INTRODUCTION: The inferior phrenic artery is a paired artery with a variable origin and course, primarily supplying the diaphragm, but also the suprarenal glands, inferior vena cava, stomach, and oesophagus. The aim of this study is to investigate the origin and course of the inferior phrenic arteries on multidetector computed tomography and angiography. MATERIALS AND METHODS: The anatomy of the inferior phrenic artery was analysed on 2449 multidetector computed tomography scans. Three-dimensional reconstructions were made of the main variations. Additionally, the course and branching pattern of the inferior phrenic artery were descriptively analysed in a cohort of 28 angiograms. RESULTS: In 565 (23.1%) cases the inferior phrenic arteries arose as a common trunk and in 1884 (76.9%) cases as individual vessels. The most common origins of a common trunk were the coeliac trunk (n=303; 53.6%) and abdominal aorta (n=255; 45.1%). The most common origins of the right inferior phrenic artery were the coeliac trunk (n=965; 51.2%), abdominal aorta (n=562; 29.8%) and renal arteries (n=214; 11.4%). The most common origins of the left inferior phrenic artery were the coeliac trunk (n=1293; 68.6%) and abdominal aorta (n=403; 21.4%). CONCLUSION: The inferior phrenic artery has a very variable anatomy. The most common origins of the inferior phrenic artery are the coeliac trunk and its branches, the abdominal aorta, and the renal arteries.
- MeSH
- angiografie metody MeSH
- aorta abdominalis anatomie a histologie diagnostické zobrazování MeSH
- arteria coeliaca * anatomie a histologie diagnostické zobrazování MeSH
- arterie anatomie a histologie diagnostické zobrazování MeSH
- bránice krevní zásobení diagnostické zobrazování anatomie a histologie MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- multidetektorová počítačová tomografie * MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- zobrazování trojrozměrné MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Způsob referování nálezu zobrazovacích metod významným způsobem ovlivňuje nutnost prohlížení CT dokumentace lékařem centra vysoce specializované cerebrovaskulární péče (KCC). V případě dlouhého intervalu při odeslání snímků do archivu KCC je významným způsobem prodloužen transport pacienta mezi centrem vysoce specializované péče o pacienta s iktem (IC) a KCC. Nezbytné je referovat rozsah ischemických změn v povodí ACM pomocí ASPECTS skóre. K vylučování pacientů z intervenční léčby na základě ASPECTS skóre je třeba přistupovat opatrně. Zásadní je dále správně identifikovat etáž okluze (zejména odlišení M1 a M2 úseku ACM), která spolurozhoduje o indikaci mechanické trombektomie. Pro strategii endovaskulárního výkonu je důležitá znalost postižení extrakraniálních tepen (stenózy, uzávěry). Referovat je vhodné anatomii krčních tepen s identifikací aortálního oblouku III. typu a výrazného vinutí krčních tepen, které mechanickou trombektomii komplikují. Tyto nálezy nejsou důvodem pro odmítnutí endovaskulárního výkonu.
The method of reporting the imaging techniques findings significantly affects the necessity of viewing the CT scans by the doctor in comprehensive cerebrovascular centre (CCC). In the case of a long interval when images are sent to the CCC archive, the transport of the patient between stroke centre (SC) and CCC is significantly prolonged. It is essential to report the extent of ischemic changes in the MCA territory using the ASPECTS score. Exclusion of patients from interventional treatment based on ASPECTS scores should be approached with caution. It is essential to correctly identify the level of occlusion (especially the distinction between M1 and M2 of the MCA segments), which co-determines the indication for mechanical thrombectomy. Knowledge of extracranial arteries involvement (stenoses, occlusions) is important for the strategy of endovascular surgery. It is appropriate to refer to the anatomy of the carotid arteries with the identification of the aortic arch type III. and significant looping of the carotid arteries, which complicate mechanical thrombectomy. These findings are not a reason to refuse an endovascular procedure.
- MeSH
- arterie anatomie a histologie MeSH
- CT angiografie MeSH
- infarkt arteria cerebri media diagnostické zobrazování patologie MeSH
- ischemická cévní mozková příhoda * diagnostické zobrazování patologie MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- mechanická trombolýza metody MeSH
- referování a indexace jako téma * MeSH
- ukazatele zdravotního stavu MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Cíl: Cílem studie bylo zmapovat morfometrii a variabilitu části břišní aorty a jejích větví - a. coeliaca (AC), a. mesenterica cranialis (AMC) a obou renálních tepen (ARS, ARD). Metodika: Byly hodnoceny CT skeny 13 zvířat (7 XY, 6 XX) o hmotnosti 28–33 kg, plemeno Přeštické černostrakaté. Měření byla prováděna na multiplanárních rekonstrukcích (MPR), tloušťka řezů 0,8 mm. Byl hodnocen průměr (P) aorty (Ao) a tepen AC, AMC a aa. renales v místě odstupu P Ao(X), včetně úhlu jejich odstupu (ÚO). Výsledky: Aorta se zužovala kaudálně, průměr v odstupu (P Ao (X)) AC a AMC byl 1,1 cm, P Ao(ARD, ARS) = 0,9 cm. Nejširší větví byla a. mesenterica cranialis. Průměrné hodnoty průsvitu kořene měřených tepen byly: P (AC) = 0,6 cm, P (AMC) = 0,7 cm, P (ARD, ARS) = 0,5 cm. Větve odstupovaly v kaudálně ostrém úhlu ÚO (X): ÚO (AC) = 67,9°, ÚO (AMC) = 75,8°, ÚO (ARD) = 64,4°, ÚO (ARS) = 72,2°. Středně silnou variabilitu úhlu odstupu jsme prokázali u úhlů odstupu AC a ARS (koeficient variace > 30, směrodatná odchylka > 20°). Sedmdesát procent renálních tepen (N = 9) odstupovalo stranově asymetricky v rozmezí L2–3. U samic byla pravá renální tepna širší (p = 0,007). Závěr: Naše výsledky mapují část tepen břicha u obou pohlaví prasete domácího (plemeno Přeštické černostrakaté, N = 13, hmotnost 28–33 kg). Předpokládáme jejich využití při plánování preklinických studií, pro zdokonalování chirurgického výcviku na prasečích modelech v oblasti cévní chirurgie i zobrazovacích metod.
Aim: The aim of the study was to map the morphometry and variability of a part of the abdominal aorta and its branches – the coeliac artery (AC), the cranial mesenteric artery (AMC) and both renal arteries (ARS, ARD). Methods: CT scans of 13 animals ((7 XY, 6 XX), weigh 28–33 kg, Přeštice black-pied breed) were evaluated. Measurements were performed in multiplanar reconstructions (MPR), slice thickness 0.8 mm. The transverse diameter (P) of aorta (Ao), AC, AMC and ARs at the point of separation P Ao(X), the exit angle (ÚO) including, were assessed. Results: Aorta narrowed caudally, in the segment between the AC and AR from 1.1 cm to 0.9 cm. The largest branch was the cranial mesenteric artery. The average values of the branches root lumen diameter P (X) were: P (AC) = 0.6 cm, P (AMC) = 0.7 cm, P (ARD, ARS) = 0.5 cm. The branches departed in a caudally sharp angle: ÚO (AC) = 67.9°, ÚO (AMC) = 75.8°, ÚO (ARD) = 64.4°, ÚO (ARS) = 72.2°. Moderately strong variability of the exit angle of the AC, and the ARS was demonstrated (coefficient of variation > 30, standard deviation > 20°). 70% of the renal arteries (N = 9) showed right-left asymmetry and exited between L2–3. In females, the right renal artery was wider (p = 0.007). Conclusions: Our results map a part of the abdominal arteries of the domestic pig, the Přeštice black-pied breed (N = 13, both sexes, weigh 28–33 kg). We anticipate their use for the preclinical studies designing, the surgical and imaging methods training in the field of vascular surgery.
- Klíčová slova
- morfometrie,
- MeSH
- aorta abdominalis anatomie a histologie diagnostické zobrazování MeSH
- arterie * anatomie a histologie diagnostické zobrazování MeSH
- CT angiografie MeSH
- neparametrická statistika MeSH
- pilotní projekty MeSH
- prasata * anatomie a histologie MeSH
- statistika jako téma MeSH
- tělesné váhy a míry MeSH
- Publikační typ
- práce podpořená grantem MeSH
INTRODUCTION: The circumflex scapular artery (CSA) has been described in detail in the literature, but the groove, i.e., the circumflex sulcus (CFS), formed by the artery on the lateral pillar of the scapula has been completely neglected. The aim of the present study was to describe the variability and anatomy of the CFS. MATERIALS AND METHODS: The study was based on the examination of 103 pairs of dry bone specimens of adult scapulae, i.e., 206 specimens, including 92 (46 pairs) male and 114 (57 pairs) female specimens. In the first step, quantitative criteria were defined for assessment of the CFS presence and type. Subsequently, statistical analysis of the obtained data was performed. RESULTS: The study revealed considerable variability of the arterial groove, which was well developed in 33% (type A), shallow in 40% (type B), and absent in 27% (type C) of cases. The mean distance between CFS and the infraglenoid tubercle was 3.3 cm CI0.95 (3.1-3.3), which corresponds to the proximal third of the lateral border of the scapula. CONCLUSION: The study has confirmed variability of the arterial groove (CFS) and its localization in relation to the inferior glenoid rim. The findings are clinically important, particularly in relation to the Judet approach to scapular fractures (localization of the CSA course).
- MeSH
- arterie anatomie a histologie MeSH
- dospělí MeSH
- lidé MeSH
- lopatka anatomie a histologie MeSH
- syndrom chronické únavy * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Cílem tohoto sdělení je shrnout dosavadní poznání anatomie tepen hlavy a krku prasete domácího pro potřeby experimentální chirurgie nebo zobrazovacích metod v biomedicínském výzkumu a translační medicíně. Potenciál prasete domácího jako velkého animálního modelu se zdá být značný i pro xenotransplantace některých orgánů. Nároky na znalost morfologických rozdílů analogických struktur člověka a vybraného experimentálního plemena rostou i v souvislosti s potřebou zpřesnění plánování experimentu nebo interpretace jeho výsledků. K prohloubení morfologických znalostí napomáhá také rozvoj zobrazovacích metod. Rešerše byla prováděna s použitím klíčových slov „prase domácí“, „tepny hlavy a krku“ v databázi MEDLINE, rozhraní PubMed.
The aim of this paper is to summarize the current knowledge of the anatomy of domestic pig head and neck arteries for the needs of experimental surgery and imaging methods in biomedical research and translational medicine. The potential of this large animal model seems to be valuable also for the xenotransplantation of certain organs. Demands for the knowledge of morphological differences between analogous human structures and particular breeds are growing also in connection with the need for more precise planning of experiments or interpretation of the results. Deepening anatomical knowledge is allowed also by the development of imaging methods. The search was performed using the keywords “domestic pig” and “arteries of the head and neck“ in the MEDLINE database, PubMed interface.
- Klíčová slova
- tepny hlavy a krku,
- MeSH
- aorta thoracica anatomie a histologie diagnostické zobrazování MeSH
- arterie * anatomie a histologie diagnostické zobrazování MeSH
- hlava diagnostické zobrazování krevní zásobení MeSH
- lidé MeSH
- modely u zvířat MeSH
- prasata MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- práce podpořená grantem MeSH
PURPOSE: The artery of Adamkiewicz (AKA) provides the major blood supply to the anterior thoracolumbar spinal cord and iatrogenic injury or inadequate reconstruction of this vessel during vascular and endovascular surgery can result in postoperative neurological deficit due to spinal cord ischemia. The aim of this study was to provide comprehensive data on the prevalence and anatomical characteristics of the AKA. METHODS: An extensive search was conducted through the major electronic databases to identify eligible articles. Data extracted included study type, prevalence of the AKA, gender, number of AKA per patient, laterality, origin based on vertebral level, side of origin, morphometric data, and ethnicity subgroups. RESULTS: A total of 60 studies (n = 5437 subjects) were included in the meta-analysis. Our main findings revealed that the AKA was present in 84.6% of the population, and patients most frequently had a single AKA (87.4%) on the left side (76.6%) originating between T8 and L1 (89%). CONCLUSION: As an AKA is present in the majority of the population, caution should be taken during vascular and endovascular surgical procedures to avoid injury or ensure proper reconstruction. All surgeons operating in the thoracolumbar spinal cord should have a thorough understanding of the anatomical characteristics and surgical implications of an AKA.
- MeSH
- arterie anatomie a histologie MeSH
- bederní obratle MeSH
- hrudní obratle MeSH
- lidé MeSH
- mícha krevní zásobení MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
- systematický přehled MeSH
- MeSH
- arterie anatomie a histologie fyziologie MeSH
- arteriovenózní anastomóza MeSH
- cévy anatomie a histologie inervace MeSH
- kolaterální oběh MeSH
- končetiny * krevní zásobení MeSH
- lidé MeSH
- lymfatické cévy anatomie a histologie fyziologie MeSH
- lymfatické uzliny anatomie a histologie fyziologie krevní zásobení MeSH
- pánev krevní zásobení MeSH
- vény anatomie a histologie fyziologie MeSH
- žilní chlopně anatomie a histologie MeSH
- Check Tag
- lidé MeSH
We offer a complete systemic review of the anatomy of arteries of the thumb, including their sources in the first web space. Eleven studies were selected from the PubMed, Medline, Embase, Scopus and Ovid databases. Data about each artery of the thumb were obtained; in particular, the incidence and dominance of each of these arteries were calculated. The ulnopalmar digital artery of the thumb (UPDAT) was found in 99.63%, the radiopalmar digital artery of the thumb (RPDAT) in 99.26%, the ulnodorsal digital artery of the thumb (UDDAT) in 83.39%, and the radiodorsal digital artery of the thumb (RDDAT) in 70.38%. The sources for the thumb arteries are the first palmar metacarpal artery (for UPDAT in 63.15%, for RPDAT in 78.88%, for UDDAT in 56.95% and for RDDAT in 41.48%), the first dorsal metacarpal artery (for UPDAT in 20.54%, for RPDAT 2.53%, for UDDAT in 20.62%, and for RDDAT in 4.81%) and the superficial palmar arch, either complete or incomplete (for UPDAT in 25.57%, for RPDAT in 23.04%, for UDDAT in 0%, and for RDDAT in 5.19%). The dominant source could be identified in 88.2% of cases: the first palmar metacarpal artery (66.2%), the first dorsal metacarpal artery (15.5%) and the superficial palmar arch, complete or incomplete (8.2%). Four arteries usually supply the thumb. Any artery in the first web space can be a source for the thumb arteries. We propose a new classification of the arteries of the hand, dividing them into three systems (superficial palmar, deep palmar and dorsal system), and suggest that the term "princeps pollicis artery" be reconsidered and systemic anatomical terms of the thumb arteries preferred. Clin. Anat. 30:963-973, 2017. ©2017 Wiley-Liss, Inc.
- MeSH
- arterie anatomie a histologie MeSH
- lidé MeSH
- palec ruky krevní zásobení MeSH
- ruka krevní zásobení MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Hemodynamics in the distal end-to-side anastomosis is related to early development of intimal hyperplasia and bypass failure. In this study we investigated the effect of diameter ratios between the target artery and the bypass at three different angles of the connection. The pulsatile flow field was visualized using particle image velocimetry in transparent models with three different angles of the connection (25°, 45°, 60°) and the diameter ratio between the bypass and the target artery was 4.6 mm : 6 mm, 6 mm : 6 mm, and 7.5 mm : 6 mm. Six parameters including location and oscillation of the stagnation point, local energy dissipation, wall shear stress (WSS), oscillatory shear index, spatial and temporal gradient of WSS and their distribution in the target artery were calculated from the flow field. In the wider bypass, the stagnation point oscillated in a greater range and was located more proximal to the anastomosis. Energy dissipation was minimal in a wider bypass with a more acute angle. The maximum WSS values were tree times greater in a narrow bypass and concentrated in a smaller circular region at the floor of the anastomosis. The oscillatory shear index increased with wider bypass and more acute angle. The maximum of spatial gradient of WSS concentrated around the floor and toe of the anastomosis and decreased with more acute angle and wider bypass, the temporal gradient of WSS was stretched more towards the side wall. Greater bypass to target vessel ratio and more acute anastomosis angle promote hemodynamics known to reduce formation of intimal hyperplasia.
- MeSH
- anastomóza chirurgická * MeSH
- arterie anatomie a histologie fyziologie chirurgie MeSH
- fyziologický stres MeSH
- hemodynamika * MeSH
- hyperplazie * MeSH
- mechanický stres MeSH
- modely kardiovaskulární MeSH
- pevnost ve smyku MeSH
- přenos energie MeSH
- pulzatilní průtok MeSH
- rychlost toku krve MeSH
- Publikační typ
- časopisecké články MeSH
We present a unique unilateral case of a superficial brachiomedian artery that coincides with a variable palmaris longus muscle in a male cadaver. The superficial brachiomedian artery branched at the distal part of the right arm and coursed superficially in the cubital and antebrachial regions. Then it passed through the carpal canal and formed a complete superficial palmar arch by joining the trunk of the ulnar artery. The variable bitendinous palmaris longus was composed of a central belly and two asymmetrical tendons inserting mainly on the ulnar side of the flexor retinaculum. The knowledge of this arterial variant is of high clinical relevance for the catheterization, for the harvesting of the forearm artery as a graft, for the collateral circulation in cases of arterial occlusion, for surgical management of the carpal tunnel syndrome, or in cases of injury of the superficially located variant artery.
