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Zhang P, Yan SJ, Hu J, Liu HP, Xia W, Yang M, Kuang QH, Shi KL, Fu MZ, Gao CL, Xia ZK. EXPRESS: Clinical Outcomes and Clinico-Pathological Correlations in Children with MPO-ANCA-Associated Glomerulonephritis Showing Renal Arteritis. J Investig Med 2024:10815589241248073. [PMID: 38594222 DOI: 10.1177/10815589241248073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
OBJECTIVE The aim of this study was to evaluate the clinical features, pathological characteristics and prognosis in myeloperoxidase (MPO)-antineutrophil cytoplasmic antibodies-associated glomerulonephritis (AAGN) with renal arteritis. METHODS The study involved 97 children from five pediatric clinical centers with MPO-AAGN who exhibited distinct clinical features. The patients were divided into AAGN-A+ and AAGN-A-, based on the presence or absence of arteritis, and the disparities in clinical, histopathological characteristics, and prognosis between the two groups were evaluated. RESULT In contrast to the AAGN-A- group, the children in the AAGN-A+ group exhibited more pronounced clinical symptoms and renal pathological injury. Arteritis positively moderately correlated with the serum creatinine (Scr), IL-6 (interleukin-6), urinary neutrophil gelatinase-associated lipocalin (NGAL), negatively moderately correlated with serum complement C3. The renal survival rate in the AAGN-A+ group was significantly poorer than AAGN-A- group (χ2=4.278, P=0.039). Arteritis showed a good predictive value for end-stage kidney disease (ESKD), and C3 deposition and arteritis were independent risk factors for the development of ESKD in children with MPO-AAGN. CONCLUSION Arteritis is a significant pathological change observed in children with MPO-AAGN, and the formation of arteritis may be related to the inflammatory response and activation of the complement system.
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Affiliation(s)
- Pei Zhang
- Department of Pediatrics, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Shi-Jun Yan
- Department of Pediatric, Qinhuai Medical District, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Jian Hu
- Department of Pediatrics, The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University, Huai'an, China
| | - Hai-Peng Liu
- Department of Emergency, Xuzhou Children's Hospital, Affiliated to Xuzhou Medical University, Xuzhou, China
| | - Wei Xia
- Department of pediatric nephrology, BenQ Medical Center,The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, China
| | - Meng Yang
- Institute of Literature in Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Qian-Huining Kuang
- Department of Pediatrics, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Kai-Li Shi
- Department of Pediatrics, Jinling Hospital, Nanjing Medical University, Nanjing, China
| | - Meng-Zhen Fu
- Department of Pediatrics, Jinling Hospital, Nanjing Medical University, Nanjing, China
| | - Chun-Lin Gao
- Department of Pediatrics, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Zheng-Kun Xia
- Department of Pediatrics, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
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Pruijssen JT, Schreuder FHBM, Wilbers J, Kaanders JHAM, de Korte CL, Hansen HHG. Performance evaluation of commercial and non-commercial shear wave elastography implementations for vascular applications. Ultrasonics 2024; 140:107312. [PMID: 38599075 DOI: 10.1016/j.ultras.2024.107312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 03/25/2024] [Accepted: 04/01/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND Shear wave elastography (SWE) is mainly used for stiffness estimation of large, homogeneous tissues, such as the liver and breasts. However, little is known about its accuracy and applicability in thin (∼0.5-2 mm) vessel walls. To identify possible performance differences among vendors, we quantified differences in measured wave velocities obtained by commercial SWE implementations of various vendors over different imaging depths in a vessel-mimicking phantom. For reference, we measured SWE values in the cylindrical inclusions and homogeneous background of a commercial SWE phantom. Additionally, we compared the accuracy between a research implementation and the commercially available clinical SWE on an Aixplorer ultrasound system in phantoms and in vivo in patients. METHODS SWE measurements were performed over varying depths (0-35 mm) using three ultrasound machines with four ultrasound probes in the homogeneous 20 kPa background and cylindrical targets of 10, 40, and 60 kPa of a multi-purpose phantom (CIRS-040GSE) and in the anterior and posterior wall of a homogeneous polyvinyl alcohol vessel-mimicking phantom. These phantom data, along with in vivo SWE data of carotid arteries in 23 patients with a (prior) head and neck neoplasm, were also acquired in the research and clinical mode of the Aixplorer ultrasound machine. Machine-specific estimated phantom stiffness values (CIRS phantom) or wave velocities (vessel phantom) over all depths were visualized, and the relative error to the reference values and inter-frame variability (interquartile range/median) were calculated. Correlations between SWE values and target/vessel wall depth were explored in phantoms and in vivo using Spearman's correlations. Differences in wave velocities between the anterior and posterior arterial wall were assessed with Wilcoxon signed-rank tests. Intra-class correlation coefficients were calculated for a sample of ten patients as a measure of intra- and interobserver reproducibility of SWE analyses in research and clinical mode. RESULTS There was a high variability in obtained SWE values among ultrasound machines, probes, and, in some cases, with depth. Compared to the homogeneous CIRS-background, this variation was more pronounced for the inclusions and the vessel-mimicking phantom. Furthermore, higher stiffnesses were generally underestimated. In the vessel-mimicking phantom, anterior wave velocities were (incorrectly) higher than posterior wave velocities (3.4-5.6 m/s versus 2.9-5.9 m/s, p ≤ 0.005 for 3/4 probes) and remarkably correlated with measurement depth for most machines (Spearman's ρ = -0.873-0.969, p < 0.001 for 3/4 probes). In the Aixplorer's research mode, this difference was smaller (3.3-3.9 m/s versus 3.2-3.6 m/s, p = 0.005) and values did not correlate with measurement depth (Spearman's ρ = 0.039-0.659, p ≥ 0.002). In vivo, wave velocities were higher in the posterior than the anterior vessel wall in research (left p = 0.001, right p < 0.001) but not in clinical mode (left: p = 0.114, right: p = 0.483). Yet, wave velocities correlated with vessel wall depth in clinical (Spearman's ρ = 0.574-0.698, p < 0.001) but not in research mode (Spearman's ρ = -0.080-0.466, p ≥ 0.003). CONCLUSIONS We observed more variation in SWE values among ultrasound machines and probes in tissue with high stiffness and thin-walled geometry than in low stiffness, homogeneous tissue. Together with a depth-correlation in some machines, where carotid arteries have a fixed location, this calls for caution in interpreting SWE results in clinical practice for vascular applications.
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Affiliation(s)
- Judith T Pruijssen
- Medical Ultrasound Imaging Center (MUSIC), Department of Medical Imaging/Radiology, Radboud university medical center, Nijmegen, the Netherlands.
| | - Floris H B M Schreuder
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Joyce Wilbers
- Center of Expertise for Cancer Survivorship, Radboud university medical center, Nijmegen, the Netherlands
| | - Johannes H A M Kaanders
- Department of Radiation Oncology, Radboud university medical center, Nijmegen, the Netherlands
| | - Chris L de Korte
- Medical Ultrasound Imaging Center (MUSIC), Department of Medical Imaging/Radiology, Radboud university medical center, Nijmegen, the Netherlands; Physics of Fluid Group, MESA+ Institute for Nanotechnology, and MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, the Netherlands
| | - Hendrik H G Hansen
- Medical Ultrasound Imaging Center (MUSIC), Department of Medical Imaging/Radiology, Radboud university medical center, Nijmegen, the Netherlands
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Yarlagadda S, Mandava A, Fonseca D, Koppula V. Mucoepidermoid Carcinoma of the Lung in Intralobar Bronchopulmonary Sequestration. Radiol Cardiothorac Imaging 2024; 6:e230365. [PMID: 38602467 DOI: 10.1148/ryct.230365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Affiliation(s)
- Sneha Yarlagadda
- From the Departments of Radiodiagnosis (S.Y., A.M., V.K.) and Pathology and Laboratory Medicine (D.F.), Basavatarakam Indo American Cancer Hospital & Research Institute, Road No. 10, Banjara Hills, Hyderabad, Telangana 500034, India
| | - Anitha Mandava
- From the Departments of Radiodiagnosis (S.Y., A.M., V.K.) and Pathology and Laboratory Medicine (D.F.), Basavatarakam Indo American Cancer Hospital & Research Institute, Road No. 10, Banjara Hills, Hyderabad, Telangana 500034, India
| | - Daphne Fonseca
- From the Departments of Radiodiagnosis (S.Y., A.M., V.K.) and Pathology and Laboratory Medicine (D.F.), Basavatarakam Indo American Cancer Hospital & Research Institute, Road No. 10, Banjara Hills, Hyderabad, Telangana 500034, India
| | - Veeraiah Koppula
- From the Departments of Radiodiagnosis (S.Y., A.M., V.K.) and Pathology and Laboratory Medicine (D.F.), Basavatarakam Indo American Cancer Hospital & Research Institute, Road No. 10, Banjara Hills, Hyderabad, Telangana 500034, India
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Ganz JC. Anatomy after Hippocrates. Prog Brain Res 2024; 284:49-52. [PMID: 38609294 DOI: 10.1016/bs.pbr.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
This brief chapter has a single purpose which is not directly related to cranial surgery. However, between Hippocrates and Celsus and Galen a number of improvements in the understanding of anatomy had been discovered and this chapter briefly outlines the nature and importance of these advances.
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Affiliation(s)
- Jeremy C Ganz
- Department of Neurosurgery, Haukeland University Hospital, Bergen, Norway.
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Suyamburajan S, Bhat R, Rao R, Srilatha Parampalli S. Simultaneous Presentation of Takayasu Arteritis and Crohn's Disease in a Middle-Aged Patient: Are they two sides of the same coin? BMJ Case Rep 2024; 17:e259110. [PMID: 38531553 DOI: 10.1136/bcr-2023-259110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024] Open
Abstract
Autoimmune disorders have a wide spectrum of symptoms, often with multiorgan involvement. Multiple autoimmune disorders also often occur concurrently in the same patient. These two possibilities must be distinguished in patients with multiorgan involvement to ensure early diagnosis and treatment. Here, we report a case of a previously healthy man who presented with simultaneous Takayasu arteritis and Crohn's disease. He presented with heart failure with reduced ejection fraction and severe aortic regurgitation. An echocardiogram demonstrated a greatly dilated aorta, and a diagnosis of Takayasu arteritis was made, confirmed with CT aortogram. Inpatient treatment was begun, but the patient subsequently developed bloody diarrhoea a few days after admission. Colonoscopy done to locate the source of bleeding showed colonic ulcers; a biopsy confirmed a diagnosis of Crohn's disease. The patient was successfully managed with medical management of heart failure, steroids, mesalamine and azathioprine, and has been in remission for the last 2 years.
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Affiliation(s)
| | - Rama Bhat
- General Medicine, Kasturba Medical College, Manipal, Karnataka, India
| | - Raghavendra Rao
- General Medicine, Kasturba Medical College, Manipal, Karnataka, India
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Yang F, Shan T, Li C, Sun Y, Shen R, Gao C, Wang Z. The Origin and Course of the Blood Supply to the Lower Eyelid Orbital Fat: Anatomical Study and Clinical Significance. Aesthetic Plast Surg 2024:10.1007/s00266-024-03991-6. [PMID: 38528126 DOI: 10.1007/s00266-024-03991-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 02/29/2024] [Indexed: 03/27/2024]
Abstract
PURPOSE The aim of this study is to investigate the origin and course of the orbital fat arterial supply in the lower eyelid using traditional anatomy and three-dimensional computed tomography (CT). METHODS Twenty-seven cadaver heads were infused with mercury sulfide contrast media through the ophthalmic artery, maxillary artery, transverse facial artery, and facial artery. CT images were obtained after contrast agent injection, three-dimensional CT scans were reconstructed, and the cadaver heads were dissected. RESULTS Forty-five qualified hemifaces showed that the orbital fat arterial supply in the lower eyelid originates primarily from the inferomedial muscular trunk (IMT) of the ophthalmic artery and the orbital branch of the infraorbital artery. The medial branch of the IMT terminated at the medial fat pad (35.6%) or the orbital floor (64.4%). The lateral branch terminated at the inferior oblique (IO) muscle (28.9%) or the central and lateral fat pads (17.8%). In 53.3%, the lateral branch extended to the anterior part of the lateral fat pad and terminated in the orbital wall or the zygomaticoorbital foramina. The orbital branch of the infraorbital artery coursed between the orbital floor and the orbital fat, providing supply to the IO muscle, inferior rectus (IR) muscle, nasolacrimal duct, and orbital fat. CONCLUSION This study elucidated the origin and course of the orbital fat arterial supply in the lower eyelid, which may help to avoid reducing the blood supply of the orbital fat pedicles during surgery. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Fan Yang
- The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, Shandong Province, China
| | - Tao Shan
- School of Basic Medicine, Qingdao University, Qingdao, Shandong Province, China
| | - Cong Li
- The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, Shandong Province, China
| | - Yu Sun
- The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, Shandong Province, China
| | - Ruowu Shen
- School of Basic Medicine, Qingdao University, Qingdao, Shandong Province, China
| | - Chuanping Gao
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, Shandong Province, China
| | - Zhiguo Wang
- Department of Burn and Plastic Surgery, The Affiliated Hospital of Qingdao University, Qingdao University, No. 16, Jiangsu Road, Qingdao, Shandong Province, China.
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Mehra R, Swain P, Aggarwal R, Balasubramaniam D. Complex aortic-arch pseudoaneurysm with aorto-innominate vein fistula in a case of traumatic chest injury. BMJ Case Rep 2024; 17:e260184. [PMID: 38521516 PMCID: PMC10961578 DOI: 10.1136/bcr-2024-260184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2024] Open
Abstract
A patient in his late 30s presented with issues of retrosternal chest pain and palpitations. He had sustained a splinter injury to the left hemithorax a year ago for which he had been managed with a tube thoracostomy. During subsequent evaluations, he was found to have atrial fibrillations and a CT angiography revealed an arch of the aorta pseudoaneurysm with a fistulous communication with the innominate vein, which being a rare condition has no established treatment protocols. Endovascular salvage of the condition required an aortic Ishimaru zone 2 deployment of the thoracic endovascular aortic repair stent graft to provide an adequate landing zone. The elective left subclavian artery revascularisation was obtained by a left carotid artery to left subclavian artery bypass. Post procedure there was complete exclusion of the pseudoaneurysm sac, and the fistulous aorto-venous communication inflow tract. The patient recuperated well and has returned to full active duties.
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Affiliation(s)
- Rohit Mehra
- Department of Vascular and Endovascular Surgery, Command Hospital (Southern Command), Pune, Maharashtra, India
| | - Pranati Swain
- Department of Vascular and Endovascular Surgery, Command Hospital (Southern Command), Pune, Maharashtra, India
| | - Rohit Aggarwal
- Department Radiodiagnosis, Command Hospital (Southern Command), Pune, Maharashtra, India
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Kern AY, Kreinin Y, Charle L, Epshrein M, Korin N, Mangin PH. A macrofluidic model to investigate the intrinsic thrombogenicity of clinically used stents and develop less thrombogenic stents. Heliyon 2024; 10:e26550. [PMID: 38463800 PMCID: PMC10920166 DOI: 10.1016/j.heliyon.2024.e26550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 02/08/2024] [Accepted: 02/15/2024] [Indexed: 03/12/2024] Open
Abstract
Microfluidic blood flow models have been instrumental to study the functions of blood platelets in hemostasis and arterial thrombosis. However, they are not suited to investigate the interactions of platelets with the foreign surfaces of medical devices such as stents, mainly because of the dimensions and geometry of the microfluidic channels. Indeed, the channels of microfluidic chips are usually rectangular and rarely exceed 50 to 100 μm in height, impairing the insertion of clinically used stents. To fill this gap, we have developed an original macrofluidic flow system, which precisely reproduces the size and geometry of human vessels and therefore represents a biomimetic perfectly suited to insert a clinical stent and study its interplay with blood cells. The system is a circular closed loop incorporating a macrofluidic flow chamber made of silicone elastomer, which can mimic the exact dimensions of any human vessel, including the coronary, carotid or femoral artery. These flow chambers allow the perfect insertion of stents as they are implanted in patients. Perfusion of whole blood anticoagulated with hirudin through the device at relevant flow rates allows one to observe the specific accumulation of fluorescently labeled platelets on the stent surface using video-microscopy. Scanning electron microscopy revealed the formation of very large thrombi composed of tightly packed activated platelets on the stents.
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Affiliation(s)
- Axelle Y. Kern
- University of Strasbourg, INSERM, EFS Grand-Est, BPPS UMR_S1255, FMTS, F-67065 Strasbourg, France
| | - Yevgeniy Kreinin
- Department of Biomedical Engineering Technion, Israel Institute of Technology, Haifa, Israel
| | - Lise Charle
- University of Strasbourg, INSERM, EFS Grand-Est, BPPS UMR_S1255, FMTS, F-67065 Strasbourg, France
| | - Mark Epshrein
- Department of Biomedical Engineering Technion, Israel Institute of Technology, Haifa, Israel
| | - Netanel Korin
- Department of Biomedical Engineering Technion, Israel Institute of Technology, Haifa, Israel
| | - Pierre H. Mangin
- University of Strasbourg, INSERM, EFS Grand-Est, BPPS UMR_S1255, FMTS, F-67065 Strasbourg, France
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Nagpal R, Lalani K, Ramachandran P. Giant coronary sinus aneurysm: an incidental discovery in a case of acute coronary syndrome. BMJ Case Rep 2024; 17:e258727. [PMID: 38479829 PMCID: PMC10941150 DOI: 10.1136/bcr-2023-258727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2024] Open
Abstract
Coronary sinus (CS) anomalies, although infrequent, are increasingly diagnosed with advances in interventional procedures and imaging techniques. Most cases are asymptomatic and incidentally diagnosed. We present a case of an elderly male without comorbidities who presented with acute angina. Coronary catheterisation revealed a double-vessel disease, but incidentally, sequential angiograms captured contrast filling in the levophase of CS, revealing a giant CS. Primary percutaneous angioplasty of the right coronary artery was performed successfully. Echocardiography confirmed the aneurysm, and a CT scan showed an aneurysmally dilated CS and other coronary veins alongside a normal-sized persistent left superior vena cava draining to the right atrium through CS. CS aneurysms may lead to complications such as thrombosis, embolic events, arrhythmias and heart failure, stressing the importance of vigilant monitoring and timely intervention. This case underscores the significance of recognising CS anomalies in cardiac procedures, even when asymptomatic, for proper management.
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Affiliation(s)
- Raghav Nagpal
- Department of Cardiology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Kanhai Lalani
- Department of Cardiology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Padmakumar Ramachandran
- Department of Cardiology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Di C, Wang Q, Wu Y, Lin W. Treatment of accidental puncture of the left subclavian artery and ongoing haemorrhage with vascular stenting. BMJ Case Rep 2024; 17:e258432. [PMID: 38417931 PMCID: PMC10900311 DOI: 10.1136/bcr-2023-258432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024] Open
Abstract
A man in his 60s was admitted for radiofrequency catheter ablation (RFCA) as a treatment for atrial fibrillation. A decapolar catheter (Synaptic Medical, Beijing, China) was inserted into the coronary sinus via the left subclavian vein. Two hours after RFCA, the patient presented new symptoms of cough, mild haemoptysis, mild dyspnoea and mild chest discomfort. Contrast-enhanced CT showed a mediastinal haematoma with contrast medium extravasation at the interlobular fissure outside the parietal pleura and mild-moderate pericardial effusion. Active left subclavian artery bleeding, rather than venous bleeding due to superior vena cava perforation, was finally diagnosed. Ongoing haemorrhage conservative treatment with red cell concentrate and intravenous fluid (normal saline) replacement may lead to compression of the mediastinum, and a covered stent was used to treat this iatrogenic complication.
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Affiliation(s)
- Chengye Di
- First Department of Cardiology, TEDA International Cardiovascular Hospital, Tianjin, China
- Cardiovascular Institute, Tianjin University, Tianjin, China
- College of Clinical Cardiology, Tianjin Medical University, Tianjin, China
| | - Qun Wang
- First Department of Cardiology, TEDA International Cardiovascular Hospital, Tianjin, China
- Cardiovascular Institute, Tianjin University, Tianjin, China
- College of Clinical Cardiology, Tianjin Medical University, Tianjin, China
| | - Yanxi Wu
- First Department of Cardiology, TEDA International Cardiovascular Hospital, Tianjin, China
- Cardiovascular Institute, Tianjin University, Tianjin, China
- College of Clinical Cardiology, Tianjin Medical University, Tianjin, China
| | - Wenhua Lin
- First Department of Cardiology, TEDA International Cardiovascular Hospital, Tianjin, China
- Cardiovascular Institute, Tianjin University, Tianjin, China
- College of Clinical Cardiology, Tianjin Medical University, Tianjin, China
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Korim F, Kuricová M, Vdoviaková K, Krešáková L. Fascinating wonderful network: Rete mirabile of the maxillary artery in cats - minireview. Vet Res Commun 2024; 48:11-18. [PMID: 37525064 PMCID: PMC10811120 DOI: 10.1007/s11259-023-10181-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 07/19/2023] [Indexed: 08/02/2023]
Abstract
Cats are one of the most common companion animals, and they differ from dogs in several important ways. Considering the central importance of anatomy in high-quality medicine, the treatment of the feline mandible, mostly during intraoral procedures requiring general anaesthesia, has many important features. In cats, the major artery of the brain is the maxillary artery that forms unique structure - the rete mirabile. The rete mirabile is a plexus like vascular structure that lies extracranially and communicates with brain arterial circle through the orbital fissure. The development of the brain vasculature is different in cats, and it includes obliteration mechanisms of the internal carotid artery. The course of the maxillary artery that forms the rete mirabile has a strong relationship to the angular process of the mandible. Emphasis should be placed on manipulation with the feline mandible, especially during open-mouth procedures, as mistakes can lead to blindness, deafness, and central neurological disorders due to compression of the maxillary artery by the angular process of the mandible. This paper focuses on the anatomy and function of the blood supply to the brain, which is very specific in domestic cats and other felids.
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Affiliation(s)
- Filip Korim
- Department of Morphological Disciplines, University of Veterinary Medicine and Pharmacy in Košice, Komenského 73, Košice, 041 81, Slovak Republic.
| | - Mária Kuricová
- Small Animal Clinic, University Veterinary Hospital, University of Veterinary Medicine and Pharmacy in Košice, Komenského 73, Košice, 041 81, Slovak Republic
| | - Katarína Vdoviaková
- Department of Morphological Disciplines, University of Veterinary Medicine and Pharmacy in Košice, Komenského 73, Košice, 041 81, Slovak Republic
| | - Lenka Krešáková
- Department of Morphological Disciplines, University of Veterinary Medicine and Pharmacy in Košice, Komenského 73, Košice, 041 81, Slovak Republic
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Suzuki M, Hojo M, Sugiyama H. Idiopathic multiple bronchial artery aneurysms and racemose haemangioma without symptoms. BMJ Case Rep 2024; 17:e258606. [PMID: 38176756 PMCID: PMC10773295 DOI: 10.1136/bcr-2023-258606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024] Open
Affiliation(s)
- Manabu Suzuki
- Respiratory Medicine, National Center for Global Health and Medicine Hospital, Shinjuku-ku, Japan
| | - Masayuki Hojo
- Respiratory Medicine, National Center for Global Health and Medicine Hospital, Shinjuku-ku, Japan
| | - Haruhito Sugiyama
- Respiratory Medicine, National Center for Global Health and Medicine Hospital, Shinjuku-ku, Japan
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Qin M, Liu M, Huang R, Gong M, Huang H, Wei X, Wei H, Lu W, Ding K. Preoperative T-staging of Colorectal Cancer by Dual-energy Computed Tomography: A Retrospective Study. Curr Med Imaging 2024; 20:1-7. [PMID: 38389349 DOI: 10.2174/0115734056260218231107111544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/18/2023] [Accepted: 09/23/2023] [Indexed: 02/24/2024]
Abstract
BACKGROUND Preoperative T-staging is essential for planning optimal treatment and care for colorectal cancer (CRC). OBJECTIVE To evaluate the accuracy of Dual-energy CT (DECT) in preoperative T-staging of CRC. METHODS The clinical data and DECT images of 37 patients with 39 CRC lesions were retrospectively analyzed. The performance of the DECT quantitative parameters in CRC T-staging was evaluated. Postoperative pathologic results were used as a gold standard. Receiver operating characteristic curves were used to assess the diagnostic efficacy of DECT parameters. P < 0.05 was deemed significant. RESULTS The overall accuracy of T-staging by DECT was 76.9%. The DECT parameters were significantly different between the T3 pericolic fat stranding, T4a pericolic fat stranding, and normal pericolic fat stranding. Arterial phase λHU had the best diagnostic performance with a cut-off value of ≥0.967, resulting in a 70.6% sensitivity and a 100% specificity in differentiating between T3 and T4a stages of CRC. CONCLUSION DECT has high accuracy in the T-staging of CRC. Arterial phase λHU has the best diagnostic performance in differentiating between T3 and T4a stages of CRC.
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Affiliation(s)
- Mi Qin
- Department of Radiology, Guangxi Medical University Third Affiliated Hospital, Nanning 530031, China
| | - Manrong Liu
- Department of Ultrasound, Guangxi Medical University Third Affiliated Hospital, Nanning 530031, China
| | - Ruisui Huang
- Department of Radiology, Guangxi Medical University Third Affiliated Hospital, Nanning 530031, China
| | - Mofeng Gong
- Department of Radiology, Guangxi Medical University Third Affiliated Hospital, Nanning 530031, China
| | - Haibo Huang
- Department of Radiology, Guangxi Medical University Third Affiliated Hospital, Nanning 530031, China
| | - Xue Wei
- Department of Radiology, Guangxi Medical University Third Affiliated Hospital, Nanning 530031, China
| | - Haotang Wei
- Department of Gastrointestinal Surgery, Guangxi Medical University Third Affiliated Hospital, Nanning 530031, China
| | - Wei Lu
- Department of Pathology, Guangxi Medical University Third Affiliated Hospital, Nanning 530031, China
| | - Ke Ding
- Department of Radiology, Guangxi Medical University Third Affiliated Hospital, Nanning 530031, China
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Moscatelli S, Gatehouse P, Krupickova S, Mohiaddin R, Voges I, Giese D, Nielles-Vallespin S, Pennell DJ. Impact of compressed sensing (CS) acceleration of two-dimensional (2D) flow sequences in clinical paediatric cardiovascular magnetic resonance (CMR). MAGMA 2023; 36:869-876. [PMID: 37202654 PMCID: PMC10667407 DOI: 10.1007/s10334-023-01098-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 05/20/2023]
Abstract
OBJECTIVES Two-dimensional (2D) through-plane phase-contrast (PC) cine flow imaging assesses shunts and valve regurgitations in paediatric CMR and is considered the reference standard for Clinical quantification of blood Flow (COF). However, longer breath-holds (BH) can reduce compliance with possibly large respiratory manoeuvres altering flow. We hypothesize that reduced BH time by application of CS (Short BH quantification of Flow) (SBOF) retains accuracy while enabling faster, potentially more reliable flows. We investigate the variance between COF and SBOF cine flows. METHODS Main pulmonary artery (MPA) and sinotubular junction (STJ) planes were acquired at 1.5 T in paediatric patients by COF and SBOF. RESULTS 21 patients (mean age 13.9, 10-17y) were enrolled. The BH times were COF mean 11.7 s (range 8.4-20.9 s) vs SBOF mean 6.5 s (min 3.6-9.1 s). The differences and 95% CI between the COF and SBOF flows were LVSV -1.43 ± 13.6(ml/beat), LVCO 0.16 ± 1.35(l/min) and RVSV 2.95 ± 12.3(ml/beat), RVCO 0.27 ± 0.96(l/min), QP/QS were SV 0.04 ± 0.19, CO 0.02 ± 0.23. Variability between COF and SBOF did not exceed intrasession variation of COF. CONCLUSION SBOF reduces breath-hold duration to 56% of COF. RV flow by SBOF was biased compared to COF. The variation (95% CI) between COF and SBOF was similar to the COF intrasession test-retest 95% CI.
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Affiliation(s)
- Sara Moscatelli
- Department of Paediatric Cardiology, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK
- Department of CMR, Royal Brompton Hospital, Part of Guy's and St Thomas' NHS Foundation Trust, Sydney Street, London, SW3 6NP, UK
| | - Peter Gatehouse
- Department of CMR, Royal Brompton Hospital, Part of Guy's and St Thomas' NHS Foundation Trust, Sydney Street, London, SW3 6NP, UK.
- National Heart and Lung Institute, Imperial College, London, England.
| | - Sylvia Krupickova
- Department of Paediatric Cardiology, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK
- Department of CMR, Royal Brompton Hospital, Part of Guy's and St Thomas' NHS Foundation Trust, Sydney Street, London, SW3 6NP, UK
- National Heart and Lung Institute, Imperial College, London, England
| | - Raad Mohiaddin
- Department of CMR, Royal Brompton Hospital, Part of Guy's and St Thomas' NHS Foundation Trust, Sydney Street, London, SW3 6NP, UK
- National Heart and Lung Institute, Imperial College, London, England
| | - Inga Voges
- Department of Congenital Heart Disease and Pediatric Cardiology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Daniel Giese
- Magnetic Resonance, Siemens Healthcare GmbH, Erlangen, Germany
| | - Sonia Nielles-Vallespin
- Department of CMR, Royal Brompton Hospital, Part of Guy's and St Thomas' NHS Foundation Trust, Sydney Street, London, SW3 6NP, UK
- National Heart and Lung Institute, Imperial College, London, England
| | - Dudley J Pennell
- Department of CMR, Royal Brompton Hospital, Part of Guy's and St Thomas' NHS Foundation Trust, Sydney Street, London, SW3 6NP, UK
- National Heart and Lung Institute, Imperial College, London, England
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Radhakrishnan J, Valakkada J, Ayyappan A, Bellala PK. Corkscrew Mesenteric Arteries and Tortuous Descending Aorta in Autosomal Recessive Cutis Laxa. Radiol Cardiothorac Imaging 2023; 5:e230138. [PMID: 38166335 DOI: 10.1148/ryct.230138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Affiliation(s)
- Jayakrishnan Radhakrishnan
- From the Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India
| | - Jineesh Valakkada
- From the Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India
| | - Anoop Ayyappan
- From the Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India
| | - Pavan Kumar Bellala
- From the Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India
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Nguyen VH, Cheng-Kuan L, Nguyen TA, Cai THNT. Facial artery: anatomical variations in the perioral region in cadavers. Arch Craniofac Surg 2023; 24:266-272. [PMID: 38176760 PMCID: PMC10766500 DOI: 10.7181/acfs.2023.00493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/27/2023] [Accepted: 12/07/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND In recent years, there has been an increase in reports of perioral vascular complications resulting from filler injections, such as necrosis of the lip or alar rim, occlusion, and in severe cases, blindness. Conversely, the use of perioral arterial flaps is becoming more prevalent in the treatment of cleft lips, cancer, and trauma. A thorough understanding of perioral arteries is essential to minimize complications and maximize the success of these flaps. However, the course of the facial artery (FA) in the perioral region remains incompletely understood. The aim of this study was to describe the variations of the FA in the perioral region. METHODS We dissected 52 embalmed and formaldehyde-fixed Vietnamese cadavers. We then studied the size and distribution of perioral arteries in 102 specimens. RESULTS The superior labial artery (SLA) was the most common branch, occurring in 87.25% of cadavers, followed by the inferior labial artery (ILA) at 78.43%. The SLA primarily originated above the mouth corner (cheilion), accounting for 91.01% of cases, and predominantly exhibited a tortuous course within the submucosa (78.65%). The ILA's branching pattern varied, but it was primarily located below the cheilion (91.25%). The ILA also followed a twisted path, generally within the submucosa. The ILA exhibited two patterns: the typical pattern, distributed at the vermilion border of the lower lip (8.82%), and the horizontal labiomental artery pattern, which ran horizontally in the middle of the lower lip area (69.61%). At their origin, the SLA and ILA had average external diameters of 1.29 mm and 1.28 mm, respectively. CONCLUSION Numerous anatomical variations in the FA in the perioral region were found. A detailed anatomic description, suggested landmarks, and angiography before the procedure will be useful to help doctors avoid complications.
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Affiliation(s)
- Vu Hoang Nguyen
- Department of Anatomy, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Lin Cheng-Kuan
- Department of Environmental Health, Harvard Chan School of Public Health, Boston, MA, USA
| | - Tuan Anh Nguyen
- Department of Plastic and Cosmetic Surgery, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Trang Huu Ngoc Thao Cai
- Department of Plastic and Cosmetic Surgery, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
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Park H, Baek JW, Jeong HW, Heo YJ, Yun S, Han JY. Persistent Primitive Olfactory Artery Type 4 with Fusiform Aneurysm: A Case Report. J Korean Soc Radiol 2023; 84:1361-1366. [PMID: 38107687 PMCID: PMC10721419 DOI: 10.3348/jksr.2022.0139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 01/29/2023] [Accepted: 04/15/2023] [Indexed: 12/19/2023]
Abstract
The persistent primitive olfactory artery (PPOA) is a rare variant of the anterior cerebral artery, first reported in 1979. It reportedly has a high correlation with the development of aneurysms, owing to the hemodynamic stress induced by the structural characteristics of the hairpin turn. Herein, we present a rare case of PPOA type 4 with a fusiform aneurysm at the hairpin turn segment in a 46-year-old female with occasional headaches. Time-of-flight MR angiography and transfemoral cerebral angiography revealed an unusual branch arising from the left A1 segment, running anteromedially along the ipsilateral olfactory tract, and turning the hairpin posterior to the olfactory bulb. This branch continued into the left accessory middle cerebral artery, and a fusiform aneurysm was observed at the hairpin segment. No further treatment was performed, and follow-up imaging was recommended. Nevertheless, it is essential to recognize and diagnose these rare variations.
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18
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Pistoia F, Camerino PL, Ioppi A, Picasso R, Zaottini F, Caprioli S, Mocellin D, Ascoli A, Pansecchi M, Carobbio ALC, Parrinello G, Marchi F, Peretti G, Martinoli C. High-resolution US of the facial vessels with new facial vein landmarks for reconstructive surgery and dermal injection. Eur Radiol Exp 2023; 7:49. [PMID: 37691033 PMCID: PMC10493206 DOI: 10.1186/s41747-023-00363-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 06/12/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND Accurate knowledge of vessel anatomy is essential in facial reconstructive surgery. The technological advances of ultrasound (US) equipment with the introduction of new high-resolution probes improved the evaluation of facial anatomical structures. Our study had these objectives: the primary objective was to identify new surgical landmarks for the facial vein and to verify their precision with US, the secondary objective was to evaluate the potential of high-resolution US examination in the study of both the facial artery and vein. METHODS Two radiologists examined a prospective series of adult volunteers with a 22-8 MHz hockey-stick probe. Two predictive lines of the facial artery and vein with respective measurement points were defined. The distance between the facial vein and its predictive line (named mandibular-orbital line) was determined at each measurement point. The distance from the skin and the area of the two vessels were assessed at every established measurement point. RESULTS Forty-one volunteers were examined. The median distance of the facial vein from its predictive line did not exceed 2 mm. The facial vein was visible at every measurement point in all volunteers on the right side, and in 40 volunteers on the left. The facial artery was visible at every measurement point in all volunteers on the right and in 37 volunteers on the left. CONCLUSIONS The facial vein demonstrated a constant course concerning the mandibular-orbital line, which seems a promising clinical and imaging-based method for its identification. High-resolution US is valuable in studying the facial artery and vein. RELEVANCE STATEMENT High-resolution US is valuable for examining facial vessels and can be a useful tool for pre-operative assessment, especially when combined with the mandibular-orbital line, a new promising imaging and clinical technique to identify the facial vein. KEY POINTS • High-resolution US is valuable in studying the facial artery and vein. • The facial vein demonstrated a constant course concerning its predictive mandibular-orbital line. • The clinical application of the mandibular-orbital line could help reduce facial surgical and cosmetic procedure complications.
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Affiliation(s)
- Federico Pistoia
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, Genoa, Italy.
| | - Paola Lovino Camerino
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, Genoa, Italy
| | - Alessandro Ioppi
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, Genoa, Italy
| | - Riccardo Picasso
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, Genoa, Italy
| | - Federico Zaottini
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, Genoa, Italy
| | - Simone Caprioli
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, Genoa, Italy
| | - Davide Mocellin
- Department of Otorhinolaryngology, Ospedale S. Paolo, Savona, Italy
| | - Alessandro Ascoli
- Department of Otorhinolaryngology, Ospedale Giovanni Borea, Sanremo, Italy
| | - Michelle Pansecchi
- Department of Health Sciences (DISSAL), Radiology Section, University of Genova, Via Pastore 1, Genoa, Italy
| | - Andrea Luigi Camillo Carobbio
- Department of Neurosciences, Section of Otorhinolaryngology-Head and Neck Surgery, University of Padua "Azienda Ospedaliera Di Padova", 35128, Padua, Italy
| | | | - Filippo Marchi
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, Genoa, Italy
- Department of Internal Medicine (DIMI), University of Genoa, Genoa, Italy
| | - Giorgio Peretti
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, Genoa, Italy
- Department of Internal Medicine (DIMI), University of Genoa, Genoa, Italy
| | - Carlo Martinoli
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi, 10, Genoa, Italy
- Department of Health Sciences (DISSAL), Radiology Section, University of Genova, Via Pastore 1, Genoa, Italy
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Jashari R, Bouzet V, Alcaraz Blanco MJ, Oleffe A, Lecocq E, Mastrobuoni S. Vascular allografts for clinical application in Europe: assessment of 30 years of experience with vascular tissue banking in Brussels. Cell Tissue Bank 2023; 24:613-625. [PMID: 36595150 PMCID: PMC9809507 DOI: 10.1007/s10561-022-10063-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/06/2022] [Indexed: 01/04/2023]
Abstract
Vascular tissue banking has been carried out in Brussels for over 30 years in compliance with EU and Swiss tissue banking regulations. A total of 2.765 vascular tissue donations were performed in Belgian, French, Netherlands and Suisse transplant centres: 547(20%), 1.013(37%) and 1.205(43%) during the first, second and third periods, respectively. 85% and 18% increase in donations during the second and third decades compared to previous one, were remarkable. Of the 7.066 evaluated vascular tissues, 2.407(227, 921 and 1.259) were discarded (34.1%), whereas 4.659(523, 1.861 and 2.275) accepted (65.9%) during the respective period. Of the 92 donated veins, 44(47.8%) were discarded and 48(52.2%) accepted. Allografts available for clinical application were stored in vapours of liquid nitrogen. A total of 4.636 allografts were delivered and transplanted for cases of infection (58%), critical limb ischaemia (16%) and congenital cardiac surgery (15%). Thirty veins were implanted. The progressive increases in donations of 20%, 37% and 43% and in transplantations of 20.8%, 34.6% and 45% during the first, second and third periods, respectively, were remarkable. Complications were reported after transplantation and these included acute rejection of two femoral arteries one month after transplantation. We conclude that the donation and transplantation of cryopreserved vascular allografts was stable with a progressive increase over time. Allografts were used predominantly for the treatment of infection, limb salvage for critical ischaemia and for neonates and infants with congenital cardiac malformation. Immune related rejection was observed. This should be a subject of future investigation.
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Affiliation(s)
- Ramadan Jashari
- European Homograft Bank (EHB), Cliniques Universitaires St. Luc (UCL), Av. Emmanuel Mounier 49, Tour Rosalind Franklin (Entrée F), Route 703, 2E Étage, 1200 Brussels, Belgium
| | - Vanessa Bouzet
- European Homograft Bank (EHB), Cliniques Universitaires St. Luc (UCL), Av. Emmanuel Mounier 49, Tour Rosalind Franklin (Entrée F), Route 703, 2E Étage, 1200 Brussels, Belgium
| | - Maria-Josee Alcaraz Blanco
- European Homograft Bank (EHB), Cliniques Universitaires St. Luc (UCL), Av. Emmanuel Mounier 49, Tour Rosalind Franklin (Entrée F), Route 703, 2E Étage, 1200 Brussels, Belgium
| | - Alison Oleffe
- European Homograft Bank (EHB), Cliniques Universitaires St. Luc (UCL), Av. Emmanuel Mounier 49, Tour Rosalind Franklin (Entrée F), Route 703, 2E Étage, 1200 Brussels, Belgium
| | - Emilie Lecocq
- European Homograft Bank (EHB), Cliniques Universitaires St. Luc (UCL), Av. Emmanuel Mounier 49, Tour Rosalind Franklin (Entrée F), Route 703, 2E Étage, 1200 Brussels, Belgium
| | - Stefano Mastrobuoni
- European Homograft Bank (EHB), Cliniques Universitaires St. Luc (UCL), Av. Emmanuel Mounier 49, Tour Rosalind Franklin (Entrée F), Route 703, 2E Étage, 1200 Brussels, Belgium
- Department of Cardiac Surgery, Hospital Saint Luc, UCL, Brussels, Belgium
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Little MW, Harrison R, MacGill S, Speirs A, Briggs JH, Tayton E, Davies NLC, Hausen HS, McCann C, Levine LL, Sharma RA, Gibson M. Genicular Artery Embolisation in Patients with Osteoarthritis of the Knee (GENESIS 2): Protocol for a Double-Blind Randomised Sham-Controlled Trial. Cardiovasc Intervent Radiol 2023; 46:1276-1282. [PMID: 37337060 PMCID: PMC10471661 DOI: 10.1007/s00270-023-03477-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 05/23/2023] [Indexed: 06/21/2023]
Abstract
Knee osteoarthritis is a leading cause of chronic disability and economic burden. In many patients who are not surgical candidates, existing treatment options are insufficient. Clinical evidence for a new treatment approach, genicular artery embolisation (GAE), is currently limited to single arm cohort, or small population randomised studies. This trial will investigate the use of a permanent embolic agent for embolisation of abnormal genicular arterial vasculature to reduce pain in patients with mild to moderate knee osteoarthritis. Up to 110 participants, 45 years or older, with knee pain for ≥ 3 months resistant to conservative treatment will be randomised (1:1) to GAE or a sham procedure. The treatment group will receive embolisation using 100-micron Embozene™ microspheres (Varian, a Siemens Healthineers Company) (investigational use for this indication in the UK), and the sham group will receive 0.9% saline in an otherwise identical procedure. Patients will be followed for 24 months. At 6 months, sham participants will be offered crossover to GAE. The primary endpoint is change of 4 Knee Injury and OA Outcome Score subscales (KOOS4) at 6 months post-randomisation. The study will also evaluate quality of life, health economics, imaging findings, and psychosocial pain outcomes. The primary manuscript will be submitted for publication after all participants complete 6 months of follow-up. The trial is expected to run for 3.5 years. Trial Registration: ClinicalTrials.gov, Identifier: NCT05423587.
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Affiliation(s)
- Mark W Little
- University Department of Radiology, Royal Berkshire Hospital, London Road, Reading, RG1 5AN, UK.
- Centre for Integrative Neuroscience and Neurodynamics, University of Reading, Reading, UK.
| | - Richard Harrison
- Centre for Integrative Neuroscience and Neurodynamics, University of Reading, Reading, UK
| | - Sarah MacGill
- University Department of Radiology, Royal Berkshire Hospital, London Road, Reading, RG1 5AN, UK
| | - Archie Speirs
- University Department of Radiology, Royal Berkshire Hospital, London Road, Reading, RG1 5AN, UK
| | - James H Briggs
- University Department of Radiology, Royal Berkshire Hospital, London Road, Reading, RG1 5AN, UK
| | - Edward Tayton
- Department of Orthopaedics, Royal Berkshire Hospital, Reading, UK
| | - Nev L C Davies
- Department of Orthopaedics, Royal Berkshire Hospital, Reading, UK
| | | | - Claire McCann
- Varian, a Siemens Healthineers Company, Palo Alto, USA
| | - Lisa L Levine
- Varian, a Siemens Healthineers Company, Palo Alto, USA
| | | | - Matthew Gibson
- University Department of Radiology, Royal Berkshire Hospital, London Road, Reading, RG1 5AN, UK
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Georgakarakos E, Papadopoulou M, Karangelis D, Fiska A. Teaching vascular anatomy: the anatomy we know, the anatomy we see or the anatomy we need? Surg Radiol Anat 2023; 45:1155-1164. [PMID: 37458825 DOI: 10.1007/s00276-023-03203-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 07/03/2023] [Indexed: 09/22/2023]
Abstract
PURPOSE This article presents the evolution of the subject of vascular anatomy and discusses the associated clinical applicability. METHODS Clinically-driven surgical examples met in our everyday practice were used to depict characteristic anatomical paradoxes raised by the inconsistencies between classical anatomical perception, current imaging modalities and modern surgical techniques. RESULTS Consequent anatomy-driven modifications of medical devices comprise a characteristic example of the vivid, modern and meaningful role that anatomy can have on clinical decision-making and improvement of technical and clinical success. Clinical experience provides a feedback that shifts the focus of anatomic research towards new fields of interest, such as the role of arterial collateral networks as therapeutic targets. The clinical feedback brings into light queries and issues where traditional anatomical answers may be vague and inadequate to apply, thereby necessitating further research, refinement and reevaluation. CONCLUSION While the traditional teaching of vascular anatomy is based on information and illustrations derived from dissection and prosection courses, the development of modern imaging technologies applied in large numbers of living patients and application of minimally invasive techniques challenge our understanding of what should be perceived as fixed and permanent. Moreover, the recently introduced evidence-based philosophy in anatomy elaborate more robust data which not only update, validate and enrich the existing knowledge of anatomical variations but also enable subgroup analyses with respect to race, age and sex, identifying specific anatomic features associated with a significant impact on patient treatment.
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Affiliation(s)
- Efstratios Georgakarakos
- Department of Vascular Surgery, University Hospital of Alexandroupolis, Democritus University of Thrace, Medical School, 68100, Dragana, Alexandroupolis, Greece.
| | - Myrto Papadopoulou
- Department of Anatomy, Medical School of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Dimos Karangelis
- Department of Cardiac Surgery, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Aliki Fiska
- Department of Anatomy, Medical School of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
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Yang Y, Huan X, Guo D, Wang X, Niu S, Li K. Performance of deep learning-based autodetection of arterial stenosis on head and neck CT angiography: an independent external validation study. Radiol Med 2023; 128:1103-1115. [PMID: 37464200 DOI: 10.1007/s11547-023-01683-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 07/10/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE To externally validate the performance of automated stenosis detection on head and neck CT angiography (CTA) and investigate the impact factors using an independent bi-center dataset with digital subtraction angiography (DSA) as the ground truth. MATERIAL AND METHODS Patients who underwent head and neck CTA and DSA between January 2019 and December 2021 were retrospectively included. The degree of stenosis was automatically evaluated using CerebralDoc based on CTA. The performance of CerebralDoc across levels (per-patient, per-region, per-vessel, and per-segment) and thresholds (≥ 50%, ≥ 70%, and = 100%) was evaluated. Logistic regression was performed to identify independent factors associated with false negative results. RESULTS 296 patients were analyzed. Specificity across levels and thresholds was high, exceeding 92%. The area under the curve ranged from poor (0.615, 95% CI: 0.544, 0.686; at the region-based analysis for stenosis ≥ 70%) to excellent (0.945, 95% CI: 0.905, 0.985; at the patient-based analysis for stenosis ≥ 50%). Sensitivity ranged from 0.714 (95% CI: 0.675, 0.750) at the segment-based analysis for stenosis ≥ 70% to 0.895 (95% CI: 0.849, 0.919) at the patient-based analysis for stenosis ≥ 50%. The multiple logistic regression analysis revealed that false negative results were primarily more likely to specific stenosis locations (particularly the M2 segment and skull base segment of the internal carotid artery) and occlusion. CONCLUSIONS CerebralDoc has the potential to automated stenosis detection on head and neck CTA, but further efforts are needed to optimize its performance.
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Affiliation(s)
- Yongwei Yang
- Department of Radiology, the Second Affiliated Hospital of Chongqing Medical University, Yuzhong District, No. 74 Linjiang Rd, Chongqing, 400010, China
- Department of Radiology, the Fifth People's Hospital of Chongqing, Chongqing, China
| | - Xinyue Huan
- Department of Radiology, the Second Affiliated Hospital of Chongqing Medical University, Yuzhong District, No. 74 Linjiang Rd, Chongqing, 400010, China
| | - Dajing Guo
- Department of Radiology, the Second Affiliated Hospital of Chongqing Medical University, Yuzhong District, No. 74 Linjiang Rd, Chongqing, 400010, China
| | - Xiaolin Wang
- Department of Radiology, the Second Affiliated Hospital of Chongqing Medical University, Yuzhong District, No. 74 Linjiang Rd, Chongqing, 400010, China
| | - Shengwen Niu
- Department of Radiology, the Second Affiliated Hospital of Chongqing Medical University, Yuzhong District, No. 74 Linjiang Rd, Chongqing, 400010, China
| | - Kunhua Li
- Department of Radiology, the Second Affiliated Hospital of Chongqing Medical University, Yuzhong District, No. 74 Linjiang Rd, Chongqing, 400010, China.
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Katekaru-Tokeshi DI, Stöger JL, Jongbloed MRM, Jiménez-Santos M. Late Diagnosis of Uncorrected Tricuspid Atresia with Transposition of the Great Arteries in an Adult Patient. Radiol Cardiothorac Imaging 2023; 5:e230030. [PMID: 37693192 PMCID: PMC10483243 DOI: 10.1148/ryct.230030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 07/18/2023] [Accepted: 08/08/2023] [Indexed: 09/12/2023]
Affiliation(s)
- Diana Isabel Katekaru-Tokeshi
- From the Service of Cardiology, Hospital Nacional Dos de Mayo,
Cardiology Avenue Miguel Grau 13, Lima, Peru (D.I.K.T.); Departments of
Radiology (J.L.S.), Cardiology (M.R.M.J.), and Anatomy & Embryology
(M.R.M.J.), Center of Congenital Heart Disease Amsterdam Leiden (CAHAL), Leiden
University Medical Center, Leiden, the Netherlands; and Department of Radiology,
Service of Computed Tomography, Instituto Nacional de Cardiología Ignacio
Chavez, Mexico City, Mexico (M.J.S.)
| | - J. Lauran Stöger
- From the Service of Cardiology, Hospital Nacional Dos de Mayo,
Cardiology Avenue Miguel Grau 13, Lima, Peru (D.I.K.T.); Departments of
Radiology (J.L.S.), Cardiology (M.R.M.J.), and Anatomy & Embryology
(M.R.M.J.), Center of Congenital Heart Disease Amsterdam Leiden (CAHAL), Leiden
University Medical Center, Leiden, the Netherlands; and Department of Radiology,
Service of Computed Tomography, Instituto Nacional de Cardiología Ignacio
Chavez, Mexico City, Mexico (M.J.S.)
| | - Monique R. M. Jongbloed
- From the Service of Cardiology, Hospital Nacional Dos de Mayo,
Cardiology Avenue Miguel Grau 13, Lima, Peru (D.I.K.T.); Departments of
Radiology (J.L.S.), Cardiology (M.R.M.J.), and Anatomy & Embryology
(M.R.M.J.), Center of Congenital Heart Disease Amsterdam Leiden (CAHAL), Leiden
University Medical Center, Leiden, the Netherlands; and Department of Radiology,
Service of Computed Tomography, Instituto Nacional de Cardiología Ignacio
Chavez, Mexico City, Mexico (M.J.S.)
| | - Moisés Jiménez-Santos
- From the Service of Cardiology, Hospital Nacional Dos de Mayo,
Cardiology Avenue Miguel Grau 13, Lima, Peru (D.I.K.T.); Departments of
Radiology (J.L.S.), Cardiology (M.R.M.J.), and Anatomy & Embryology
(M.R.M.J.), Center of Congenital Heart Disease Amsterdam Leiden (CAHAL), Leiden
University Medical Center, Leiden, the Netherlands; and Department of Radiology,
Service of Computed Tomography, Instituto Nacional de Cardiología Ignacio
Chavez, Mexico City, Mexico (M.J.S.)
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Zamani S, Safaee A, Azimi SM, Homayoun M. A Case Report: An Unusual Variation in the Facial Artery. Adv Biomed Res 2023; 12:178. [PMID: 37694254 PMCID: PMC10492597 DOI: 10.4103/abr.abr_258_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 11/30/2022] [Accepted: 01/01/2023] [Indexed: 09/12/2023] Open
Abstract
The facial artery is the main artery supplying the face occasionally. It gives three branches on the face, the inferior labial, the superior labial, and the lateral nasal, and terminates as the angular artery. Due to congenital vascular variations in the facial artery, it has been considered in the dissection of the head and neck region. During the dissection of a 65-year-old woman to expose this region, we discovered that the left facial artery is terminated by the superior labial artery after giving off the submental and inferior labial branches. At the level of the left oral commissure, the facial artery was attached to the buccinator muscle as connective tissue, with a noticeable decrease in diameter. The purpose of this study is to report a new variation of the facial artery that is particularly important for cadaver dissection, and head and neck surgeries, as well as for facial artery angiography.
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Affiliation(s)
- Saeed Zamani
- Department of Anatomical and Molecular Biology Sciences, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azadeh Safaee
- Department of Anatomical and Molecular Biology Sciences, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sayed Mehrdad Azimi
- Department of Anatomical and Molecular Biology Sciences, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mansour Homayoun
- Department of Anatomical and Molecular Biology Sciences, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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25
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Alharbi YA. Anatomical study of divergences in facial artery endings. Anat Cell Biol 2023:acb.22.262. [PMID: 37019658 DOI: 10.5115/acb.22.262] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 04/07/2023] Open
Abstract
Despite several studies focusing on the facial arteries variable courses, the findings have significantly differed. The divergent findings have made it increasingly challenging to establish consistent correlations. Thus, as a vital artery, the facial artery is prone to numerous variations, which makes the identification of the variations vital to clinical practice, particularly for the orofacial and rhinoplastic surgery, and the increasingly selective chemotherapy procedures. The present research uses angiography images for analysis in studying the bilateral facial artery variations noted in patients undergoing carotid angiography for the evaluation of congenital anomalies, cerebral vascular malformations, and intra-arterial procedures. Conventional angiography was used, as it is a vital assessment tool that helps in the assessment of variations in the facial arteries and is suitable in evaluating smaller vascular anatomy, due to the perfect spatial resolution and portrayal of vascular anatomy. Thus, rather than normal ending of the facial artery as an angular artery, the study disclosed that in certain instances, the artery termination took the form of a superior labial artery with a small lateral nasal artery branch located closer to the midline compared to the normal cases. Also, the study has disclosed a conspicuous pre-masseteric branch with small branches originating from the infraorbital artery and providing potential compensation for the facial artery's shortness. Regardless of the infrequency of such variations, it is vital that they are considered during the performance of any facial surgical procedure.
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Affiliation(s)
- Yasser Ayish Alharbi
- Department of Basic Medical Sciences, College of Medicine, King Saud Bin Abdul Aziz University for Health Sciences, (KSAU-HS), King Abdullah International Medical Research Center (KAIMRC), National Guard Health Affair (NGHA), King Abdul-Aziz Medical City, Jeddah, Saudi Arabia
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26
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Bauer MJ, Nano N, Adolf R, Will A, Hendrich E, Martinoff SA, Hadamitzky M. Prognostic Value of Machine Learning-based Time-to-Event Analysis Using Coronary CT Angiography in Patients with Suspected Coronary Artery Disease. Radiol Cardiothorac Imaging 2023; 5:e220107. [PMID: 37124636 PMCID: PMC10141344 DOI: 10.1148/ryct.220107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 02/09/2023] [Accepted: 02/22/2023] [Indexed: 05/02/2023]
Abstract
Purpose To assess the long-term prognostic value of a machine learning (ML) approach in time-to-event analyses incorporating coronary CT angiography (CCTA)-derived and clinical parameters in patients with suspected coronary artery disease. Materials and Methods The retrospective analysis included patients with suspected coronary artery disease who underwent CCTA between October 2004 and December 2017. Major adverse cardiovascular events were defined as the composite of all-cause death, myocardial infarction, unstable angina, or late revascularization (>90 days after index scan). Clinical and CCTA-derived parameters were assessed as predictors of major adverse cardiovascular events and incorporated into two models: a Cox proportional hazards model with recursive feature elimination and an ML model based on random survival forests. Both models were trained and validated by employing repeated nested cross-validation. Harrell concordance index (C-index) was used to assess the predictive power. Results A total of 5457 patients (mean age, 61 years ± 11 [SD]; 3648 male patients) were evaluated. The predictive power of the ML model (C-index, 0.74; 95% CI: 0.71, 0.76) was significantly higher than the Cox model (C-index, 0.71; 95% CI: 0.68, 0.74; P = .02). The ML model also outperformed the segment stenosis score (C-index, 0.69; 95% CI: 0.66, 0.72; P < .001), which was the best performing CCTA-derived parameter, and patient age (C-index, 0.66; 95% CI: 0.63, 0.69; P < .001), the best performing clinical parameter. Conclusion An ML model for time-to-event analysis based on random survival forests had higher performance in predicting major adverse cardiovascular events compared with established clinical or CCTA-derived metrics and a conventional Cox model.Keywords: Machine Learning, CT Angiography, Cardiac, Arteries, Heart, Arteriosclerosis, Coronary Artery DiseaseSupplemental material is available for this article.© RSNA, 2023.
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27
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Wood A, Antonopoulos A, Chuaiphichai S, Kyriakou T, Diaz R, Al Hussaini A, Marsh AM, Sian M, Meisuria M, McCann G, Rashbrook VS, Drydale E, Draycott S, Polkinghorne MD, Akoumianakis I, Antoniades C, Watkins H, Channon KM, Adlam D, Douglas G. PHACTR1 modulates vascular compliance but not endothelial function: a translational study. Cardiovasc Res 2023; 119:599-610. [PMID: 35653516 PMCID: PMC10064844 DOI: 10.1093/cvr/cvac092] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 05/09/2022] [Accepted: 05/19/2022] [Indexed: 11/13/2022] Open
Abstract
AIMS The non-coding locus at 6p24 located in Intron 3 of PHACTR1 has consistently been implicated as a risk allele in myocardial infarction and multiple other vascular diseases. Recent murine studies have identified a role for Phactr1 in the development of atherosclerosis. However, the role of PHACTR1 in vascular tone and in vivo vascular remodelling has yet to be established. The aim of this study was to investigate the role of PHACTR1 in vascular function. METHODS AND RESULTS Prospectively recruited coronary artery disease (CAD) patients undergoing bypass surgery and retrospectively recruited spontaneous coronary artery dissection (SCAD) patients and matched healthy volunteers were genotyped at the PHACTR1 rs9349379 locus. We observed a significant association between the PHACTR1 loci and changes in distensibility in both the ascending aorta (AA = 0.0053 ± 0.0004, AG = 0.0041 ± 0.003, GG = 0.0034 ± 0.0009, P < 0.05, n = 58, 54, and 7, respectively) and carotid artery (AA = 12.83 ± 0.51, AG = 11.14 ± 0.38, GG = 11.69 ± 0.66, P < 0.05, n = 70, 65, and 18, respectively). This association was not observed in the descending aorta or in SCAD patients. In contrast, the PHACTR1 locus was not associated with changes in endothelial cell function with no association between the rs9349379 locus and in vivo or ex vivo vascular function observed in CAD patients. This finding was confirmed in our murine model where the loss of Phactr1 on the pro-atherosclerosis ApoE-/- background did not alter ex vivo vascular function. CONCLUSION In conclusion, we have shown a role for PHACTR1 in arterial compliance across multiple vascular beds. Our study suggests that PHACTR1 has a key structural role within the vasculature.
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Affiliation(s)
- Alice Wood
- Department of Cardiovascular Sciences, Glenfield Hospital, Leicester, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Alexios Antonopoulos
- BHF Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
| | - Surawee Chuaiphichai
- BHF Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford, UK
| | - Theodosios Kyriakou
- BHF Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford, UK
| | - Rebeca Diaz
- BHF Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford, UK
| | - Abtehale Al Hussaini
- Department of Cardiovascular Sciences, Glenfield Hospital, Leicester, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Anna-Marie Marsh
- Department of Cardiovascular Sciences, Glenfield Hospital, Leicester, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Manjit Sian
- Department of Cardiovascular Sciences, Glenfield Hospital, Leicester, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Mitul Meisuria
- Department of Cardiovascular Sciences, Glenfield Hospital, Leicester, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Gerry McCann
- Department of Cardiovascular Sciences, Glenfield Hospital, Leicester, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Victoria S Rashbrook
- BHF Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford, UK
| | - Edward Drydale
- BHF Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford, UK
| | - Sally Draycott
- BHF Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford, UK
| | - Murray David Polkinghorne
- BHF Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
| | - Ioannis Akoumianakis
- BHF Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
| | - Charalambos Antoniades
- BHF Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
| | - Hugh Watkins
- BHF Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford, UK
| | - Keith M Channon
- BHF Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford, UK
| | - David Adlam
- Department of Cardiovascular Sciences, Glenfield Hospital, Leicester, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Gillian Douglas
- BHF Centre of Research Excellence, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford, UK
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28
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Iwanaga J, Pineda E, Miyamoto Y, Wysiadecki G, Anadkat S, Tubbs RS. The sphenopalatine vein: anatomical study of a rarely described structure. Anat Cell Biol 2023:acb.22.231. [PMID: 36843319 DOI: 10.5115/acb.22.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/09/2022] [Accepted: 01/10/2023] [Indexed: 02/28/2023] Open
Abstract
Although in counterpart, the sphenopalatine artery (SPA), has been well described in the medical literature, the sphenopalatine vein (SPV) has received scant attention. Therefore, the present anatomical study was performed. Additionally, we discuss the variations, embryology, and clinical significance of the SPV. Adult cadaveric specimens underwent dissection of the SPV. In addition, some specimens were submitted for histological analysis of this structure. The SPV was found to drain from the sphenoidal sinus and nasal septum. Small tributaries traveled through the nasal septum with the posterior septal branches of the SPA and nasopalatine nerve. The SPA and SPV were found to travel through the sphenopalatine foramen and another tributary was found to perforate the medial plate of the pterygoid process and to connect to the pterygoid venous plexus which traveled lateral to the medial plate of the pterygoid process. The vein traveled through the posterior part of the lateral wall of the nasal cavity with the posterior lateral nasal branches of the SPA and the lateral superior posterior nasal branches of the maxillary nerve. To our knowledge, this is the first anatomical study on the SPV in humans. Data on the SPV provides an improved anatomical understanding of the vascular network of the nasal cavity. Developing a more complete picture of the nasal cavity and its venous supply might help surgeons and clinicians better manage clinical entities such as posterior epistaxis, cavernous sinus infections, and perform endoscopic surgery with fewer complications.
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Affiliation(s)
- Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Eric Pineda
- Tulane University School of Medicine, New Orleans, LA, USA
| | - Yusuke Miyamoto
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyusyu University, Fukuoka, Japan
| | - Grzegorz Wysiadecki
- Department of Normal and Clinical Anatomy, Chair of Anatomy and Histology, Medical University of Lodz, Lodz, Poland
| | - Samir Anadkat
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Anatomical Sciences, St. George's University, St. George's, Grenada, West Indies, 8Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA.,University of Queensland, Brisbane, Australia
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29
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Pivac VT, Herceg-Čavrak V, Hojsak I, Mišak Z, Jadrešin O, Kolaček S. Children with inflammatory bowel disease already have an altered arterial pulse wave. Eur J Pediatr 2023; 182:1771-1779. [PMID: 36763192 DOI: 10.1007/s00431-023-04858-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 01/20/2023] [Accepted: 02/02/2023] [Indexed: 02/11/2023]
Abstract
Adults with inflammatory bowel disease (IBD) have an increased risk for vascular events. This study aims to evaluate arterial parameters in paediatric IBD. Carotid intima-media thickness (CIMT) was measured by ultrasound, and Arteriograph was used to assess aortic pulse wave velocity (PWVao), brachial and aortic augmentation indexes (AixBrach, AixAo), central systolic blood pressure (SBPao), and heart rate (HR). A total of 161 children were included; 55 (34%) children with newly diagnosed IBD (median age 14.35 (11.88-16.31) years, 53% males), 53(33%) in remission (median age 15.62 (13.46-16.70) years, 66% males), and 53 (33%) controls (median age 14.09 (11.18-14.09) years, 55% males) were recruited into a case-control study. Compared to controls, patients with active disease and those in clinical remission had significantly lower AixBrach and AixAo (P < 0.001, P = 0.009; P < 0.001, P = 0.003). PWVao and CIMT were still normal. HR was higher in both IBD groups than in controls (P < 0.001; P = 0.006). HR positively correlated with disease duration (P = 0.001). In the ordinary least squares regression models, anti-tumour necrosis factor (TNF) α treatment predicted lower peripheral and central systolic blood pressures, in contrast to aminosalicylates and methotrexate. Aminosalicylate treatment predicted increased HR. Conclusion: Children with IBD have an increased heart rate, a lower augmentation index and, therefore, an altered pulse waveform. In paediatric IBD, arterial stiffness and CIMT are still normal, indicating the potential for adequate IBD treatment to preserve arterial health. What is Known: • Adult patients with inflammatory bowel disease (IBD) have increased carotid intima-media thickness and arterial stiffness, which positively correlates with cardiovascular risk and predicts mortality. Adequate treatment, especially anti-tumour necrosis factor (TNF) α medications, lower these risks. • Children with IBD have impaired endothelial function and reduced heart rate (HR) variability. What is New: • Children with IBD have impaired endothelial function and reduced heart rate (HR) variability. • Anti-TNFα treatment in children and adolescents with IBD lowers systolic pressure, whereas methotrexate and aminosalicylates have the opposite effect. Amiynosalyiciylate treatment also increases HR.
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Affiliation(s)
| | - Vesna Herceg-Čavrak
- Children's Hospital Zagreb, Klaićeva 16, Zagreb, Croatia.,Libertas International University, Trg John F Kennedy, Zagreb, Croatia
| | - Iva Hojsak
- Children's Hospital Zagreb, Klaićeva 16, Zagreb, Croatia
| | - Zrinjka Mišak
- Children's Hospital Zagreb, Klaićeva 16, Zagreb, Croatia.,University of Zagreb, School of Medicine, Šalata 3b, Zagreb, Croatia
| | - Oleg Jadrešin
- Children's Hospital Zagreb, Klaićeva 16, Zagreb, Croatia
| | - Sanja Kolaček
- Children's Hospital Zagreb, Klaićeva 16, Zagreb, Croatia.,University of Zagreb, School of Medicine, Šalata 3b, Zagreb, Croatia
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30
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Kobayashi K, Saito S. Impact of Reconstructing Intercostal Artery on Spinal Cord Circulation During Open Surgery for Thoracoabdominal Aortic Aneurysm. Braz J Cardiovasc Surg 2023; 38:38-1. [PMID: 36112737 PMCID: PMC10010729 DOI: 10.21470/1678-9741-2021-0219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
Abstract
INTRODUCTION We evaluated the outcomes of the selective intercostal artery reconstruction for preventing spinal cord injury during thoracoabdominal aortic aneurysm repair. METHODS We retrospectively assessed 84 consecutive patients who underwent thoracoabdominal aortic aneurysm repairs between 2004 and 2016. The mean age of the patients was 57.3 years. We performed preoperative multidetector computed tomography in 74 patients (88.0%) to identify the Adamkiewicz artery. Spinal cord injury preventive measures included motor evoked potential monitoring, hypothermia induction, Adamkiewicz artery or other intercostal artery reconstruction, and cerebrospinal fluid drainage. RESULTS The hospital death rate was 5.9%, and paraplegia occurred in four patients (4.7%). The Adamkiewicz artery or other intercostal arteries were reconstructed selectively in 46 patients (54.7%). Of these patients, 41 underwent postoperative multidetector computed tomography, which revealed occlusion of the reconstructed grafts in 23 patients (56.0%). There was no paraplegia in the patients who underwent reconstruction of the Adamkiewicz artery, which was patent on postoperative multidetector computed tomography. Univariate analysis showed no significant effect of various risk factors on the development of spinal cord injury. CONCLUSION Outcome of open surgery for thoracoabdominal aortic aneurysm in our institution regarding spinal cord injury was satisfactory. The benefits of Adamkiewicz artery reconstruction remain inconclusive, and further larger studies are required to identify its validation for spinal cord protection in thoracoabdominal aortic aneurysm repair.
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Affiliation(s)
- Kei Kobayashi
- Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical University, Tokyo, Japan
| | - Satoshi Saito
- Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical University, Tokyo, Japan
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31
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Stoudemire CE, Sachsenmeier CN, Link BL, Klein FM, Kulesza RJ. A portal quadrad with triple hepatic arteries. Anat Cell Biol 2023:acb.22.248. [PMID: 36655306 DOI: 10.5115/acb.22.248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 12/22/2022] [Indexed: 01/20/2023] Open
Abstract
The arterial support of the liver is most commonly from the celiac trunk via the proper hepatic artery (PHA). The PHA divides into left and right branches: the right hepatic artery (RHA) supplies the right and caudate lobes while the left hepatic artery (LHA) supplies the left and quadrate lobes. Aberrant hepatic arteries are relatively common, and the most frequent contributors are the superior mesenteric artery and left gastric artery. Herein we present findings from postmortem dissection of an abdominal cavity that revealed a rare combination of reported variations. Specifically, this subject had three extrahepatic arteries - a replaced LHA (rLHA), a PHA, and a replaced RHA (rRHA). The rLHA originated from the left gastric and the rRHA originated from the superior mesenteric artery. Knowledge of these variations is important for surgical and radiological procedures to avoid complications during treatment and improve patient outcomes.
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Affiliation(s)
- Claire E Stoudemire
- Department of Anatomy, Lake Erie College of Osteopathic Medicine, Erie, PA, USA
| | | | - Brittney L Link
- Department of Anatomy, Lake Erie College of Osteopathic Medicine, Erie, PA, USA
| | - Faith M Klein
- Department of Anatomy, Lake Erie College of Osteopathic Medicine, Erie, PA, USA
| | - Randy J Kulesza
- Department of Anatomy, Lake Erie College of Osteopathic Medicine, Erie, PA, USA
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32
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Nourinezhad J, Ranjbar R, Rostamizadeh V, Tabrizinejad MN, Hallak A, Janeczek M. Morphology of the pattern of branching of the aortic arch (Arcus aortae) in Syrian hamsters (Mesocricetus auratus). Vet Res Commun 2023; 47:51-60. [PMID: 35435569 DOI: 10.1007/s11259-022-09927-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 04/12/2022] [Indexed: 01/27/2023]
Abstract
The branching patterns of the aortic arches of 28 adult male and female Syrian hamsters (SH) were thoroughly examined under a stereomicroscope for the first time by using latex injection and corrosion casting to determine their general arrangements and morphological variations as well as their differences and similarities to other rodents and rabbits. Three major arteries, namely, the brachiocephalic trunk (BC), left common carotid artery (CC) and left subclavian artery (SA), originating from the aortic arch (AR), were uniformly noted in SH. The BC was consistently divided into the right SA and the right CA. SA in SH normally releases the internal thoracic, deep cervical, dorsal scapular, vertebral, superficial cervical and supreme intercostal arteries. The costocervical trunk typically consisted of supreme intercostal and internal thoracic arteries and a common trunk for dorsal scapular and deep cervical arteries. To comprehend the comparative morphology of the pattern of branching of AR more completely, our results were compared with previous studies in rodents and rabbits. (1) The general morphology of the great arteries from AR in SH was similar to that in mole rats, rats, mice, porcupines, and gerbils but was essentially different from that in rabbits, guinea pigs, red squirrels, ground squirrels, pacas and chinchillas. (2) The typical pattern of the branching of the subclavian arteries in SH was similar to that in guinea pigs, rats, and rabbits but was different from that of the reported rodents regardless of the origins of the bronchoesophageal and internal thoracic arteries and the composition of the costocervical trunk.
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Affiliation(s)
- Jamal Nourinezhad
- Division of Anatomy and Embryology, Department of Basic Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran, B.O.X: 61355-145.
| | - Raza Ranjbar
- Division of Anatomy and Embryology, Department of Basic Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran, B.O.X: 61355-145
| | - Vahid Rostamizadeh
- Ph.D. Student of Comparative Anatomy and Embryology, Division of Anatomy and Embryology, Department of Basic Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Marzieh Norouzi Tabrizinejad
- Ph.D. Student of Comparative Anatomy and Embryology, Division of Anatomy and Embryology, Department of Basic Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Abdulaziz Hallak
- Ph.D. Student of Comparative Anatomy and Embryology, Division of Anatomy and Embryology, Department of Basic Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Maciej Janeczek
- Division of Animal Anatomy, Department of Biostructure and Animal Physiology, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wrocław, Poland
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Kirkland LG, Garbe CG, Hadaya J, Benson PV, Wagener BM, Tankovic S, Hoover DB. Sympathetic innervation of human and porcine spleens: implications for between species variation in function. Bioelectron Med 2022; 8:20. [PMID: 36536461 PMCID: PMC9762010 DOI: 10.1186/s42234-022-00102-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The vagus nerve affects innate immune responses by activating spleen-projecting sympathetic neurons, which modulate leukocyte function. Recent basic and clinical research investigating vagus nerve stimulation to engage the cholinergic anti-inflammatory pathway (CAP) has shown promising therapeutic results for a variety of inflammatory diseases. Abundant sympathetic innervation occurs in rodent spleens, and use of these species has dominated mechanistic research investigating the CAP. However, previous neuroanatomical studies of human spleen found a more restricted pattern of innervation compared to rodents. Therefore, our primary goal was to establish the full extent of sympathetic innervation of human spleens using donor tissue with the shortest procurement to fixation time. Parallel studies of porcine spleen, a large animal model, were performed as a positive control and for comparison. METHODS Human and porcine spleen tissue were fixed immediately after harvest and prepared for immunohistochemistry. Human heart and porcine spleen were stained in conjunction as positive controls. Several immunohistochemical protocols were compared for best results. Tissue was stained for tyrosine hydroxylase (TH), a noradrenergic marker, using VIP purple chromogen. Consecutive tissue slices were stained for neuropeptide Y (NPY), which often co-localizes with TH, or double-labelled for TH and CD3, a T cell marker. High-magnification images and full scans of the tissue were obtained and analyzed for qualitative differences between species. RESULTS TH had dominant perivascular localization in human spleen, with negligible innervation of parenchyma, but such nerves were abundant throughout ventricular myocardium. In marked contrast, noradrenergic innervation was abundant in all regions of porcine spleen, with red pulp having more nerves than white pulp. NPY stain results were consistent with this pattern. In human spleen, noradrenergic nerves only ran close to T cells at the boundary of the periarterial lymphatic sheath and arteries. In porcine spleen, noradrenergic nerves were closely associated with T cells in both white and red pulp as well as other leukocytes in red pulp. CONCLUSION Sympathetic innervation of the spleen varies between species in both distribution and abundance, with humans and pigs being at opposite extremes. This has important implications for sympathetic regulation of neuroimmune interactions in the spleen of different species and focused targeting of the CAP in humans.
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Affiliation(s)
- Logan G. Kirkland
- grid.255381.80000 0001 2180 1673Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37614 USA
| | - Chloe G. Garbe
- grid.255381.80000 0001 2180 1673Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37614 USA
| | - Joseph Hadaya
- grid.19006.3e0000 0000 9632 6718UCLA Cardiac Arrhythmia Center and Neurocardiology Research Program of Excellence, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095 USA ,grid.19006.3e0000 0000 9632 6718Molecular, Cellular, and Integrative Physiology Program, University of California, Los Angeles, Los Angeles, CA USA
| | - Paul V. Benson
- grid.265892.20000000106344187Department of Pathology, The University of Alabama at Birmingham, Heersink School of Medicine, Birmingham, AL 35249 USA
| | - Brant M. Wagener
- grid.265892.20000000106344187Department of Anesthesiology and Perioperative Medicine, The University of Alabama at Birmingham, Heersink School of Medicine, Birmingham, AL 35249 USA
| | - Sanjin Tankovic
- grid.265892.20000000106344187Department of Anesthesiology and Perioperative Medicine, The University of Alabama at Birmingham, Heersink School of Medicine, Birmingham, AL 35249 USA
| | - Donald B. Hoover
- grid.255381.80000 0001 2180 1673Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37614 USA ,grid.255381.80000 0001 2180 1673Department of Biomedical Sciences, Quillen College of Medicine and Center of Excellence in Inflammation, Infectious Disease and Immunity, East Tennessee State University, Johnson City, TN 37614 USA
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Yunaiyama D, Takara Y, Kobayashi T, Muraki M, Tanaka T, Okubo M, Saguchi T, Nakai M, Saito K, Tsukahara K, Ishii Y, Homma H. Transcatheter arterial embolization for traumatic injury to the pharyngeal branch of the ascending pharyngeal artery: Two case reports. World J Clin Cases 2022; 10:12015-12021. [PMID: 36405265 PMCID: PMC9669858 DOI: 10.12998/wjcc.v10.i32.12015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/13/2022] [Accepted: 10/17/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The ascending pharyngeal artery (APhA) comprises the pharyngeal trunk (PT) and neuromeningeal trunk. The PT feeds the nasopharynx and adjacent tissue, which potentially connects with the sphenopalatine artery (SPA), branched from the internal maxillary artery (IMA). Due to its location deep inside the body, the PT is rarely injured by trauma. Here, we present two cases that underwent transcatheter arterial embolization (TAE) of the PT of the APhA due to trauma and iatrogenic procedure.
CASE SUMMARY Case 1 is a 49-year-old Japanese woman who underwent transoral endoscopy under sedation for a medical check-up. The nasal airway was inserted as glossoptosis occurred during sedation. Bleeding from the nasopharynx was observed during the endoscopic procedure. As the bleeding continued, the patient was referred to our hospital for further treatment. Contrast-enhanced computed tomography (CT) demonstrated extravasation in the nasopharynx originating from the right Rosenmuller fossa. TAE was performed and the extravasation disappeared after embolization. Case 2 is a 28-year-old Japanese woman who fell from the sixth floor of a building and was transported to our hospital. Contrast-enhanced CT demonstrated a complex facial fracture accompanying extravasation in the left pterygopalatine fossa to the nasopharynx. Angiography demonstrated an irregular third portion of the IMA. As angiography after TAE of the IMA demonstrated extravasation from the PT of the APhA, additional TAE to the artery was performed. The bleeding stopped after the procedure.
CONCLUSION Radiologists should be aware that the PT of the APhA can be a bleeding source, which has a potential connection with the SPA.
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Affiliation(s)
- Daisuke Yunaiyama
- Department of Radiology, Tokyo Medical University Hospital, Shinjuku-ku 160-0023, Japan
| | - Yuki Takara
- Department of Radiology, Tokyo Medical University Hospital, Shinjuku-ku 160-0023, Japan
| | - Takehiro Kobayashi
- Department of Radiology, Tokyo Medical University Hospital, Shinjuku-ku 160-0023, Japan
| | - Mika Muraki
- Department of Radiology, Tokyo Medical University Hospital, Shinjuku-ku 160-0023, Japan
| | - Taro Tanaka
- Department of Radiology, Tokyo Medical University Hospital, Shinjuku-ku 160-0023, Japan
| | - Mitsuru Okubo
- Department of Radiology, Tokyo Medical University Hospital, Shinjuku-ku 160-0023, Japan
| | - Toru Saguchi
- Department of Radiology, Tokyo Medical University Hospital, Shinjuku-ku 160-0023, Japan
| | - Motoki Nakai
- Department of Radiology, Tokyo Medical University Hospital, Shinjuku-ku 160-0023, Japan
| | - Kazuhiro Saito
- Department of Radiology, Tokyo Medical University Hospital, Shinjuku-ku 160-0023, Japan
| | - Kiyoaki Tsukahara
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hospital, Shinjuku-ku 160-0023, Japan
| | - Yuri Ishii
- Department of Emergency and Critical Care Medicine, Tokyo Medical University Hospital, Shinjuku-ku 160-0023, Japan
| | - Hiroshi Homma
- Department of Emergency and Critical Care Medicine, Tokyo Medical University Hospital, Shinjuku-ku 160-0023, Japan
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Ramirez-Suarez KI, Cohen SA, Barrera CA, Levine MA, Goldberg DJ, Otero HJ. Longitudinal assessment of vascular calcification in generalized arterial calcification of infancy. Pediatr Radiol 2022; 52:2329-2341. [PMID: 35438330 PMCID: PMC10406615 DOI: 10.1007/s00247-022-05364-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 02/18/2022] [Accepted: 03/18/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Generalized arterial calcification of infancy (GACI), also known as idiopathic infantile arterial calcification, is a very uncommon genetic disorder characterized by calcifications and stenoses of large- and medium-size arteries that can lead to end-organ damage. OBJECTIVE To describe changes in imaging findings in 10 children with GACI at a single institution from 2010 to 2021. MATERIALS AND METHODS In this retrospective study we reviewed initial and follow-up body imaging in children with genetic confirmation of GACI at our hospital. All initial images were analyzed for the presence and distribution of arterial calcifications, stenoses and wall thickening/irregularity within the chest, abdomen and pelvis. We compared available follow-up studies to the initial imaging findings. We extracted clinical information including prenatal and postnatal treatment from the children's medical records. RESULTS We evaluated 10 children (five boys) with a diagnosis of GACI. Median age at first body imaging was 8 days (range: 1 day to 5 years). Six children were identified prenatally and four postnatally. Postnatal presentation included cardiac failure, seizures and hypertension. Images in newborns (n = 8) most commonly showed diffuse arterial calcifications (6/8; 75%), while stenoses were less common (2/8; 25%) during this period. Two children were diagnosed after the neonatal period - one in infancy and one during childhood. In total, half the children (5/10; 50%) had arterial stenoses - three cases visualized at first imaging and two identified on follow-up images during infancy. Stenoses had completely resolved in one child (1/5; 20%) at last follow-up. Eight children received prenatal or postnatal treatment or both. All children who received both prenatal and postnatal treatment (n = 4) had completely resolved calcifications at last follow-up. CONCLUSION Children with GACI might have characteristic vascular calcifications at birth that raise the suspicion of this disease. Arterial calcifications decrease or disappear spontaneously or after treatment, but arterial stenoses usually persist. Calcifications and arterial stenoses can be easily identified and followed with non-contrast CT and CT angiography.
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Affiliation(s)
- Karen I Ramirez-Suarez
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA
| | - Sara A Cohen
- Department of Radiology at Weill Cornell Medicine, New York, NY, USA
| | - Christian A Barrera
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA
| | - Michael A Levine
- Division of Endocrinology and Diabetes, Center for Bone Health, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - David J Goldberg
- Division of Cardiology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Hansel J Otero
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA.
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
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Brzozowska A, Stankiewicz T, Błaszczyk B, Chundekkad P, Udała J, Wojtasiak N. Ultrasound parameters of early pregnancy and Doppler indices of blood vessels in the placenta and umbilical cord throughout the pregnancy period in sheep. BMC Vet Res 2022; 18:326. [PMID: 36042514 PMCID: PMC9426239 DOI: 10.1186/s12917-022-03424-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 08/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ultrasonography is one of the most important techniques that enable the detection and monitoring of pregnancy. One such study using this technique is the assessment of the hemodynamics of fetal and umbilical blood vessels. However, there is little data on blood flow in the placentomes, which is the basic structural unit of the sheep's placenta. Therefore, the aim of this study was to determine the Doppler parameters in the arterial vessels of the caruncles, cotyledons and the umbilical cord as well as measuring venous flow rates during the entire gestation period of the sheep. Additionally, the usefulness of various other ultrasound parameters in the early diagnosis of pregnancy in sheep was analyzed. RESULTS Most of the Doppler parameters in umbilical, cotyledonary and caruncular arteries were significantly correlated with the day of pregnancy (p < 0.01). In the early stages of pregnancy, the peak systolic velocity (PSV), regardless of the location of the artery, was significantly lower than that in the later stages of pregnancy (p < 0.01). PSV was also found to be significantly higher in the umbilical artery than in the cotyledonary and caruncular arteries (p < 0.01). Until the 50th day of pregnancy, the end diastolic velocity (EDV) was not found in the umbilical and cotyledonary arteries. EDV was significantly higher in the caruncular arteries than in the cotyledonary and umbilical arteries (p < 0.01). The resistance index (RI) and pulsatility index (PI) in the early stages of pregnancy were found to be significantly higher than that in the later stages of pregnancy (p < 0.01). The RI and PI were significantly lower in the caruncular arteries than in the arteries of the cotyledons and umbilical cord (p < 0.01). In the umbilical vein, all Doppler parameters were observed to be significantly higher than those in the placentomal veins (p < 0.01 or p < 0.05). Using transrectal ultrasound, pregnancy was detected between 20 and 28 days after mating. The ovaries were observed to have corpora lutea, the diameter of which was fairly consistent from the 17th to the 56th day of pregnancy. CONCLUSIONS It has been demonstrated that both the location of the arterial vessel in the placental-umbilical circulation and the gestational age have a significant impact on hemodynamic parameters. The results also provide new insights about the blood flow in caruncular and cotyledonary arteries, which could contribute to a more holistic understanding of hemodynamic changes in the placentas of sheep. Analyzing haemodynamic parameters in the umbilical and placental veins are preliminary studies in sheep, but it could inspire further research in this field. Furthermore, the research conducted confirms the practicality and convenience of transrectal ultrasonography in the early diagnosis of pregnancy in sheep and also indicates that the identification and imaging of the corpus luteum using B-mode ultrasonography can be a very early and simple method of confirming effective mating in sheep.
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Affiliation(s)
- Angelika Brzozowska
- West Pomeranian University of Technology in Szczecin, Faculty of Biotechnology and Animal Husbandry, Department of Animal Reproduction Biotechnology and Environmental Hygiene, 29 Klemensa Janickiego Street, 71-270, Szczecin, Poland
| | - Tomasz Stankiewicz
- West Pomeranian University of Technology in Szczecin, Faculty of Biotechnology and Animal Husbandry, Department of Animal Reproduction Biotechnology and Environmental Hygiene, 29 Klemensa Janickiego Street, 71-270, Szczecin, Poland.
| | - Barbara Błaszczyk
- West Pomeranian University of Technology in Szczecin, Faculty of Biotechnology and Animal Husbandry, Department of Animal Reproduction Biotechnology and Environmental Hygiene, 29 Klemensa Janickiego Street, 71-270, Szczecin, Poland
| | - Pavitra Chundekkad
- Department of Biology, University of Victoria, 3800 Finnerty Road Victoria BC, Victoria, V8P 5C2, Canada
| | - Jan Udała
- West Pomeranian University of Technology in Szczecin, Faculty of Biotechnology and Animal Husbandry, Department of Animal Reproduction Biotechnology and Environmental Hygiene, 29 Klemensa Janickiego Street, 71-270, Szczecin, Poland
| | - Natalia Wojtasiak
- West Pomeranian University of Technology in Szczecin, Faculty of Biotechnology and Animal Husbandry, Department of Animal Reproduction Biotechnology and Environmental Hygiene, 29 Klemensa Janickiego Street, 71-270, Szczecin, Poland
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Chen Zhou ZH, Martínez Chamorro E, Ibánez Sanz L, Sanz De Lucas R, Chico Fernández M, Borruel Nacenta S. Traumatic arterial injuries in upper and lower limbs: what every radiologist should know. Emerg Radiol 2022; 29:781-790. [PMID: 35513546 DOI: 10.1007/s10140-022-02053-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/25/2022] [Indexed: 11/26/2022]
Abstract
Traumatic arterial injuries of the extremities are a rare but potentially fatal event. Computed tomography (CT) angiography of the extremities has become the technique of choice and can provide rapid accurate detection and characterization of vascular lesions. Vascular injuries can be classified in active hemorrhage, vasospasm, occlusion, post-traumatic arteriovenous fistula, pseudoaneurysm, and patterns of intimal injuries. The learning objectives of this pictorial essay are to review the normal arterial anatomy of the upper and lower limbs, describe the technique of CT angiography in vascular trauma of the extremities, describe and illustrate the CT-angiography findings of traumatic arterial injuries, and know the potential pitfalls when interpreting a CT-angiography of the extremities.
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Affiliation(s)
- Zhao Hui Chen Zhou
- Department of Radiology, Hospital Universitario Doce de Octubre, Avenida de Córdoba s/n, 28041, Madrid, Spain.
| | - Elena Martínez Chamorro
- Department of Radiology, Hospital Universitario Doce de Octubre, Avenida de Córdoba s/n, 28041, Madrid, Spain
| | - Laín Ibánez Sanz
- Department of Radiology, Hospital Universitario Doce de Octubre, Avenida de Córdoba s/n, 28041, Madrid, Spain
| | - Raquel Sanz De Lucas
- Department of Radiology, Hospital Universitario Doce de Octubre, Avenida de Córdoba s/n, 28041, Madrid, Spain
| | - Mario Chico Fernández
- Intensive Care Unit, Hospital Universitario Doce de Octubre, Avenida de Córdoba s/n, 28041, Madrid, Spain
| | - Susana Borruel Nacenta
- Department of Radiology, Hospital Universitario Doce de Octubre, Avenida de Córdoba s/n, 28041, Madrid, Spain
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Zhang X, Deng W, Ju J, Zhang S, Wang H, Geng K, Wang D, Zhang G, Le Y, Hou R. A Method to Visualize and Quantify the Intraosseous Arteries of the Femoral Head by Vascular Corrosion Casting. Orthop Surg 2022; 14:1864-1872. [PMID: 35818638 PMCID: PMC9363727 DOI: 10.1111/os.13319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To describe a method to display the three-dimensional distribution of intraosseous arteries in the femoral head by vascular corrosion casting. METHODS An experimental study was done to expose the intraosseous arteries of the femoral head by a microperfusion corrosion method between January 2021 and May 2021. Specimens were 23 swine femoral heads (12 female specimens and 11 male specimens, where age of swine ranged from 8 to 12 months, and the weight was approximately 150 kg). The femoral heads were microperfused with the vascular casting resin through retinacular arteries, and the bone of the femoral head was dissolved with 50% sodium hydroxide and 10% hydrochloric acid and rinsed under the microscope until the vessel casts were completely exposed. The distribution and anastomosis of the arteries in the femoral head were observed under direct vision and microscopy. The diameter of the artery in the femoral head was measured at 0.5 cm after its entry into the bone of the femoral head with a microscale under the microscope. The number of internal arteries with diameter ≥0.05 mm was counted. The number and diameter of the main trunk of the epiphyseal arteries in the femoral head between male and female swine were compared. RESULTS The vascular casting specimen of the swine femoral head was successfully produced by using epoxy resin as a casting agent, and the three-dimensional intraosseous vascular structures were clearly visible. The number of epiphyseal arteries in male and female swine was 8.55 ± 2.15 and 8.83 ± 2.15 (t = -0.31, p = 0.38), respectively. The diameters of the superior epiphyseal arteries in male and female swine were 0.35 ± 0.09 and 0.31 ± 0.08 mm (t = 1.03, p = 0.16), the diameters of the inferior epiphyseal arteries were 0.47 ± 0.05 and 0.49 ± 0.09 mm (t = -0.57, p = 0.29), and the diameters of the anterior epiphyseal arteries were 0.34 ± 0.08 and 0.33 ± 0.13 mm (t = 0.32, p = 0.37). There was no significant difference in the number and diameter of the main trunk of intraosseous arteries between male and female swine (p > 0.05). The main trunk of intraosseous arteries formed an anastomosis in the center of the femoral head. Among 23 swine femoral head samples, three types of intraosseous anastomosis were observed, including 13 (57%) posterior superior-posterior inferior, seven (30%) posterior inferior-anterior, and three (13%) uniform intraosseous anastomosis. CONCLUSION The microperfusion corrosion method can produce the vascular casting specimen of swine femoral head revealing the three-dimensional structure of the intraosseous artery, which clearly shows the origin, course and branches, and diameter, as well as the anastomosis, of nutrient arteries in the femoral head. This method provides a simple and rapid technique for quantifying and visualizing intraosseous arteries.
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Affiliation(s)
- XiangNan Zhang
- Department of Orthopaedics, Suzhou Ruihua Orthopedic Hospital, Suzhou, China.,Suzhou Medical College of Soochow University, Suzhou, China
| | - Wei Deng
- Department of Orthopaedics, Suzhou Ruihua Orthopedic Hospital, Suzhou, China.,Suzhou Medical College of Soochow University, Suzhou, China
| | - JiHui Ju
- Department of Orthopaedics, Suzhou Ruihua Orthopedic Hospital, Suzhou, China.,Teaching Hospital of Medical College of Yangzhou University, Suzhou Ruihua Orthopedic Hospital, Suzhou, China
| | - Songqiang Zhang
- Department of Orthopaedics, Suzhou Ruihua Orthopedic Hospital, Suzhou, China
| | - HongYu Wang
- Department of Orthopaedics, Suzhou Ruihua Orthopedic Hospital, Suzhou, China
| | - KaiLong Geng
- Department of Orthopaedics, Suzhou Ruihua Orthopedic Hospital, Suzhou, China
| | - DingSong Wang
- Department of Orthopaedics, Suzhou Ruihua Orthopedic Hospital, Suzhou, China
| | - GuangLiang Zhang
- Department of Orthopaedics, Suzhou Ruihua Orthopedic Hospital, Suzhou, China
| | - YingYing Le
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
| | - RuiXing Hou
- Department of Orthopaedics, Suzhou Ruihua Orthopedic Hospital, Suzhou, China.,Teaching Hospital of Medical College of Yangzhou University, Suzhou Ruihua Orthopedic Hospital, Suzhou, China
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Giancaspro G, Hahn L, Hsiao A, Kligerman SJ. Anomalous Systemic Arterial Supply to Normal Basal Segments of the Lung. Radiol Cardiothorac Imaging 2022; 4:e220029. [PMID: 35923748 PMCID: PMC9308464 DOI: 10.1148/ryct.220029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/22/2022] [Accepted: 04/12/2022] [Indexed: 06/15/2023]
Abstract
Supplemental material is available for this article.
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40
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Gonzalez-Urquijo M, Cordoba-Chamorro E, Moreno-Díaz SJ, Mejia-Villate GF, Fabiani MA. Gunshot Wounds Causing Distal Arterial Bullet Embolisms. Bull Emerg Trauma 2022; 10:87-91. [PMID: 35434160 PMCID: PMC9008342 DOI: 10.30476/beat.2021.88434.1206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 03/18/2021] [Accepted: 05/16/2021] [Indexed: 11/20/2022] Open
Abstract
We report two cases involving small-caliber gunshot wounds to the chest with embolization of the bullet which complete occluding arterial circulation into the left lower extremity. A 30-years-old and 19-years-old men suffered gunshots wound to the thorax and abdomen with subsequent arterial embolisms into their left legs. Image studies revealed the left popliteal and femoral arteries occlusion by the missiles. Arteriotomies were auspiciously performed to retrieve the projectiles along with Fogarty catheters thrombectomies which conclude successful outcomes. At a 6 and 36 months' follow-up, the patients were doing well without any vascular associated complications. Bullet embolization of the arterial or venous systems is a rare complication of penetrating gunshot injuries with diagnostic and therapeutic challenges. This complication's suspicion should rise when there is a gunshot injury without an exit wound and with sudden pain or ischemia in an extremity. Individualized treatment should be urgently performed to avoid irreversible damage to the affected area.
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Affiliation(s)
| | | | | | | | - Mario Alejandro Fabiani
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Monterrey, Nuevo León, México ,Corresponding author: Mario Alejandro Fabiani, Address: Ignacio Morones Prieto, O 3000, Monterrey, Nuevo León, México. 64710. Tel: +52-181-19779899; e-mail:
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Lindner T, Guerreiro H, Austein F, Fiehler J. Individualized arterial spin labeling background suppression by rapid T1 mapping during acquisition. Eur Radiol 2022; 32:4521-4526. [PMID: 35118530 PMCID: PMC9213266 DOI: 10.1007/s00330-022-08550-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 11/29/2022]
Abstract
Objective Arterial spin labeling blood perfusion signal relies on the difference between a label and a control image. Background suppression pulses are commonly used to improve the contrast, yet these are based on estimates of tissue relaxation times. The aim of this study is to improve the perfusion contrast by individualizing the timing of these background suppression pulses by means of T1 mapping. Methods The optimized timing of the background suppression pulses is obtained by rapid T1 mapping employing the variable flip angle technique. Ten healthy volunteers were included in this study. To compare the results, visual grading and the Wilcoxon signed-rank test was used comparing three categories of image quality. Results The readers confirmed that the images of the proposed method generally show a higher signal-to-background ratio and cortical structures are better visible. Noise was mostly comparable to the standard method. Relative blood flow was statistically significant higher in the modified method. Conclusion The individually optimized background suppression pulses improve the image appearance and allow for a better visualization of cortical structures. The proposed technique however prolongs scan time, which can be seen as negative result, yet needs to be further evaluated. Key Points • Background suppression timing in ASL can vary. • Both the label and control condition can be modified for T1 mapping. • Adapting the pulse timing improves the signal-to-background ratio.
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Affiliation(s)
- T Lindner
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Hamburg-Eppendorf, Martinistr. 52, Gebauede W14, 20251, Hamburg, Germany.
| | - H Guerreiro
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Hamburg-Eppendorf, Martinistr. 52, Gebauede W14, 20251, Hamburg, Germany
| | - F Austein
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Hamburg-Eppendorf, Martinistr. 52, Gebauede W14, 20251, Hamburg, Germany
| | - J Fiehler
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Hamburg-Eppendorf, Martinistr. 52, Gebauede W14, 20251, Hamburg, Germany
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Abstract
Background Abnormal fetal growth is associated with increased cardiovascular risk in adulthood. We investigated the effect of fetal programming on arterial health and morphology during early childhood. Methods We examined 90 children (median age 5.81 years, interquartile range: 5.67; 5.95), born small for gestational age with fetal growth restriction, large or appropriate for gestational age (SGA, N = 23, LGA, N = 19, AGA N = 48). We measured body composition, anthropometrics, blood pressure, pulse wave velocity (PWV), lipids, glucose and inflammatory markers, and assessed carotid, brachial, radial and femoral arterial morphology and stiffness using very-high resolution ultrasound (46–71 MHz). Results LGA showed increased anthropometry, lean body mass and body mass index. SGA displayed decreased anthropometry and lean body mass. Blood pressure, PWV, carotid artery stiffness and blood work did not differ groupwise. Differences in lumen diameters, intima-media thicknesses (IMT) and adventitia thicknesses disappeared when adjusted for lean body mass and sex. In multiple regression models arterial dimensions were mainly predicted by lean body mass, with birth weight remaining associated only with carotid and brachial lumen dimensions, and not with IMTs. Carotid-femoral PWV was predicted by height and blood pressure only. No independent effect of adiposity was observed. Conclusions Arterial dimensions in childhood associate with current anthropometrics, especially lean body mass, and sex, explaining differences in arterial layer thickness. We found no signs of fetal programming of cardiovascular risk or arterial health in early childhood. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02951-2.
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Affiliation(s)
- Rasmus F W Olander
- Children's Hospital, Pediatric Research Center, University of Helsinki, and Helsinki University Hospital, Stenbäckinkatu 9, POB 347, FIN-00029, Helsinki, Finland. .,Minerva Foundation Institute for Medical Research, Helsinki, Finland.
| | - Johnny K M Sundholm
- Children's Hospital, Pediatric Research Center, University of Helsinki, and Helsinki University Hospital, Stenbäckinkatu 9, POB 347, FIN-00029, Helsinki, Finland.,Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Sanna Suonsyrjä
- Children's Hospital, Pediatric Research Center, University of Helsinki, and Helsinki University Hospital, Stenbäckinkatu 9, POB 347, FIN-00029, Helsinki, Finland.,Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Taisto Sarkola
- Children's Hospital, Pediatric Research Center, University of Helsinki, and Helsinki University Hospital, Stenbäckinkatu 9, POB 347, FIN-00029, Helsinki, Finland.,Minerva Foundation Institute for Medical Research, Helsinki, Finland
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da Silva MOM, Amorim Santos H, da Silva AFV, Marum G, de Godoy JMP. Thrombosis of the right iliac, femoral, popliteal, and tibial arteries in a post-COVID-19 in adolescent. Ann Pediatr Surg 2021; 17:57. [PMID: 34899882 PMCID: PMC8422057 DOI: 10.1186/s43159-021-00124-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/25/2021] [Indexed: 01/11/2023] Open
Abstract
Background Viral infection into lung, muscular, and endothelial cells results in inflammatory response, including edema, degeneration, and necrotic alterations. The involvement of the major arteries in adolescent with COVID-19 has been infrequently reported in the literature. The aim of the present study is to report thrombosis of the right iliac, femoral and tibial arteries and stenosis of left iliac artery in an adolescent with COVID-19 and to discuss the pathophysiological hypotheses. Case presentation We report the case of a 17-year-old female patient with COVID-19 infection. She was seen at the physician specialized general medicine in her hometown, was diagnosed with COVID-19 but did not require hospitalization. After 15 days, she had sudden pain in the left leg that has limited her ability to walk more than 10 met, associated with extremity cyanosis and coldness. Angiotomography revealed thrombosis of a portion of the iliac and popliteal arteries. Na emergency embolectomy was successfully performed, followed by full-dose heparinization with unfractionated heparin. Conclusion Arterial thrombosis of large arteries may be associated with chronic inflammatory syndrome secondary to COVID-19 infection and the treatment with a late embolectomy was successful, even in a thrombotic event.
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Affiliation(s)
| | - Henrique Amorim Santos
- Service Vascular Surgery, Medicine School in Sao Jose do Rio Preto (FAMERP), São Jose do Rio Preto, Brazil
| | | | - Guilherme Marum
- Service Vascular Surgery, Medicine School in Sao Jose do Rio Preto (FAMERP), São Jose do Rio Preto, Brazil
| | - Jose Maria Pereira de Godoy
- Cardiology and Cardiovascular Surgery Department in Medicine School of Sao Jose do Rio Preto-FAMERP, São Jose do Rio Preto, Brazil.,CNPq (National Council for Research and Development), Rua Floriano Peixoto, São Jose do Rio Preto, SP 2950 Brazil
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Evans LL, Aarabi S, Durand R, Upperman JS, Jensen AR. Torso vascular trauma. Semin Pediatr Surg 2021; 30:151126. [PMID: 34930597 DOI: 10.1016/j.sempedsurg.2021.151126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Vascular injury within the chest or abdomen represents a unique challenge to the pediatric general surgeon, as these life- or limb-threatening injuries are rare and may require emergent treatment. Vascular injury may present as life-threatening hemorrhage, or with critical ischemia from intimal injury, dissection, or thrombosis. Maintaining the skillset and requisite knowledge to address these injuries is of utmost importance for pediatric surgeons that care for injured children, particularly for surgeons practicing in freestanding children's hospitals that frequently do not have adult vascular surgery coverage. The purpose of this review is to provide an overview of torso vascular trauma, with a specific emphasis in rapid recognition of torso vascular injury as well as both open and endovascular management options. Specific injuries addressed include blunt and penetrating mediastinal vascular injury, subclavian injury, abdominal aortic and visceral segment injury, inferior vena cava injury, and pelvic vascular injury. Operative exposure, vascular repair techniques, and damage control options including preperitoneal packing for pelvic hemorrhage are discussed. The role and limitations of endovascular treatment of each of these injuries is discussed, including endovascular stent graft placement, angioembolization for pelvic hemorrhage, and resuscitative endovascular balloon occlusion of the aorta (REBOA) in children.
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Affiliation(s)
- Lauren L Evans
- Division of Pediatric Surgery, UCSF Benioff Children's Hospitals, Department of Surgery, University of California San Francisco, San Francisco, CA 94611, USA.
| | - Shahram Aarabi
- UCSF-East Bay Surgery Program, Department of Surgery, University of California San Francisco, San Francisco, CA 94611, USA.
| | - Rachelle Durand
- UCSF Benioff Children's Hospitals, and Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94611, USA.
| | - Jeffrey S Upperman
- Department of Pediatric Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
| | - Aaron R Jensen
- Division of Pediatric Surgery, UCSF Benioff Children's Hospitals, Department of Surgery, University of California San Francisco, San Francisco, CA 94611, USA.
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Ballenger BK, Hunter GR, Fisher G. Vascular hemodynamics and blood pressure differences between young and older women. Clin Hypertens 2021; 27:25. [PMID: 34776005 PMCID: PMC8591875 DOI: 10.1186/s40885-021-00181-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 09/25/2021] [Indexed: 11/30/2022] Open
Abstract
Background Cardiovascular disease is one of the main causes of death in the United States, and hypertension is a primary risk factor. Therefore, the primary causes of hypertension need to be identified so they may be addressed for treatment. The purpose of this study was to compare blood pressure with hemodynamic values and identify factors that may explain blood pressure differences between a cohort of healthy normotensive younger and older women. Methods Participants were 49 young (age: 33.8 ± 5.9) and 103 old (age: 65.8 ± 4) who were non-hypertensive, had no previous history of heart disease or type 2 diabetes, body mass index less than 30 kg/m2, normal electrocardiography response at rest and during exercise, nonsmokers, and no use of medications known to affect cardiovascular or metabolic function. Body composition measured by dual-energy X-ray absorptiometry. Hemodynamic values measured by non-invasive pulse wave velocity through radial artery tonometry. Markers of inflammation measured through blood sample analysis. Results Significant differences exist between young and old groups in %fat (P < 0.001), systolic blood pressure (SBP) (P = 0.001), large artery elasticity (P = 0.005), small artery elasticity (P < 0.001), systemic vascular resistance (P = 0.004), total vascular impedance (P < 0.001), estimated cardiac output (P < 0.001), and tumor necrosis factor-⍺ (TNF-⍺) (P < 0.001). Using ANCOVA the difference in SBP between age groups was no longer significant after adjusting for small artery elasticity (P < 0.001) and TNF-⍺ (P = 0.041). Conclusions These data demonstrate that blood pressure and vascular hemodynamic measures differ significantly between young and old women independent of body composition. Furthermore, these differences may be explained by the inflammation marker TNF-⍺ and/or small artery elasticity.
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Affiliation(s)
- Brantley K Ballenger
- Department of Kinesiology, Mississippi State University, Mississippi State, MS, 39762, USA.
| | - Gary R Hunter
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, 35233, USA
| | - Gordon Fisher
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, 35233, USA.,Department of Human Studies, University of Alabama at Birmingham, Birmingham, AL, 35233, USA
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Li J, Wang YH, Zheng FL, Chen XY, Lin Y, Zhu CR, Wu YF, Xu Q, Jin ZY, Xue HD. Feasibility of utilizing ultra-low-dose contrast medium for pancreatic artery depiction using the combination of advanced virtual monoenergetic imaging and high-concentration contrast medium: an intra-patient study. Insights Imaging 2021; 12:166. [PMID: 34767101 PMCID: PMC8589906 DOI: 10.1186/s13244-021-01079-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 07/18/2021] [Indexed: 11/10/2022] Open
Abstract
Objectives The least amount of contrast medium (CM) should be used under the premise of adequate diagnosis. The purpose of this study is to evaluate the feasibility of utilizing ultra-low-dose (224 mgI/kg) CM for pancreatic artery depiction using the combination of advanced virtual monoenergetic imaging (VMI+) and high-concentration (400 mgI/mL) CM.
Materials and methods 41 patients who underwent both normal dose CM (ND-CM, 320 mgI/kg) and low dose CM (LD-CM, 224 mgI/kg) thoracoabdominal enhanced CT for tumor follow-up were prospectively included. The VMI+ at the energy level of 40-kev for LD-CM images was reconstructed. CT attenuation, signal-to-noise ratios (SNRs), and contrast-to-noise ratios (CNRs) of the abdominal artery, celiac artery, and superior mesenteric artery (SMA) and qualitative scores of pancreatic arteries depiction were recorded and compared among the three groups (ND-CM, LD-CM, and VMI+ LD-CM images). ANOVA and Friedman tests were used for statistical analysis. Results All quantitative and qualitative parameters on LD-CM images were lower than that on ND-CM images (all p < 0.01). There were no significant differences of all arteries’ qualitative scores between ND-CM and VMI+ LD-CM images (all p > 0.05). VMI+ LD-CM images had the highest mean CT and CNR values of all arteries (all p < 0.0001). The CM volume was 52.6 ± 9.4 mL for the ND-CM group and 37.0 ± 6.7 mL for the LD-CM group. Conclusion Ultra-low-dose CM (224 mgI/kg) was feasible for depicting pancreatic arteries. Inferior angiographic image quality could be successfully compensated by VMI+ and high-concentration CM.
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Affiliation(s)
- Juan Li
- Department of Radiology, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yu-Hong Wang
- Department of Radiology, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Fu-Ling Zheng
- Department of Radiology, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | | | - Yun Lin
- Global Medical and Regulatory Affairs, Bracco Imaging Medical Technologies Co., Ltd, Shanghai, China
| | - Cai-Rong Zhu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yi-Fan Wu
- Global Medical and Regulatory Affairs, Bracco Imaging Medical Technologies Co., Ltd, Shanghai, China
| | - Qiang Xu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Zheng-Yu Jin
- Department of Radiology, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
| | - Hua-Dan Xue
- Department of Radiology, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
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Ishida H, Yamaguchi M, Saito SY, Furukawa T, Shannonhouse JL, Kim YS, Ishikawa T. Na +-dependent inactivation of vascular Na +/Ca 2+ exchanger responsible for reduced peripheral blood flow in neuropathic pain model. Eur J Pharmacol 2021; 910:174448. [PMID: 34454926 PMCID: PMC8518190 DOI: 10.1016/j.ejphar.2021.174448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 10/20/2022]
Abstract
Reduced skin blood flow has been reported in neuropathic pain patients as well as various peripheral neuropathic pain model animals. We have previously shown that vasodilators, which improves reduced skin blood flow, correlatively alleviate neuropathic pain in chronic constriction injury (CCI) mice, a model of neuropathic pain from peripheral nerve injury. Here, we sought to elucidate the mechanism underlying the reduced skin blood flow in CCI rats. The skin blood flow of the ipsilateral plantar arteries was significantly reduced compared to that of the contralateral ones 4 weeks after loose ligation of the sciatic nerve. The contraction induced by noradrenaline, serotonin, and U46619, a thromboxane receptor agonist, in the isolated ipsilateral plantar arteries was significantly enhanced compared to that in the contralateral ones. KB-R7943, a Na+/Ca2+ exchanger (NCX) inhibitor, shifted the concentration-response curves of noradrenaline to the left in the contralateral arteries but had no effect on the ipsilateral side. There was no significant difference in concentration-response curves of noradrenaline between the ipsilateral and contralateral arteries in the presence of KB-R7943. Amiloride, a non-specific inhibitor of Na+ channels and transporters, comparably shifted concentration-response curves of noradrenaline to the left in both the contralateral and ipsilateral arteries. One hundred nM of noradrenaline induced intracellular Ca2+ elevation in the ipsilateral arteries, which was significantly larger than that induced by 300-nM noradrenaline in the contralateral arteries. These results suggest that reduced peripheral blood flow after nerve injury is due to Na+-dependent inactivation of NCX in the ipsilateral plantar arteries.
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Affiliation(s)
- Hirotake Ishida
- Department of Pharmacology, School of Pharmaceutical Sciences, University of Shizuka, 52-1 Yada, Suruga Ward, Shizuoka City,Shizuoka, 422-8526, Japan; Department of Oral & Maxillofacial Surgery, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
| | - Momoka Yamaguchi
- Department of Pharmacology, School of Pharmaceutical Sciences, University of Shizuka, 52-1 Yada, Suruga Ward, Shizuoka City,Shizuoka, 422-8526, Japan
| | - Shin-Ya Saito
- Department of Pharmacology, School of Pharmaceutical Sciences, University of Shizuka, 52-1 Yada, Suruga Ward, Shizuoka City,Shizuoka, 422-8526, Japan; Faculty of Veterinary Medicine, Okayama University of Science, 1-3 Ikoinooka, Imabari City, Ehime, 794-8555, Japan
| | - Takuma Furukawa
- Department of Pharmacology, School of Pharmaceutical Sciences, University of Shizuka, 52-1 Yada, Suruga Ward, Shizuoka City,Shizuoka, 422-8526, Japan
| | - John L Shannonhouse
- Department of Oral & Maxillofacial Surgery, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
| | - Yu Shin Kim
- Department of Oral & Maxillofacial Surgery, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA; Programs in Integrated Biomedical Sciences & Translational Sciences, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
| | - Tomohisa Ishikawa
- Department of Pharmacology, School of Pharmaceutical Sciences, University of Shizuka, 52-1 Yada, Suruga Ward, Shizuoka City,Shizuoka, 422-8526, Japan.
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Shobeiri E, Rai A, Rouzbahani M, Heidari Moghadam R, Azimivghar J, Pourmirza F, Tadbiri H, Salehi N. Assessing the Stress Echocardiography in Women With Breast Arterial Calcification. J Family Reprod Health 2021; 15:196-201. [PMID: 34721611 PMCID: PMC8536829 DOI: 10.18502/jfrh.v15i3.7138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective: breast arterial calcification (BAC) is one of the most prevalent mammographic findings and has been debated as a marker of cardiovascular disease (CVDs). The present study aimed to assess the findings of stress echo in women with BAC. Materials and methods: This cross-sectional study was conducted on women who undergo mammography for routine breast cancer screening at Imam Reza hospital, western Iran from March 2018 to July 2018. The patients underwent stress echocardiography to evaluate the probability of myocardial ischemia (MI). Chi-square and independent t-tests were used to assess the differences between subgroups. Results: BAC was present in 61 (15.2%) women. The mean age of the patients with BAC was significantly higher than the patients without BAC (58.59± 7.82 vs. 55.32±6.57, p =0.003). Prevalence rates of the menopause (88.5% vs. 71.1%, p=0.009), hypertension (29.5% vs. 17.7%, p=0.032), and hypercholesterolemia (24.6% vs. 13.0, p=0.018) were significantly higher in the patients with BAC compared to the patients without BAC. The prevalence rate of MI symptoms in the patients with BAC was equal to 24.6%. Significantly, more women with BAC were positive for myocardial ischemia compared to the women without BAC (24.6% vs. 8.5%, p<0.001). The prevalence rates of the diabetes mellitus, hypertension, hypercholesterolemia, and history of CVDs were significantly higher in the patients who were positive for MI. Conclusion: It was found that BACs are correlated with an increased occurrence rate of CVDs. Our results illustrated that the patients who were positive for MI were more plausible to be diabetic, hyperlipidemic, hypertensive, and having a history of CVDs.
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Affiliation(s)
- Elham Shobeiri
- Department of Radiology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Rai
- Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Rouzbahani
- Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Reza Heidari Moghadam
- Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Javad Azimivghar
- Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Faranak Pourmirza
- Department of Radiology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hooman Tadbiri
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Nahid Salehi
- Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Choi TW, Chung JW, Kim HC, Lee M, Choi JW, Jae HJ, Hur S. Anatomic Variations of the Hepatic Artery in 5625 Patients. Radiol Cardiothorac Imaging 2021; 3:e210007. [PMID: 34498005 DOI: 10.1148/ryct.2021210007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/20/2021] [Accepted: 07/19/2021] [Indexed: 12/27/2022]
Abstract
Purpose To analyze the origin and anatomic course of the hepatic arteries by using digital subtraction angiography (DSA) and multidetector CT in a large study sample. Materials and Methods This retrospective study included 5625 patients who underwent liver CT and chemoembolization between January 2005 and December 2018 (mean age, 60 years ± 11 [range, 11-99 years]; 4464 males). The CT and DSA images were reviewed to evaluate the visceral arterial anatomy for variations in the celiac axis and hepatic arteries. Aberrant right hepatic arteries (aRHAs) and aberrant left hepatic arteries (aLHAs) were defined on the basis of their origin and anatomic course. Statistical analyses were performed to evaluate the association between aRHAs and aLHAs and the association between variations in the hepatic artery and celiac axis. Results Right hepatic arteries were categorized as being aRHAs (if originating from the proximal to middle common hepatic artery, gastroduodenal artery, superior mesenteric artery [SMA], celiac axis, aorta, splenic artery, or left gastric artery [LGA]) or as being aLHAs (if arising from the LGA, celiac axis, aorta, or SMA). The prevalence of aRHAs (15.63%; 879 of 5625) and the prevalence aLHAs (16.32%; 918 of 5625) were similar. Patients with an aRHA were more likely to have an aLHA than those without an aRHA (29.01% vs 13.97%; P < .001), and patients with an aLHA were more likely to have an aRHA than those without an aLHA (27.78% vs 13.26%; P < .001). There was no association between the hepatic arterial variations and celiac axis variations. A hypothetical anatomic model summarizing the observed variations was created. Conclusion A comprehensive list of hepatic arterial variations and a three-dimensional hypothetical model for the observed variations were described.Keywords: CT, Angiography, Liver, Anatomy, Arteries© RSNA, 2021 Supplemental material is available for this article. See also commentary by Sutphin and Kalva in this issue.
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Affiliation(s)
- Tae Won Choi
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Jin Wook Chung
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Hyo-Cheol Kim
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Myungsu Lee
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Jin Woo Choi
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Hwan Jun Jae
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Saebeom Hur
- Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
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50
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Murphy JG, Rajagopal KR. Inflation of residually stressed Fung-type membrane models of arteries. J Mech Behav Biomed Mater 2021; 122:104699. [PMID: 34332451 DOI: 10.1016/j.jmbbm.2021.104699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/28/2021] [Accepted: 07/05/2021] [Indexed: 11/24/2022]
Abstract
Elastic arteries are idealised as being incompressible orthotropic nonlinearly elastic cylinders. They are further idealised as being membranes in order to analyse the effect of the experimentally observed pre-stressing of arterial tissue on inflation. The pre-stress is modelled here using the opening-angle method. It is shown that there can be multiple unloaded states of arterial segments of Fung materials, suggesting the corresponding set of material parameters will not yield reliable predictions of arterial stress in three dimensions as there is no experimental evidence to support this non-uniqueness. It is also shown that the circumferential pre-strain has a simple magnifying scaling effect on the pressure-radial strain relation and on the axial force needed to maintain the membrane length during inflation; the effect of the axial pre-strain is more nuanced.
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Affiliation(s)
- J G Murphy
- Department of Mechanical Engineering, Dublin City University, Glasnevin, Dublin D09 W6Y4, Ireland; School of Mathematics, Statistics and Applied Mathematics, National University of Ireland Galway, University Road, Galway, Ireland.
| | - K R Rajagopal
- Department of Mechanical Engineering, Texas A&M University, College Station, TX 77845, USA
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