Facial Arterial Variations in Asians: A Study on Computed Tomographic Angiography

2021 ◽  
Author(s):  
Dawei Wang ◽  
Shixuan Xiong ◽  
Ning Zeng ◽  
Yiping Wu
Keyword(s):  
Computed Tomographic Angiography ◽  
Facial Artery ◽  
Nasolabial Fold ◽  
Anatomical Landmarks ◽  
Filler Injection ◽  
Computed Tomographic ◽  
Arterial Variations ◽  
Significant Difference ◽  
Tomographic Angiography

Abstract Background A consensus on facial artery (FA) anatomy has not been established due to the discrepancies in previous studies. Objectives The purpose of this study was to assess the branches, course, and location of the FA in Asians utilizing computed tomographic angiography (CTA). Methods The CTA images of 300 FAs from 150 Asian patients were evaluated. According to the termination branch, the FA was classified as follows: type 1, FA terminates superior labial or inferior labial artery; type 2: FA terminates lateral nasal or inferior alar artery; type 3: FA terminates medial canthal artery; type 4: FA is divided into duplex branches with dominant medial canthal artery laterally. The relationship between nasolabial fold and FA was evaluated, and the distances from anatomical landmarks to FA were measured to position the course. Results 70 arteries (23.3%), 163 arteries (54.3%), 49 arteries (16.3%), and the other 18 arteries (6.0%) were classified as type 1, 2, 3 and 4, respectively. 72.3% of FAs were located medially to the nasolabial fold, and only 14.7% of arteries were lateral to the nasolabial fold. The vertical distance between FA and the inner canthus or the midpoint of inferior orbital rim decreased from type 1 to type 4 FA (P < 0.0001). No significant difference was found among the four types of FA in the distances between the mandibular angle (P = 0.1226) or oral commissure (P = 0.1030) and the FA at inferior of mandible. Conclusions The detailed findings of facial artery will provide a valuable reference for filler injection in cosmetic procedures and flap design in reconstructive surgery.

The Facial Vein on Computed Tomographic Angiography: Implications for Plastic Surgery and Filler Injection

2021 ◽  
Author(s):  
Dawei Wang ◽  
Shixuan Xiong ◽  
Ning Zeng ◽  
Yiping Wu
Keyword(s):  
Plastic Surgery ◽  
Three Dimensional ◽  
Computed Tomographic Angiography ◽  
Medial Canthus ◽  
Filler Injection ◽  
Computed Tomographic ◽  
Nasal Ala ◽  
Facial Vein ◽  
Tomographic Angiography ◽  
Oral Commissure

Abstract Background The knowledge of the anatomy of the facial vein (FV) is essential for plastic surgery and filler injection. Objectives The purpose of this study was to investigate the variation and three-dimensional course of FV using computed tomographic angiography (CTA). Methods The CTA images of 300 FVs from 150 Asian patients were included in this study. The distance between each anatomical landmark and FV was measured to position the course. The depth of FV beneath the skin and the height of FV above the periosteum were measured at five anatomical planes. Results The facial vein showed a relatively constant course with a frequency of 7.0% variation. The average diameter of FVs was 2.42 ± 0.58 mm. The vertical distance between medial canthus, the midpoint of inferior orbital rim or external canthus and the facial vein was 10.28 ± 2.17 mm, 6.86 ± 2.02 mm, or 48.82 ± 7.26 mm, respectively. The horizontal distance between medial canthus, nasal alar or oral commissure and the facial vein was 6.04 ± 1.44 mm, 22.34 ± 3.79 mm, or 32.21 ± 4.84 mm, respectively. The distance between mandibular angle or oral commissure and the facial vein at the inferior of mandible was 24.99 ± 6.23 mm, or 53.04 ± 6.56 mm. The mean depth of FV beneath the skin at the plane of medial canthus, infraorbital, nasal ala, oral commissure, and mandible was 1.16 ± 0.99 mm, 5.83 ± 1.64 mm, 16.07 ± 4.56 mm, 14.92 ± 2.49 mm, and 9.67 ± 2.88 mm, respectively. The mean height of FV above the periosteum at the plane of medial canthus, infraorbital, nasal ala, and mandible was 1.17 ± 1.32 mm, 3.59 ± 1.48 mm, 3.92 ± 1.95 mm, and 3.50 ± 2.03 mm, respectively. Conclusions This study revealed the three-dimensional course of the facial vein with reference to the anatomical landmarks. The detailed findings of the facial vein will provide a valuable reference for plastic surgery and filler injection.

Erectile Dysfunction in Peripheral Vascular Disease: Endovascular Revascularization as a Potential Therapeutic Target

2020 ◽  
Vol 54 (8) ◽  
pp. 707-711
Author(s):  
Kapila S. Benaragama ◽  
Aminder A. Singh ◽  
Tahani Taj ◽  
Julian Hague ◽  
Jonathan R. Boyle ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Arterial Disease ◽  
Computed Tomographic Angiography ◽  
Computed Tomographic ◽  
Endovascular Revascularization ◽  
Significant Difference ◽  
Ethical Approval ◽  
Peripheral Arterial ◽  
Tomographic Angiography ◽  
The Impact

Introduction: Erectile dysfunction (ED) affects more than 150 million men worldwide, with deleterious effects on quality of life. ED is known to be associated with ischemic heart disease but the impact of ED in patients with peripheral arterial disease (PAD) is unknown. We assessed the prevalence and severity of ED in patients with PVD. Methods: Following ethical approval, sequential male patients diagnosed with PAD over a 1-year period following diagnosis of intermittent claudication. The patient demographics and comorbidities were recorded, with the International Index of Erectile Function (IIEF-5) questionnaire used to grade severity of ED. Computed tomographic angiography and severity of stenosis in the proximal vessels and internal pudendal arteries were correlated using a modified Bollinger Matrix scoring system. Results: 60 patients were recruited, most (77.2%) reported erectile dysfunction (52.5% severe, 22.5% moderate). Patients with severe ED were more likely to have 2 or more comorbidities (P = .009). 86.7% with severe ED had bilateral internal pudendal artery stenosis with a mean modified Bollinger score of 17.6. 35.5% of moderate ED patients had bilateral internal pudendal stenosis with a mean Bollinger score of 11.75. There was significant difference in overall scores between moderate and severe erectile dysfunction (p< 0.05), thus indicating a potential link between ED severity and extent of vessel stenosis. Conclusion: There is a substantial burden of clinically significant ED among patients with PAD. This study suggests ED should be discussed with all PAD patients and ED may precede a PAD diagnosis. There is scope for endovascular revascularization as a treatment option for ED secondary to arterial insufficiency.

Commentary on: Facial Arterial Variations in Asians: A Study on Computed Tomographic Angiography

2021 ◽  
Author(s):  
Sebastian Cotofana ◽  
Nicola Lowrey ◽  
Konstantin Frank ◽  
Michael G Alfertshofer ◽  
Luis Antezana ◽  
...  
Keyword(s):  
Computed Tomographic Angiography ◽  
Computed Tomographic ◽  
Arterial Variations ◽  
Tomographic Angiography

scholarly journals Diagnostic usefulness of pregnancy-associated plasma protein-A in suspected pulmonary embolism

2013 ◽  
Vol 8 ◽  
Author(s):  
Serdar Berk ◽  
Omer Tamer Dogan ◽  
Eylem Itir Aydemir ◽  
Asli Bingol ◽  
Sefa Levent Ozsahin ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Plasma Protein ◽  
Protein A ◽  
Computed Tomographic Angiography ◽  
Computed Tomographic ◽  
Significant Difference ◽  
Diagnostic Usefulness ◽  
Tomographic Angiography ◽  
Tomography Scan

Background: The role of biomarkers for prognostication and diagnosis of pulmonary embolism (PE) is increasing. It has been reported that pregnancy-associated plasma protein-A (PAPP-A) can be used as a proatherosclerotic marker. The present study was aimed to evaluate whether PAPP-A levels are helpful in the differential diagnosis of patients presenting with suspected PE. Methods: 53 consecutive patients evaluated for suspected PE were prospectively enrolled in the study. Serum PAPP-A levels were measured in the blood samples which were taken at admission. Multi-slice computed tomographic angiography was used to verify the diagnosis of PE. Results: PE was detected in 24 out of the 53 patients, while it was excluded in 29 patients by thorax multi-detector computerized tomography scan. No significant difference was detected in mean serum PAPP-A level between groups (5.72 ± 0.31 mg/L vs. 5.67 ± 0.06 mg/L, respectively). Conclusions: Serum PAPP-A level has no role in the evaluation for PE.

Noninvasive Evaluation of the Effectiveness of Endovascular AAA Exclusion

2003 ◽  
Vol 10 (3) ◽  
pp. 458-462
Author(s):  
Maarten J. van der Laan ◽  
Arno Teutelink ◽  
Rudy Meijer ◽  
Christopher L. Wixon ◽  
Jan D. Blankensteijn
Keyword(s):  
Stent Graft ◽  
Wall Motion ◽  
Endovascular Aneurysm Repair ◽  
Computed Tomographic Angiography ◽  
Computed Tomographic ◽  
Significant Difference ◽  
Vitro Model ◽  
Tomographic Angiography

Purpose: To evaluate the relationship between aneurysm sac pressure and endograft wall motion in vitro and in vivo and to compare this to sac volume changes after endovascular aneurysm repair. Methods: In a flow model of an aneurysm with a stent-graft in situ, sac pressure was incrementally increased by adding volume to an otherwise excluded sac; sac pressure waves were registered. Clinically, 43 patients who had unsupported endografts were monitored for stent-graft wall motion using electrocardiographically-guided M-mode ultrasonography. At 3 predetermined points in the cardiac cycle, 2 independent observers measured the maximal endograft diameter. Graft wall motion was then compared to changes in aneurysm thrombus volume (shrinking, static, growth) based on serial spiral computed tomographic angiography measurements. Results: In the in vitro model, as the sac was incrementally pressurized, the initially static pressure waveform changed to a more dynamic waveform identical to that of the systemic pressure. Additionally, graft wall motion was noted visually when the pressure exceeded 40 mm; it became increasingly vigorous at higher pressures. The 0.13-cm wall motion in the growth group (n=5) was significantly larger than the 0.04 cm in the static group (n=19; p=0.012) and the 0.03 cm in the shrinking group (n=19; p=0.002). No significant difference was found between the static and the shrinking groups (p=0.209). Conclusions: Increases in sac pressure are reflected as increased wall motion in unsupported endografts. Clinically, increased endograft wall motion can be demonstrated by M-mode ultrasound; in growing aneurysms, the significant change in wall motion may suggest increased sac pressures as the etiology of the aneurysm growth.

Abstract 20015: Value of Quantitative Atherosclerotic Plaque Assessment Using CCTA to Predict Lesion-specific Ischemia, Data from 407 Coronary Lesions

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Ran Heo ◽  
Hyung-Bok Park ◽  
Nakazato Ryo ◽  
Iksung Cho ◽  
Heidi Gransar ◽  
...  
Keyword(s):  
Invasive Coronary Angiography ◽  
Computed Tomographic Angiography ◽  
Plaque Burden ◽  
Fractional Flow ◽  
Luminal Diameter ◽  
Computed Tomographic ◽  
Flow Reserve ◽  
Significant Difference ◽  
Coronary Lesions ◽  
Tomographic Angiography

Introduction: While coronary computed tomographic angiography (CCTA) demonstrates high diagnostic performance for identification and exclusion of high-grade anatomic stenosis, it is unable to effectively discriminate coronary lesions that causes ischemia. Hypothesis: To study whether quantitative assessment of CCTA offer incremental information for discrimination of lesion ischemia beyond stenosis measures. Methods: 252 consecutive patients with suspected or known coronary artery disease (CAD) from 17 centers in 5 countries were enrolled (mean age 63±9 years, 71% male). Patients underwent CCTA and invasive coronary angiography (ICA), with 407 coronary lesions interrogated by invasive fractional flow reserve (FFR) at the time of maximum hyperemia. For these coronary lesions, we evaluated % diameter stenosis (%DS), % area stenosis (%AS), minimal luminal diameter (MLD, mm), minimal luminal area (MLA, mm 2 ), and plaque burden at MLA by CCTA. Plaque burden (PB, %) was defined as (vessel area–lumen area)/vessel areaх100. Lesion-specific ischemia by FFR was defined as a value ≤0.8. Results: In quantitative analysis area under the receiver operating characteristic curves (AUC) value of %DS, %AS, MLD, MLA, and PB for prediction of ischemia were 0.72 (95% confidence interval (CI) 0.68-0.77, p<0.001), 0.73 (95% CI 0.68-0.77, p<0.001), 0.75 (95% CI 0.70-0.79, p<0.001), 0.75 (95% CI 0.70-0.79, p<0.001), and 0.77 (95% CI 0.73-0.81, p<0.001), respectively. PB showed significantly improved AUC when compared to % area stenosis (p=0.002). However, PB didn’t show incremental power over MLA (p=0.213). There also was no significant difference in AUC between MLA and % area stenosis (p=0.330) Conclusions: Quantitative plaque assessment using CCTA could predict lesion-specific ischemia with good discrimination. Plaque burden showed incremental value over % area stenosis for ischemia prediction.

scholarly journals Reducing Radiation Dose Without Compromising Image Quality in Preoperative Perforator Flap Imaging With CTA Using ASIR Technology

2014 ◽  
Vol 99 (4) ◽  
pp. 485-491 ◽  
Author(s):  
Vachara Niumsawatt ◽  
Andrew N. Debrotwir ◽  
Warren Matthew Rozen
Keyword(s):  
Image Quality ◽  
Radiation Dosage ◽  
Perforator Flap ◽  
Computed Tomographic Angiography ◽  
Preoperative Imaging ◽  
Diep Flap ◽  
Subjective Analysis ◽  
Computed Tomographic ◽  
Significant Difference ◽  
Tomographic Angiography

Abstract Computed tomographic angiography (CTA) has become a mainstay in preoperative perforator flap planning in the modern era of reconstructive surgery. However, the increased use of CTA does raise the concern of radiation exposure to patients. Several techniques have been developed to decrease radiation dosage without compromising image quality, with varying results. The most recent advance is in the improvement of image reconstruction using an adaptive statistical iterative reconstruction (ASIR) algorithm. We sought to evaluate the image quality of ASIR in preoperative deep inferior epigastric perforator (DIEP) flap surgery, through a direct comparison with conventional filtered back projection (FBP) images. A prospective review of 60 consecutive ASIR and 60 consecutive FBP CTA images using similar protocol (except for radiation dosage) was undertaken, analyzed by 2 independent reviewers. In both groups, we were able to accurately identify axial arteries and their perforators. Subjective analysis of image quality demonstrated no statistically significant difference between techniques. ASIR can thus be used for preoperative imaging with similar image quality to FBP, but with a 60% reduction in radiation delivery to patients.

scholarly journals Heart rate-reducing therapy with add-on ivabradine and bisoprolol before coronary computed tomographic angiography in a fast-track ambulatory setting

2018 ◽  
Vol 46 (6) ◽  
pp. 2249-2257 ◽  
Author(s):  
Viktoria Muster ◽  
Markus Wallner ◽  
Albrecht Schmidt ◽  
Martin Kapl ◽  
Friederike von Lewinski ◽  
...  
Keyword(s):  
Heart Rate ◽  
Radiation Dose ◽  
Beta Blockers ◽  
Computed Tomographic Angiography ◽  
Motion Artifacts ◽  
Ambulatory Setting ◽  
Coronary Computed Tomographic Angiography ◽  
Computed Tomographic ◽  
Significant Difference ◽  
Tomographic Angiography

Objective This study was performed to determine whether add-on oral ivabradine in patients treated with beta blockers 1 hour before coronary computed tomographic angiography (CCTA) is effective in lowering the heart rate and thus improving CCTA quality. Methods In this single-center cohort study, the data of 294 patients referred for ambulant CCTA were retrospectively screened. Patients with an initial heart rate of ≥75 bpm (n = 112) were pretreated with either a combination of bisoprolol and ivabradine or with bisoprolol alone. Results During the scan, there was no difference in heart rate between the two groups Likewise, there was no significant difference in additionally administered intravenous bradycardic agents, the number of motion artifacts, or the radiation dose. Both drug regimens were tolerated well. Conclusion Additive oral ivabradine 1 hour before CCTA does not result in a further reduction of the heart rate. Consequently, neither movement artifacts nor radiation dose can be reduced. Therefore, pretreatment with ivabradine does not seem reasonably appropriate in an outpatient clinical setting with short patient contact.

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