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The Journal of Vascular Access Dec 2023The anatomy of the femoral artery and vein plays an integral role in vascular access. Both technical feasibility and complication rates are associated with femoral...
BACKGROUND
The anatomy of the femoral artery and vein plays an integral role in vascular access. Both technical feasibility and complication rates are associated with femoral vessel diameter and depth. The goal of this study is to establish normative values for common femoral artery (CFA) and vein (CFV) depth and diameter using a large, diverse patient population.
METHODS
A retrospective review of all patients undergoing lower extremity venous duplex imaging over a 1 year period were reviewed. Patients with inadequate imaging or with evidence of deep vein thrombosis were excluded. The index image of all studies was a non-compressed view of the common femoral vein at the saphenous-femoral junction. All measurements were taken from this still. Vessel diameters were measured from intima to intima. Depth was measured from skin to intima. BMI and BSA were calculated using standard formulas. Chi square was used for univariate analysis. Linear regression was used to establish correlation.
RESULTS
Over the 1 year period, 983 patients met criteria for inclusion. The majority were male (53%) with a mean age of 55. The patients were 47% white and 44% black. The majority had hypertension (53%). The mean BMI and BSA were 29 and 2, respectively. Mean CFA depth was 1.7 cm, while mean CFV depth was 1.8 cm. The mean CFA and CFV diameters were 0.9 and 1.1 cm, respectively. Amongst height, weight, BMI, and BSA, weight correlated best with CFA ( = 0.548) and CFV ( = 0.552) depth, while BSA correlated best for diameter for both CFA ( = 0.390) and CFV ( = 0.440).
CONCLUSIONS
This study establishes mean diameters and depths for the common femoral artery and vein using a large, diverse patient group. BSA was most closely associated with vessel diameter, while weight was correlated with depth. This study provides normative diameter and depth values for the common femoral vasculature, which may assist in vascular access planning for providers.
PubMed: 38087816
DOI: 10.1177/11297298231200036 -
Journal of Clinical Medicine May 2022We aimed to determine whether retinal vessel diameters and retinal oxygen saturation in newly diagnosed patients with multiple sclerosis (pwMS) are different from those...
We aimed to determine whether retinal vessel diameters and retinal oxygen saturation in newly diagnosed patients with multiple sclerosis (pwMS) are different from those of a healthy population. Retinal blood vessel diameters were measured using imaging with a spectrophotometric non-invasive retinal oximeter. Twenty-three newly diagnosed untreated relapsing-remitting MS (RRMS) patients (mean age: 32.2 ± 7.5 years, age range = 18-50 years, 56.5% female) were measured and compared to 23 age- and sex-matched healthy controls (HCs) (mean age: 34.8 ± 8.1 years). Patients with Optic Neuritis were excluded. Retinal venular diameter (143.8 µm versus 157.8 µm: mean; = 0.0013) and retinal arteriolar diameter (112.6 µm versus 120.6 µm: mean; = 0.0089) were smaller in pwMS when compared with HCs, respectively. There was no significant difference in the oxygen saturation in retinal venules and arterioles in pwMS (mean: 60.0% and 93.7%; = 0.5980) compared to HCs (mean: 59.3% and 91.5%; = 0.8934), respectively. There was a significant difference in the median low contrast visual acuity (2.5% contrast) between the pwMS and the HC groups ( = 0.0143) Retinal arteriolar and venular diameter may have potential as objective biomarkers for MS.
PubMed: 35683496
DOI: 10.3390/jcm11113109 -
Investigative Ophthalmology & Visual... May 2022Infantile nystagmus syndrome (INS) causes altered visual development and can be associated with abnormal retinal structure, to which vascular development of the retina...
PURPOSE
Infantile nystagmus syndrome (INS) causes altered visual development and can be associated with abnormal retinal structure, to which vascular development of the retina is closely related. Abnormal retinal vasculature has previously been noted in albinism but not idiopathic infantile nystagmus. We compared the number and diameter of retinal vessels in participants with albinism (PWA) and idiopathic infantile nystagmus (PWIIN) with controls.
METHODS
Fundus photography data from 24 PWA, 10 PWIIN, and 34 controls was analyzed using Automated Retinal Image Analyzer (ARIA) software on a field of analysis centered on the optic disc, the annulus of which extended between 4.2 mm and 8.4 mm in diameter.
RESULTS
Compared with controls, the mean number of arterial branches was reduced by 24% in PWA (15.5 vs. 20.3, P < 0.001), and venous branches were reduced in both PWA (29%; 12.9 vs. 18.2, P < 0.001) and PWIIN (17%; 15.1 vs. 18.2, P = 0.024). PWA demonstrated 7% thinner "primary" (before branching) arteries (mean diameter: 75.39 µm vs. 80.88 µm, P = 0.043), and 13% thicker (after branching) "secondary" veins (66.72 µm vs. 59.01 µm in controls, P = 0.009).
CONCLUSIONS
PWA and PWIIN demonstrated reduced retinal vessel counts and arterial diameters compared with controls. These changes in the superficial retinal vascular network may be secondary to underdevelopment of the neuronal network, which guides vascular development and is also known to be disrupted in INS.
Topics: Albinism; Genetic Diseases, X-Linked; Humans; Nystagmus, Congenital; Nystagmus, Pathologic; Optic Disk; Retinal Vessels
PubMed: 35616929
DOI: 10.1167/iovs.63.5.33 -
SAGE Open Medicine 2022Activities that require increased load bearing are known to cause bony hypertrophy. This phenomenon has been documented in the dominant arm of athletes in sports...
OBJECTIVE
Activities that require increased load bearing are known to cause bony hypertrophy. This phenomenon has been documented in the dominant arm of athletes in sports requiring significant utilization of a single limb. The literature addressing this effect in rodeo athletes, however, is minimal. Studies evaluating rodeo athletes are primarily focused on acute injury management rather than chronic symptoms resulting from changes in bone and soft tissue. We designed a study to evaluate bony hypertrophy in athletes without acute injury.
METHOD
Rodeo bareback riders presented with frequent pain in their grip arm, no radiographic evidence of injury, and clinical signs of peripheral nerve compression. Anteroposterior and lateral X-rays taken for initial evaluation in 17 bareback rodeo athletes were retrospectively reviewed. The diameter of bilateral ulnas was measured at its longitudinal midpoint. Ratio of Ulnar Diameters (grip arm/free arm) and Percentage Diameter Difference were calculated. An independent samples -test was used to assess differences in diameters of grip and non-grip arms.
RESULT
The mean ulnar diameter was 18.4 ± 3.5 in the grip arm and 16.6 ± 3.5 in the non-grip arm ( < 0.001). The mean ratio of grip to free arm ulnar diameter was 1.42 ± 0.21 (range = 1.05-1.92). The mean diameter percent difference measured 42.3% (range = 4.7%-92.0%), and the grip arm was observed to have a greater ulnar diameter compared to the non-grip arm.
CONCLUSION
There are significant anatomic differences in the grip arm of bareback rodeo athletes compared to the contralateral arm. In cases of persistent pain in the grip arm and no evidence of acute injury, these differences may be relevant to pain symptoms and should be considered as part of the assessment and treatment algorithm.
PubMed: 35223028
DOI: 10.1177/20503121221077831 -
Acta Radiologica (Stockholm, Sweden :... Apr 2022Multiple sclerosis (MS) is a chronic neuroinflammatory disease characterized by inflammation involving the peripheral nerves. Shear wave elastography (SWE) is...
BACKGROUND
Multiple sclerosis (MS) is a chronic neuroinflammatory disease characterized by inflammation involving the peripheral nerves. Shear wave elastography (SWE) is potentially a method of choice for detecting peripheral nerve involvement.
PURPOSE
To compare the degree of thickening and nerve elasticity of brachial plexus (BP) nerve roots and evaluate the usefulness of sonoelastography in patients with clinically diagnosed MS without brachial plexopathy.
MATERIAL AND METHODS
Thirty-two patients with MS and 32 controls were included in the study. Bilateral C5, C6, and C7 mean nerve root diameters, and mean elasticity values in kiloPascal (kPa) were measured in the patient and control groups. The relationship between the age, height, and weight values and nerve diameter-elasticity values of the patient and control groups was compared.
RESULTS
The elasticity values of the C5 and C6 nerve roots were increased, and the nerve root thickness was decreased in the MS group compared to that in the control ( < 0.05). There was no difference between the C7 mean nerve root elasticity (kPa) and diameter measurements in the patient and control groups ( > 0.05).
CONCLUSION
Our study showed an increase in the BP nerve root elasticity values (kPa) in patients with MS compared to that of the control group and a decrease in diameter values thought to be related to the possible chronic atrophic process. The results are consistent with the demyelinating process of the peripheral nervous system (PNS) due to MS.
Topics: Adolescent; Adult; Brachial Plexus; Elasticity Imaging Techniques; Female; Humans; Male; Middle Aged; Multiple Sclerosis; Prospective Studies; Young Adult
PubMed: 33730859
DOI: 10.1177/02841851211002828 -
Turkish Journal of Anaesthesiology and... Feb 2022Debates continue about the cricoid pressure, which has been used for many years to prevent gastric aspiration during intubation. Using ultrasound, the effects of this...
OBJECTIVE
Debates continue about the cricoid pressure, which has been used for many years to prevent gastric aspiration during intubation. Using ultrasound, the effects of this maneuver and alternatives like paralaryngeal pressure are revealed. The aim of this observational study was to determine the effect of paralaryngeal pressure with an ultrasound probe on the esophageal diameter in patients with different body mass indexes and neck circumferences.
METHODS
After measuring the neck circumference at the level of the cricoid cartilage, the esophagus was visualized by ultrasonography. Compression was applied medially at a 45° angle toward the vertebral column by the ultrasound probe and esophageal anteroposterior outer diameters were measured. Correlations between body mass index, neck circumference, esophageal diameter, and esophageal diameter change ratio were evaluated with Pearson's r value.
RESULTS
One hundred ten volunteers (52 women and 58 men) with mean age 33.7 ± 8.02 years and mean body mass index 25.6 ± 4.65 kg m-2 were recruited. The esophagus was located 78.18% partially to the left, 4.54% completely to the left, 1.81% to the right of the cricoid ring. In 15.45%, esophagus could not be displayed. The mean diameter of the esophagus was 7.6 ± 1.1 mm before pressure and 5.6 ± 0.09 mm after pressure (P < .001). There was no significant correlation between diameter change percentage and body mass index (r=-0.22; P > .05). However, weak correlation was found between diameter change percentage and neck circumference (r=-0.33; P=.016).
CONCLUSIONS
Paralaryngeal pressure with an ultrasound probe has the potential to occlude the esophagus and may be effective in all patient groups.
PubMed: 35256340
DOI: 10.5152/TJAR.2021.1427 -
The Journal of Vascular Access Jul 2023There is no consensus of the optimal arterial and venous sizes on arteriovenous fistula (AVF) function and patency. The purpose of our study was to determine the...
BACKGROUND
There is no consensus of the optimal arterial and venous sizes on arteriovenous fistula (AVF) function and patency. The purpose of our study was to determine the influence of vein and artery sizes on maturation and patency in autologous first time AVF in a vascular access clinic of Mexican Social Security.
METHODS
Approved IRB single-center retrospective study in patients referred for their first AVF from 01/2018/ to 04/2020. Perianastomotic inner vein diameter and single inner artery diameter was recorded by duplex ultrasound. Outcomes were: failure to mature (FTM) and cumulative primary patency survival.
RESULTS
Eighty-six AVF's were created (mean age 45.5 ± 15.1 years; 62.8% male; mean BMI 25.9 ± 4.3 kg/m). About 86% were brachiocephalic AVF. Eight (8.1%) AVF had FTM. Mean follow-up was 19.7 ± 8.5 months. Two-year patency survival was 81.4%. FTM vein and artery diameters (2.1 ± 0.3 and 2.8 ± 0.7 mm respectively) were smaller than successful AVF's (3.1 ± 0.9 and 3.5 ± 0.6 mm) ( < 0.05). ROC curve calculated a 2.15 mm vein diameter cutoff (AUC: 0.86) and a 2.95 mm artery diameter cutoff (AUC: 079) for FTM AVF's (83% sensitivity, 72% specificity both) ( < 0.05). AVF's created with a vein diameter <2.15 mm and <2.95 mm artery diameter had statistically significant lower patency survival than AVF's with larger vein and artery diameters ( < 0.05).
CONCLUSION
Vein diameter <2.15 mm and artery diameter <2.95 mm influences AVF maturation and patency in a Mexican population.
Topics: Humans; Male; Adult; Middle Aged; Female; Arteriovenous Shunt, Surgical; Retrospective Studies; Renal Dialysis; Vascular Patency; Arteries; Arteriovenous Fistula; Treatment Outcome
PubMed: 34494490
DOI: 10.1177/11297298211044023 -
Journal of the American Veterinary... Mar 2024To measure the tracheal diameter and length in kittens using radiography and CT and to evaluate the concordance between measurements obtained with these 2 modalities.
OBJECTIVE
To measure the tracheal diameter and length in kittens using radiography and CT and to evaluate the concordance between measurements obtained with these 2 modalities.
ANIMALS
15 kittens with an estimated age of 12 weeks and mean body weight of 1.49 kg.
METHODS
Radiographic and CT images were retrospectively evaluated to measure tracheal lengths and diameters. Tracheal diameters were measured at 5 different sites (A [at the level of the C2-3 intervertebral disk space], B [at the level of the C4-5 intervertebral disk space], C [at the cranial end of the manubrium sterni], D [at the level of the second rib], and E [1 cm cranial to the carina]) along the trachea. The cross-sectional area and transverse and vertical diameter ratios were calculated for each measurement site.
RESULTS
The cross-sectional area was largest at site A and decreased from site C to site E. Based on the vertical diameter ratio, the tracheal shape was most circular at sites A and E, whereas from sites B to D, it was elliptical. The vertical diameters of the trachea on radiography and CT did not differ statistically significantly. However, the tracheal length measured on radiography was approximately 6 mm longer than that measured on CT (P < .05).
CLINICAL RELEVANCE
Using the first rib as an anatomical reference, the placement of a cuffed endotracheal tube is recommended in kittens. In emergency situations, regression equations based on body weight may be helpful in predicting tracheal diameters.
Topics: Female; Animals; Cats; Trachea; Retrospective Studies; Tomography, X-Ray Computed; Body Weight; Intubation, Intratracheal
PubMed: 38134454
DOI: 10.2460/javma.23.09.0538 -
Biomedical Physics & Engineering Express Aug 2022: Molecular breast imaging (MBI) is used clinically to visualize the uptake ofTc-sestamibi in breast cancers. Here, we use Monte Carlo simulations to develop a...
: Molecular breast imaging (MBI) is used clinically to visualize the uptake ofTc-sestamibi in breast cancers. Here, we use Monte Carlo simulations to develop a methodology to estimate tumor diameter in focal lesions and explore a semi-automatic implementation for clinical data.: A validated Monte Carlo simulation of the GE Discovery NM 750b was used to simulate >75,000 unique spherical/ellipsoidal tumor, normal breast, and image acquisition conditions. Subsets of this data were used to 1) characterize the dependence of the full-width at half-maximum (FWHM) of a tumor profile on tumor, normal breast, and acquisition conditions, 2) develop a methodology to estimate tumor diameters, and 3) quantify the diameter accuracy in a broad range of clinical conditions. Finally, the methodology was implemented in patient images and compared to diameter estimates from physician contours on MBI, mammography, and ultrasound imaging.: Tumor profile FWHM was determined be linearly dependent on tumor diameter but independent of other factors such as tumor shape, uptake, and distance from the detector. A linear regression was used to calculate tumor diameter from the FWHM estimated from a background-corrected profile across a tumor extracted from a median-filtered single-detector MBI image, i.e., diameter = 1.2 mm + 1.2 × FWHM, for FWHM ≥ 13 mm. Across a variety of simulated clinical conditions, the mean error of the methodology was 0.2 mm (accuracy), with >50% of cases estimated within 1-pixel width of the truth (precision). In patient images, the semi-automatic methodology provided the longest diameter in 94% (60/64) of cases. The estimated true diameters, for oval lesions with homogeneous uptake, differed by ± 5 mm from physician measurements.: This work demonstrates the feasibility of accurately quantifying tumor diameter in clinical MBI, and to our knowledge, is the first to explore its implementation and application in patient data.
Topics: Breast; Breast Neoplasms; Female; Humans; Mammography; Monte Carlo Method; Radionuclide Imaging
PubMed: 35917778
DOI: 10.1088/2057-1976/ac85f0 -
Clinical Oral Investigations Sep 2023To investigate the intraosseous arterial pathways and anastomoses in the alveolar aspects of the maxilla in order to better understand the arterial scattering pattern.
OBJECTIVES
To investigate the intraosseous arterial pathways and anastomoses in the alveolar aspects of the maxilla in order to better understand the arterial scattering pattern.
MATERIALS AND METHODS
Eleven cadavers were selected for macroscopic intraosseous arterial analyses by corrosion casting. The red-colored acrylic resin was injected into the external carotid arteries. The specimens were kept in an enzymatic solution at 36 °C for about 60 days, depending on the process progression. After removal of the soft tissues and drying, the bone was macerated by potassium hydroxide to analyze the course and the mean diameters of the intraosseous anastomoses.
RESULTS
Vertico-oblique and horizontal intraosseous arteries and anastomoses between the greater palatine-, posterior superior alveolar-, and infraorbital arteries were detected. The vertico-oblique anastomoses were found on the anterolateral wall of the maxilla and the alveolar crest with a mean diameter of 0.46 mm; nevertheless, the horizontal (transalveolar) anastomoses were identified in the interdental septum/alveolar crest with the mean diameter of 0.41 mm. From the horizontal anastomoses, small intraseptal branches supplied the territory of the alveolar socket in various directions.
CONCLUSIONS
The localization of intraosseous arterial anastomoses is critical in implant-related surgeries, predominantly to maintain proper circulation.
CLINICAL RELEVANCE
Based on vertico-oblique and transalveolar anastomoses, simultaneous buccal- and palatal flap elevation (particularly on the palatal side) should be avoided to minimize patient morbidity and intra- or postoperative complications. Moreover, preserving transverse loops in the interdental septum is essential during implant surgeries, which can significantly influence collateral periosteal and osteal circulation to prevent ischemia.
Topics: Humans; Maxilla; Dental Implants; Arteries; Cadaver
PubMed: 37460902
DOI: 10.1007/s00784-023-05141-9