286 results
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2. Invited Commentary on Cyclists Paper
- Author
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Jonathan Beard and D.C. Mitchell
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Diagnostic Imaging ,Medicine(all) ,Medical education ,business.industry ,Posture ,Arterial Occlusive Diseases ,Constriction, Pathologic ,Iliac Artery ,Bicycling ,Treatment Outcome ,Predictive Value of Tests ,Risk Factors ,Exercise Test ,Medicine ,Humans ,Surgery ,Registries ,Cardiology and Cardiovascular Medicine ,business ,Risk Reduction Behavior ,Vascular Surgical Procedures - Published
- 2009
- Full Text
- View/download PDF
3. Successful Transcatheter Arterial Embolization of Abdominal Wall Hematoma from the Left Deep Circumflex Iliac Artery after Abdominal Paracentesis in a Patient with Liver Cirrhosis: Case Report and Literature Review.
- Author
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Seo YE, Lim CJ, Lim JW, Kim JS, Oh HH, Ma KY, You GR, Im CM, Lee BC, and Joo YE
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- Humans, Female, Aged, Angiography, Ascites etiology, Ascites therapy, Embolization, Therapeutic, Hematoma etiology, Hematoma diagnosis, Hematoma therapy, Paracentesis, Liver Cirrhosis complications, Iliac Artery diagnostic imaging, Abdominal Wall, Tomography, X-Ray Computed
- Abstract
The occurrence of an abdominal wall hematoma caused by abdominal paracentesis in patients with liver cirrhosis is rare. This paper presents a case of an abdominal wall hematoma caused by abdominal paracentesis in a 67-year-old woman with liver cirrhosis with a review of the relevant literature. Two days prior, the patient underwent abdominal paracentesis for symptom relief for refractory ascites at a local clinic. Upon admission, a physical examination revealed purpuric patches with swelling and mild tenderness in the left lower quadrant of the abdominal wall. Abdominal computed tomography revealed advanced liver cirrhosis with splenomegaly, tortuous dilatation of the para-umbilical vein, a large volume of ascites, and a large acute hematoma at the left lower quadrant of the abdominal wall. An external iliac artery angiogram showed the extravasation of contrast media from the left deep circumflex iliac artery. Embolization of the target arterial branches using N-butyl-2-cyanoacrylate was then performed, and the bleeding was stopped. The final diagnosis was an abdominal wall hematoma from the left deep circumflex iliac artery after abdominal paracentesis in a patient with liver cirrhosis.
- Published
- 2024
- Full Text
- View/download PDF
4. Patient doses in endovascular and hybrid revascularization of aortoiliac segment
- Author
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Svetla Dineva, Stefan S Stanev, Desislava Kostova-Lefterova, Desislava Kostova-Lefterova, and Svetla Dineva
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Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,MEDLINE ,Aortoiliac occlusive disease ,Arterial Occlusive Diseases ,Radiation Dosage ,Radiography, Interventional ,Revascularization ,Iliac Artery ,Text mining ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,In patient ,Aorta ,Aged ,Retrospective Studies ,Aged, 80 and over ,Full Paper ,business.industry ,Endovascular Procedures ,General Medicine ,Middle Aged ,medicine.disease ,Surgery ,Fluoroscopy ,Female ,business - Abstract
Objectives: Constantly increasing number of procedures performed – endovascular or hybrid in patients with aortoiliac occlusive disease during the last decades finds its explanation in the lower morbidity and mortality rates, compared to bypass surgery. The purpose of the current survey was to estimate patients’ radiation exposure in aortoiliac segment after endovascular or hybrid revascularization and to study the main factors which have direct contribution. Methods: A retrospective study of 285 procedures conducted with the help of a mobile C-arm system in 223 patients was performed. Procedures were grouped according to criteria such as: type of intervention, vascular access, level of complexity and operating team. Different analyses were performed within the groups and dose values. Results: The median values of kerma–air product (KAP), the number of series and the peak skin dose (PSD) significantly increase with the increasing number of vascular accesses: for one access (16.68 Gy.cm2, 6 and 336 mGy), for two (56.93 Gy.cm2, 11 and 545 mGy), and for three (102.28 Gy.cm2, 15 and 781 mGy). Significant dependence was observed in the case of single access site between the type of access and the dose values: hybrid and retrograde common femoral artery/superficial femoral artery (CFA/SFA) endovascular accesses, 10.06 Gy.cm2/301 mGy and 13.23 Gy.cm2/318 mGy respectively, in contrast with the contralateral CFA and left brachial access, 33 Gy.cm2/421 mGy and 38.33 Gy.cm2/448 mGy respectively. Conclusion: The results demonstrate that the most important factors increasing the dose values are number and type of vascular accesses, followed by the combination and number of implanted stents with the complexity of the procedure. The PSD values for a single procedure were between 2 and 12 times lower than those IAEA proposed as trigger levels for radiation-induced erythema. This study shows that trigger levels were not reached even for patients with repeated procedures in the same segment in 1-year period. Advances in knowledge: The study gives important understanding and clarity on the growing awareness for dose-modifying factors during endovascular and hybrid revascularization of aortoiliac segment.
- Published
- 2021
5. Advantages and disadvantages of single-source dual-energy whole-body CT angiography with 50% reduced iodine dose at 40 keV reconstruction
- Author
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Noriyuki Yasuda, Hiroshi Kawada, Fuminori Hyodo, Toshiharu Miyoshi, Fumihiko Nakamura, Yoshifumi Noda, Nobuyuki Kawai, and Masayuki Matsuo
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Male ,Body height ,Computed Tomography Angiography ,Radiography ,Contrast Media ,Whole body ct ,Aorta, Thoracic ,Signal-To-Noise Ratio ,030218 nuclear medicine & medical imaging ,Body Mass Index ,Radiography, Dual-Energy Scanned Projection ,0302 clinical medicine ,Abdomen ,Aorta, Abdominal ,Prospective Studies ,Aged, 80 and over ,Dual energy ,medicine.diagnostic_test ,Full Paper ,Phantoms, Imaging ,General Medicine ,Arteries ,Middle Aged ,Radiation Exposure ,Computed tomographic angiography ,030220 oncology & carcinogenesis ,Female ,Iodine ,Materials science ,chemistry.chemical_element ,Body weight ,Radiation Dosage ,Iliac Artery ,Pelvis ,03 medical and health sciences ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Aged ,business.industry ,Body Weight ,Body Height ,Aortic Dissection ,chemistry ,Angiography ,Feasibility Studies ,business ,Nuclear medicine ,Aortic Aneurysm, Abdominal - Abstract
Objectives: To assess the feasibility of whole-body dual-energy computed tomographic angiography (DECTA) at 40 keV with 50% reduced iodine dose protocol. Methods: Whole-body CTA was performed in 65 patients; 31 of these patients underwent 120 kVp single-energy computed tomographic angiography (SECTA) with standard iodine dose (600 mgI/kg) and 34 with 40 keV DECTA with 50% reduced iodine dose (300 mgI/kg). SECTA data were reconstructed with adaptive statistical iterative reconstruction of 40% (SECTA group), and DECTA data were reconstructed with adaptive statistical iterative reconstruction of 40% (DECTA-40% group) and 80% (DECTA-80% group). CT numbers of the thoracic and abdominal aorta, iliac artery, background noise, signal-to-noise ratio (SNR), and arterial depiction were compared among the three groups. The CT dose index volumes (CTDIvol) for the thorax, abdomen, and pelvis were compared between SECTA and DECTA protocols. Results: The vascular CT numbers and background noise were found to be significantly higher in DECTA groups than in the SECTA group (p < 0.001). SNR was significantly higher in the order corresponding to DECTA-80%, SECTA, and DECTA-40% (p < 0.001). The arterial depiction was comparable in almost all arteries; however, intrapelvic arterial depiction was significantly worse in DECTA groups than in the SECTA group (p < 0.0001–0.017). Unlike the pelvic region (p = 0.055), CTDIvol for the thorax (p < 0.0001) and abdomen (p = 0.0031) were significantly higher in the DECTA protocol than in the SECTA protocol. Conclusion: DECTA at 40 keV with 50% reduced iodine dose provided higher vascular CT numbers and SNR than SECTA, and almost comparable arterial depiction, but had a degraded intrapelvic arterial depiction and required a larger radiation dose. Advances in knowledge: DECTA enables 50% reduction of iodine dose while maintaining image quality, arterial depiction in almost all arteries, vascular CT numbers, and SNR; however, it does not allow clear visualization of intrapelvic arteries, requiring a slightly larger radiation dose compared with SECTA with standard iodine dose.
- Published
- 2021
6. Effective Percutaneous Treatment of Type 2 Endoleak via Target Artery Punction Under the Guidance of Fluoroscopy and Ultrasound.
- Author
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Naser, Abdulrahman, Isgandarov, Khagani, Fırat, Ahmet Kemal, Şahin, Müslüm, and Güven, Oya
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ENDOVASCULAR aneurysm repair ,DOPPLER ultrasonography ,THERAPEUTIC embolization ,COMPUTED tomography ,BLOOD vessel prosthesis ,TREATMENT effectiveness ,ANGIOGRAPHY ,MANIPULATION therapy ,ILIAC artery ,ABDOMINAL aortic aneurysms ,SURGICAL hemostasis ,COMPRESSION therapy ,FLUOROSCOPY - Abstract
Copyright of Bosphorus Medical Journal / Boğaziçi Tıp Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2024
- Full Text
- View/download PDF
7. Evaluation of the Effectiveness of Screening for Iliac Arterial Calcification in Kidney Transplant Candidates
- Author
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Randall S. Sung, Ivy A. Ochieng, Anjan K. Saha, and Stephanie A. DeBolle
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Male ,Parathyroidectomy ,medicine.medical_specialty ,medicine.medical_treatment ,Iliac Artery ,Organ transplantation ,030218 nuclear medicine & medical imaging ,Coronary artery disease ,Peripheral Arterial Disease ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Vascular Calcification ,Kidney transplantation ,Retrospective Studies ,Original Paper ,Transplantation ,business.industry ,Vascular disease ,Organ Transplantation ,General Medicine ,Middle Aged ,medicine.disease ,Kidney Transplantation ,Arterial calcification ,030220 oncology & carcinogenesis ,Female ,Radiology ,Tomography, X-Ray Computed ,business ,Calcification - Abstract
BACKGROUND Peripheral vascular disease and iliac arterial calcification are prevalent in kidney transplant candidates and jeopardize graft outcomes. We report our experience with computed tomography (CT) screening for iliac arterial calcification. MATERIAL AND METHODS We retrospectively reviewed electronic medical records of 493 renal transplant candidates from protocol initiation in 2014. Non-contrast CT was performed or retrospectively reviewed if any of the following criteria were present: diabetes, ESRD >6 years, 25 pack-years of smoking or current smoker, diagnosis of peripheral vascular disease, parathyroidectomy, and coronary artery disease intervention. Differences in evaluation and transplant outcomes between groups were compared with chi-squared analysis. Multivariate logistic regression identified predictive criteria for presence of iliac arterial calcification. RESULTS Of 493 candidates evaluated, CTs were reviewed in 346 (70.2%). Iliac arterial calcification was identified in 119 screened candidates (34.4%). Of candidates with iliac arterial calcification identified on CT, 16 (13.4%) were excluded for CT findings, and 9 (7.6%) had their surgical management plan changed. Overall, 91 (76.5%) candidates with iliac arterial calcification on CT were approved, compared to 203 (89.4%) without calcification (P
- Published
- 2020
8. Inferior mesenteric artery embolization for persistent postpartum hemorrhage after sufficient bilateral iliac arteries embolization: safety and efficacy in eight patients
- Author
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Ji Hoon Shin, Jong Woo Kim, Heung-Kyu Ko, Chengshi Chen, Hai-Liang Li, Hyun-Ki Yoon, and Hee Ho Chu
- Subjects
Adult ,medicine.medical_specialty ,Computed Tomography Angiography ,medicine.medical_treatment ,Treatment outcome ,Inferior mesenteric artery ,Iliac Artery ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Text mining ,medicine.artery ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Embolization ,Retrospective Studies ,030219 obstetrics & reproductive medicine ,Full Paper ,business.industry ,Arterial Embolization ,Postpartum Hemorrhage ,Retrospective cohort study ,Mesenteric Artery, Inferior ,General Medicine ,Embolization, Therapeutic ,Surgery ,Treatment Outcome ,Female ,business - Abstract
Objective: To assess the safety and efficacy of transcatheter arterial embolization (TAE) of the inferior mesenteric artery (IMA) for the management of post-partum hemorrhage (PPH). Methods: A retrospective analysis was performed regarding eight patients (mean age, 34.4 y; age range, 31 – 40 y) who underwent TAE of the IMA for PPH between March 2001 and September 2018. Obstetric records, including maternal characteristics, clinical manifestations, complications, and clinical outcomes, as well as TAE details were obtained. Results: All eight patients had primary PPH and the vaginal delivery mode. CT scans of two patients showed active bleeding from the lower uterus or hematoma and with the origin of contrast extravasation abutting the adjacent rectum. In seven patients, an aortogram or IMA arteriogram following persistent vaginal bleeding after sufficient embolization of the bleeding focus from the bilateral iliac arteries, found the bleeding focus of the IMA, while in one patient, the IMA bleeding focus was found at the second session 4 h after the first session. TAE of the IMA was technically successful in all eight patients and cessation of bleeding without repeated TAE or additional hemostatic surgery was achieved in all patients after TAE of the IMA. There were neither procedure-related complications nor bowel ischemia during follow-up. Conclusion: TAE of the IMA for PPH was safe and effective with successful hemostasis. Bleeding from the IMA should be suspected when there is persistent vaginal bleeding after sufficient embolization of bleeders from the bilateral iliac arteries. Advances in knowledge: Bleeding from the IMA should be suspected when there is persistent vaginal bleeding after sufficient embolization of bleeders from the bilateral iliac arteries.
- Published
- 2019
9. A novel polymer-free ciglitazone-coated vascular stent: in vivo and ex vivo analysis of stent endothelialization in a rabbit iliac artery model
- Author
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Sylvia Otto, Tudor C. Poerner, Kristin Jaeger, Marcus Franz, Harald Schubert, Frank D. Kolodgie, Hans R. Figulla, Diana Muehlstaedt, Renu Virmani, and Sabine Bischoff
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CD31 ,medicine.medical_specialty ,Vascular smooth muscle ,Endothelium ,endothelium ,Polymers ,medicine.medical_treatment ,vascular remodeling ,Myocytes, Smooth Muscle ,Urology ,030204 cardiovascular system & hematology ,Ligands ,Iliac Artery ,Muscle, Smooth, Vascular ,ciglitazone ,03 medical and health sciences ,0302 clinical medicine ,In vivo ,Ciglitazone ,Pathology Section ,medicine ,PPARg ,Animals ,Ultrasonics ,030212 general & internal medicine ,Microscopy, Confocal ,business.industry ,Stent ,drug-eluting stents ,Endothelial Cells ,Histology ,equipment and supplies ,Research Paper: Pathology ,Surgery ,PPAR gamma ,Disease Models, Animal ,Microscopy, Electron ,medicine.anatomical_structure ,Cholesterol ,Oncology ,Metals ,Spectrophotometry, Ultraviolet ,Thiazolidinediones ,Rabbits ,business ,Ex vivo ,Tomography, Optical Coherence - Abstract
// Sylvia Otto 1 , Kristin Jaeger 1 , Frank D. Kolodgie 2 , Diana Muehlstaedt 1 , Marcus Franz 1 , Sabine Bischoff 3 , Harald Schubert 3 , Hans R. Figulla 1 , Renu Virmani 2 and Tudor C. Poerner 1 1 Department of Medicine 1, Division of Cardiology, University Hospital of Jena, Thuringia, Germany 2 Institute for Laboratory Animal Science and Animal Protection (IVuT), University Hospital of Jena, Thuringia, Germany 3 CV Path Institute Inc., Gaithersburg, MD, USA Correspondence to: Sylvia Otto, email: // Keywords : PPARg, ciglitazone, endothelium, vascular remodeling, drug-eluting stents, Pathology Section Received : July 16, 2016 Accepted : August 20, 2016 Published : August 24, 2016 Abstract Aim: Peroxisome proliferator-activated receptor-gamma (PPARg) agonists have known pleiotropic cardiovascular effects with favourable properties in vascular remodeling, and specifically in suppression of vascular smooth muscle cell proliferation. A novel vascular stent coating using the PPARg ligand ciglitazone (CCS) was investigated regarding its effects on endothelialization after 7 and 28 days. Methods: Microporous bare metal stents (BMS) were coated with ciglitazone by ultrasonic flux with a load of 255 μg ciglitazone/stent. SixteenNew Zealand white rabbits, fed a with high cholesterol diet, underwent stent implantation in both iliac arteries. Everolimus-eluting stents (EES) and BMS were comparators. Histology (CD 31 immunostaining, confocal and scanning electron microscopy, morphometry) was performed after 7 and 28 days and by OCT (optical coherence tomography) in vivo after 28 days. Results: Microscopy showed comparable results with near complete endothelialization in CCS and BMS (%CD31 above stent struts after 7 days: 67.92±36.35 vs. 84.48±23.86; p = 0.55; endothel % above stent struts: 77.22±27.9 vs. 83.89±27.91; p = 0.78). EES were less endothelialized with minimal fibrin deposition, not found in BMS and CCS (% CD 31 above struts after 28 days, BMS: 100.0±0.0 vs. EES: 95.9±3.57 vs. CCS: 100.0±0.0; p = 0.0292). OCT revealed no uncovered struts in all stents after 28 days. Conclusions: Polymer-free coating with ciglitazone, a PPARg agonist is feasible and stable over time. Our data prove unimpaired endothelial coverage of a ciglitazone-coated vascular stent system by histology and OCT. Thus, this PPARg agonist coating deserves further investigation to evaluate its potency on local neointimal suppression.
- Published
- 2016
10. Risk factors for massive bleeding based on angiographic findings in patients with placenta previa and accreta who underwent balloon occlusion of the internal iliac artery during cesarean section
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Yoshito Tsushima, Hiroyuki Tokue, Takeshi Kameda, and Azusa Tokue
- Subjects
Adult ,medicine.medical_specialty ,medicine.medical_treatment ,Blood Loss, Surgical ,Placenta Previa ,Collateral Circulation ,Placenta Accreta ,Postoperative Hemorrhage ,Hysterectomy ,Aortography ,Iliac Artery ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Risk Factors ,medicine.artery ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Aorta, Abdominal ,Round Ligament of Uterus ,Retrospective Studies ,Ultrasonography ,Aorta ,030219 obstetrics & reproductive medicine ,Full Paper ,medicine.diagnostic_test ,Cesarean Section ,business.industry ,Ovary ,Uterus ,Angiography ,Retrospective cohort study ,Arteries ,General Medicine ,Balloon Occlusion ,medicine.disease ,Collateral circulation ,Internal iliac artery ,Hemostasis, Surgical ,Placenta previa ,Surgery ,Female ,business - Abstract
Objective:We evaluated the risk factors for massive bleeding based on angiographic findings in patients with placenta previa and accreta who underwent balloon occlusion of the internal iliac artery (BOIA) during cesarean section.Methods:We performed a retrospective analysis using the clinical records of 42 patients with placenta previa and accreta who underwent BOIA during cesarean section between 2006 and 2017 in Gunma university hospital. We reviewed incidence of collateral arteries to the uterus on the initial aortography. We evaluated the visualization of the ovarian artery arising directly from the abdominal aorta, round ligament artery arising from the external iliac artery/inferior epigastric artery, and the iliolumbar artery. In addition, the clinical characteristics were reviewed. Patients with an estimated blood loss during delivery of >2500 ml, >4 packed red blood cell transfusions, uterine artery embolization after delivery, or hysterectomy were defined as the massive bleeding group. We compared between the massive and non-massive bleeding groups.Results:20 patients (48%) had a massive bleeding. No procedure-related severe complications were observed. The massive and non-massive bleeding groups differed in terms of operation time (p < 0.001), hysterectomy (p < 0.001), post-operative hospital stay (p < 0.05), and visualization of round ligament arteries to the uterus [15/20 (75%) patients, p < 0.01].Conclusion:The incidence of collateral blood supply from a round ligament artery to the uterus may be a risk factor for massive bleeding in patients with placenta previa and accreta who have undergone BOIA during cesarean section.Advances in knowledge:Angiographic visualization of collateral circulation from the round ligament artery to the uterus may be a risk factor for massive bleeding in patients with placenta previa and accreta who have undergone BOIA during cesarean section.
- Published
- 2019
11. A239 BRISK GASTROINTESTINAL BLEED: AN ATYPICAL CULPRIT
- Author
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J LeBlanc and K Waschke
- Subjects
Iliac artery ,medicine.medical_specialty ,Small bowel resection ,Gastrointestinal bleeding ,medicine.diagnostic_test ,business.industry ,Rectal examination ,medicine.disease ,Culprit ,Gastroenterology ,Hematochezia ,Gastrointestinal Bleed ,Paper Sessions ,Internal medicine ,Medicine ,medicine.symptom ,business ,Abscess - Abstract
BACKGROUND: A 68 year-old female is referred to the Gastroenterology consultation service from the Emergency Department (ED) for brisk gastrointestinal bleeding. Five months prior, she was admitted for multiple intra-abdominal abscesses from perforated appendix, requiring right hemicolectomy and small bowel resection. She was also known for deep vein thrombosis on low-molecular-weight heparin and ovarian cancer considered in remission. AIMS: Case report and review of the literature METHODS: See above RESULTS: She presented to the Royal Victoria Hospital for witnessed syncope and significant hematochezia of acute onset. She was profoundly hypotensive, requiring aggressive fluid resuscitation. Her physical exam showed mild epigastric and right lower quadrant pain, as well as bright red blood on the digital rectal examination. Her initial hemoglobin of 80 dropped to 32, with ongoing hematochezia. Nasogastric tube insertion was unsuccessful. A gastroscopy showed normal mucosa with no blood seen up to the distal duodenum. Overnight, she suffered from a recurrent episode of brisk hematochezia, requiring the activation of a massive transfusion protocol. Given her ongoing blood loss, she was sent for a mesenteric angiogram which identified an actively-bleeding fistula from the right external iliac artery to the transverse colon. The interventional radiologist decided to deploy a balloon-assisted covered stent to close off the fistula. Immediately after deployment, the patient’s hemodynamics improved. The vascular surgery team decided against operative management in view of a suspected low operative success from multiple prior surgeries and radiation therapy. Asymptomatic, she was discharged eleven days after her presentation. CONCLUSIONS: This rare case highlights the importance of early recognition of life-threatening conditions, such as arterioenteric fistulas (AEF). It also illustrates a rare mechanism of fistula formation. Most cases of AEFs are described as secondary, namely as a complication of prior aortic reconstruction. Approximately 250 cases of primary AEF have been reported in the published literature, of which only 15% affected the colon. In our patient’s case, the main risk factors for primary AEF were encasing peri-iliac abscesses, subsequent bowel manipulation and prior radiation therapy. Prompt investigation is a key component of AEF prognosis. Angiography permits direct AEF visualization and potential placement of a covered stent graft, either as a bridge to open surgery or as a definitive therapy for patients with high operative risk. However, stent placement harbours significant rebleeding rates and infectious complications. Optimal management in these cases remains controversial, such as the use of prophylactic antibiotics or serial imaging. Even though high-quality evidence is scarce, angiography with endovascular intervention is considered first-line treatment in patients with hemodynamic instability. FUNDING AGENCIES: None
- Published
- 2018
12. Proximal occlusion of unaffected internal iliac artery versus distal occlusion of aneurysmatic internal iliac artery prior to EVAR: a comparative evaluation of efficacy and clinical outcome
- Author
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Richard Kellersmann, Alexander Dierks, Alexander Sauer, Nicole Hassold, Franziska Wolfschmidt, Ralph Kickuth, and Thorsten A. Bley
- Subjects
Male ,medicine.medical_specialty ,Endoleak ,Septal Occluder Device ,medicine.medical_treatment ,Radiography ,030204 cardiovascular system & hematology ,Radiography, Interventional ,Endovascular aneurysm repair ,Iliac Artery ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Blood Vessel Prosthesis Implantation ,0302 clinical medicine ,medicine.artery ,Occlusion ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Embolization ,Iliac Aneurysm ,Proximal occlusion ,Aged ,medicine.diagnostic_test ,Full Paper ,business.industry ,Endovascular Procedures ,Angiography ,General Medicine ,Internal iliac artery ,Surgery ,Treatment Outcome ,Female ,Radiology ,business - Abstract
Occlusion of the internal iliac artery (IIA) may be necessary prior to endovascular aneurysm repair (EVAR) to prevent endoleak Type II. We compared efficacy and clinical outcome after proximal occlusion of an unaffected IIA (ProxEmbx) using an Amplatzer vascular plug (AVP) I vs distal occlusion of aneurysmatic IIA with coils and plugs (DistEmbx).Between 2009 and 2012, 22 patients underwent EVAR. In 9 patients with unaffected IIA, occlusion was performed by a single AVP. In 13 patients with aneurysmatic IIA, more distal embolization (DistEmbX) was conducted by using several coils and additional AVPs. Retrospectively, technical success, clinical outcome and complications were evaluated.Embolization of the IIA was successful in all patients. Three patients with more DistEmbX of aneurysmatic IIAs suffered from new onset of sexual dysfunction after occlusion without statistically significant difference (p 0.05). Transient buttock claudication was observed in three patients in each group. Bowel ischaemia did not occur. The procedure time (p = 0.013) and fluoroscopy time (p = 0.038) was significantly lower in the ProxEmbx group than in the DistEmbx group.Proximal occlusion of an unaffected IIA and more distal occlusion of an aneurysmatic IIA prior to EVAR had the same technical and clinical outcome. However, proximal plug embolization of an unaffected IIA prior to EVAR was associated with shorter procedure and fluoroscopy time in comparison with more DistEmbX of aneurysmatic IIAs. Advances in knowledge: Proximal embolization of unaffected IIA and DistEmbX of aneurysmatic IIA before EVAR are both effective in preventing Type II endoleaks and have the same technical and clinical outcome.
- Published
- 2017
13. Comparison of early vascular morphological changes between bioresorbable poly-L-lactic acid scaffolds and metallic stents in porcine iliac arteries
- Author
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Yuko Kitagawa, Kentaro Matsubara, Hirohisa Harada, Yasuhito Sekimoto, Naoki Fujimura, and Hideaki Obara
- Subjects
Neointima ,Poly l lactic acid ,Male ,Embryology ,medicine.medical_specialty ,Arterial disease ,Swine ,Polyesters ,Biomedical Engineering ,Lumen (anatomy) ,030204 cardiovascular system & hematology ,Iliac Artery ,03 medical and health sciences ,0302 clinical medicine ,Intravascular ultrasound ,Absorbable Implants ,medicine ,Bare metal ,Animals ,cardiovascular diseases ,030212 general & internal medicine ,Ultrasonography, Interventional ,Transplantation ,medicine.diagnostic_test ,Tissue Scaffolds ,business.industry ,Angiography, Digital Subtraction ,Digital subtraction angiography ,equipment and supplies ,medicine.disease ,Research Papers ,Stenosis ,surgical procedures, operative ,Metals ,Swine, Miniature ,Stents ,Radiology ,business ,Developmental Biology ,Biomedical engineering - Abstract
Bioresorbable scaffolds have the potential to overcome several problems associated with metallic stents. Bioresorbable poly-L-lactic acid (PLLA) scaffold implantation for the treatment of peripheral artery disease has already been reported in animal models and clinical trials; however, no studies comparing PLLA scaffolds and bare metal stents (BMSs) with regard to early vascular morphological changes, identified using intravascular ultrasound (IVUS) analysis, have been reported. In this study, PLLA scaffolds and BMSs were implanted bilaterally in iliac arteries of five miniature pigs. Digital subtraction angiography and IVUS were performed before and immediately after stent implantation and at 6-week follow-up. All PLLA scaffolds and BMSs were patent at 6-week follow-up. Per IVUS analysis, the percent area stenosis did not significantly differ between PLLA scaffolds and BMSs (65.7% vs. 67.2%, P = .761). Furthermore, percent vessel lumen change also did not differ significantly. Neointima formation (the neointimal area plus medial area) was significantly less with PLLA scaffolds than with BMSs (15.65 mm2 vs. 25.69 mm2, P < .001). In conclusion, based on IVUS results, short-term results after stent implantation in porcine iliac arteries were comparable between PLLA scaffolds and BMSs. Therefore, PLLA scaffolds are safe and feasible for implantation in peripheral arteries.
- Published
- 2017
14. Perfusion CT to assess angiogenesis in colon cancer: technical limitations and practical challenges
- Author
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Nelesh Jeyadevan, Gina Brown, E Castellano, M Orten, M U Koh, S. Dighe, Helena Blake, and Ian Swift
- Subjects
medicine.medical_specialty ,Angiogenesis ,Colorectal cancer ,Iohexol ,Movement ,Perfusion Imaging ,Contrast Media ,Iliac Artery ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Shallow breathing ,Neovascularization, Pathologic ,Full Paper ,business.industry ,Respiratory motion ,General Medicine ,medicine.disease ,Contrast injection ,Colonic Neoplasms ,Feasibility Studies ,Radiology ,medicine.symptom ,Tomography, X-Ray Computed ,business ,Nuclear medicine ,Perfusion ,Software - Abstract
Perfusion CT may have the potential to quantify the degree of angiogenesis of solid tumours in vivo. This study aims to identify the practical and technical challenges inherent to the technique, and evaluate its feasibility in colorectal tumours.51 patients from 2 institutions prospectively underwent a single perfusion CT on 2 different multidetector scanners. The patients were advised to breath-hold as long as possible, followed by shallow breathing, and were given intravenous buscopan to reduce movement. Numerous steps were explored to identify the challenges.43 patients successfully completed the perfusion CT as per protocol. Inability to detect the tumour (n=3), misplacement of dynamic sequence co-ordinates (n=2), failure of contrast injection (n=2) and displacement of tumour (n=1) were the reasons for failure. In 14 cases excessive respiratory motion displaced the tumour out of the scanning field along the temporal sequence, leading to erroneous data capture. In nine patients, minor displacements of the tumour were corrected by repositioning the region of interest (ROI) to its original position after reviewing each dynamic sequence slice. In 20 patients the tumour was stable, and data captured from the ROI were representative, and could have been analysed by commercially available Body Tumor Perfusion 3.0® software (GE Healthcare, Waukesha, WI). Hence all data were manually analysed by MATLAB® processing software (MathWorks, Cambridge, UK).Perfusion CT in tumours susceptible to motion during acquisition makes accurate data capture challenging and requires meticulous attention to detail. Motion correction software is essential if perfusion CT is to be used routinely in colorectal cancer.
- Published
- 2012
15. Echocardiographic evaluation of aorto-iliac occlusive disease
- Author
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Grzegorz Rosinski, Cezary Szmigielski, Anna Kaczyńska, Grzegorz Styczynski, Jerzy Leszczyński, and A. Kuch-Wocial
- Subjects
Male ,medicine.medical_specialty ,Population ,Arterial Occlusive Diseases ,Femoral artery ,Constriction, Pathologic ,Doppler echocardiography ,Aortography ,Iliac Artery ,Sensitivity and Specificity ,Aortic aneurysm ,Predictive Value of Tests ,Internal medicine ,medicine.artery ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,education ,Cardiac imaging ,Computed tomography angiography ,Aged ,education.field_of_study ,Original Paper ,medicine.diagnostic_test ,business.industry ,Aorto-iliac occlusive disease ,Middle Aged ,medicine.disease ,Abdominal aortic aneurysm ,Echocardiography, Doppler, Color ,Stenosis ,Radiology Nuclear Medicine and imaging ,Regional Blood Flow ,Cardiology ,cardiovascular system ,Screening ,Feasibility Studies ,Female ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Tomography, X-Ray Computed ,Aortic Aneurysm, Abdominal - Abstract
Several studies demonstrated feasibility of visual assessment of the common femoral artery Doppler waveform, in an indirect evaluation of aorto-iliac segment stenosis. Patients with cardiac diseases referred for echocardiography often have coexistent arterial pathology. Since many of them are potential candidates for endovascular procedures, we decided to study, whether echocardiography can be useful for detection of aorto-iliac occlusive disease. We evaluated 92 patients with abdominal aortic aneurysm or peripheral artery occlusive disease, referred from the vascular surgery department for cardiac evaluation before surgery. At the end of an echocardiographic examination, evaluation of flow in the distal external iliac arteries with an echocardiographic probe was performed. The Doppler waveform was classified into normal--with early diastolic flow reversal or abnormal--without early diastolic flow reversal. Echocardiographic results were compared in a blinded fashion with reports from computed tomography angiography. Overall there were 58 iliac segments with significant (≥70%) area stenosis or occlusion and 126 iliac segments without significant disease on computed tomography angiography. Abnormal Doppler waveform was found in 56 out of 58 abnormal iliac segments-sensitivity 97%, and normal waveform was found in 106 out of 126 normal iliac segments-specificity 84%. Positive predictive value of abnormal Doppler waveform for significant iliac disease was 74%, and negative predicting value was 98%. Detection of significant stenoses in aorto-iliac segments is feasible with echocardiography. Further studies are necessary to evaluate its potential utility in a population of patients with cardiac disease referred for echocardiographic study.
- Published
- 2011
16. Accuracy of multislice CT angiography for the assessment of in-stent restenoses in the iliac arteries at reduced dose: a phantom study
- Author
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John Damilakis, K. Zourari, A Papadakis, Dimitrios Tsetis, K. Perisinakis, Antonis Tzedakis, E Manousaki, and Apostolos H. Karantanas
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Arterial Occlusive Diseases ,Femoral artery ,Radiation Dosage ,Iliac Artery ,Imaging phantom ,Recurrence ,medicine.artery ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Multislice ct ,Iliac artery ,Full Paper ,medicine.diagnostic_test ,Phantoms, Imaging ,business.industry ,Reproducibility of Results ,Stent ,General Medicine ,Reduced dose ,Femoral Artery ,Contrast medium ,Angiography ,Female ,Stents ,Radiology ,Tomography, X-Ray Computed ,business - Abstract
Objective: We investigated the potential of low-dose CT angiography for accurate assessment of in-stent restenoses (ISRs) of the iliac artery. Method: A Rando anthropomorphic phantom (Alderson Research Labs, Stanford, CA), custom-made wax simulating hyperplastic tissue and a nitinol stent were used to simulate a patient with clinically relevant iliac artery ISRs. The cylindrical lumen was filled with a solution of iodine contrast medium diluted in saline, representing a patient’s blood during CT angiography. The phantom was subjected to standard- and low-dose angiographic exposures using a modern multidetector (MD) CT scanner. The percentage of ISR was determined using the profile along a line normal to the lumen axis on reconstructed images of 2 and 5 mm slice thickness. Percentage ISRs derived using the standard- and low-dose protocols were compared. In a preliminary study, seven patients with stents were subjected to standard- and low-dose MDCT angiography during followup. The resulting images were assessed and compared by two experienced radiologists. Results: The accuracy in measuring the percentage ISR was found to be better than 12% for all simulated stenoses. The differences between percentage ISRs measured on images obtained at 120 kVp/160 mAs and 80 kVp/80 mAs were below 6%. Patient image sets acquired using low-exposure factors were judged to be of satisfactory diagnostic quality. The assessment of ISR did not differ significantly between image sets acquired using the standard factors and those acquired using the low-exposure factors, although the mean reduction in patient effective dose was 48%. Conclusion: A reduction in exposure factors during MDCT angiography of the iliac artery is possible without affecting the accuracy in the determination of ISRs.
- Published
- 2011
17. Effects of Losartan on expression of connexins at the early stage of atherosclerosis in rabbits
- Author
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Jin-feng Duan, Wei Cai, Jun-zhu Chen, and Li-ming Ruan
- Subjects
Male ,Neointima ,connexin ,medicine.medical_specialty ,Statin ,medicine.drug_class ,Blotting, Western ,Myocytes, Smooth Muscle ,Connexin ,Angiotensin-Converting Enzyme Inhibitors ,Iliac Artery ,Connexins ,Losartan ,vascular proliferation ,gap junction ,Western blot ,Internal medicine ,balloon angioplasty ,medicine ,Animals ,RNA, Messenger ,biology ,medicine.diagnostic_test ,Reverse Transcriptase Polymerase Chain Reaction ,statin ,Gap junction ,Gap Junctions ,Arteries ,General Medicine ,Atherosclerosis ,Immunohistochemistry ,Endocrinology ,Enzyme inhibitor ,Connexin 43 ,cardiovascular system ,biology.protein ,Rabbits ,Research Paper ,medicine.drug - Abstract
Aim: to investigate effects of Losartan on expression of connexin 40 and 43 (Cx40 and Cx43), in arteries at the early stage of atherosclerosis in a rabbit model. Methods: A total of 28 male New Zealand white rabbits were divided into following groups: control group, high fat diet group, and Losartan group (10 mg/kg/day). Losartan was administrated in food for two weeks. Iliac arteries were obtained for immunohistochemistry, transmission electron microscopy, Western blot, and reverse transcriptase-polymerase chain reaction (RT-PCR). Results: Transmission electron microscopy revealed abundant gap junctions between neointimal smooth muscle cells (SMCs), which were markedly reduced by treatment. RT-PCR and Western blot assay showed that the mRNA and protein expression of Cx40 and Cx43 were elevated in the neointimal area at the early stage of atherosclerosis. The mRNA and protein expression of Cx43 were significantly down-regulated by losartan treatment but those of Cx40 were not markedly changed. Conclusion: Cx40 and Cx43 in the neointimal SMCs were up-regulated at the early stage of atherosclerosis. Losartan (an angiotensin-converting enzyme inhibitor) could reduce neointima proliferation and down-regulate the elevated protein expression of Cx43, suggesting the rennin-angiotensin system (RAS) plays an important role in the remodeling of gap junction between ventricular myocytes under pathological conditions.
- Published
- 2010
18. Comparison of retrograde anatomy iliac bone flap grafting versus anterograde anatomy iliac bone flap grafting for treatment of osteonecrosis of the femoral head.
- Author
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Wu, Panfeng, Xiao, Yu, Qing, Liming, Tang, Juyu, Huang, Chengxiong, and Cao, Zheming
- Subjects
SURGICAL blood loss ,SURGICAL flaps ,OSTEONECROSIS ,ILIAC artery ,RETROSPECTIVE studies ,DISEASES ,COMPARATIVE studies ,FEMUR ,BONE grafting - Abstract
Background: Iliac bone flap with deep circumflex iliac artery is a common option in the treatment of Osteonecrosis of the femoral head (ONFH), and dissection of iliac bone flap is the key step for successful operation. This paper aims to introduce a new operative technique for dissecting iliac bone flap with deep circumflex iliac artery based on analysis of its advantages. Methods: A total of 49 patients treated by retrograde anatomy and 52 patients treated by anterograde anatomy from January 2010 to December 2020 were recruited. The two groups were then compared in terms of the preoperative baseline conditions, intraoperative data, and postoperative Harris hip score (HHS). Results: Compared with the retrograde anatomy group, the anterograde anatomy group had a significantly longer operating time, a significantly heavier intraoperative blood loss, a significantly higher rate of donor complication morbidity, a significantly higher rate of donor–recipient delayed healing, a significantly higher failure rate of iliac bone flap resection, a significantly higher rate of lateral femoral cutaneous nerve (LFCN) injury, and a significantly higher rate of ectopic ossification. No difference was found in postoperative HHS score between the two groups. Conclusion: As a new operative technique that can accurately locate the nutrient vessels of the iliac bone flap and quickly dissect the iliac bone flap with deep circumflex iliac artery while maintaining a comparable clinical effect, retrograde anatomy exhibited distinct advantages over anterograde anatomy in terms of simpler intraoperative operation, safer dissection, shorter operation time, lower blood loss, and fewer donor complications. Level of evidence: III, Retrospective. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
19. Differences in Cardiac-Pulsatility-Induced Displacement and Geometry Changes between the Cook ZBIS and Gore IBE: Postoperative Comparison Using ECG-Gated CTA Scans.
- Author
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Simmering, Jaimy A., van Helvert, Majorie, van Herwaarden, Joost A., Slump, Cornelis H., Geelkerken, Robert H., and Reijnen, Michel M. P. J.
- Subjects
HEART beat ,ILIAC artery ,GEOMETRY ,TORSION ,TORTUOSITY - Abstract
To what extent the stentgraft design of iliac branch devices (IBDs) relates to dynamic deformation is currently unknown. Therefore, this study aimed to quantify and compare displacement and geometry changes during the cardiac cycle of two common IBDs. This paper presents a two-center trial with patients treated with a Zenith bifurcated iliac side (ZBIS) or Gore iliac branch endoprosthesis (IBE). All patients underwent a retrospective electrocardiogram (ECG)-gated computed tomographic angiography (CTA) during follow-up. Cardiac-pulsatility-induced displacement was quantified for the following locations: (neo) bifurcation of the aorta, IBD flow divider, distal markers of the internal iliac artery (IIA) component and first IIA bifurcation. Geometrical parameters (length, tortuosity index, curvature and torsion) were quantified over centerlines. Displacement was more pronounced for the IBE than the ZBIS, e.g., craniocaudal displacement of 0.91 mm (0.91–1.13 mm) vs. 0.57 mm (0.40–0.75 mm, p = 0.004), respectively. The IBDs demonstrated similar geometrical parameters in the neo-common iliac artery and distal IIA, except for the larger dynamic curvature and torsion of the distal IIA in IBEs. The IBEs showed more dynamic length and curvature change compared to the ZBIS in the stented IIA. The IIA trajectory showed more pronounced deformation during the cardiac cycle after placement of an IBE than a ZBIS, suggesting the IBE is more conformable than the ZBIS. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
20. Vascular replacement using a layered elastin-collagen vascular graft in a porcine model: one week patency versus one month occlusion
- Author
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A G Krasznai, J.A. van der Vliet, R Praster, Martin J.W. Koens, Willeke F. Daamen, A. Hanssen, T.H. van Kuppevelt, and Thijs Hendriks
- Subjects
Graft Rejection ,Embryology ,medicine.medical_specialty ,Swine ,Biomedical Engineering ,Arterial Occlusive Diseases ,Prosthesis Design ,Iliac Artery ,Duplex scanning ,Extracellular matrix ,Tissue engineering ,medicine ,Animals ,Vascular Patency ,Bioprosthesis ,Transplantation ,Extracellular Matrix Proteins ,biology ,business.industry ,Non Research Personnel Central Animal Laboratory are not attached to an institute / theme ,Heparin ,Surgery ,Blood Vessel Prosthesis ,Elastin ,Equipment Failure Analysis ,Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10] ,medicine.anatomical_structure ,Treatment Outcome ,surgical procedures, operative ,Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10] ,NWP personeel van CDL vallen niet onder een instituut / thema ,biology.protein ,cardiovascular system ,Female ,Vascular Grafting ,Collagen ,business ,Type I collagen ,Developmental Biology ,medicine.drug ,Blood vessel ,Artery ,Research Paper - Abstract
Contains fulltext : 152926.pdf (Publisher’s version ) (Closed access) A persistent clinical demand exists for a suitable arterial prosthesis. In this study, a vascular conduit mimicking the native 3-layered artery, and constructed from the extracellular matrix proteins type I collagen and elastin, was evaluated for its performance as a blood vessel equivalent. A tubular 3-layered graft (elastin-collagen-collagen) was prepared using highly purified type I collagen fibrils and elastin fibers, resembling the 3-layered native blood vessel architecture. The vascular graft was crosslinked and heparinised (37 +/- 4 mug heparin/mg graft), and evaluated as a vascular graft using a porcine bilateral iliac artery model. An intra-animal comparison with clinically-used heparinised ePTFE (Propaten(R)) was made. Analyses included biochemical characterization, duplex scanning, (immuno)histochemistry and scanning electron microscopy. The tubular graft was easy to handle with adequate suturability. Implantation resulted in pulsating grafts without leakage. One week after implantation, both ePTFE and the natural acellular graft had 100% patencies on duplex scanning. Grafts were partially endothelialised (Von Willebrand-positive endothelium with a laminin-positive basal membrane layer). After one month, layered thrombi were found in the natural (4/4) and ePTFE graft (1/4), resulting in occlusion which in case of the natural graft is likely due to the porosity of the inner elastin layer. In vivo application of a molecularly-defined tubular graft, based on nature's matrix proteins, for vascular surgery is feasible.
- Published
- 2015
21. Laparoscopic Vascular Control Techniques in Donor Nephrectomy: Effects on Vessel Length
- Author
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Bernie, Jonathan E., Sundaram, Chandru P., and Guise, Amy I.
- Subjects
Sutures ,Vena Cava, Inferior ,Equipment Design ,Iliac Vein ,Nephrectomy ,Iliac Artery ,Tissue Donors ,surgical procedures, operative ,Stapler ,Vascular ,Surgical Stapling ,Scientific Papers ,Cadaver ,Humans ,Laparoscopy ,Aorta, Abdominal ,Donor ,Vascular Surgical Procedures - Abstract
Background: Various techniques for vascular control have been used during urologic laparoscopic procedures. The importance of optimizing the vessel length and securing reliable vascular control are critical for procedures like laparoscopic donor nephrectomy. We aimed to determine the length of vessel lost by using 4 common techniques of vascular control in a fresh human cadaveric vascular model. Methods: The techniques include application of 2 nonabsorbable polymer-ligating clips (10-mm Hem-o-Lok MLX Weck Closure Systems, Research Triangle Park, NC), Endo-GIA II stapler (30-mm length, 2.5-mm staples, Auto Suture, US Surgical, Norwalk, CT), Endopath ETS35 stapler (35mm length, 2.5mm staples, Ethicon Endo-Surgery), and the Endo Ta-30 stapler (30-mm length, 2.5-mm staples, Auto Suture, US Surgical, Norwalk, CT). Results: The Endo-TA-30 stapler and the polymer clips resulted in significantly less compromise of the vessel length, when compared with the other methods of vascular control. Conclusions: The Endo-TA-30 stapler and the polymer clips can be applied during laparoscopic procedures where optimizing vascular length is important.
- Published
- 2006
22. A rare cause of unilateral leg swelling: May–Thurner Syndrome.
- Author
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Channane, Hamid, Spiliotis, Panagiotis M, Sandica, Andreea M, Snopok, Iurii, and Viebahn, Richard
- Subjects
VENOUS thrombosis ,ILIAC vein ,ENDOVASCULAR surgery ,ILIAC artery ,SYNDROMES - Abstract
Common left iliac vein compression, otherwise known as May–Thurner Syndrome (MTS), is a medical condition that refers to chronic compression of an anatomical variant of the left iliac vein by the overlying right common iliac artery and is a predisposing factor for deep vein thrombosis of the left lower limb (LDVT). Although MTS is not often, its true prevalence is underestimated due to misdiagnose, fact that can result to life-threatening conditions such as the development of LDVT and pulmonary embolism. In this paper, we present a case of MTS presenting at our department with unilateral leg swelling without LDTV that was treated through endovascular management along with long-term anticoagulation. With this presentation, the authors wish to emphasise the importance of MTS as a frequently under-diagnosed condition that needs to be ruled out in unilateral left leg swelling with or without LDVT. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
23. Comparison of diamond-like carbon-coated nitinol stents with or without polyethylene glycol grafting and uncoated nitinol stents in a canine iliac artery model
- Author
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Jong Hoon Kim, Moon Mw, Kyung Min Shin, Tae Hyun Kim, Kwang-Ryeol Lee, Shin Dh, Won Yh, Kwideok Park, Dong Keun Han, and Ji Hoon Shin
- Subjects
Nitinol stent ,medicine.medical_specialty ,medicine.medical_treatment ,Polyethylene glycol ,Iliac Artery ,Polyethylene Glycols ,chemistry.chemical_compound ,Blood Vessel Prosthesis Implantation ,Dogs ,Restenosis ,Coated Materials, Biocompatible ,Neointima ,Occlusion ,medicine ,Alloys ,Animals ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,Neointimal hyperplasia ,Iliac artery ,Hyperplasia ,Full Paper ,business.industry ,Stent ,General Medicine ,equipment and supplies ,medicine.disease ,Thrombosis ,Surgery ,surgical procedures, operative ,chemistry ,Stents ,business - Abstract
Objective: Neointimal hyperplasia is a major complication of endovascular stent placement with consequent in-stent restenosis or occlusion. Improvements in the biocompatibility of stent designs could reduce stent-associated thrombosis and in-stent restenosis. We hypothesised that the use of a diamond-like carbon (DLC)-coated nitinol stent or a polyethylene glycol (PEG)-DLC-coated nitinol stent could reduce the formation of neointimal hyperplasia, thereby improving stent patency with improved biocompatibility. Methods: A total of 24 stents were implanted, under general anaesthesia, into the iliac arteries of six dogs (four stents in each dog) using the carotid artery approach. The experimental study dogs were divided into three groups: the uncoated nitinol stent group (n58), the DLC-nitinol stent group (n58) and the PEG-DLC-nitinol stent group (n58). Results: The mean percentage of neointimal hyperplasia was significantly less in the DLC-nitinol stent group (26.7i7.6%) than in the nitinol stent group (40.0i20.3%) (p50.021). However, the mean percentage of neointimal hyperplasia was significantly greater in the PEG-DLC-nitinol stent group (58.7i24.7%) than in the nitinol stent group (40.0i20.3%) (p50.01). Conclusion: Our findings indicate that DLC-coated nitinol stents might induce less neointimal hyperplasia than conventional nitinol stents following implantation in a canine iliac artery model; however, the DLC-coated nitinol stent surface when reformed with PEG induces more neointimal hyperplasia than either a conventional or DLCcoated nitinol stent.
- Published
- 2011
24. Laparoscopic hernia repair--complications
- Author
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P R, Miguel, M, Reusch, A L, daRosa, and J R, Carlos
- Subjects
Adult ,Male ,Pain, Postoperative ,Laparoscopic hernioplasty ,Incidence ,Inguinal hernia ,Hernia, Inguinal ,Middle Aged ,Iliac Artery ,Testicular Hydrocele ,Survival Rate ,Treatment Outcome ,Recurrence ,Hernioplasty ,Scientific Papers ,Humans ,Female ,Laparoscopy ,Aged ,Follow-Up Studies - Abstract
Laparoscopic hernioplasty is a technique which can present a number of specific complications. This paper reviews the complications that can occur during laparoscopic hernia repair and ways to avoid them; it also describes the surgical technique used successfully in over 1000 cases. Initial experience suggests that complications can be avoided with adequate knowledge, attention to surgical anatomy and the proper technique of laparoscopic hernioplasty. Early recurrences are rare and invariably result from inadequate surgical technique. Inadequate fixation of the mesh, inadequate mesh size, and failure to cover unidentified wall defects (hernias which have never been repaired), are the main causes of early recurrence of hernia. Experience, knowledge of complications and how to avoid them, adequate training and attention to the anatomy of the inguinal region are the most important factors in correcting inguinal hernia successfully by laparoscopy.
- Published
- 1999
25. Is the obturator artery safe when performing ischial osteotomy during periacetabular osteotomy?
- Author
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Koichi Kinoshita, Kei Shiramizu, Yoshinari Nakamura, Satoshi Kamada, and Masatoshi Naito
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Osteotomy ,Iliac Artery ,Ischium ,Cadaver ,medicine.artery ,medicine ,Humans ,Orthopedics and Sports Medicine ,Aged, 80 and over ,Original Paper ,Periacetabular osteotomy ,business.industry ,Acetabulum ,Vascular System Injuries ,Surgery ,Orthopedic surgery ,Obturator artery ,Female ,Anterior approach ,business - Abstract
The purposes of this study were (1) to evaluate the actual distance between the obturator artery and the ischial osteotomy site when performing periacetabular osteotomy via an anterior approach and (2) to determine a safe method to avoid injuring the obturator artery during this procedure. Twenty-nine hemipelves from cadavers were used in this study. The mean distance between the obturator artery and the ischial osteotomy site was 35.6 ± 7.5 mm and always exceeded 20 mm. Therefore, the procedure can be performed safely when a chisel blade of 20 mm or shorter is used.
- Published
- 2010
26. Acute onset of lower limb claudication as a manifestation of a spontaneous common iliac artery dissection.
- Author
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Hapka, Lukasz and Halena, Grzegorz
- Subjects
INTERMITTENT claudication ,ILIAC artery ,ENDOVASCULAR surgery ,EPIDEMIOLOGY ,ETIOLOGY of diseases ,SURGERY - Abstract
Isolated abdominal aortic dissection constitutes a relatively small percentage of all aortic dissections. In this paper we present a case of a 59-year-old man who reported to the hospital because of the sudden appearance of intermittent claudication of his left lower limb. After establishing the diagnosis the patient was qualified for endovascular treatment due to dissection involving the final 1 cm of his abdominal aorta and extending to his left common iliac artery with significant true lumen compression. Stent was implanted into the left common iliac artery with almost complete occlusion of the false lumen and expansion of the true lumen of his iliac artery. During the 70-month follow-up we achieved a good result with evidence of stent patency and no signs of expansion of the false lumen. The paper discusses the epidemiology, aetiology, diagnosis and treatment of isolated abdominal dissections. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
27. Connexin-mimetic peptides dissociate electrotonic EDHF-type signalling via myoendothelial and smooth muscle gap junctions in the rabbit iliac artery
- Author
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Andrew T, Chaytor, Linda M, Bakker, David H, Edwards, and Tudor M, Griffith
- Subjects
Male ,Indoles ,Microscopy, Confocal ,Patch-Clamp Techniques ,Gap Junctions ,Iliac Artery ,Immunohistochemistry ,Connexins ,Muscle, Smooth, Vascular ,Electrophysiology ,Biological Factors ,Papers ,Animals ,Rabbits ,Peptides ,Microelectrodes - Abstract
Synthetic peptides corresponding to the Gap 26 and Gap 27 domains of the first and second extracellular loops of the major vascular connexins (Cx37, Cx40 and Cx43), designated as (43)Gap 26, (40)Gap 27, (37,40)Gap 26 and (37,43)Gap 27 according to Cx homology, were used to investigate the role of gap junctions in the spread of endothelial hyperpolarizations evoked by cyclopiazonic acid (CPA) through the wall of the rabbit iliac artery. Immunostaining and confocal microscopy demonstrated that gap junction plaques constructed from Cx37 and Cx40 were abundant in the endothelium, whereas Cx43 was the dominant Cx visualized in the media. None of the Cx-mimetic peptides affected endothelial hyperpolarizations evoked by CPA directly. When administered individually, (40)Gap 27, (37,40)Gap 26 and (37,43)Gap 27, but not (43)Gap 26, attenuated endothelium-dependent subintimal smooth muscle hyperpolarization. By contrast, only (43)Gap 26 and (37,43)Gap 27 reduced the spread of subintimal hyperpolarization through the media of the rabbit iliac artery. The site of action of the peptides therefore correlated closely with the expression of their target Cxs in detectable gap junction plaques. The findings provide further evidence that the EDHF phenomenon is electrotonic in nature, and highlight the contribution of myoendothelial and homocellular smooth muscle communication via gap junctions to arterial function.
- Published
- 2005
28. Lumbar sympathetic nerve activity and hindquarter blood flow during REM sleep in rats
- Author
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Kenju, Miki, Michiyo, Oda, Nozomi, Kamijyo, Kazumi, Kawahara, and Misa, Yoshimoto
- Subjects
Male ,Sympathetic Nervous System ,Electromyography ,Polysomnography ,Lumbosacral Region ,Neural Conduction ,Sleep, REM ,Blood Pressure ,Electroencephalography ,Denervation ,Iliac Artery ,Research Papers ,Hindlimb ,Rats ,Electrophysiology ,Electrocardiography ,Norepinephrine ,Regional Blood Flow ,Animals ,Muscle, Skeletal - Abstract
The present study aimed to investigate the response of lumbar sympathetic nerve activity (LSNA) to the onset of rapid eye movement (REM) sleep and its contribution to the regulation of muscle blood flow during REM sleep in rats. Electrodes for the measurements of LSNA, electroencephalogram, electromyogram and electrocardiogram and a Doppler flow cuff for the measurements of blood flow in the common iliac and mesenteric arteries, also catheters for the measurements of systemic arterial and central venous pressures were implanted chronically. REM sleep resulted in a step increase in LSNA, by 22 ± 9% (mean ±s.e.m., P < 0.05), a reduction of iliac vascular conductance, by −16 ± 3% (P < 0.05) and a gradual increase in systemic arterial pressure, reaching a maximum value of 8.1 ± 2.0 mmHg (P < 0.05) at 89 s after onset of REM sleep, while mesenteric vascular conductance increased simultaneously by 5 ± 2% (P < 0.05). There was a significant (Pearson's correlation coefficient = 0.94, P < 0.05) inverse linear relationship between LSNA and the iliac blood flow. Unilateral lumbar sympathectomy blunted the reduction of iliac blood flow induced by the onset of REM sleep. The present observations suggest that the onset of REM sleep appears to be associated with a vasodilation in viscera and a vasoconstriction in skeletal muscle, such that systemic arterial pressure increases during REM sleep in rats.
- Published
- 2004
29. The effect of dehydroepiandrosterone on regional blood flow in prepubertal anaesthetized pigs
- Author
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C, Molinari, A, Battaglia, E, Grossini, D A S G, Mary, C, Vassanelli, and G, Vacca
- Subjects
Male ,Nitric Oxide Synthase Type III ,Swine ,Blood Pressure ,Nitric Oxide ,Iliac Artery ,Renal Circulation ,Adrenergic beta-2 Receptor Antagonists ,Heart Rate ,Animals ,Anesthesia ,Sexual Maturation ,Splanchnic Circulation ,Enzyme Inhibitors ,Adrenergic alpha-Antagonists ,Aorta ,Dose-Response Relationship, Drug ,Cardiac Pacing, Artificial ,Isoproterenol ,Dehydroepiandrosterone ,Adrenergic beta-Agonists ,Research Papers ,Electric Stimulation ,Electrodes, Implanted ,NG-Nitroarginine Methyl Ester ,Regional Blood Flow ,Female ,Vascular Resistance ,Nitric Oxide Synthase - Abstract
Dehydroepiandrosterone has been implicated in vascular disease and its associated insulin resistance and hypertension, though little is known about its vascular effects. We have recently shown in prepubertal anaesthetized pigs that intravenous infusion of dehydroepiandrosterone caused coronary vasoconstriction through the inhibition of a vasodilatory beta-adrenergic receptor-mediated effect related to the release of nitric oxide. The present study was designed to investigate the effect of dehydroepiandrosterone on mesenteric, renal and iliac vascular beds. In prepubertal pigs of both sexes anaesthetized with sodium pentobarbitone, changes in superior mesenteric, left renal and left external iliac blood flow caused by intravenous infusion of dehydroepiandrosterone were assessed using electromagnetic flowmeters. Changes in heart rate and arterial blood pressure were prevented by atrial pacing and by connecting the arterial system to a pressurized reservoir containing Ringer solution. In 22 pigs, infusion of 1 mg h(-1) of dehydroepiandrosterone decreased mesenteric, renal and iliac blood flow. In a further 10 pigs, dose-response curves were obtained by graded increases in the infused dose of hormone between 0.03 and 4 mg h(-1). The mechanisms of the above response were studied in the 22 pigs by repeating the experiment after haemodynamic variables had returned to the control values observed before infusion. Blockade of alpha-adrenoceptors with intravenous phentolamine (five pigs) did not affect the dehydroepiandrosterone-induced mesenteric, renal and iliac vasoconstriction. This response was abolished by blockade of beta(2)-adrenoceptors with intravenous butoxamine (five pigs) and by blockade of mesenteric, renal and iliac nitric oxide synthase with intra-arterial administration of N(omega)-nitro-L-arginine methyl ester (seven pigs), even after reversing the increase in local vascular resistance caused by the two blocking agents with intravenous infusion of papaverine. In five pigs, the increase in measured blood flow caused by intravenous infusion of isoproterenol (isoprenaline) was significantly reduced by infusion of dehydroepiandrosterone. The present study showed that intravenous infusion of dehydroepiandrosterone primarily caused mesenteric, renal and iliac vasoconstriction. The mechanisms of this response were shown to be due to the inhibition of a vasodilatory beta(2)-adrenergic receptor-mediated effect, which possibly involved the release of nitric oxide.
- Published
- 2004
30. Morphometric and immunohistochemical characterization of the intimal layer throughout the arterial system of elderly humans
- Author
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Cornelius Borst, Aryan Vink, Marieke Poppen, Arjan H. Schoneveld, Gerard Pasterkamp, and Dominique P.V. de Kleijn
- Subjects
Pathology ,medicine.medical_specialty ,Histology ,Brachial Artery ,Arteriosclerosis ,Carotid Artery, Common ,Autopsy ,Cell Count ,Iliac Artery ,Medicine ,Humans ,Molecular Biology ,Ecology, Evolution, Behavior and Systematics ,Aged ,Aged, 80 and over ,Hyperplasia ,business.industry ,Macrophage infiltration ,Macrophages ,Cell Biology ,medicine.disease ,Coronary Vessels ,Lipids ,Research Papers ,Arterial tree ,Coronary arteries ,Stenosis ,medicine.anatomical_structure ,Lipid content ,Radial Artery ,Immunohistochemistry ,Anatomy ,business ,Tunica Intima ,Developmental Biology ,Artery - Abstract
The purpose of the present study was to obtain insight into the natural development of adaptive intimal thickening and atherosclerosis in the arterial tree of human species. The morphometry and composition of the intimal layer were studied in the arterial system of elderly individuals. Post mortem, a total of 703 arterial segments were dissected from 24 subjects (age 81.9 +/- 9.9 years). From each subject, segments were dissected from 31 different arteries. Area stenosis [(plaque area/vessel area) x 100%] was determined in each segment. By (immuno)histochemistry, lipid content and the presence of inflammatory cells (macrophages) were assessed in the coronary, common carotid, brachial, radial and internal iliac arteries. Adaptive intimal thickening or advanced atherosclerosis was observed in all studied artery types. Area stenosis was highest in the coronary arteries (median, 30%) and lowest in the arteries supplying the brain (median,or = 7%). Plaques hiding a lipid-rich core and plaques with macrophage infiltration were observed in all five selected artery types. In summary, the present observation demonstrates that intimal thickening is a systemic process involving most artery types. Within elderly humans, features of advanced atherosclerotic disease, a lipid-rich core and macrophages, can be observed in the intimal layer of artery types that are recognised for their relation with clinical syndroms as well as artery types that remain clinically silent.
- Published
- 2002
31. Pathological role of a constitutively active population of alpha(1D)-adrenoceptors in arteries of spontaneously hypertensive rats
- Author
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Regina, Gisbert, Khalid, Ziani, Raquel, Miquel, M Antonia, Noguera, M Dolores, Ivorra, Elsa, Anselmi, and Pilar, D'Ocon
- Subjects
Male ,Tail ,Captopril ,Muscle Relaxation ,Aorta, Thoracic ,In Vitro Techniques ,Iliac Artery ,Rats, Inbred WKY ,Muscle, Smooth, Vascular ,Piperazines ,Norepinephrine ,Phenylephrine ,Rats, Inbred SHR ,Receptors, Adrenergic, alpha-1 ,Animals ,Adrenergic alpha-Antagonists ,Antihypertensive Agents ,Dose-Response Relationship, Drug ,Age Factors ,Hemodynamics ,Arteries ,Prazosin ,Mesenteric Arteries ,Rats ,Vasodilation ,Vasoconstriction ,Hypertension ,Papers ,Adrenergic alpha-Agonists ,Muscle Contraction - Abstract
1. The role of a constitutively active population of alpha(1D)-adrenoceptors was analysed in arteries obtained from spontaneously hypertensive rats (SHR) and controls (WKY) divided into three groups: young prehypertensive, adult hypertensive, and adult animals chronically treated with captopril (50 mg kg(-1) per day orally) in order to prevent the hypertensive state. 2. In adult SHR, a significant increase in BMY 7378 potency (not in prazosin potency) was observed in aorta, mesenteric artery, and the first and second branches of the small mesenteric arteries with respect to WKY rats. This difference was not observed in iliac and tail arteries, which suggests an increased functional role of alpha(1D)-adrenoceptors only in some vessels of SHR. 3. The increase in the resting tone (IRT) observed in absence of agonist, inhibited by BMY 7378, that represents the constitutively active population of alpha(1D)-adrenoceptors, was also significantly greater in aorta and mesenteric artery from adult SHR. 4. In young and captopril treated adult animals, no differences between strains with respect to BMY 7378 potency, or IRT were observed. 5. The increase in the functional role of alpha(1D)-adrenoceptors and their constitutive activity observed in hypertension is prevented by captopril treatment. The pathological consequence of this change is the slower rate of recovery of the basal tone after removal of an adrenergic stimulus, observed in vessels from hypertensive animals that had shown an increase in the functionality of constitutively active alpha(1D)-adrenoceptors. This change was not observed in prehypertensive or captopril treated animals.
- Published
- 2002
32. Involvement of accumulated endogenous NOS inhibitors and decreased NOS activity in the impaired neurogenic relaxation of the rabbit proximal urethra with ischaemia
- Author
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Masuda, Hitoshi, Tsujii, Toshihiko, Okuno, Tetsuo, Kihara, Kazunori, Goto, Moritaka, and Azuma, Hiroshi
- Subjects
Male ,Nitroprusside ,Muscle Relaxation ,Body Weight ,Blood Pressure ,In Vitro Techniques ,Arginine ,Iliac Artery ,Electric Stimulation ,Phenylephrine ,NG-Nitroarginine Methyl Ester ,Urethra ,Ischemia ,Papers ,Animals ,Nitric Oxide Donors ,Rabbits ,Enzyme Inhibitors ,Nitric Oxide Synthase ,Cyclic GMP - Abstract
1. We examined the effect of ischaemia on the neurogenic and nitric oxide (NO)-mediated urethral relaxation. 2. Rabbits were divided into control and urethral ischaemia (UI) groups, which was prepared by the partial occlusion of bilateral iliac arteries using blood vessel occluders. 3. Neurogenic and NO-mediated proximal urethral relaxation induced by electrical field stimulation (EFS) was greatly impaired in the UI group, while relaxation by sodium nitroprusside (SNP) as a NO donor showed no difference between the two groups. Pretreatment with L-arginine significantly improved but did not normalize the impaired relaxation in the UI group. Not only basal level, but also stimulated production of cyclic GMP with EFS, were significantly decreased in the UI group. 4. The tissue contents of N(G)-methyl-L-arginine (L-NMA) and asymmetric N(G), N(G)-dimethyl-L-arginine (ADMA) in the proximal urethra were increased following ischaemia. While L-arginine and symmetric N(G), N'(G)-dimethyl-L-arginine (SDMA) contents remained unchanged. Exogenously applied authentic L-NMA and ADMA (1 -- 100 microM) concentration-dependently inhibited the EFS-induced urethral relaxation in the control group. The inhibition with L-NMA and ADMA was undetectable in the presence of 3 mM L-arginine. 5. The Ca(2+)-dependent NOS activity in the urethra from the UI group was significantly lower than that from the control group and was not restored by an addition of 3 mM L-arginine. 6. These results suggest that the impaired neurogenic and NO-mediated urethral relaxation with ischaemia is closely related to the increased accumulation of L-NMA and ADMA and decreased NOS activity, which would result in an accelerated reduction in NO production/release.
- Published
- 2001
33. Treatment of Aortic and Iliac Artery Occlusion by Catheter Thrombolysis Combined with Catheter Thrombectomy and Aortic Bifurcation Endovascular Stent Reconstruction.
- Author
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Zhao, Xinyu, Liu, Delang, Yu, Chaowen, Sun, Yong, and Chen, Shiyuan
- Subjects
ILIAC artery ,AORTA ,ARTERIAL occlusions ,THROMBECTOMY ,CATHETERS - Abstract
Aortoiliac occlusive disease (AIOD) is an occlusive disease of the infrarenal aorta and iliac arteries usually caused by stenosis or occlusion at the end of the abdominal aorta-common iliac artery. Herein, we reported a case of Trans-Atlantic Inter-Society Consensus- (TASC-) D AIOD with pale, cool, and intangible dorsalis pedis artery treated with catheter thrombolysis combined with catheter thrombectomy and aortic bifurcation endovascular stent reconstruction, which proved to be safe, effective, and minimally invasive approach. In the present paper, we discussed the physical and imaging manifestations, as well as treatments. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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34. Free superficial circumflex iliac artery perforator flap with a single-pedicle bilobed design for pediatric multi-digit defect reconstruction.
- Author
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Li Z, Zheng D, Zheng J, Qi W, Qi Q, and Liu Y
- Subjects
- Age Factors, Child, Cohort Studies, Female, Finger Joint, Humans, Male, Range of Motion, Articular, Recovery of Function, Finger Injuries surgery, Iliac Artery, Multiple Trauma surgery, Perforator Flap blood supply, Plastic Surgery Procedures methods
- Abstract
Objectives: This paper describes imaging and anatomical features, in order to assess the feasibility of superficial circumflex iliac artery perforator (SCIP) flap with a single-pedicle bilobed design for multi-digit skin and soft tissue reconstruction in pediatric patients., Methods: A total of 7 pediatric patients who were being treated with free single-pedicle bilobed SCIP flap reconstruction for multi-digit defects were included in this study. The details of the clinical features were collected, and the following were successively analyzed: the preoperative computed tomographic angiography (CTA) and color Doppler sonography (CDS) examinations for flap design, the intraoperative anatomy for perforator vessel, defect reconstruction and interphalangeal range of motion (ROM) and tactile sense, pain sense, and two-point discrimination recovery results., Results: CTA and CDS performed preoperatively could accurately and rapidly identify the position, location and course of the superficial circumflex iliac artery perforator. All wounds healed by the first follow-up and no complications occurred at the follow-up visit. All flaps survived, the patients achieved proximal interphalangeal joint (PIP) ranges of motions (ROM) from 80 to 100° and distal interphalangeal joint (DIP) ROM from 65 to 80°. The tactile sense and pain sense recovered, and average of the two-point discrimination scores was 9.3 mm (range 7-12 mm). The donor area was primarily sutured with a tidy scar in the underwear region., Conclusion: CTA and CDS performed preoperatively are accurate and intuitive methods for assessing the location and course of SCIP. The SCIP flap is suitable for pediatric patients due to its small vessel caliber, specific functional and esthetic benefits. It can be designed in a lobulated fashion in order to repair two or more wounds during one surgery. We suggest that the free single-pedicle bilobed SCIP flap should be considered a good option choice for multi-digit defect reconstruction in pediatric patients in the clinic.
- Published
- 2020
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35. Small invasive technique of Internal Iliac Artery ligation for postpartum haemorrhage.
- Author
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Raba G
- Subjects
- Adult, Cohort Studies, Female, Humans, Pregnancy, Prospective Studies, Iliac Artery surgery, Ligation methods, Ligation standards, Minimally Invasive Surgical Procedures methods, Minimally Invasive Surgical Procedures standards, Postpartum Hemorrhage surgery, Practice Guidelines as Topic
- Abstract
Objectives: Internal Iliac artery ligation (IIAL) is an effective life-saving method to control obstetric hemorrhage, and a hysterectomy can often be avoided. A standard ligation procedure requires wide tissues dissection: incision in the peritoneum lateral to and parallel with the ureter. That can be traumatic and is difficult in practice what results in a rare use of IIAL in surgical emergency. As an alternative a novel, small invasive technique was used, which protocol is attached to the paper as a video presentation file., Material and Methods: Forty-five women treated by Internal Iliac Artery ligation for postpartum haemorrhage. In 27 patients (Cohort A) standard IIAL procedure by Kelly's method was used. In the remaining 18 patients (Cohort B) a novel, small invasive technique was performed. Time of both surgical procedures of IIAL was measured., Results: Time of Standard technique of IIAL vs Novel small invasive technique of IIAL: 34 (26-41) min. vs 13 (8-16) min. p < 0.001., Conclusions: The presented novel small invasive technique of Internal Iliac artery ligation can be an easier and safe alternative for standard ligation procedure.
- Published
- 2020
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36. Popliteal Aneurysms are Common Among Men With Screening Detected Abdominal Aortic Aneurysms, and Prevalence Correlates With the Diameters of the Common Iliac Arteries.
- Author
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Cervin A, Wanhainen A, and Björck M
- Subjects
- Aged, Aorta, Abdominal diagnostic imaging, Aortic Aneurysm, Abdominal diagnostic imaging, Femoral Artery diagnostic imaging, Humans, Male, Organ Size, Popliteal Artery diagnostic imaging, Prevalence, Sweden epidemiology, Aortic Aneurysm, Abdominal epidemiology, Iliac Artery diagnostic imaging, Mass Screening statistics & numerical data, Popliteal Artery pathology
- Abstract
Background: Data on the prevalence of popliteal artery aneurysm (PA) are scarce and difficult to interpret as the definition differs among papers. The aim was to investigate the prevalence among men with screening detected abdominal aortic aneurysms (≥30 mm, AAAs) and subaneurysmal aortic dilatation (25-29 mm, SAA), and to explore whether the existence of a PA correlated with the diameters of the aorta, iliac, and femoral arteries., Methods: In Uppsala, Sweden, a county with 376 000 inhabitants, AAA screening of 65 year old men was initiated in 2006. All men with AAA and SAA also had measurements of the common iliac artery (CIA). The common femoral (CFA), superficial femoral (SFA), and popliteal arteries were evaluated at re-examination, performed after 1-2 years for AAA and five years for SAA. PA was defined as ≥ 12 mm, or 1.5 times larger than the distal SFA according to the ISCVS/SVS Ad Hoc Committee. The relationships between PA and other vessel diameters were explored., Results: A total of 19 820 65 year old men (84.6%) accepted the invitation to screening between 2006 and 2017. AAA was found in 173 (0.9%), and SAA in 149 subjects (1.1% of those screened 2006-2013, eligible for this study). In the whole cohort, 14.2% of those examined had at least one PA of any size, 3.0% were ≥15 mm and 2.2% ≥ 20 mm. There was no difference in PA prevalence between AAA and SAA: 15.9% vs. 12.2% (p = .48). There was no difference in aortic diameter in those with or without PA (p = .46), but there were significant correlations with CIA (p < .001), CFA (p < .001), and SFA (p < .001) diameters., Conclusions: A high prevalence of PA among subjects with screening detected AAA and SAA was found. PA was not correlated with the aortic diameter in this cohort, where all had dilated aortas, while correlations with peripheral and iliac artery diameters were identified., (Copyright © 2019 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved.)
- Published
- 2020
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37. Application of Oblique Lateral Interbody Fusion in Treatment of Lumbar Spinal Tuberculosis in Adults.
- Author
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Zhuang, Quan‐kui, Li, Wei, Chen, Yong, Bai, Liang, Meng, Yong, Li, Yang, and Gu, Yu‐tong
- Subjects
SPINAL tuberculosis ,SPINAL fusion ,SPINAL surgery ,BLOOD sedimentation ,ILIAC vein ,TREATMENT effectiveness ,ILIAC artery - Abstract
Objective: The purpose of the present paper was to evaluate the safety and clinical efficacy of mini‐open retroperitoneal oblique lumbar interbody fusion (OLIF) for the treatment of lumbar spinal tuberculosis. Methods: A total of 115 patients who suffered from lumbar spinal tuberculosis from June 2014 to December 2017 were included in this research. A total of 59 patients underwent OLIF and percutaneous pedicle screw fixation (OLIF group) and 56 patients underwent the anterior‐only approach (anterior‐only group). All patients were followed up for at least 24 months. Operation time, blood loss, and rate of complications were used to assess the safety of these two techniques. The visual analog scale (VAS) and the Oswestry disability index (ODI) were used to evaluate the relief of neurological and functional symptoms. The erythrocyte sedimentation rate (ESR) and C‐reactive protein (CRP) were measured to investigate the activity and recurrence of spinal tuberculosis. The Cobb angle, the sagittal vertical axis of the spine (SVA), the pelvic tilt (PT), the sacral slope (SS), the pelvic incidence (PI), and postoperative Frankel classification were also used to assess the efficiency of the spine deformity correction and the recovery of long‐term neurological function. Results: Most patients were successfully treated with OLIF and the anterior‐only technique and attained satisfactory clinical efficiency during the 24‐month follow‐up period. In the perioperative period, the mean operative time (154.68 ± 23.64 min, P < 0.001), the mean blood loss (110.57 ± 87.67 mL, P < 0.001), and the mean hospital stay (9.55 ± 3.62 days, P < 0.001) of the OLIF group were all significantly lower than in the anterior‐only group (172.49 ± 25.67 min, 458.56 ± 114.89 mL, and 14.89 ± 3.89 days, respectively). A total of 10 patients (16.95%) experienced complications in the OLIF group, including neurological injury, segmental artery and iliac vein lacerations, peritoneal injury, instrument failure, and infection of incisions; this rate of complications was lower than in the anterior‐only group (37.50%, P = 0.013). Regard to spinal deformity correction, the Cobb angle (9.42° ± 1.72°, P = 0.032), the SVA (2.23 ± 1.07 cm, P = 0.041), the PT (14.26° ± 2.37°, P = 0.037), and the SS (39.49° ± 2.17°, P = 0.042) of the OLIF group at last follow‐up were all significantly different when compared to the anterior‐only group (14.75° ± 2.13°, 3.48 ± 0.76 cm, 18.58° ± 1.45°, and 36.78° ± 1.96°, respectively). The VAS and the ODI of the OLIF group at 1 week postoperatively (3.15 ± 0.48, 21.85 ± 3.78, P = 0.032, 0.037) and at the last follow‐up (2.12 ± 0.35, 16.70 ± 5.25, P = 0.043, 0.035) were both lower than for the anterior‐only group (5.18 ± 0.56, 29.83 ± 5.42 and 3.67 ± 0.62, 20.68 ± 6.23). The Frankel classification was improved for both OLIF and anterior‐only patients; however, there were 35 cases (59.32%) classified as Frankel grade E in the OLIF group and 22 cases (39.29%, P = 0.021) in the anterior‐only group Conclusion: The OLIF surgical technique for single lumbar (L2–L5) spinal tuberculosis is less invasive, has lower complication rates, and is more efficient than the anterior‐only approach. However, the long‐term effects of this surgical technique still need to be explored. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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38. Computed Tomography Imaging Agent Based on Gold Nanoparticles for Internal Iliac Artery Embolization after Endovascular Abdominal Aortic Repair and CCN3 Protection Mechanism.
- Author
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Pei, Siying, Sun, Yao, Fan, Dongxu, Deng, Shuhua, Mei, Haoran, and Wang, Hanrui
- Subjects
ILIAC artery ,COMPUTED tomography ,ABDOMINAL aortic aneurysms ,GOLD nanoparticles ,ABDOMINAL aorta ,VISIBLE spectra - Abstract
Abdominal aortic aneurysm is more stressful and has more complications in many diseases. During treatment and repair, arteriosclerosis, abdominal congestion deposition, and abdominal swelling cannot be eliminated. In this paper, we used the seed growth method to obtain gold nanoparticles (AuNPs) with good morphology and dispersion. The AuNPs of larger aspect ratio synthesized in this experiment moved their longitudinal plasmon resonance absorption peak to the near-infrared region, which provided suitable materials for subsequent experiments and laid the foundation for the photothermal therapy of tumors. Experiments show that near-infrared rays can penetrate into deep tissues to overcome the shortcomings that visible light cannot penetrate abdominal aorta well. AuNPs absorb near-infrared rays, thereby generating heat energy to achieve the purpose of treating tumors. In addition, AuNPs also have fluorescent properties, combined with other forms of imaging methods, to achieve the purpose of multimodal imaging, and improve the diagnostic accuracy of studying the protection mechanism of the nephroblastoma overexpressed (NOV or CCN3) gene. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
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39. Coexistence of isolated internal iliac artery aneurysm with uterine cervical carcinoma.
- Author
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BURDAN, FRANCISZEK, CZARNOCKI, KRZYSZTOF, MOCARSKA, AGNIESZKA, BURDAN, MACIEJ, ŻELAZOWSKA-CIEŚLIŃSKA, IWONNA, and STAROSŁAWSKA, ELŻBIETA
- Subjects
ILIAC artery ,THROMBOCYTOPENIA ,CERVICAL cancer ,UTERINE artery ,ANEURYSMS - Abstract
Isolated internal iliac artery aneurysms are rarely described in the available literature. The paper presents a case of a 70-year-old female with idiopathic thrombocytopenia, squamous cell cervical carcinoma, and saccular aneurysm of the left internal iliac artery, detected in magnetic resonance. The review of aneurysm of the common, external and internal iliac arteries is added. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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- View/download PDF
40. Morphological and morphometrical aspects of intima and media of the common, external and internal iliac arteries in Chinchilla lanigera (Rodentia, Chinchillidae) bred in captivity.
- Author
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Martonos, C. O., Damian, A., Alexandru, G., Viorel, M., Rus, V., and Stan, F. G.
- Subjects
ILIAC artery ,RODENTS ,BLOOD vessels ,CAPTIVITY ,ARTERIES - Abstract
The paper approaches deal with fine differential morphological and morphometrical aspects of the structure of three main blood vessels in Chinchilla lanigera: the common iliac artery, the internal iliac artery and the external iliac artery. A series of morphological assessments combined with morphometrical data of the intimal layer, dimensions of the media of the vessels, number of elastic laminae and characteristics observed, alow an interesting conclusion when data is regarded in the light of the classical division of the vessels – of muscular, elastic or transitional type. A complex statistical approach (PostHoc tests) is added to highlight some fine differences in terms of metrical data among these three arteries. The complex statistical investigation brings some interesting facts in terms of series resemblances, leading to a reasonable conclusion that the transition from elastic to muscular type of arteries should not be regarded inflexibly, arteries sharing different features, depending on anatomical sector and species. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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41. A Rare Case of Iliac Saccular Aneurysm Communicating with a Transplant Renal Artery.
- Author
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Xiwu Zhang, Chengshu Xu, and Gang Zhao
- Subjects
RENAL artery ,DIGITAL subtraction angiography ,KIDNEY transplantation ,FALSE aneurysms ,ANEURYSMS ,ILIAC artery - Abstract
Objective: Unknown etiology. Background: Isolated iliac aneurysms are rare. Although they grow very slowly, they can rupture when large enough. Rarely, they rupture into an adjacent organ, such as the colon, the bladder, or even an adjacent vein. Cases of aneurysms rupturing into or communicating with an adjacent vein, leading to an arteriovenous fistula, have been reported. However, reports of aneurysms that rupture and communicate with another adjacent artery have not been found in the literature. Case Report: A 52-year-old man who underwent a renal transplantation in the left iliac fossa 21 years ago was admitted for chronic left lower abdominal pain that began 1 year ago. He did not have a history of any invasive procedures or severe trauma after the renal transplantation. Duplex ultrasound showed an oval-shaped hypoechoic structure adjacent to the left external iliac artery (EIA), with a swirling motion of blood flow inside. Computed tomography angiography showed an aneurysm of the left EIA, with a size of 35×34×47 mm, closely adjacent to or even communicating with the transplant renal artery (TRA). There was calcification in the aneurysm wall, without surrounding hematoma. The aneurysm was considered to be a true aneurysm, not a pseudoaneurysm. Endovascular therapy was performed. Digital subtraction angiography confirmed the communication between the aneurysm and the TRA. After the EIA was reconstructed with a covered stent, no leakage was demonstrated; however, contrast still flowed into the aneurysm though the TRA. A second covered stent graft was implanted in the TRA. Subsequently, the aneurysm was successfully excluded. Conclusions: The pathogenesis of this strange aneurysm communicating with another adjacent artery is not well established. Stenting of multiple arteries was needed to treat this aneurysm. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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42. An Asymptomatic Sigmoid Colonic Fistula Arising from a Large Aneurysm of the Internal Iliac Artery Was Discovered during a Medical Examination.
- Author
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Kim, Myung Jo, Yoo, Kwon Cheol, and Kim, Dae Hoon
- Subjects
ILIAC artery ,PERIODIC health examinations ,VIRTUAL colonoscopy ,SIGMOIDOSCOPY ,FISTULA ,ANEURYSMS ,SIGMOID colon ,HOSPITAL admission & discharge - Abstract
The rupture of an internal iliac artery aneurysm in the colon is a rare but potentially fatal complication. We report a rectal fistula of an asymptomatic internal iliac artery aneurysm that was discovered incidentally during a medical examination. A 77-year-old man presented at a local hospital for a general medical examination. Although the blood reports revealed severe anemia, the patient did not complain of any associated symptoms including dizziness and hematochezia. Moreover, there was no palpable mass in the patient's abdomen, and there was no evidence of hematochezia, as the patient had been using a bidet. Interestingly, computed tomography (CT) revealed a large right internal iliac artery aneurysm. There was a suspicious finding of a fistula within the colon in the CT, but it was undetected in the preoperative sigmoidoscopy. Furthermore, operative findings showed a protruding retroperitoneal mass adhering to the mesentery of the sigmoid colon. During aneurysm resection, the presence of a fistula was unclear. However, a fistula tract, devoid of any infectious bacteria such as tuberculosis, was found in the specimen after colon resection. After a recovery period of approximately one week, the patient was discharged from the hospital without any unusual findings on the post-operative CT. Sigmoid colonic fistulas arising from iliac artery aneurysms are rare. Also, diagnosis may be delayed in special circumstances wherein a patient routinely uses a bidet. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
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43. Should limb revascularization take priority over dissection repair in type a aortic dissection presenting as isolated acute limb ischaemia.
- Author
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Preece R, Srivastava V, Akowuah E, and Kendall S
- Subjects
- Acute Disease, Aged, Aortic Dissection complications, Angiography, Aortic Aneurysm, Thoracic diagnosis, Aortic Aneurysm, Thoracic surgery, Humans, Ischemia diagnosis, Ischemia etiology, Male, Aortic Dissection surgery, Aortic Aneurysm, Thoracic complications, Iliac Artery, Ischemia surgery, Lower Extremity blood supply, Vascular Surgical Procedures methods
- Abstract
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was should limb revascularization take priority over dissection repair in acute type A aortic dissection (ATAAD) presenting as isolated acute limb ischaemia? Altogether 133 papers were found using the reported search, of which 7 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Six studies showed that aortic repair alone resulted in the reperfusion of 60-100% of ischaemic lower limbs and recommended a strategy prioritizing aortic repair. In those with persistent isolated limb ischaemia post-aortic repair, expeditious peripheral revascularization procedures produced excellent patient outcomes comparable to those of ATAAD patients without malperfusion syndromes. In the remaining study, aortic repair was delayed in order to prioritize percutaneous reperfusion therapy aimed at treating the peripheral malperfusion. However, this resulted in one-third of patients not surviving to aortic surgery. We conclude that delaying aortic repair for limb reperfusion procedures results in unacceptably high mortality rates and that repair alone results in high reperfusion rates of ischaemic limbs. We therefore strongly recommend that aortic repair be the primary therapy for ATAAD patients even when limb ischaemia is the presenting feature. Limbs should be reassessed immediately after aortic repair and revascularization procedures undertaken urgently if any pulse deficits remain., (© The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
- Published
- 2017
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44. Mechanical guidelines on the properties of human healthy arteries in the design and fabrication of vascular grafts: experimental tests and quasi-linear viscoelastic model.
- Author
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FATURECHI, RAHIM, HASHEMI, ATA, ABOLFATHI, NABIOLLAH, and SOLOUK, ATEFEH
- Subjects
VASCULAR grafts ,SUBCLAVIAN artery ,ARTERIES ,ILIAC artery ,ABDOMINAL aorta ,BRACHIOCEPHALIC trunk ,BIOMATERIALS ,STRESS relaxation (Mechanics) - Abstract
Purpose: Knowledge of mechanical behavior of healthy human arteries as the guidelines to target properties of vascular grafts deserves special attention. There is a lack of mathematical model to characterize mechanical behavior of biomaterial while many mathematical models to reflect mechanics of human arteries have been proposed. The objective of this paper was set to measure mechanical properties of healthy human arteries including Common Carotid Artery (CCA), Abdominal Aorta Artery (AAA), Subclavian Artery (SA), Common Iliac Artery (CIA) and Right and Left Iliac Artery (RIA and LIA) and compare them to those of commercial ePTFE and Dacron®. Methods: Series of stress relaxation and strain to failure tests vere performed on all samples. The experimental data was utilized to develop quasi-linear viscoelastic (QLV) model of both natural and artificial arteries. Results: ePTFE is the stiffest sample, while the CCA is the most compliant one among all. RIA and CIA are more viscous than the other natural arteries, while AA and CCA are less viscous. The proposed model demonstrated an accurate fit to the experimental results, a proof of its ability to model both nonlinear elasticity and viscoelasticity of the human arteries and commercial ones. Conclusions: ePTFE and Dacron® are much stiffer than human arteries that may lead to the disruption of blood hemodynamic and may not be biomechanically feasible as a replacement. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
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45. Normative data of postural sway by using sway meter among young healthy adults.
- Author
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Nalawade, Tejal C. and Ganvir, Shyam D.
- Subjects
POSTURE disorders ,ILIAC artery ,ACCELEROMETERS ,GYROSCOPES ,ELECTRONICS - Abstract
Background: Postural control involves controlling body s position in space tor dual purpose of stability and orientation. Postural stability or balance is defined as the ability to maintain the projected Center of motion (COM) within the limits of Base of Support (BOS). During quite stance there is a separate Center of Pressure (COP) under each foot. The net center of pressure lies between the feet and depend on each limb support. Normally no one stand erect, instead the body sways in small amount, mainly forward and backward. Thus quite stance is characterized by small amount of spontaneous postural sway. The device (sway meter) consists of inflexible 40 cm long rod with vertically mounted pen at its end. The rod was mounted 20 cm wide metal plate which will be fitted at the level of PSIS (Posterior superior iliac spine) over lower back region of participants by firm belt. A low tech Sway meter was designed to address the needs of clinicians and researchers with limited resources (e.g. no access to force plates or motion laboratories). It is a useful field test, as it is compact, lightweight, has short administration and data processing time. Unlike other lightweight and easily applied systems, such as accelerometers and gyroscopes, the Sway meter involves no electronics or computer processing. Thus, assessment can be conducted in a variety of community settings and health care facilities. Several research groups have found the Sway meter to be feasible for use in different populations of young and older people. The Sway meter has been used in numerous studies of balance as well as retrospective and prospective investigations of falls risk in older people. The purpose of study was to find out normative data of postural sway by using sway meter in among young adults and the validity of the Sway meter against the floor and foot print. Aim and objectives: To study the normative data of postural sway by using sway meter among young healthy adults, to study the normative data of postural sway by using sway meter among young healthy adults with eye open and eye close, to study the normative data of postural sway by using sway meter compare with the normal values of the lord's and Sherrington's study. Material and methods: The subjects were instructed to keep their hand by their sides during standing. Subjects were informed about procedure before starting. Duration of each trial was 30 second. A starting point was marked on the graph paper. At end of the 30 seconds, the rod of the sway meter was taken away from the graph sheet. 5-10 seconds rest was given during trial, but they were not allowed to move away from the foot print. The procedure was repeated for each trial. A total of six trials were taken including, 3 trial with eyes opened and 3 for eyes closed. Maximum duration for all trial was 6-7 minutes and maximum deviation in 3 trials was taken for analysis. Results: In eye open condition, in anterior direction, total 60 (100%) subjects are had sway in 0.1 to 2 cm. In Posterior direction, total 60 (100%) subjects are had sway in 0.1 to 2 cm. In right lateral direction, total 59 (98%) subjects had sway in 0.1 to 2 cm; remaining 1 (2%) subject had sway in 2.1 to 3 cm. In left lateral direction, total 56 (95%) subjects had sway in 0.1 to 2 cm; remaining 2 (3%) subjects had 2.1 to 3 cm sway and 2 (2%) subjects had 3.1 to 4 cm sway in left side. In eye closed condition, in anterior direction 57 (95%) subjects had 0.1 to 2 cm sway in anteriorly, but remaining 2 (3%) subjects had 2.1 to 3 cm sway, and 1 (2%) subject had 3.1 to 4 cm sway. In posterior direction 59 (98%) subjects had 0.1 to 2 cm sway in posterior; rest 1 (2%) subject had nil sway in posterior. In right lateral direction 56 (93%) subjects had 0.1 to 2 cm sway, and rest of the 2 (4%) subjects had nil sway, and 2 (3%) had 2.1 to 3 cm sway in right direction. In left lateral direction 57 (95%) subjects had 0. 1 to 2 cm sway, and 1 (2%) subjects had nil sway, rest 2 (3%) subjects had sway in 2.1 to 3 cm. Conclusion: It has been concluded that this study support the self constructed sway meter as a clinical tool for identifying sways in various directions (anterior, posterior, right lateral and left lateral). Similarly 100% of sway was seen in anterior and posterior direction with eye open. [ABSTRACT FROM AUTHOR]
- Published
- 2015
46. Outcome of Recent Thromboembolic Occlusions of Limb Arteries Treated with Streptokinase
- Author
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Jozef Vermylen, W. Deloof, Marc Verstraete, and A Amery
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Streptokinase ,Femoral artery ,Iliac Artery ,Amputation, Surgical ,Hypesthesia ,Thromboembolism ,medicine.artery ,Occlusion ,Humans ,Medicine ,Popliteal Artery ,Pulse ,Retrospective Studies ,General Environmental Science ,medicine.diagnostic_test ,business.industry ,Angiography ,General Engineering ,Sensory loss ,Papers and Originals ,General Medicine ,Popliteal artery ,Surgery ,Femoral Artery ,medicine.anatomical_structure ,Amputation ,General Earth and Planetary Sciences ,business ,Artery ,medicine.drug - Abstract
All our patients with a recent thromboembolic occlusion of limb arteries treated with streptokinase have been reviewed retrospectively. Clearing of the main artery, as judged by arteriography or reappearance of arterial pulsations, occurred more often when treatment was started early. If only patients with an iliac, femoral, or popliteal artery occlusion are considered, those who received a lower initial dose had a significantly higher clearing rate and a significantly lower mortality than those who received a high initial dose (500,000 units of streptokinase or more). Therefore an initial standard dose of 1,200,000 units of streptokinase is no longer recommended in these conditions, and even an individually titrated initial dose of more than half a million units could be hazardous. If no neurological abnormalities were present on admission amputation was never necessary, even if clearing of the main artery did not occur. If there was sensory loss of at least part of a limb, amputation was avoided only if the pulsations returned in at least one artery of hand or foot.
- Published
- 1970
47. Variability of the origin and course of the uterine artery in clinical practice.
- Author
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Sobolewska, Adela, Gierulska, Natalia, Stachowicz, Hubert, Iwaniuk, Kaja, Białkowska, Zuzanna, Daniluk, Aleksander, Ostański, Jan, Bucze, Jakub, Samczuk, Maciej, and Gawłowicz, Łukasz
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UTERINE artery ,MATERNAL mortality ,LITERATURE reviews ,ILIAC artery ,SURGICAL complications ,ANATOMICAL variation - Abstract
In 2020, approximately 287,000 mothers died during pregnancy or childbirth, with one of the leading causes of maternal mortality being peripartum hemorrhage. It can be treated both pharmacologically and procedurally, for example, through uterine artery ligation, embolization, or hysterectomy. In case of procedural treatment, it is essential for the medical team to familiarize themselves with the anatomical structure of the patient's uterine arteries. Various variations in the course of this vessel are distinguished, such as the uterine artery branching as a bifurcation with the inferior gluteal artery, a common trunk of the uterine artery with another vessel, or even its duplication. Using radiological techniques such as angiography, it is possible to visualize vessels and their variations, which can allow for better patient care. Unfamiliarity with the departure and trajectory of the uterine artery may be associated with an increased risk of postoperative complications, especially after hysterectomy, where the uterine arteries close at the level of the uterus or at the beginning of their departure from the internal iliac artery. Ligating them in other place may result in ischemia of an area that should be continuously supplied with blood. Also, during surgery, special attention should be paid to possible anatomical variations of the patient's uterine artery, which, although rare, can cause intraoperative complications. A thorough analysis of the departure and trajectory of the uterine artery by physicians can prevent postoperative complications and also allow for the safe conduct of embolization procedures. The following article presents a literature review on the departure and course of the uterine artery and its variations, as well as procedural interventions related to this vessel. [ABSTRACT FROM AUTHOR]
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- 2024
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48. Neurogenic Intermittent Claudication
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John Grimley Evans
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medicine.medical_specialty ,Cauda Equina ,Radiography ,Aortic Diseases ,Iliac Artery ,Spinal Puncture ,Aortic disease ,Diagnosis, Differential ,Pathology ,Humans ,Medicine ,Meningitis ,General Environmental Science ,Inflammation ,business.industry ,General Engineering ,Cerebrospinal fluid proteins ,Cauda equina ,Cerebrospinal Fluid Proteins ,Papers and Originals ,General Medicine ,Intermittent Claudication ,medicine.disease ,Intermittent claudication ,Surgery ,medicine.anatomical_structure ,General Earth and Planetary Sciences ,Arachnoid ,Differential diagnosis ,medicine.symptom ,business ,Spinal Canal ,Intervertebral Disc Displacement - Published
- 1964
49. Lower Abdominal vs. Lateral Thigh Perforator Flaps in Microsurgical Sarcoma Reconstruction: The Aesthetics of Donor Site Matters.
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Brunetti, Beniamino, Salzillo, Rosa, De Bernardis, Riccardo, Petrucci, Valeria, Pazzaglia, Matteo, Camilloni, Chiara, Putti, Alessandra, Morelli Coppola, Marco, Tenna, Stefania, and Persichetti, Paolo
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PERFORATOR flaps (Surgery) ,FREE flaps ,THIGH ,PATIENT satisfaction ,SARCOMA ,ILIAC artery ,PATIENTS' attitudes - Abstract
Introduction: Sarcoma resection often leaves patients with big defects only amenable through microsurgical reconstruction. In such cases, it is hard for the surgeon to uphold low donor-site morbidity with an aesthetic result. The purpose of this study was to investigate the clinical outcome and the patient's perception regarding the donor site in a cohort of patients undergoing microsurgical reconstruction with lateral thigh and lower abdominal perforator flaps. Methods: A retrospective evaluation of all patients who underwent sarcoma reconstruction with flaps harvested from the lower abdominal region (deep inferior epigastric artery perforator flap, superficial circumflex iliac artery perforator flap) or lateral thigh region (anterolateral thigh perforator flap and its variations) was performed. Only patients with defects greater than 100 cm
2 were included. Patient demographics and operative variables were recorded, together with complications. Patient satisfaction and quality of life with the donor site were registered using the SCAR-Q questionnaire, which was administered at least six months post-operatively. Results: Eighteen anterolateral thigh (ALT) perforator flaps and twenty-two deep inferior epigastric artery perforator (DIEP) and superficial circumflex iliac artery perforator (SCIP) flap procedures were performed. The two groups were homogeneous for major post-operative complications (p > 0.999). Patient satisfaction with the donor site measured using the SCAR-Q questionnaire showed significantly higher scores in the DIEP/SCIP group when compared with the thigh group (p < 0.001), indicating a superiority of the lower abdominal area as an aesthetic donor site. Conclusions: The DIEP and SCIP flaps are a versatile option for reconstructing large soft-tissue defects following sarcoma resection. Therefore, flaps harvested from the lower abdomen yield a higher patient satisfaction with the donor site, which is a feature worth considering when planning a reconstructive procedure. [ABSTRACT FROM AUTHOR]- Published
- 2024
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50. Pediatric renal transplantation: a single center experience.
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KIDNEY transplantation ,CHRONIC kidney failure ,CHILD patients ,KIDNEY failure ,RENAL replacement therapy ,ILIAC artery - Abstract
Introduction: The rising prevalence of global end-stage renal disease (ESRD) is a significant health concern, especially among children. Although renal replacement therapy is available, children with ESRD are at an increased risk of mortality. Kidney transplantation is the preferred modality of treatment and surpasses renal replacement therapy in terms of survival. However, pediatric renal transplantation could prove difficult due to factors like smaller recipients and donor-recipient mismatches leading to higher complications. Materials and methods: A retrospective single-group case series study was conducted on children with ESRD who were planned to undergo kidney transplantation from living donors between 2015 and 2021. The data was collected from two centers in the city of Sulaymaniyah. Results: The study comprised a predominantly male patient population, with a total of 39 individuals (n = 39) and 13 female patients. The donors were mostly males between 25-40 years old. The majority of participants were 15-18 years old. In majority of the patients Thymoglobulin was the immunosuppressive agent used in induction. The most common etiology for renal failure was reflux nephropathy and artery anastomosis was performed to the external iliac artery in the majority of patients. Only 9 patients had complications following the transplantation and 3 patients had an episode of acute rejection. Conclusions: Renal transplantation is the preferred treatment of renal failure in pediatric patients in the city of Sulaymaniyah. The most common etiology for pediatric renal failure was reflux nephropathy which was different from the findings of North American Pediatric Renal Trials and Collaborative Studies. [ABSTRACT FROM AUTHOR]
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- 2024
- Full Text
- View/download PDF
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