Congenital coronary artery anomalies
Jana Popelová, Erwin Oechslin, Harald Kaemmerer, Martin G St John Sutton, Pavel Žáček in Congenital Heart Disease in Adults, 2008
In adulthood, congenital coronary artery anomalies represent more often as an incidental finding rather than the cause of clinical complaints. However, in some cases, congenital coronary anomalies may cause atypical chest pains, anginal pain, arrhythmias, sudden death or heart failure, even in adulthood. In patients with this coronary anomaly, the left coronary artery usually arises from the left posterior sinus of the pulmonary artery, rarely as far as the pulmonary artery trunk or branch. Its branching pattern is usually normal into left anterior descending and left circumflex arteries. While not usually dilated in childhood, an anomalous left coronary artery is usually tortuous, dilated and thin-walled in adulthood, and resembles a vein. A communication of a coronary artery with right-heart chambers creates a left-to-right shunt whose size is dependent on the fistula flow rate. In large fistulas, the shunt results in volume overload, right-heart chamber dilatation and increased pulmonary flow.
Clinical Importance and Management of Splanchnic Artery Aneurysms
Samuel Eric Wilson in 50 Landmark Papers Every Vascular and Endovascular Surgeon Should Know, 2020
Splanchnic artery aneurysms are unusual but important vascular lesions. Nearly 22% of all reported splanchnic artery aneurysms present as clinical emergencies, including 8.5% that result in death. More than 2,000 of these aneurysms have been documented in the literature. The most commonly involved vessels, in decreasing order of frequency, include the history and treatment must be individualized. The Society for Vascular Surgery proposed Clinical Practice Guidelines on the management of visceral artery aneurysm in 2020. This document summarizes that, because of their potential for rupture, most visceral artery pseudoaneurysms, mycotic aneurysms, and many larger and asymptomatic true aneurysms warrant intervention. Treatment can generally be accomplished by either open surgical or endovascular approaches, with the goal of preventing aneurysm expansion and potential rupture by exclusion from the arterial circulation while maintaining necessary distal or collateral bed perfusion.
Stenting and Medical Therapy for Atherosclerotic Renal-Artery Stenosis
Samuel Eric Wilson in 50 Landmark Papers Every Vascular and Endovascular Surgeon Should Know, 2020
Atherosclerotic renal-artery stenosis is a common problem in the elderly. Despite two randomized trials that did not show a benefit of renal-artery stenting with respect to kidney function, the usefulness of stenting for the prevention of major adverse renal and cardiovascular events is uncertain. This chapter discusses the Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL) study aimed to investigate the clinical outcomes of stenting in atherosclerotic renal artery disease. Specifically, this study was performed to assess the effects of renal-artery stenting on major cardiovascular and renal outcomes in patients with hypertension, chronic kidney disease, or both as a result of atherosclerotic renal artery stenosis. The CORAL study was designed to elucidate the effects of renal artery stenting on major cardiovascular and renal outcomes and showed that when added to comprehensive medical therapy, stenting did not confer a significant clinical benefit, in accordance with the prior renal artery stenting randomized trials.
Anatomy: Macroanatomic investigations of the blood supply of thoracic limb of Kangal dogs
Published in Veterinary Quarterly, 2001
S. Tipirdamaz, H. Yalçin, N. Dursun
Summary In this study, the arterial supply of the thoracic limb was investigated in Kangal dogs. Twelve adult healthy Kangal dogs of either sex were used. Latex was injected into the common carotid artery, and then the axillary artery was dissected. The axillary artery is a continuation of the sub‐clavian artery and supplies the thoracic limb in Kangal dogs. The axillary artery gave off a deltoid branch and external thoracic, lateral thoracic, and subscapular thoracic arteries in its course along the thoracic wall. The axillary artery continues distally as the brachial artery in the arm. The brachial artery gives rise to the cranial humeral circumflex, deep brachial, bicipital, ulnar collateral, superficial brachial, transverse cubital, and common interosseus arteries. It continues as the median artery after giving off the common interosseus artery. It was observed that the deep antebrachial artery arose from the median artery at the proximal third of the forearm. In the distal third of the forearm, the median artery divided into the palmar carpal and dorsal carpal branches. The deep palmar branch of the radial artery and deep branch of the palmar branch of the caudal interosseus artery form the deep palmar arch. The median artery joined the superficial branch of the palmar branch of the caudal interosseus artery to constitute the superficial palmar arch. The radial artery and cranial interosseus artery contributed to the dorsal carpal rete. The ulnar artery contributed to the formation of the deep and superficial palmar arches.
Microsurgical anatomy of the short central artery
Published in Neurological Research, 1998
Moises Vasquez-Loayza, Manuel Dujovny, Celso Agner, Mukesh Misra
We studied the origin, length, external diameter, disposition, branching patterns and the perforators ofshort central artery in the circle of Willis in eighty fresh, unfixed cerebral hemispheres (40 brains). We also examined the relationship of the short central artery, the recurrent artery of Heubner, and M 1 perforators to the anterior perforated substance, caudate and putamen. The short central artery arises at 5.2 ± 3.36 mm from the origin of the anterior cerebral artery, hidden and overlapped by the internal carotid artery bifurcation. The recurrent artery ofHeubner arises distally to the origin of the short central artery. Four main anatomical variations were found: 1. Presence of short central artery and recurrent artery of Heubner (37.5±). 2. Isolated presence of the short central artery (27.5%). 3. Isolated presence of the recurrent artery of Heubner (21.25%). 4. Absence of short central artery and recurrent artery of Heubner (73.75%). Two different branching patterns were observed: 1. 2-4 straight perforators from the short central artery, perforators from the recurrent artery of Heubner and lenticulostriate from the most medial portion of the M 1, in 42 of 80 hemispheres (52.5%). 2. 8-10 perforators from only short central artery in 10 of 80 hemispheres (12.5%) with absent or hypoplastic recurrent artery of Heubner and lenticulostriates from M1 and M2. [Neural Res 1998; 20: 209-217]
The effect of loading dose of magnesium sulfate on uterine, umbilical, and fetal middle cerebral arteries Doppler in women with severe preeclampsia: A case control study
Published in Hypertension in Pregnancy, 2016
Ahmed M. Maged, Ahmed M. T. Hashem, Sherine H. Gad Allah, Mohamed El Mahy, Walaa A. I. Mostafa, Amal Kotb
SYNOPSIS IV MgSO4 administration in women with severe preeclampsia resulted in a decrease in umbilical artery, uterine artery, and fetal middle cerebral artery Doppler indices. Objective: To evaluate Doppler parameters of the umbilical artery (UmA), uterine artery (UA), and fetal middle cerebral artery (MCA) before and after MgSO4 administration in women with severe preeclampsia. Methods: A case control study included 100 pregnant women with severe preeclampsia. Umbilical artery, uterine artery, and fetal middle cerebral artery Doppler were measured before and 20 minutes after intravenous administration of 6 g of magnesium sulfate. Results: There was a significant difference between maternal systolic blood pressure (173.20 ± 22.72 vs. 156.60 ± 19.18), diastolic blood pressure (109.60 ± 9.14 vs. 101.90 ± 10.05), and heart rate (80.52 ± 11.52 vs. 88.48 ± 12.08) before and after administration of MgSO4 in the studied patients (p value < 0.001). There was a significant difference between umbilical artery, middle cerebral artery, and uterine artery Doppler parameters before and after administration of MgSO4 in the studied patients (p value < 0.001). There was no significant difference between umbilical artery/middle cerebral artery with regard to RI and PI. However, there was significant difference with regard to the S/D ratio (p value < 0.001). The decrease in the values of Doppler parameters before and after administration of MgSO4 was more in the middle cerebral artery than in the umbilical artery. Conclusion: Intravenous administration of magnesium sulfate in pregnant women with severe preeclampsia resulted in a decrease in umbilical artery, uterine artery, and fetal middle cerebral artery Doppler indices with reduced resistance to blood flow in these vessels.