ahmad, Rana Altaf; Ahmad, Suhail; Naveed, Anjum; Baig, Mirza Ahmad Raza

    2017-01-01

    To determine the accuracy of peripheral (radial) arterial access as compared to central (femoral) arterial access for measurement of invasive blood pressure (IBP) in critically ill patients after cardiopulmonary bypass. Sixty patients (60) who required high inotropic/vasopressor support on weaning from cardio-pulmonary bypass and weaned off in 2(nd) attempt were included in this study. The duration of this study was from June 2015 to August 2016. Radial and femoral arterial access was achieved in all patients for simultaneous measurement of blood pressure. Arterial pressures were noted after 5, 15 and 30 minutes of weaning from cardiopulmonary bypass for both radial and femoral artery simultaneously. Mean age of study patients was 56.48±11.17 years. 85% patients were male. There was significant difference in systolic blood pressure, diastolic blood pressure and mean arterial pressures between the radial artery and femoral artery cannulation. Mean arterial pressures were significantly high in femoral artery as compared to the radial artery. The mean arterial pressures after five minutes of weaning using central access were 76.28±10.21 mmHg versus 64.15±6.76 mmHg in peripheral arterial access (p-value arterial pressures after 15 minutes of weaning from cardiopulmonary bypass 78.70±10.12 mmHg in central access versus 72.03±6.76 mmHg using peripheral arterial access (p-value arterial pressures were less marked as compared to the previous differences after 30 minutes of weaning from cardiopulmonary bypass as compared to the earlier readings (p-value 0.001). Peripheral arterial pressures are unreliable in critically ill patients after cardiopulmonary bypass receiving high dose of inotropic drugs. Central arterial access should be used in these patients to get accurate estimates of patients' blood pressure in early periods after cardiopulmonary bypass.

  13. Arterial Stiffness.

    Science.gov (United States)

    Avolio, Alberto

    2013-04-01

    Stiffness of large arteries has been long recognized as a significant determinant of pulse pressure. However, it is only in recent decades, with the accumulation of longitudinal data from large and varied epidemiological studies of morbidity and mortality associated with cardiovascular disease, that it has emerged as an independent predictor of cardiovascular risk. This has generated substantial interest in investigations related to intrinsic causative and associated factors responsible for the alteration of mechanical properties of the arterial wall, with the aim to uncover specific pathways that could be interrogated to prevent or reverse arterial stiffening. Much has been written on the haemodynamic relevance of arterial stiffness in terms of the quantification of pulsatile relationships of blood pressure and flow in conduit arteries. Indeed, much of this early work regarded blood vessels as passive elastic conduits, with the endothelial layer considered as an inactive lining of the lumen and as an interface to flowing blood. However, recent advances in molecular biology and increased technological sophistication for the detection of low concentrations of biochemical compounds have elucidated the highly important regulatory role of the endothelial cell affecting vascular function. These techniques have enabled research into the interaction of the underlying passive mechanical properties of the arterial wall with the active cellular and molecular processes that regulate the local environment of the load-bearing components. This review addresses these emerging concepts.

  14. A review on fracture prevention of stent in femoropopliteal artery

    Science.gov (United States)

    Atan, Bainun Akmal Mohd; Ismail, Al Emran; Taib, Ishkrizat; Lazim, Zulfaqih

    2017-01-01

    Heavily calcific lesions, total occlusions, tortuous blood vessels, variable lengths of arteries, various dynamic loads and deformations in the femoropopliteal (FP) arterial segment make stenosis treatments are complicated. The dynamic forces in FP artery including bending, torsion and radial compression may lead to stent fracture (SF) and eventually to in-stent restenosis (ISR). Stent design specifically geometrical configurations are a major factor need to be improved to optimize stent expansion and flexibility both bending and torsion during stent deployment into the diseased FP artery. Previous studies discovered the influence of various stent geometrical designs resulted different structural behaviour. Optimizing stent design can improve stent performances: flexibility and radial strength to prevent SF in FP arterial segment

  15. Reduced arterial diameter during static exercise in humans

    DEFF Research Database (Denmark)

    Olesen, H L; Mitchell, J H; Friedman, D B

    1995-01-01

    of another limb. Static exercise increased heart rate and mean arterial pressure, which were largest during one-leg knee extension. After exercise heart rate and mean arterial pressure returned to the resting level. No changes were recorded in arterial carbon dioxide tension, and the rate of perceived......In eight subjects luminal diameter of the resting limb radial and dorsalis pedis arteries was determined by high-resolution ultrasound (20 MHz). This measurement was followed during rest and during 2 min of static handgrip or of one-leg knee extension at 30% of maximal voluntary contraction...... exertion was approximately 15 units after both types of exercise. The dorsalis pedis arterial diameter was 1.50 +/- 0.20 mm (mean and SE) and the radial AD 2.45 +/- 0.12 mm. During both types of contractions the luminal diameters decreased approximately 3.5% within the first 30 s (P

  16. Severity grading in radial dysplasia.

    Science.gov (United States)

    Vilkki, S K

    2014-11-01

    A functional scoring method to grade the usefulness and quality of the upper limbs in congenital radial dysplasia is presented. It is based on the author's examinations of 44 arms with congenital deficiency of the radius. The hand (H), wrist (W) and proximal parts (P) of the extremity are each scored from 0 to 10 points for severity. The scoring is expressed similarly to the TNM (tumour, nodes, metastasis) tumour classification, for example as H5W4P2. The maximum severity index is 30 points. A severity grade of mild is between 1 and 8 points, moderate between 9 and 16 points and severe 17 points and over. In the author's series, the grades were mild in eight, moderate in 21 and severe in 15 cases. The functional severity grading should allow better comparison of radially deficient limbs and the results of treatment between groups of patients. © The Author(s) 2014.

  17. Superficial Radiation Therapy for the Treatment of Nonmelanoma Skin Cancers.

    Science.gov (United States)

    McGregor, Sean; Minni, John; Herold, David

    2015-12-01

    Superficial radiation therapy has become more widely available to dermatologists. With the advent of more portable machines, it has become more convenient for dermatology practices to employ in an office-based setting. The goal of this paper is to provide a deeper insight into the role of superficial radiation therapy in dermatology practice and to review the current literature surrounding its use in the treatment of both basal and squamous cell carcinomas.

  18. Functional Compartmentalization of the Human Superficial Masseter Muscle

    OpenAIRE

    Guzmán-Venegas, Rodrigo A.; Biotti Picand, Jorge L.; Francisco J Berral de la Rosa

    2015-01-01

    Some muscles have demonstrated a differential recruitment of their motor units in relation to their location and the nature of the motor task performed; this involves functional compartmentalization. There is little evidence that demonstrates the presence of a compartmentalization of the superficial masseter muscle during biting. The aim of this study was to describe the topographic distribution of the activity of the superficial masseter (SM) muscle's motor units using high-density surface e...

  19. Tendon vibration attenuates superficial venous vessel response of the resting limb during static arm exercise

    Directory of Open Access Journals (Sweden)

    Ooue Anna

    2012-11-01

    Full Text Available Abstract Background The superficial vein of the resting limb constricts sympathetically during exercise. Central command is the one of the neural mechanisms that controls the cardiovascular response to exercise. However, it is not clear whether central command contributes to venous vessel response during exercise. Tendon vibration during static elbow flexion causes primary muscle spindle afferents, such that a lower central command is required to achieve a given force without altering muscle force. The purpose of this study was therefore to investigate whether a reduction in central command during static exercise with tendon vibration influences the superficial venous vessel response in the resting limb. Methods Eleven subjects performed static elbow flexion at 35% of maximal voluntary contraction with (EX + VIB and without (EX vibration of the biceps brachii tendon. The heart rate, mean arterial pressure, and rating of perceived exertion (RPE in overall and exercising muscle were measured. The cross-sectional area (CSAvein and blood velocity of the basilic vein in the resting upper arm were assessed by ultrasound, and blood flow (BFvein was calculated using both variables. Results Muscle tension during exercise was similar between EX and EX + VIB. However, RPEs at EX + VIB were lower than those at EX (P P vein in the resting limb at EX decreased during exercise from baseline (P vein at EX + VIB did not change during exercise. CSAvein during exercise at EX was smaller than that at EX + VIB (P vein did not change during the protocol under either condition. The decreases in circulatory response and RPEs during EX + VIB, despite identical muscle tension, showed that activation of central command was less during EX + VIB than during EX. Abolishment of the decrease in CSAvein during exercise at EX + VIB may thus have been caused by a lower level of central command at EX + VIB rather than EX. Conclusion Diminished central command induced by tendon

  20. Imaging of the most frequent superficial soft-tissue sarcomas

    Energy Technology Data Exchange (ETDEWEB)

    Morel, Melanie; Taieb, Sophie; Ceugnart, Luc [Centre Oscar Lambret, Department of Radiology, Lille (France); Penel, Nicolas [Centre Oscar Lambret, Department of Oncology, Lille (France); Mortier, Laurent [Centre Hospitalier Universitaire de Lille, Department of Dermatology, Hopital Claude Huriez, Lille (France); Vanseymortier, Luc [Centre Oscar Lambret, Department of Surgery, Lille (France); Robin, Y.M. [Centre Oscar Lambret, Departement of Pathology, Lille (France); Gosset, Pierre [Groupement Hospitalier de l' Institut Catholique-Faculte Libre de Medecine de Lille, Department of Pathology, Hopital Saint-Philibert, Lomme (France); Cotten, Anne [Centre Hospitalier Universitaire de Lille, Department of Musculoskeletal Radiology, Centre Hopital Roger Salengro, Lille (France)

    2011-03-15

    Superficial soft-tissue sarcomas are malignant mesenchymal tumors located within the cutaneous and/or subcutaneous layers. Most superficial soft-tissue sarcomas are low-grade tumors; yet, the risk of local recurrence is high, and initial wide surgery is the main prognostic factor. Some of these superficial sarcomas may grow, following an infiltrative pattern, and their real extent may be underestimated clinically. Imaging techniques are useful to determine precisely the real margins of the tumor, especially in cases of clinically doubtful or recurrent or large superficial lesions. Imaging tools enable one to determine the relationship with the superficial fascia separating the subcutaneous layer from the underlying muscle. In our institution ultrasonographic examination is followed by magnetic resonance (MR) imaging when the size of the lesion exceeds 3-5 cm. Imaging assessment is performed prior to biopsy, enabling optimal surgical management. Imaging features of the main superficial sarcomas are detailed in the following article, according to their major locations: those arising in the epidermis and/or dermis, which are most often diagnosed by dermatologists, and the subcutaneous sarcomas. (orig.)

  1. Velocidades radiales en Collinder 121

    Science.gov (United States)

    Arnal, M.; Morrell, N.

    Se han llevado a cabo observaciones espectroscópicas de unas treinta estrellas que son posibles miembros del cúmulo abierto Collinder 121. Las mismas fueron realizadas con el telescopio de 2.15m del Complejo Astronómico El Leoncito (CASLEO). El análisis de las velocidades radiales derivadas del material obtenido, confirma la realidad de Collinder 121, al menos desde el punto de vista cinemático. La velocidad radial baricentral (LSR) del cúmulo es de +17 ± 3 km.s-1. Esta velocidad coincide, dentro de los errores, con la velocidad radial (LSR) de la nebulosa anillo S308, la cual es de ~20 ± 10 km.s-1. Como S308 se encuentra físicamente asociada a la estrella Wolf-Rayet HD~50896, es muy probable que esta última sea un miembro de Collinder 121. Desde un punto de vista cinemático, la supergigante roja HD~50877 (K3Iab) también pertenecería a Collinder 121. Basándonos en la pertenencia de HD~50896 a Collinder 121, y en la interacción encontrada entre el viento de esta estrella y el medio interestelar circundante a la misma, se estima para este cúmulo una distancia del orden de 1 kpc.

  2. Combined aerobic and resistance exercise training decreases peripheral but not central artery wall thickness in subjects with type 2 diabetes.

    NARCIS (Netherlands)

    Schreuder, T.H.A.; Munckhof, I.C.L. van den; Poelkens, F.; Hopman, M.T.; Thijssen, D.H.

    2015-01-01

    OBJECTIVE: Little is known about the impact of exercise training on conduit artery wall thickness in type 2 diabetes. We examined the local and systemic impact of exercise training on superficial femoral (SFA), brachial (BA), and carotid artery (CA) wall thickness in type 2 diabetes patients and con

  3. Combined aerobic and resistance exercise training decreases peripheral but not central artery wall thickness in subjects with type 2 diabetes.

    NARCIS (Netherlands)

    Schreuder, T.H.A.; Munckhof, I.C.L. van den; Poelkens, F.; Hopman, M.T.; Thijssen, D.H.

    2015-01-01

    OBJECTIVE: Little is known about the impact of exercise training on conduit artery wall thickness in type 2 diabetes. We examined the local and systemic impact of exercise training on superficial femoral (SFA), brachial (BA), and carotid artery (CA) wall thickness in type 2 diabetes patients and

  4. Drenaje suplementario del sistema venoso superficial en colgajos pediculados Supplementary drainage of superficial venous system in pedicled flaps

    Directory of Open Access Journals (Sweden)

    A. Fernández García

    2012-06-01

    Full Text Available Los colgajos pediculados pueden sufrir edema y congestión debido a que su drenaje a trevés del sistema venoso superfical es imposible y el flujo hacia el sistema profundo a nivel del pedículo es precario. Esta situación suele evolucionar hacia la necrosis parcial o la pérdida total del colgajo en pocas horas. La apertura del sistema venoso superficial permite el drenaje adecuado de los tejidos transferidos y evita estas complicaciones. Este artículo analiza el papel de las anastomosis microquirúrgicas en el sistema venoso superficial de los colgajos pediculados. Esta técnica permite comunicar el sistema venoso superfical de los tejidos transferidos con el sistema venoso superficial del territorio que rodea al defecto. Presentamos los resultados obtenidos con esta técnica en colgajos de perforante en hélice, colgajos miocutáneos, colgajos neurocutáneos y colgajos fasciograsos volteados.The pedicled flaps can suffer edema and congestion due to the impossibility of drainage toward the superficial venous system and the precarious flow via the deep system at the level of the pedicle. The evolution of this situation is usually partial necrosis or total loss of the flap in a few hours. The opening of the venous superficial system achieves an appropriate drainage of the transfered tissues and avoids these complications. In this article we analyze the role of the microsurgical anastomosis at the level of the superficial venous system of pedicled flaps. This technique allows to communicate the superficial venous system of the transfered tissues with the superficial venous system of the territory around the defect. We report the results with this method in propeller perforator flaps, miocutaneous flaps, neurocutaneous flaps and adipofascial turn over flaps.

  5. Lack of Methylene Blue Staining in Superficial Epithelia as a Possible Marker for Superficial Lateral Spread of Bile Duct Cancer

    Directory of Open Access Journals (Sweden)

    I. Maetani

    1996-01-01

    epithelia. The cancerous epithelia stained significantly less often than either the normal (p = 0.000005 or the metaplastic (p = 0.001 epithelia. Evaluation of methylene blue staining during PTCS revealed that this stain was absorbed by the cholangial epithelia, not superficially stuck to it. The difference in methylene blue staining properties between the cancerous and normal epithelia could be helpful to clarify the boundary of superficial lateral spread of bile duct cancer.

  6. Carotid artery surgery

    Science.gov (United States)

    Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery ... through the catheter around the blocked area during surgery. Your carotid artery is opened. The surgeon removes ...

  7. Amniotic membrane transplant with superficial keratectomy in superficial corneal degenerations: Efficacy in a rural population of north India

    Directory of Open Access Journals (Sweden)

    Rao Aparna

    2008-01-01

    Full Text Available Aim: To evaluate the applicability and efficacy of superficial keratectomy with transplantation of preserved amniotic membrane in superficial corneal degenerations in a rural population of Northern India in terms of visual improvement and surface regularization. Settings: Peripheral referral center in rural north India. Materials and Methods: This was a prospective non-comparative interventional case series where 24 eyes of 20 farmers from peripheral rural areas (M:F = 19:1 with visually significant superficial degenerative disorders (15 eyes with climatic droplet keratopathy one of which was associated with Salzmann nodular degeneration and nine eyes with band-shaped keratopathy were subjected to amniotic membrane transplantation (single or multiple layer combined with superficial keratectomy. Subjective and objective outcomes after surgery were evaluated and analyzed and statistical significance of the outcomes in various disorders was evaluated. Results: Eighty-eight per cent (21 eyes had symptomatic relief from distressing preoperative symptoms while postoperative visual improvement by two or more lines was achieved in 23 eyes (96% over a mean follow-up period of 26.8 ± 10.2 months. The surface irregularity present preoperatively was relieved in 23 cases while postoperative decline of vision with visually significant scarring was seen in one case (4%, which was labeled as failure. Conclusions: Amniotic membrane transplant with superficial keratectomy helped achieve subjective comfort, visual rehabilitation and clinical regularization of the corneal surface in superficial corneal degenerations during the mean followup of 26.8 ± 10.2 months in rural setups.

  8. Biochemical composition of the superficial layer of articular cartilage.

    Science.gov (United States)

    Crockett, R; Grubelnik, A; Roos, S; Dora, C; Born, W; Troxler, H

    2007-09-15

    To gain more information on the mechanism of lubrication in articular joints, the superficial layer of bovine articular cartilage was mechanically removed in a sheet of ice that formed on freezing the cartilage. Freeze-dried samples contained low concentrations of chondroitin sulphate and protein. Analysis of the protein by SDS PAGE showed that the composition of the sample was comparable to that of synovial fluid (SF). Attenuated total reflection infrared (ATR-IR) spectroscopy of the dried residue indicated that the sample contained mostly hyaluronan. Moreover, ATR-IR spectroscopy of the upper layer of the superficial layer, adsorbed onto silicon, showed the presence of phospholipids. A gel could be formed by mixing hyaluronan and phosphatidylcholine in water with mechanical properties similar to those of the superficial layer on cartilage. Much like the superficial layer of natural cartilage, the surface of this gel became hydrophobic on drying out. Thus, it is proposed that the superficial layer forms from hyaluronan and phospholipids, which associate by hydrophobic interactions between the alkyl chains of the phospholipids and the hydrophobic faces of the disaccharide units in hyaluronan. This layer is permeable to material from the SF and the cartilage, as shown by the presence of SF proteins and chondroitin sulphate. As the cartilage dries out after removal from the joint, the phospholipids migrate towards the surface of the superficial layer to reduce the surface tension. It is also proposed that the highly efficient lubrication in articular joints can, at least in part, be attributed to the ability of the superficial layer to adsorb and hold water on the cartilage surface, thus creating a highly viscous boundary protection.

  9. Management of femoral artery pseudoaneurysm due to addictive drug injection

    Institute of Scientific and Technical Information of China (English)

    李建文; 王三明; 陈小东

    2004-01-01

    Objective: To study surgical management for patients with femoral pseudoaneurysm resulting from addictive druginjection.Methods: Clinical data of 34 patients with femoral pseudoaneurysm resulting from addictive drug injection were retrospectively reviewed.Results: Thirteen patients underwent bypass graft ( end to side) of external iliac artery and superficial femoral artery using expanded polytetrafluoroethylene (ePTFE).Three patients who had an autogenous saphenous vein graft in situs, one of whom was then performed an ePTFE graft when rupture and bleeding occurred at the anastomotic site. Color Doppler image showed patent grafted blood vessels in all the patients after operation. Eighteen patients had their femoral arteries ligated. Limbs of all the 34 patients were saved.Conclusions: Ligating femoral artery is an effective way to treat femoral artery pseudoaneurysm if autogenous saphenous vein graft or artificial vessel graft is notapplicable.

  10. Efecto del alcohol y el hidróxido de sodio sobre la humectabilidad de la superficie de la madera de Tectona grandis L.F. de plantaciones de rápido crecimiento

    OpenAIRE

    Garro-Chavarría, Michael; Estudiante Instituto Tecnológico de Costa Rica, Escuela de Ingeniería Forestal; Cartago, Costa Rica

    2012-01-01

    Se determinó el efecto de la aplicación de dos soluciones químicas polares sobre la humectabilidad de la madera de Tectona grandis (teca). Las soluciones aplicadas fueron: solución concentrada de hidróxido de sodio y alcohol 90%. Se midió el ángulo de contacto entre la gota de agua y la superficie de la madera, en dos tipos de corte: tangencial y radial. Los resultados mostraron que el tratamiento de la superficie con hidróxido de sodio y alcohol aumenta significativamente la humectabilidad e...

  11. Radial vibrations of BPS skyrmions

    CERN Document Server

    Adam, C; Romanczukiewicz, T; Wereszczynski, A

    2016-01-01

    We study radial vibrations of spherically symmetric skyrmions in the BPS Skyrme model. Concretely, we numerically solve the linearised field equations for small fluctuations in a skyrmion background, both for linearly stable oscillations and for (unstable) resonances. This is complemented by numerical solutions of the full nonlinear system, which confirm all the results of the linear analysis. In all cases, the resulting fundamental excitation provides a rather accurate value for the Roper resonance, supporting the hypothesis that the BPS Skyrme model already gives a reasonable approximate description of this resonance.

  12. Coronary artery fistula

    Science.gov (United States)

    Congenital heart defect - coronary artery fistula; Birth defect heart - coronary artery fistula ... A coronary artery fistula is often congenital, meaning that it is present at birth. It generally occurs when one of the coronary arteries ...

  13. Superficial dose evaluation of four dose calculation algorithms

    Science.gov (United States)

    Cao, Ying; Yang, Xiaoyu; Yang, Zhen; Qiu, Xiaoping; Lv, Zhiping; Lei, Mingjun; Liu, Gui; Zhang, Zijian; Hu, Yongmei

    2017-08-01

    Accurate superficial dose calculation is of major importance because of the skin toxicity in radiotherapy, especially within the initial 2 mm depth being considered more clinically relevant. The aim of this study is to evaluate superficial dose calculation accuracy of four commonly used algorithms in commercially available treatment planning systems (TPS) by Monte Carlo (MC) simulation and film measurements. The superficial dose in a simple geometrical phantom with size of 30 cm×30 cm×30 cm was calculated by PBC (Pencil Beam Convolution), AAA (Analytical Anisotropic Algorithm), AXB (Acuros XB) in Eclipse system and CCC (Collapsed Cone Convolution) in Raystation system under the conditions of source to surface distance (SSD) of 100 cm and field size (FS) of 10×10 cm2. EGSnrc (BEAMnrc/DOSXYZnrc) program was performed to simulate the central axis dose distribution of Varian Trilogy accelerator, combined with measurements of superficial dose distribution by an extrapolation method of multilayer radiochromic films, to estimate the dose calculation accuracy of four algorithms in the superficial region which was recommended in detail by the ICRU (International Commission on Radiation Units and Measurement) and the ICRP (International Commission on Radiological Protection). In superficial region, good agreement was achieved between MC simulation and film extrapolation method, with the mean differences less than 1%, 2% and 5% for 0°, 30° and 60°, respectively. The relative skin dose errors were 0.84%, 1.88% and 3.90%; the mean dose discrepancies (0°, 30° and 60°) between each of four algorithms and MC simulation were (2.41±1.55%, 3.11±2.40%, and 1.53±1.05%), (3.09±3.00%, 3.10±3.01%, and 3.77±3.59%), (3.16±1.50%, 8.70±2.84%, and 18.20±4.10%) and (14.45±4.66%, 10.74±4.54%, and 3.34±3.26%) for AXB, CCC, AAA and PBC respectively. Monte Carlo simulation verified the feasibility of the superficial dose measurements by multilayer Gafchromic films. And the rank

  14. A fully relativistic radial fall

    CERN Document Server

    Spallicci, Alessandro D A M

    2014-01-01

    Radial fall has historically played a momentous role. It is one of the most classical problems, the solutions of which represent the level of understanding of gravitation in a given epoch. A {\\it gedankenexperiment} in a modern frame is given by a small body, like a compact star or a solar mass black hole, captured by a supermassive black hole. The mass of the small body itself and the emission of gravitational radiation cause the departure from the geodesic path due to the back-action, that is the self-force. For radial fall, as any other non-adiabatic motion, the instantaneous identity of the radiated energy and the loss of orbital energy cannot be imposed and provide the perturbed trajectory. In the first part of this letter, we present the effects due to the self-force computed on the geodesic trajectory in the background field. Compared to the latter trajectory, in the Regge-Wheeler, harmonic and all others smoothly related gauges, a far observer concludes that the self-force pushes inward (not outward) ...

  15. Peripheral arterial blood pressure monitoring adequately tracks central arterial blood pressure in critically ill patients: an observational study.

    Science.gov (United States)

    Mignini, Mariano Alejandro; Piacentini, Enrique; Dubin, Arnaldo

    2006-01-01

    Invasive arterial blood pressure monitoring is a common practice in intensive care units (ICUs). Accuracy of invasive blood pressure monitoring is crucial in evaluating the cardiocirculatory system and adjusting drug therapy for hemodynamic support. However, the best site for catheter insertion is controversial. Lack of definitive information in critically ill patients makes it difficult to establish guidelines for daily practice in intensive care. We hypothesize that peripheral and central mean arterial blood pressures are interchangeable in critically ill patients. This is a prospective, observational study carried out in a surgical-medical ICU in a teaching hospital. Fifty-five critically ill patients with clinical indication of invasive arterial pressure monitoring were included in the study. No interventions were made. Simultaneous measurements were registered in central (femoral) and peripheral (radial) arteries. Bias and precision between both measurements were calculated with Bland-Altman analysis for the whole group. Bias and precision were compared between patients receiving high doses of vasoactive drugs (norepinephrine or epinephrine >0.1 microg/kg/minute or dopamine >10 microg/kg/minute) and those receiving low doses (norepinephrine or epinephrine arterial pressure was 3 +/- 4 mmHg higher than peripheral mean arterial pressure for the whole population and there were no differences between groups (3 +/- 4 mmHg for both groups). Measurement of mean arterial blood pressure in radial or femoral arteries is clinically interchangeable. It is not mandatory to cannulate the femoral artery, even in critically ill patients receiving high doses of vasoactive drugs.

  16. Long-term evolution of superficial optic disc drusen

    DEFF Research Database (Denmark)

    Malmqvist, Lasse; Lund-Andersen, Henrik; Hamann, Steffen

    2017-01-01

    with hereditary ODD were included. RESULTS: Mean age at initial and follow-up examination was, respectively, 16.8 and 73.3 years. The median follow-up time was 56 years. A minimal or non-existing change in superficial ODD anatomy (size and number) was seen in 10 of 12 eyes. There was a tendency towards more......PURPOSE: Optic disc drusen (ODD) is hyaline deposits in the optic nerve head seen in 1-2% of the population. Long-term evolution of ODD anatomy and visual field defects in ODD patients is a key factor for learning more about pathophysiology and prognosis of the condition. With a median follow......-up period of 56 years, this is the first study that evaluates superficial optic disc anatomy and visual fields in patients with ODD over a life span. METHODS: Observational case series investigating progression of superficial optic disc anatomy and visual fields in ODD patients. Eight patients...

  17. Física de superficies: métodos experimentales

    OpenAIRE

    2012-01-01

    Hace unos 30 años se empezó con el estudio de superficies sólidas y hoy son muchos los investigadores que en el mundo entero se dedican al estudio de las propiedades físicas y químicas de superficies e interfaces.La motivación radica en que en las interacciones entre los diversos sistemas que componen nuestro universo se hallan involucradas sus superficies, razón suficiente para captar la importancia de su estudio para la vida humana y su repercusión tecnológica y económica. A ella habría que...

  18. Evaluation of Allen's test in both arms and arteries of left and right-handed people.

    Science.gov (United States)

    Oettlé, A C; van Niekerk, A; Boon, J M; Meiring, J H

    2006-03-01

    The Allen's test as described in 1929 by Edgar V. Allen has been modified, adapted and complemented by other newer modalities but remains a first line standard test to evaluate the arterial supply of the hand. In this study an attempt has been made to add more information regarding the arterial supply of the hand, in left- and right-handed individuals, left and right hands and the ulnar and radial arteries, when doing the Allen's test. A modified Allen's test using an oxygen saturation monitor was used. The sample group consisted of 80 (30 left-handed and 50 right-handed) students. No significant differences between the Allen's test of the left and right hands in the left and right-handed individuals were found. There was a marginal but not significant difference between the two arteries. The ulnar artery took slightly longer to reach baseline values as compared to the radial artery. The results suggest that a positive Allen's test can be found in both left and right-handed people, with regard to the left and right hands and both radial and ulnar arteries may be implicated. This information should be kept in mind when selecting either the radial or ulnar artery for grafting purposes (e.g. coronary angiosurgery) and forearm artery cannulation.

  19. Case report: cochlear implantation in a patient with superficial siderosis.

    Science.gov (United States)

    Ryan, Michelle; Piplica, Doris; Zhang, Ming

    2014-12-01

    This is a retrospective case review study. Current understanding of cochlear implantation in patients with superficial siderosis is limited, with roughly 15 reported cases worldwide. The purpose of this study is to report an additional case of cochlear implantation in a patient with superficial siderosis and to contribute to the current literature available on outcomes of implantation in these individuals. One cochlear implant user with superficial siderosis in a tertiary referral center. Therapeutic and rehabilitative. Open set speech perception word scores increased from 0% preimplantation with bilateral hearing aids to 8% postimplantation in the bimodal condition (cochlear implant in the left ear and hearing aid in the right ear). Phoneme scores increased from 16% preimplantation to 36% postimplantation. The patient also demonstrated improvement from 38% preimplantation to 83% postimplantation on a closed set word test. Performance on open set recorded sentences did not improve; however, open set sentences administered live voice revealed an increase in performance from 4% preimplantation to 25% postimplantation in the auditory only condition and from 59% to 86% in the auditory-visual condition. For this patient with superficial siderosis, only marginal improvements in test scores at 11 months postimplantation were seen. Minimally, the use of a cochlear implant did prevent further deterioration of auditory performance. Therefore, patients with superficial siderosis who choose to proceed with cochlear implantation may still report perceived benefit from the maintenance of speech perception abilities even in the presence of minimal improvement. Rapid deterioration in hearing thresholds and speech discrimination before implantation may be an indicator of an actively progressing case of superficial siderosis, which may suggest possible limited benefit from cochlear implantation.

  20. UV radiation sensors with unitary and binary superficial barrier

    Science.gov (United States)

    Dorogan, Valerian; Vieru, Tatiana; Kosyak, V.; Damaskin, I.; Chirita, F.

    1998-07-01

    UV radiation sensors with unitary and binary superficial barrier, made on the basis of GaP - SnO2 and GaAs - AlGaAs - SnO2 heterostructures, are presented in the paper. Technological and constructive factors, which permit to realize a high conversion efficiency and to exclude the influence of visible spectrum upon the photoanswer, are analyzed. It was established that the presence of an isotypical superficial potential barrier permits to suppress the photoanswer component formed by absorption of visible and infrared radiation in semiconductor structure bulk.

  1. PHOTODYNAMIC DIAGNOSIS AND FLUORESCENCE SPECTROSCOPY IN SUPERFICIAL BLADDER CANCER

    Directory of Open Access Journals (Sweden)

    I. G. Rusakov

    2009-01-01

    Full Text Available A comprehensive fluorescence technique has been developed to study the urinary bladder mucosa in patients with superficial bladder cancer (BC, by using alasense, white light cystoscopy, fluorescence cytoscopy, and local fluorescence spectroscopy in vivo. Quantification of urothelium fluorescence in the red emission foci of 5-ALA-induced protophorphyrin, with the local autofluorescence intensity being borne in mind, has been shown to increase the specificity of photodynamic diagnosis of superficial BC from 70 to 85% (p ≤ 0.05 and the total accuracy of the technique from 80 to 86%.  

  2. Giant pediatric aneurysm treated with ligation of the middle cerebral artery with the Drake tourniquet and extracranial-intracranial bypass.

    Science.gov (United States)

    Lansen, T A; Kasoff, S S; Arguelles, J H

    1989-07-01

    Saccular intracranial aneurysms occur infrequently in children, and the incidence of pediatric giant aneurysms is statistically in the same proportion as in adults. The management of these giant aneurysms can be treacherous. This paper presents a case of a 9-year-old boy with a giant aneurysm of the right middle cerebral artery that was successfully managed by ligation of the middle cerebral artery using a Drake tourniquet with the patient awake and by augmentation of the middle cerebral artery circulation with superficial temporal artery-middle cerebral artery anastomosis without excision of the lesion.

  3. Formulas for Radial Transport in Protoplanetary Disks

    Science.gov (United States)

    Desch, Steven J.; Estrada, Paul R.; Kalyaan, Anusha; Cuzzi, Jeffrey N.

    2017-05-01

    The quantification of the radial transport of gaseous species and solid particles is important to many applications in protoplanetary disk evolution. An especially important example is determining the location of the water snow lines in a disk, which requires computing the rates of outward radial diffusion of water vapor and the inward radial drift of icy particles; however, the application is generalized to evaporation fronts of all volatiles. We review the relevant formulas using a uniform formalism. This uniform treatment is necessary because the literature currently contains at least six mutually exclusive treatments of radial diffusion of gas, only one of which is correct. We derive the radial diffusion equations from first principles using Fick's law. For completeness, we also present the equations for radial transport of particles. These equations may be applied to studies of diffusion of gases and particles in protoplanetary and other accretion disks.

  4. Percutaneous transradial artery approach for coronary Palmaz-Schatz stent implantation.

    Science.gov (United States)

    Kiemeneij, F; Laarman, G J

    1994-07-01

    The purpose of this study was to evaluate feasibility, safety, and efficacy of implantation of unsheathed Palmaz-Schatz coronary stents via the radial artery. Anticoagulation after coronary stenting has the hazard of vascular complications if large-bore guiding catheters are introduced via the femoral artery. Such complications have serious local sequelae, are associated with suboptimal anticoagulation, and prolong hospitalization. By combining 6F guiding catheters and low-profile dilatation catheters with bare Palmaz-Schatz stents, smaller vessels such as the radial artery can be selected as the entry site. It is postulated that no major puncture site-related complications occur because hemostasis is easily achieved and no veins and nerves are near the radial artery. With double blood supply to the hand, radial artery occlusion is well tolerated. Twenty-five bare Palmaz-Schatz stents were implanted via the radial artery through 6F guiding catheters in 20 consecutive patients for venous bypass graft stenosis (n = 9; 45%), native coronary artery restenosis (n = 7; 35%) and suboptimal transradial artery PTCA (n = 4; 20%). Immediately after stent implantation and assessment of the result by means of computerized quantitative coronary analysis, the arterial sheath was withdrawn followed by intense anticoagulation and free ambulation of the patient. Radial artery function and anatomy were assessed by two-dimensional and Doppler ultrasound examination. Lesions (n = 24) were of type A (n = 13; 54%), B (n = 6; 25%) and C (n = 5; 21%). The reference diameter of the stented segments was 3.2 +/- 0.5 mm (2.2 to 4.2 mm).(ABSTRACT TRUNCATED AT 250 WORDS)

  5. Radial keratotomy associated endothelial degeneration

    Directory of Open Access Journals (Sweden)

    Moshirfar M

    2012-02-01

    Full Text Available Majid Moshirfar, Andrew Ollerton, Rodmehr T Semnani, Maylon HsuJohn A Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT, USAPurpose: To describe the presentation and clinical course of eyes with a history of radial keratotomy (RK and varying degrees of endothelial degeneration.Methods: Retrospective case series were used.Results: Thirteen eyes (seven patients were identified with clinical findings of significant guttata and a prior history of RK. The mean age of presentation for cornea evaluation was 54.3 years (range: 38–72 years, averaging 18.7 years (range: 11–33 years after RK. The presentation of guttata varied in degree from moderate to severe. Best corrected visual acuity (BCVA ranged from 20/25 to 20/80. All patients had a history of bilateral RK, except one patient who did not develop any guttata in the eye without prior RK. No patients reported a family history of Fuch’s Dystrophy. One patient underwent a penetrating keratoplasty in one eye and a Descemet’s stripping automated endothelial keratoplasty (DSAEK in the other eye.Conclusions: RK may induce a spectrum of endothelial degeneration. In elderly patients, the findings of guttata may signify comorbid Fuch’s dystrophy in which RK incisions could potentially hasten endothelial decomposition. In these select patients with stable cornea topography and prior RK, DSAEK may successfully treat RK endothelial degeneration.Keywords: radial keratotomy, RK, Descemet’s stripping automated endothelial keratoplasty, DSAEK, guttata, endothelial degeneration, Fuch’s dystrophy

  6. A CONSERVATIVE VIEW OF RADIAL KERATOTOMY

    Institute of Scientific and Technical Information of China (English)

    Steven; Olkowski; Walter; J.; Stark; John; D.; Gottsch; Gerri; Goodman; Daniel; Goodman; A.E.; Maumenee; Ivan; Esente

    1991-01-01

    It has been known for almost a century that radial keratotomy (RK) will flatten the cornea and reduce myopia. Since the introduction of radial keratotomy (RK) in the United States by Bores in 1978, there have been many published studies documenting the effects of this procedure. The questions. about radial keratotomy today are not only quantitative but also qualitative in nature. We know this technique can flatten the cornea, but how reliably can the results be predicted? Does the patient benefit suffic...

  7. On radial geodesic forcing of zonal modes

    OpenAIRE

    Kendl, Alexander

    2011-01-01

    The elementary local and global influence of geodesic field line curvature on radial dispersion of zonal modes in magnetised plasmas is analysed with a primitive drift wave turbulence model. A net radial geodesic forcing of zonal flows and geodesic acoustic modes can not be expected in any closed toroidal magnetic confinement configuration, since the flux surface average of geodesic curvature identically vanishes. Radial motion of poloidally elongated zonal jets may occur in the presence of g...

  8. Stirling Engine With Radial Flow Heat Exchangers

    Science.gov (United States)

    Vitale, N.; Yarr, George

    1993-01-01

    Conflict between thermodynamical and structural requirements resolved. In Stirling engine of new cylindrical configuration, regenerator and acceptor and rejector heat exchangers channel flow of working gas in radial direction. Isotherms in regenerator ideally concentric cylinders, and gradient of temperature across regenerator radial rather than axial. Acceptor and rejector heat exchangers located radially inward and outward of regenerator, respectively. Enables substantial increase in power of engine without corresponding increase in diameter of pressure vessel.

  9. Hollow Cathode With Multiple Radial Orifices

    Science.gov (United States)

    Brophy, John R.

    1992-01-01

    Improved hollow cathode serving as source of electrons has multiple radial orifices instead of single axial orifice. Distributes ion current more smoothly, over larger area. Prototype of high-current cathodes for ion engines in spacecraft. On Earth, cathodes used in large-diameter ion sources for industrial processing of materials. Radial orientation of orifices in new design causes current to be dispersed radially in vicinity of cathode. Advantageous where desireable to produce plasma more nearly uniform over wider region around cathode.

  10. Safety and efficacy of coronary drug eluting stent for atherosclerotic stenosis of the small renal artery

    Institute of Scientific and Technical Information of China (English)

    LI Chun-jie; WU Zheng; YAN Hong-bing; WANG Jian; ZHAO Han-jun

    2009-01-01

    @@ Small diameter renal artery refers to the renal artery with the cross-section diameter less than 5 mm, the incidence of which is approximately 8%.1 Small diameter renal artery is common in patients with congenital multi-branch renal arteries, diabetes and multi-coronary artery lesions. Renal artery bare-mental stent (BMS) implantation is the standard treatment for ostial renal artery stenosis.2,3 However, the restenosis rate4-6 is too high and becomes one of the relative contraindications for small diameter renal artery stent implantation. Clinical trials (e.g. RAVEL,7,8 SIRIUS9 and TAXUS-IV10) have proved that drug eluting stent (DES), compared with BMS, can reduce the restenosis rate after the percutanous coronary intervention (PCI). And Huda et al11 claimed that DES had the better results than BMS in the treatment of obstructive superficial femoral artery disease. However,there are few studies involved restenosis after the renal artery intervention. We hypothesized that coronary DES applied in renal artery stenosis might inhibit intimal proliferation effectively as in coronary artery disease;therefore we evaluated the results of 25 patients with atherosclerotic renal artery stenosis treated using coronary DES to assess the safety and efficacy of coronary DES in patients with small renal artery stenotic lesions.

  11. On radial geodesic forcing of zonal modes

    CERN Document Server

    Kendl, Alexander

    2011-01-01

    The elementary local and global influence of geodesic field line curvature on radial dispersion of zonal modes in magnetised plasmas is analysed with a primitive drift wave turbulence model. A net radial geodesic forcing of zonal flows and geodesic acoustic modes can not be expected in any closed toroidal magnetic confinement configuration, since the flux surface average of geodesic curvature identically vanishes. Radial motion of poloidally elongated zonal jets may occur in the presence of geodesic acoustic mode activity. Phenomenologically a radial propagation of zonal modes shows some characteristics of a classical analogon to second sound in quantum condensates.

  12. Toeplitz Operators with Essentially Radial Symbols

    Directory of Open Access Journals (Sweden)

    Roberto C. Raimondo

    2012-01-01

    Full Text Available For Topelitz operators with radial symbols on the disk, there are important results that characterize boundedness, compactness, and its relation to the Berezin transform. The notion of essentially radial symbol is a natural extension, in the context of multiply-connected domains, of the notion of radial symbol on the disk. In this paper we analyze the relationship between the boundary behavior of the Berezin transform and the compactness of when ∈2(Ω is essentially radial and Ω is multiply-connected domains.

  13. Tromboflebite superficial: epidemiologia, fisiopatologia, diagnóstico e tratamento Superficial thrombophlebitis: epidemiology, physiopathology, diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Marcone Lima Sobreira

    2008-06-01

    Full Text Available A tromboflebite superficial de membros inferiores é doença de ocorrência comum, estando associada a diversas condições clínicas e cirúrgicas. Historicamente considerada doença benigna, devido à sua localização superficial e ao fácil diagnóstico, o tratamento foi conservador durante muito tempo, na maioria dos casos. Entretanto, relatos recentes de freqüências altas de complicações tromboembólicas associadas - 22 a 37% para trombose venosa profunda e até 33% para embolia pulmonar - alertaram para a necessidade de abordagens diagnósticas e terapêuticas mais amplas, visando diagnosticar e tratar essas possíveis complicações. A possibilidade da coexistência dessas e de outras desordens sistêmicas (colagenoses, neoplasias, trombofilias interfere na avaliação e influencia a conduta terapêutica, que pode ser clínica, cirúrgica ou combinada. No entanto, devido à falta de ensaios clínicos controlados e às incertezas quanto a sua história natural, o diagnóstico e o tratamento da tromboflebite superficial continuam indefinidos. Neste trabalho, foi feita uma revisão da literatura analisando-se a epidemiologia, fisiopatologia e estado atual do diagnóstico e tratamento da tromboflebite superficial.Superficial thrombophlebitis of the lower limbs is a commonly occurring disease, and it is associated with various clinical and surgical conditions. Historically considered to be a benign disease due to its superficial location and easy diagnosis, its treatment was, for a long time, conservative in most cases. Nevertheless, recent reports of high frequency and associated thromboembolic complications, which vary from 22 to 37% for deep venous thrombosis and up to 33% for pulmonary embolism, have indicated the need for broader diagnostic and therapeutic approaches in order to diagnose and treat such possible complications. The possibility of coexistence of these and other systemic disorders (collagenosis, neoplasia, thrombophilia

  14. Interpolación y ajuste de superficies en componentes mecánicos digitalizados empleando superficies B-Spline

    OpenAIRE

    2014-01-01

    Este documento de tesis tiene el propósito de describir una metodología para obtener nubes de puntos que representen a superficies (o parches de geometría compleja) de piezas mecánicas que pueden ser replicadas en la industria. Estos puntos se obtuvieron utilizando el método de interpolación superficial B-Spline que deben cumplir un margen de error conocido y controlado de acuerdo a las tolerancias de fabricación utilizados en estos procesos de fabricación. En primer lugar e...

  15. Comparative efficacy and safety of the left versus right radial approach for percutaneous coronary procedures: a meta-analysis including 6870 patients.

    Science.gov (United States)

    Xia, S L; Zhang, X B; Zhou, J S; Gao, X

    2015-08-01

    The radial approach is widely used in the treatment of patients with coronary artery disease. We conducted a meta-analysis of published results on the efficacy and safety of the left and right radial approaches in patients undergoing percutaneous coronary procedures. A systematic search of reference databases was conducted, and data from 14 randomized controlled trials involving 6870 participants were analyzed. The left radial approach was associated with significant reductions in fluoroscopy time [standardized mean difference (SMD)=-0.14, 95% confidence interval (CI)=-0.19 to -0.09; Pprocedural failure of the left and the right radial approaches [risk ratios (RR)=0.98; 95%CI=0.77-1.25; P=0.88] or procedural time (SMD=-0.05, 95%CI=0.17-0.06; P=0.38). Tortuosity of the subclavian artery (RR=0.27, 95%CI=0.14-0.50; Pright radial approach. A greater number of catheters were used with the left than with the right radial approach (SMD=0.25, 95%CI=0.04-0.46; P=0.02). We conclude that the left radial approach is as safe as the right radial approach, and that the left radial approach should be recommended for use in percutaneous coronary procedures, especially in percutaneous coronary angiograms.

  16. Diagnostic and therapeutic challenges in superficial CNS siderosis

    DEFF Research Database (Denmark)

    Kondziella, Daniel; Lindelof, M.; Haziri, Donika

    2015-01-01

    that neurodegeneration due to haemosiderin-associated iron toxicity becomes irreversible with time. CONCLUSION: Surgical therapy in superficial CNS siderosis is rarely achieved. We suggest that prospective, large-scale multicentre studies are needed to search for non-surgical therapies that reverse (or prevent) ongoing...... neurotoxicity due to accumulating iron toxicity. FUNDING: not relevant. TRIAL REGISTRATION: not relevant....

  17. Anterior urethral recurrence of superficial bladder cancer: its clinical significance.

    Directory of Open Access Journals (Sweden)

    Saika T

    2003-12-01

    Full Text Available The aim of this study was to reveal the clinical features of anterior urethral recurrence in patients with superficial bladder cancer, and to determine the appropriate treatment. Three hundred and three patients with superficial bladder cancer, who were newly diagnosed and initially treated conservatively in our hospital between 1965 and 1990, were followed for at least 5 years and their clinical outcomes were analyzed. Clinical factors, including anterior urethral recurrence, were evaluated statistically regarding tumor progression. Eight patients (2.6% had anterior urethral recurrence following superficial bladder cancer. Twenty-four patients (7.9% had tumor progression and 149 (49.2% had tumor recurrence. In a multivariate analysis using a logistic model, anterior urethral recurrence was the most important factor, followed by histological grade. Four of 5 patients who were treated for anterior urethral recurrent tumors by transurethral resection showed progression and died of the cancer within one year. Two of the remaining three patients who underwent radical cysto-urethrectomy at the time of anterior urethral recurrence survived. Anterior urethral recurrence following superficial bladder cancer is a predictor for rapid subsequent malignant progression. Once there is anterior urethral recurrence, radical intensive therapy, including radical cysto-urethrectomy, should be carried out immediately.

  18. Superficies bioactivas en implantología: una nueva perspectiva

    Directory of Open Access Journals (Sweden)

    A. Cutando

    2007-02-01

    Full Text Available Actualmente, tras años de investigación en implantología, en los cuales se han realizado muchos trabajos, en donde se han estudiado diferentes tipos de superficies de implantes, lisas y rugosas, en un intento de mejorar, tanto en el tiempo como en la calidad , la osteointegración, se ha concluido que los implantes de superficie rugosa con un intervalo de rugosidad entre 1,0-2,0 nm, son los que parecen dar una mejor respuesta ósea y mejores resultados clínicos, pero desde un punto de vista exclusivamente mecánico. Hoy en día las investigaciones se centran en el desarrollo de superficies denominadas bioactivas, las cuales son capaces de interaccionar con el hueso que rodea al implante, como ocurre cuando el implante es revestido con carbonato cálcico o bien con flúor. Pero sabemos que dentro del metabolismo óseo, juegan importantes papeles, moléculas, como son la melatonina y la hormona del crecimiento entre otras, las cuales deben de ser tenidas en cuenta a la hora de hablar de osteointegración. Se realiza una breve descripción de la fisiología de ambas moléculas y se valora su aplicación al concepto de superficie bioactiva en implantología.

  19. Superficial Needling Therapy for Tennis Elbow in 40 Cases

    Institute of Scientific and Technical Information of China (English)

    GE Heng-bi; XIAO Yuan-chun

    2003-01-01

    Superficial needling therapy was employed to treat 40 cases of tennis elbow. For the cases of qi and blood stagnation, cupping therapy was added. Thirty-eight cases were cured after one treatment and 2 cases were cured after two treatments.

  20. Frey′s Syndrome as a Sequela of Superficial Parotidectomy

    Directory of Open Access Journals (Sweden)

    Rishi Kumar Bali

    2006-01-01

    The disorder is characterized by unilateral sweating and flushing of facial skin in the area of parotid gland occurring during meals. We present a case of a patient who developed symptoms of Frey Syndrome 4 months after undergoing superficial parotidectomy on left side.

  1. Atypical Presentation of Fibrolipomatous Hamartoma of Superficial Peroneal Nerve.

    Science.gov (United States)

    Dhinsa, Baljinder Singh; Lidder, Surjit; Abbasian, Ali

    2016-01-01

    Fibrolipomatous hamartoma is a rare presentation in the foot. An accurate diagnosis is key, with magnetic resonance imaging findings considered definitive. The management is dependent on the symptoms. We present an atypical presentation of fibrolipomatous hamartoma of the superficial peroneal nerve and discuss the current published data.

  2. Superficial dermatomycoses: a prospective clinico-mycological study

    Directory of Open Access Journals (Sweden)

    Surekha A

    2015-01-01

    Full Text Available Background: Dermatomycoses are more prevalent in India due to favourable climatic conditions, poverty, poor hygiene and overcrowding. Sparse published data are available regarding superficial dermatomycoses from India. Methods: In this prospective study, demographic characteristics, clinical spectrum and risk factors for the development were studied in 198 patients with superficial dermatomycoses. Results: Their mean age was 34.1 ± 15.3 years; there were 108 (54.5% males. Majority of the patients (50.5% belonged to upper-lower socio-economic status (Class IV as per modified Kuppuswamy’s classification. Most of the patients (69.7% had presented with dermatophytoses. Among superficial dermatomy-coses, tinea corporis was the most common (29.3% clinical type. Potassium hydroxide mount was positive in 77.7% and culture was positive in 30.8%. Trichophyton rubrum was the most common species isolated (64%. Multivariable analysis using logistic regression revealed older age (> 50 years to be an independent predictor for the development of tinea corporis (p<0.001. Conclusions: Our observations suggest that superficial dermatomycoses are an important cause of morbidity and should be carefully searched for especially in the elderly so that effective curative treatment can be instituted.

  3. Tattoo removal by superficial dermabrasion. Five-year experience.

    Science.gov (United States)

    Clabaugh, W A

    1975-04-01

    A 5-year clinical experience using superficial dermabrasion to remove tattoos is presented. This procedure can be done quickly in the office with low patient risk. Good pigment removal is obtained with little or no scar formation. Cases are presented which are typical of the 250 tattoos removed in the last 5 years.

  4. The Society of Thoracic Surgeons Clinical Practice Guidelines on Arterial Conduits for Coronary Artery Bypass Grafting.

    Science.gov (United States)

    Aldea, Gabriel S; Bakaeen, Faisal G; Pal, Jay; Fremes, Stephen; Head, Stuart J; Sabik, Joseph; Rosengart, Todd; Kappetein, A Pieter; Thourani, Vinod H; Firestone, Scott; Mitchell, John D

    2016-02-01

    Internal thoracic arteries (ITAs) should be used to bypass the left anterior descending (LAD) artery when bypass of the LAD is indicated (class of recommendation [COR] I, level of evidence [LOE] B). As an adjunct to left internal thoracic artery (LITA), a second arterial graft (right ITA or radial artery [RA]) should be considered in appropriate patients (COR IIa, LOE B). Use of bilateral ITAs (BITAs) should be considered in patients who do not have an excessive risk of sternal complications (COR IIa, LOE B). To reduce the risk of sternal infection with BITA, skeletonized grafts should be considered (COR IIa, LOE B), smoking cessation is recommended (COR I, LOE C), glycemic control should be considered (COR IIa, LOE B), and enhanced sternal stabilization may be considered (COR IIb, LOE C). As an adjunct to LITA to LAD (or in patients with inadequate LITA grafts), use of a RA graft is reasonable when grafting coronary targets with severe stenoses (COR IIa, LOE: B). When RA grafts are used, it is reasonable to use pharmacologic agents to reduce acute intraoperative and perioperative spasm (COR IIa, LOE C). The right gastroepiploic artery may be considered in patients with poor conduit options or as an adjunct to more complete arterial revascularization (COR IIb, LOE B). Use of arterial grafts (specific targets, number, and type) should be a part of the discussion of the heart team in determining the optimal approach for each patient (COR I, LOE C).

  5. Radial head button holing: a cause of irreducible anterior radial head dislocation

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Su-Mi; Chai, Jee Won; You, Ja Yeon; Park, Jina [Seoul National University Seoul Metropolitan Government Boramae Medical Center, Department of Radiology, Seoul (Korea, Republic of); Bae, Kee Jeong [Seoul National University Seoul Metropolitan Government Boramae Medical Center, Department of Orthopedic Surgery, Seoul (Korea, Republic of)

    2016-10-15

    ''Buttonholing'' of the radial head through the anterior joint capsule is a known cause of irreducible anterior radial head dislocation associated with Monteggia injuries in pediatric patients. To the best of our knowledge, no report has described an injury consisting of buttonholing of the radial head through the annular ligament and a simultaneous radial head fracture in an adolescent. In the present case, the radiographic findings were a radial head fracture with anterior dislocation and lack of the anterior fat pad sign. Magnetic resonance imaging (MRI) clearly demonstrated anterior dislocation of the fractured radial head through the torn annular ligament. The anterior joint capsule and proximal portion of the annular ligament were interposed between the radial head and capitellum, preventing closed reduction of the radial head. Familiarity with this condition and imaging findings will aid clinicians to make a proper diagnosis and fast decision to perform an open reduction. (orig.)

  6. A Novel Laboratory Approach for the Demonstration of Hemodynamic Principles: The Arterial Blood Flow Reflection

    Science.gov (United States)

    Djelic, Marina; Mazic, Sanja; Zikic, Dejan

    2013-01-01

    In the frame of a laboratory training course for medicine students, a new approach for laboratory exercises has been applied to teach the phenomena of circulation. The exercise program included measurements of radial artery blood flow waveform for different age groups using a noninvasive optical sensor. Arterial wave reflection was identified by…

  7. Drug-eluting technologies in femoral artery lesions.

    Science.gov (United States)

    Deloose, K; Lauwers, K; Callaert, J; Maene, L; Keirse, K; Verbist, J; Peeters, P; Bosiers, M

    2013-04-01

    The treatment of femoropopliteal lesions has known an important evolution in the last years. An important limitation of current endovascular therapy remains the occurrence of restenosis. In order to minimize restenosis rates, drug eluting technologies are evolving. The use of drug-eluting stents (DES) in coronary arteries shows beneficial results, leading to investigation of DES in femoropopliteal arteries. In this article, we give an overview of current available data on treatment with drug eluting technologies in the superficial femoral artery (SFA). This paper summarizes also the current available data of the use of drug-coated balloons (DCB) in the femoropopliteal tract. Currently, no data are available on the use of DCB in long lesions. A drug eluting bioresorbable scaffold seems to be very promising in coronary arteries. The transfer to the peripheral area is nowadays ongoing. Which technique and device for which lesion and patient requires further investigation to build up a real evidence based SFA treatment strategy.

  8. Investigation of the dynamic diameter deformation of vascular stents during fatigue testing with radial loading

    Directory of Open Access Journals (Sweden)

    Boeck Maria

    2015-09-01

    Full Text Available Endovascular stents are exposed to cyclic loads resulting from daily activity and pulsatile arterial blood pressure. DIN EN ISO 25539-2 and FDA guideline 1545 recommend durability testing, exposing stents to physiological cyclic loads for a 10 year equivalent. For accelerated testing, the simulated deformation has to be comparable to physiological in-vivo deformation. A new test setup is presented to determine diameter deformation of vascular stents during fatigue testing with radial loading.

  9. Transradial artery Palmaz-Schatz coronary stent implantation: results of a single-center feasibility study.

    Science.gov (United States)

    Kiemeneij, F; Laarman, G J

    1995-07-01

    The purpose of this study was to evaluate the feasibility and safety of implantation of unsheathed Palmaz-Schatz coronary stents introduced via the radial artery. Anticoagulation after coronary stenting carries the risk of vascular complications if large-bore guiding catheters are introduced via the femoral artery. These complications have serious local sequelae and lead to suboptimal anticoagulation and prolonged hospitalization. By combining 6F guiding catheters and low-profile dilatation catheters mounted with Palmaz-Schatz stents, smaller vessels such as the radial artery can be selected as the entry site. It is hypothesized that with this technique major puncture site-related complications rarely occur because hemostasis is easily achieved and because no veins and nerves are near this artery. With the double blood supply to the hand, radial artery occlusion is well tolerated. In 100 consecutive patients, stent implantation was attempted for 122 lesions in 104 vessels. Immediately after stent implantation and final angiography, the introducer sheath was withdrawn and intense anticoagulation and mobilization initiated. The radial artery puncture site was studied by two-dimensional and Doppler ultrasound. Successful stent implantation via the radial artery was achieved in 96 patients. In 2 patients, arterial puncture failed but was followed by successful stenting via another entry site. In 1 patient, stent implantation was achieved with a stent delivery system via the femoral artery after a failed attempt to cross the lesion with a bare stent via the radial approach, complicated by groin bleeding requiring transfusions and vascular surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

  10. Radial keratotomy associated endothelial degeneration.

    Science.gov (United States)

    Moshirfar, Majid; Ollerton, Andrew; Semnani, Rodmehr T; Hsu, Maylon

    2012-01-01

    To describe the presentation and clinical course of eyes with a history of radial keratotomy (RK) and varying degrees of endothelial degeneration. Retrospective case series were used. Thirteen eyes (seven patients) were identified with clinical findings of significant guttata and a prior history of RK. The mean age of presentation for cornea evaluation was 54.3 years (range: 38-72 years), averaging 18.7 years (range: 11-33 years) after RK. The presentation of guttata varied in degree from moderate to severe. Best corrected visual acuity (BCVA) ranged from 20/25 to 20/80. All patients had a history of bilateral RK, except one patient who did not develop any guttata in the eye without prior RK. No patients reported a family history of Fuch's Dystrophy. One patient underwent a penetrating keratoplasty in one eye and a Descemet's stripping automated endothelial keratoplasty (DSAEK) in the other eye. RK may induce a spectrum of endothelial degeneration. In elderly patients, the findings of guttata may signify comorbid Fuch's dystrophy in which RK incisions could potentially hasten endothelial decomposition. In these select patients with stable cornea topography and prior RK, DSAEK may successfully treat RK endothelial degeneration.

  11. Computer Simulation of Radial Immunodiffusion

    Science.gov (United States)

    Trautman, Rodes

    1972-01-01

    Theories of diffusion with chemical reaction are reviewed as to their contributions toward developing an algorithm needed for computer simulation of immunodiffusion. The Spiers-Augustin moving sink and the Engelberg stationary sink theories show how the antibody-antigen reaction can be incorporated into boundary conditions of the free diffusion differential equations. For this, a stoichiometric precipitate was assumed and the location of precipitin lines could be predicted. The Hill simultaneous linear adsorption theory provides a mathematical device for including another special type of antibody-antigen reaction in antigen excess regions of the gel. It permits an explanation for the lowered antigen diffusion coefficient, observed in the Oudin arrangement of single linear diffusion, but does not enable prediction of the location of precipitin lines. The most promising mathematical approach for a general solution is implied in the Augustin alternating cycle theory. This assumes the immunodiffusion process can be evaluated by alternating computation cycles: free diffusion without chemical reaction and chemical reaction without diffusion. The algorithm for the free diffusion update cycle, extended to both linear and radial geometries, is given in detail since it was based on gross flow rather than more conventional expressions in terms of net flow. Limitations on the numerical integration process using this algorithm are illustrated for free diffusion from a cylindrical well. PMID:4629869

  12. Combination radial and thrust magnetic bearing

    Science.gov (United States)

    Blumenstock, Kenneth A. (Inventor)

    2002-01-01

    A combination radial and thrust magnetic bearing is disclosed that allows for both radial and thrust axes control of an associated shaft. The combination radial and thrust magnetic bearing comprises a rotor and a stator. The rotor comprises a shaft, and first and second rotor pairs each having respective rotor elements. The stator comprises first and second stator elements and a magnet-sensor disk. In one embodiment, each stator element has a plurality of split-poles and a corresponding plurality of radial force coils and, in another embodiment, each stator element does not require thrust force coils, and radial force coils are replaced by double the plurality of coils serving as an outer member of each split-pole half.

  13. An unusual cause of radial nerve palsy

    Directory of Open Access Journals (Sweden)

    Agrawal Hemendra Kumar

    2014-06-01

    Full Text Available Neurapraxia frequently occurs following traction injury to the nerve intraoperatively, leading to radial nerve palsy which usually recovers in 5-30 weeks. In our case, we had operated a distal one-third of humeral shaft fracture and fixed it with 4.5 mm limited contact dynamic compression plate. The distal neurovascular status of the limb was assessed postoperatively in the recovery room and was found to be intact and all the sensory-motor functions of the radial nerve were normal. On the second postoperative day, following the suction drain removal and dressing, patient developed immediate radial nerve palsy along with wrist drop. We reviewed theliterature and found no obvious cause for the nerve palsy and concluded that it was due to traction injury to the radial nerve while removing the suction drain in negative pressure. Key words: Radial nerve; Humeral fractures; Paralysis; Diaphyses

  14. Radial velocity moments of dark matter haloes

    CERN Document Server

    Wojtak, R; Gottlöber, S; Mamon, G A; Wojtak, Radoslaw; Lokas, Ewa L.; Gottloeber, Stefan; Mamon, Gary A.

    2005-01-01

    Using cosmological N-body simulations we study the radial velocity distribution in dark matter haloes focusing on the lowest-order even moments, dispersion and kurtosis. We determine the properties of ten massive haloes in the simulation box approximating their density distribution by the NFW formula characterized by the virial mass and concentration. We also calculate the velocity anisotropy parameter of the haloes and find it mildly radial and increasing with distance from the halo centre. The radial velocity dispersion of the haloes shows a characteristic profile with a maximum, while the radial kurtosis profile decreases with distance starting from a value close to Gaussian near the centre. We therefore confirm that dark matter haloes possess intrinsically non-Gaussian, flat-topped velocity distributions. We find that the radial velocity moments of the simulated haloes are very well reproduced by the solutions of the Jeans equations obtained for the halo parameters with the anisotropy measured in the simu...

  15. The specific role of gravitational accelerations for arterial adaptations.

    Science.gov (United States)

    Weber, Tobias; Ducos, Michel; Mulder, Edwin; Herrera, Frankyn; Brüggemann, Gert-Peter; Bloch, Wilhelm; Rittweger, Jörn

    2013-02-01

    It is mostly agreed that arterial adaptations occur, among others, in response to changes in mechanical stimuli. Models like bed rest, spinal cord injury, or limb suspension have been applied to study vascular adaptations to unloading in humans. However, these models cannot distinguish the role of muscle contractions and the role of gravitational accelerations for arterial adaptation. The HEPHAISTOS orthosis allows normal ambulation, while it significantly reduces force generation in the lower leg muscles. Eleven subjects wore HEPHAISTOS unilaterally for 56 days and were followed up for another 4 wk. Arterial diameters, intima media thickness (IMT), flow-mediated dilation (FMD), and resting blood flow (BF(rest)) were measured using high-frequency ultrasonography. Arterial adaptations were investigated in the superficial femoral artery (SFA), the brachial artery (BA), and the carotid artery (CA). Mean SFA resting diameter was decreased from 6.57 mm (SD = 0.74 mm) at baseline to 5.77 mm (SD = 0.87 mm) at the end of the intervention (P muscular contractions for arterial diameter adaptations. Moreover, we propose that FMD and wall-to-lumen ratio are unaffected by ambulating with the HEPHAISTOS orthosis, which is suggestive of habitual acceleration profiles in the lower leg constituting an important stimulus for the maintenance of FMD and wall-to-lumen ratio.

  16. Irbesartan improves arterial compliance more than lisinopril

    Science.gov (United States)

    Ali, Khalid; Rajkumar, Chakravarthi; Fantin, Francesco; Schiff, Rebekah; Bulpitt, Christopher J

    2009-01-01

    Background Antihypertensive agents can reduce arterial stiffness. We hypothesized that an angiotensin receptor blocker (ARB) irbesartan and an angiotensin converting enzyme inhibitor (ACEI) lisinopril improved arterial compliance. Methods A randomized, double-blind, double-dummy, controlled crossover trial. Fifteen hypertensive patients, mean age 65.5 ± 8.9 years (mean ± SD) were given irbesartan (150 to 300 mg/day) or lisinopril (10 to 20 mg/day) for 12 weeks and then crossed over for 12 weeks. Pulse wave velocity (PWV) in the carotid-femoral (CF), carotid-radial (CR), and femoral dorsalis-pedis (FD) were measured using a Complior® PWV system. Results After 12 weeks, systolic blood pressure (SBP) decreased from 162.4 ± 12.9 to 134.5 ± 14.8 with irbesartan and to 145.2 ± 25 mmHg with lisinopril. Irbesartan and lisinopril reduced PWV (CF) in the elastic arterial system from 15.1 ± 5 to 13.3 ± 2.6 (p < 0.005) and to 14 ± 4.7 (p < 0.05) m/s respectively (p = 0.345). Irbesartan reduced PWV (CR) and PWV (FD), whereas lisinopril did not. The difference between treatments was significant after SBP adjustment (p = 0.037 for PWV (CR) and p < 0.001 for PWV (FD)). Conclusions Irbesartan improved arterial compliance in elastic and muscular arteries, whereas lisinopril improved it only in elastic arteries. PMID:19649309

  17. Peripheral arterial line (image)

    Science.gov (United States)

    A peripheral arterial line is a small, short plastic catheter placed through the skin into an artery of the arm or leg. The purpose of a peripheral arterial line is to allow continuous monitoring of ...

  18. Arterial Elasticity, Strength, Fatigue, and Endurance in Older Women

    Directory of Open Access Journals (Sweden)

    Gary R. Hunter

    2014-01-01

    Full Text Available Arterial health may influence muscle function in older adults. Study purpose was to determine whether arterial elasticity is related to strength, central and peripheral fatigue, fatigue at rest, and treadmill endurance. Subjects were 91 healthy women aged >60. Treadmill endurance and maximal oxygen uptake (VO2 max were measured. Peripheral and central fatigue for the knee extensors were evaluated using two isometric fatigue tests (one voluntary and one adding electrical stimulation. Arterial elasticity was determined using radial artery pulse wave analysis. Linear multiple regression was used in statistical analysis. Large artery elasticity was associated with central fatigue (P<0.01 and treadmill endurance (P<0.02 after adjusting for VO2 max and knee extension strength. Subjective fatigue at rest was related to large artery elasticity after adjusting for ethnic origin (<0.02. Strength was significantly related to small artery elasticity after adjusting for ethnic origin, leg lean tissue, age, and blood pressure. Arterial elasticity is independently related to strength and fatigue in older women, especially in the central nervous system where arterial elasticity is independently related to perceptions of fatigue at rest and central fatigue. These results suggest that arterial health may be involved with the ability of the central nervous system to activate muscle in older women.

  19. A combined chemo-mechanical approach for aesthetic management of superficial enamel defects

    NARCIS (Netherlands)

    Ardu, S.; Benbachir, N.; Stavridakis, M.; Dietschi, D.L.; Krejci, I.; Feilzer, A.J.

    2009-01-01

    Objective The aim of this article is to describe an easy technique for managing small superficial defects in light to medium fluorosis. Method and materials The proposed technique is based on a selective abrasion of the superficial enamel and a recreation of the superficial macro and micro morpholog

  20. A combined chemo-mechanical approach for aesthetic management of superficial enamel defects

    NARCIS (Netherlands)

    Ardu, S.; Benbachir, N.; Stavridakis, M.; Dietschi, D.L.; Krejci, I.; Feilzer, A.J.

    2009-01-01

    Objective The aim of this article is to describe an easy technique for managing small superficial defects in light to medium fluorosis. Method and materials The proposed technique is based on a selective abrasion of the superficial enamel and a recreation of the superficial macro and micro morpholog

  1. Rugosidad y textura de superficies: experimentos y simulaciones

    Directory of Open Access Journals (Sweden)

    Watson L. Vargas

    2006-01-01

    Full Text Available En este trabajo se aplican algunos elementos de la geometría fractal al estudio y caracterización de la rugosidad superficial. Los materiales bajo estudio consisten en agregados naturales, de amplia aplicación en la industria de la construcción. Se aplican tanto técnicas experimentales basadas en análisis de imágenes como modelos teóricos. En particular se explora el potencial de la lacunaridad –un método de análisis derivado de la geometría fractal, para describir patrones y dispersión espacial. Los resultados ilustran su aplicación en la caracterización de rugosidad superficial. Se discuten igualmente, limitaciones y ventajas de esta aproximación.

  2. Effects of superficial gas velocity on process dynamics in bioreactors

    Science.gov (United States)

    Devi, T. T.; Kumar, B.

    2014-06-01

    Present work analyzes the flow hydrodynamics and mass transfer mechanisms in double Rushton and CD-6 impeller on wide range (0.0075-0.25 m/s) of superficial gas velocity ( v g) in a gas-liquid phase bioreactor by employing computational fluid dynamics (CFD) technique. The volume averaged velocity magnitude and dissipation rate are found higher with increasing superficial gas velocity. Higher relative power draw ( P g/ P 0) is predicted in CD-6 than the Rushton impeller but no significant difference in volume averaged mass transfer coefficient ( k L a) observed between these two types of impeller. The ratio of power draw with mass transfer coefficient has been found higher in CD-6 impeller (25-50 %) than the Rushton impeller.

  3. Movimiento superficial del glaciar rocoso de las Argualas

    Directory of Open Access Journals (Sweden)

    Sanjosé, J. J.

    1995-12-01

    Full Text Available At present the Argualas rock glacier is active and it flows to a surface axial mean velocity of 22,3 cm/year. The flow velocities have been determinated by surveying techniques made between 1991 and 1994. This technic complements the geomorphological observations and deepens in the knov/ledge of the glacier surface dynamics.

    El glaciar rocoso de las Argualas es activo en la actualidad y fluye a una velocidad media axial en superficie de 22.3 cm/año. El flujo se ha determinado median te las técnicas de auscultación topográfica realizadas entre los años 1991 y 1994. Esta técnica ha permitido complementar el análisis geomorfológico, profundizado en el estudio de la dinámica superficial del glaciar.

  4. Endoscopic removal or ablation of oesophageal and gastric superficial tumours.

    Science.gov (United States)

    Deprez, P H; Aouattah, T; Piessevaux, H

    2006-01-01

    Endoscopic mucosal resection was developed in Eastern countries as a curative treatment for superficial carcinomas in the stomach and oesophagus. Experience in Western countries is more recent and limited due to less frequent diagnosis of early gastric cancers compared to the Japanese and Korean populations and to more frequent use of ablation techniques such as argon plasma coagulation and photodynamic therapy in pre-neoplastic lesions and superficial tumours. This review summarizes the respective indications, advantages, disadvantages, limitations and complications of the different ablative and resection techniques in the upper gastrointestinal tract. Several methods are described such as electrocoagulation, argon plasma coagulation, photodynamic therapy, lift and cut resection, cap assisted aspiration and band ligation mucosectomy, and endoscopic submucosal dissection. Local results in more than 170 patients managed with endoscopic resection of oesophageal high grade dysplasia or squamous cell carcinoma and gastric or Barrett's epithelium high grade dysplasia or adenocarcinoma furthermore demonstrate the safety and effectiveness of endoscopic resection practiced in experienced centres.

  5. Causative agents of superficial mycoses in Istanbul, Turkey: retrospective study.

    Science.gov (United States)

    Koksal, Fatma; Er, Emine; Samasti, Mustafa

    2009-09-01

    The aim of the present study was to determine the percentage of agents, which can give rise to superficial fungal infections in Istanbul, Turkey. Between 2000 and 2007, the clinical samples collected from 8,200 patients attending the outpatient Dermatology Clinic at Mihrimahsultan Medical Center were examined by direct microscopy and culture. Pathogen fungi were detected in 5,722 of the patients. Of the isolates were 4,218 (74%) dermatophytes, 1,196 (21%) Candida sp., 170 (3%) Malassezia furfur, and 138 (2%) Trichosporon sp. Among the dermatophytes, Trichophyton sp. was the most common isolate followed by Epidermophyton floccosum (243) and Microsporum sp. Among the Candida species, C. albicans (549) was also frequently found. Onychomycosis was the most prevalent type of infection, followed by tinea pedis, tinea cruris, tinea corporis, and tinea capitis. In conclusion, our study showed that the most common isolated agents from superficial infections were T. rubrum being Candida sp. the second most prevalent.

  6. [Femoral artery pseudoaneurysms encountered in orthopedics and traumatology].

    Science.gov (United States)

    Raherinantenaina, F; Rajaonanahary, T M A; Rakoto Ratsimba, H N

    2015-12-01

    Most published articles regarding orthopedic- and trauma-related femoral artery pseudoaneurysms (FAPs) are case reports in English. Reported cases are often associated with a literature review but actually provide little robust data. We wanted to summarize the current knowledge on diagnostic and therapeutic features of these FAPs. A new case of superficial FAP is described followed by a review of the literature. A bibliographic search was performed online (PubMed, ScinceDirect) from 1964 to 2015 using the descriptors "traumatic femoral pseudoaneurysm, orthopedic surgery, osteochondroma". A total of 64 cases of FAPs was analyzed. There were 50 men with an average age of 40.72±26.45 years old. The most common clinical presentation was painful swelling (34%). Arteriography was the commonest radiological investigation used (63%). The main etiologies were orthopedic injuries (47%), surgery of the upper thigh (30%) and femoral osteochondromas (23%). Arterial injuries included superficial femoral (47%) and profunda femoris artery (50%). The treatment was open surgery (56%) or endovascular repair (36%). Deep femoral artery and its branches were embolized (47%) or ligated (38%). Endovascular stenting was performed in 30% of posttraumatic FAPs. All FAPs relating to osteochondromas were repaired surgically. Postoperative courses were uneventful in 95% of patients. Endovascular embolization is preferred in management of postsurgical FAPs which have usually involved the deep femoral artery. Endovascular stenting graft may be proposed for posttraumatic FAPs, for which the superficial femoral trunk is the most often involved vessel. Surgical repair should be performed when endovascular stenting graft is not feasible. Surgical repair is mandatory for all FAPs secondary to traumatic exostoses. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  7. Novel Integration Radial and Axial Magnetic Bearing

    Science.gov (United States)

    Blumenstock, Kenneth; Brown, Gary

    2000-01-01

    Typically, fully active magnetically suspended systems require one axial and two radial magnetic bearings. Combining radial and axial functions into a single device allows for more compact and elegant packaging. Furthermore, in the case of high-speed devices such as energy storage flywheels, it is beneficial to minimize shaft length to keep rotor mode frequencies as high as possible. Attempts have been made to combine radial and axial functionality, but with certain drawbacks. One approach requires magnetic control flux to flow through a bias magnet reducing control effectiveness, thus resulting in increased resistive losses. This approach also requires axial force producing magnetic flux to flow in a direction into the rotor laminate that is undesirable for minimizing eddy-current losses resulting in rotational losses. Another approach applies a conical rotor shape to what otherwise would be a radial heteropolar magnetic bearing configuration. However, positional non-linear effects are introduced with this scheme and the same windings are used for bias, radial, and axial control adding complexity to the controller and electronics. For this approach, the amount of axial capability must be limited. It would be desirable for an integrated radial and axial magnetic bearing to have the following characteristics; separate inputs for radial and axial control for electronics and control simplicity, all magnetic control fluxes should only flow through their respective air gaps and should not flow through any bias magnets for minimal resistive losses, be of a homopolar design to minimize rotational losses, position related non-linear effects should be minimized, and dependent upon the design parameters, be able to achieve any radial/axial force or power ratio as desired. The integrated radial and axial magnetic bearing described in this paper exhibits all these characteristics. Magnetic circuit design, design equations, and magnetic field modeling results will be presented.

  8. Novel Integrated Radial and Axial Magnetic Bearing

    Science.gov (United States)

    Blumenstock, Kenneth A.; Brown, Gary L.; Powers, Edward I. (Technical Monitor)

    2000-01-01

    Typically, fully active magnetically suspended systems require one axial and two radial magnetic bearings. Combining radial and axial functions into a single device allows for more compact and elegant packaging. Furthermore, in the case of high-speed devices such as energy storage flywheels, it is beneficial to minimize shaft length to keep rotor mode frequencies as high as possible. Attempts have been made to combine radial and axial functionality, but with certain drawbacks. One approach requires magnetic control flux to flow through a bias magnet reducing control effectiveness, thus resulting in increased resistive losses. This approach also requires axial force producing magnetic flux to flow in a direction into the rotor laminate that is undesirable for minimizing eddy-current losses resulting in rotational losses. Another approach applies a conical rotor shape to what otherwise would be a radial heteropolar magnetic bearing configuration. However, positional non-linear effects are introduced with this scheme and the same windings are used for bias, radial, and axial control adding complexity to the controller and electronics. For this approach, the amount of axial capability must be limited. It would be desirable for an integrated radial and axial magnetic bearing to have the following characteristics, separate inputs for radial and axial control for electronics and control simplicity, all magnetic control fluxes should only flow through their respective air gaps and should not flow through any bias magnets for minimal resistive losses, be of a homopolar design to minimize rotational losses, position related non-linear effects should be minimized, and dependent upon the design parameters, be able to achieve any radial/axial force or power ratio as desired. The integrated radial and axial magnetic bearing described in this paper exhibits all these characteristics. Magnetic circuit design, design equations, and analysis results will be presented.

  9. How often should we perform arterial blood gas analysis during thoracoscopic surgery?

    Science.gov (United States)

    Ganter, Michael T; Schneider, Uwe; Heinzelmann, Michel; Zaugg, Michael; Lucchinetti, Eliana; Zollinger, Andreas; Hofer, Christoph K

    2007-12-01

    To continuously measure arterial blood gases (ABGs), to calculate the percentage of anticipated changes over time, and to develop recommendations for sampling frequencies of arterial blood gases in patients undergoing thoracoscopic surgery. Prospective, observational clinical trial. University hospital. 43 consecutive elective patients undergoing thoracoscopic surgery with one-lung ventilation. A Paratrend 7 probe for continuous arterial partial pressure of oxygen and arterial partial pressure of carbon dioxide measurement was introduced through a radial artery cannula in the awake patient before surgery. Data were collected throughout the procedure until patients left the operating room. Afterward, time courses of arterial blood gas values were transformed into frequency space by fast Fourier transform analysis, and the expected deviations in arterial blood gases were calculated over time. Forty-three consecutive patients undergoing thoracoscopic surgery were included, and arterial blood gas values were measured during a total of 141.5 h. Critical arterial partial pressure of oxygen values arterial partial pressure of oxygen and arterial partial pressure of carbon dioxide time courses in all patients. It takes only 5, 10, or 20 minutes for the arterial partial pressure of oxygen to change 10%, 20%, or 40%, respectively (95% confidence). Current standards to monitor arterial blood gases are not sufficient to detect and prevent hypoxemic events during thoracoscopic surgery with one-lung ventilation. Intermittent arterial blood gas analyses must be performed more frequently, up to every 10 minutes, to detect changes of 20% in arterial partial pressure of oxygen.

  10. Measurement of the angle of superficial tension by images

    Science.gov (United States)

    Yanez M., Javier; Alonso R., Sergio

    2006-02-01

    When a liquid is deposited on a surface, this one form a certain angle with respect to the surface, where depending on its value, it will conclude that so hard it is his adhesion with the surface. By means of the analysis of images we looked for to measure this angle of superficial tension. In order to make this measurement, we propose a technique by means of projective transformations and one method of regression to estimation parameters to conic fitting.

  11. Cervical Spinal Meningeal Melanocytoma Presenting as Intracranial Superficial Siderosis

    Directory of Open Access Journals (Sweden)

    Savitha Srirama Jayamma

    2015-01-01

    Full Text Available Meningeal melanocytoma is a rare pigmented tumor of the leptomeningeal melanocytes. This rare entity results in diagnostic difficulty in imaging unless clinical and histopathology correlation is performed. In this case report, we describe a case of meningeal melanocytoma of the cervical region presenting with superficial siderosis. Extensive neuroradiological examination is necessary to locate the source of the bleeding in such patients. Usually, the patient will be cured by the complete surgical excision of the lesion.

  12. Superficial urinary bladder tumors treatment results: A 10-year experience

    Directory of Open Access Journals (Sweden)

    Stanković Jablan

    2007-01-01

    Full Text Available Background/Aim. The most common urinary bladder tumors are superficial tumors. Due to their tension to relapse and progress towards deeper layers after surgical therapy, an adequate therapy significantly contributed to the improvement of the results of urinary bladder tumors treatment. Staging and gradus of the tumor, presence of the carcinoma in situ (CIS or relapses significantly influenced the choice of the therapy. The aim of this study was to ascertain the effectiveness of the intravesicelly applied BCG (Bacille Colmette - Guerin vaccine or chemiotherapy in the prevention of the relapses and further progression of superficial urinary bladder tumors. Methods. All of the diagnosed superficial tumors of bladder were removed by transurethral resection (TUR. After receiving the patohistological finding they were subjected to adjuvant therapy, immune BCG vaccine or chemiotherapy (epirubicin, doxorubicin, mitomycin-C. The third group did not accept adjuvant therapy, but had regularly scheduled cystoscopic controls. The appearance of relapses, progression of stage and grades of the tumor, as well as possible unwanted effects of adjuvant therapy were registered. Results. The applied immunotherapy (BCG influenced decreased tumor relapses (7% and statistically important difference between patients who had taken adjuvant chemotherapy (relapses 18.4% and those without this therapy was acknowledged. Grades of tumor did not show statistically significant difference on tumor relapse. A significantly longer period of time in the appearance of tumor relapse after BCG (29.33 months, had significant importance comparing to chemio (9.44 months or non-taken adjuvant therapy (9.84 months. Very small number of unwanted effects suggested an obligatory undertaking adjuvant therapy after TUR of superficial tumors. Conclusion. A significant decrease of relapses as well as avoidance of further progression of urinary bladder tumors, has introduced adjuvant therapy in

  13. Transient superficial peroneal nerve palsy after anterior cruciate ligament reconstruction

    OpenAIRE

    Majed Alrowaili

    2016-01-01

    A 19-year-old male subject was diagnosed with medial meniscal, lateral meniscal and anterior cruciate ligament (ACL) tear. The symptoms did not subside after 4 months of physical therapy, and he underwent arthroscopic partial medial and lateral meniscectomy and ACL reconstruction. Immediately after the patient woke up from general anesthesia, he started experience loss of sensation in the area of superficial peroneal nerve with inverted dorsiflexion of foot and ankle. Instantly, the bandage a...

  14. Roughening dynamics of spontaneous radial imbibition

    CERN Document Server

    Chen, Yong-Jun

    2015-01-01

    We performed an experimental observation on the spontaneous imbibition of water in a porous media in a radial Hele-Shaw cell and confirmed Washburn's law, where r is distance and t is time. Spontaneous imbibition with a radial interface window followed scaling dynamics when the front invaded into the porous media. We found a growth exponent (\\b{eta}=0.6) that was independent of the pressure applied at the liquid inlet. The roughness exponent decreased with an increase in pressure. The roughening dynamics of two dimensional spontaneous radial imbibition obey Family-Vicsek scaling, which is different from that with a one-dimensional planar interface window.

  15. Spectral Distortion in a Radially Inhomogeneous Cosmology

    CERN Document Server

    Caldwell, R R

    2013-01-01

    The spectral distortion of the cosmic microwave background blackbody spectrum in a radially inhomogeneous spacetime, designed to exactly reproduce a LambdaCDM expansion history along the past light cone, is shown to exceed the upper bound established by COBE-FIRAS by a factor of approximately 3000. This simple observational test helps uncover a slew of pathological features that lie hidden inside the past light cone, including a radially contracting phase at decoupling and, if followed to its logical extreme, a naked singularity at the radially inhomogeneous Big Bang.

  16. Spectral distortion in a radially inhomogeneous cosmology

    Science.gov (United States)

    Caldwell, R. R.; Maksimova, N. A.

    2013-11-01

    The spectral distortion of the cosmic microwave background blackbody spectrum in a radially inhomogeneous space-time, designed to exactly reproduce a ΛCDM expansion history along the past light cone, is shown to exceed the upper bound established by COBE-FIRAS by a factor of approximately 3700. This simple observational test helps uncover a slew of pathological features that lie hidden inside the past light cone, including a radially contracting phase at decoupling and, if followed to its logical extreme, a naked singularity at the radially inhomogeneous big bang.

  17. Discontinuity effects on radial cavity transmission lines

    Energy Technology Data Exchange (ETDEWEB)

    Seidel, D.B.

    1979-04-01

    Pulse propagation in radial cavity transmission lines such as those found on a radial line accelerator is considered. Specifically, the effects of discontinuities along the line are examined in detail. It is found that previous analyses of such effects have been incorrect, and here two alternate solution techniques are presented. Depending upon the parameters of such a radial line, the discontinuity effects considered here may or may not be significant; however, if they are significant, it is recommended that the alternate solution techniques presented here be used.

  18. Accuracy of continuous noninvasive arterial pressure monitoring in living-liver donors during transplantation.

    Science.gov (United States)

    Araz, Coskun; Zeyneloglu, Pinar; Pirat, Arash; Veziroglu, Nukhet; Camkiran Firat, Aynur; Arslan, Gulnaz

    2015-04-01

    Hemodynamic monitoring is vital during liver transplant surgeries because distinct hemodynamic changes are expected. The continuous noninvasive arterial pressure (CNAP) monitor is a noninvasive device for continuous arterial pressure measurement by a tonometric method. This study compared continuous noninvasive arterial pressure monitoring with invasive direct arterial pressure monitoring in living-liver donors during transplant. There were 40 patients analyzed while undergoing hepatic lobectomy for liver transplant. Invasive pressure monitoring was established at the radial artery and continuous noninvasive arterial pressure monitoring using a finger sensor was recorded simultaneously from the contralateral arm. Systolic, diastolic, and mean arterial pressures from the 2 methods were compared. Correlation between the 2 methods was calculated. A total of 5433 simultaneous measurements were obtained. For systolic arterial blood pressure, 55% continuous noninvasive arterial pressure measurements were within 10% direct arterial measurement; the correlation was 0.479, continuous noninvasive arterial pressure bias was -0.3 mm Hg, and limits of agreement were 32.0 mm Hg. For diastolic arterial blood pressure, 50% continuous noninvasive arterial pressure measurements were within 10% direct arterial measurement; the correlation was 0.630, continuous noninvasive arterial pressure bias was -0.4 mm Hg, and limits of agreement were 21.1 mm Hg. For mean arterial blood pressure, 60% continuous noninvasive arterial pressure measurements were within 10% direct arterial measurement; the correlation was 0.692, continuous noninvasive arterial pressure bias was +0.4 mm Hg, and limits of agreement were 20.8 mm Hg. The 2 monitoring techniques did not show acceptable agreement. Our results suggest that continuous noninvasive arterial pressure monitoring is not equivalent to invasive arterial pressure monitoring in donors during living-donor liver transplant.

  19. Glans-preserving surgery for superficial penile cancer.

    Science.gov (United States)

    Li, Pengchao; Song, Ninghong; Yin, Changjun; Zhang, Wei; Li, Ji