scholarly journals Relationship between upper and lower limb conduit artery vasodilator function in humans

2011 ◽  
Vol 111 (1) ◽  
pp. 244-250 ◽  
Author(s):  
Dick H. J. Thijssen ◽  
Nicola Rowley ◽  
Jaume Padilla ◽  
Grant H. Simmons ◽  
M. Harold Laughlin ◽  
...  
Keyword(s):  
Endothelial Function ◽  
Femoral Artery ◽  
Brachial Artery ◽  
Superficial Femoral Artery ◽  
Popliteal Artery ◽  
Lower Limb ◽  
Strong Predictor ◽  
Lower Limbs ◽  
Conduit Artery ◽  
Healthy Humans

Brachial artery flow-mediated dilation (FMD) is a strong predictor of future cardiovascular disease and is believed to represent a “barometer” of systemic endothelial health. Although a recent study [Padilla et al. Exp Biol Med (Maywood) 235: 1287–1291, 2010] in pigs confirmed a strong correlation between brachial and femoral artery endothelial function, it is unclear to what extent brachial artery FMD represents a systemic index of endothelial function in humans. We conducted a retrospective analysis of data from our laboratory to evaluate relationships between the upper (i.e., brachial artery) vs. lower limb (superficial femoral n = 75; popliteal artery n = 32) endothelium-dependent FMD and endothelium-independent glyceryl trinitrate (GTN)-mediated dilation in young, healthy individuals. We also examined the relationship between FMD assessed in both brachial arteries ( n = 42). There was no correlation between brachial and superficial femoral artery FMD ( r2 = 0.008; P = 0.46) or between brachial and popliteal artery FMD ( r2 = 0.003; P = 0.78). However, a correlation was observed in FMD between both brachial arteries ( r2 = 0.34; P < 0.001). Brachial and superficial femoral artery GTN were modestly correlated ( r2 = 0.13; P = 0.007), but brachial and popliteal artery GTN responses were not ( r2 = 0.08; P = 0.11). Collectively, these data indicate that conduit artery vasodilator function in the upper limbs (of healthy humans) is not predictive of that in the lower limbs, whereas measurement of FMD in one arm appears to be predictive of FMD in the other. These data do not support the hypothesis that brachial artery FMD in healthy humans represents a systemic index of endothelial function.

Impact of acute exposure to increased hydrostatic pressure and reduced shear rate on conduit artery endothelial function: a limb-specific response

2009 ◽  
Vol 297 (3) ◽  
pp. H1103-H1108 ◽  
Author(s):  
Jaume Padilla ◽  
Ryan D. Sheldon ◽  
Diana M. Sitar ◽  
Sean C. Newcomer
Keyword(s):  
Hydrostatic Pressure ◽  
Shear Rate ◽  
Endothelial Function ◽  
Pressure Gradient ◽  
Brachial Artery ◽  
Popliteal Artery ◽  
Lower Limbs ◽  
Acute Exposure ◽  
Specific Response ◽  
Conduit Artery

Unlike quadrupeds, humans exhibit a larger hydrostatic pressure in the lower limbs compared with the upper limbs during a major part of the day. It is plausible that repeated episodes of elevated pressure in the legs may negatively impact the endothelium, hence contributing to the greater predisposition of atherosclerosis in the legs. We tested the hypothesis that an acute exposure to increased hydrostatic pressure would induce conduit artery endothelial dysfunction. In protocol 1, to mimic the hemodynamic environment of the leg, we subjected the brachial artery to a hydrostatic pressure gradient (∼15 mmHg) by vertically hanging the arm for 3 h. Brachial artery flow-mediated dilation (FMD) was assessed in both arms before and following the intervention. In protocol 2, we directly evaluated popliteal artery FMD before and after a 3-h upright sitting (pressure gradient ∼48 mmHg) and control (supine position) intervention. Our arm-hanging model effectively resembled the hemodynamic milieu (high pressure and low shear rate) present in the lower limbs during the seated position. Endothelium-dependent vasodilation at the brachial artery was attenuated following arm hanging ( P < 0.05); however, contrary to our hypothesis, upright sitting did not have an impact on popliteal artery endothelial function ( P > 0.05). These data suggest an intriguing vascular-specific response to increased hydrostatic pressure and reduced shear rate. Further efforts are needed to determine if this apparent protection of the leg vasculature against an acute hydrostatic challenge is attributable to posture-induced chronic adaptations.

scholarly journals Absence of the genicular arterial anastomosis as generally depicted in textbooks

2013 ◽  
Vol 95 (6) ◽  
pp. 405-409 ◽  
Author(s):  
M Sabalbal ◽  
M Johnson ◽  
V McAlister
Keyword(s):  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Popliteal Artery ◽  
Collateral Circulation ◽  
Lower Limbs ◽  
Direct Communication ◽  
Profunda Femoris Artery ◽  
Arterial Anastomosis ◽  
Lateral Circumflex Femoral ◽  
Profunda Femoris

Introduction Textbook representations of the genicular arterial anastomosis show a large direct communication between the descending branch of the lateral circumflex femoral artery (DBLCFA) and a genicular branch of the popliteal artery but this is not compatible with clinical experience. The aim of this study was to determine whether the arterial anastomosis at the knee is sufficient, in the event of traumatic disruption of the superficial femoral artery, to infuse protective agents or to place a stent to restore flow to the lower leg. Methods Dissection of ten cadaveric lower limbs was performed to photograph the arterial anatomy from the inguinal ligament to the tibial tubercle. Anastomosis with branches of the popliteal artery was classified as: ‘direct communication’, ‘approaching communication’ or ‘no evident communication’. Results A constant descending artery in the lateral thigh (LDAT) was found to have five types of origin: Type 1 (2/10 limbs) involved the lateral circumflex femoral branch of the femoral artery, Type 2 (3/10 limbs) the lateral circumflex femoral branch of the profunda femoris artery, Type 3 (1/10 limbs) the femoral artery, Type 4 (3/10 limbs) the superficial femoral artery and Type 5 (2/10 limbs) the profunda femoris artery. In one limb, there were two descending arteries (Types 4 and 5). Collateral circulation at the knee was also variable: direct communicating vessels (3/10 limbs); approaching vessels with possible communication via capillaries (5/10 limbs); no evident communication (2/10 limbs). Communicating vessels, if present, are too small to provide immediate collateral circulation. Conclusions Modern representations of the genicular arterial anastomosis are inaccurate, derived commonly from an idealised image that first appeared Gray’s Anatomy in 1910. The afferent vessel is not the DBLCFA. The majority of subjects have the potential to recruit collateral circulation via the LDAT following gradual obstruction to normal arterial flow, which may be important if the LDAT is removed for bypass or flap surgery. A direct communication is rarely present and is never as robust as generally depicted in textbooks.

scholarly journals Variability of Lower Limb Artery Systolic–Diastolic Velocities in Futsal Athletes and Non-Athletes: Evaluation by Arterial Doppler Ultrasound

2020 ◽  
Vol 17 (2) ◽  
pp. 570
Author(s):  
Pedro Duarte-Mendes ◽  
Rui Paulo ◽  
Patrícia Coelho ◽  
Francisco Rodrigues ◽  
Vasco Marques ◽  
...  
Keyword(s):  
Doppler Ultrasound ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Popliteal Artery ◽  
Lower Limb ◽  
Vascular Remodeling ◽  
Deep Femoral Artery ◽  
Cross Sectional ◽  
Diastolic Velocity ◽  
The Right

Background: Sports athletes, namely high-intensity practitioners, suffer from vascular remodeling overtime. The purpose of this study was to analyze the systolic and diastolic velocities’ variation between non-athletes and futsal athletes by means of arterial lower limb doppler ultrasound. Additionally, we intended to verify if the velocity variations occur primarily at the systolic or the diastolic level and in which arteries. Methods: Seventy-six young males (mean ± SD: 24.9 ± 2.8 years old) volunteered to participate in this cross-sectional study and were divided into two groups: a futsal athletes group (n = 38; 24 ± 2.78 years) in the central region of Portugal playing on the 2nd national league with the same level of practice (16 ± 2.4 years of practice) and a non-athletes group (n = 38: 26 ± 1.8 years) who did not practice sports regularly and were not federated in any sport. All the subjects agreed to participate in the study with the aim of assessing the arterial lower limb through doppler ultrasound (Philips HD7 echograph with linear transducer 7–12 MHz). Results: Differences between groups (p ≤ 0.05) in the systolic velocity of the left deep femoral artery (p = 0.022; d = 0.546, small) and in the right superficial femoral artery (p = 0.028; d = −0.515, small) were found. We also found differences in the diastolic velocity: in the left common femoral artery (p = 0.002; d = −0.748, moderate), in the right deep femoral artery (p = 0.028; d = −0.521, small), in the right superficial femoral artery (p = 0.026; d = −0.522, small), in the right popliteal artery (p = 0.002; d = −0.763, moderate), and in the left popliteal artery (p = 0.007; d = −0.655, moderate). Moreover, the athletes’ group presented the highest mean values, with the exception of the systolic velocity of the left deep femoral artery. In intragroup analysis of variance referring to systolic and diastolic velocities in arterial levels in the right and left arteries, differences were found in all analyses (p ≤ 0.05). Conclusions: We conclude that futsal athletes of our sample go through a process of changes such as increased blood flow velocity in systolic and diastolic cardiac phase in all studied lower limb arteries, showing that the remodeling occurs regardless of vessel radius. Our results reinforce the existence of vascular remodeling that may vary with the sport and its intensity.

A Variant Origin Of Profunda Femoris Artery and A Common Stem for the origin of Medial And Lateral Circumflex Arteries – A Case Report

2017 ◽  
Vol 1 (4) ◽  
Author(s):  
Pralhad D. S.
Keyword(s):  
Case Report ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Popliteal Artery ◽  
Lower Limb ◽  
Considerable Extent ◽  
Profunda Femoris Artery ◽  
Left Lower Limb ◽  
Profunda Femoris

The variations of the profunda and its branches are numerous and to a considerable extent, largely associated with one another. In occlusion of the superficial femoral artery, the profunda femoris artery forms an effective collateral bed between the ileo-femoral segment and the popliteal artery and its branches. Acharya Sushrutha has clearly mentioned about the importance of dissection., One who is intended to acquire definite knowledge of surgery should keenly study the anatomy from the books as well as from the dissection. Femoral artery is the most important artery supplying the lower limb and in case of cadavers this artery is used for the embalmment procedure. During the routine dissection classes for the UG’s, a variation was observed in the origin of profunda femoris and a common stem for the origin of medial and lateral circumflex arteries in the left lower limb.

scholarly journals Evaluation of Lower Limb Arteriovenous Diameters in Indoor Soccer Athletes: Arterial Doppler Ultrasound Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Sónia Mateus ◽  
Rui Paulo ◽  
Patrícia Coelho ◽  
Francisco Rodrigues ◽  
Vasco Marques ◽  
...  
Keyword(s):  
Doppler Ultrasound ◽  
Femoral Artery ◽  
Popliteal Artery ◽  
Lower Limb ◽  
Femoral Vein ◽  
Common Femoral Artery ◽  
Lower Limbs ◽  
Popliteal Vein ◽  
Ultrasound Study ◽  
The Right

The purpose of this study was to analyze the arterial and venous diameters of lower limbs in indoor soccer athletes and non-athletes using Doppler ultrasound to identify the differences in the variation of arterial and venous diameters between groups. Additionally, we intended to verify the differences of arterial and venous diameters between the skilled member (right member) and the not skilled member in each group. 74 male volunteers, aged between 19 and 30 years old, were divided in a group of athletes (n = 37, 24 ± 2.7 years, soccer players from national championship), and a group of non-athletes (n = 37, 26 ± 2.83 years). Vascular lower limb was assessed using Doppler ultrasound (Philips HD7 echograph with linear transducer 7–12 MHz). The athletes showed higher diameters of right common femoral artery (p = 0.009; moderate), left common femoral artery (p = 0.005; moderate), right deep femoral artery (p = 0.013; moderate), right popliteal artery (p = 0.003; moderate), and left popliteal artery (p = 0.017; small) than non-athletes. Veins’ diameters were also higher in athletes, specifically the right deep femoral vein (p ≤ 0.001; large), left deep femoral vein (p ≤ 0.001; large), right popliteal vein (p ≤ 0.001; large), and left popliteal vein (p ≤ 0.001; large). Differences were found between the skilled and non-skilled leg in athletes in the popliteal vein (7.68 ± 1.44 mm vs. 7.22 ± 1.09 mm, respectively, p &lt; 0.003). It seems that futsal athletes have superior mean diameters of lower limbs arteries and veins of the deep venous system to non-athletes. Moreover, the veins presented greater dilation, namely of the leg of the skilled lower limb.

Crush implantation of a self-expanding interwoven stent over a subintimally recanalized standard stent in a TASC D lesion of the superficial femoral artery

VASA ◽  
2012 ◽  
Vol 41 (6) ◽  
pp. 458-462 ◽  
Author(s):  
Vogel ◽  
Strothmeyer ◽  
Cebola ◽  
A. Katus ◽  
Blessing
Keyword(s):  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Popliteal Artery ◽  
Duplex Ultrasound ◽  
Stent Fracture ◽  
Nitinol Stent ◽  
Nitinol Stents ◽  
Walking Capacity ◽  
Radial Strength ◽  
Good Treatment Option

We demonstrate feasibility of implantation of a self-expanding interwoven nitinol stent in a claudicant, where recanalization attempt of a heavily calcified, occluded superficial femoral artery (TASC D lesion) was complicated by a previously implanted, fractured standard stent. Wire passage through the occlusion and beyond the fractured stent could only be achieved through the subintimal space. A dedicated reentry device was used to allow distal wire entry into the true lumen at the level of the popliteal artery. Despite crushing of the fractured stent with a series of increasingly sized standard balloons, a significant recoil remainded in the area of the crushed stent. To secure patency of the femoro-popliteal artery we therefore decided to implant the novel self-expanding interwoven nitinol stent (Supera Veritas (TM), IDEV), whose unique feature is an exceptional high radial strength. Patient presented asymptomatic without any impairment of his walking capacity at three month follow up and duplex ultrasound confirmed patency of the stent. Subintimal recanalizations can be complicated by previously implanted stents, in particular in the presence of stent fracture, where intraluminal wire passage often can not be achieved. Considering the high radial strength and fracture resistance, interwoven nitinol stents represent a good treatment option in those challenging cases and they can be used to crush standard nitinol and ballonexpandable stents.

scholarly journals Effects of posture on shear rates in human brachial and superficial femoral arteries

2008 ◽  
Vol 294 (4) ◽  
pp. H1833-H1839 ◽  
Author(s):  
S. C. Newcomer ◽  
C. L. Sauder ◽  
N. T. Kuipers ◽  
M. H. Laughlin ◽  
C. A. Ray
Keyword(s):  
Shear Rate ◽  
Femoral Artery ◽  
Brachial Artery ◽  
Superficial Femoral Artery ◽  
Upright Posture ◽  
Brachial Artery Diameter ◽  
Shear Rates ◽  
Femoral Arteries ◽  
Lower Shear ◽  
Relative Shear

Shear rate is significantly lower in the superficial femoral compared with the brachial artery in the supine posture. The relative shear rates in these arteries of subjects in the upright posture (seated and/or standing) are unknown. The purpose of this investigation was to test the hypothesis that upright posture (seated and/or standing) would produce greater shear rates in the superficial femoral compared with the brachial artery. To test this hypothesis, Doppler ultrasound was used to measure mean blood velocity (MBV) and diameter in the brachial and superficial femoral arteries of 21 healthy subjects after being in the supine, seated, and standing postures for 10 min. MBV was significantly higher in the brachial compared with the superficial femoral artery during upright postures. Superficial femoral artery diameter was significantly larger than brachial artery diameter. However, posture had no significant effect on either brachial or superficial femoral artery diameter. The calculated shear rate was significantly greater in the brachial (73 ± 5, 91 ± 11, and 97 ± 13 s−1) compared with the superficial femoral (53 ± 4, 39 ± 77, and 44 ± 5 s−1) artery in the supine, seated, and standing postures, respectively. Contrary to our hypothesis, our current findings indicate that mean shear rate is lower in the superficial femoral compared with the brachial artery in the supine, seated, and standing postures. These findings of lower shear rates in the superficial femoral artery may be one mechanism for the higher propensity for atherosclerosis in the arteries of the leg than of the arm.

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