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The branches of the external carotid artery can show variation, and common trunks are occasionally found. Because the common trunks such as the thyrolingual, linguofacial, and thyrolinguofacial trunks are formed from two or all of the superior thyroid artery, lingual artery, and facial arteries, maxillofacial trunks are extremely rare. We report a rare case with the maxillofacial and thyrolingual trunks identified by three-dimensional computed tomography angiography. [ABSTRACT FROM AUTHOR]

Hemifacial spasm (HFS) results from vascular compression at the root exit of the facial nerve. Although the underlying etiology has yet to be identified, it has been suggested that congenital vascular anomalies are involved. We have hypothesized common trunk anomaly of the anterior inferior cerebellar artery (AICA) and posterior inferior cerebellar artery (PICA) which may play a role in HFS. However, no previous studies have directly compared the incidence of this anomaly between HFS patients and normal subjects. The present study was designed to address this gap in the literature. This case-control study compared magnetic resonance angiography data from 65 HFS patients and 65 normal subjects. Dominant AICA/PICA is defined as the absence of PICA/AICA, with the remaining AICA/PICA supplying both vascular territories. The term "common trunk" encompasses both dominant AICA and dominant PICA. The frequency of common trunk and dominant AICA/PICA was compared between the 2 groups. There were no significant differences in the incidence of a common trunk (68.5% and 64.6%), dominant AICA (30.8% and 32.3%) and dominant PICA (37.7% and 32.3%) between the 2 groups. Additionally, no differences were found in the frequency of atherosclerosis risk factors. There was no apparent association between common trunk anomaly and HFS. It is suspected that some vascular anomalies other than a common trunk are involved in HFS. [ABSTRACT FROM AUTHOR]

Introduction: The rich vascularity of most parts of the head and neck is mainly maintained by the carotids and their branches. However, variations in the External Carotid Artery (ECA) and Superior Thyroid Artery (STA) can pose risks during neck surgeries. Aim: This study aimed to examine relationship of ECA at point of origin and variations in the origin of superior thyroid artery. Materials and Methods: A cross-sectional study was conducted at the Department of Anatomy, Government Medical College, Kota, Rajasthan, India. Fifty common carotid arteries were obtained from 20 adult human cadavers and five sagittal sections of head and neck specimens. The specimens were dissected bilaterally, resulting in a total of 50 carotids observed. Data analysis was performed using SPSS software version 25. Results: In 86% of the specimens, the ECA originated at the upper border of the thyroid cartilage, while in 14% of the specimens, it was at a higher level. Transposition of the ECA laterally was observed in 4% of the specimens, and medial transposition was observed in 96% of the specimens. The STA originated from the ECA in 76% of the specimens, from the carotid bifurcation in 16% of the specimens, and from the Common Carotid Artery (CCA) in 8% of the specimens. Conclusion: The anatomical level of the CCA bifurcation is crucial clinically and surgically. These findings contribute to our understanding of the vascular anatomy of the carotid triangle, aiding students, radiologists, and surgeons in preventing complications and improving head and neck surgeries.

Background: The common trunk anomaly of the anterior and posterior inferior cerebellar artery (APC) is a variant artery that causes a hemifacial spasm (HFS). The anatomical characteristics include a large diameter of the trunk and the existence of the bifurcation near the facial nerve root entry zone (REZ). Despite APC being encountered at a constant rate in microvascular decompression (MVD), the anatomical and technical issues of transposing APC have not been entirely focused on yet. Methods: We reviewed our 68 cases with APC involvement. Patient background, radiological findings, and operative video recordings were reviewed retrospectively. The location of the bifurcation of APC and the distribution of perforators were investigated. Surgical outcomes were assessed in the long term. Results: APC involvement was diagnosed preoperatively in all cases by careful observation with MRI. Three-dimensional images determined the anatomical characteristics of APC and depicted the relationship with the facial nerve. All patients had a bifurcation close to the root entry zone that was required to transpose, including the common trunk and the distal branches, to achieve sufficient decompression. While adequate transposition from the REZ was accomplished in most cases, it was difficult to complete transposition due to short perforators in 6 patients (8.8%), resulting in interposition. Fifty-three patients (77.9%) became spasm free immediately after surgery, 66 patients (97.1%) were after 6 months, and all patients (100%) became spasm free within a year. Spasm-free status was maintained during the follow-up period (4.7 years) in all patients except one in whom facial spasm recurred 2 years after the initial surgery. Conclusions: Transposing the common trunk with the bifurcation and distal branches contributes to obtaining favorable surgical outcomes in APC-related HFS. [ABSTRACT FROM AUTHOR]

Purpose: In this article, we describe a complex and rare variant of the common trunk arising as a branch of the subclavian artery. This description highlights the clinical relevance of such a variation for medical practice. Methods: A routine dissection was carried out on an adult 74-year-old female cadaver. After identification and preparation of the common trunk, measurements and photographs were taken. Results: The dissection revealed a common trunk arising from the first part of the left subclavian artery. It divided into the left internal thoracic artery, the inferior thyroid artery, and the thyrocervical trunk. Further on, the branches of the thyrocervical trunk supplied blood to the trapezius muscle, the longus colli muscle and the supraspinatus muscle. Conclusion: For the first time, we report the specific appearance of a common trunk from the left subclavian artery that includes the origin of the left internal thoracic artery, inferior thyroid artery, and thyrocervical trunk. Knowledge of the different variations of subclavian branches is essential because of the high frequency with which this region is involved in diagnostic and surgical procedures. Level of evidence: II Basic Science Research. [ABSTRACT FROM AUTHOR]

In clinical and surgical procedures, the variable origins of the axillary artery branches are significant for identifying uncommon signs and symptoms. The present case report documents an unusual origin of the axillary artery branches during dissection of a male cadaver in the Anatomy Department of an undergraduate and postgraduate teaching medical college in India. Normally, the superior thoracic artery arises from the first part of the axillary artery. In the present case, the second part of the axillary artery gave rise to a common trunk, from which the thoracoacromial, lateral thoracic, and subscapular arteries originated. Further, the thoracodorsal, circumflex humeral, and posterior circumflex humeral arteries originate from the subscapular artery whereas the anterior circumflex humeral artery only originates from the third part of the axillary artery. During surgical procedures performed in the region of the axilla, anatomists, radiologists, and cardiologists need to be aware of variations in the origin of axillary artery branches.

The external carotid artery (ECA) is a major branched artery that supplies head and neck structures. An undocumented variation of the ECA was discovered during cadaveric dissection of the anterolateral cervical region, in which a common origin for the ascending pharyngeal, facial, and lingual arteries was identified. In addition, bilateral, duplicate ascending pharyngeal arteries (APAs) were identified at the aforementioned common trunk and the bifurcation of the external and internal carotid arteries. Anatomical knowledge regarding the location of the APA is essential to physicians, as this vessel is a primary supply source for many skull base tumors and vascular lesions. Furthermore, such anatomical knowledge is essential to physicians, as there have been cases of misdiagnosis regarding APA anomalies as an internal carotid artery (ICA) dissection. In this cadaver, both ECAs exhibited typical branching into the superior thyroid artery (STA), occipital artery, posterior auricular artery, maxillary artery, and superficial temporal artery., Competing Interests: Human subjects: All authors have confirmed that this study did not involve human participants or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Okereke et al.)

Superselective intra-arterial chemotherapy (SSIAC) for oral cancer can deliver a higher concentration of anticancer agent into a tumor-feeding artery than intravenous systemic chemotherapy. However, the agent distribution between the lingual artery and facial artery (FA) is not clear in SSIAC for patients with the linguofacial trunk. The agent distribution in the SSIAC method was investigated using computational fluid dynamics (CFD). Ten three-dimensional vessel models were created from CT images of two patients with oral cancer (patients A and B) with the linguofacial trunk. Catheter models were combined with vessel models to mimic intra-arterial infusion, and the agent flow was analyzed. In patient A models, the agent distribution varied depending on the catheter tip position in the linguofacial trunk, while all anticancer agents flowed into the FA only in patient B models. This study revealed that the behavior of the agent in the common trunk is determined by the blood flow field which depends on the topography of the vessels in each patient. Therefore, the catheter tip position should be changed according to the vessel topography to deliver anticancer agents into the tumor-feeding artery. Moreover, CFD can be a useful method to predict the agent flow for each patient before SSIAC. [ABSTRACT FROM AUTHOR]

Summary: Background: In 2015 medical training regulations have been restructured for postgraduate medical training in Austria resulting in a significant shortening of the training period. Furthermore, a restriction of working hours for physicians to 48 h per week was implemented affecting the framework of postgraduate medical training. The aim of this study was to obtain a self-assessment of students and young physicians in Austria regarding their self-confidence in clinical skills and their working and learning environment. Methods: In this study 6th year medical students, physicians in their basic training (common trunk), physicians in family medicine training, and residents in their first 18 months of training were asked to participate in a survey. Self-reported data were collected for five different prespecified domains (communication, motor skills, knowledge, documentation, and emergency). Results: In all domains, self-confidence increased significantly during medical training. Analysis further revealed better results of residents compared with all other groups in all domains, whereas physicians in family medicine training only rated themselves better in the documentation domain (p = 0.010); however, the interest in family medicine was low, even among physicians in family medicine training. The workload significantly increased during medical education, with the highest stress levels for physicians in family medicine training and residents (p = 0.001). Conclusions: Self-confidence of young physicians but also their stress levels increased during the medical training. Further studies are needed to answer the question why the interest in family medicine was so unexpectedly low in this cohort. [ABSTRACT FROM AUTHOR]

Background. Atrial fibrillation (AF) is a common clinical problem. The left atrium anatomy makes up a factor that may significantly affect the effectiveness of the AF ablation. Objectives. The aim of the study was to evaluate a long-term effectiveness ablation in patients with common pulmonary vein trunk (CPVT) and AF. Material and methods. The outcomes of 129 procedures in 95 patients with CPVT out of 1,475 procedures carried out in 1,150 patients with AF treated with ablation, were analyzed. Ablation with CARTO 3 system (Johnson & Johnson, New Brunswick, USA), cryoballoon, and the circular multipolar duty-cycled radiofrequency-based pulmonary vein ablation producer with catheter (PVAC) were considered as advanced methods. The following data was recorded for every patient: age, gender, AF duration and type, previous antiarrhythmic drugs, weight, height, any prior cardioversion, and comorbidities, including hypertension, diabetes, hypothyreosis, thyrotoxicosis, heart failure, and stroke/transient ischemic attack. The following anatomical factors were assessed: the presence of patent foramen ovale (PFO) and localization of the CPVT on the basis of venography or computed tomography (CT). In the 1st year after ablation, 24-hour Holter monitoring was performed 3-5 times, and the patients were encouraged to visit their doctor or an emergency department if a cardiac arrhythmia occurred. Long-term ablation effectiveness was assessed based on a telephone interview and patients' answers to the questionnaires including 12-lead electrocardiography (ECG). Results. Sinus rhythm was maintained in 44 patients (43.6%) after a median of 42 months (range: 12-120). A lower number of clinical factors (odds ratio (OR) = 0.09; 95% confidence interval (95% CI) = 0.02-0.56; p < 0.01), and advanced ablation methods (OR = 3.1; 95% CI = 1.4-7.1; p < 0.01) were related to a better long-term effectiveness. Conclusions. The long-term effectiveness of pulmonary vein (PV) isolation in patients with AF and CPVT is higher when advanced ablation techniques are used. Accumulation of clinical factors was found to be the most tremendous predictor of AF recurrence. [ABSTRACT FROM AUTHOR]

Background and aims: Study of origin of obturator artery, its variable origin and course is significant as knowledge attained by such studies help surgeons to avoid injuries, hemorrhage during operative procedures. Present study is aimed at finding out the variable origin of obturator artery, clinical significance and to correlate its embryological basis. Materials and Methods: Present study was conducted on 60 formalin fixed hemi section of cadaveric pelvis, which were allotted to the under graduate students of Mandya Institute of Mcdical Sciences, Mandya. Observations obtained were compared with the studies of previous workers. Results: Normal pattern of origin, from the anterior division of internal iliac artery was seen in 40% (24 cadavers). In 60% of the cadavers variations were observed. The most common variant mode of origin was from inferior epigastric artery (18.3%). Next common was origin from superior gluteal artery and least common variant of origin was from inferior vesical artery. Conclusion: Variations observed in present study were at par with the variations observed by previous studies. Although anomalous origins of the obturator artery rarely produces clinical symptoms, their knowledge is necessary for operating surgeons to avoid injuries and is of academic interest.

Superselective intra-arterial chemotherapy (SSIAC) for oral cancer can deliver a higher concentration of anticancer agent into a tumor-feeding artery than intravenous systemic chemotherapy. However, the agent distribution between the lingual artery and facial artery (FA) is not clear in SSIAC for patients with the linguofacial trunk. The agent distribution in the SSIAC method was investigated using computational fluid dynamics (CFD). Ten three-dimensional vessel models were created from CT images of two patients with oral cancer (patients A and B) with the linguofacial trunk. Catheter models were combined with vessel models to mimic intra-arterial infusion, and the agent flow was analyzed. In patient A models, the agent distribution varied depending on the catheter tip position in the linguofacial trunk, while all anticancer agents flowed into the FA only in patient B models. This study revealed that the behavior of the agent in the common trunk is determined by the blood flow field which depends on the topography of the vessels in each patient. Therefore, the catheter tip position should be changed according to the vessel topography to deliver anticancer agents into the tumor-feeding artery. Moreover, CFD can be a useful method to predict the agent flow for each patient before SSIAC.

Introduction: The Left Hepatic Vein (LHV) and the Middle Hepatic Vein (MHV) presents with wide variations, the knowledge of which is very important during various surgeries of the left lobe as well as right lobe of liver. Aim: To study about the variations in the branching pattern of LHV and the MHV draining the left lobe of liver. Materials and Methods: A total of 60 adult human livers were dissected manually. The LHV and the MHV were typed into five types. Further, few of these types were again divided into subtypes. Results: The incidence of presence of common trunk of LHV and MHV was 76.6% (n=46). In 20% (n=12) livers these veins were present as separate trunks. In 3.33% (n=2), no trunk of the LHV was seen and the left medial vein and the left lateral vein were found to drain independently into the Inferior Vena Cava (IVC). Conclusion: Appropriate knowledge of the anatomy of liver is very important, for different surgical procedures for treatment of malignancies or other ailments of liver.

Coronary artery anomalies are found in around 1-2% of patients undergoing coronary angiography. Uncovering of more coronary anomalies has increased with increase in awareness and easy availability of non invasive Computed Tomography Coronary Angiography (CTCA). We present a rare case of a 64-year-old female with a history of atypical chest pain and mild ST depression ECG changes who underwent CTCA. The present case revealed unusual findings of an anomalous origin of the Left Circumflex Coronary artery (LCx) from the proximal Right Coronary Artery (RCA) with duplicated right coronary artery after arising as a common trunk from right coronary cusp. In the present case report we attempted to highlight the rarity of this coronary anomaly.

Background and aim : Study of variation in branching pattern of arch of aorta is important for cardiovascular surgeons to avoid injury during procedures like angiography and stenting of aorta. These variations are frequently encountered during surgical procedures, as a developmental alteration in branchial arch during embryonic period. The aim of present study is to describe variation in branching pattern of arch of aorta belonging to Gujarati population and these results will be of significance for anatomists for relating it with embryological basis, cardiovascular surgeons and radiologists. Materials and methods : Forty embalmed cadavers were observed for study of branching pattern of arch of aorta during period of four year in Department of Anatomy in Smt N.H.L.Municipal Medical College, Ahmedabad. Results : In the present study, normal branching pattern of the arch of aorta was found in 92.5% cases. In 2.5% cases only two vessels originated from the arch of aorta, one of them was common trunk for brachiocephalic trunk and left common carotid artery and the second trunk was left subclavian artery. In 5% of cases four vessels arose from arch of aorta , the left vertebral artery arose directly from aorta with normal branching pattern. Conclusion : Vascular invasive procedures are increasing since last decade. So knowledge of variation in branches of arch of aorta is essential for cardiologist, cardiovascular surgeon as well as for radiologist.

Introduction: The Left Hepatic Vein (LHV) and the Middle Hepatic Vein (MHV) presents with wide variations, the knowledge of which is very important during various surgeries of the left lobe as well as right lobe of liver. Aim: To study about the variations in the branching pattern of LHV and the MHV draining the left lobe of liver. Materials and Methods: A total of 60 adult human livers were dissected manually. The LHV and the MHV were typed into five types. Further, few of these types were again divided into subtypes. Results: The incidence of presence of common trunk of LHV and MHV was 76.6% (n=46). In 20% (n=12) livers these veins were present as separate trunks. In 3.33% (n=2), no trunk of the LHV was seen and the left medial vein and the left lateral vein were found to drain independently into the Inferior Vena Cava (IVC). Conclusion: Appropriate knowledge of the anatomy of liver is very important, for different surgical procedures for treatment of malignancies or other ailments of liver. [ABSTRACT FROM AUTHOR]

Knowledge of the morphological variations within the abdominal cavity is significant for all medical practitioners planning surgery. This report presents the rare origin of a common trunk for the right inferior phrenic artery, and superior and inferior suprarenal artery from the right renal artery. An accessory hepatic artery was found, which served as a branch of the right inferior phrenic artery. The diameter of the common trunk was 3.95 mm, and the diameters of the inferior and superior suprarenal arteries were 1.84 and 1.36 mm, respectively. The diameter of the right inferior phrenic artery was 2.55 mm. Both the embryological background and the potential clinical significance of this morphological variation are discussed. Knowledge of this common trunk and the occurrence of the accessory right hepatic artery may be of significance in diagnostic and surgical procedures. [ABSTRACT FROM AUTHOR]

Background and aims: Study of branching pattern of arch of aorta and its variation is very significant. This study helps in avoiding the surgical, accidental injuries of blood vessels during cardiovascular surgeries and radiological procedures. Present study is aimed at finding out the branching pattern of arch of aorta, variations of its incidence, clinical significance and to correlate its embryological basis. Materials and methods: Present study was conducted on 30 formalin fixed cadavers, which were allotted to the undergraduate students of Bangalore Medical College and Research Institute. A comparative analysis was done with previous studies. Results: Usual three-branched aortic arch was found in 23 cadavers (76.66%); variations were found in seven cadavers (23.33%); 10% presented left vertebral artery arising directly from the arch of aorta; 6.66% presented common trunk of left vertebral artery and left subclavian artery; 3.33% presented thyroidea ima artery arising from the arch; 3.33% presented common trunk of brachiocephalic trunk and left common carotid artery. Conclusion: Variations observed in present study were in par with the variations observed by previous studies. Although anomalous origins of the aortic arch branches very rarely produces clinical symptoms but their knowledge is necessary for operating surgeons and interventional radiologist to avoid complications in the thorax, head and neck region.

The axillary artery is the primary arterial supply of the upper limb and functions as a key landmark in the region of the axilla. Anatomical variations in the axillary artery may arise from abnormal angiogenesis in the upper limb bud during embryological development. The routine dissection of the upper limb of an 88-year-old male cadaver revealed unilateral variations in the left axillary artery, including an abnormal anteromedial course with respect to the divisions and cords of the brachial plexus, while no variations were observed in the right axillary artery. Variations in branching were observed in each part of the artery. In the first part of the artery, variations included an accessory branch coursing towards the clavicle and another to the subscapularis muscle. A total of four branches arose from the second part of the artery: a thoracoacromial artery, an accessory pectoral branch, and two common trunks. The first common trunk gave off the alar thoracic artery, an accessory lateral thoracic artery, and the subscapular artery, which further gave off the thoracodorsal and lateral thoracic arteries, prior to continuing as the circumflex scapular artery. The second common trunk yielded the anterior and posterior circumflex humeral arteries prior to continuing as the profunda brachii artery. No branches arose from the third part of the artery. Awareness of variations in the course and branching patterns of the axillary artery as observed in this cadaveric donor is essential for anesthetic, radiographic, surgical, and other interventional procedures of the upper limb., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Oza et al.)

In clinical and surgical procedures, the variable origins of the axillary artery branches are significant for identifying uncommon symptoms and signs. The present case report documents an unusual origin of the axillary artery branches during dissection of a male cadaver in the anatomy department of an undergraduate and postgraduate teaching medical college in India. Normally, the superior thoracic artery arises from the first part of the axillary artery. In the present case, the second part of the axillary artery gave rise to a common trunk, from which the thoracoacromial, lateral thoracic, and subscapular arteries originated. Further, the thoracodorsal, circumflex humeral, and posterior circumflex humeral arteries originate from the subscapular artery whereas the anterior circumflex humeral artery only originates from the third part of the axillary artery. During surgical procedures performed in the region of the axilla, anatomists, radiologists, and cardiologists need to be aware of variations in the origin of axillary artery branches. During surgical procedures performed in the region of the axilla, anatomists, radiologists, and cardiologists need to be aware of variations in the origin of axillary artery branches. [ABSTRACT FROM AUTHOR]