-
Surgical and Radiologic Anatomy : SRA Dec 2014The superior horizontal pancreatic artery was described in 1910, and after a few years, it was forgot by most investigators. This research is aimed to revive the... (Review)
Review
PURPOSE
The superior horizontal pancreatic artery was described in 1910, and after a few years, it was forgot by most investigators. This research is aimed to revive the description of this artery, describing course, pattern of branching and frequency.
METHODS
More than 1,000 of angiographies including studies of the superior mesenteric artery, celiac trunk and its branches, were selected from the angiographic archives of the ex-institutes of Radiology of Siena, Rome (University of Sacro Cuore) and Perugia, and the arterial anatomy of the pancreas was studied.
RESULTS
A pancreatic branch of the splenic artery running along the superior border of the pancreatic body and tail was observed in 25.93% of cases. This branch matched the description of the superior horizontal pancreatic artery and, when existing, replaced the pancreatica magna artery. For this reason, we considered the superior horizontal pancreatic artery as a variant of the pancreatica magna artery. Variable in caliber and importance, in most cases the superior horizontal pancreatic artery gave off descending branches that anastomosed with the inferior pancreatic artery.
CONCLUSIONS
A superior horizontal pancreatic artery could be visualized more easily by selective angiography of the splenic artery. When coupled with the inferior pancreatic artery, the presence of the superior horizontal pancreatic artery outlined a longitudinally arranged pattern of blood supply of the distal pancreas that should be known. In particular circumstances, extended resections of the gland cutting both longitudinal arteries might jeopardize the surviving of the pancreas remnant.
Topics: Angiography; Arteries; Celiac Artery; Hepatic Artery; Humans; Mesenteric Artery, Superior; Pancreas; Splenic Artery
PubMed: 24599560
DOI: 10.1007/s00276-014-1276-8 -
Cellular and Molecular Life Sciences :... Aug 2022Endothelial cells in veins differ in morphology, function and gene expression from those in arteries and lymphatics. Understanding how venous and arterial identities are...
Endothelial cells in veins differ in morphology, function and gene expression from those in arteries and lymphatics. Understanding how venous and arterial identities are induced during development is required to understand how arterio-venous malformations occur, and to improve the outcome of vein grafts in surgery by promoting arterialization of veins. To identify factors that promote venous endothelial cell fate in vivo, we isolated veins from quail embryos, at different developmental stages, that were grafted into the coelom of chick embryos. Endothelial cells migrated out from the grafted vein and their colonization of host veins and/or arteries was quantified. We show that venous fate is promoted by sympathetic vessel innervation at embryonic day 11. Removal of sympathetic innervation decreased vein colonization, while norepinephrine enhanced venous colonization. BMP treatment or inhibition of ERK enhanced venous fate, revealing environmental neurotransmitter and BMP signaling and intrinsic ERK inhibition as actors in venous fate acquisition. We also identify the BMP antagonist Noggin as a potent mediator of venous arterialization.
Topics: Animals; Arteries; Cell Differentiation; Chick Embryo; Endothelial Cells; Signal Transduction; Veins
PubMed: 35987946
DOI: 10.1007/s00018-022-04470-4 -
Journal of Hypertension Aug 2017
Topics: Adult; Arteries; Carotid Arteries; Carotid Stenosis; Female; Humans; Male; Manometry; Middle Aged; Models, Cardiovascular; Pulse Wave Analysis; Ultrasonography; Vascular Stiffness
PubMed: 28657974
DOI: 10.1097/HJH.0000000000001394 -
Circulation Research Jan 2015The hypothesis that immunity and inflammation participate in the pathogenesis of vascular diseases has now gained widespread recognition and stimulated work around the... (Review)
Review
The hypothesis that immunity and inflammation participate in the pathogenesis of vascular diseases has now gained widespread recognition and stimulated work around the globe. Broadening knowledge has extended the recognition of the role of immune and inflammatory mechanisms to all of the layers of the artery, to all levels of the arterial tree, and implicated virtually all arms, cellular players, and effector molecules and pathways involved in these crucial host defenses, that turn against us in disease. We provide here a guide to a compendium series of articles that aimed to look forward and broaden the traditional focus of immunopathogenesis of arterial disease, with the goal of integrating the players and the layers involved. Although the field has advanced remarkably, much remains to be done, and this commentary also aims to highlight some of the gaps that future research should strive to close on the participation of inflammation and immunity in arterial diseases.
Topics: Animals; Arteries; Humans; Immunity, Innate; Inflammation; Vascular Diseases
PubMed: 25593275
DOI: 10.1161/CIRCRESAHA.116.301313 -
The Western Journal of Emergency... Dec 2015Penetrating injury to the forearm may cause an isolated radial or ulnar artery injury, or a complex injury involving other structures including veins, tendons and... (Review)
Review
INTRODUCTION
Penetrating injury to the forearm may cause an isolated radial or ulnar artery injury, or a complex injury involving other structures including veins, tendons and nerves. The management of forearm laceration with arterial injury involves both operative and nonoperative strategies. An evolution in management has emerged especially at urban trauma centers, where the multidisciplinary resource of trauma and hand subspecialties may invoke controversy pertaining to the optimal management of such injuries. The objective of this review was to provide an evidence-based, systematic, operative and nonoperative approach to the management of isolated and complex forearm lacerations. A comprehensive search of MedLine, Cochrane Library, Embase and the National Guideline Clearinghouse did not yield evidence-based management guidelines for forearm arterial laceration injury. No professional or societal consensus guidelines or best practice guidelines exist to our knowledge.
DISCUSSION
The optimal methods for achieving hemostasis are by a combination approach utilizing direct digital pressure, temporary tourniquet pressure, compressive dressings followed by wound closure. While surgical hemostasis may provide an expedited route for control of hemorrhage, this aggressive approach is often not needed (with a few exceptions) to achieve hemostasis for most forearm lacerations. Conservative methods mentioned above will attain the same result. Further, routine emergent or urgent operative exploration of forearm laceration injuries are not warranted and not cost-beneficial. It has been widely accepted with ample evidence in the literature that neither injury to forearm artery, nerve or tendon requires immediate surgical repair. Attention should be directed instead to control of bleeding, and perform a complete physical examination of the hand to document the presence or absence of other associated injuries. Critical ischemia will require expeditious surgical restoration of arterial perfusion. In a well-perfused hand, however, the presence of one intact artery is adequate to sustain viability without long-term functional disability, provided the palmar arch circulation is intact. Early consultation with a hand specialist should be pursued, and follow-up arrangement made for delayed primary repair in cases of complex injury.
CONCLUSION
Management in accordance with well-established clinical principles will maximize treatment efficacy and functional outcome while minimizing the cost of medical care.
Topics: Arteries; Forearm; Forearm Injuries; Humans; Lacerations; Ligation; Tourniquets; Trauma Centers
PubMed: 26759666
DOI: 10.5811/westjem.2015.10.28327 -
Journal of Vascular Surgery Aug 2019Sport-related vascular trauma is an important consequence of increased physical activity. Repetitive, high-intensity movements predispose athletes to vascular disease,... (Review)
Review
BACKGROUND/OBJECTIVE
Sport-related vascular trauma is an important consequence of increased physical activity. Repetitive, high-intensity movements predispose athletes to vascular disease, including arterial pathology, by exerting increased pressure on neurovascular structures. This is an important source of morbidity in an otherwise young and healthy population. Arterial pathology associated with repetitive trauma is often misdiagnosed as musculoskeletal injury. This article increases awareness of sport-related arterial disease by reviewing the symptomatology, investigation, and treatment modalities of this pathology. In addition, prognostic outcomes specific to the athlete are discussed.
RESULTS
Arterial thoracic outlet syndrome and vascular quadrilateral space syndrome are associated with athletes involved in overhead throwing exercises. Sport-related arterial pathology of the lower limb include external iliac artery endofibrosis (EIAE), popliteal artery entrapment syndrome (PAES), and adductor canal syndrome. Vascular stress and kinking secondary to vessel tethering are important contributors to pathology in EIAE. Chronic exertional compartment syndrome must also be considered, presenting with clinical features similar to PAES. In addition, athletes are predisposed to blunt mechanical trauma. Hypothenar hammer syndrome is one such example, contributing to a high burden of morbidity in this population.
CONCLUSIONS
In arterial thoracic outlet syndrome and vascular quadrilateral space syndrome, surgery is advocated in symptomatic individuals, with postoperative outcomes favorable for the athlete. Acute limb ischemia may occur as a result of secondary thrombosis or embolization, often without preceding claudication. PAES and adductor canal syndrome are associated with functional entrapment in the athlete, secondary to muscular hypertrophy. Surgical exploration may be indicated. Poorer outcomes are noted when this process is associated with vascular reconstruction. Surgical treatment of EIAE follows failure of conservative management, with limited data available on postoperative prognosis. Investigations for all these conditions should be targeted based on clinical suspicion. A delay in diagnosis can have severe consequences on return to competition in these high-functioning individuals.
Topics: Arteries; Athletes; Athletic Injuries; Humans; Recovery of Function; Return to Sport; Risk Factors; Treatment Outcome; Vascular System Injuries
PubMed: 31113722
DOI: 10.1016/j.jvs.2019.02.002 -
Current Opinion in Clinical Nutrition... Nov 2019The purpose of this review is to provide a concise overview of the polyphenol curcumin for improving arterial health, specifically endothelial function and arterial... (Review)
Review
PURPOSE OF REVIEW
The purpose of this review is to provide a concise overview of the polyphenol curcumin for improving arterial health, specifically endothelial function and arterial stiffness, to reduce cardiovascular disease (CVD) risk and to highlight potential mechanisms of action by which curcumin may improve artery function.
RECENT FINDINGS
The primary findings of this review support the notion for curcumin to improve arterial health both with aging and obesity. There are few clinical trials on curcumin, and those that currently exist are small in scale but provide evidence for curcumin to improve endothelial function in older adults and reduce arterial stiffness in young, obese men. The antioxidant and anti-inflammatory properties of curcumin appear to be important targets of curcumin that are related to improved arterial health. Mechanistic studies have revealed superoxide dismutase, heme oxygenase-1 and nuclear factor erythroid 2-related factor 2 as emerging targets for the beneficial effects of curcumin on the vasculature.
SUMMARY
In summary, the efficacy of curcumin for improving arterial function is promising in the limited number of clinical studies performed to date. Still, much investigation is needed to elucidate the effectiveness of curcumin for improving arterial health to lower CVD risk.
Topics: Anti-Inflammatory Agents; Antioxidants; Arteries; Curcumin; Humans; Inflammation; Oxidative Stress; Vascular Diseases; Vascular Stiffness
PubMed: 31577640
DOI: 10.1097/MCO.0000000000000598 -
AJNR. American Journal of Neuroradiology Dec 2019Although considerable variability exists as to the overall caliber of radiculomedullary arteries, dominant radiculomedullary arteries such as the artery of Adamkiewicz...
BACKGROUND AND PURPOSE
Although considerable variability exists as to the overall caliber of radiculomedullary arteries, dominant radiculomedullary arteries such as the artery of Adamkiewicz exist. The existence of a great posterior radiculomedullary artery has attracted little attention and has been a matter of debate. The aim of this anatomic study was to determine the presence or absence of the great posterior radiculomedullary artery.
MATERIALS AND METHODS
We performed microsurgical dissection on formaldehyde-fixed cadaveric human spinal cords. The artery of Adamkiewicz in the spinal cord specimens ( = 50) was injected with colored latex until the small-caliber arterial vessels were filled and the great posterior radiculomedullary artery was identified. The course, diameter, and location of great posterior radiculomedullary artery were documented.
RESULTS
A great posterior radiculomedullary artery was identified in 36 (72%) spinal cord specimens. In 11 (22%) specimens, bilateral great posterior radiculomedullary arteries were present. In 13 cases (26%), a unilateral left-sided great posterior radiculomedullary artery was identified. In 11 cases (22%), a unilateral right-sided great posterior radiculomedullary artery was identified. In 1 specimen (2%), 3 right-sided great posterior radiculomedullary arteries were noted. The average size of the great posterior radiculomedullary arteries was 0.44 mm (range, 0.120-0.678 mm on the left and 0.260-0.635 mm on the right).
CONCLUSIONS
A great posterior radiculomedullary artery is present in most (72%) individuals. The authors describe the microsurgical anatomy of the great posterior radiculomedullary artery with emphasis on its morphometric parameters as well as its implications for spinal cord blood supply. Variations of the arterial supply to the dorsal cord are of great importance due to their implications for ischemic events, endovascular procedures, and surgical approaches.
Topics: Adult; Aged; Arteries; Cadaver; Female; Humans; Lumbosacral Region; Male; Microdissection; Middle Aged; Regional Blood Flow; Spinal Cord; Young Adult
PubMed: 31753838
DOI: 10.3174/ajnr.A6304 -
Stroke Oct 2021The anatomic distribution of the deep cerebral perforators is considered either a given or subject to enormous variability. Most published overviews on this topic only... (Review)
Review
The anatomic distribution of the deep cerebral perforators is considered either a given or subject to enormous variability. Most published overviews on this topic only report findings from a limited number of anatomic dissections, and no attempt has been made to date to provide a comprehensive overview of all published data. A comprehensive literature search was performed on MEDLINE, Embase, and Google Scholar with the help of an information specialist. Three types of studies were included: (1) articles that described the anatomy and distribution territories of perforator groups arising from the arteries of the circle of Willis; (2) studies that evaluated the anatomy of the deep cerebral perforators using imaging techniques; and (3) studies that evaluated either microsurgically or radiologically confirmed perforator occlusion and reported the (magnetic resonance imaging-confirmed) distribution territory of the infarction together with a description of the clinical symptoms associated as a result of the infarction. A total of 2715 articles were screened and 53 were included. Of these, 40 dealt with the anatomic and imaging anatomy of perforator groups (37 reported results of dissections and 3 results of imaging studies), with a total of 2421 hemispheres investigated. Another 13 articles with 680 patients were included that evaluated perforator infarction territories. The deep cerebral perforator distribution shows large variability with poor concordance rates among reported studies, with the exception of the posterior communicating and anterior choroidal artery perforators. Despite the assumption that cerebral perforator anatomy is a given, studies show large variability in the anatomic distribution of various perforator groups. Perforator anatomy and relationships between perforator groups, as well as potential collateral circulation in these territories should be prioritized as a research topic in cerebrovascular disease in the near future.
Topics: Animals; Arterial Occlusive Diseases; Carotid Artery, Internal; Cerebral Arteries; Cerebrovascular Circulation; Collateral Circulation; Humans; Magnetic Resonance Imaging
PubMed: 34311568
DOI: 10.1161/STROKEAHA.120.034096 -
Anatomical Record (Hoboken, N.J. : 2007) Nov 2020The congenital short limb (CSL) with fibular deficiency has traditionally been graded by plain radiography. The most popular orthopedic classification sorts the fibular... (Review)
Review
The congenital short limb (CSL) with fibular deficiency has traditionally been graded by plain radiography. The most popular orthopedic classification sorts the fibular dysmorphologies into three radiographic groupings: IA (thinned), IB (proximally truncated), or II (absent). In contrast, the soft tissues have been relatively neglected. Since bone formation of the fibula progresses from the anlage, a scaffolding cartilage mold intermediate, cartilage transformation to bone is dependent upon timely embryonic arterial invasion. Absences of the requisite arteries predicate specific skeletal dysmorphologies. The usual arterial supply of the fibula is comprised primarily of the anterior tibialis artery (ATA), which uniquely supplies the proximal portion of the fibula, and also joins the peroneal artery (PA) in supplying the mid to distal fibular shaft. Combinations of the two nutrient arteries allow four potential variations of fibular vascular supply, among which the ATA and PA conjoin to supply the normal fibula and variably supply the three dysmorphic fibular models. The IA and IB deformities conform, respectively, to the absences of the PA and the ATA. Combined ATA and PA absences present in the radiographically "absent" fibula. Thus, each of the four fibular (dys)morphologies conforms to a specific embryonic pattern of arterial development. The term "dystrophism" most accurately characterizes such malformed long bones.
Topics: Arteries; Fibula; Humans; Lower Extremity Deformities, Congenital; Radiography
PubMed: 31872958
DOI: 10.1002/ar.24348