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Canadian Association of Radiologists... Feb 2022The purpose of this article is to review the embryology of the lower limb arterial anatomy along with common variants and their clinical relevance. (Review)
Review
OBJECTIVES
The purpose of this article is to review the embryology of the lower limb arterial anatomy along with common variants and their clinical relevance.
DESIGN
Embryologic variations of the lower limb arterial system may be explained by i.) persistence of primordial arterial segments, ii.) abnormal fusion, iii.) segmental hypoplasia/absence, or a combination of both. Persistent sciatic artery, corona mortis, and popliteal entrapment syndrome will also be discussed with associated symptoms, and potential complications.
CONCLUSION
Knowledge of these variations is essential for surgical and endovascular management as failure to recognize them can result in complications.
Topics: Arteries; Female; Humans; Lower Extremity; Male
PubMed: 33886403
DOI: 10.1177/08465371211003860 -
Acta Neurologica Belgica Apr 2023Numerous but inconclusive findings have sparked an ongoing debate about whether the arteries of migraine patients undergo vascular alterations. The outlet angle of the...
BACKGROUND
Numerous but inconclusive findings have sparked an ongoing debate about whether the arteries of migraine patients undergo vascular alterations. The outlet angle of the superior cerebellar artery (SUCA) and the lateral displacement of basilar arteries are good surrogate parameters for determining elongation of the vertebrobasilar arteries.
METHODS
We retrospectively determined the SUCA outlet angle and the lateral displacement of the basilar artery in 63 patients with migraine (30.6 ± 8.9 years, 84% women, 16% chronic migraine, 60% migraine with aura) and compared these with 126 age- and sex-matched control subjects.
RESULTS
In patients with migraine, the SUCA outlet angle was lower (159 ± 26° vs. 169 ± 29°, p = 0.020) and the lateral displacement of the basilar artery was greater (3.7 ± 2.7 mm vs. 2.8 ± 2.4 mm, p = 0.020) than in the control subjects. Age, gender, migraine characteristics and presence of any cardiovascular risk factors did not affect the SUCA outlet angle or lateral displacement of the basilar artery.
CONCLUSION
Migraine patients exhibited a lower SUCA outlet angle and greater lateral displacement of the basilar arteries. Both may be attributable to the elongation of the vertebrobasilar arteries, which is an indication of arterial wall pathology in migraine.
Topics: Adult; Female; Humans; Male; Basilar Artery; Cardiovascular Diseases; Cross-Sectional Studies; Migraine Disorders; Retrospective Studies; Risk Factors
PubMed: 35906498
DOI: 10.1007/s13760-022-02039-3 -
Current Opinion in Hematology May 2020Elastin has historically been described as an amorphous protein that functions to provide recoil to tissues that stretch. However, evidence is growing that elastin's... (Review)
Review
PURPOSE OF REVIEW
Elastin has historically been described as an amorphous protein that functions to provide recoil to tissues that stretch. However, evidence is growing that elastin's role may not be limited to biomechanics. In this minireview, we will summarize current knowledge regarding vascular elastic fibers, focusing on structural differences along the arterial tree and how those differences may influence the behavior of affiliated cells.
RECENT FINDINGS
Regional heterogeneity, including differences in elastic lamellar number, density and cell developmental origin, plays an important role in vessel health and function. These differences impact cell-cell communication, proliferation and movement. Perturbations of normal cell-matrix interactions are correlated with human diseases including aneurysm, atherosclerosis and hypertension.
SUMMARY
Although classically described as a structural protein, recent data suggest that differences in elastin deposition along the arterial tree have important effects on heterotypic cell interactions and human disease.
Topics: Animals; Arteries; Elastic Tissue; Elastin; Humans; Vascular Diseases
PubMed: 32141894
DOI: 10.1097/MOH.0000000000000578 -
American Journal of Physiology.... Mar 2022Breath-hold diving evokes a complex cardiovascular response. The degrees of hypertension induced by the diving reflex are substantial and accentuated by the underwater...
Breath-hold diving evokes a complex cardiovascular response. The degrees of hypertension induced by the diving reflex are substantial and accentuated by the underwater swimming. This condition provides a circulatory challenge to properly buffer and cushion cardiac pulsations. We determined hemodynamic changes during the diving maneuver and hypothesized that central artery compliance would be augmented during simulated breath-hold diving. A total of 20 healthy young adults were studied. Hemodynamics were measured during exercise on a cycle ergometer, apnea, face immersion in cold water (trigeminal stimulation), and simulated breath-hold diving. Arterial compliance was measured by recording the carotid artery diameter from images derived from an ultrasound machine at the cephalic portion of the common carotid artery 1-2 cm proximal to the carotid bulb, whereas arterial pressure waveforms were obtained using an arterial tonometry placed on the contralateral carotid artery and recorded on a data acquisition software. The change in diameter was divided by the change in blood pressure to calculate arterial compliance. Arterial compliance increased with simulated diving compared with rest ( = 0.007) and was elevated compared with exercise and apnea alone ( < 0.01). A significant increase in heart rate was observed with exercise, apnea, and facial immersion when compared with rest ( < 0.001). However, simulated diving brought the heart rate down to resting levels. Cardiac output increased with all conditions ( < 0.001), with an attenuated response during simulated diving compared with exercise and facial immersion ( < 0.05). Mean blood pressure was elevated during all conditions ( < 0.001), with a further elevation observed during simulated diving compared with exercise ( < 0.001), apnea ( = 0.016), and facial immersion ( < 0.001). Total peripheral resistance was decreased during exercise and facial immersion compared with rest ( < 0.001) but was increased during simulated diving compared with exercise ( < 0.001), apnea ( = 0.008), and facial immersion ( = 0.003). We concluded that central artery compliance is augmented during simulated breath-hold diving to help buffer cardiac pulsations.
Topics: Adaptation, Physiological; Adult; Arterial Pressure; Breath Holding; Carotid Arteries; Diving; Diving Reflex; Female; Healthy Volunteers; Heart Rate; Hemodynamics; Humans; Male; Vascular Resistance; Vasoconstriction
PubMed: 35018822
DOI: 10.1152/ajpregu.00202.2021 -
International Angiology : a Journal of... Oct 2019Visceral arterial aneurysms and pseudoaneurysms are rare entities. Despite infrequent, these lesions are clinically important and potentially lethal, since 22% present... (Review)
Review
Visceral arterial aneurysms and pseudoaneurysms are rare entities. Despite infrequent, these lesions are clinically important and potentially lethal, since 22% present as clinical emergencies and 8.5% result in death. As such, early detection and treatment is essential. Through this work, we aim to address both visceral arterial aneurysms and pseudoaneurysms, with particular focus on their epidemiology, etiology and risk factors, as well as report current diagnostic workups and treatment strategies. A full literature review was performed through a comprehensive electronic search of PubMed databases, including articles published until the end of November 2018 and using the following keywords: "visceral aneurysm," "pseudoaneurysm" and "endovascular treatment." From this research, 2043 articles had their abstract assessed, 359 were read integrally, 213 were excluded for not being directly related to the subject and 146 were included, according to the authors preference and scientific relevance in this work's context. Visceral arterial aneurysms and pseudoaneurysms have fairly similar clinical presentations and diagnostic workups. Differences reside mainly in their etiology and indications for treatment, since immediate treatment is recommended for pseudoaneurysms regardless of their size, while true aneurysms have specific treatment cutoffs. Despite a significant improvement on current diagnostic and treatment strategies, these lesions are still frequently diagnosed only upon rupture, with significant mortality rates. Endovascular strategies represent the first line of treatment on the majority of cases, although open surgery continues to play a role in specific conditions. Visceral arterial aneurysms and pseudoaneurysms are rare but potentially fatal and, as such, proper diagnosis and treatment is of capital importance. Due to its minimally invasive nature, endovascular therapies currently represent the standard of care in the majority of situations, although there are still solid indications for open surgery. Technique selection should be performed according to the clinical scenario and baseline anatomy.
Topics: Aneurysm; Aneurysm, False; Arteries; Diagnostic Imaging; Embolization, Therapeutic; Endovascular Procedures; Humans; Risk Factors; Treatment Outcome; Viscera
PubMed: 31284707
DOI: 10.23736/S0392-9590.19.04194-4 -
Scientific Reports Mar 2022Aging and atherosclerotic progression can lead to geometric changes in the carotid arteries. We conducted a longitudinal study to investigate geometric changes in the...
Aging and atherosclerotic progression can lead to geometric changes in the carotid arteries. We conducted a longitudinal study to investigate geometric changes in the bilateral carotid arteries. We conducted a retrospective study of 177 subjects who underwent carotid contrast-enhanced magnetic resonance angiography (MRA) at our clinic at baseline and 10 years after the procedure. Semi-automated methods were used to segment the bilateral carotid arteries to obtain carotid artery geometric measurements. The mean age for the total population after 10 years was 70.7 ± 10.6 years (male, 40.1%). The mean time interval between baseline and after 10 years for all subjects was 130.2 ± 8.1 months. The bilateral bifurcation angle, the diameters for both common carotid arteries (CCAs), and areas of both CCAs significantly increased (p < 0.001) over a 10-year period. The maximum diameter and internal carotid artery area did not significantly change. The bifurcation angle of the right carotid artery was significantly increased compared to the left carotid artery. However, the diameter and area of the CCA of the left carotid artery was significantly increased compared to the right carotid artery. The bifurcation angle, diameter and area of both CCAs significantly increased over a decade. The change in the bifurcation angle over a 10-year period was predominant in the right carotid artery and the change of the area and diameter of the CCA was dominant in the left carotid artery.
Topics: Carotid Arteries; Carotid Artery, Common; Child; Humans; Longitudinal Studies; Magnetic Resonance Angiography; Male; Retrospective Studies
PubMed: 35322148
DOI: 10.1038/s41598-022-09062-7 -
BioMed Research International 2019In an attempt to describe the morphofunctional consequences of uni- and bilateral aplasia of the common carotid artery (CCA), which is usually a vascular source of the... (Review)
Review
In an attempt to describe the morphofunctional consequences of uni- and bilateral aplasia of the common carotid artery (CCA), which is usually a vascular source of the external carotid (ECA) and internal carotid (ICA) arteries, we investigated online databases of anatomical and clinical papers published from the 18th century to the present day. We found 87 recorded cases of uni- and bilateral CCA aplasia in subjects from the first hours to the eighth decade of life, which had been discovered in 14 (known) countries. Four crucial parameters were described: the embryology of the carotid arteries, morphophysiology of the carotid arteries, CCA aplasia, and unilateral versus bilateral CCA aplasia, including history, general data, diagnosing, vascular sources, caliber, course of the separated ECA and ICA, associated vascular variants, and pathological disorders. To complete the knowledge of the morphofunctional consequences of the absence of some artery of the carotid system, and risking the possibility of repeating some words, as "carotid artery", or "carotid aplasia" and the headings from our previous article about bilateral ICA absence, this review is the first in the literature that recorded all cases of the CCA aplasia published and/or cited for the past 233 years. Main characteristic of the CCA absence is its association with 21 different diseases, among which the aneurysms were in 13.69% of cases, and 17.80% of cases were without pathology.
Topics: Carotid Arteries; Carotid Artery Diseases; Carotid Artery, Common; Carotid Artery, External; Carotid Artery, Internal; Databases, Factual; Humans
PubMed: 31976332
DOI: 10.1155/2019/9896138 -
Medicina (Kaunas, Lithuania) Jan 2022: The "classic" thyroid gland arterial vascularization takes into account two superior thyroid arteries (STA), two inferior thyroid arteries (ITA) and, occasionally, a... (Review)
Review
: The "classic" thyroid gland arterial vascularization takes into account two superior thyroid arteries (STA), two inferior thyroid arteries (ITA) and, occasionally, a thyroid ima artery (TIMA). The present review focuses on exploring the available data concerning thyroid gland arterial vascularization and its variations. : Here, we analysed 49 articles from the last century, ranging from case reports to reviews concerning cadaver dissection classes, surgical intervention, and non-invasive techniques as well. : The harvested data clearly highlighted that: (i) the STA originates predominantly from the external carotid artery; (ii) the ITA is a branch of the thyrocervical trunk; and (iii) the TIMA is a very uncommon variant predominantly occurring to compensate for ITA absence. : A systematic review of a highly vascularized organ is of great relevance during surgical intervention and, thus, the knowledge of normal anatomy and its modification is essential both for fact-finding and in surgery.
Topics: Arteries; Cadaver; Humans; Neovascularization, Pathologic; Thyroid Gland
PubMed: 35056445
DOI: 10.3390/medicina58010137 -
Oral and Maxillofacial Surgery Mar 2022The close topographic relationship between vascular and osseous structures in the condylar and subcondylar region and marked variability in the arterial course has been...
Proximity of the middle meningeal artery and maxillary artery to the mandibular head and mandibular neck as revealed by three-dimensional time-of-flight magnetic resonance angiography.
PURPOSE
The close topographic relationship between vascular and osseous structures in the condylar and subcondylar region and marked variability in the arterial course has been revealed by both imaging and cadaveric studies. This study aimed to verify the previously published information in a large sample and to determine a safe surgical region.
METHODS
We analyzed the three-dimensional time-of-flight magnetic resonance angiography images of 300 individuals.
RESULTS
The mean distance between the middle meningeal artery and the apex of the condyle or the most medial point of the condyle was 18.8 mm (range: 11.2-25.9 mm) or 14.5 mm (range: 8.8-22.9 mm) respectively. The course of the maxillary artery relative to the lateral pterygoid muscle was medial in 45.7% of cases and lateral in 54.3%. An asymmetric course was evident in 66 patients (22%). The mean distance between the maxillary artery and condylar process at the deepest point of the mandibular notch was 6.2 mm in sides exhibiting a medial course (range: 3.7-9.8 mm) and 6.6 mm in sides exhibiting a lateral course (range: 3.9-10.4 mm). The distances were significantly influenced by age, gender, and the course of the maxillary artery.
CONCLUSION
Our study emphasizes the marked inter- and intra-individual variability of the maxillary and middle meningeal arterial courses. We confirmed the proximity of the arteries to the condylar process. Extensive surgical experience and thorough preparation for each individual case are essential to prevent iatrogenic vascular injury.
Topics: Humans; Magnetic Resonance Angiography; Mandible; Mandibular Condyle; Maxillary Artery; Meningeal Arteries
PubMed: 34024006
DOI: 10.1007/s10006-021-00960-0 -
Medicina (Kaunas, Lithuania) Jan 2023: Anatomical variations of the arterial circle of Willis (cW) are common. A posterior cerebral artery (PCA) fed mostly or exclusively from the internal carotid artery is...
: Anatomical variations of the arterial circle of Willis (cW) are common. A posterior cerebral artery (PCA) fed mostly or exclusively from the internal carotid artery is a fetal PCA (FPCA), partial (p-FPCA), or full/complete (f-FPCA), respectively. Because FPCA occurs in different anatomical configurations of the cW sides, we aimed to document in detail these morphological possibilities of FPCA within the cW. : FPCAs were documented on a retrospective set of 139 computed tomography angiograms. : FPCAs were found in thirteen cases, nine males and four females. In 7/13 cases there were two modified sides of the cW. In 5/13 cases there were three altered sides of the cW. Another case with FPCA showed four altered sides of the cW. In 10/13 cases, FPCA was unilateral and in the other three cases it was bilateral. Compared to the overall group, unilateral p-FPCAs were found in 1.43%, while unilateral f-FPCAs were found in 5.75%. A bilateral p-FPCA-f-FPCA combination was found in 0.71% and a bilateral f-FPCA-f-FPCA combination occurred in 1.43%. An anatomically isolated ICA was found in just one case with bilateral f-FPCA (0.71%). In 7/13 FPCA cases there were arterial variants exclusively in the posterior cW. In the other 6/13 FPCA cases, there were variants in both anterior and posterior circulation. There were no statistically significant associations of FPCA with sex or age. The higher prevalence of right-sided FPCA was not statistically significant. : Anatomical assessments of cW should be performed on a case-by-case basis, as they may correspond to different cW morphologies.
Topics: Male; Female; Humans; Posterior Cerebral Artery; Retrospective Studies; Arteries; Circle of Willis; Tomography, X-Ray Computed
PubMed: 36837433
DOI: 10.3390/medicina59020231