scholarly journals Local Hemodynamic Changes Immediately after Correction of an Aberrant Right Subclavian Artery in a Dog: A Contrast Computed Tomographic Study

2021 ◽  
Vol 8 (6) ◽  
pp. 104
Author(s):  
Yohei Mochizuki ◽  
Shoma Mikawa ◽  
Kenji Kutara ◽  
Keisuke Sugimoto ◽  
Hirosei Sakoya ◽  
...  

A 1-year-old female Akita dog was referred for intermittent regurgitation. Computed tomographic angiography (CTA) showed an aberrant right subclavian artery (ARSA), resulting in constriction of the esophagus. After surgical ligation of the ARSA, CTA showed that the ARSA was not enhanced by contrast medium, and that sufficient collateral circulation of the right forelimb was supplied through the vertebral artery. Furthermore, the right and left vertebral arteries merged into the basilar artery at the level of the atlas, and no abnormal expansion of the ventral spinal artery was observed. Overall, we demonstrated the importance of post-surgical CTA for identification of surgical complications, including the formation of abnormal vessel alterations.

2021 ◽  
pp. 154431672110023
Author(s):  
Winnie Nguyen ◽  
Tammy Albanese ◽  
Vanessa Tran ◽  
Anne Moore ◽  
Laligam Sekhar

This is a case report of a 35-year-old female pedestrian struck by a semi-truck. computed tomographic angiography (CTA) revealed a pseudoaneurysm at the proximal brachiocephalic artery measuring 1.8 cm in cranio-caudal length and 1.2 × 0.6 cm transverse. Just distal to the pseudoaneurysm, there was severe luminal narrowing caused by either a dissection flap or mural thrombus. Due to profound left-sided weakness, transcranial Doppler ultrasound was performed which demonstrated “hesitant” waveforms in the right middle cerebral and right vertebral arteries secondary to proximal obstruction. Hesitant waveforms display mid-systolic velocity deceleration and may also be referred to as the “bunny” waveform. Emboli monitoring of the right middle cerebral and basilar arteries were positive for active embolization


2013 ◽  
Vol 24 (3) ◽  
pp. 485-493 ◽  
Author(s):  
Alper Karacan ◽  
Aysel Türkvatan ◽  
Keziban Karacan

AbstractPurpose: The aim of this study was to investigate the frequency and gender distribution of variations in the aortic arch branching pattern using 64-slice computed tomograhic angiography. Materials and methods: A total of 1000 patients with a normal left-sided aortic arch who underwent computed tomographic angiography for various reasons were analysed retrospectively for the frequency of variation of aortic arch branching; the variations were categorised into seven types. Results: Of the 1000 patients, 79.2% had a normal aortic arch branching pattern – type 1 – and 20.8% had variations. The frequency of type 2 variation – brachiocephalic and left common carotid arteries arising from the aortic arch in a common trunk – was 14.1%, that of type 3 – left vertebral artery originating from the aortic arch – was 4.1%, that of type 4 – coexistence of type 2 and type 3 – was 1.2%, that of type 5 – aberrant right subclavian artery – was 0.6%, that of type 6 – coexistence of aberrant right subclavian artery and bicarotid trunk – was 0.7%, and that for type 7 – thyroidea ima artery arising from the aortic arch – was 0.1%. The incidences of the variations of aortic arch branching were similar among males and females (20% versus 22.1%). The incidence of an aberrant right subclavian artery – type 5 and type 6 – was higher among females compared with males (2.5% versus 0.5), whereas the frequencies of the other variations were either equal or similar in both genders. Conclusion: Recognition of variations of aortic arch branching is important because they may cause symptoms due to tracheoesophageal compression or complications during surgical or endovascular interventional procedures of the aorta and its branches.


2021 ◽  
Vol 12 (2) ◽  
pp. 712-716
Author(s):  
Edsel Ing ◽  
Felix Tyndel ◽  
Joyce Tang ◽  
Thomas R. Marotta

A 67-year-old woman had delayed initial diagnosis of her right low flow carotid cavernous fistula (CCF) during the coronavirus disease (COVID-19) pandemic due to difficulty detecting ocular signs via online virtual examinations. Her right eye conjunctival erythema and proptosis with medial rectus enlargement on computed tomography scan was initially misdiagnosed as euthyroid thyroid-associated orbitopathy without lid retraction. She developed vision loss, and increasing episcleral venous congestion and CCF was suspected. Computed tomographic angiography did not show an obvious fistula. Digital subtraction angiography revealed the right-sided low flow CCF, which was fed from vessels from the contralateral side.


2017 ◽  
Vol 86 ◽  
Author(s):  
Mladen Gasparini ◽  
Primož Praček ◽  
Jani Muha ◽  
Uroš Tomić

Background: In the present article we present the characteristics of Eagle syndrome, which is an often overlooked cause of chronic pain in the neck and head. The syndrome is caused by the compression of an elongated styloid process on the adjacent cranial nerves or the carotid arteries. Since there are disparate data in the literature regarding the proportion of people with an elongated styloid process, we conducted a survey to determine the percentage of patients with an elongated styloid process in a group of subjects who underwent computed tomographic imaging of the neck vessels in our institution.Methods: We analyzed the images of 104 patients who were referred to our institution for computed tomographic angiography of the neck between the years 2014 and 2016. With the help of a software measurement tool, we determined the length of the styloid processes and compared the length of the processes on both sides and in both genders. Patients with an elongated styloid process were reviewed for any symptoms of Eagle syndrome.Results: The average age of the reviewed patients was 67.1 years. Both genders were equally represented (51 % men and 49 % women). The average length of the styloid process was 23.8 (7.0) mm, with 23 patients (22.1 %) having a styloid process longer than 30 mm. In one third of those patients the styloid process was elongated bilaterally. There were no differences in the average length of the styloid process between men and women and between the left and the right side. Among patients with an elongated styloid process, only one (4.3 %) had symptoms attributable to the Eagle syndrome.Conclusions: Eagle syndrome should be suspected in a patient with repetitive, dull pain in the throat and neck, which worsens during speaking, chewing or swallowing. The diagnosis is confirmed by computed tomography which could demonstrate an elongated styloid process and exclude other causes for neck pain. With regard to the results of our study, an elongated styloid process is found in a relatively high percentage of patients but the condition is only rarely symptomatic.


Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Leonard yeo ◽  
Amit Batra ◽  
Ashley Tan ◽  
Song Majinyang ◽  
Darren Low ◽  
...  

Background and aims: The diameters of the vertebral arteries (VAs) are very often unequal and the larger artery is called ‘dominant’. We investigated whether the hemodynamic parameters differ between the ‘dominant’ and ‘non-dominant’ variants. Methods: Consecutive patients who underwent computed tomographic angiography (CTA) of cervical and intracranial arteries, cervical duplex (CDU) and transcranial Doppler (TCD) ultrasonography were included. VA diameters (cervical and intracranial segments) were measured on CTA. Flow velocities recorded were peak systolic (PSV), end-diastolic (EDV), mean flow (MFV). Pulsatility index (PI) and ratio of distal-to-proximal VAs were computed. Results: Of the total 501 patients admitted during 2012 with acute ischemic stroke, both CTA and ultrasound data were available for VAs for 161 (32%). The dominant VA was more frequent on the left side (p<0.01). Non-dominant VAs were found to have lower MFV (27cm/s versus 38cm/s; p<0.01) and higher PI (1.27 versus 1.0; p<0.01) as compared to the dominant variant. In most patients, proximal basilar artery was noted to be on the side of non-dominant artery. Posterior inferior cerebellar artery territory infarcts and lateral medullary infarcts were noted in 38 (7.6%) patients. These infarcts were noted more commonly on the same side as the non-dominant intracranial VA side (p<0.01), especially when associated with low MFV (p<0.01) and high PI (p<0.01). Conclusions: The risk of ischemic stroke in VA territory is higher with the non-dominant artery, especially when it is associated with higher-resistance flow pattern.


2016 ◽  
Vol 19 (6) ◽  
pp. 269 ◽  
Author(s):  
Xiaodong Li ◽  
Liping Chen ◽  
Xiumei Duan ◽  
Xiaocong Wang

Pedicled mobile thrombus in the right atrium is an extremely rare condition. Here, we described a case of a 42-year-old male hospitalized with complaints of chest pain and hemoptysis. Computed tomographic angiography of the pulmonary artery showed signs of embolism, and thoracic echocardiography indicated a pedicled mobile cloudy echo in the right atrium, which was initially suspected to be a myxoma. However, it was confirmed to be a thrombus by histopathological examination. Postoperatively, the patient was treated with anticoagulant therapy comprising of low molecular heparin and warfarin, and the patient recovered well. Thoracic echocardiography performed 3 months after surgery ruled out any recurrence of right atrial thrombus.


2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Fortune O. Alabi ◽  
Fred Umeh ◽  
Maximo Lama ◽  
Francis G. Christian

Scimitar syndrome, a rare congenital cardiopulmonary condition, presents in both pediatric and adult populations as an anomalous pulmonary venous return of most of the right lung to the inferior vena cava. Recently, asymptomatic adult cases have been diagnosed with advances in imaging studies. We report the case of an asymptomatic 43-year-old male, with a complex variant scimitar syndrome diagnosed by computed tomographic angiography.


Author(s):  
Barbara Buffoli ◽  
Vincenzo Verzeletti ◽  
Lena Hirtler ◽  
Rita Rezzani ◽  
Luigi Fabrizio Rodella

AbstractA rare branching pattern of the aortic arch in a female cadaver is reported. An aberrant right subclavian artery originated from the distal part of the aortic arch and following a retroesophageal course was recognized. Next to it, from the left to the right, the left subclavian artery and a short bicarotid trunk originating the left and the right common carotid artery were recognized. An unusual origin of the vertebral arteries was also identified. The left vertebral artery originated directly from the aortic arch, whereas the right vertebral artery originated directly from the right common carotid artery. Retroesophageal right subclavian artery associated with a bicarotid trunk and ectopic origin of vertebral arteries represents an exceptional and noteworthy case.


2021 ◽  
pp. 154431672110309
Author(s):  
Mariana de Gregório Faria ◽  
Mauro de Deus Passos ◽  
Dilson Palhares Ferreira ◽  
Luciano Moreira Alves

This report describes the case of a 63-year-old asymptomatic patient presenting findings compatible with partial subclavian steal syndrome on color Doppler ultrasound of the carotid and vertebral arteries. The ultrasonic analysis of the cervical vessels showed no apparent cause to justify the subclavian steal. Computed tomographic angiography of the thoracic aorta showed left subclavian artery kinking proximal to the origin of the vertebral artery, an extremely rare finding that led to the subclavian steal. The patient underwent conservative treatment.


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