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Cardiovascular system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
The thoracic aorta commences at the aortic valve and passes into the abdomen by passing through the diaphragmatic hiatus at the level of the T12 vertebral body. It is divided into the ascending aorta, aortic arch and descending aorta. Major vessels arise from the ascending aorta and arch. The right and left coronary arteries arise from the root of the ascending aorta close to the aortic valve cusps. The aortic arch gives rise to three large vessels that supply the head and neck region and the upper limbs: the brachiocephalic artery (also known as the brachiocephalic trunk or innominate artery), the left common carotid artery and the left subclavian artery. The brachiocephalic artery divides and give rise to the right common carotid and right subclavian arteries. Each common carotid artery divides into the internal and external carotid arteries. The vertebral artery arises as the first branch of the subclavian artery on each side. The subclavian artery passes laterally to continue as the axillary artery at the lateral border of the first rib. The axillary artery continues down the arm and at the inferior margin of the teres major muscle it becomes the brachial artery. At the cubital fossa the brachial artery divides into the radial and ulnar arteries, which continue down the forearm to the hand.
The new generation double layered flow diverters for endovascular treatment of intracranial aneurysms: current status of ongoing clinical uses
Published in Expert Review of Medical Devices, 2021
Orlin Pavlov, Adesh Shrivastava, Luis Rafael Moscote-Salazar, Rakesh Mishra, Ashish Gupta, Amit Agrawal
The insertion of FRED is achieved most commonly via transfemoral approach, where 6 F to 8 F guiding catheter is used. Under fluoroscopic control, the guiding catheter reaches the carotid artery or the vertebral artery. The length of FRED to be deployed depends solely on the width of the aneurysm’s neck, ensuring that at least 2 mm additional coverage in proximal and distal parts. The FRED is delivered via a microcatheter and under roadmap guidance, is unsheathed by slowly withdrawing the delivery microcatheter. Afterward an in-stent percutaneous transluminal angioplasty (PTA) is performed under fluoroscopy [15–17]. Like all similar devices, a preparation of the patient is required in order to reduce the risk of thromboembolic events. The start of double antiplatelet therapy (Aspirin/clopidogrel) is one week prior to the procedure and maintaining continuity for up to 6 months [18].
Comprehensive, technology-based, team approach for a patient with locked-in syndrome: A case report of improved function & quality of life
Published in Assistive Technology, 2019
Keara McNair, Madeline Lutjen, Kara Langhamer, Jeremiah Nieves, Kimberly Hreha
A.R. is a 39 year-old attorney and active cyclist with a past medical history of hypertension and hyperlipidemia. He was admitted to an acute hospital with new-onset left-sided weakness, left facial droop, impaired vision, and slurred speech. The initial Magnetic Resonance Imaging (MRI) of the brain revealed occlusions of the right vertebral artery and the basilar artery. He underwent mechanical thrombectomy and was intubated for airway protection. Repeat MRI of the brain revealed restricted diffusion within the bilateral cerebellar hemispheres, pons, left hippocampus, and right thalamus consistent with an evolving area of infarction. Also seen on this MRI was superimposed susceptibility within the pons compatible with hemorrhagic transformation of the area of infarction, a new focus of restricted diffusion within the left posteromedial midbrain, a small amount of hemorrhage layering dependently within the lateral ventricles, and scattered subarachnoid hemorrhages within the interpeduncular cistern and cerebral sulci. He later underwent tracheostomy and gastrostomy placement. Once medically stabilized, he was transferred to an inpatient rehabilitation facility with a primary diagnosis of LIS.
Porous interbody fusion cage design via topology optimization and biomechanical performance analysis
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2023
Nan Li, Yang Zhang, Qiaohong Tang, Hongkun Wang, Da He, Yan Yao, Yubo Fan
Degenerative Cervical spondylosis (DCS) has become a worldwide concern as its incidence tends to rise gradually. Severe DCS would cause compression of the cervical spinal cord, nerve root or vertebral artery, which could bring a series of clinical syndrome dysfunction, and needed surgical intervention treatment. In clinics, the treatment of DCS is generally anterior fusion and posterior fusion surgeries (Broekema et al. 2021). Anterior fusion surgery can directly relieve compression from the front of the spinal cord, has been the mainstream treatment of cervical spondylosis (Dean et al. 2009; Blais et al. 2017). As a kind of anterior fusion surgery, anterior cervical discectomy and fixation (ACDF) surgery can effectively restore the height of the intervertebral space, maintain the physiological curvature of the cervical spine and reconstruct the stability of the diseased segments (Robinson and Smith 2010). It has become the most commonly used surgical method for the treatment of various types of degenerative cervical spine diseases recently. The use of an intervertebral fusion cage in the ACDF surgery could help to achieve immediate postoperative stabilization, distract and maintain the height of the intervertebral space, and had achieved satisfactory clinical efficacy (Hacker 2002). However, 44% of patients still experienced cage subsidence (about 2-3 mm) (Tang et al. 2014) reported by an 11 years follow-up of the cases that use an interbody fusion cage. A mismatch of elastic modulus between fusion cages and bone endplates is considered one of the most common causes of cage subsidence (van Dijk et al. 2002; Lin et al. 2004; Kurtz and Devine 2007; Mobbs et al. 2016). Therefore, mechanical optimization of the fusion cage is required to improve the clinical efficacy.