Normal Vascular Anatomy: Normal Arterial Anatomy

2009 ◽  
Keyword(s):  
Vascular Anatomy ◽  
Arterial Anatomy

scholarly journals ARTERY FIRST TECHNIQUE FOR MANAGEMENT OF ABERRANT HEPATIC ARTERIAL ANATOMY DURING PANCREATICODUODENECTOMY-EXPERIENCE FROM A SPECIALIZED HEPATO-PANCREATO-BILIARY UNIT

2016 ◽  
Vol 2 (2) ◽  
Author(s):  
Muhammad Taqi Pirzada ◽  
Raza Sayyed ◽  
Aamir Ali Syed ◽  
Fasial Hanif
Keyword(s):  
Hepatic Artery ◽  
Vascular Anatomy ◽  
Liver Parenchyma ◽  
Replaced Right Hepatic Artery ◽  
Classi Cation ◽  
Hepatic Vessels ◽  
Artery First ◽  
Operative Recovery ◽  
Arterial Anatomy ◽  
Liver Ischaemia

Purpose: Aberrant hepatic arterial anatomy poses a challenge for surgeon during pancreaticoduodenectomy (PD). These anomalies are best picked up on pre-operative imaging to avoid inadvertent injury to the aberrant vasculature resulting in liver ischaemia or biliary-enteric anastomotic failure. We present our experience of dealing with aberrant hepatic vessels during PD. Methods: Patients with aberrant hepatic vasculature who underwent PD between September 2014 and August 2015 were included in the study. We used artery rst technique for dissection in cases identified on pre operative imaging. Aberrations were classed according to Hiatt classi cation. Results: A total of 23 PD were performed with aberrant arterial anatomy in 10 (43%) cases. These vessels were recognised and preserved in nine cases. In one patient, the replaced right hepatic artery (RRHA) arising from superior mesenteric artery (SMA) was coursing through pancreatic parenchyma needing resection and reconstruction with uneventful post-operative recovery. We also identified one RRHA arising from SMA coursing lateral to common bile duct and entering liver parenchyma in gallbladder fossa. Conclusion: Aberrant hepatic arterial anomalies are common and should ideally be picked up by pre-operative imaging. It is possible to preserve these vessels in most cases with careful surgical dissection using artery first technique. Surgeons performing PD should be well versed with the aberrant vascular anatomy to minimise any inadvertent damage. Key words: Aberrant hepatic artery, artery first technique, pancreaticoduodenectomy 

scholarly journals Segmental Identity and Vulnerability in Cerebral Arteries

2000 ◽  
Vol 6 (2) ◽  
pp. 113-124 ◽  
Author(s):  
P.L. Lasjaunias
Keyword(s):  
Regional Differences ◽  
Morphological Analysis ◽  
Cerebral Arteries ◽  
Vascular Anatomy ◽  
Arterial Segment ◽  
Biological Responses ◽  
Short Period ◽  
Regional Specificity ◽  
Arterial Anatomy ◽  
Segmental Identity

Clinical experience shows that certain diseases involve specific areas of the vascular tree and remarkably spare others. Topographic differences in the vascular environment already suggest a regional specificity of the vascular anatomy. The biological grounds of such regional differences, although unknown, can account for the specificity of biological responses to stimuli. Such segmental specificities are beyond morphological analysis. They create an invisible discontinuity in an apparently homogenous anatomical, histological and haemodynamic system. We call this property segmental identity and thus vulnerability. Most of this identity is established during development and is preserved throughout life; its expression, however, may vary over time according to various stresses and create various clinical phenotypes. The memory of the evolutionary steps and their chronology is imprinted on the arterial anatomy and thus potentially readable. One can postulate that since the age of each arterial segment is different, its resistance to time and stimuli is most likely variable. The vulnerability of these segments cannot be permanent both in a qualitative and quantitative way. Some genetic functions only seem to be active during a short period of time: during vasculogenesis for example. Therefore either the trigger is always active and the target vulnerability window of the cells time-limited, or the target is permanently exposed and the trigger agent can either be exogenous and rare, or most of the time inactive or inactivated.

scholarly journals Impact of Virtual Reality in Arterial Anatomy Detection and Surgical Planning in Patients with Unruptured Anterior Communicating Artery Aneurysms

2020 ◽  
Vol 10 (12) ◽  
pp. 963
Author(s):  
Samer Zawy Alsofy ◽  
Ioanna Sakellaropoulou ◽  
Makoto Nakamura ◽  
Christian Ewelt ◽  
Asem Salma ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Surgical Planning ◽  
Haptic Feedback ◽  
Three Dimensional ◽  
Vascular Anatomy ◽  
Anatomical Variations ◽  
Surgical Strategy ◽  
Anterior Communicating Artery ◽  
Head Positioning ◽  
Arterial Anatomy

Anterior-communicating artery (ACoA) aneurysms have diverse configurations and anatomical variations. The evaluation and operative treatment of these aneurysms necessitates a perfect surgical strategy based on review of three-dimensional (3D) angioarchitecture using several radiologic imaging methods. We analyzed the influence of 3D virtual reality (VR) reconstructions versus conventional computed tomography angiography (CTA) scans on the identification of vascular anatomy and on surgical planning in patients with unruptured ACoA aneurysms. Medical files were retrospectively analyzed regarding patient- and disease-related data. Preoperative CTA scans were retrospectively reconstructed to 3D-VR images and visualized via VR software to detect the characteristics of unruptured ACoA aneurysms. A questionnaire was used to evaluate the influence of VR on the identification of aneurysm morphology and relevant arterial anatomy and on surgical strategy. Twenty-six patients were included and 520 answer sheets were evaluated. The 3D-VR modality significantly influenced detection of the aneurysm-related vascular structure (p = 0.0001), the recommended head positioning (p = 0.005), and the surgical approach (p = 0.001) in the planning of microsurgical clipping. Thus, reconstruction of conventional preoperative CTA scans into 3D images and the spatial presentation in VR models enabled greater understanding of the anatomy and pathology, provided realistic haptic feedback for aneurysm surgery, and influenced operation planning and strategy.

Normal cerebrovascular physiology and vascular anatomy

2019 ◽  
pp. 539-558
Author(s):  
Diederik O. Bulters ◽  
Andrew Durnford
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Intracranial Pressure ◽  
Cerebral Perfusion ◽  
Vascular Anatomy ◽  
Vessel Diameter ◽  
Cerebral Veins ◽  
Deep Cerebral Veins ◽  
Neurovascular Anatomy ◽  
Arterial Anatomy

The first part of this chapter describes normal neurovascular anatomy including its embryology, histology, and normal arterial variants. It includes angiographic arterial anatomy and also the structures and territories supplied by specific vessels. The anatomy of the venous sinuses and both the superficial and deep cerebral veins are described. The second part details normal cerebral neurophysiology, including autoregulation and the control of cerebral perfusion. It covers the myogenic, metabolic, and neurogenic mechanisms of cerebral blood flow and vessel diameter regulation. Finally, the role and influence of mannitol on cerebral blood flow is described, and how although it acutely reduces cerebral volume and intracranial pressure, its exact mechanism of action remains unclear.

scholarly journals The Usefulness of Magnetic Resonance Angiography to Analyse the Variable Arterial Facial Anatomy in an Effort to Reduce Filler-Associated Blindness: Anatomical Study and Visualisation Through an Augmented Reality Application

2021 ◽  
Author(s):  
Marc Mespreuve ◽  
Karl Waked ◽  
Barbara Collard ◽  
Joris De Ranter ◽  
Francis Vanneste ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Augmented Reality ◽  
Minimally Invasive ◽  
Vascular Anatomy ◽  
Facial Rejuvenation ◽  
Dermal Filler ◽  
Facial Anatomy ◽  
The Individual ◽  
Arterial Anatomy

Abstract Background The use of soft tissue fillers for facial rejuvenation is increasing rapidly and the complications, unfortunately, follow the same path. Blindness caused by intravascular filler injections is a rare but devastating complication. Knowledge of the individual arterial anatomy may aid the injector in avoiding injecting into an artery. Increasing the awareness about and illustration of the extreme variations in the individual vascular anatomy and subsequently procuring information for the accurate planning of those, so called, minimally invasive procedures may help to prevent blindness. Objectives To evaluate if the use of Magnetic Resonance Angiography (MRA) may visualise the arterial facial anatomy in a contrast- and radiation-free way and study the individual arterial variations using an augmented reality (AR) image. Methods The individual arterial anatomy of the three terminal branches of the Ophthalmic Artery (Supraorbital (SO); Supratrochlear (STr); and Dorsal Nasal (DN) arteries) of 20 volunteers was studied by a 3 Tesla MRI, adapting a recently published imaging technique, combining infrared (IR) facial warming and 3D-TOF MOTSA MRA. The resulting visualisation of the facial arteries was shown on the patient’s face through AR technology. Results The MRA was able to visualise the SO in 90.0%, STr in 92.5%, and DN arteries in 75% of the examined patients, as well as numerous variations in both vessel localization and path. Furthermore, a proof-of-concept of the AR-visualisation of the individual arterial anatomy was successfully implemented. Conclusions Dermal filler injectors should be aware of the risk of filler-induced blindness and familiarise themselves with the visualisation of the variable facial vascular anatomy around the eye. The implementation of a one-time MRA and subsequent AR-visualisation may be useful in the accurate planning of minimally invasive facial rejuvenation procedures.

Balloon anchoring technique for thrombectomy in hostile craniocervical arterial anatomy

2020 ◽  
Vol 12 (8) ◽  
pp. 763-767
Author(s):  
Vera Sharashidze ◽  
Raul G Nogueira ◽  
Alhamza R Al-Bayati ◽  
Jonathan A Grossberg ◽  
Diogo C Haussen
Keyword(s):  
Aortic Arch ◽  
Vascular Anatomy ◽  
Large Vessel ◽  
Large Vessel Occlusion ◽  
Vessel Occlusion ◽  
Guide Catheter ◽  
Procedural Time ◽  
Type 3 ◽  
Arterial Anatomy ◽  
Anchoring Technique

BackgroundCraniocervical catheter access in large vessel occlusion acute ischemic strokes can be challenging in cases of unfavorable aortic arch/cervical vascular anatomy, leading to lower recanalization rates, increased procedural time and worse clinical outcomes. We aim to demonstrate the feasibility of the balloon-anchoring technique (BAT) that can be attempted before switching to alternative access sites.MethodsRetrospective review of prospectively collected information on 11 patients in which two variants of the BAT (proximal anchoring: balloon guide catheter (BGC) is inflated to provide support for distal access; distal anchoring: compliant balloon is inflated in an intracranial artery to allow advancement of the support system) were utilized to facilitate craniocervical access due to failure of conventional maneuvers.ResultsTen patients had anterior and one patient had posterior circulation large vessel occlusions. Mean age was 81 years and 81% were females. Type 3 arches were found in 82% and a 9 French balloon guide catheter was used in 82%. Proximal anchoring with BGC was used in four cases while distal anchoring was used in seven patients to allow access to the target vessel, avoiding the need to puncture alternative access sites. Successful reperfusion (modified treatment in cerebral ischemia 2b-3) was achieved in all cases and no complications were observed.ConclusionBAT is safe and feasible. It can be considered as a rescue maneuver in order to avoid switching to a different access during thrombectomy in individuals with unfavorable aortic arch/craniocervical anatomy.

scholarly journals Preoperative identification of anomalous arterial anatomy at pancreaticoduodenectomy

2014 ◽  
Vol 96 (5) ◽  
pp. e34-e36 ◽  
Author(s):  
P Müller ◽  
K Randhawa ◽  
KJ Roberts
Keyword(s):  
Abdominal Surgery ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Vascular Anatomy ◽  
Anatomical Variations ◽  
Common Hepatic Artery ◽  
Rare Finding ◽  
Upper Abdominal ◽  
Arterial Anatomy ◽  
Pancreatic Gland

The understanding of abdominal vascular anatomy and its anatomical variations is of considerable importance in upper abdominal surgery. We present the rare finding of a common hepatic artery arising from the superior mesenteric artery and passing anterior to the pancreatic gland in a patient undergoing a pancreaticoduodenectomy.

Variations in the Anterolateral Thigh Flap's Vascular Anatomy in African Americans

2017 ◽  
Vol 34 (04) ◽  
pp. 300-306 ◽  
Author(s):  
Soobin Lim ◽  
Noah Atwi ◽  
Sarah Long ◽  
Aran Toshav ◽  
Frank Lau
Keyword(s):  
Multinomial Logistic Regression ◽  
Medical Center ◽  
Academic Medical Center ◽  
Vascular Anatomy ◽  
Preoperative Imaging ◽  
Chi Square ◽  
Circumflex Femoral Artery ◽  
Organ Systems ◽  
Anterolateral Thigh ◽  
Arterial Anatomy

Background Variations in anterolateral thigh (ALT) arterial anatomy are well documented. Ethnicity is a known risk factor for vascular variation in several organ systems, but its impact on ALT anatomy has not been studied. Anecdotally, we observed frequent ALT arterial variation in African American (AA) patients. We thus hypothesized that AA patients have higher rates of anomalous branching. Materials and Methods A total of 277 computed tomography angiograms (513 lower extremities) captured between May 1, 2013 and May 31, 2015 at a tertiary academic medical center were retrospectively analyzed to determine ALT arterial branching. Patient records were examined to ascertain demographics. Data were analyzed using descriptive statistics and multinomial logistic regression. Results Males comprised 84.5%. Ethnic distribution was 55.2% AA and 36.5% Caucasian. The descending branch of the lateral circumflex femoral artery (dLCFA) originated from non-LCFA arteries (deep femoral, common femoral, or superficial femoral arteries) in 18.9% of Caucasian versus 9.1% of AA (odds ratio [OR]: 2.28; 95% confidence interval [CI]: 1.33–3.93, p < 0.01). An oblique branch was identified in 41.1% of Caucasian versus 51.9% of AA (OR: 1.56; 95% CI: 1.08–2.24, p = 0.02). Ethnicity was the only driving factor of dLCFA and oblique branch of the LCFA (oLCFA) anatomy (Wald chi-square: 14 and 11, p = 0.03 and 0.02, respectively). Conclusions Ethnicity significantly affects ALT arterial anatomy. AA are more likely to have classical dLCFA branching with a fourth oLCFA branch. A flap with an unrecognized oLCFA-dominant supply places patients at a higher risk for flap failure and loss. We recommend preoperative imaging before undertaking an ALT flap reconstruction.

scholarly journals Modification of cerebral vascular anatomy induced by Leo stent placement depending on the site of stenting: A series of 102 cases

2016 ◽  
Vol 22 (6) ◽  
pp. 666-673 ◽  
Author(s):  
Y Chau ◽  
L Mondot ◽  
M Sachet ◽  
J Gaudart ◽  
D Fontaine ◽  
...  
Keyword(s):  
Stent Placement ◽  
Stent Implantation ◽  
Cerebral Circulation ◽  
Vascular Anatomy ◽  
Arterial Segment ◽  
Significant Difference ◽  
Before And After ◽  
The Impact ◽  
Arterial Anatomy ◽  
Cerebral Vascular

Background and purpose Recent studies demonstrated the capacity of stents to modify cerebral vascular anatomy. This study evaluates arterial anatomy deformation after Leo stent placement according to the stenting site and the impact on the immediate postoperative and six-month degree of aneurysmal occlusion. Materials and methods A total of 102 stents were placed against the neck of aneurysms situated in the anterior cerebral circulation. Aneurysms were classified into two groups: The first was called the distal group ( n = 62) and comprised aneurysms situated in the middle cerebral and anterior communicating arteries and the second was called the proximal group ( n = 40) and comprised aneurysms in other sites. The stented arterial segment was classified as deformed or non-deformed by blinded review and superimposition of anonymised films before and after stenting. The degree of occlusion was determined immediately postoperatively and at six months. Results Significantly, anatomical deformity was observed in the distal group compared to the proximal group (85% vs 28%). No significant difference was observed between the two groups in terms of postoperative degree of occlusion. At six months, a significant difference was observed between the two groups: three recurrences in the distal group vs 10 recurrences in the proximal group. Two (3%) recurrences were observed in the deformed group vs 11 (31%) recurrences in the non-deformed group. Conclusions Arterial deformity induced by stenting is even more marked for distal aneurysms. The recurrence rate is smaller when the stent placement results in an arterial anatomical change. The percentage of recurrence is lower when anatomy was amended by stent implantation.

Prostate Arterial Anatomy: A Primer for Interventional Radiologists

2020 ◽  
Vol 23 (3) ◽  
pp. 100689
Author(s):  
Srini Tummala ◽  
Ashli Everstine ◽  
Vedant Acharya ◽  
Shivank Bhatia
Keyword(s):  
Arterial Anatomy
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