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Sample records for arterial tipo iii

  1. Emergent surgical and endovascular repair of a level III carotid arterial gunshot injury

    PubMed Central

    Ray, M. Jordan; Shaw, Cathryn J.; Layton, Kennith F.

    2011-01-01

    Traumatic injury to the level III internal carotid artery (ICA) is infrequently encountered; however, rapid and effective treatment is mandatory for the prevention of a neurological catastrophe. Many case reports have demonstrated decreased morbidity and mortality of endovascular repair of traumatic injury to large vessels using covered stents or endovascular coiling of posttraumatic pseudoaneurysms. We present the case of a transected level III ICA requiring emergent, complex sacrifice. PMID:21566754

  2. Critical scaling and type-III intermittent chaos in isolated rabbit resistance arteries

    NASA Astrophysics Data System (ADS)

    Griffith, T. M.; Parthimos, D.; Crombie, J.; Edwards, D. H.

    1997-12-01

    We have shown that spontaneous oscillations in flow in rabbit ear resistance arteries may sometimes exhibit behavior typical of type-III Pomeau-Manneville intermittency. The average number of oscillations per laminar length was related to a bifurcation parameter ɛ according to power-law scaling of the form ~ɛ-β. The critical exponent β was estimated as ~0.80, which is within the range reported for type-III intermittent chaos in nonbiological systems.

  3. Plasma apolipoprotein C-III levels, triglycerides, and coronary artery calcification in type 2 diabetics.

    PubMed

    Qamar, Arman; Khetarpal, Sumeet A; Khera, Amit V; Qasim, Atif; Rader, Daniel J; Reilly, Muredach P

    2015-08-01

    Triglyceride-rich lipoproteins have emerged as causal risk factors for developing coronary heart disease independent of low-density lipoprotein cholesterol levels. Apolipoprotein C-III (ApoC-III) modulates triglyceride-rich lipoprotein metabolism through inhibition of lipoprotein lipase and hepatic uptake of triglyceride-rich lipoproteins. Mutations causing loss-of-function of ApoC-III lower triglycerides and reduce coronary heart disease risk, suggestive of a causal role for ApoC-III. Little data exist about the relationship of ApoC-III, triglycerides, and atherosclerosis in patients with type 2 diabetes mellitus (T2DM). Here, we examined the relationships between plasma ApoC-III, triglycerides, and coronary artery calcification in patients with T2DM. Plasma ApoC-III levels were measured in a cross-sectional study of 1422 subjects with T2DM but without clinically manifest coronary heart disease. ApoC-III levels were positively associated with total cholesterol (Spearman r=0.36), triglycerides (r=0.59), low-density lipoprotein cholesterol (r=0.16), fasting glucose (r=0.16), and glycosylated hemoglobin (r=0.12; P<0.0001 for all). In age, sex, and race-adjusted analysis, ApoC-III levels were positively associated with coronary artery calcification (Tobit regression ratio, 1.78; 95% confidence interval, 1.27-2.50 per SD increase in ApoC-III; P<0.001). As expected for an intermediate mediator, these findings were attenuated when adjusted for both triglycerides (Tobit regression ratio, 1.43; 95% confidence interval, 0.94-2.18; P=0.086) and separately for very low-density lipoprotein cholesterol (Tobit regression ratio, 1.14; 95% confidence interval, 0.75-1.71; P=0.53). In persons with T2DM, increased plasma ApoC-III is associated with higher triglycerides, less favorable cardiometabolic phenotypes, and higher coronary artery calcification, a measure of subclinical atherosclerosis. Therapeutic inhibition of ApoC-III may thus be a novel strategy for reducing plasma

  4. British Society of Interventional Radiology Iliac Artery Angioplasty-Stent Registry III

    SciTech Connect

    Uberoi, Raman Milburn, Simon; Moss, Jon

    2009-09-15

    The objective of this study was to audit current practice in iliac artery intervention in the United Kingdom. In 2001 the British Society of Interventional Radiology Iliac Artery Angioplasty-Stent (BIAS) III registry provided the first national database for iliac intervention. It recommended that data collection needed to continue in order to facilitate the dissemination of comparative data to individual units. BIAS III was designed to continue this work and has a simplified data set with an online submission form. Interventionalists were invited to complete a 3-page tick sheet for all iliac angioplasties and stents. Questions covered risk factors, procedural data, and outcome. Data for 2233 patients were submitted from 37 institutions over a 43-month period. Consultants performed 80% of the procedures, 62% of which were for claudication. Fifty-four percent of lesions were treated with stents and 25% of patients underwent bilateral intervention, resulting in a residual stenosis of <50% in 98%. Ninety-seven percent of procedures had no limb complication and there was a 98% inpatient survival rate. In conclusion, these figures provide an essential benchmark for both audit and patient information. National databases need to be expanded across the range of interventional procedures, and their collection made simple and, preferably, online.

  5. Postoperative prophylactic hepatic arterial infusion chemotherapy for stage III colorectal cancer: a retrospective study

    PubMed Central

    Wang, Yao; Sun, Xin Rong; Feng, Wen Ming; Bao, Ying; Zheng, Yin Yuan

    2016-01-01

    Background Radical resection is the main treatment for colorectal cancer (CRC), but metastasis or recurrence is common in which liver metastasis accounted for 83% of the cases. Therefore, the prognosis of patients with advanced CRC may be improved if liver metastasis is prevented. This study aims to investigate the efficacy of hepatic arterial infusion chemotherapy (HAIC) on liver metastases of stage III CRC patients after curative resection. Methods Between 2002 and 2008, 287 stage III CRC patients who had undergone radical resection were included in this study. According to postoperative adjuvant chemotherapy modality, these patients were divided into two groups. Patients in the combined therapy group received two cycles of HAIC plus four cycles of systemic chemotherapy, while patients in the monotherapy group received six cycles of systemic chemotherapy alone. The HAIC regimen consisted of hepatic arterial infusion of oxaliplatin (OXA, 85 mg/m2) on day 1 and 5-fluorouracil (5-FU, 2,400 mg/m2) on days 2 and 3 followed by a vein infusion of folinic acid (FA, 200 mg/m2) as a 2-hour infusion on days 2 and 3. The systemic chemotherapy regimen consisted of a 2-hour infusion of OXA (85 mg/m2) on day 1 followed by FA (200 mg/m2) as a 2-hour infusion on days 2 and 3, and by 5-FU (2,400 mg/m2) as a 48-hour infusion. This was repeated every 4 weeks. All cases were followed up for 5 years or until death. The 5-year overall survival, disease-free survival, liver metastases-free survival, and the overall liver metastases rates were retrospectively compared. Results Significant differences were found in the 5-year overall survival (combined therapy, 70.71%; monotherapy, 57.14%; P=0.014), disease-free survival (combined therapy, 69.29%; monotherapy, 55.78%; P=0.021), and liver metastases-free survival rates (combined therapy, 70%; monotherapy, 56.46%; P=0.019). Conclusion Prophylactic adjuvant HAIC can prevent metachronous liver metastases and improve the prognosis of patients

  6. Endovascular Repair of a Type III Thoracoabdominal Aortic Aneurysm in a Patient with Occlusion of Visceral Arteries

    SciTech Connect

    Klonaris, Chris Katsargyris, Athanasios; Giannopoulos, Athanasios; Georgopoulos, Sotiris; Tsigris, Chris; Michail, Othon; Marinos, George; Bastounis, Elias

    2007-07-15

    The successful endovascular repair of a type III thoracoabdominal aortic aneurysm (TAAA) with the use of a tube endograft is reported. A 56-year-old male with a 6.4-cm type III TAAA, a 4.2-cm infrarenal abdominal aortic aneurysm, and chronic renal insufficiency presented with flank pain, nausea, acute anuria, and serum creatinine of 6.1 mg/dl. Acute occlusion of the left solitary renal artery was diagnosed and emergent recanalization with percutaneus transluminal angioplasty and stenting was performed successfully, with reversal of the serum creatinine level at 1.6 mg/dl. Further imaging studies for TAAA management revealed ostial occlusion of both the celiac artery (CA) and the superior mesenteric artery (SMA) but a hypertrophic inferior mesenteric artery (IMA) providing retrograde flow to the aforementioned vessels. This rare anatomic serendipity allowed us to repair the TAAA simply by using a two-component tube endograft without fenestrations (Zenith; William Cook, Bjaeverskov, Denmark) that covered the entire length of the aneurysm, including the CA and SMA origins, since a natural arterial bypass from the IMA to the CA and SMA already existed, affording protection from gastrointestinal ischemic complications. The patient had a fast and uneventful recovery and is currently doing well 6 months after the procedure. To our knowledge, this is the first report in the English literature of successful endovascular repair of a TAAA involving visceral arteries with the simple use of a tube endograft.

  7. Superficial femoral artery plaque and functional performance in peripheral arterial disease: walking and leg circulation study (WALCS III).

    PubMed

    McDermott, Mary M; Liu, Kiang; Carroll, Timothy J; Tian, Lu; Ferrucci, Luigi; Li, Debiao; Carr, James; Guralnik, Jack M; Kibbe, Melina; Pearce, William H; Yuan, Chun; McCarthy, Walter; Kramer, Christopher M; Tao, Huimin; Liao, Yihua; Clark, Elizabeth Talley; Xu, Dongxiang; Berry, Jarett; Orozco, Jennifer; Sharma, Leena; Criqui, Michael H

    2011-07-01

    We studied associations of magnetic resonance imaging measurements of plaque area and relative percent lumen reduction in the proximal superficial femoral artery with functional performance among participants with peripheral arterial disease. The clinical significance of directly imaged plaque characteristics in lower extremity arteries is not well established. A total of 454 participants with an ankle brachial index <1.00 underwent magnetic resonance cross-sectional imaging of the proximal superficial femoral artery and completed a 6-min walk test, measurement of 4-m walking velocity at usual and fastest pace, and measurement of physical activity with a vertical accelerometer. Adjusting for age, sex, race, body mass index, smoking, statin use, comorbidities, and other covariates, higher mean plaque area (1st quintile [least plaque]: 394 m, 2nd quintile: 360 m, 3rd quintile: 359 m, 4th quintile: 329 m, 5th quintile [greatest plaque]: 311 m; p trend <0.001) and smaller mean percent lumen area (1st quintile [greatest plaque]: 319 m, 2nd quintile: 330 m, 3rd quintile: 364 m, 4th quintile: 350 m, 5th quintile: 390 m; p trend <0.001) were associated with shorter distance achieved in the 6-min walk test. Greater mean plaque area was also associated with slower usual-paced walking velocity (p trend = 0.006) and slower fastest-paced 4-m walking velocity (p trend = 0.003). Associations of mean plaque area and mean lumen area with 6-min walk distance remained statistically significant even after additional adjustment for the ankle brachial index and leg symptoms. Among participants with peripheral arterial disease, greater plaque burden and smaller lumen area in the proximal superficial femoral artery are associated independently with poorer functional performance, even after adjusting for the ankle brachial index and leg symptoms. Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  8. Apolipoprotein C-III Levels and Incident Coronary Artery Disease Risk: The EPIC-Norfolk Prospective Population Study.

    PubMed

    van Capelleveen, Julian C; Bernelot Moens, Sophie J; Yang, Xiaohong; Kastelein, John J P; Wareham, Nicholas J; Zwinderman, Aeilko H; Stroes, Erik S G; Witztum, Joseph L; Hovingh, G Kees; Khaw, Kay-Tee; Boekholdt, S Matthijs; Tsimikas, Sotirios

    2017-06-01

    Apolipoprotein C-III (apoC-III) is a key regulator of triglyceride metabolism. Elevated triglyceride-rich lipoproteins and apoC-III levels are causally linked to coronary artery disease (CAD) risk. The mechanism(s) through which apoC-III increases CAD risk remains largely unknown. The aim was to confirm the association between apoC-III plasma levels and CAD risk and to explore which lipoprotein subfractions contribute to this relationship between apoC-III and CAD risk. Plasma apoC-III levels were measured in baseline samples from a nested case-control study in the European Prospective Investigation of Cancer (EPIC)-Norfolk study. The study comprised 2711 apparently healthy study participants, of whom 832 subsequently developed CAD. We studied the association of baseline apoC-III levels with incident CAD risk, lipoprotein subfractions measured by nuclear magnetic resonance spectroscopy and inflammatory biomarkers. ApoC-III levels were significantly associated with CAD risk (odds ratio, 1.91; 95% confidence interval, 1.48-2.48 for highest compared with lowest quintile), retaining significance after adjustment for traditional CAD risk factors (odds ratio, 1.47; 95% confidence interval, 1.11-1.94). ApoC-III levels were positively correlated with triglyceride levels, (r=0.39), particle numbers of very-low-density lipoprotein (r=0.25), intermediate-density lipoprotein (r=0.23), small dense low-density lipoprotein (r=0.26), and high-sensitivity C-reactive protein (r=0.15), whereas an inverse correlation was observed with large low-density lipoprotein particle number (r=-0.11), P<0.001 for each. Mediation analysis indicated that the association between apoC-III and CAD risk could be explained by triglyceride elevation (triglyceride, very-low-density lipoprotein, and intermediate-density lipoprotein particles), small low-density lipoprotein particle size, and high-sensitivity C-reactive protein. ApoC-III levels are significantly associated with incident CAD risk. Elevated

  9. Double stent technique for the treatment of an internal carotid artery pseudoaneurysm caused by zone III stab injury.

    PubMed

    Hori, Yuzo; Kiyosue, Hiro; Kashiwagi, Junichi; Asano, Tomoshige; Shuto, Rieko; Matsumoto, Yushi; Nagatomi, Hirofumi; Mori, Hiromu

    2007-10-01

    A 77-year-old man was transferred to the hospital with swelling of his neck and oropharynx after a stab injury to his oral cavity with pruning shears. Findings at complete neurologic examination were normal. Contrast-enhanced computed tomography (CT) and angiography revealed a pseudoaneurysm at the pharyngeal portion of the right internal carotid artery. Endovascular treatment was undertaken by using the double bare stent technique. The pseudoaneurysm was completely occluded immediately after the procedure. There were no complications. There were no further symptoms or evidence of recurrence of the aneurysm during the 18-month follow-up period. The double bare stent technique is safe and effective for the treatment of zone III carotid artery stab injuries.

  10. Transanal haemorrhoidal artery echodoppler ligation and anopexy (THD) is effective for II and III degree haemorrhoids: a prospective multicentric study.

    PubMed

    Infantino, A; Bellomo, R; Dal Monte, P P; Salafia, C; Tagariello, C; Tonizzo, C A; Spazzafumo, L; Romano, G; Altomare, D F

    2010-08-01

    We report a multicentric prospective study which aimed to evaluate Doppler-assisted ligation of the terminal haemorrhoidal arteries (THD) for II and III degree haemorrhoids. A total of 112 patients from five colorectal units, including 81 men, mean age 48 +/- 13 years, with II degree (39) and III degree (73) haemorrhoids were treated by Doppler-guided transanal de-arterialization and anopexy using a new device (THD). The mean operative time was 33.9 +/- 8.8 minutes, and the mean number of ligatures applied was 7.2 +/- 1.5. Postoperatively, 72% of patients did not need analgesics and the other 28% used nonsteroidal antiinflammatory drugs 1-3 times/day for less than 2 days. All the patients were operated as a day case. Early postoperative complications included haemorrhoidal thrombosis (2 patients), bleeding (1) treated by haemostatic suture, dysuria (6) and acute urinary retention (1). After a mean follow-up of 15.6 +/- 6.5 months (range 6-32), 2/105 (20.9%) patients complained of minor bleeding, while mild pain was still present in 4/51 patients (7.8%). There were no statistically significant differences in the sample population regarding the gender or stage of the disease. Tenesmus was cured in 15/17 patients, dyschaezia in 20/22 patients and mucous soiling in 10/10 patients. No new cases of altered defaecation or faecal incontinence were recorded. Overall, 85.7% of patients were cured and 7.1% improved. Residual haemorrhoids were treated by elastic band ligation in nine (8%) patients and by surgical excision in further five patients (4.5%). Doppler-assisted ligation of the terminal branches of the haemorrhoidal arteries for II and III degree haemorrhoids is highly effective and painless. Complications are few and the technique can be performed as a day case.

  11. Investigação dos perfís temporais de alta resolução de explosões solares tipo-III decimétricas

    NASA Astrophysics Data System (ADS)

    Cecatto, J. R.; Fernandes, F. C. R.; Sawant, H. S.; Madsen, F. R. H.

    2003-08-01

    Explosões solares tipo-III indicam a presença de feixes de elétrons acelerados durante "flares" solares. Sua investigação fornece informações tanto sobre os processos de aceleração de partículas quanto das características do agente causador e do local de aceleração. Explosões tipo-III decimétricas são geradas por feixes de elétrons viajando através de arcos magnéticos densos da baixa coroa solar. Os perfís temporais destes fenômenos, quando tomados com alta resolução, informam sobre os mecanismos de aceleração de partículas do feixe e o meio de transporte da energia liberada a partir da região de aceleração. Usando o Brazilian Solar Spectroscope (BSS), em operação no INPE, foram registradas dezenas de explosões tipo-III decimétricas, dentro da faixa de 2050-2250 MHz com alta resolução temporal (20 ms), em 13 de setembro de 2001, entre 13:00 e 16:10 UT. Foram selecionadas 10 explosões isoladas para uma investigação estatística detalhada de seus perfís temporais, em todos os cerca de 50 canais de freqüência. Os resultados indicam que cerca de 70% dos perfís temporais são complexos tanto durante a subida quanto descida. Os 30% restantes indicam que os perfís da subida podem ser bem representados, na maioria dos casos, por um processo não-linear e uma parcela significativa por processos lineares. Os perfís temporais da descida são dominados por um decaimento não-linear. Neste trabalho, será efetuada uma análise dos perfís temporais, tanto durante a subida quanto descida do fluxo, para as explosões selecionadas, em termos dos prováveis mecanismos de aceleração e relaxamento. 2

  12. Intra-Arterial Infusion Chemotherapy Using Cisplatin With Radiotherapy for Stage III Squamous Cell Carcinoma of the Cervix

    SciTech Connect

    Kaneyasu, Yuko Nagai, Nobutaka; Nagata, Yasushi; Hashimoto, Yasutoshi; Yuki, Shintaro; Murakami, Yuji; Kenjo, Masahiro; Kakizawa, Hideaki; Toyota, Naoyuki; Fujiwara, Hisaya; Kudo, Yoshiki; Ito, Katsuhide

    2009-10-01

    Purpose: To examine the effectiveness of concomitant intra-arterial infusion chemotherapy (IAIC) using cisplatin (CDDP) with radiotherapy for Stage III squamous cell carcinoma of the cervix. Materials and Methods: We analyzed 29 cases of Stage III squamous cell carcinoma of the uterine cervix treated with radiotherapy and IAIC of CDDP from 1991 to 2006. External-beam therapy was given to the whole pelvis using four opposing parallel fields with an 18-MV linear accelerator unit. A central shield was used after 30-40 Gy with external whole-pelvic irradiation, and the total dose was 50 Gy. High-dose-rate brachytherapy was given with {sup 192}Ir microSelectron. The dose at Point A was 6 Gy per fraction, 2 fractions per week, and the total number of fractions was either 3 or 4. Two or three courses of IAIC were given concomitantly with CDDP 120 mg or carboplatin 300 mg. Results: We confirmed excellent medicine distribution directly by using computed tomographic angiography. The 5-year overall survival rate for Stage III patients was 62%, the cause-specific survival rate was 70%, and the local relapse-free survival rate was 89%. Local recurrence, distant metastasis, and occurrences of both were 7%, 38%, and 3%, respectively. The incidence of severe acute hematologic adverse reactions (Grade {>=}3) was 27% for all patients; however, all recovered without interruption of radiotherapy. Severe nonhematologic effects (Grade {>=}3) were 3%, including nausea and ileus. Only 1 patient's radiotherapy was interrupted for a period of 1 week because of ileus. Severe late complication rates (Grade {>=}3) for the bladder, rectum, and intestine were 3%, 3%, and 10%, respectively. Conclusion: A combination of IAIC and systemic chemotherapy should be considered to improve the prognosis of patients with Stage III squamous cell carcinoma of the cervix.

  13. Comparison between off-pump and on-pump coronary artery bypass grafting in patients with severe lesions at the circumflex artery territory: 5-year follow-up of the MASS III trial.

    PubMed

    Vieira de Melo, Rodrigo Morel; Hueb, Whady; Rezende, Paulo Cury; Alves da Costa, Leandro Menezes; Oikawa, Fernando Teiichi Costa; Lima, Eduardo Gomes; Hueb, Alexandre Ciappina; Scudeler, Thiago Luis; Kalil Filho, Roberto

    2015-03-01

    The technical difficulty in the revascularization of the circumflex artery territory with off-pump surgery may compromise the outcome of this method in clinical follow-up. We aimed to evaluate cardiac events in patients with stable coronary artery disease and severe obstruction of the circumflex system, undergoing coronary artery bypass grafting (CABG) with or without cardiopulmonary bypass. MASS III was a single-centre study that evaluated 308 patients with multivessel coronary artery disease randomized to on-pump (153) or off-pump (155) CABG. Of this total, 260 (84.4%) patients had, on coronary angiography, at least one 70% obstruction in the circumflex territory (141 on-pump and 119 off-pump). The combined outcome was death, myocardial infarction, target vessel revascularization (angioplasty or surgery) or hospitalization for cardiac causes. Variables with possible associations (P < 0.1) were included in the multivariate analysis. The two groups were well matched for demographics and clinical and angiographic characteristics. After 5 years of follow-up, off-pump CABG had higher combined events than on-pump had: 25 (21%) vs 17 (12%), hazard ratio 1.88, 95% confidence interval 1.02-3.48, P = 0.041. In the multivariate model with the inclusion of the following variables: age (P = 0.09) and complete revascularization (P = 0.68), off-pump surgery remained as a predictor of combined events in 5 years, P = 0.03. In patients with multivessel coronary artery disease and severe lesions in the circumflex territory, off-pump coronary artery bypass surgery resulted in a higher incidence of cardiac events at 5-year follow-up. ISRCTN59539154 (http://www.controlled-trials.com). © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  14. Early Diagnosis and Treatment of Coronary Heart Disease in Symptomatic Subjects With Advanced Vascular Atherosclerosis of the Carotid Artery (Type III and IV b Findings Using Ultrasound)

    PubMed Central

    Adams, Ansgar; Bojara, Waldemar; Schunk, Klaus

    2017-01-01

    Background A study was conducted as to whether the early diagnosis of coronary heart disease (CHD) in symptomatic patients with advanced atherosclerosis of the carotid artery was more successful using ultrasound technology than exercise electrocardiography (ECG). Methods Within the scope of an occupational screening program using subjects from diverse employment sectors, people were given the opportunity to determine their risk of heart attack. During the study, the total plaque area (TPA), the maximum plaque thickness in the carotid artery and the PROCAM scores of 3,513 healthy men and 2,088 healthy women between the ages of 20 and 65 were determined. During the subsequent follow-up study, 36 subjects developed symptoms such as exertional dyspnea, atypical angina pectoris (AP) or typical AP. Four patients displayed no symptoms. The initial cardiac diagnostic testing was conducted on 31 patients using an exercise ECG, four patients were assessed using a coronary angiogram, and five further patients were assessed using a computed tomography (CT) coronary angiogram. An ultrasound examination of the carotid artery of 39 patients revealed a type IV b finding and in one patient, the examination revealed a type III finding. Results In 17 patients, the PROCAM score was < 10%, 13 patients had a score of 10-20% and 10 patients had a score of > 20%. In the final analysis, only two patients had entirely smooth coronary arteries, seven had coronary sclerosis, seven had a 30% stenosis, one had a 30-40% stenosis, one had a 40% stenosis, and 22 patients had a stenosis ≥ 50%, and in extreme cases, a left main coronary artery stenosis with three-vessel disease was shown. The exercise ECG only achieved a true positive result in four patients, and in 21 patients, the result was false negative. Conclusions Symptomatic patients with advanced atherosclerosis of the carotid artery (type III and type IV b findings) had a high risk for CHD. The diagnosis of CHD is better achieved by

  15. Contraction of arterial smooth muscle of normotensive and spontaneously hypertensive rats by manganese(III)tetrakis(1-methyl-4-pyridyl)porphyrin (MnTMPyP).

    PubMed

    Sekiguchi, Fumiko; Seo, Mikako; Sunano, Satoru

    2003-06-01

    Manganese(III)tetrakis(1-methyl-4-pyridyl)porphyrin (MnTMPyP), which has been known as a cell permeable superoxide dismutase mimetic, induced concentration-dependent contraction in rat carotid artery acting directly on smooth muscle. The contractile action was more prominent in the preparation from stroke-prone spontaneously hypertensive rats (SHRSP) compared with that from Wistar Kyoto rats (WKY). It was abolished by the removal of extracellular Ca(2+) or the application of verapamil. These results suggest that the MnTMPyP-induced contraction is brought about by Ca(2+) influx through voltage-dependent Ca(2+) channels (VDCC) and that the difference in VDCC is the cause of the difference in MnTMPyP action between preparations from WKY and SHRSP.

  16. Survival in patients with class III idiopathic pulmonary arterial hypertension treated with first line oral bosentan compared with an historical cohort of patients started on intravenous epoprostenol

    PubMed Central

    Sitbon, O; McLaughlin, V; Badesch, D; Barst, R; Black, C; Galie, N; Humbert, M; Rainisio, M; Rubin, L; Simonneau, G

    2005-01-01

    Background: The oral dual endothelin receptor antagonist bosentan improves exercise capacity and delays clinical worsening in patients with pulmonary arterial hypertension, but its use could delay starting intravenous epoprostenol, a life saving treatment. Methods: Survival in patients with functional class III idiopathic pulmonary arterial hypertension (PAH) treated with bosentan in clinical trials was compared with historical data from similar patients treated with epoprostenol in the clinic. Statistical methods were used to adjust for possible underlying differences between the two groups. Results: Baseline factors for the 139 patients treated with bosentan and the 346 treated with epoprostenol suggested that the epoprostenol cohort had more severe disease—that is, a lower cardiac index (2.01 v 2.39 l/min/m2) and higher pressures and resistance. Kaplan-Meier survival estimates after 1 and 2 years were 97% and 91%, respectively, in the bosentan cohort and 91% and 84% in the epoprostenol cohort. Cox regression analyses adjusting for differences in baseline factors showed a greater probability of death in the epoprostenol cohort (hazard ratio 2.2 (95% confidence interval 1.2 to 4.0) in the model adjusted for haemodynamics). Alternative regression analyses and analyses to adjust for different data collection dates gave consistently similar results. When matched cohorts of 83 patients each were selected, survival estimates were similar. In the bosentan cohort 87% and 75% of patients followed for 1 and 2 years, respectively, remained on monotherapy. Conclusions: No evidence was found to suggest that initial treatment with oral bosentan, followed by or with the addition of other treatment if needed, adversely affected the long term outcome compared with initial intravenous epoprostenol in patients with class III idiopathic PAH. PMID:16055621

  17. Clinical Effectiveness of Intravenous Exenatide Infusion in Perioperative Glycemic Control after Coronary Artery Bypass Graft Surgery: A Phase II/III Randomized Trial.

    PubMed

    Besch, Guillaume; Perrotti, Andrea; Mauny, Frederic; Puyraveau, Marc; Baltres, Maude; Flicoteaux, Guillaume; Salomon du Mont, Lucie; Barrucand, Benoit; Samain, Emmanuel; Chocron, Sidney; Pili-Floury, Sebastien

    2017-08-18

    We aimed to assess the clinical effectiveness of intravenous exenatide compared to insulin in perioperative blood glucose control in coronary artery bypass grafting surgery patients. Patients more than 18 yr old admitted for elective coronary artery bypass grafting were included in a phase II/III nonblinded randomized superiority trial. Current insulin use and creatinine clearance of less than 60 ml/min were exclusion criteria. Two groups were compared: the exenatide group, receiving exenatide (1-h bolus of 0.05 µg/min followed by a constant infusion of 0.025 µg/min), and the control group, receiving insulin therapy. The blood glucose target range was 100 to 139 mg/dl. The primary outcome was the proportion of patients who spent at least 50% of the study period within the target range. The consumption of insulin (Cinsulin) and the time to start insulin (Tinsulin) were compared between the two groups. In total, 53 and 51 patients were included and analyzed in the exenatide and control groups, respectively (age: 70 ± 9 vs. 68 ± 11 yr; diabetes mellitus: 12 [23%] vs. 10 [20%]). The primary outcome was observed in 38 (72%) patients in the exenatide group and in 41 (80%) patients in the control group (odds ratio [95% CI] = 0.85 [0.34 to 2.11]; P = 0.30). Cinsulin was significantly lower (60 [40 to 80] vs. 92 [63 to 121] U, P < 0.001), and Tinsulin was significantly longer (12 [7 to 16] vs. 7 [5 to 10] h, P = 0.02) in the exenatide group. Exenatide alone at the dose used was not enough to achieve adequate blood glucose control in coronary artery bypass grafting patients, but it reduces overall consumption of insulin and increases the time to initiation of insulin.

  18. The class III anti-arrhythmic agent, amiodarone, inhibits voltage-dependent K(+) channels in rabbit coronary arterial smooth muscle cells.

    PubMed

    Li, Hongliang; Kim, Han Sol; Kim, Hye Won; Shin, Sung Eun; Jung, Won-Kyo; Ha, Kwon-Soo; Han, Eun-Taek; Hong, Seok-Ho; Firth, Amy L; Bae, Young Min; Choi, Il-Whan; Park, Won Sun

    2016-07-01

    We examined the inhibitory effect of amiodarone, a class III anti-arrhythmic agent, on voltage-dependent K(+) (Kv) currents in freshly isolated rabbit coronary arterial smooth muscle cells, using a whole-cell patch clamp technique. Amiodarone inhibited Kv currents in a concentration-dependent manner, with a half-maximal inhibitory concentration (IC50) value of 3.9 ± 1.44 μM and a Hill coefficient of 0.45 ± 0.14. Amiodarone did not have a significant effect on the steady-state activation of Kv channels, but shifted the inactivation current toward a more negative potential. Application of consecutive pulses progressively augmented the amiodarone-induced Kv channel inhibition. Another class III anti-arrhythmic agent, dofetilide, did not inhibit the Kv current or change the inhibitory effect of amiodarone on Kv channels. Therefore, these results strongly suggest that amiodarone inhibits Kv currents in a concentration- and state-dependent manner.

  19. Effects of phase III cardiac rehabilitation programs on health-related quality of life in elderly patients with coronary artery disease: Juntendo Cardiac Rehabilitation Program (J-CARP).

    PubMed

    Seki, Eriko; Watanabe, Yoshiro; Sunayama, Satoshi; Iwama, Yoshitaka; Shimada, Kazunori; Kawakami, Kazunobu; Sato, Mizue; Sato, Hiroyuki; Mokuno, Hiroshi; Daida, Hiroyuki

    2003-01-01

    The purpose of this prospective randomized controlled trial was to assess the impact of phase III comprehensive cardiac rehabilitation (CR) on health-related quality of life (HRQOL) in elderly patients with coronary artery disease (CAD). Thirty-eight elderly males (mean age, 70 years) with CAD were stratified as the intervention group (n=20) and the control group (n=18). In the intervention group, patients participated in CR for 6 months, whereas in the control group, they received standard care. Validated questionnaires were obtained to evaluate HRQOL using the Medical Outcome Study Short-Form 36 Health Status Survey (SF-36), State-trait anxiety inventory questionnaire (STAI) and Self-rating Depression Scale (SDS) at baseline and after 6 months. At baseline, scores of SF-36 except for general health, STAI and SDS were not different in either group. After 6 months, in the intervention group, scores of bodily pain, general health, vitality and mental health of SF-36 improved significantly compared with baseline. State anxiety scores also improved significantly (p<0.01), but SDS depression scores were not improved. In the control group, none of the parameters significantly changed. These results indicate that elderly patients with CAD should be vigorously encouraged to pursue CR even in chronic phase III.

  20. A Randomized Controlled Trial Comparing Suture-Fixation Mucopexy and Doppler-Guided Hemorrhoidal Artery Ligation in Patients with Grade III Hemorrhoids

    PubMed Central

    Zhai, Min; Zhang, Yong-An; Wang, Zhen-Yi; Sun, Jian-Hua; Wen, Jie; Zhang, Qi; Li, Jin-De; Wu, Yi-Zheng; Zhou, Feng; Xu, Hui-Lei

    2016-01-01

    Background. We aimed to evaluate the effectiveness of a suture-fixation mucopexy procedure by comparing with Doppler-guided hemorrhoidal artery ligation (DGHAL) in the management of patients with grade III hemorrhoids. Methods. This was a randomized controlled trial. One hundred patients with grade III hemorrhoids were randomly assigned to receive suture-fixation mucopexy (n = 50) or DGHAL (n = 50). Outcome assessments were performed at 2 weeks, 12 months, and 24 months. Assessments included resolution of clinical symptoms, postoperative complications, duration of hospitalization, and total costs. Results. At 2 weeks, one (2%) patient in suture-fixation group and four (8%) patients in DGHAL group had persistent prolapsing hemorrhoids. Postoperative bleeding was observed in two patients (4%) in suture-fixation group and one patient in DGHAL group. There was no significant difference in short-term recurrence between groups. Postoperative complications and duration of hospitalization were comparable between the two groups. Rates of recurrence of prolapse or bleeding at 12 months did not differ between groups. However, recurrence of prolapse at 24 months was significantly more common in DGHAL group (19.0% versus 2.3%, p = 0.030). Conclusions. Compared with DGHAL, the suture-fixation mucopexy technique had comparable short-term outcomes and favorable long-term outcomes. PMID:27066071

  1. Doppler-guided haemorrhoidal artery ligation with suture mucopexy compared with suture mucopexy alone for the treatment of Grade III haemorrhoids: a prospective randomized controlled trial.

    PubMed

    Aigner, F; Kronberger, I; Oberwalder, M; Loizides, A; Ulmer, H; Gruber, L; Pratschke, J; Peer, S; Gruber, H

    2016-07-01

    Novel minimally invasive techniques aimed to reposition the haemorrhoidal zone have been established for prolapsing haemorrhoids. We present a prospective randomized controlled trial to evaluate the efficacy of additional Doppler-guided ligation of submucosal haemorrhoidal arteries (DG-HAL) in patients with symptomatic Grade III haemorrhoids. The trial was registered as ClinicalTrials.gov identifier NCT02372981. All consecutive patients with symptomatic Grade III haemorrhoids were randomly allocated to one of the two study arms: (i) Group A, DG-HAL with mucopexy or (ii) Group B, mucopexy alone. End-points were postoperative pain, faecal incontinence, bleeding, residual prolapse and alterations of the vascularization of the anorectal vascular plexus. Vascularization of the anorectal vascular plexus was assessed by transperineal contrast enhanced ultrasound. Patients recorded their symptoms in a diary maintained for a month. Forty patients were recruited and randomized to the two study groups. Patients in Group A had less pain in the first two postoperative weeks. At the 12-month follow-up, two patients in Group A (10%) and one in Group B (5%) showed recurrent Grade III haemorrhoids (P = 0.274). No significant morphological changes were observed in the transperineal ultrasound findings between the preoperative assessment and the assessment at 1 and 6 months in either group (P > 0.05). Mucopexy techniques for treating prolapsing haemorrhoids are effective, but DG-HAL does not add significantly to the results achieved by mucopexy. Repositioning the haemorrhoidal zone is the key to success, and mucopexy should be placed at the sites of the largest visible prolapse. Colorectal Disease © 2016 The Association of Coloproctology of Great Britain and Ireland.

  2. Management of coronary artery disease in Kyrgyzstan: a comparison with Turkey and europe according to European Action on Primary and secondary prevention by intervention to reduce events III results.

    PubMed

    Kutlu, Rasim; Muratalievic, Tolkun Murataliev; Memetoglu, Mehmet Erdem

    2014-09-01

    The European Action on Primary and Secondary Prevention by Intervention to Reduce Events (EUROASPIRE III) Study in coronary artery disease had been undertaken between the years of 2006 and 2007, with the participation of 22 countries in Europe including Turkey (76 centers). In this study, the situation in the management of coronary artery disease in Kyrgyzstan was compared with EUROASPIRE III findings of Turkey and Europe. The results of 1067 patients with stable coronary artery disease admitted to 22 centers in Kyrgyzstan were studied retrospectively and compared with the European and Turkish findings in EUROASPIRE III. During the study, the patients were interviewed and examined in the first year after the initial coronary event and/or intervention. The gender distribution of the 1067 patients in the study was 658 female (61.7%) and 409 male (38.3%), and the average age was 68 ± 14 years. The ratio of young patients (<50 years) in Kyrgyzstan and Turkey were higher compared with the other European countries (Kyrgyzstan 28.2%, Turkey 20% and Europe 12.7%). The number of patients followed after the coronary event in Kyrgyzstan was 524 (49.1%). Although there was not a big difference of the classical risk factors between Turkey and Europe, in Kyrgyzstan, smoking (75%), hypertension (84%), dyslipidemia (86.5%), and diabetes (74.4%) were much higher when compared to the other countries. The biggest difference between Kyrgyzstan and the other countries in EUROASPIRE III study including Turkey, was the infrequency of medical (78% vs. 95%) and interventional treatment (1.9% vs. 57%). Also, smoking cessation (27.4% vs.70.8% in Europe), physical activity (17.5% vs. 59.1% in Europe), and weight loss (37.2% vs. 58.2% in Europe) ratios after the coronary event were found to be much lower in Kyrgyzstan than in EUROASPIRE III study. When compared to the results of EUROASPIRE III study of Turkey and Europe; the Kyrgyzstan results were found to be behind for the prevention

  3. ANATOMIC VARIATIONS OF HEPATIC ARTERY: A STUDY IN 479 LIVER TRANSPLANTATIONS.

    PubMed

    Fonseca-Neto, Olival Cirilo Lucena da; Lima, Heloise Caroline de Souza; Rabelo, Priscylla; Melo, Paulo Sérgio Vieira de; Amorim, Américo Gusmão; Lacerda, Cláudio Moura

    2017-01-01

    ão especialmente importantes no contexto do transplante ortotópico hepático, visto que, além de representar oportunidade ideal para seu estudo anatômico cirúrgico, a sua precisa identificação é determinante para o sucesso do procedimento. Identificar as variações anatômicas no sistema arterial hepático em transplantes hepáticos. Foram analisados retrospectivamente, no período de 13 anos, 479 prontuários de pacientes adultos transplantados, sendo coletados dados referentes à anatomia arterial hepática do doador falecido. Identificou-se anatomia arterial hepática normal em 416 doadores (86,84%). Os outros 63 indivíduos (13,15%) apresentaram alguma variação. De acordo com a classificação de Michels, as anomalias mais frequentes foram: artéria hepática direita ramo da artéria mesentérica superior (Tipo III, n=27, 5,63%); artéria hepática esquerda ramo da artéria gástrica esquerda (Tipo II, n=13, 2,71%); artéria hepática direita ramo da artéria mesentérica superior associada à artéria hepática esquerda ramo da artéria gástrica esquerda (Tipo IV, n=4, 0,83%). Do mesmo modo, em relação à Classificação de Hiatt, as variações mais prevalentes foram: artéria hepática direita acessória ou substituta da artéria mesentérica superior (Tipo III, n=28, 6,05%), seguida da artéria hepática esquerda acessória ou substituta da artéria gástrica esquerda (Tipo II, n=16, 3,34%). Quatorze pessoas (2,92%) apresentaram alterações anatômicas sem classificação definida, sendo a de maior frequência o tronco hepatomesentérico, identificado em cinco (1,04%). O conhecimento detalhado das variações da anatomia arterial hepática é de grande importância aos cirurgiões que realizam abordagens nessa região, em especial no transplante hepático, visto que sua identificação e correto manejo são fundamentais para o êxito do procedimento.

  4. Coronary Arteries

    MedlinePlus

    ... and animations for grades K-6. The Coronary Arteries Coronary Circulation The heart muscle, like every other ... into two main coronary blood vessels (also called arteries). These coronary arteries branch off into smaller arteries, ...

  5. Efficacy and safety of a biodegradable polymer Cobalt-Chromium sirolimus-eluting stent (EXCEL2) in treating de novo coronary artery disease: A pooled analysis of the CREDIT II and CREDIT III trials.

    PubMed

    Wang, Geng; Wang, Heyang; Xu, Bo; Yang, Yuejin; Yang, Zhiming; Li, Hui; Zhang, Zheng; Wang, Haichang; Yang, Lixia; Han, Yaling

    2017-03-01

    The safety and efficacy of the second-generation biodegradable polymer Cobalt-Chromium sirolimus-eluting stent (EXCEL2) in daily clinical practice remains unknown. Additionally, to meet the China Food and Drug Administration requirements, we conducted an objective performance criterion study from the CREDIT II and CREDIT III trials. CREDIT II was a randomized trial comparing the EXCEL2 versus EXCEL stent in patients with up to 2 de novo coronary lesions. CREDIT III was a prospective, single-arm study evaluating the efficacy and safety of EXCEL2 in broad types of de novo coronary artery lesions. This pooled analysis included patients in the CREDIT III and EXCEL2 arm of the CREDIT II trial. The primary outcome was 12-month target lesion failure (TLF), a composite of cardiac death, target vessel myocardial infarction (TV-MI), and clinical indicated target lesion revascularization (CI-TLR). The patient-oriented composite endpoint (PoCE) of all-cause death, all MI, or any revascularization was also analyzed. A total of 833 patients were included, consisting of 625 in the CREDIT III trial and 208 in the EXCEL2 arm of the CREDIT II trial. Twelve-month TLF occurred in 6.1% patients, cardiac death in 0.4%, TV-MI in 5%, and CI-TLR in 1.1%. Additionally, 64 (7.7%) PoCE and 3 probable late stent thromboses (0.4%) were recorded. EXCEL2 stent met the objective performance criterion on efficacy and safety with a low level of 12-month TLF as well as stent thrombosis when treating patients with de novo coronary lesions. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  6. [Advantages of quinapril therapy in patients with arterial hypertension and functional class III chronic heart failure with preserved left ventricular ejection fraction].

    PubMed

    Kanorskiĭ, S G; Tregubov, V G; Pokrovskiĭ, V M

    2012-01-01

    To determine advantages of therapy of functional class (FC) I-II chronic heart failure (CHF) with preserved left ventricular (LV) ejection fraction in patients with hypertensive disease (HD) with metoprolol succinate or quinapril and to assess their effect on regulatory-adaptive status. Two hundred patients with I-II FC CHF and LVEF >50% at the background of stage I-II hypertensive disease participated in this study. They were randomized into 2 groups. Group I comprised 104 patients (mean age 52.8+1.9 years) who were prescribed metoprolol succinate 87.7+/-7.6 mg/day. Patients of group 2 (n=96, mean age 55.0+/-1.4 years) were prescribed quinapril 21.0+55 mg/day. Examination at baseline and after 6 months of therapy included 6 min walk test, treadmillometry with assessment of maximal oxygen consumptiion (VO2max), echocardiography, 24 hour blood pressure monitoring, measurement of N-terminal precursor of brain natriuretic peptide (NT-proBNP); test of cardio-respiratory synchronism was used for objective qualitative determination of the state of the ,renin-angiotensin system. Both drugs improved parameters of LV diastolic function, but only quinapril effectively changed LV structural geometric parameters and systolic function. Only treatment with quinapril was associated with improvement of RAS, elevation of tolerance to physical effort, and increased VO2max. Quinapril more substantially lowered level of NT-proBNP. Quinapril has an advantage over metoprolol succinate in therapy of patients with FC I-II CHF and preserved LF EF at the background of stage I-II HD.

  7. Cyanoacrylate glue for type iii lad perforation.

    PubMed

    Trehan, V K; Nigam, Arima

    2008-01-01

    Coronary artery perforation especially type III is a rare and catastrophic complication of percutaneous coronary intervention. It mandates emergency open heart surgery if hemostasis is not achieved promptly. We report a case of type III left anterior descending artery (LAD) perforation which was managed successfully with cyanoacrylate glue.

  8. Relation of Internal Elastic Lamellar Layer Disruption to Neointimal Cellular Proliferation and Type III Collagen Deposition in Human Peripheral Artery Restenosis.

    PubMed

    Krishnan, Prakash; Purushothaman, K-Raman; Purushothaman, Meerarani; Baber, Usman; Tarricone, Arthur; Vasquez, Miguel; Wiley, Jose; Kini, Annapoorna; Sharma, Samin K; O'Connor, William N; Moreno, Pedro R

    2016-04-01

    Smooth muscle cell proliferation and extracellular matrix formation are responsible for disease progression in de novo and restenotic atherosclerosis. Internal elastic lamella (IEL) layer maintains the structural integrity of intima, and disruption of IEL may be associated with alterations in neointima, type III collagen deposition, and lesion progression in restenosis. Nineteen restenotic plaques (12 patients) procured during peripheral interventions were compared with 13 control plaques (12 patients) without restenosis. Hematoxylin & Eosin and elastic trichrome stains were used to measure length and percentage of IEL disruption, cellularity, and inflammation score. Type I and III collagens, smooth muscle cell (smc), fibroblast density, and nuclear proliferation (Ki67) percentage were evaluated by immunohistochemistry. IEL disruption percentage (28 ± 3.6 vs 6.1 ± 2.4; p = 0.0006), type III collagen content (0.33 ± 0.06 vs 0.17 ± 0.07; p = 0.0001), smc density (2014 ± 120 vs 923 ± 150; p = 0.0001), fibroblast density (2,282 ± 297 vs 906 ± 138; p = 0.0001), and Ki67 percentage (21.6 ± 2 vs 8.2 ± 0.65; p = 0.0001) were significantly increased in restenotic plaques compared to de novo plaques. Logistic regression analysis identified significant correlation between IEL disruption and neointimal smc density (r = 0.45; p = 0.01) and with type III collagen deposition (r = 0.61; p = 0.02) in restenosis. Increased IEL disruption may trigger cellular proliferation, altering collagen production, and enhancing restenotic neointima. In conclusion, understanding the pathologic and molecular basis of restenosis and meticulous-guided interventions oriented to minimize IEL damage may aid to reduce neointimal proliferation and the occurrence of restenosis. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. National Cholesterol Education Program Adult Treatment Panel III Versus International Diabetic Federation Definition of Metabolic Syndrome, Which One is Associated with Diabetes Mellitus and Coronary Artery Disease?

    PubMed

    Rezaianzadeh, Abbas; Namayandeh, Seyedeh-Mahdieh; Sadr, Seyed-Mahmood

    2012-08-01

    A cluster of risk factors for cardiovascular diseases and type 2 diabetes mellitus, which occur together more often than by chance alone, have been known as the metabolic syndrome. Various definitions have been proposed by different organizations over the past decade. This study was designed to evaluate a new definition of the metabolic syndrome for the prediction of diabetes mellitus among the Iranian population. This study was carried out in an urban population, aged 20 to 74 years, from Yazd, a city in the center of Iran. The study is a part of the phase I of Yazd Healthy Heart Program, that is, a community-based intervention study for the prevention of cardiovascular disease. The significance level has been defined as P<0.05. Prevalence of the metabolic syndrome by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria was 21.3 ± .017%, and by International Diabetes Federation (IDF) criteria it was 30.16 ± .02%. The multivariate analysis showed that the most important relevant factors of diabetes mellitus were: Increased age and metabolic syndrome by both definitions of NCEP and IDF criteria, and also, the most important relevant factors of stable angina were: Increased age, male sex, and metabolic syndrome by only IDF definitions, but the NCEP definition of the metabolic syndrome cannot predict diabetes mellitus independent of age and sex. This study showed that increased age and metabolic syndrome are the most important relevant factors for diabetes mellitus, especially by using the IDF criteria for definition of the metabolic syndrome.

  10. Type III Hyperlipoproteinaemia

    PubMed Central

    Borrie, Peter

    1969-01-01

    Eighteen patients with type III hyperlipoproteinaemia, diagnosed on the basis of skin lesions, serum lipids, and lipoprotein electrophoresis, have been fully investigated over a period of 15 years. The incidence of coronary artery disease was only slightly increased, and was not increased at all among first-degree relatives. Peripheral occlusive arterial disease was probably more common. An increased incidence of carbohydrate intolerance was found in neither the patients nor their relatives. The effects of treatment on the skin were uniformly good. ImagesFig. 1Fig. 2 PMID:5783124

  11. Arterial insufficiency

    MedlinePlus

    ... is atherosclerosis or "hardening of the arteries." Fatty material (called plaque) builds up on the walls of your arteries. This causes them to become narrow and stiff. As a result, it is hard for blood to flow through your arteries. Blood flow may be suddenly ...

  12. Acute arterial occlusion - kidney

    MedlinePlus

    Acute renal arterial thrombosis; Renal artery embolism; Acute renal artery occlusion; Embolism - renal artery ... kidneys need a good blood supply. The main artery to the kidney is called the renal artery. ...

  13. Arterial grafts: clinical classification and pharmacological management

    PubMed Central

    2013-01-01

    In comparison with standard saphenous vein grafts, use of the internal mammary artery (IMA) as a coronary artery bypass graft has achieved superior long-term results. This is related to the differences in the biological characteristics between the venous and arterial grafts. However, even arterial grafts are not uniform in their biological characteristics. The variation in the perioperative behavior of the grafts and in their long-term patency may be related to different characteristics. These factors should be taken into account in the use of arterial grafts, some of which are subjected to more active pharmacological intervention during and after the operation to obtain satisfactory results. To better understand the biological behavior of the grafts, their common features and their differences, a clinical classification may be useful for a practicing surgeon. Based on experimental studies of their vasoreactivity combined with anatomical, physiological and embryological considerations, we have proposed a functional classification for arterial grafts that may be useful clinically. Our classification suggests that there are three types of arterial grafts: Type I—somatic arteries; Type II—splanchnic arteries; and Type III—limb arteries. Type I arteries have enhanced endothelial function and release more nitric oxide and other relaxing factors. Type II arteries, such as the gastro-epiploic artery, and Type III arteries, such as the radial artery (RA), have higher pharmacological reactivity to vasoconstrictors. This classification explains why the IMA has the best long-term patency. Because Type II and III arteries are prone to spasms due to higher contractility, they require more active pharmacological interventions. Furthermore, the harvesting technique of the conduits, including the saphenous vein and IMA, are described and discussed in this article. Prevention of spasms using two cocktails of medications (verapamil + nitroglycerin and nicardipine

  14. Brachioradial arteries with anastomotic arteries connecting to brachial arteries bilaterally.

    PubMed

    Hong, Tong; Qiuhong, Dan; Haipeng, Cai

    2010-01-01

    We present a patient with a failed radial coronary angioplasty as a result of bilateral brachioradial arteries, the radial arteries anomalously originating from the axillary arteries. We review the literature concerning abnormal origins of the radial artery and propose the left ulnar artery as optimal access of choice in cases with a right brachioradial artery of relatively small size in its proximal part.

  15. Arterial calcifications

    PubMed Central

    Rennenberg, Roger J M W; Schurgers, Leon J; Kroon, Abraham A; Stehouwer, Coen D A

    2010-01-01

    Abstract Arterial calcifications as found with various imaging techniques, like plain X-ray, computed tomography or ultrasound are associated with increased cardiovascular risk. The prevalence of arterial calcification increases with age and is stimulated by several common cardiovascular risk factors. In this review, the clinical importance of arterial calcification and the currently known proteins involved are discussed. Arterial calcification is the result of a complex interplay between stimulating (bone morphogenetic protein type 2 [BMP-2], RANKL) and inhibitory (matrix Gla protein, BMP-7, osteoprotegerin, fetuin-A, osteopontin) proteins. Vascular calcification is especially prevalent and related to adverse outcome in patients with renal insufficiency and diabetes mellitus. We address the special circumstances and mechanisms in these patient groups. Treatment and prevention of arterial calcification is possible by the use of specific drugs. However, it remains to be proven that reduction of vascular calcification in itself leads to a reduced cardiovascular risk. PMID:20716128

  16. The arterial supply of the metacarpophalangeal joint in the Bactrian camel (Camelus bactrianus).

    PubMed

    Wang, J; Cuisheng

    1998-09-01

    The arterial supply of the six metacarpophalangeal joints was studied in Bactrian camels. The arterial branches supplying the metacarpophalangeal joints were derived from the metacarpal distal perforating, medial and lateral branches of the palmar metacarpal artery III, medial and lateral branches of the palmar common digital artery III and the abaxial palmar proper digital arteries III and IV. These arterial branches were the proximal dorsoaxial distal metacarpal, distal dorsoaxial distal metacarpal, abaxial distal metacarpal, palmar distal metacarpal, interosseous distal metacarpal, dorsoaxial proximal proximal phalangeal, palmoxial proximal proximal phalangeal, palmoabaxial proximal proximal phalangeal and dorsoabaxial proximal proximal phalangeal branches. They linked with each other around the metacarpophalangeal joint.

  17. SAGE III

    Atmospheric Science Data Center

    2017-01-13

    SAGE III Data and Information The Stratospheric Aerosol and Gas ... on the spacecraft. SAGE III produced L1 and L2 scientific data from 5/07/2002 until 12/31/2005. The flight of the second instrument is as ... Additional Info:  Data Format: HDF-EOS or Big Endian/IEEE Binary SCAR-B Block:  ...

  18. The arterial supply to the digits of the forelimb in the Bactrian camel (Camelus bactrianus)

    PubMed Central

    WANG, JIAN-LIN; GAO-LAN; WANG, GEN-XUAN; LI, HAI-YAN

    2000-01-01

    The arterial supply of the digits of the forelimb of the Bactrian camel is described. The arteries supplying the digits were the palmar metacarpal and common palmar digital arteries III. The palmar metacarpal artery III was the continuation of the deep medial proximal metacarpal branch which was derived from the medial branch of the radial artery. It gave rise to a nutrient branch, medial branch, lateral branch and distal perforating palmar branch at the proximal end of the distal sixth of the cannon bone (fused third and fourth metacarpal bones). The common palmar digital artery III was the continuation of the median artery, which divided into medial and lateral branches. The medial branch of common palmar digital artery III which occasionally arose from the axial palmar proper digital artery III, after giving rise to the axial proximal proximal phalangeal branch, divided into the axial and abaxial palmar proper digital arteries III. The axial palmar proper digital artery III gave off the dorsoaxial distal proximal phalangeal, dorsoaxial proximal middle phalangeal, dorsoaxial distal middle phalangeal, palmoaxial middle phalangeal, palmoaxial distal phalangeal, dorsoaxial distal phalangeal branches, coronal artery and some digital tori branches. The abaxial palmar proper digital artery III gave rise to the abaxial proximal proximal phalangeal, dorsoabaxial distal proximal phalangeal, dorsoabaxial middle phalangeal, palmoabaxial middle phalangeal, palmoabaxial distal phalangeal, dorsoabaxial distal phalangeal branches, coronal artery and some digital tori branches. The lateral branch of the common palmar digital artery III in its origin, course, branching pattern and supply in the fourth digit was similar to the medial branch of common palmar digital artery III in the third digit. PMID:10739015

  19. Mesenteric artery ischemia

    MedlinePlus

    ... bowel - mesenteric; Dead gut - mesenteric; Atherosclerosis - mesenteric artery; Hardening of the arteries - mesenteric artery ... the aorta, the main artery from the heart. Hardening of the arteries occurs when fat, cholesterol, and ...

  20. Peripheral Artery Disease

    MedlinePlus

    ... Physician Resources Professions Site Index A-Z Peripheral Artery Disease (PAD) Peripheral artery disease (PAD) refers to ... is peripheral artery disease treated? What is peripheral artery disease (PAD)? Peripheral artery disease, or PAD, refers ...

  1. Angioplasty and stent placement - peripheral arteries

    MedlinePlus

    Percutaneous transluminal angioplasty - peripheral artery; PTA - peripheral artery; Angioplasty - peripheral arteries; Iliac artery -angioplasty; Femoral artery - angioplasty; Popliteal artery - angioplasty; Tibial artery - angioplasty; Peroneal artery - ...

  2. Effects of intravenous ABT-870 (iron (III)-hydroxide oligosaccharide) on mean arterial pressure and heart rate in the anaesthetized beagle: comparison with other iron-containing haematinic agents.

    PubMed

    Preusser, Lee C; Fryer, Ryan M; Gerhardt, Armin; Hu, Yanhui; Delgado-Herrera, Leticia; Melnick, Joel Z; Williams, Laura A; Cox, Bryan F; Reinhart, Glenn A

    2005-12-01

    Iron-deficiency anaemia, a complication of end-stage renal disease (ESRD), is often treated with parenteral iron therapies that have been shown to produce dose-limiting hypotension in patients. ABT-870 (iron-(III)-hydroxide-oligosaccharide) is comprised of elemental iron complexed with oligosaccharide, a composition that we hypothesised would allow the hypotensive effects of parenteral iron therapy to be overcome, thus allowing a rapid rate of infusion to be well tolerated. Mean arterial pressure (MAP) and heart rate (HR) were monitored in anaesthetized dogs following the infusion of ABT-870 and iron sucrose administered at doses of 7.1 and 21.3 mg/kg using a rapid 30 s infusion. ABT-870 and iron sucrose were also monitored at doses of 7.1, 21.3 and 50 mg/kg administered over a 10 min period. Sodium ferric gluconate complex (SFGC) was administered in an identical fashion at doses of 12.5 and 31.2 mg/kg. A 30 s rapid infusion of ABT-870 at doses of 7.1 and 14.3 mg/kg or a 10 min infusion of ABT-870 at doses of 7.1 and 21.3 mg/kg produced little effect on MAP and HR. Infusion of the highest dose of ABT-870 (50 mg/kg) produced no consistent hypotension, but did produce an increase in HR (maximal increase 35 +/- 9 b.p.m.), an effect that lasted only 15 min. A 30 s rapid infusion of iron sucrose at 7.1 mg/kg produced modest increases in MAP and HR (5 +/- 1 mmHg and 5 +/- 2 b.p.m., respectively). However, rapid infusion of iron sucrose at 14.3 mg/kg produced hypotension (to -8 +/- 1 mmHg below baseline) and exerted variable, biphasic effects on HR ranging from -16 to +50 b.p.m. Although 10 min infusion of iron sucrose at 7.1 mg/kg exerted little effect on MAP and HR, at doses of 21.3 and 50 mg/kg iron sucrose elicited a profound dose-dependent decrease in MAP (-34 +/- 11 and -83 +/- 5 mmHg, respectively) and a pronounced increase in HR ranging from 32 to 49 b.p.m. above baseline. A 10 min infusion of SFGC at doses of 12.5 and 31.2 mg/kg produced a dose-dependent decrease

  3. BIOPLUME III

    EPA Pesticide Factsheets

    BIOPLUME III is a two-dimensional finite difference model for simulating the natural attenuation of organic contaminants in groundwater due to the processes of advection, dispersion, sorption, and biodegradation.

  4. Arterial Stiffness.

    PubMed

    Avolio, Alberto

    2013-04-01

    Stiffness of large arteries has been long recognized as a significant determinant of pulse pressure. However, it is only in recent decades, with the accumulation of longitudinal data from large and varied epidemiological studies of morbidity and mortality associated with cardiovascular disease, that it has emerged as an independent predictor of cardiovascular risk. This has generated substantial interest in investigations related to intrinsic causative and associated factors responsible for the alteration of mechanical properties of the arterial wall, with the aim to uncover specific pathways that could be interrogated to prevent or reverse arterial stiffening. Much has been written on the haemodynamic relevance of arterial stiffness in terms of the quantification of pulsatile relationships of blood pressure and flow in conduit arteries. Indeed, much of this early work regarded blood vessels as passive elastic conduits, with the endothelial layer considered as an inactive lining of the lumen and as an interface to flowing blood. However, recent advances in molecular biology and increased technological sophistication for the detection of low concentrations of biochemical compounds have elucidated the highly important regulatory role of the endothelial cell affecting vascular function. These techniques have enabled research into the interaction of the underlying passive mechanical properties of the arterial wall with the active cellular and molecular processes that regulate the local environment of the load-bearing components. This review addresses these emerging concepts.

  5. Effects of residual coronary artery disease on results of coronary artery bypass grafting.

    PubMed

    Iskandrian, A S; Hakki, A H; Nestico, P F; DePace, N L; Goel, I P; Kane, S

    1984-10-01

    To assess the effects of residual coronary artery disease (non-revascularized coronary vessels) after coronary artery bypass grafting on symptoms and exercise left ventricular function, we categorized 77 patients into 3 groups according to the extent of residual coronary artery disease: group I (n = 17) had no residual coronary artery disease (residual score = 0); group II (n = 30) had light residual coronary artery disease (score of 1 to 9, mean 4.7); and group III (n = 30) had moderate residual coronary artery disease (score greater than or equal to 10, mean 23). Sixty patients were asymptomatic after coronary artery bypass grafting (14 in group I, 24 in group II, and 22 in group III), but the remaining patients had occasional angina pectoris. The resting left ventricular ejection fraction was significantly higher in group I than in the remaining 2 groups (56 +/- 18% in group I, 47 +/- 19% in group II, and 43 +/- 16% in group III, P less than 0.05). The exercise left ventricular ejection fraction was also significantly higher in group I (61 +/- 16% in group I, 51 +/- 18% in group II and 45 +/- 18% in group III, P less than 0.01). The ejection fraction response to exercise was abnormal in 5 patients in group I, 15 patients in group II, and 19 patients in group III. Thus, coronary artery bypass grafting results in symptomatic improvement, even in patients with residual coronary artery disease. The presence of residual coronary artery disease, however, may be a determinant of exercise left ventricular function in these patients.

  6. Carotid artery surgery

    MedlinePlus

    Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery ... through the catheter around the blocked area during surgery. Your carotid artery is opened. The surgeon removes ...

  7. Global Positioning System III (GPS III)

    DTIC Science & Technology

    2013-12-01

    Global Positioning System III ( GPS III) As of FY 2015 President’s Budget...00-00-2013 to 00-00-2013 4. TITLE AND SUBTITLE Global Positioning System III ( GPS III) 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT...Responsible Office References Program Name Global Positioning System III ( GPS III) DoD Component Air Force

  8. Welding III.

    ERIC Educational Resources Information Center

    Allegheny County Community Coll., Pittsburgh, PA.

    Instructional objectives and performance requirements are outlined in this course guide for Welding III, an advanced course in arc welding offered at the Community College of Allegheny County to provide students with the proficiency necessary for industrial certification. The course objectives, which are outlined first, specify that students will…

  9. Welding III.

    ERIC Educational Resources Information Center

    Allegheny County Community Coll., Pittsburgh, PA.

    Instructional objectives and performance requirements are outlined in this course guide for Welding III, an advanced course in arc welding offered at the Community College of Allegheny County to provide students with the proficiency necessary for industrial certification. The course objectives, which are outlined first, specify that students will…

  10. Carotid Artery Screening

    MedlinePlus

    ... Physician Resources Professions Site Index A-Z Carotid Artery Screening What is carotid artery screening? Who should ... information about carotid artery screening? What is carotid artery screening? Screening examinations are tests performed to find ...

  11. Coronary Artery Bypass Grafting

    MedlinePlus

    ... from the NHLBI on Twitter. What Is Coronary Artery Bypass Grafting? Coronary artery bypass grafting (CABG) is ... bypass multiple coronary arteries during one surgery. Coronary Artery Bypass Grafting Figure A shows the location of ...

  12. Arterial embolism

    MedlinePlus

    ... for embolization (especially to the brain) is mitral stenosis . Endocarditis (infection of the inside of the heart) can also cause arterial emboli. A common source for an embolus is from areas of hardening (atherosclerosis) in the aorta and other large blood vessels. These clots can ...

  13. Arterial switch.

    PubMed

    Planche, C; Lacour-Gayet, F; Serraf, A

    1998-01-01

    A relatively large spectra of anatomic variations are found within the unifying features of discordant ventriculoarterial connections. Variants that lend themselves to anatomic repair by the arterial switch operation are discussed, these include transposition of the great arteries with intact ventricular septum (TGA IVS), TGA associated with a ventricular septal defect (TGA VSD), double-outlet right ventricle with subpulmonary VSD (DORV VSD), and TGA or DORV with VSD associated with coarctation. Double discordance with VSD, which is currently treated by double switch or Rastelli and atrial switch and which probably represents, in our department, the only remaining indication for atrial switch, is not discussed. Also, we exclude TGA associated with pulmonary stenosis, which is treated by Rastelli or REV operation.

  14. Protótipo do primeiro interferômetro brasileiro - BDA

    NASA Astrophysics Data System (ADS)

    Cecatto, J. R.; Fernandes, F. C. R.; Neri, J. A. C. F.; Bethi, N.; Felipini, N. S.; Madsen, F. R. H.; Andrade, M. C.; Soares, A. C.; Alonso, E. M. B., Sawant, H. S.

    2004-04-01

    A interferometria é uma poderosa ferramenta usada para investigar estruturas espaciais de fontes astrofísicas fornecendo uma riqueza de detalhes inatingível pelas técnicas convencionais de imageamento. Em particular, a interferometria com ondas de rádio abre o horizonte de conhecimento do Universo nesta ampla banda do espectro eletromagnético, que vai de cerca de 20 kHz até centenas de GHz já próximo ao infravermelho, e que está acessível a partir de instrumentos instalados em solo. Neste trabalho, apresentamos o interferômetro designado por Arranjo Decimétrico Brasileiro (BDA). Trata-se do primeiro interferômetro a ser desenvolvido no Brasil e América Latina que já está em operação na fase de protótipo. Apresentamos o desenvolvimento realizado até o momento, o sítio de instalação do instrumento, o protótipo e os principais resultados dos testes de sua operação, as perspectivas futuras e a ciência a ser desenvolvida com o instrumento nas fases II e III. Neste trabalho é dada ênfase ao desenvolvimento, testes de operação e principais resultados do protótipo. É discutida brevemente a ciência que pode ser feita com o instrumento. Tanto os detalhes técnicos quanto os principais parâmetros estimados para o instrumento nas próximas fases de desenvolvimento e o desempenho do protótipo serão publicados em breve.

  15. Carotid Artery Disease

    MedlinePlus

    ... brain with blood. If you have carotid artery disease, the arteries become narrow, usually because of atherosclerosis. ... one of the causes of stroke. Carotid artery disease often does not cause symptoms, but there are ...

  16. Peripheral arterial line (image)

    MedlinePlus

    A peripheral arterial line is a small, short plastic catheter placed through the skin into an artery of the arm or leg. The purpose of a peripheral arterial line is to allow continuous monitoring of blood pressure ...

  17. Epidemiology of the arterial stiffness.

    PubMed

    Breithaupt-Grögler, K; Belz, G G

    1999-06-01

    Aortic stiffening is as much an important risk factor in cardiovascular morbidity and mortality, as it serves as reliable surrogate marker for clinical endpoints like myocardial and cerebrovascular incidents. Elevated aortic stiffness induces high systolic blood pressure, augmented pulse pressure with increased ventricular afterload, reduced subendocardial blood flow and augmented pulsatile stress in the peripheral arteries. Factors with relevant impact on the epidemiology of arterial stiffness are widely spread. 3 major groups of parameters influencing the stiffness of the aorta and the large arteries have been studied and described up to now: (i) physiological properties like age, gender, body height, pressure, hormonal state, genetic factors; (ii) environmental factors like nutrition (fish-, salt-, garlic consumption), smoking, performance of sports and aerobic capacity; (iii) diseases like hypertension, hypercholesterolemia, diabetes, coronary heart disease, cerebrovascular disease, renal failure, Marfan-syndrome, growth hormone deficiency. Close association between several of these factors impedes analyzing them independently from each other. Age and blood pressure were found to be the most prominent predictors of arterial stiffness in normal as well as in disease populations. Physiological and environmental factors can modulate these effects of aging, diseases generally seem to amplify them.

  18. Vascular Aging and Arterial Stiffness.

    PubMed

    Mikael, Luana de Rezende; Paiva, Anelise Machado Gomes de; Gomes, Marco Mota; Sousa, Ana Luiza Lima; Jardim, Paulo César Brandão Veiga; Vitorino, Priscila Valverde de Oliveira; Euzébio, Maicon Borges; Sousa, Wátila de Moura; Barroso, Weimar Kunz Sebba

    2017-06-29

    Cardiovascular diseases (CVD) account annually for almost one third of all deaths worldwide. Among the CVD, systemic arterial hypertension (SAH) is related to more than half of those outcomes. Type 2 diabetes mellitus is an independent risk factor for SAH because it causes functional and structural damage to the arterial wall, leading to stiffness. Several studies have related oxidative stress, production of free radicals, and neuroendocrine and genetic changes to the physiopathogenesis of vascular aging. Indirect ways to analyze that aging process have been widely studied, pulse wave velocity (PWV) being considered gold standard to assess arterial stiffness, because there is large epidemiological evidence of its predictive value for cardiovascular events, and it requires little technical knowledge to be performed. A pulse wave is generated during each cardiac contraction and travels along the arterial bed until finding peripheral resistance or any bifurcation point, determining the appearance of a reflected wave. In young individuals, arteries tend to be more elastic, therefore, the reflected wave occurs later in the cardiac cycle, reaching the heart during diastole. In older individuals, however, the reflected wave occurs earlier, reaching the heart during systole. Because PWV is an important biomarker of vascular damage, highly valuable in determining the patient's global cardiovascular risk, we chose to review the articles on vascular aging in the context of cardiovascular risk factors and the tools available to the early identification of that damage. Resumo As doenças cardiovasculares são anualmente responsáveis por quase um terço do total de mortes no mundo. Dentre elas, a hipertensão arterial sistêmica (HAS) está relacionada com mais da metade desses desfechos. O diabetes mellitus tipo 2 é visto com um fator de risco independente para HAS por causar lesões funcionais e estruturais na parede arterial, ocasionando-lhe enrijecimento. Diversos estudos

  19. Carotid artery anatomy (image)

    MedlinePlus

    There are four carotid arteries, two on each side of the neck: right and left internal carotid arteries, and right and left external carotid arteries. The carotid arteries deliver oxygen-rich blood from the heart to the head and brain.

  20. Vapor resistant arteries

    NASA Technical Reports Server (NTRS)

    Shaubach, Robert M. (Inventor); Dussinger, Peter M. (Inventor); Buchko, Matthew T. (Inventor)

    1989-01-01

    A vapor block resistant liquid artery structure for heat pipes. A solid tube artery with openings is encased in the sintered material of a heat pipe wick. The openings are limited to that side of the artery which is most remote from the heat source. The liquid in the artery can thus exit the artery through the openings and wet the sintered sheath, but vapor generated at the heat source is unlikely to move around the solid wall of the artery and reverse its direction in order to penetrate the artery through the openings. An alternate embodiment uses finer pore size wick material to resist vapor entry.

  1. Coronary Artery Fistula

    DTIC Science & Technology

    2007-04-01

    ascending aorta and pulmonary artery) and congenital coronary artery stenosis . Most coronary artery fistulas are congenital but may also...MILITARY MEDICINE, 172, 4: xi-xii, 2007 Military Medicine, Vol. 172, 4, April 2007 Radiology Corner Case #11 Coronary Artery Fistula...man with a single episode of vague sub- sternal chest pain was referred for evaluation of possible coronary artery disease. His medical history was

  2. Late-term clinical outcomes with zotarolimus- and sirolimus-eluting stents. 5-year follow-up of the ENDEAVOR III (A Randomized Controlled Trial of the Medtronic Endeavor Drug [ABT-578] Eluting Coronary Stent System Versus the Cypher Sirolimus-Eluting Coronary Stent System in De Novo Native Coronary Artery Lesions).

    PubMed

    Kandzari, David E; Mauri, Laura; Popma, Jeffrey J; Turco, Mark A; Gurbel, Paul A; Fitzgerald, Peter J; Leon, Martin B

    2011-05-01

    This study sought to compare late safety and efficacy outcomes following percutaneous coronary revascularization with zotarolimus-eluting stents (ZES) and sirolimus-eluting stents (SES). Despite higher late lumen loss and binary restenosis with ZES compared with SES, it is uncertain whether differences in early angiographic measures translate into more disparate late clinical events. Clinical outcomes were prospectively evaluated through 5 years in the ENDEAVOR III (A Randomized Controlled Trial of the Medtronic Endeavor Drug [ABT-578] Eluting Coronary Stent System Versus the Cypher Sirolimus-Eluting Coronary Stent System in De Novo Native Coronary Artery Lesions) that randomized 436 patients of relatively low anatomic and clinical risk to treatment with ZES (n = 323) or SES (n = 113) and evaluated a primary endpoint of 8-month angiographic late lumen loss. At 5 years (completeness of follow-up: 95.2%), pre-specified endpoints of all-cause mortality (5.2% vs. 13.0%, p = 0.02), myocardial infarction (1.0% vs. 4.6%, p = 0.03), and the composite event rates of cardiac death/myocardial infarction (1.3% vs. 6.5%, p = 0.009) and major adverse cardiac events (14.0% vs. 22.2%, p = 0.05) were significantly lower among patients treated with ZES. Rates of target lesion (8.1% ZES vs. 6.5% SES, p = 0.68) and target vessel revascularization were similar between treatment groups. Stent thrombosis was infrequent and similar in both groups (0.7% ZES vs. 0.9% SES, p = 1.0). Between 9 months and 5 years, progression of major adverse cardiac events was significantly more common with SES than with ZES (16.7% vs. 7.8%, p = 0.015). Despite initially higher angiographic late lumen loss, rates of clinical restenosis beyond the protocol-specified angiographic follow-up period remain stable with ZES compared with the rates for SES, resulting in similar late-term efficacy. Over 5 years, significant differences in death, myocardial infarction, and composite endpoints favored treatment with ZES

  3. [CHANGES OF CAROTID AND VERTEBRAL ARTERIES IN PATENTS WITH ARTERIAL HYPERTENSION AND HEPATOBILIARY PATHOLOGY].

    PubMed

    Polyakov, V Ya; Nikolaev, Yu A; Pegova, S V; Matsievskaya, T R; Obukhov, I V

    2016-01-01

    The study included 1172 patients (410 men and 762 women) at the mean age of 60.3 ± 10.4 years with grade I-II (stage I-II) arterial hypertension (AH) admitted to the clinic of Institute of Experimental Medicine. The patients were divided into 2 groups based on the results of clinical and laboratory diagnostics. Group 1 (n = 525) included patients with AH and hepatobiliary system (HBS) diseases, group 2 (n = 647) patients with AH without HBS diseases. The patients group 1 had a thicker intima-media complex of carotid arteries, higher peak systolic bloodflow rate in the internal and vertebral carotid arteries, more pronounced coiling of internal carotid arteries than patients of group 2. Patients with AH and HBS diseases exhibited correlation between bloodflow rate in external carotid arteries and atherogenicity coefficient. Duplex scanning of neck vessels of in patients with AH without HBS diseases revealed peculiar changes of the intima-media thickness and hemodynamically significant changes of the blood flow in the internal carotid arteries that may be of prognostic value in this nosological syntropy and require the personified approach to diagnostics, treatment, and prevention of these conditions.

  4. Lifesaving Embolization of Coronary Artery Perforation

    SciTech Connect

    Katsanos, Konstantinos; Patel, Sundip; Dourado, Renato; Sabharwal, Tarun

    2009-09-15

    Coronary artery perforation remains one of the most fearsome complications during cardiac catheterization procedures. Although emergent bypass surgery is the preferred treatment for cases with uncontrollable perforation, endovascular vessel sealing and arrest of bleeding with a combination of balloons, covered stents, or embolic materials have also been proposed. The authors describe a case of emergent lifesaving microcoil embolization of the distal right coronary artery in a patient with uncontrollable grade III guidewire perforation resulting in cardiac tamponade. The relevant literature is reviewed and the merits and limitations of the endovascular approach are highlighted.

  5. Cooled artery extension

    NASA Technical Reports Server (NTRS)

    Gernert, Nelson J. (Inventor)

    1990-01-01

    An artery vapor trap. A heat pipe artery is constructed with an extension protruding from the evaporator end of the heat pipe beyond the active area of the evaporator. The vapor migrates into the artery extension because of gravity or liquid displacement, and cooling the extension condenses the vapor to liquid, thus preventing vapor lock in the working portion of the artery by removing vapor from within the active artery. The condensed liquid is then transported back to the evaporator by the capillary action of the artery extension itself or by wick located within the extension.

  6. Anterior spinal arteries. Origin and distribution in man.

    PubMed

    Rodríguez-Baeza, A; Muset-Lara, A; Rodríguez-Pazos, M; Domenech-Mateu, J M

    1989-01-01

    This study was designed to extend our present knowledge of the origin and distribution of anterior spinal arteries and was carried our using 31 human cadavers with arterial injections of natural latex. The conclusions reached are that there are always one or two anterior spinal arteries (right or left), which proceed from the intracranial segment of the vertebral arteries. These arteries have a descending course, with distribution into the ventral face of the medulla oblongata and the first cervical segments of the medulla spinalis. In cases where there are two anterior spinal arteries, they anastomose with each other to form the common, unpaired and median anterior spinal artery. The different observed locations of the origins of anterior spinal arteries may be systematised into three types. Each of these types has differential characteristics: bilateral origin (type I; 77.4%), unilateral origin (type II; 9.7%) and origin in an intervertebral transversal anastomosis (type III; 12.9%). We do however subdivide the bilateral origin group, according to the calibre of the arteries, into the subtypes 'balanced' (type Ia; 22.6%), 'right dominated' (type Ib; 32.2%) and 'left dominated' (type Ic; 22.6%). The collaterals of the anterior spinal arteries which distribute into the ventral face of the medulla oblongata are described.

  7. Coronary Artery Anomalies

    MedlinePlus

    ... Center for Coronary Artery Anomalies Doctors at the Texas Heart Institute's Center for Coronary Artery Anomalies (CCAA) ... comments. Terms of Use and Privacy Policy © Copyright Texas Heart Institute All rights reserved.

  8. Carotid Artery Disease

    MedlinePlus

    ... coronary artery disease: High levels of low-density lipoprotein cholesterol (bad cholesterol) and triglycerides in the blood. High blood pressure Diabetes Smoking Family history of coronary artery disease Obesity ...

  9. Spontaneous Coronary Artery Dissection

    MedlinePlus

    ... artery dissection (SCAD). It's not yet clear what role these factors play in causing the disease. Common factors include: Female sex. Though spontaneous coronary artery dissection (SCAD) can occur ...

  10. Peripheral artery disease - legs

    MedlinePlus

    ... pale. When PAD becomes severe, you may have: Impotence Pain and cramps at night Pain or tingling ... emboli that block small arteries Coronary artery disease Impotence Open sores (ischemic ulcers on the lower legs) ...

  11. Retinal artery occlusion

    MedlinePlus

    ... These blockages are more likely if there is hardening of the arteries ( atherosclerosis ) in the eye. Clots ... Blindness and vision loss Blood clots Diabetes Glaucoma Hardening of the arteries High blood cholesterol levels High ...

  12. Radial Artery Catheterization

    MedlinePlus

    ... of the radial artery for cardiac catheterization procedures. Advantages of Radial Artery Catheterization Any catheter placement into ... walk, and eat immediately. This is a particular advantage for patients with back problems because there is ...

  13. Hardening of the arteries

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/000171.htm Hardening of the arteries To use the sharing features on this page, please enable JavaScript. Hardening of the arteries, also called atherosclerosis, occurs when ...

  14. Carotid artery surgery - slideshow

    MedlinePlus

    ... page: //medlineplus.gov/ency/presentations/100124.htm Carotid artery surgery - series—Normal anatomy To use the sharing ... out of 4 Overview There are four carotid arteries, with a pair located on each side of ...

  15. Peripheral artery bypass - leg

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/007394.htm Peripheral artery bypass - leg To use the sharing features on this page, please enable JavaScript. Peripheral artery bypass is surgery to reroute the blood supply ...

  16. Uterine artery embolization

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/007384.htm Uterine artery embolization To use the sharing features on this page, please enable JavaScript. Uterine artery embolization (UAE) is a procedure to treat fibroids ...

  17. Coronary artery fistula

    MedlinePlus

    Congenital heart defect - coronary artery fistula; Birth defect heart - coronary artery fistula ... attaches to one of the chambers of the heart (the atrium or ventricle) or another blood vessel ( ...

  18. Coronary Artery Disease

    MedlinePlus

    Coronary artery disease (CAD) is the most common type of heart disease. It is the leading cause of death in the United States in both men and women. CAD happens when the arteries that supply blood to ...

  19. Coronary artery disease

    MedlinePlus Videos and Cool Tools

    ... heart muscle itself. Damage to or blockage of a coronary artery can result in injury to the heart. Normally, blood flows through a coronary artery unimpeded. However, a process called atherosclerosis ...

  20. [Morphofunctional correlation in congenital anomalies of the coronary arteries. I. Coronary artery fistulas].

    PubMed

    Rangel-Abundis, A; Muñoz-Castellanos, L; Marín, G; Chávez Pérez, E; Badui, E

    1994-01-01

    In order to explain the congenital coronary arteries malformations, the authors review the recent concepts on the coronary artery morphogenesis, based in the findings that in the human embryo, these arteries evolve from three sources: 1) endothelial aortic buds, 2) cavitary cellular groups from pericardial origin and with angiogenic character, which migrate to the cardiac zones where the coronary arteries will be distributed, and 3) the intramyocardial sinusoids. The anatomic and histologic cardiac alterations will be reflected in modifications of the coronary artery pattern. The coronary artery fistulae are formed by the persistence of the sponge structure of the myocardial wall, present in the early ontogenic steps of the cardiac development; such fistulae alter the normal functions of the coronary vascular tree and are capable to cause angina pectoris to the patient through diverse mechanisms: absence of capillarization, steal phenomenon aggravated by the altered coronary arteries properties when aneurysm or vascular channels are developed. The authors suggest a classification of the congenital coronary arteries anomalies: I. Anomalous origin in the sinus of Valsalva (anomalous and ectopic origin), II. Malformations of the coronary branches (in number, distribution and wall anomalies) and III. Anomalous connection of the coronary arteries: fistulae and persistence of the intramyocardial sinusoids isolated or communicated to left and right ventricles. The latter are frequently associated with aortic or pulmonary valve atresia. They do not cause myocardial ischemia and are formed secondary to the intracavitary elevated pressure which maintained the persistence, dilatation and communication of the ventricular chambers with such sinusoids and coronary arteries in the case of pulmonary valve atresia and with coronary veins in the case of aortic valve atresia.

  1. What Is Peripheral Artery Disease?

    MedlinePlus

    ... from the NHLBI on Twitter. What Is Peripheral Artery Disease? Peripheral artery disease (P.A.D.) is ... that affects blood flow to the legs. Normal Artery and Artery With Plaque Buildup The illustration shows ...

  2. Global Positioning System III (GPS III)

    DTIC Science & Technology

    2015-12-01

    modernization of the constellation . GPS III complies with 10 United States Code (USC) § 2281, ensuring the continued sustainment and operation of GPS for... constellations , further increasing the accuracy and availability of user PNT solutions. GPS III December 2015 SAR March 23, 2016 16:15:29 UNCLASSIFIED

  3. Renal artery aneurysms.

    PubMed

    González, J; Esteban, M; Andrés, G; Linares, E; Martínez-Salamanca, J I

    2014-01-01

    A renal artery aneurysm is defined as a dilated segment of renal artery that exceeds twice the diameter of a normal renal artery. Although rare, the diagnosis and incidence of this entity have been steadily increasing due to the routine use of cross-sectional imaging. In certain cases, renal artery aneurysms may be clinically important and potentially lethal. However, knowledge of their occurrence, their natural history, and their prognosis with or without treatment is still limited. This article aims to review the recent literature concerning renal artery aneurysms, with special consideration given to physiopathology, indications for treatment, different technical options, post-procedure complications and treatment outcomes.

  4. Extracranial vertebral artery intervention.

    PubMed

    Mukherjee, Debabrata; Pineda, Guillermo

    2007-12-01

    Atherosclerosis is the commonest cause of vertebral artery stenosis and has a predilection for the origin and proximal section of the extracranial portion of the vessel and also the intracranial portion of the vessel. Although it has generally been thought that extracranial vertebral artery (ECVA) disease has a more benign outcome compared to intracranial vertebral artery disease, significant occlusive disease of the proximal vertebral artery is the primary cause of vertebral artery ischemia in a significant proportion of patients. We focus on the interventional management of patients with proximal ECVA disease in this article.

  5. External artery heat pipe

    NASA Technical Reports Server (NTRS)

    Gernert, Nelson J. (Inventor); Ernst, Donald M. (Inventor); Shaubach, Robert M. (Inventor)

    1989-01-01

    An improved heat pipe with an external artery. The longitudinal slot in the heat pipe wall which interconnects the heat pipe vapor space with the external artery is completely filled with sintered wick material and the wall of the external artery is also covered with sintered wick material. This added wick structure assures that the external artery will continue to feed liquid to the heat pipe evaporator even if a vapor bubble forms within and would otherwise block the liquid transport function of the external artery.

  6. Jet pump assisted artery

    NASA Technical Reports Server (NTRS)

    1975-01-01

    A procedure for priming an arterial heat pump is reported; the procedure also has a means for maintaining the pump in a primed state. This concept utilizes a capillary driven jet pump to create the necessary suction to fill the artery. Basically, the jet pump consists of a venturi or nozzle-diffuser type constriction in the vapor passage. The throat of this venturi is connected to the artery. Thus vapor, gas, liquid, or a combination of the above is pumped continuously out of the artery. As a result, the artery is always filled with liquid and an adequate supply of working fluid is provided to the evaporator of the heat pipe.

  7. Transradial artery coronary angioplasty.

    PubMed

    Kiemeneij, F; Laarman, G J; de Melker, E

    1995-01-01

    This study explored the feasibility and safety of percutaneous coronary balloon angioplasty (PTCA) with miniaturized PTCA equipment via the radial artery. Coronary angioplasty (PTCA) via the femoral or brachial arteries may be associated with rare vascular complications such as bleeding and damage to the artery and adjacent structures. It was postulated that PTCA via the radial artery with miniaturized angioplasty equipment is feasible and that no major puncture site-related complications occur because hemostasis is obtained easily and because no major structures are near the radial artery. With double blood supply to the hand, radial artery occlusion is well tolerated. In 100 patients with collateral blood supply to the right hand, PTCA was attempted with 6F guiding catheters and rapid-exchange balloon catheters for exertional angina (87 patients) or nonexertional angina (13 patients). Angioplasty was attempted in 122 lesions (type A n = 67 [55%], Type B n = 37 [30%], and type C n = 18 [15%]). Pre- and post-PTCA computerized quantitative coronary analysis was performed. Radial artery function and structure were assessed clinically and with Doppler and two-dimensional ultrasound on the day of discharge. Coronary catheterization via the radial artery was successful in 94 patients (94%). The 6 remaining patients had successful PTCA via the femoral artery (n = 5) or the brachial artery (n = 1). Procedural success (120 of 122 lesions) was achieved in 92 patients (98%) via the radial artery and in 98 patients of the total study population.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. The effect of collagenase on the critical buckling pressure of arteries.

    PubMed

    Martinez, Ricky; Han, Hai-Chao

    2012-03-01

    The stability of arteries is essential to normal arterial functions and loss of stability can lead to arterial tortuosity and kinking. Collagen is a main extracellular matrix component that modulates the mechanical properties of arteries and collagen degradation at pathological conditions weakens the mechanical strength of arteries. However, the effects of collagen degradation on the mechanical stability of arteries are unclear. The objective of this study was to investigate the effects of collagen degradation on the critical buckling pressure of arteries. Arterial specimens were subjected to pressurized inflation testing and fitted with nonlinear thick-walled cylindrical model equations to determine their stress strain relationships. The arteries were then tested for the critical buckling pressure at a set of axial stretch ratios. Then, arteries were divided into three groups and treated with Type III collagenase at three different concentrations (64, 128, and 400 U/ml). Mechanical properties and buckling pressures of the arteries were determined after collagenase treatment. Additionally, the theoretical buckling pressures were also determined using a buckling equation. Our results demonstrated that the buckling pressure of arteries was lower after collagenase treatment. The difference between pre- and post- treatment was statistically significant for the highest concentration of 400U/ml but not at the lower concentrations. The buckling equation was found to yield a fair estimation to the experimental critical pressure measurements. These results shed light on the role of matrix remodeling on the mechanical stability of arteries and developments of tortuous arteries.

  9. Buckling Reduces eNOS Production and Stimulates Extracellular Matrix Remodeling in Arteries in Organ Culture.

    PubMed

    Xiao, Yangming; Liu, Qin; Han, Hai-Chao

    2016-09-01

    Artery buckling alters the fluid shear stress and wall stress in the artery but its temporal effect on vascular wall remodeling is poorly understood. The purpose of this study was to investigate the early effect of artery buckling on endothelial nitric oxide synthase (eNOS) expression and extracellular matrix remodeling. Bilateral porcine carotid arteries were maintained in an ex vivo organ culture system with and without buckling while under the same physiological pressure and flow rate for 3-7 days. Matrix metalloproteinase-2 (MMP-2), MMP-9, fibronectin, elastin, collagen I, III and IV, tissue inhibitor of metalloproteinase-2 (TIMP-2), and eNOS were determined using Western blotting and immunohistochemistry. Our results showed that MMP-2 expression level was significantly higher in buckled arteries than in the controls and higher at the inner curve than at the outer curve of buckled arteries, while collagen IV content showed an opposite trend, suggesting that artery buckling increased MMP-2 expression and collagen IV degradation in a site-specific fashion. However, no differences for MMP-9, fibronectin, elastin, collagen I, III, and TIMP-2 were observed among the outer and inner curve sides of buckled arteries and straight controls. Additionally, eNOS expression was significantly decreased in buckled arteries. These results suggest that artery buckling triggers uneven wall remodeling that could lead to development of tortuous arteries.

  10. [Effect of complex sanatorium treatment including magnetotherapy on hemodynamics in patients with arterial hypertension].

    PubMed

    Efremushkin, G G; Duruda, N V

    2003-01-01

    Forty nine patients with arterial hypertension of stage I-II received combined sanatorium treatment. Of them, 21 had adjuvant total magnetotherapy. All the patients were examined for parameters of central, cerebral hemodynamics and microcirculation. The adjuvant magnetotherapy produced a beneficial effect on hypertension: clinical symptoms attenuated, arterial pressure became more stable, hemodynamics improved, duration of hospitalization reduced, requirement in hypotensive drugs diminished.

  11. Duplicated middle cerebral artery.

    PubMed

    Perez, Jesus; Machado, Calixto; Scherle, Claudio; Hierro, Daniel

    2009-01-01

    Duplicated middle cerebral artery (DMCA) is an anomalous vessel arising from the internal carotid artery. The incidence DMCA is relatively law, and an association between this anomaly and cerebral aneurysms has been documented. There is a controversy whether DMCA may have perforating arteries. This is an important fact to consider in aneurysm surgery. We report the case of a 34-year-old black woman who suffered a subarachnoid hemorrhage and the angiography a left DMCA, and an aneurysm in an inferior branch of the main MCA. The DMCA and the MCA had perforating arteries. The aneurysm was clipped without complications. The observation of perforating arteries in our patient confirms that the DMCA may have perforating arteries. This is very important to be considered in cerebral aneurysms surgery. Moreover, the DMCA may potentially serve as a collateral blood supply to the MCA territory in cases of MCA occlusion.

  12. Palmar artery aneurysm

    PubMed Central

    Shutze, Ryan A.; Liechty, Joseph

    2017-01-01

    Aneurysms of the hand are rarely encountered and more rarely reported. The least common locations of these aneurysms are the palmar and digital arteries. The etiologies of these entities are quite varied, although they usually present as a pulsatile mass. Following a thorough evaluation, including arterial anatomic imaging, they should be repaired. The reported results following repair have been good. Herein we report a girl with a spontaneous palmar artery aneurysm and its management. PMID:28127131

  13. Arterial waveform analysis.

    PubMed

    Esper, Stephen A; Pinsky, Michael R

    2014-12-01

    The bedside measurement of continuous arterial pressure values from waveform analysis has been routinely available via indwelling arterial catheterization for >50 years. Invasive blood pressure monitoring has been utilized in critically ill patients, in both the operating room and critical care units, to facilitate rapid diagnoses of cardiovascular insufficiency and monitor response to treatments aimed at correcting abnormalities before the consequences of either hypo- or hypertension are seen. Minimally invasive techniques to estimate cardiac output (CO) have gained increased appeal. This has led to the increased interest in arterial waveform analysis to provide this important information, as it is measured continuously in many operating rooms and intensive care units. Arterial waveform analysis also allows for the calculation of many so-called derived parameters intrinsically created by this pulse pressure profile. These include estimates of left ventricular stroke volume (SV), CO, vascular resistance, and during positive-pressure breathing, SV variation, and pulse pressure variation. This article focuses on the principles of arterial waveform analysis and their determinants, components of the arterial system, and arterial pulse contour. It will also address the advantage of measuring real-time CO by the arterial waveform and the benefits to measuring SV variation. Arterial waveform analysis has gained a large interest in the overall assessment and management of the critically ill and those at a risk of hemodynamic deterioration.

  14. Buckling instability in arteries.

    PubMed

    Vandiver, Rebecca M

    2015-04-21

    Arteries can become tortuous in response to abnormal growth stimuli, genetic defects and aging. It is suggested that a buckling instability is a mechanism that might lead to artery tortuosity. Here, the buckling instability in arteries is studied by examining asymmetric modes of bifurcation of two-layer cylindrical structures that are residually stressed. These structures are loaded by an axial force, internal pressure and have nonlinear, anisotropic, hyperelastic responses to stresses. Strain-softening and reduced opening angle are shown to lower the critical internal pressure leading to buckling. In addition, the ratio of the media thickness to the adventitia thickness is shown to have a dramatic impact on arterial instability.

  15. [Platelets and arterial thrombosis].

    PubMed

    Cazenave, Jean-Pierre; Gachet, Christian; Lanza, François; Wiesel, Marie-Louise

    2003-01-01

    The pathological mechanisms involved in arterial thrombus formation are similar to the mechanisms involved in physiological hemostasis. Arterial thrombosis is initiated following lesion of the vessel wall, either through rupture of an atherosclerotic plaque containing lipids, adhesive proteins and tissue factor or after angioplasty exposing the thrombogenic subendothelial matrix. Platelets play a major role in arterial thrombus formation through ADP secretion and thrombin generation on their activated surface. Arterial thrombosis is a frequent complication of atherosclerotic lesions and leads to acute ischemic events. These events are therapeutic emergencies which require administration of antithrombotic drugs inhibiting platelet functions and thrombin.

  16. Single Umbilical Artery

    PubMed Central

    Cairns, J. David; McKee, James

    1964-01-01

    A prospective study of 2000 obstetrical deliveries was undertaken to establish the incidence of single umbilical artery in the newborn and the frequency of congenital malformations reported to be associated with this disorder. Twenty cases of single umbilical artery were discovered; two proved to have an associated congenital malformation. In neither of these cases was medical management affected by the discovery of a single artery. In addition, the vascular arrangement in the cords of 31 concurrently occurring congenitally malformed babies was examined, and in no instance was a single umbilical artery found. PMID:14214230

  17. Pressure drop and arterial compliance - Two arterial parameters in one measurement.

    PubMed

    Rotman, Oren M; Zaretsky, Uri; Shitzer, Avraham; Einav, Shmuel

    2017-01-04

    Coronary artery pressure-drop and distensibility (compliance) are two major, seemingly unrelated, parameters in the cardiovascular clinical setting, which are indicative of coronary arteries patency and atherosclerosis severity. While pressure drop is related to flow, and therefore serves as a functional indicator of a stenosis severity, the arterial distensibility is indicative of the arterial stiffness, and hence the arterial wall composition. In the present study, we hypothesized that local pressure drops are dependent on the arterial distensibility, and hence can provide information on both indices. The clinical significance is that a single measurement of pressure drop could potentially provide both functional and bio-mechanical metrics of lesions, and thus assist in real-time decision making prior to stenting. The goal of the current study was to set the basis for understanding this relationship, and define the accuracy and sensitivity required from the pressure measurement system. The investigation was performed using numerical fluid-structure interaction (FSI) simulations, validated experimentally using our high accuracy differential pressure measurement system. Simplified silicone mock coronary arteries with zero to intermediate size stenoses were used, and various combinations of arterial distensibility, diameter, and flow rate were simulated. Results of hyperemic flow cases were also compared to fractional flow reserve (FFR). The results indicate the potential clinical superiority of a high accuracy pressure drop-based parameter over FFR, by: (i) being more lesion-specific, (ii) the possibility to circumvent the FFR dependency on pharmacologically-induced hyperemia, and, (iii) by providing both functional and biomechanical lesion-specific information.

  18. Configurations and classifications of composite arterial grafts in coronary bypass surgery.

    PubMed

    Yuan, Shi-Min; Shinfeld, Amihay; Raanani, Ehud

    2008-01-01

    The aim of this review is to present the configurations and classifications of composite arterial grafts in coronary bypass surgery. Articles were collected by tracking references cited in the literature with regard to the configurations of composite arterial grafts in coronary bypass surgery. Figures of the configurations were drawn in accordance to the schematic drawings, angiograms, photographs, table contents or written captions of the literature. According to their structural nature, composite arterial grafts can be classified as: (i) alphabetical (Y, T, I, U, K, X and H) and (ii) complex grafts (TY, loop, pi and sling grafts). According to the conduits that form the composite graft, they can be classified as: (i) definite (all standard alphabetical grafts, classic pi and sling grafts); (ii) varying [internal mammary artery (IMA) loop, modified pi graft]; and (iii) indefinite conduit graft (TY graft). According to their application in coronary artery bypass grafting (CABG), they can be divided into complete arterial revascularization for: (i) triple vessel disease (T, Y, K, X, TY, pi and sling grafts); (ii) two vessel disease (U, right Y, and two-thirds right IMA T grafts); and (iii) single vessel disease, mainly the left anterior descending artery with or without the diagonal branch (H, I, IMA loop and left IMA T grafts). According to the CABG method, they can be classified as: (i) for conventional CABG (sling graft); (ii) for minimally invasive direct coronary artery bypass (H graft); and (iii) for both conventional CABG and off-pump coronary artery bypass (T, Y, U, K, I, TY, IMA loop, and pi grafts). Standard Y and T grafts have been accepted as the common figurations of composite arterial grafts to maximum graft length for the bypass of triple vessel disease. Composite arterial grafts overcome the limited availability of arterial conduits for performing total arterial myocardial revascularization, allow a gain in conduit length, and minimize the ascending

  19. Accumulation of calcium and phosphorus in the coronary arteries of Thai subjects.

    PubMed

    Tohno, Yoshiyuki; Tohno, Setsuko; Mahakkanukrauh, Pasuk; Minami, Takeshi; Sinthubua, Apichat; Suwannahoy, Patipath; Khanpetch, Pongsak; Azuma, Cho

    2012-03-01

    To clarify the manner of accumulation of Ca and P in the coronary arteries, the authors divided the coronary arteries into many segments based on arterial ramification and investigated the element contents of the segments by direct chemical analysis. After ordinary dissection at Chiang Mai University was finished, the left coronary (LC) and the right coronary (RC) arteries were removed successively from the hearts of Thai subjects. The Thai subjects consisted of seven men and five women, ranging in age from 42 to 87 years (average age = 73.9 ± 13.5 years). The LC and the RC arteries were divided into 19 segments based on arterial ramification. After incineration with nitric acid and perchloric acid, element contents of the segments were analyzed by inductively coupled plasma-atomic emission spectrometry. In two cases, a significant content of Ca and P was contained only in the left anterior descending (LAD) artery (type I). In four cases, a significant content of Ca and P was contained in both the LAD and the RC arteries (type II). In five cases, a significant content of Ca and P was contained in all the LAD, the RC, and the circumflex (CF) arteries (type III). In the other one case, no significant content of Ca and P was contained in the coronary arteries. The manner of accumulation of Ca and P in the coronary arteries was classified into the three types, I, II, and III. Regarding the average content of elements in 12 cases, the average content of Ca was the highest in the segment of the LAD artery ramifying the first left diagonal artery and was higher in the proximal and distal adjacent segments of the LAD artery ramifying the first left diagonal artery, the proximal segment of the RC artery, and the proximal segment of the CF artery. To examine an effect of arterial ramification on accumulation of Ca and P, the differences in the Ca and P content between artery-ramifying and non-ramified proximal or distal segments of the coronary arteries were

  20. Measuring How Elastic Arteries Function.

    ERIC Educational Resources Information Center

    DeMont, M. Edwin; MacGillivray, Patrick S.; Davison, Ian G.; McConnell, Colin J.

    1997-01-01

    Describes a procedure used to measure force and pressure in elastic arteries. Discusses the physics of the procedure and recommends the use of bovine arteries. Explains the preparation of the arteries for the procedure. (DDR)

  1. Living with Carotid Artery Disease

    MedlinePlus

    ... from the NHLBI on Twitter. Living With Carotid Artery Disease If you have carotid artery disease, you can take steps to manage the ... treatment plan, and getting ongoing care. Having carotid artery disease raises your risk of having a stroke . ...

  2. What Is Carotid Artery Disease?

    MedlinePlus

    ... from the NHLBI on Twitter. What Is Carotid Artery Disease? Carotid artery disease is a disease in ... blood to your face, scalp, and neck. Carotid Arteries Figure A shows the location of the right ...

  3. Peripheral Artery Disease and Diabetes

    MedlinePlus

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Peripheral Artery Disease & Diabetes Updated:Jan 26,2016 People with ... developing atherosclerosis, the most common cause of peripheral artery disease (PAD) . And individuals with PAD have a ...

  4. Measuring How Elastic Arteries Function.

    ERIC Educational Resources Information Center

    DeMont, M. Edwin; MacGillivray, Patrick S.; Davison, Ian G.; McConnell, Colin J.

    1997-01-01

    Describes a procedure used to measure force and pressure in elastic arteries. Discusses the physics of the procedure and recommends the use of bovine arteries. Explains the preparation of the arteries for the procedure. (DDR)

  5. Screening for Carotid Artery Stenosis

    MedlinePlus

    ... Task Force learned about the potential benefits and harms of screening for carotid artery stenosis: Health professionals ... blood flow through the arteries. Potential Benefits and Harms of Carotid Artery Stenosis Screening and Treatment The ...

  6. Genetics in Arterial Calcification

    PubMed Central

    Rutsch, Frank; Nitschke, Yvonne; Terkeltaub, Robert

    2011-01-01

    Artery calcification reflects an admixture of factors such as ectopic osteochondral differentiation with primary host pathological conditions. We review how genetic factors, as identified by human genome-wide association studies, and incomplete correlations with various mouse studies, including knockout and strain analyses, fit into “pieces of the puzzle” in intimal calcification in human atherosclerosis, and artery tunica media calcification in aging, diabetes mellitus, and chronic kidney disease. We also describe in sharp contrast how ENPP1, CD73, and ABCC6 serve as “cogs in a wheel” of arterial calcification. Specifically, each is a minor component in the function of a much larger network of factors that exert balanced effects to promote and suppress arterial calcification. For the network to normally suppress spontaneous arterial calcification, the “cogs” ENPP1, CD73, and ABCC6 must be present and in working order. Monogenic ENPP1, CD73, and ABCC6 deficiencies each drive a molecular pathophysiology of closely related but phenotypically different diseases (generalized arterial calcification of infancy (GACI), pseudoxan-thoma elasticum (PXE) and arterial calcification caused by CD73 deficiency (ACDC)), in which premature onset arterial calcification is a prominent but not the sole feature. PMID:21852556

  7. Coronary artery stent (image)

    MedlinePlus

    ... with a balloon catheter and expands when the balloon is inflated. The stent is then left there to help keep the artery open. ... with a balloon catheter and expands when the balloon is inflated. The stent is then left there to help keep the artery open.

  8. [Pulmonary artery intimal sarcoma].

    PubMed

    Bourry, N; Chabrot, P; Jeannin, G; Filaire, M; Charpy, C; Bay, J O; Kemeny, J L; Caillaud, D; Escande, G; Boyer, L

    2008-02-01

    Pulmonary artery sarcoma is a rare tumor. We present a case of intimal sarcoma arising from right pulmonary artery and left lower pulmonary vein observed in a 44-year-old man with a non-productive cough. Computed tomographic scans and magnetic resonance imaging showing filling defect enhancement contributed early, suggesting the diagnosis of primary vascular tumor, hypothesis confirmed by pathologist findings.

  9. Coronary artery disease (image)

    MedlinePlus

    ... through these arteries is critical for the heart. Coronary artery disease usually results from the build-up of fatty material and plaque, a condition called atherosclerosis. As the ... blood to the heart can slow or stop, causing chest pain (stable ...

  10. Arterial Pressure Analog.

    ERIC Educational Resources Information Center

    Heusner, A. A.; Tracy, M. L.

    1980-01-01

    Describes a simple hydraulic analog which allows students to explore some physical aspects of the cardiovascular system and provides them with a means to visualize and conceptualize these basic principles. Simulates the behavior of arterial pressure in response to changes in heart rate, stroke volume, arterial compliance, and peripheral…

  11. Diagnosis of Intracranial Artery Dissection

    PubMed Central

    KANOTO, Masafumi; HOSOYA, Takaaki

    2016-01-01

    Cerebral arterial dissection is defined as a hematoma in the wall of a cervical or an intracranial artery. Cerebral arterial dissection causes arterial stenosis, occlusion, and aneurysm, resulting in acute infarction and hemorrhage. Image analysis by such methods as conventional angiography, computed tomography, magnetic resonance imaging, and so on plays an important role in diagnosing cerebral arterial dissection. In this study, we explore the methods and findings involved in the diagnosis of cerebral arterial dissection. PMID:27180630

  12. Primary pulmonary artery sarcoma.

    PubMed

    Jin, Tao; Zhang, Chong; Feng, Zhiying; Ni, Yiming

    2008-08-01

    Primary pulmonary artery sarcoma is an uncommon tumor. We report a case of a 73-year-old male patient with a two-week history of palpitations and shortness of breath, aggravated for two days and was believed to be pulmonary hypertension. Emergency heart ultrasound after admission presented a massive pulmonary embolism in the pulmonary artery. The patient's condition was successfully managed with urgent pulmonary artery embolectomy. The patient demonstrated improvement in hemodynamics after the operation. Histologic and immunohistochemical assays were performed and a diagnosis was made as primary pulmonary artery sarcoma arising from the left pulmonary artery. Resection of the tumor is recommended for the treatment of this rare malignant tumor. The corresponding chemotherapy, follow-up and prognosis are described as well in this case report.

  13. Internal carotid artery occlusion: association with atherosclerotic disease in other arterial beds and vascular risk factors.

    PubMed

    Paraskevas, Kosmas I; Mikhailidis, Dimitri P; Liapis, Christos D

    2007-01-01

    The aim of this article is to investigate the association between internal carotid artery occlusion (ICAO) and the presence of atherosclerotic disease and vascular risk factors. The clinical characteristics and risk factors of 120 patients presenting with ICAO were retrospectively reviewed. All patients (n = 120) had at least 1 of the 4 vascular risk factor (diabetes, smoking, hypercholesterolemia, and hypertension); 2, 3, or all 4 risk factors were present in 14 to 82 of the patients (11.7% to 68.3%), 10 to 39 of the patients (8.3% to 32.5%), and 9 of the patients (7.5%), respectively. A total of 84 patients (70%) with ICAO had disease in at least 1 additional vascular bed (aorta, coronary or lower limb arteries). In addition to ICAO, vascular disease was present in 2 and all 3 of these arterial beds in 42 (35%) and 9 (7.5%) patients, respectively. Furthermore, stenosis or occlusion of the ipsilateral or contralateral vertebral arteries was recorded in 19 of 120 patients (15.8%). Regarding the contralateral carotid artery, 1 patient had bilateral ICAO. One patient had contralateral common carotid artery occlusion, and 1 patient was excluded from the analysis because of surgery to the contralateral carotid artery. Of the remaining 117 patients, 34 (29.0%) had less than 50% contralateral carotid artery stenosis. Thirty-two patients (27.4%) had 50% to 69%, and 51 (43.6%) had 70% to 99% stenosis. Ultrasonographic imaging of the carotid plaque of the contralateral carotid artery revealed that 52 of the 120 arteries (43.3%) were uniformly or predominantly echolucent (types I and II, respectively). Fifty-nine (49.2%) were predominantly or uniformly echogenic (types III and IV), and 9 (7.5%) could not be classified. A similar distribution of echomorphology was observed on the occluded side. ICAO is associated with widespread atherosclerotic disease and a high prevalence of vascular risk factors. Detection of ICAO should prompt the investigation of other arterial beds and

  14. SUPERSTARS III: K-2.

    ERIC Educational Resources Information Center

    North Carolina State Dept. of Public Education, Raleigh.

    SUPERSTARS III is a K-8 program designed as an enrichment opportunity for self-directed learners in mathematics. The basic purpose of SUPERSTARS III is to provide the extra challenge that self-motivated students need in mathematics and to do so in a structured, long-term program that does not impinge on the normal classroom routine or the…

  15. Peripheral pulmonary artery stenosis in three cats

    PubMed Central

    AOKI, Takuma; SUNAHARA, Hiroshi; SUGIMOTO, Keisuke; ITO, Tetsuro; KANAI, Eiichi; FUJII, Yoko

    2014-01-01

    Case 1 involved a 4-month-old intact male Somali cat in which peripheral pulmonary artery stenosis (PPS) was recognized after a cardiac murmur remained following patent ductus arteriosus ligation. Case 2, which involved a 1-year-old neutered male Norwegian Forest cat, and Case 3, which involved a 6-month-old intact female American Curl cat, were referred, because of cardiac murmurs. Grades III to IV/VI systolic heart murmurs were auscultated at the left heart base in all 3 cats. All cases showed bilateral pulmonary artery stenosis, although there were no associated clinical signs. In Cases 1 and 2, the pressure gradient through the stenosis decreased after treatment with atenolol. PMID:25650057

  16. Mesenteric Artery Insufficiency

    PubMed Central

    Coles, John C.; Walker, John B.; Gergely, N. F.; Buttigliero, Jorge

    1963-01-01

    The syndromes of superior mesenteric artery insufficiency are briefly reviewed. Three cases associated with infarction of bowel which were treated with restoration of arterial flow and resection of residual irretrievable bowel are reported. In two patients an embolectomy and in one patient a bypass graft were used to restore arterial continuity. The importance of the recognition and removal of irretrievable bowel at the time of vascular reconstruction is emphasized. Success is not necessarily predicated by the time factor alone, although the importance of early diagnosis and surgical intervention cannot be denied. PMID:14042788

  17. Ruptured visceral artery aneurysms.

    PubMed

    Chiaradia, M; Novelli, L; Deux, J-F; Tacher, V; Mayer, J; You, K; Djabbari, M; Luciani, A; Rahmouni, A; Kobeiter, H

    2015-01-01

    Visceral artery aneurysms are rare but their estimated mortality due to rupture ranges between 25 and 70%. Treatment of visceral artery aneurysm rupture is usually managed by interventional radiology. Specific embolization techniques depend on the location, affected organ, locoregional arterial anatomy, and interventional radiologist skill. The success rate following treatment by interventional radiology is greater than 90%. The main complication is recanalization of the aneurysm, showing the importance of post-therapeutic monitoring, which should preferably be performed using MR imaging. Copyright © 2015 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

  18. Bilateral variant testicular arteries with double renal arteries

    PubMed Central

    2009-01-01

    Background The testicular arteries normally arise from the abdominal aorta. There are reports about the variant origin of these arteries. Accessory renal arteries are also a common finding but their providing origin to testicular arteries is an important observation. The variations described here are unique and provide significant information to surgeons dissecting the abdominal cavity. Case presentation During routine dissection classes of abdominal region of a 60-year-old male cadaver, we observed bilateral variant testicular arteries and double renal arteries. Conclusion Awareness of variations of the testicular arteries such as those presented here becomes important during surgical procedures like varicocele and undescended testes. PMID:19187540

  19. Effect of hypothermic pulmonary artery flushing on capillary filtration coefficient.

    PubMed

    Andrade, R S; Wangensteen, O D; Jo, J K; Tsai, M Y; Bolman, R M

    2000-07-27

    We previously demonstrated that surfactant dilution and inhibition occur immediately after pulmonary artery flushing with hypothermic modified Euro-Collins solution. Consequently, we speculated that increased capillary permeability contributed to these surfactant changes. To test this hypothesis, we evaluated the effects of hypothermic pulmonary artery flushing on the pulmonary capillary filtration coefficient (Kfc), and additionally performed a biochemical analysis of surfactant. We used a murine isolated, perfused lung model to measure the pulmonary capillary filtration coefficient and hemodynamic parameters, to determine the wet to dry weight ratio, and to evaluate surfactant by biochemical analysis of lung lavage fluid. We defined three study groups. In group I (controls), we harvested lungs without hypothermic pulmonary artery flushing, and measured Kfc immediately. In group II (in situ flush), we harvested lungs after hypothermic pulmonary artery flushing with modified Euro-Collins solution, and then measured Kfc. Experiments in groups I and II were designed to evaluate persistent changes in Kfc after pulmonary artery flushing. In group III (ex vivo flush), we flushed lungs ex vivo to evaluate transient changes in Kfc during hypothermic pulmonary artery flushing. Groups I and II did not differ significantly in capillary filtration coefficient and hemodynamics. Group II showed significant alterations on biochemical surfactant analysis and a significant increase in wet-to-dry weight ratio, when compared with group I. In group III, we observed a significant transient increase in capillary filtration coefficient during pulmonary artery flushing. Hypothermic pulmonary artery flushing transiently increases the capillary filtration coefficient, leads to an increase in the wet to dry weight ratio, and induces biochemical surfactant changes. These findings could be explained by the effects of hypothermic modified Euro-Collins solution on pulmonary capillary

  20. Postoperative internal thoracic artery spasm after coronary artery bypass grafting.

    PubMed

    Harskamp, Ralf E; McNeil, Jeffrey D; van Ginkel, Margreet W; Bastos, Renata B; Baisden, Clinton E; Calhoon, John H

    2008-02-01

    Spasm of the left internal thoracic artery in the perioperative period represents a life-threatening complication after coronary artery bypass grafting. We present a case in which graft spasm was treated with the administration of intra-arterial nitroglycerin and verapamil. Although vasospasm is more often seen in radial artery grafts, this case demonstrates that left internal thoracic artery grafts are also prone to spasm.

  1. Anomalous left coronary artery from pulmonary artery with mitral stenosis.

    PubMed

    Das, Mrinalendu; Mahindrakar, Pallavi; Das, Debasis; Behera, Sukanta Kumar; Chowdhury, Saibal Roy; Bandyopadhyay, Biswajit

    2011-08-01

    The usual presentation of anomalous left coronary artery from pulmonary artery is severe left-sided heart failure and mitral valve insufficiency presenting during the first months of life. The manifestations of left heart failure may be masked if pulmonary artery pressure remains high. We believe this is a rarest of rare case of anomalous left coronary artery from pulmonary artery with severe mitral stenosis and pulmonary hypertension in which pulmonary hypertension, along with good collateral circulation helped to preserve left ventricular function.

  2. Pelvic Arterial Anatomy Relevant to Prostatic Artery Embolisation and Proposal for Angiographic Classification

    SciTech Connect

    Assis, André Moreira de Moreira, Airton Mota Paula Rodrigues, Vanessa Cristina de; Harward, Sardis Honoria; Antunes, Alberto Azoubel Srougi, Miguel; Carnevale, Francisco Cesar

    2015-08-15

    PurposeTo describe and categorize the angiographic findings regarding prostatic vascularization, propose an anatomic classification, and discuss its implications for the PAE procedure.MethodsAngiographic findings from 143 PAE procedures were reviewed retrospectively, and the origin of the inferior vesical artery (IVA) was classified into five subtypes as follows: type I: IVA originating from the anterior division of the internal iliac artery (IIA), from a common trunk with the superior vesical artery (SVA); type II: IVA originating from the anterior division of the IIA, inferior to the SVA origin; type III: IVA originating from the obturator artery; type IV: IVA originating from the internal pudendal artery; and type V: less common origins of the IVA. Incidences were calculated by percentage.ResultsTwo hundred eighty-six pelvic sides (n = 286) were analyzed, and 267 (93.3 %) were classified into I–IV types. Among them, the most common origin was type IV (n = 89, 31.1 %), followed by type I (n = 82, 28.7 %), type III (n = 54, 18.9 %), and type II (n = 42, 14.7 %). Type V anatomy was seen in 16 cases (5.6 %). Double vascularization, defined as two independent prostatic branches in one pelvic side, was seen in 23 cases (8.0 %).ConclusionsDespite the large number of possible anatomical variations of male pelvis, four main patterns corresponded to almost 95 % of the cases. Evaluation of anatomy in a systematic fashion, following a standard classification, will make PAE a faster, safer, and more effective procedure.

  3. Peripheral Arterial Disease

    MedlinePlus

    Peripheral arterial disease (PAD) happens when there is a narrowing of the blood vessels outside of your heart. The cause of ... smoking. Other risk factors include older age and diseases like diabetes, high blood cholesterol, high blood pressure, ...

  4. Uterine artery embolization - discharge

    MedlinePlus

    ... your uterus (uterine artery). Small plastic or gelatin particles were injected into the blood vessels that carry blood to the fibroids. These particles block the blood supply to the fibroids. Without ...

  5. Carotid artery disease

    MedlinePlus

    ... a stroke recover most or all of their functions. Others die of the stroke itself or from complications. About half of people ... patients with extracranial carotid and vertebral artery disease: executive summary: ... American Association of Neuroscience Nurses, American Association ...

  6. Peripheral Artery Disease

    MedlinePlus

    ... needed to restore blood flow: Angioplasty : In an angioplasty procedure, an interventional radiologist threads a catheter through a blood vessel to the affected artery and inflates a small balloon to reopen it. In some cases, the insertion ...

  7. Renal arteries (image)

    MedlinePlus

    A renal angiogram is a test used to examine the blood vessels of the kidneys. The test is performed ... main vessel of the pelvis, up to the renal artery that leads into the kidney. Contrast medium ...

  8. Coronary artery spasm

    MedlinePlus

    ... blocker or a long-acting nitrate long-term. Beta-blockers are another type of medicine that is used with other coronary artery problems. However, beta-blockers may make this problem worse. They should be ...

  9. Median artery revisited

    PubMed Central

    RODRÍGUEZ-NIEDENFÜHR, M.; SAÑUDO, J. R.; VÁZQUEZ, T.; NEARN, L.; LOGAN, B.; PARKIN, I.

    1999-01-01

    This study confirms that the median artery may persist in adult life in 2 different patterns, palmar and antebrachial, based on their vascular territory. The palmar type, which represents the embryonic pattern, is large, long and reaches the palm. The antebrachial type, which represents a partial regression of the embryonic artery is slender, short, and terminates before reaching the wrist. These 2 arterial patterns appear with a different incidence. The palmar pattern was studied in the whole sample (120 cadavers) and had an incidence of 20%, being more frequent in females than in males (1.3∶1), occurring unilaterally more often than bilaterally (4∶1) and slightly more frequently on the right than on the left (1.1∶1). The antebrachial pattern was studied in only 79 cadavers and had an incidence of 76%, being more frequent in females than in males (1.6∶1); it was commoner unilaterally than bilaterally (1.5∶1) and was again slightly more prevalent on the right than on the left (1.2∶1). The origin of the median artery was variable in both patterns. The palmar type most frequently arose from the caudal angle between the ulnar artery and its common interosseous trunk (59%). The antebrachial pattern most frequently originated from the anterior interosseous artery (55%). Other origins, for both patterns, were from the ulnar artery or from the common interosseous trunk. The median artery in the antebrachial pattern terminated in the upper third (74%) or in the distal third of the forearm (26%). However, the palmar pattern ended as the 1st, 2nd or 1st and 2nd common digital arteries (65%) or joined the superficial palmar arch (35%). The median artery passed either anterior (67%) or posterior (25%) to the anterior interosseous nerve. It pierced the median nerve in the upper third of the forearm in 41% of cases with the palmar pattern and in none of the antebrachial cases. In 1 case the artery pierced both the anterior interosseous and median nerves. PMID

  10. Internal mammary artery.

    PubMed

    Calafiore, Antonio M; Weltert, Luca; Mauro, Michele Di; Actis-Dato, Guglielmo; Iacò, Angela L; Centofanti, Paolo; Torre, Michele La; Patanè, Francesco

    2005-01-01

    The internal mammary artery (IMA) has been already used in some pioneering experiences since the middle of last century but it became the graft of choice only in the 1980s, after widespread angiographic and clinical demonstration of its superiority over the saphenous vein graft (SVG). The use of both mammary arteries was then explored in order to achieve better long-term results when compared to single IMA and SVG. The IMA can be harvested pedicled or skeletonized and used as an in situ graft or as a source for composite graft (Y-graft, lengthened graft). When the bilateral internal mammary artery (BIMA) is grafted in situ, the left internal mammary artery (LIMA) is generally used for the left descending artery (LAD) and the RIMA for the right coronary artery (RCA), or for the lateral wall, usually going through the transverse sinus. In the case of Y-graft, the left coronary system is more frequently chosen as the target site of revascularization. Our experience shows that: (1) The use of IMA provides better 15-year clinical results when compared to SVG. (2) The use of BIMA in patients younger than 75 years can produce higher 10-year freedom from cardiac-related events than the single one, even in diabetic patients.

  11. Arterial endothelial function in a porcine model of early stage atherosclerotic vascular disease

    PubMed Central

    Turk, James R; Henderson, Kyle K; Vanvickle, Gregory D; Watkins, Justin; Laughlin, M Harold

    2005-01-01

    Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the United States and is projected to become the leading cause of mortality in the world. Atherosclerosis is the most important single factor contributing to this disease burden. In this study, we characterize relationships between endothelial dysfunction and vascular disease in an animal model of diet-induced, early-stage atherosclerotic vascular disease. We tested the hypothesis that hypercholesterolaemia induces vascular disease and impairs endothelium-dependent relaxation (EDR) in conduit arteries of adult male Yucatan pigs. Pigs were fed a normal fat (NF) or high fat cholesterol (HFC) diet for 20–24 weeks. Results indicate that, while the HFC diet did not alter EDR in femoral or brachial arteries, EDR was significantly decreased in both carotid and coronary arteries. Sudanophilic fatty streaks were significantly present in the abdominal aorta and common carotid artery. Histopathology revealed increased intima-media thickness (IMT) and foam cell accumulation in Stary Stage I–III lesions in the abdominal aorta, common carotid artery and femoral arteries. In the coronary arteries, the accumulation of foam cells in Stary Stage I and II lesions resulted in a trend for increased IMT. There was no evidence of vascular disease in the brachial arteries. These results indicate that early stages of CVD (Stary Stage I–III) precede decreases in EDR induced by HFC diet, because femoral arteries exhibited foam cell accumulation and an increased IMT but no change in endothelial function. PMID:16191105

  12. Antithrombin III blood test

    MedlinePlus

    ... AT III) is a protein that helps control blood clotting. A blood test can determine the amount of ... may mean you have an increased risk of blood clotting. This can occur when there is not enough ...

  13. Arterial stump pressure: a determinant of arterial patency?

    PubMed

    Nunley, J A; Goldner, R D; Koman, L A; Gelberman, R; Urbaniak, J R

    1987-03-01

    Twenty-seven patients with acute injuries to the radial or ulnar arteries had arterial repairs using microvascular techniques. No patient had an ischemic hand secondary to his arterial injury. The overall patency rate for all repaired vessels was 56%. For sharp, clean lacerations, the success rate for repairs was 55%. Repairs of acute, sharp lacerations yielded no better results than delayed reconstructions. The average distal end arterial stump pressure for patent arteries was 66% of mean, while for thrombosed vessels it was 76% of mean; this was not a statistically significant difference (p = 0.9). There was no statistical correlation between forearm arterial patency, age, sex, vessel injured, mechanism of injury, time of repair, or clinically measured distal arterial stump pressure. At the present time, it does not appear to be possible to predict arterial patency by measuring arterial stump pressure at the time of definitive repair.

  14. Evolution of complete arterial grafting. For coronary artery disease.

    PubMed Central

    Buxton, B F; Fuller, J A; Tatoulis, J

    1998-01-01

    Arterial grafting for the correction of coronary artery disease preceded the use of saphenous vein grafts, but the overwhelming popularity of the saphenous vein from 1970 to 1985 left the development of arterial grafting dormant. Excellent graft patency results from pedicled internal thoracic artery grafting and continued saphenous vein graft failure prompted our unit to explore complete arterial grafting with internal thoracic artery and radial artery grafts. One thousand and fifty-three patients who received a combination of internal thoracic artery and radial artery grafts were compared with 1,156 patients who received internal thoracic artery and saphenous vein grafts. All patients underwent primary coronary artery bypass surgery between 1995 and 1998. The early mortality and morbidity and the probability of survival at 2 years were similar in both groups of patients. Early graft patency studies of 35 radial artery grafts showed 33 (94%) were patent at a mean of 12 months. Complete arterial grafting using internal thoracic and radial arteries is safe and may provide a long-term benefit. Images PMID:9566058

  15. Case-Control Study of Intra-arterial Verapamil for Intraprostatic Anastomoses to Extraprostatic Arteries in Prostatic Artery Embolization for Benign Prostatic Hypertrophy.

    PubMed

    Yu, Simon Chun Ho; Cho, Carmen; Hung, Esther; Wang, Defeng; Chiu, Peter; Yee, Chi Hang; Ng, Anthony

    2017-08-01

    It is hypothesized that intra-arterial administration of verapamil is a safe and effective way to reverse the flow in intraprostatic anastomoses to extraprostatic arteries without compromising treatment outcomes in prostatic artery embolization (PAE) for benign prostatic hypertrophy (BPH). A prospective study of 62 prostate sides in 31 consecutive patients (median age, 66 y; range, 60-71 y) with symptomatic BPH was undertaken. Median prostate volume was 72.4 mL (range, 48.8-85.8 mL), median International Prostate Symptom Score was 21 (range, 15-23), and median urine peak flow rate was 4 mL/s (range, 2-6 mL/s). The arterial anastomoses were classified as types I-III according to vascular morphology. Treatment safety was assessed in terms of adverse events and complications, and treatment effectiveness was assessed in terms of success rate of angiographic flow reversal. The PAE procedure was successfully completed in all 31 patients (100%). Adverse events in both groups were transient and mild and did not necessitate prolonged hospitalization. There was no clinical evidence of any significant nontarget ischemic complication in either group. Intraprostatic anastomosis was diagnosed in 19 of 31 patients (61.3%) and 22 of 62 prostate sides (35.5%). Success rates of verapamil treatment were 88.9% overall (20 of 22) and 100% (19 of 19) in type II and III anastomoses. There was no difference between the treatment group and the control group in clinical, urologic, and imaging outcomes of PAE. Intra-arterial verapamil treatment was probably safe and effective in causing flow reversal in type II and III intraprostatic anastomoses and in preventing ischemic complications in PAE for BPH without compromising PAE outcomes. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

  16. Blood Flow in Arteries

    NASA Astrophysics Data System (ADS)

    Ku, David N.

    Blood flow in arteries is dominated by unsteady flow phenomena. The cardiovascular system is an internal flow loop with multiple branches in which a complex liquid circulates. A nondimensional frequency parameter, the Womersley number, governs the relationship between the unsteady and viscous forces. Normal arterial flow is laminar with secondary flows generated at curves and branches. The arteries are living organs that can adapt to and change with the varying hemodynamic conditions. In certain circumstances, unusual hemodynamic conditions create an abnormal biological response. Velocity profile skewing can create pockets in which the direction of the wall shear stress oscillates. Atherosclerotic disease tends to be localized in these sites and results in a narrowing of the artery lumena stenosis. The stenosis can cause turbulence and reduce flow by means of viscous head losses and flow choking. Very high shear stresses near the throat of the stenosis can activate platelets and thereby induce thrombosis, which can totally block blood flow to the heart or brain. Detection and quantification of stenosis serve as the basis for surgical intervention. In the future, the study of arterial blood flow will lead to the prediction of individual hemodynamic flows in any patient, the development of diagnostic tools to quantify disease, and the design of devices that mimic or alter blood flow. This field is rich with challenging problems in fluid mechanics involving three-dimensional, pulsatile flows at the edge of turbulence.

  17. Coronary artery imaging in children.

    PubMed

    Goo, Hyun Woo

    2015-01-01

    Coronary artery problems in children usually have a significant impact on both short-term and long-term outcomes. Early and accurate diagnosis, therefore, is crucial but technically challenging due to the small size of the coronary artery, high heart rates, and limited cooperation of children. Coronary artery visibility on CT and MRI in children is considerably improved with recent technical advancements. Consequently, CT and MRI are increasingly used for evaluating various congenital and acquired coronary artery abnormalities in children, such as coronary artery anomalies, aberrant coronary artery anatomy specific to congenital heart disease, Kawasaki disease, Williams syndrome, and cardiac allograft vasculopathy.

  18. Coronary Artery Imaging in Children

    PubMed Central

    2015-01-01

    Coronary artery problems in children usually have a significant impact on both short-term and long-term outcomes. Early and accurate diagnosis, therefore, is crucial but technically challenging due to the small size of the coronary artery, high heart rates, and limited cooperation of children. Coronary artery visibility on CT and MRI in children is considerably improved with recent technical advancements. Consequently, CT and MRI are increasingly used for evaluating various congenital and acquired coronary artery abnormalities in children, such as coronary artery anomalies, aberrant coronary artery anatomy specific to congenital heart disease, Kawasaki disease, Williams syndrome, and cardiac allograft vasculopathy. PMID:25741188

  19. Traumatic Distal Ulnar Artery Thrombosis

    PubMed Central

    Karaarslan, Ahmet A.; Karakaşlı, Ahmet; Mayda, Aslan; Karcı, Tolga; Aycan, Hakan; Kobak, Şenol

    2014-01-01

    This paper is about a posttraumatic distal ulnar artery thrombosis case that has occurred after a single blunt trauma. The ulnar artery thrombosis because of chronic trauma is a frequent condition (hypothenar hammer syndrome) but an ulnar artery thrombosis because of a single direct blunt trauma is rare. Our patient who has been affected by a single blunt trauma to his hand and developed ulnar artery thrombosis has been treated by resection of the thrombosed ulnar artery segment. This report shows that a single blunt trauma can cause distal ulnar artery thrombosis in the hand and it can be treated merely by thrombosed segment resection in suitable cases. PMID:25276455

  20. Type III burst pair

    NASA Astrophysics Data System (ADS)

    Ning, Zongjun; Fu, Qijun; Lu, Quankang

    2000-05-01

    We present a special solar radio burst detected on 5 January 1994 using the multi-channel (50) spectrometer (1.0-2.0 GHz) of the Beijing Astronomical Observatory (BAO). Sadly, the whole event could not be recorded since it had a broader bandwidth than the limit range of the instrument. The important part was obtained, however. The event is composed of a normal drift type III burst on the lower frequency side and a reverse drift type III burst appearing almost simultaneously on the high side. We call the burst type III a burst pair. It is a typical characteristic of two type III bursts that they are morphologically symmetric about some frequency from 1.64 GHz to 1.78 GHz on the dynamic spectra records, which indicates that there are two different electron beams from the same acceleration region travelling simultaneously in opposite directions (upward and downward). A magnetic reconnection mode is a nice interpretation of type III burst pair since the plasma beta β~=0.01 is much less than 1 and the beams have velocity of about 1.07×10^8 cm s^-1 after leaving the reconnection region if we assume that the ambient magnetic field strength is about 100 G.

  1. Type III burst pair.

    NASA Astrophysics Data System (ADS)

    Zongjun, Ning; Fu, Qijun; Quankang, Lu

    2000-05-01

    Presents a special solar radio burst detected on 5 January 1994 using the multi-channel (50) spectrometer (1.0 - 2.0 GHz) of the Beijing Astronomical Observatory. Sadly, the whole event could not be recorded since it had a broader bandwidth than the limit range of the instrument. The important part was obtained, however. The event is composed of a normal drift type III burst on the lower frequency side and a reverse drift type III burst appearing almost simultaneously on the high side. The authors call the burst type III a burst pair. It is a typical characteristic of two type III bursts that they are morphologically symmetric about some frequency from 1.64 GHz to 1.78 GHz on the dynamic spectra records, which indicates that there are two different electron beams from the same acceleration region travelling simultaneously in opposite directions (upward and downward). A magnetic reconnection mode is an interpretation of type III burst pair.

  2. Ruptured jejunal artery aneurysm

    PubMed Central

    Costa, Sílvia; Costa, Alexandre; Pereira, Tiago; Maciel, Jorge

    2013-01-01

    Visceral artery aneurysms (VAAs), unlike aortic aneurysms, are very rare, but are also a potentially lethal vascular disease. Jejunal artery aneurysms only account for less than 3% of VAAs, but have a 30% risk of rupture, with 20% death rate, presenting with only few and vague symptoms. We report the case of a 76-year-old man presenting at the emergency department (ED) with a crampy epigastric pain and vomiting. An ultrasound performed diagnosed free abdominal fluid and immediate CT scan diagnosed jejunal artery aneurysm spontaneously rupturing, followed by hypovolaemic shock. Emergent surgery was undertaken, and aneurysmectomy, followed by partial enterectomy with primary anastomosis were performed, because of segmentary jejunal ischaemia. The patient's recovery was unremarkable. High level of suspicion, rapid diagnosis capability and prompt surgical or endovascular intervention, as well as an effective teamwork in the ED are critical to avoid the devastating consequences of ruptured VAAs. PMID:23771962

  3. Transcatheter Arterial Embolization for Spontaneous Rupture of the Omental Artery

    SciTech Connect

    Matsumoto, Tomohiro; Yamagami, Takuji; Morishita, Hiroyuki; Iida, Shigeharu; Tazoe, Jun; Asai, Shunsuke; Masui, Koji; Ikeda, Jun; Nagata, Akihiro; Sato, Osamu; Nishimura, Tsunehiko

    2011-02-15

    We encountered a rare case of spontaneous rupture of the omental artery. A 25-year-old man without any episode of abdominal trauma or bleeding disorders came to the emergency unit with left upper abdominal pain. Hematoma with extravasation of the greater omentum and a hemoperitoneum was confirmed on abdominal contrast-enhanced computed tomography. Bleeding from the omental artery was suspected based on these findings. Transcatheter arterial embolization was successfully performed after extravasation of the omental artery, which arises from the left gastroepiploic artery, was confirmed on arteriography. Partial ometectomy was performed 10 days after transcatheter arterial embolization, revealing that the hematoma measured 10 cm in diameter in the greater omentum. Pathological examination showed rupture of the branch of an omental artery without abnormal findings, such as an aneurysm or neoplasm. Thus, we diagnosed him with spontaneous rupture of the omental artery. The patient recovered and was discharged from the hospital 10 days after the surgery, with a favorable postoperative course.

  4. Targeting ApoC-III to Reduce Coronary Disease Risk.

    PubMed

    Khetarpal, Sumeet A; Qamar, Arman; Millar, John S; Rader, Daniel J

    2016-09-01

    Triglyceride-rich lipoproteins (TRLs) are causal contributors to the risk of developing coronary artery disease (CAD). Apolipoprotein C-III (apoC-III) is a component of TRLs that elevates plasma triglycerides (TGs) through delaying the lipolysis of TGs and the catabolism of TRL remnants. Recent human genetics approaches have shown that heterozygous loss-of-function mutations in APOC3, the gene encoding apoC-III, lower plasma TGs and protect from CAD. This observation has spawned new interest in therapeutic efforts to target apoC-III. Here, we briefly review both currently available as well as developing therapies for reducing apoC-III levels and function to lower TGs and cardiovascular risk. These therapies include existing options including statins, fibrates, thiazolidinediones, omega-3-fatty acids, and niacin, as well as an antisense oligonucleotide targeting APOC3 currently in clinical development. We review the mechanisms of action by which these drugs reduce apoC-III and the current understanding of how reduction in apoC-III may impact CAD risk.

  5. Splenic artery aneurysm.

    PubMed

    Tcbc-Rj, Rui Antônio Ferreira; Ferreira, Myriam Christina Lopes; Ferreira, Daniel Antônio Lopes; Ferreira, André Gustavo Lopes; Ramos, Flávia Oliveira

    2016-01-01

    Splenic artery aneurysms - the most common visceral artery aneurysms - are found most often in multiparous women and in patients with portal hypertension. Indications for treatment of splenic artery aneurysm or pseudoaneurysm include specific symptoms, female gender and childbearing age, presence of portal hypertension, planned liver transplantation, a pseudoaneurysm of any size, and an aneurysm with a diameter of more than 2.5cm. Historically, the treatment of splenic artery aneurysm has been surgical ligation of the splenic artery, ligation of the aneurysm, or aneurysmectomy with or without splenectomy, depending on the aneurysm location. There are other percutaneous interventional techniques. The authors present a case of a splenic artery aneurysm in a 51-year-old woman, detected incidentally. RESUMO Aneurismas da artéria esplênica - os aneurismas arteriais viscerais mais comuns - são encontrados mais frequentemente em mulheres multíparas e em pacientes com hipertensão portal. As indicações para o seu tratamento incluem sintomas específicos, sexo feminino e idade fértil, presença de hipertensão portal, paciente em fila de transplante hepático, um pseudoaneurisma de qualquer tamanho, e um aneurisma com um diâmetro superior a 2,5cm. Historicamente, o tratamento do aneurisma da artéria esplênica tem sido a ligadura cirúrgica da artéria esplênica, a ligadura do aneurisma ou a aneurismectomia, com ou sem esplenectomia, dependendo do local do aneurisma. Existem outras técnicas intervencionistas percutâneas. Os autores apresentam o caso de um aneurisma de artéria esplênica em uma mulher de 51 anos de idade, diagnosticado incidentalmente.

  6. Increased platelet deposition on atherosclerotic coronary arteries.

    PubMed Central

    van Zanten, G H; de Graaf, S; Slootweg, P J; Heijnen, H F; Connolly, T M; de Groot, P G; Sixma, J J

    1994-01-01

    A ruptured atherosclerotic plaque leads to exposure of deeper layers of the plaque to flowing blood and subsequently to thrombus formation. In contrast to the wealth of data on the occurrence of thrombi, little is known about the reasons why an atherosclerotic plaque is thrombogenic. One of the reasons is the relative inaccessibility of the atherosclerotic plaque. We have circumvented this problem by using 6-microns cryostat cross sections of human coronary arteries. These sections were mounted on coverslips that were exposed to flowing blood in a rectangular perfusion chamber. In normal-appearing arteries, platelet deposition was seen on the luminal side of the intima and on the adventitia. In atherosclerotic arteries, strongly increased platelet deposition was seen on the connective tissue of specific parts of the atherosclerotic plaque. The central lipid core of an advanced plaque was not reactive towards platelets. The results indicate that the atherosclerotic plaque by itself is more thrombogenic than the normal vessel wall. To study the cause of the increased thrombus formation on the atherosclerotic plaque, perfusion studies were combined with immunohistochemical studies. Immunohistochemical studies of adhesive proteins showed enrichment of collagen types I, III, V, and VI, vitronectin, fibronectin, fibrinogen/fibrin, and thrombospondin in the atherosclerotic plaque. Laminin and collagen type IV were not enriched. von Willebrand Factor (vWF) was not present in the plaque. The pattern of increased platelet deposition in serial cross sections corresponded best with areas in which collagen types I and III were enriched, but there were also areas in the plaque where both collagens were enriched but no increased reactivity was seen. Inhibition of platelet adhesion with a large range of antibodies or specific inhibitors showed that vWF from plasma and collagen types I and/or III in the plaque were involved. Fibronectin from plasma and fibronectin, fibrinogen

  7. Idiopathic pulmonary artery aneurysm.

    PubMed

    Kotwica, Tomasz; Szumarska, Joanna; Staniszewska-Marszalek, Edyta; Mazurek, Walentyna; Kosmala, Wojciech

    2009-05-01

    Pulmonary artery aneurysm (PAA) is an uncommon lesion, which may be associated with different etiologies including congenital cardiovascular diseases, systemic vasculitis, connective tissue diseases, infections, and trauma. Idiopathic PAA is sporadically diagnosed by exclusion of concomitant major pathology. We report a case of a 56-year-old female with an idiopathic pulmonary artery dilatation identified fortuitously by echocardiography and confirmed by contrast-enhanced computed tomography. Neither significant pulmonary valve dysfunction nor pulmonary hypertension and other cardiac abnormalities which might contribute to the PAA development were found. Here, we describe echocardiographic and computed tomography findings and review the literature on PAA management.

  8. Pulmonary Artery Sarcoma

    PubMed Central

    Shomaf, Maha; Obeidat, Nathir; Najjar, Saleh

    2014-01-01

    Pulmonary artery sarcomas (PAS) are extremely rare sarcomas of uncertain histogenesis that often mimic pulmonary thromboemboli. This is a report of a 60-year-old female patient who presented with recurrent chest pain and cough. The patient was first diagnosed with pulmonary embolism but she did not improve on anticoagulant therapy. Follow-up imaging studies revealed a mass in the left hilar region extending into the pulmonary trunk and branches of the left pulmonary artery. The tru-cut biopsy revealed an undifferentiated sarcoma. The patient died 10 months after her initial presentation. PMID:26425600

  9. Harvesting the radial artery

    PubMed Central

    Osterday, Robert M.; Brodman, Richard F.

    2013-01-01

    The radial artery (RA) has emerged as an important arterial graft for coronary bypass surgery. With improving five-year patency rates and increasing uptake, great attention has been focused on the optimal conduit harvesting technique. We herein present our approach to RA harvesting. Prerequisites of a successful harvest include adherence to important anatomical landmarks, protection of the sensory innervation to the volar forearm, and meticulous handling of the RA branches. Regardless of the harvesting methodology chosen, adherence to a “no-touch” technique will optimize the patency and durability of the RA conduit. PMID:23977633

  10. Understanding Arteries | Coronary Artery Disease | NIH MedlinePlus the Magazine

    MedlinePlus

    ... this page please turn Javascript on. Feature: Coronary Artery Disease Understanding Arteries Past Issues / Fall 2010 Table of Contents Below: ... the arteries and veins are healthy. A Healthy Artery An artery is a muscular tube. It has ...

  11. HERMES III source characterization

    SciTech Connect

    Radasky, W.A. ); Halbleib, J. ); Nunan, S. )

    1991-01-01

    The Distant Light Program sponsored by the Defense Nuclear Agency (RAEE) is directed toward understanding the response of electronic systems to Source Region EMP (SREMP) and will result in the development of proven system hardening and validation techniques for SREMP. This program relies very strongly on testing in above ground test (AGT) simulators such as the HERMES III gamma ray simulator at Sandia National Laboratories in Albuquerque, New Mexico. This paper describes theoretical and experimental efforts aimed at understanding the gamma ray flux produced by HERMES III in terms of its time dependence, spatial variation and spectrum. As part of this characterization, the calibration of various measuring devices must be considered. This paper describes the progress made in characterizing the HERMES III radiation output through December of 1990.

  12. Fusion Power Demonstration III

    SciTech Connect

    Lee, J.D.

    1985-07-01

    This is the third in the series of reports covering the Fusion Power Demonstration (FPD) design study. This volume considers the FPD-III configuration that incorporates an octopole end plug. As compared with the quadrupole end-plugged designs of FPD-I and FPD-II, this octopole configuration reduces the number of end cell magnets and shortens the minimum ignition length of the central cell. The end-cell plasma length is also reduced, which in turn reduces the size and cost of the end cell magnets and shielding. As a contiuation in the series of documents covering the FPD, this report does not stand alone as a design description of FPD-III. Design details of FPD-III subsystems that do not differ significantly from those of the FPD-II configuration are not duplicated in this report.

  13. Alterations in structure and mechanics of resistance arteries from ouabain-induced hypertensive rats.

    PubMed

    Briones, Ana M; Xavier, Fabiano E; Arribas, Silvia M; González, M Carmen; Rossoni, Luciana V; Alonso, María J; Salaices, Mercedes

    2006-07-01

    We have previously described that chronic administration of ouabain induces hypertension and functional alterations in mesenteric resistance arteries. The aim of this study was to analyze whether ouabain treatment also alters the structural and mechanical properties of mesenteric resistance arteries. Wistar rats were treated for 5 wk with ouabain (8.0 microg/day sc). The vascular structure and mechanics of the third-order branches of the mesenteric artery were assessed with pressure myography and confocal microscopy. Total collagen content was determined by picrosirius red staining, collagen I/III was analyzed by Western blot, and elastin was studied by confocal microscopy. Vascular reactivity was analyzed by wire myography. Internal and external diameters and cross-sectional area were diminished, whereas the wall-to-lumen ratio was increased in arteries from ouabain-treated rats compared with controls. In addition, arteries from ouabain-treated rats were stiffer. Ouabain treatment decreased smooth muscle cell number and increased total and I/III collagens in the vascular wall. However, this treatment did not modify adventitia and media thickness, nuclei morphology, elastin structure, and vascular reactivity to norepinephrine and acetylcholine. The present work shows hypotrophic inward remodeling of mesenteric resistance arteries from ouabain-treated rats that seems to be the consequence of a combination of decreased cell number and impaired distension of the artery, possibly due to a higher stiffness associated with collagen deposition. The narrowing of resistance arteries could play a role in the pathogenesis of hypertension in this model.

  14. Reconstructive surgery for segmental arterial mediolysis involving both the internal carotid artery and visceral arteries.

    PubMed

    Obara, Hideaki; Matsumoto, Kenji; Narimatsu, Yoshiaki; Sugiura, Hitoshi; Kitajima, Masaki; Kakefuda, Toshihiro

    2006-03-01

    Segmental arterial mediolysis (SAM) is a rare, nonatherosclerotic, noninflammatory arteriopathy. A 52-year-old man with sudden hemiparesis of the right side was found to have an aneurysm of the left internal carotid artery and concomitant multiple aneurysms of the extrahepatic, celiac, and superior mesenteric arteries. Reconstructive operations using autologous vein graft were performed to treat the aneurysms. The histopathology analyses of resected arterial and aneurysmal specimens showed characteristics consistent with SAM. To our knowledge, a successfully treated case of SAM affecting both the carotid artery and visceral arteries has not previously been described.

  15. [The ultrasound image characteristics of lower extremities arteries in diabetic foot].

    PubMed

    Wen, Xiao-Rong; Lü, Xia-Fei; Liu, Chun-Cheng; Luo, Yan; Chen, Da-Wei; Wang, Chun; Ran, Xing-Wu

    2012-09-01

    To identify the ultrasound image characteristics of lower limb arteries in diabetic feet. 189 patients with diabetic feet were recruited in this study. 375 lower limbs of the patients were classified into grade I-IV according to their Fontaine classifications and accepted Color Doppler Ultrasound examinations. Of the 375 lower limbs, 210 were classified as level I, 46 as level II, 43 as level III and 76 as level IV. The degree of artery stenosis was categorized into < or = 50% reduction in diameter, 51%-99% reduction in diameter and complete occlusion. The lesion characteristics of common femoral arteries, superficial femoral arteries, popliteal arteries, anterior tibial arteries, posterior tibial arteries, peroneal arteries and dorsalis pedis arteries were analyzed. The ultrasound scores of lower limbs arterial diseases were compared in the patients with different levels of Fontaine classifications. The incidence of plagues in lower extremities arteries was 97.60% (366/375). Most plaques (97.60%, 366/375) were distributed in crus arteries and the majority of plaques (59.47%, 223/375) were serious. The incidence of PAD was 63.73% (239/375). Crus vasculars involvement was more serious. The levels of Fontaine classifications of the lower limb arteries were associated with ultrasound vascular disease severity scores. The higher grade had higher scores. The lower limbs with at least one occlusive blood vessel in the patients with Fontaine grade I reached 30%. The Ultrasound image is an important screening tool for PAD in diabetic feet. It can estimate the type of plaques, the seriousness of artery diseases and the location of lesions. Because up to 30% diabetic feet with Fontaine I classifications have at least one occlusive blood vessel, the clinical manifestations do not provide enough evidence for the diagnosis of PAD.

  16. Peripheral Arterial Disease and Claudication

    MedlinePlus

    ... of fatty deposits inside them. This is called atherosclerosis. If you have PAD, your arms, and more ... also more likely in people who already have atherosclerosis in other arteries, such as the arteries in ...

  17. A rare case report of subscapular artery.

    PubMed

    Khaki, Amir Afshin; Shoja, M A Mohagjel; Khaki, Arash

    2011-01-01

    Axillary artery is one of the most important arteries of the upper limb, which is a continua- tion of the subclavian artery. It begins at the lateral border of the first rib and ends at the inferior border of the teres major where it becomes the brachial artery. Axillary artery has six important branches included: 1) Superior thoracic artery 2) Thoracoacromial artery 3) Lateral thoracic artery 4) Subscapular artery 5) Posterior circumflex humeral artery 6) Anterior circumflex humeral artery. Subscapular artery arises from the third part of axillary artery normally and then divides into cir- cumflex scapular artery that extremely enters the triangular space. The other branch of subscapular artery, the thoracodorsal artery, accompanies thracodorsal nerve to lateral border of scapula and supplies and innervates that region. In this case the subscapular artery was absent in both sides and instead of that the circumflex scapular artery was directly derived from axillary artery and the thoracodorsal artery is separated from circumflex scapular artery as a thin and short branch, too. It seemed that the lateral thoracic artery, which was thicker than its normal condition, supplied the muscles of the lateral part of scapula and the thoracodorsal muscle. Other branches of the axillary artery demonstrated without any abnormally. Since axillary artery has the highest rate of rapture and damage coming after the popliteal artery, knowing the variations is important and essential for surgeons, radiologist and anatomist.

  18. Arterial Chemoradiotherapy for Locally Advanced Tongue Cancer: Analysis of Retrospective Study of Therapeutic Results in 88 Patients

    SciTech Connect

    Fuwa, Nobukazu Kodaira, Takesi; Furutani, Kazuhisa; Tachibana, Hiroyuki; Nakamura, Tatsuya; Nakahara, Rie; Tomoda, Takuya; Inokuti, Haruo; Daimon, Takashi

    2008-11-15

    Purpose: To retrospectively investigate the therapeutic results of arterial injection therapy by way of the superficial temporal artery for 88 cases of Stage III and IV (M0) tongue cancer and to clarify the factors that affected the therapeutic results. Methods and Materials: We administered intra-arterial chemoradiotherapy by continuous infusion of carboplatin in 39 patients between January 1993 and July 2002. Systemic concurrent chemotherapy was given to 19 of these patients. We administered intra-arterial chemoradiotherapy with cisplatin with sodium thiosulfate to 49 patients between October 2002 and December 2006. Concurrent systemic chemotherapy was given to 38 of these patients. Results: The 3-year local control rate was 72% (T2-T3, 80%; and T4, 48%), and the 3-year survival rate was 57% (Stage III, 67%; Stage IV, 43%). On univariate analysis, age, T stage, N stage, overall stage, systemic chemotherapy, difference in intra-arterial chemotherapy, and performance status had a significant effect on survival. On multivariate analysis, N stage, systemic chemotherapy, difference in intra-arterial chemotherapy, and artery selected had a significant effect on survival. Conclusions: The therapeutic results of intra-arterial chemoradiotherapy using the superficial temporal artery were not inferior to the results of surgery. In particular, the results of arterial injection therapy using cisplatin with sodium thiosulfate were excellent, and we believe it will be a new therapy for advanced tongue cancer.

  19. Traumatic Brachial Artery Injuries

    PubMed Central

    Ergunes, Kazim; Yilik, Levent; Ozsoyler, Ibrahim; Kestelli, Mert; Ozbek, Cengiz; Gurbuz, Ali

    2006-01-01

    We performed this retrospective study to analyze our strategies for managing and surgically treating brachial artery injuries. Fifty-seven patients with a total of 58 traumatic brachial artery injuries underwent surgery at our institution, from August 1996 through November 2004. Fifty-four patients were male and 3 were female (age range, 7 to 75 years; mean, 29.4 years). Forty-four of the patients had penetrating injuries (18 had stab wounds; 16, window glass injuries; and 10, industrial accidents), 10 had blunt trauma injuries (traffic accidents), and 3 had gunshot injuries. Fourteen patients (24.6%) had peripheral nerve injury. All patients underwent Doppler ultrasonographic examination. The repair of the 58 arterial injuries involved end-to-end anastomosis for 32 injuries (55.2%), reverse saphenous vein graft interpositional grafts for 18 (31%), and primary repair for 8 (13.8%). Venous continuity was achieved in 11 (84.6%) of 13 patients who had major venous injuries. Nine of the 57 patients (15.8%) required primary fasciotomy. Follow-up showed that 5 of the 14 patients with peripheral nerve injury had apparent disabilities due to nerve injury. One patient underwent amputation. There were no deaths. We believe that good results can be achieved in patients with brachial artery injuries by use of careful physical examination, Doppler ultrasonography, and restoration of viability with vascular repair and dbridement of nonviable tissues. Traumatic neurologic injury frequently leads to disability of the extremities. PMID:16572866

  20. Pancreaticoduodenal arterial aneurysms.

    PubMed Central

    Verta, M J; Dean, R H; Yao, J S; Conn, J; Mehn, W H; Bergan, J J

    1977-01-01

    Experience with four aneurysms of the pancreaticoduodenal artery is reviewed and compared to the reported experience of 19 other cases. In view of the common presentation of such lesions as intra-abdominal hemorrhage preceded by non-specific abdominal pain and other digestive symptoms, it is suggested that angiography perfomed preoperatively or intraoperatively allows definitive diagnosis and leads to specific therapy. PMID:406863

  1. Hepatic Artery Infusion Chemotherapy

    PubMed Central

    Schüller, J.; Kroiss, A.; Dinstl, K.

    1990-01-01

    Hepatic artery chemotherapy was given to 36 patients, using totally implantable devices consisting of a port and external pump. Twenty-seven patients had inoperable liver metastases of colorectal origin. The infusion system was inserted by laparotomy into the hepatic artery via the gastroduodenal artery. There was no operative mortality. Thirteen infusion systems could not be used for chemotherapy due to dislodgement, early death and lack of follow-up. FUdR was infused every two weeks. There were minor local complications like thrombosis of the system and dislodgement of the port. Toxic effects could be managed by reducing the dose. Response to chemotherapy was evaluated by survival, clinical condition, CEA, ultrasound and CT six months after onset of arterial chemotherapy. Ten/twenty-three patients (43%) responded to therapy, eight of them died on the average 19 months after initial chemotherapy. Six patients were non-responders, seven had stable disease. Five/ten patients developed extrahepatic metastases. Mean survival time was 13.1 months, mean interval until relapse 10.6 months. PMID:2149279

  2. Absent or occult pulmonary artery.

    PubMed Central

    Presbitero, P; Bull, C; Haworth, S G; de Leval, M R

    1984-01-01

    Of 12 patients with angiographically absent pulmonary artery, 11 were investigated surgically. The previously occult pulmonary artery was found in 10 patients, in five of whom a vestige of an intrapericardial artery was present and in five the artery was patent only at the hilus, a gap existing between the main pulmonary artery and the hilar vessel, and no artery was found in one. All patients with an intrapericardial artery had right ventricular outflow tract obstruction and a ductus descending vertically from underneath the aortic arch. In those without an intrapericardial vessel the occult artery was on the side opposite the aortic arch, and there was evidence of a ductus coming from the innominate artery on the side of the interruption. The occult pulmonary artery, where identified at operation, was usually joined initially to the systemic circulation. Ultimately, continuity between the hilar and main pulmonary artery may be established surgically. Where no intrapericardial vessel exists, however, a conduit may be required to bridge the gap. It seems advisable to search for the occult artery as early in life as is feasible in the hope that providing a blood supply will ensure development of the vessel and normal lung growth. Images PMID:6743435

  3. Summary of Session III

    SciTech Connect

    Furman, M.A.

    2002-06-19

    This is a summary of the talks presented in Session III ''Simulations of Electron-Cloud Build Up'' of the Mini-Workshop on Electron-Cloud Simulations for Proton and Positron Beams ECLOUD-02, held at CERN, 15-18 April 2002.

  4. CITY III Director's Guide.

    ERIC Educational Resources Information Center

    Envirometrics, Inc., Washington, DC.

    CITY III is a computer-assisted simulation game which allows the participants to make decisions affecting various aspects of the economic, governmental, and social sectors of a simulated urban area. The game director selects one of five possible starting city configurations, may set a number of conditions in the city before the start of play, and…

  5. The Apple III.

    ERIC Educational Resources Information Center

    Ditlea, Steve

    1982-01-01

    Describes and evaluates the features, performance, peripheral devices, available software, and capabilities of the Apple III microcomputer. The computer's operating system, its hardware, and the commercially produced software it accepts are discussed. Specific applications programs for financial planning, accounting, and word processing are…

  6. [Influences of inferior mesenteric artery types and Riolan artery arcade absence on the incidence of anastomotic leakage after laparoscopic resection of rectal cancer].

    PubMed

    Huang, Jun; Zhou, Jiaming; Wan, Yingjie; Lin, Yanghao; Deng, Yanhong; Zhou, Zhiyang; Qiu, Jianping; Wang, Jianping; Huang, Meijin

    2016-10-25

    To evaluate the influences of inferior mesenteric artery (IMA) types and Riolan artery arcade absence on the incidence of anastomotic leakage(AL) after laparoscopic resection of rectal cancer. Clinical data of 116 local advanced rectal cancer patients who underwent laparoscopic resection in The Sixth Affiliated Hospital of Sun Yat-sen University from January 2012 to December 2014 were analyzed retrospectively. IMA and Riolan artery arcade were examined by preoperative computed tomography angiography (CTA) reconstruction. The influences of IMA type, Riolan artery arcade absence and ligation site (high or low) on AL were analyzed by Logistic regression. The proportion of IMA types(I(-IIII() was 57.8%(67/116), 10.3%(12/116), 31.0%(36/116) and 0.9%(1/116), respectively. Riolan artery arcade absence was found in 60.3%(70/116). Eight (6.9%) patients suffered from AL. IMA type III( had significantly higher AL incidence as compared to other IMA types [19.4%(7/36) vs. 1.2%(1/80), P=0.001]. Meanwhile, patients with Riolan artery arcade absence also had significantly higher AL incidence[11.4%(8/70) vs. 0.0%(0/46), P=0.030]. However, the difference in AL incidence between high and Low IMA ligation was not statistically significant [8.0%(7/87) vs. 3.4%(1/29), P=0.531]. Seven of these 8 AL patients were found in IMA type III( with Riolan artery arcade absence and high ligation. Multivariate analysis showed that IMA type III( (P=0.001) and Riolan artery arcade absence (P=0.002) were independent risk factors of AL. IMA type III( with Riolan artery arcade absence increases AL incidence significantly in laparoscopic resection of rectal cancer. IMA type and Riolan aretry arcade absence or not contribute to the selection of IMA ligation site in the operation. For the colorectal cancer patients with IMA type III( and Riolan artery arcade absence, selective low IMA ligation with root lymph node dissection should be recommended.

  7. Cerebral Arterial Fenestrations

    PubMed Central

    Cooke, Daniel L; Stout, Charles E; Kim, Warren T; Kansagra, Akash P; Yu, John Paul; Gu, Amy; Jewell, Nicholas P; Hetts, Steven W; Higashida, Randall T; Dowd, Christopher F; Halbach, Van V

    2014-01-01

    Summary Arterial fenestrations are an anatomic variant with indeterminate significance. Given the controversy surrounding fenestrations we sought their prevalence within our practice along with their association with other cerebrovascular anomalies. We retrospectively reviewed 10,927 patients undergoing digital subtraction angiography between 1992 and 2011. Dictated reports were searched for the terms “fenestration” or “fenestrated” with images reviewed for relevance, yielding 228 unique cases. A Medline database search from February 1964 to January 2013 generated 304 citations, 127 cases of which were selected for analysis. Cerebral arterial fenestrations were identified in 228 patients (2.1%). At least one aneurysm was noted in 60.5% of patients, with an aneurysm arising from the fenestration in 19.6% of patients. Aneurysmal subarachnoid hemorrhage or non-aneurysmal subarachnoid hemorrhage were present in 60.1% and 15.8%, respectively. For the subset of patients with an aneurysm arising directly from a fenestration relative to those patients with an aneurysm not immediately associated with a fenestration, the prevalence of aneurysmal subarachnoid hemorrhage was 66.7% vs. 58.6% (p = 0.58). Fenestrations were more often within the posterior circulation (73.2%) than the anterior circulation (24.6%), though there was no difference in the prevalence of aneurysms within these groups (61.1% vs. 60.7%, p = 1.0). Cerebral arterial fenestrations are an anatomic variant more often manifesting at the anterior communicating arterial complex and basilar artery and with no definite pathological relationship with aneurysms. PMID:24976087

  8. Successful small diameter arterial grafting using cryopreserved allograft arteries.

    PubMed

    Eskew, T D; Ollerenshaw, J D; Philpott, J M; Dennis, K; Dawson, P; Sun, Y S; Chitwood, W R; Lust, R M

    1997-01-01

    Intimal hyperplasia (IH) limits the long-term success of veins as arterial grafts. IH occurs in veins partly as an adaptive process to arterial pressure conditions. The authors have previously reported early success with cryopreserved (CP) saphenous veins as aortocoronary bypass grafts, and they have hypothesized that CP arterial segments were already structurally adapted for arterial conditions. Six femoral arterial segments were harvested from three adult donor dogs, and cryopreserved. The segments were thawed and implanted into six recipient dogs, in end-to-end fashion, as interpositional grafts in the femoral artery. A similar length of native femoral artery was removed from the implant site and grafted in the contralateral femoral artery of the same animal to serve as native autograft-matched controls. Grafts were harvested bilaterally after 2 (n = 3) and 4 weeks (n = 3), perfusion fixed (80 mmHg, 15 min), and analyzed histologically. All grafts were patent at harvest, and flows distal to the grafted segments were not significantly different between grafts within an animal either at implant or subsequent harvest. Although CP arterial grafts still showed slight but significant dilation compared with native autograft, the dilation was much less than seen previously with either CP or native venous segments. No evidence of inflammation or IH was seen in CP arterial grafts. The absence of early IH or inflammation suggests that CP small diameter arteries may perform better than many currently available allograft tissues and synthetic prosthetics.

  9. Spasm in Arterial Grafts in Coronary Artery Bypass Grafting Surgery.

    PubMed

    He, Guo-Wei; Taggart, David P

    2016-03-01

    Spasm of arterial grafts in coronary artery bypass grafting surgery is still a clinical problem, and refractory spasm can occasionally be lethal. Perioperative spasm in bypass grafts and coronary arteries has been reported in 0.43% of all coronary artery bypass grafting surgery, but this may be an underestimate. Spasm can develop not only in the internal mammary artery but more frequently in the right gastroepiploic and radial artery. The mechanism of spasm can involve many pathways, particularly those involving regulation of the intracellular calcium concentration. Endothelial dysfunction also plays a role in spasm. Depending on the clinical scenario, the possibility of spasm during and after coronary artery bypass grafting should be confirmed by angiography. If present, immediate intraluminal injection of vasodilators is often effective, although other procedures such as an intraaortic balloon pump or extracorporeal membrane oxygenation may also become necessary to salvage the patient. Prevention of spasm involves many considerations, and the principles are discussed in this review article.

  10. [Digital subtract arteriographic characteristics of carotid artery, vertebral artery, subclavian artery and renal artery in type 2 diabetic patients with lower extremities peripheral arterial disease].

    PubMed

    Chen, Da-Wei; Lu, Wu-Sheng; Wang, Chun; Jiao, He; Tian, Hao-Ming; Ran, Xing-Wu

    2012-09-01

    To investigate angiographical characteristics of carotid, vertebral, subclavian, and renal arteries in the type 2 diabetic patients with lower extremities peripheral arterial disease (LEPAD). There were 104 type 2 diabetic patients with LEPAD recruited in this study, who received digital subtract arteriography (DSA). Ankle-brachial index (ABI) assessment was also performed in 50 participants. Dependent upon the stenosis degree of vertebral artery, subclavian artery and renal artery measured by DSA, the patients were divided into normal group (stenosis < or = 50%) or pathological group(stenosis > 50% or blocked lesions). The angiographic features of carotid, vertebral, subclavian, and renal arteries were analyzed and the relationship between arterial stenosis and ABI was explored. DSA results of 104 patients showed that the most common lesion in the arteries was plaque. The stenosis degrees of 51%-74% and 75%-99% were most commonly observed in renal artery, with incidence of 22.1% and 5.8%, respectively. Arterial occlusion was most commonly observed in vertebral artery, with incidence of 27.9%. The patients with stenosis or occlusion of arteries had lower ABI (P = 0.000), and the patients with stenosis or occlusion of vertebral and renal arteries also had lower ABI (P = 0.003 and 0.02, respectively), compared with those without stenosis. ABI < 0.9 indicated higher risk of stenosis or occlusion of vertebral and renal arteries (P = 0.008 and 0.047 respectively). Between the patients with subclavian arterial stenosis and those without this artery stenosis, there was no statistical significant difference observed in ABI level. Type 2 diabetic patients with LEPAD can affect multiple arteries, showing plaque formation, multi-segmental stenosis and occlusion of arteries. The patients with ABI < 0.9 have higher risk of multiple arterial stenosis or occlusion lesions.

  11. Anatomical Study of the Fingertip Artery in Tamai Zone I: Clinical Significance in Fingertip Replantation.

    PubMed

    Nam, Yong Seok; Jun, Young Joon; Kim, In-Beom; Cho, Sung Hun; Han, Hyun Ho

    2017-01-01

    Background There are a few previous studies of the vascular anatomy of the fingertips. The aim of this study was to evaluate this anatomy and the distribution of fingertip arteries. Patients and Methods A total of 31 cadaveric hands were used for evaluation of the vascular pattern of the fingertips on X-ray images obtained using a radiopaque material. We analyze the anatomy of the fingertip arteries, and classified it into three types in Tamai zone I. If only one dominant artery branched off from the distal transverse palmar arch, it was classified as type I. If the fingertip had branches of two dominant arteries, it was classified as type II, and if the fingertip had branches of three or more dominant arteries, it was classified as type III. Results The incidence of type I was 27%, that of type II was 28%, and the incidence of type III was 45%, the latter being the most frequent. In addition, we analyzed the pattern in each finger. The frequency of type III decreased from the index finger to the little finger, and the frequencies of types I and II increased from the index finger to the little finger. Conclusion Type III was the most common type in fingers, and its frequency decreased from the index finger to the little finger.

  12. Pacific Barrier Radar III (PACBAR III)

    NASA Astrophysics Data System (ADS)

    Miller, C. D.; Sigler, J. D.

    1983-11-01

    The Pacific Barrier (PACBAR III) C-band radar is being installed at the Western Space and Missile Center to furnish Revolution 0 detection of foreign launches. Previously installed on a tracking ship, the upgraded system will also identify and target space objects, maintain a catalog, and cover maneuvers and decay of space objects. Nominal operation will comprise a search of a predesignated 15 deg azimuth with the capability of detecting a 6 sq m target in a 400 km orbit, track spacecraft in orbits up to 800 km altitude, have a range resolution of about 80 yd, provide realtime payload and rocket body discrimination, and transmit two-way digital message traffic between the Center and NORAD in Cheyenne Mt. Interlaced vertical and horizontal pulses will augment the search and acquisition capabilities, and the antenna will have a 140 deg plunge range. The transmitter will function at 5.4-5.65 GHz, 320 p/sec, with a peak power of 0.8 MW, and the system will have a nonambiguous range of 32,768 nmi.

  13. Pharmacokinetic evaluation of pancreatic arterial infusion chemotherapy after unification of the blood supply in an animal model.

    PubMed

    Tanaka, Toshihiro; Yamamoto, Kiyosei; Sho, Masayuki; Nishiofuku, Hideyuki; Inoue, Masayoshi; Sueyoshi, Satoru; Anai, Hiroshi; Sakaguchi, Hiroshi; Nakajima, Yoshiyuki; Kichikawa, Kimihiko

    2010-01-01

    The purpose of this study was to investigate the potential pharmacokinetic advantage of pancreatic arterial infusion chemotherapy of 5-fluorouracil (5-FU) with temporary unification of the pancreatic blood supply for advanced pancreatic cancer in an animal model. Nine pigs were divided into three groups of three pigs each. 5-FU (20 mg/kg) was infused via jugular vein (group I), celiac artery (group II), and celiac artery with balloon occlusion of the superior mesenteric artery (SMA; group III). At 0, 10, 30, and 60 minutes after drug infusion, the concentrations of 5-FU were measured in plasma and tissues including the liver, pancreatic head, pancreatic uncinate process, and duodenum. Areas under the concentration-time curve (AUCs) were calculated and statistically compared. The temporary unification of the pancreatic blood supply by converting from dual blood supply through the celiac artery and SMA into a single celiac arterial supply was confirmed by dye injection. Mean AUCs in the pancreas head and liver were significantly higher for groups II and III compared with group I (P < .05). In contrast, there were no significant differences in plasma 5-FU concentrations between groups. In addition, the AUC in the pancreatic uncinate process was significantly higher for group III compared with groups I and II (P < .05). Pancreatic arterial infusion chemotherapy allows efficient regional drug delivery into the pancreas and liver. Importantly, the unification of the pancreatic blood supply may be required to induce maximum efficacy of arterial infusion chemotherapy for the tumor in the pancreatic uncinate process.

  14. Arterial versus venous endothelial cells.

    PubMed

    dela Paz, Nathaniel G; D'Amore, Patricia A

    2009-01-01

    Vascular endothelial cells (ECs) form the inner lining of all blood vessels from the largest artery and veins, viz., the aorta and venae cavae, respectively, to the capillaries that connect the arterial and venous systems. Because these two major conducting systems of the cardiovasculature differ functionally, it is not surprising that the physical makeup of arteries and veins, including the ECs that line their lumina, are also distinct. Although few would argue that the local environment contributes to the differences between arteries and veins, recent evidence has shown that the specification of arterial and venous identity is largely genetically determined.

  15. Hyper III on ramp

    NASA Technical Reports Server (NTRS)

    1969-01-01

    The Hyper III was a full-scale lifting-body remotely piloted research vehicle (RPRV) built at what was then the NASA Flight Research Center located at Edwards Air Force Base in Southern California. The Flight Research Center (FRC--as Dryden was named from 1959 until 1976) already had experience with testing small-scale aircraft using model-airplane techniques, but the first true remotely piloted research vehicle was the Hyper III, which flew only once in December 1969. At that time, the Center was engaged in flight research with a variety of reentry shapes called lifting bodies, and there was a desire both to expand the flight research experience with maneuverable reentry vehicles, including a high-performance, variable-geometry craft, and to investigate a remotely piloted flight research technique that made maximum use of a research pilot's skill and experience by placing him 'in the loop' as if he were in the cockpit. (There have been, as yet, no female research pilots assigned to Dryden.) The Hyper III as originally conceived was a stiletto-shaped lifting body that had resulted from a study at NASA's Langley Research Center in Hampton, Virginia. It was one of a number of hypersonic, cross-range reentry vehicles studied at Langley. (Hypersonic means Mach 5--five times the speed of sound--or faster; cross-range means able to fly a considerable distance to the left or right of the initial reentry path.) The FRC added a small, deployable, skewed wing to compensate for the shape's extremely low glide ratio. Shop personnel built the 32-foot-long Hyper III and covered its tubular frame with dacron, aluminum, and fiberglass, for about $6,500. Hyper III employed the same '8-ball' attitude indicator developed for control-room use when flying the X-15, two model-airplane receivers to command the vehicle's hydraulic controls, and a telemetry system (surplus from the X-15 program) to transmit 12 channels of data to the ground not only for display and control but for data

  16. Hyper III on ramp

    NASA Technical Reports Server (NTRS)

    1969-01-01

    The Hyper III was a full-scale lifting-body remotely piloted research vehicle (RPRV) built at what was then the NASA Flight Research Center located at Edwards Air Force Base in Southern California. The Flight Research Center (FRC--as Dryden was named from 1959 until 1976) already had experience with testing small-scale aircraft using model-airplane techniques, but the first true remotely piloted research vehicle was the Hyper III, which flew only once in December 1969. At that time, the Center was engaged in flight research with a variety of reentry shapes called lifting bodies, and there was a desire both to expand the flight research experience with maneuverable reentry vehicles, including a high-performance, variable-geometry craft, and to investigate a remotely piloted flight research technique that made maximum use of a research pilot's skill and experience by placing him 'in the loop' as if he were in the cockpit. (There have been, as yet, no female research pilots assigned to Dryden.) The Hyper III as originally conceived was a stiletto-shaped lifting body that had resulted from a study at NASA's Langley Research Center in Hampton, Virginia. It was one of a number of hypersonic, cross-range reentry vehicles studied at Langley. (Hypersonic means Mach 5--five times the speed of sound--or faster; cross-range means able to fly a considerable distance to the left or right of the initial reentry path.) The FRC added a small, deployable, skewed wing to compensate for the shape's extremely low glide ratio. Shop personnel built the 32-foot-long Hyper III and covered its tubular frame with dacron, aluminum, and fiberglass, for about $6,500. Hyper III employed the same '8-ball' attitude indicator developed for control-room use when flying the X-15, two model-airplane receivers to command the vehicle's hydraulic controls, and a telemetry system (surplus from the X-15 program) to transmit 12 channels of data to the ground not only for display and control but for data

  17. Pediatric nonaortic arterial aneurysms.

    PubMed

    Davis, Frank M; Eliason, Jonathan L; Ganesh, Santhi K; Blatt, Neal B; Stanley, James C; Coleman, Dawn M

    2016-02-01

    Pediatric arterial aneurysms are extremely uncommon. Indications for intervention remain poorly defined and treatments vary. The impetus for this study was to better define the contemporary surgical management of pediatric nonaortic arterial aneurysms. A retrospective analysis was conducted of 41 children with 61 aneurysms who underwent surgical treatment from 1983 to 2015 at the University of Michigan. Arteries affected included: renal (n = 26), femoral (n = 7), iliac (n = 7), superior mesenteric (n = 4), brachial (n = 3), carotid (n = 3), popliteal (n = 3), axillary (n = 2), celiac (n = 2), ulnar (n = 2), common hepatic (n = 1), and temporal (n = 1). Intracranial aneurysms and aortic aneurysms treated during the same time period were not included in this study. Primary outcomes analyzed were postoperative complications, mortality, and freedom from reintervention. The study included 27 boys and 14 girls, with a median age of 9.8 years (range, 2 months-18 years) and a weight of 31.0 kg (range, 3.8-71 kg). Multiple aneurysms existed in 14 children. Obvious factors that contributed to aneurysmal formation included: proximal juxta-aneurysmal stenoses (n = 14), trauma (n = 12), Kawasaki disease (n = 4), Ehlers-Danlos type IV syndrome (n = 1), and infection (n = 1). Preoperative diagnoses were established using arteriography (n = 23), magnetic resonance angiography (n = 6), computed tomographic arteriography (n = 5), or ultrasonography (n = 7), and confirmed during surgery. Indications for surgery included risk of expansion and rupture, potential thrombosis or embolization of aneurysmal thrombus, local soft tissue and nerve compression, and secondary hypertension in the case of renal artery aneurysms. Primary surgical techniques included: aneurysm resection with reanastomsis, reimplantation, or angioplastic closure (n = 16), interposition (n = 10) or bypass grafts (n = 2), ligation (n = 9), plication (n = 8), endovascular occlusion (n = 3), and nephrectomy (n = 4) in

  18. Thromboembolism in pulmonary artery sarcoma.

    PubMed

    Farsad, Mohsen; Pernter, Patrizia; Triani, Antonio; Osele, Luzian; Wiedermann, Christian J

    2009-04-01

    Pulmonary artery sarcoma, although rare, must be considered in the differential diagnosis of pulmonary thromboembolism. Clinically and radiologically, it may imitate pulmonary embolism, making diagnosis difficult and delaying treatment. Patients often have no symptom resolution despite therapeutic anticoagulation. Visualization of filling defects within a pulmonary artery on contrast-enhanced CT cannot reliably differentiate between pulmonary thromboembolism and malignant lesions like leiomyosarcoma. FDG PET-CT offers the potential for identification of malignant lesions. The authors report a case with pulmonary artery thromboembolism due to thrombi formed on a pulmonary artery leiomyosarcoma. Integrated FDG PET-CT showed no FDG-uptake along the major part of the filling defect within the right main pulmonary artery suggesting blood clot and increased uptake along the posterior wall of the right main pulmonary artery and the left lower lobar artery suggesting malignancy.

  19. Familial antithrombin III deficiency in a Malay patient with massive thrombosis.

    PubMed

    Wan Ab Rahman, W S; Abdullah, W Z; Hassan, M N; Hussin, A; Zulkafli, Z; Haron, J

    2017-08-01

    Patients with low antithrombin III (AT III) has increased risk for arteriovenous thromboembolic (TE) disease. We report a 28-year-old Malay lady who presented with spontaneous right calf pain and swelling of one week duration. She was on oral contraceptive pills and had a history of travelling for a long distance prior to the presentation. Her brother who was diagnosed with AT III deficiency had arterial thrombosis at a young age. She was diagnosed as having right popliteal vein thrombosis by ultrasound and treated with subcutaneous fondaparinux. While on treatment, she developed massive bilateral pulmonary embolism (PE). Thrombophilia study showed reduced AT III activity (38μl/dl) and normal results for protein C, protein S, activated protein C resistance and lupus anticoagulant assays. This patient has heterozygous AT III deficiency added with significant acquired factors responsible for the TE events. Those with AT III deficiency may have resistance to heparin therapy and require higher doses of heparin.

  20. Arterial conduits for hepatic artery revascularisation in adult liver transplantation.

    PubMed

    Muralidharan, Vijayaragavan; Imber, Charles; Leelaudomlipi, Surasak; Gunson, Bridget K; Buckels, John A C; Mirza, Darius F; Mayer, A David; Bramhall, Simon R

    2004-05-01

    Arterial complications after orthotopic liver transplantation (OLT), including hepatic artery thrombosis (HAT), are important causes of early graft failure. The use of an arterial conduit is an accepted alternative to the utilisation of native recipient hepatic artery for specific indications. This study aims to determine the efficacy of arterial conduits and the outcome in OLT. We retrospectively reviewed 1,575 cadaveric adult OLTs and identified those in which an arterial conduit was used for hepatic revascularisation. Data on the primary disease, indication for using arterial conduit, type of vascular graft, operative technique and outcome were obtained. Thirty-six (2.3%) patients underwent OLT in which arterial conduits were used for hepatic artery (HA) revascularisation. Six of these were performed on the primary transplant, while the rest (n=30) were performed in patients undergoing re-transplantation, including six who had developed hepatic artery aneurysms. The incidence of arterial conduits was 0.4% (6/1,426 cases) in all primary OLTs and 20.1% (30/149 cases) in all re-transplants. Twenty-nine procedures utilised iliac artery grafts from the same donor as the liver, six used iliac artery grafts from a different donor, and a single patient underwent a polytetrafluoroethylene (PTFE) graft. Two techniques were used: infra-renal aorto-hepatic artery conduit and interposition between the donor and recipient native HAs, or branches of the HAs. The 30-day mortality rate for operations using an arterial conduit was 30.6%. Three conduits thrombosed at 9, 25 and 155 months, respectively, but one liver graft survived without re-transplantation. The arterial conduits had 1- and 5-year patency rates of 88.5% and 80.8%. The 1- and 5-year patient survival rates were 66.7% and 44%. We can thus conclude that an arterial conduit is a viable alternative option for hepatic revascularisation in both primary and re-transplantation. Despite a lower patency rate than that of

  1. Evaluation of Anomalous Coronary Arteries from the Pulmonary Artery

    PubMed Central

    Guzeltas, Alper; Ozturk, Erkut; Tanidir, Ibrahim Cansaran; Kasar, Taner; Haydin, Sertac

    2017-01-01

    Objective This study evaluated clinical and diagnostic findings, treatment methods, and follow-up of cases of anomalous coronary arteries from the pulmonary artery. Methods The study included all cases diagnosed with anomalous coronary arteries from the pulmonary artery between January 2012 and January 2016. Data from patients’ demographic characteristics, electrocardiography, echocardiography, angiographic findings, operation, intensive care unit stay, and follow-up were evaluated. Results The study included 12 patients (8 male, 4 female), 10 with anomalous left coronary artery from the pulmonary artery (ALCAPA) and 2 with anomalous right coronary artery from the pulmonary artery (ARCAPA). Median age at diagnosis was 4 months (range, 1 month - 10 years old) and median weight was 5.5 kg (range, 3-30 kg). The most common complaints were murmur (n=7) and respiratory distress (n=5). In 4 cases, the initial diagnosis was dilated cardiomyopathy. Electrocardiographs were pathologic in all cases. Echocardiographic examination revealed medium to severe mitral valve regurgitation in 4 cases and reduced (< 40%) ejection fraction in 6 patients. Of the 12 patients, 8 underwent direct implantation of the left coronary artery into the aorta, 2 underwent implantation of the right coronary artery into the aorta, and the remaining 2 underwent a Takeuchi procedure. There were no early mortalities. Median hospital stay was 20 days (range, 5-35 days). Median follow-up duration was 18 months (range, 5-36 months), and no cases required further surgery during follow-up. Conclusions Anomalous coronary arteries from the pulmonary artery can be successfully repaired providing there is early diagnosis and effective, appropriate intensive care unit follow-up. Therefore, coronary artery origins should be evaluated carefully, especially in cases with dilated cardiomyopathies.

  2. Transcatheter Embolization of a Renal Artery Aneurysm Using Ethylene Vinyl Alcohol Copolymer

    SciTech Connect

    Rautio, Riitta Haapanen, Arto

    2007-04-15

    Our aim was to treat a clinically silent renal artery aneurysm. The patient was a 76-year-old man with elevated prostate-specific antigen and prostata biopsies with a gradus II-III adenocarcinoma who was incidentally found to have an aneurysm in his right renal artery. We performed a successful transcatheter embolization of the aneurysm using ethylene vinyl alcohol copolymer (Onyx). To avoid migration of the liquid material into the parent artery, a balloon was inflated in the orifice of the neck of the aneurysm while the liquid was injected. Five-month follow-up computed tomography (CT) imaging confirmed total occlusion of the aneurysm.

  3. Selexipag in the treatment of pulmonary arterial hypertension: design, development, and therapy.

    PubMed

    Hardin, Elizabeth Ashley; Chin, Kelly M

    2016-01-01

    Pulmonary arterial hypertension is characterized by abnormalities in the small pulmonary arteries including increased vasoconstriction, vascular remodeling, proliferation of smooth muscle cells, and in situ thrombosis. Selexipag, a novel, oral prostacyclin receptor agonist, has been shown to improve hemodynamics in a phase II clinical trial and reduce clinical worsening in a large phase III clinical trial involving patients with pulmonary arterial hypertension. In this paper, we describe the prostacyclin signaling pathway, currently available oral prostanoid medications, and the development and clinical use of selexipag.

  4. Selexipag in the treatment of pulmonary arterial hypertension: design, development, and therapy

    PubMed Central

    Hardin, Elizabeth Ashley; Chin, Kelly M

    2016-01-01

    Pulmonary arterial hypertension is characterized by abnormalities in the small pulmonary arteries including increased vasoconstriction, vascular remodeling, proliferation of smooth muscle cells, and in situ thrombosis. Selexipag, a novel, oral prostacyclin receptor agonist, has been shown to improve hemodynamics in a phase II clinical trial and reduce clinical worsening in a large phase III clinical trial involving patients with pulmonary arterial hypertension. In this paper, we describe the prostacyclin signaling pathway, currently available oral prostanoid medications, and the development and clinical use of selexipag. PMID:27895464

  5. Caliber-Persistent Artery

    PubMed Central

    Costa, Sabrina Araújo Pinho; Ruiz, Marcelo Martinson; Kaba, Shajadi Pardo; Florezi, Giovanna Piacenza; Lemos Júnior, Celso Augusto; Witzel, Andréa Lusvarghi

    2015-01-01

    Caliber-persistent artery (CPLA) of the lip is a common vascular anomaly in which a main arterial branch extends to the surface of the mucous tissue with no reduction in its diameter. It usually manifests as pulsatile papule, is easily misdiagnosed, and is observed more frequently among older people, suggesting that its development may involve a degenerative process associated with aging; CPLA is also characterized by the loss of tone of the adjacent supporting connective tissue. Although the diagnosis is clinical, high-resolution Doppler ultrasound is a useful noninvasive tool for evaluating the lesion. This report describes the case of a 58-year-old male patient who complained of a lesion of the lower lip with bleeding and recurrent ulceration. The patient was successfully treated in our hospital after a diagnosis of CPLA and is currently undergoing a clinical outpatient follow-up with no complaints. PMID:26448884

  6. Coronary artery fistulas

    PubMed Central

    Said, S.A.M.; Thiadens, A.A.H.J.; Fieren, M.J.C.H.; Meijboom, E.J.; van der Werf, T.; Bennink, G.B.W.E.

    2002-01-01

    The aetiology of congenital coronary artery fistulas remains a challenging issue. Coronary arteries with an anatomically normal origin may, for obscure reasons, terminate abnormally and communicate with different single or multiple cardiac chambers or great vessels. When this occurs, the angiographic morphological appearance may vary greatly from discrete channels to plexiform network of vessels. Coronary arteriovenous fistulas (CAVFs) have neither specific signs nor pathognomonic symptoms; the spectrum of clinical features varies considerably. The clinical presentation of symptomatic cases can include angina pectoris, myocardial infarction, fatigue, dyspnoea, CHF, SBE, ventricular and supraventricular tachyarrhythmias or even sudden cardiac death. CAVFs may, however, be a coincidental finding during diagnostic coronary angiography (CAG). CAG is considered the gold standard for diagnosing and delineating the morphological anatomy and pathway of CAVFs. There are various tailored therapeutic modalities for the wide spectrum of clinical manifestations of CAVFs, including conservative pharmacological strategy, percutaneous transluminal embolisation and surgical ligation. ImagesFigure 1Figure 2Figure 3Figure 4 PMID:25696067

  7. Segmental arterial mediolysis.

    PubMed

    Chao, Christine P

    2009-09-01

    Segmental arterial mediolysis (SAM) is a nonatherosclerotic, noninflammatory arteriopathy, which is characterized by dissecting aneurysms resulting from lysis of the outer media of the arterial wall. The most common presentation is abdominal pain and hemorrhage in the elderly. Computed tomography (CT) and angiography imaging findings overlap with various vasculitides and include segmental changes of aneurysm and stenosis. A key distinguishing feature is the presence of dissections, the principle morphologic expression of SAM. Differentiation and exclusion of an inflammatory arteritis is crucial in appropriate management, as immunosuppressants generally used for treatment of vasculitis may be ineffective or even worsen the vasculopathy. Although the disease can be self-limiting without treatment or with conservative medical therapy, the acute process carries a 50% mortality rate and may necessitate urgent surgical and/or endovascular therapy. Prompt recognition and diagnosis are therefore of utmost importance in appropriate management of this rare entity.

  8. Renal Artery Embolization

    PubMed Central

    Sauk, Steven; Zuckerman, Darryl A.

    2011-01-01

    Renal artery embolization (RAE) is an effective minimally invasive alternative procedure for the treatment of a variety of conditions. Since the 1970s when RAE was first developed, technical advances and growing experience have expanded the indications to not only include treatment of conditions such as symptomatic hematuria and palliation for metastatic renal cancer, but also preoperative infarction of renal tumors, treatment of angiomyolipomas, vascular malformations, medical renal disease, and complications following renal transplantation. With the drastically improved morbidity associated with this technique in part due to the introduction of more precise embolic agents and smaller delivery catheters, RAE continues to gain popularity for various urologic conditions. The indications and techniques for renal artery embolization are reviewed in the following sections. PMID:23204638

  9. Renal Artery Stent Outcomes

    PubMed Central

    Murphy, Timothy P.; Cooper, Christopher J.; Matsumoto, Alan H.; Cutlip, Donald E.; Pencina, Karol M.; Jamerson, Kenneth; Tuttle, Katherine R.; Shapiro, Joseph I.; D’Agostino, Ralph; Massaro, Joseph; Henrich, William; Dworkin, Lance D.

    2016-01-01

    BACKGROUND Multiple randomized clinical trials comparing renal artery stent placement plus medical therapy with medical therapy alone have not shown any benefit of stent placement. However, debate continues whether patients with extreme pressure gradients, stenosis severity, or baseline blood pressure benefit from stent revascularization. OBJECTIVES The study sought to test the hypothesis that pressure gradients, stenosis severity, and/or baseline blood pressure affects outcomes after renal artery stent placement. METHODS Using data from 947 patients with a history of hypertension or chronic kidney disease from the largest randomized trial of renal artery stent placement, the CORAL (Cardiovascular Outcomes in Renal Atherosclerotic Lesions) study, we performed exploratory analyses to determine if subsets of patients experienced better outcomes after stent placement than the overall cohort. We examined baseline stenosis severity, systolic blood pressure, and translesion pressure gradient (peak systolic and mean) and performed interaction tests and Cox proportional hazards analyses for the occurrence of the primary endpoint through all follow-up, to examine the effect of these variables on outcomes by treatment group. RESULTS There were no statistically significant differences in outcomes based on the examined variables nor were there any consistent nonsignificant trends. CONCLUSIONS Based on data from the CORAL randomized trial, there is no evidence of a significant treatment effect of the renal artery stent procedure compared with medical therapy alone based on stenosis severity, level of systolic blood pressure elevation, or according to the magnitude of the transstenotic pressure gradient. (Benefits of Medical Therapy Plus Stenting for Renal Atherosclerotic Lesions [CORAL]; NCT00081731) PMID:26653621

  10. Coronary artery disease.

    PubMed

    Hanson, Michele A; Fareed, Mohammad Tariq; Argenio, Sandra L; Agunwamba, Akochi O; Hanson, Teresa R

    2013-03-01

    Coronary artery disease (CAD) is the leading cause of death worldwide. There are several presenting clinical syndromes, including sudden cardiac death. Risk factor analysis can help the primary care provider identify patients who may need more extensive evaluation or treatment. Treatment may be medical or surgical and depends on the individual patient's comorbidities and preferences. In the future, growth of new blood vessels or cardiac cells may aid in the treatment of CAD. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. Sphingosine-1-Phosphate Signaling Regulates Myogenic Responsiveness in Human Resistance Arteries

    PubMed Central

    Slack, Daniel L.; Burnstein, Marcus J.; Errett, Lee; Bonneau, Daniel; Latter, David; Rotstein, Ori D.; Bolz, Steffen-Sebastian; Lidington, Darcy; Voigtlaender-Bolz, Julia

    2015-01-01

    We recently identified sphingosine-1-phosphate (S1P) signaling and the cystic fibrosis transmembrane conductance regulator (CFTR) as prominent regulators of myogenic responsiveness in rodent resistance arteries. However, since rodent models frequently exhibit limitations with respect to human applicability, translation is necessary to validate the relevance of this signaling network for clinical application. We therefore investigated the significance of these regulatory elements in human mesenteric and skeletal muscle resistance arteries. Mesenteric and skeletal muscle resistance arteries were isolated from patient tissue specimens collected during colonic or cardiac bypass surgery. Pressure myography assessments confirmed endothelial integrity, as well as stable phenylephrine and myogenic responses. Both human mesenteric and skeletal muscle resistance arteries (i) express critical S1P signaling elements, (ii) constrict in response to S1P and (iii) lose myogenic responsiveness following S1P receptor antagonism (JTE013). However, while human mesenteric arteries express CFTR, human skeletal muscle resistance arteries do not express detectable levels of CFTR protein. Consequently, modulating CFTR activity enhances myogenic responsiveness only in human mesenteric resistance arteries. We conclude that human mesenteric and skeletal muscle resistance arteries are a reliable and consistent model for translational studies. We demonstrate that the core elements of an S1P-dependent signaling network translate to human mesenteric resistance arteries. Clear species and vascular bed variations are evident, reinforcing the critical need for further translational study. PMID:26367262

  12. Peripheral arterial disease

    PubMed Central

    2011-01-01

    Introduction Up to 20% of adults aged over 55 years have detectable peripheral arterial disease of the legs, but this may cause symptoms of intermittent claudication in only a small proportion of affected people. The main risk factors are smoking and diabetes mellitus, but other risk factors for cardiovascular disease are also associated with peripheral arterial disease. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for people with chronic peripheral arterial disease? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2010. Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review. We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 70 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review, we present information relating to the effectiveness and safety of the following interventions: antiplatelet agents, bypass surgery, cilostazol, exercise, pentoxifylline, percutaneous transluminal angioplasty (PTA), prostaglandins, smoking cessation, and statins. PMID:21477401

  13. Peripheral arterial disease

    PubMed Central

    2009-01-01

    Introduction Up to 20% of adults aged over 55 years have detectable peripheral arterial disease of the legs, but this may cause symptoms of intermittent claudication in only a small proportion of affected people. The main risk factors are smoking and diabetes mellitus, but other risk factors for cardiovascular disease are also associated with peripheral arterial disease. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for people with chronic peripheral arterial disease? We searched: Medline, Embase, The Cochrane Library, and other important databases up to March 2009. (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 59 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: antiplatelet agents; bypass surgery; cilostazol; exercise; pentoxifylline; percutaneous transluminal angioplasty (PTA); prostaglandins; smoking cessation; and statins. PMID:19454099

  14. LATENT LIFE OF ARTERIES.

    PubMed

    Carrel, A

    1910-07-23

    When a segment of artery, killed by heat, formalin or glycerin is transplanted, it undergoes a rapid degeneration. Its muscle fibers disappear while the tissue of the host reacts by building a new wall of connective tissue. When the transplanted vessel has been preserved in a condition of latent life, no degeneration of the wall occurs, or the wall undergoes only partial degeneration. The muscle fibers can keep their normal appearance, even for a long time after the operation. It is, therefore, demonstrated that arteries can be preserved outside of the body in a condition of unmanifested actual life. The best method of preservation consists of placing the vessels, immersed in vaselin, in an ice box, the temperature of which is slightly above the freezing point. From a surgical standpoint, the transplantation of preserved vessels can be used with some safety. When the arteries were kept in defibrinated blood or vaselin and in cold storage, the proportion of positive results was 75 and 80 per cent., and this can probably be increased.

  15. [Innominate artery war injury].

    PubMed

    Ilic, Radoje; Kronja, Goran; Markovic, Zoran; Tisma, Svetislav

    2005-04-01

    A case is reported of successfully surgically treated explosive war injury to the innominate artery. A 26-year-old soldier was injured in combat by a fragment of mortar shell. In the field hospital, the wound gauze packing was applied, followed by orotracheal intubation and thoracic drainage. The soldier was admitted to MMA six hours later. Physical examination, on admission, revealed huge swelling of the neck, the absence of pulse in the right arm and the right common carotid artery. Chest x-ray revealed hemopneumothorax of the right side and the foreign metal body in the projection of the right sternoclavicular joint. Due to the suspicion of large vessel injury, a median sternotomy was immediately performed. Surgery revealed disrupted bifurcation of the right innominate artery, so the ligation was performed. Aortography was performed postoperatively, followed by the reconstruction of innominate bifurcation with synthetic grafts. Control aortography showed good graft patency, and the patient was discharged from the hospital in good general condition with palpable pulses and mild anisocoria as a sole neurological sequela. A rare and life-threatening injury was successfully managed, mainly due to the rational treatment carried out in the field hospital that helped the injured to survive and arrive to the institution capable of performing the most sophisticated diagnostic and therapeutic procedures.

  16. Segmental arterial mediolysis.

    PubMed

    Pillai, Anil Kumar; Iqbal, Shams I; Liu, Raymond W; Rachamreddy, Niranjan; Kalva, Sanjeeva P

    2014-06-01

    Segmental arterial mediolysis (SAM) is an uncommon, nonatherosclerotic, noninflammatory, large- to medium-sized arteriopathy first described in 1976. It is characterized histologically by vacuolization and lysis of the outer arterial media leading to dissecting aneurysms and vessel rupture presenting clinically with self-limiting abdominal pain or catastrophic hemorrhages in the abdomen. Patients of all ages are affected with a greater incidence at the fifth and sixth decades. There is a slight male predominance. Imaging findings overlap with inflammatory vasculitis, collagen vascular disease, and fibromuscular dysplasia. The presence of segmental dissections involving the celiac, mesenteric, and/or renal arteries is the key distinguishing features of SAM. Inflammatory markers, genetic tests for collagen vascular disorders, and hypercoagulable studies are negative. Anti-inflammatory agents and immunosuppressants are not effective. A mortality rate of 50 % has been attributed to the acute presentation with aneurysmal rupture necessitating urgent surgical or endovascular treatments; in the absence of the acute presentation, SAM is a self-limiting disease and is treated conservatively. There are no established guidelines on medical therapy, although optimal control of blood pressure is considered the main cornerstone of medical therapy. The long-term prognosis is not known.

  17. The Mark III VLBI System

    NASA Technical Reports Server (NTRS)

    Rogers, A. E. E.; Whitney, A. R.; Levine, J. I.; Nesman, E. F.; Webber, J. C.; Hinteregger, H. F.

    1988-01-01

    Geodetic measurements have errors in centimeter range. Collection of three reports describes both equipment and results of some measurements taken with Mark III very-long-baseline interferometry (VLBI) system. Has demonstrated high accuracy over short baselines, where phase-delay measurements used. Advanced hardware, called Mark III A, developed to improve system performance and efficiency. Original Mark III hardware and III A subsystem upgrades developed as part of NASA Crustal Dynamics Project at Haystack Observatory.

  18. Lower extremity and carotid artery disease in COPD

    PubMed Central

    Linnhoff, Fabian; van Essen, Fabian; Pingel, Simon; Schaefer, Christian Alexander; Schahab, Nadjib; Fimmers, Rolf; Nickenig, Georg; Skowasch, Dirk

    2016-01-01

    In view of their common chronic inflammatory process, we sought to determine the linkage between peripheral artery disease and chronic obstructive pulmonary disease (COPD). 107 COPD patients (mean±sd age 64.6±10.4 years, 52.2% male) and 22 control smokers without previously diagnosed peripheral artery disease underwent standardised angiological examination for lower extremity artery disease (LEAD) and carotid artery disease. LEAD was significantly more prevalent in COPD patients than in controls (80.4% versus 54.5%, p=0.002). Among COPD patients, 57.0%, 12.2%, 10.3% and 0.9% were found to be in Fontaine stages I, IIA, IIB and III, respectively. As with carotid artery disease, its frequency increased from 36.4% in controls to 58.9% in COPD patients (p=0.003). Carotid plaque burden, LEAD Fontaine degrees as well as pulse wave index and ankle–brachial index manifested significant impairment over percentage predicted forced expiratory volume in 1 s (FEV1 % pred) (p=0.02, p<0.001, p=0.01 and p<0.001, respectively). Multivariate analysis revealed that COPD Global Initiative for Chronic Obstructive Lung Disease status was the strongest independent predictor for the presence of plaque in lower extremity arteries (odds ratio 1.63, 95% CI 1.19–2.25, p=0.003) and carotids (odds ratio 1.66, 95% CI 1.14–2.44, p=0.009). As compared with control smokers, peripheral artery disease is diagnosed in a sizeable proportion of COPD patients and exhibits significant distributive differences over FEV1 % pred that exceed the susceptibility conferred by common cardiovascular stressors. PMID:28053972

  19. Lower extremity and carotid artery disease in COPD.

    PubMed

    Pizarro, Carmen; Linnhoff, Fabian; van Essen, Fabian; Pingel, Simon; Schaefer, Christian Alexander; Schahab, Nadjib; Fimmers, Rolf; Nickenig, Georg; Skowasch, Dirk

    2016-10-01

    In view of their common chronic inflammatory process, we sought to determine the linkage between peripheral artery disease and chronic obstructive pulmonary disease (COPD). 107 COPD patients (mean±sd age 64.6±10.4 years, 52.2% male) and 22 control smokers without previously diagnosed peripheral artery disease underwent standardised angiological examination for lower extremity artery disease (LEAD) and carotid artery disease. LEAD was significantly more prevalent in COPD patients than in controls (80.4% versus 54.5%, p=0.002). Among COPD patients, 57.0%, 12.2%, 10.3% and 0.9% were found to be in Fontaine stages I, IIA, IIB and III, respectively. As with carotid artery disease, its frequency increased from 36.4% in controls to 58.9% in COPD patients (p=0.003). Carotid plaque burden, LEAD Fontaine degrees as well as pulse wave index and ankle-brachial index manifested significant impairment over percentage predicted forced expiratory volume in 1 s (FEV1 % pred) (p=0.02, p<0.001, p=0.01 and p<0.001, respectively). Multivariate analysis revealed that COPD Global Initiative for Chronic Obstructive Lung Disease status was the strongest independent predictor for the presence of plaque in lower extremity arteries (odds ratio 1.63, 95% CI 1.19-2.25, p=0.003) and carotids (odds ratio 1.66, 95% CI 1.14-2.44, p=0.009). As compared with control smokers, peripheral artery disease is diagnosed in a sizeable proportion of COPD patients and exhibits significant distributive differences over FEV1 % pred that exceed the susceptibility conferred by common cardiovascular stressors.

  20. Residual strains in conduit arteries.

    PubMed

    Rachev, A; Greenwald, S E

    2003-05-01

    Residual strains and stresses are those that exist in a body when all external loads are removed. Residual strains in arteries can be characterized by the opening angle of the sector-like cross-section which arises when an unloaded ring segment is radially cut. A review of experimental methods for measuring residual strains and the main results about the variation of the opening angle with arterial localization, age, smooth muscle activity, mechanical environment and certain vascular pathologies are presented and discussed. It is shown that, in addition to their well-established ability to homogenize the stress field in the arterial wall, residual strains make arteries more compliant and thereby improve their performance as elastic reservoirs and ensure more effective local control of the arterial lumen by smooth muscle cells. Finally, evidence that, in some cases, residual strains remain in arteries even after they have been cut radially is discussed.

  1. Middle cerebral artery alterations in a rat chronic hypoperfusion model

    PubMed Central

    Márquez-Martín, Ana; Jiménez-Altayó, Francesc; Dantas, Ana P.; Caracuel, Laura; Planas, Anna M.

    2012-01-01

    Chronic cerebral hypoperfusion (CHP) induces microvascular changes that could contribute to the progression of vascular cognitive impairment and dementia in the aging brain. This study aimed to analyze the effects of CHP on structural, mechanical, and myogenic properties of the middle cerebral artery (MCA) after bilateral common carotid artery occlusion (BCCAO) in adult male Wistar rats. Sham animals underwent a similar surgical procedure without carotid artery (CA) ligation. After 15 days of occlusion, MCA and CA were dissected and MCA structural, mechanical, and myogenic properties were assessed by pressure myography. Collagen I/III expression was determined by immunofluorescence in MCA and CA and by Western blot in CA. mRNA levels for 1A1, 1A2, and 3A1 collagen subunits were quantified by quantitative real-time PCR in CA. Matrix metalloproteinase (MMP-1, MMP-2, MMP-9, and MMP-13) and hypoxia-inducible factor-1α (HIF-1α) protein expression were determined in CA by Western blot. BCCAO diminished cross-sectional area, wall thickness, and wall-to-lumen ratio. Nevertheless, whereas wall stress was increased, stiffness was not modified and myogenic response was diminished. Hypoperfusion triggered HIF-1α expression. Collagen I/III protein expression diminished in MCA and CA after BCCAO, despite increased mRNA levels for 1A1 and 3A1 collagen subunits. Therefore, the reduced collagen expression might be due to proteolytic degradation, since the expression of MMP-1 and MMP-9 increased in the CA. These data suggest that BCCAO induces hypotrophic remodeling by a mechanism that involves a reduction of collagen I/III in association with increased MMP-1 and MMP-9 and that decreases myogenic tone in major arteries supplying the brain. PMID:22096118

  2. Noninvasive assessment of arterial compliance of human cerebral arteries with short inversion time arterial spin labeling

    PubMed Central

    Warnert, Esther AH; Murphy, Kevin; Hall, Judith E; Wise, Richard G

    2015-01-01

    A noninvasive method of assessing cerebral arterial compliance (AC) is introduced in which arterial spin labeling (ASL) is used to measure changes in arterial blood volume (aBV) occurring within the cardiac cycle. Short inversion time pulsed ASL (PASL) was performed in healthy volunteers with inversion times ranging from 250 to 850 ms. A model of the arterial input function was used to obtain the cerebral aBV. Results indicate that aBV depends on the cardiac phase of the arteries in the imaging volume. Cerebral AC, estimated from aBV and brachial blood pressure measured noninvasively in systole and diastole, was assessed in the flow territories of the basal cerebral arteries originating from the circle of Willis: right and left middle cerebral arteries (RMCA and LMCA), right and left posterior cerebral arteries (RPCA and LPCA), and the anterior cerebral artery (ACA). Group average AC values calculated for the RMCA, LMCA, ACA, RPCA, and LPCA were 0.56%±0.2%, 0.50%±0.3%, 0.4%±0.2%, 1.1%±0.5%, and 1.1%±0.3% per mm Hg, respectively. The current experiment has shown the feasibility of measuring AC of cerebral arteries with short inversion time PASL. PMID:25515216

  3. Pulmonary Arterial Hypertension and Neonatal Arterial Switch Surgery for Correction of Transposition of the Great Arteries.

    PubMed

    Domínguez Manzano, Paula; Mendoza Soto, Alberto; Román Barba, Violeta; Moreno Galdó, Antonio; Galindo Izquierdo, Alberto

    2016-09-01

    There are few reports of the appearance of pulmonary arterial hypertension following arterial switch surgery in the neonatal period to correct transposition of the great arteries. We assessed the frequency and clinical pattern of this complication in our series of patients. Our database was reviewed to select patients with transposition of the great arteries corrected by neonatal arterial switch at our hospital and who developed pulmonary hypertension over time. We identified 2 (1.3%) patients with transposition of the great arteries successfully repaired in the first week of life who later experienced pulmonary arterial hypertension. The first patient was a 7-year-old girl diagnosed with severe pulmonary hypertension at age 8 months who did not respond to medical treatment and required lung transplantation. The anatomic pathology findings were consistent with severe pulmonary arterial hypertension. The second patient was a 24-month-old boy diagnosed with severe pulmonary hypertension at age 13 months who did not respond to medical therapy. Pulmonary hypertension is a rare but very severe complication that should be investigated in all patients with transposition of the great arteries who have undergone neonatal arterial switch, in order to start early aggressive therapy for affected patients, given the poor therapeutic response and poor prognosis involved. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  4. [Pathology of coronary arterial calcification].

    PubMed

    Yutani, Chikao

    2007-03-01

    Calcification is an invariable component of advanced coronary artery atherosclerosis. Recent study showed that genetic variations such as matrix inhibitory proteins, polymorphisms for tumor necrosis factor, and inflammatory cytokines may influence coronary artery calcification. And also there have been numerous studies on screening patients for coronary artery disease using electron beam computed tomography, but details of mechanism on calcification have still been unclear. An example of coronary calcification in diabetic patients disclosed that its diffuse distribution might be metabolic on calcification mechanism.

  5. Arterial spasm during renal angioplasty

    SciTech Connect

    Beinart, C.; Sos, T.A.; Saddekni, S.; Weiner, M.A.; Sniderman, K.W.

    1983-10-01

    Spasm of the renal arteries during transluminal angioplasty is a well-documented phenomenon with serious potential sequelae, particularly in young patients with fibromusclar dysplasia. The authors report their experience in 98 cases (105 arteries). Tolazoline, lidocaine, nitrates (or calcium blockers, if available), and heparin should be administered either directly into the renal artery or systemically prior to angioplasty to decrease the incidence and severity of spasm.

  6. Radiative transport in large arteries

    PubMed Central

    Ruh, Dominic; Subramanian, Sivaraman; Theodor, Michael; Zappe, Hans; Seifert, Andreas

    2013-01-01

    A refined model for the photon energy distribution in a living artery is established by solving the radiative transfer equation in a cylindrical geometry, using the Monte Carlo method. Combining this model with the most recent experimental values for the optical properties of flowing blood and the biomechanics of a blood-filled artery subject to a pulsatile pressure, we find that the optical intensity transmitted through large arteries decreases linearly with increasing arterial distension. This finding provides a solid theoretical foundation for measuring photoplethysmograms. PMID:24466476

  7. Utilization of laser arterial angioplasty.

    PubMed

    Steg, P G; Ménasché, P

    1989-01-01

    Arterial angioplasty with continuous wave laser radiation is now available in clinical practice and, coupled with balloon catheter angioplasty, has been successful in the treatment of lower limb arterial disease. It appears premature to apply laser angioplasty to coronary artery lesions because of the high incidence of severe complications observed in clinical trials. Experimental studies suggest that some of these complications are related to thermal injury induced by continuous wave laser energy and that they could be minimized by the utilization of pulsed laser sources. Because of recent technologic advances, pulsed laser sources coupled with flexible fiberoptic devices will soon be available for peripheral arterial angioplasty in clinical practice.

  8. Intracranial Arteries - Anatomy and Collaterals.

    PubMed

    Liebeskind, David S; Caplan, Louis R

    2016-01-01

    Anatomy, physiology, and pathophysiology are inextricably linked in patients with intracranial atherosclerosis. Knowledge of abnormal or pathological conditions such as intracranial atherosclerosis stems from detailed recognition of the normal pattern of vascular anatomy. The vascular anatomy of the intracranial arteries, both at the level of the vessel wall and as a larger structure or conduit, is a reflection of physiology over time, from in utero stages through adult life. The unique characteristics of arteries at the base of the brain may help our understanding of atherosclerotic lesions that tend to afflict specific arterial segments. Although much of the knowledge regarding intracranial arteries originates from pathology and angiography series over several centuries, evolving noninvasive techniques have rapidly expanded our perspective. As each imaging modality provides a depiction that combines anatomy and flow physiology, it is important to interpret each image with a solid understanding of typical arterial anatomy and corresponding collateral routes. Compensatory collateral perfusion and downstream flow status have recently emerged as pivotal variables in the clinical management of patients with atherosclerosis. Ongoing studies that illustrate the anatomy and pathophysiology of these proximal arterial segments across modalities will help refine our knowledge of the interplay between vascular anatomy and cerebral blood flow. Future studies may help elucidate pivotal arterial factors far beyond the degree of stenosis, examining downstream influences on cerebral perfusion, artery-to-artery thromboembolic potential, amenability to endovascular therapies and stent conformation, and the propensity for restenosis due to biophysical factors. © 2016 S. Karger AG, Basel.

  9. Arterial pulse wave pressure transducer

    NASA Technical Reports Server (NTRS)

    Kim, C.; Gorelick, D.; Chen, W. (Inventor)

    1974-01-01

    An arterial pulse wave pressure transducer is introduced. The transducer is comprised of a fluid filled cavity having a flexible membrane disposed over the cavity and adapted to be placed on the skin over an artery. An arterial pulse wave creates pressure pulses in the fluid which are transduced, by a pressure sensitive transistor in direct contact with the fluid, into an electric signal. The electrical signal is representative of the pulse waves and can be recorded so as to monitor changes in the elasticity of the arterial walls.

  10. Arterial stiffness in diabetes mellitus.

    PubMed

    Prenner, Stuart B; Chirinos, Julio A

    2015-02-01

    Arterial stiffness is an age-related process that is a shared consequence of numerous diseases including diabetes mellitus (DM), and is an independent predictor of mortality both in this population and in the general population. While much has been published about arterial stiffness in patients with DM, a thorough review of the current literature is lacking. Using a systematic literature search strategy, we aimed to summarize our current understanding related to arterial stiffness in DM. We review key studies demonstrating that, among patients with established DM, arterial stiffness is closely related to the progression of complications of DM, including nephropathy, retinopathy, and neuropathy. It is also becoming clear that arterial stiffness can be increased even in pre-diabetic populations with impaired glucose tolerance, and in those with the metabolic syndrome (METS), well before the onset of overt DM. Some data suggests that arterial stiffness can predict the onset of DM. However, future work is needed to further clarify whether large artery stiffness and the pulsatile hemodynamic changes that accompany it are involved in the pathogenesis of DM, and whether interventions targeting arterial stiffness are associated with improved clinical outcomes in DM. We also review of the potential mechanisms of arterial stiffness in DM, with particular emphasis on the role of advanced glycation endproducts (AGEs) and nitric oxide dysregulation, and address potential future directions for research.

  11. Arterial Abnormalities Leading to Tinnitus.

    PubMed

    Miller, Timothy R; Serulle, Yafell; Gandhi, Dheeraj

    2016-05-01

    Tinnitus is a common symptom that usually originates in the middle ear. Vascular causes of pulsatile tinnitus are categorized by the location of the source of the noise within the cerebral-cervical vasculature: arterial, arteriovenous, and venous. Arterial stenosis secondary to atherosclerotic disease or dissection, arterial anatomic variants at the skull base, and vascular skull base tumors are some of the more common causes of arterial and arteriovenous pulsatile tinnitus. Noninvasive imaging is indicated to evaluate for possible causes of pulsatile tinnitus, and should be followed by catheter angiography if there is a strong clinical suspicion for a dural arteriovenous fistula.

  12. Idiopathic dilatation of pulmonary artery

    PubMed Central

    Sharma, Rahul Kumar; Talwar, Deepak; Gupta, Sameer K; Bansal, Shobhit

    2016-01-01

    Idiopathic dilatation of pulmonary arteries (IDPA) is a rare abnormality of pulmonary arteries, the reported incidence in literature being as low as 0.007% in autopsy samples. With the improvement in diagnostic modalities, antemortem diagnosis of IDPA has been increasingly established by excluding diseases that induce pulmonary arterial enlargement. Here, we present a rare case of idiopathic dilatation of the pulmonary artery admitted with shortness of breath where IDPA was diagnosed as an incidental finding using computed tomography pulmonary angiography and cardiac catheterization. PMID:27891002

  13. Arterial wall thermography.

    PubMed

    Diamantopoulos, Leonidas

    2003-06-01

    An atherosclerotic plaque is considered vulnerable when it is at higher risk of inducing acute cardiac events. The early detection and follow-up of the vulnerable plaque are crucial to prevent these events from happening. To date there are no proven techniques to detect such a plaque. Arterial wall thermography, tracing the heat signature of the activated macrophages, is a new and promising method in this direction. However, the difficulties of applying such a method in vivo should not be neglected. Current science proposes several potential thermographic methods. They can be generally categorized as noninvasive and invasive. Magnetic resonance thermometry (MRT) is the most important noninvasive method. It is novel, accurate, and reproducible, but is unfortunately hampered by resolution limitations due to the size and motion of the target vessels. The "infrared" and the "contact-sensor" are the most important invasive thermographic methods. Mainly due to the difficulties of infrared radiation in penetrating the flowing blood, the contact thermographic methods seem to be the most feasible at present. The superiority of thermal mapping of the arterial wall versus the localized temperature measurements is clear. The use of multiple thermal sensors arranged around the vessel's circumference and the application of motorized catheter pullback, not only ensure a large area of coverage, but also enable us to build thermal maps and vascular thermoanatomical reconstructions by using modern computer technology. It is expected that arterial thermography will undoubtedly initiate debate, mainly concerning the most appropriate therapy for the vulnerable plaque. Data collection and correct interpretation are expected to lead us into making wise decisions.

  14. Right hepatic artery aneurysm.

    PubMed

    Bernal, Astrid Del Pilar Ardila; Loures, Paulo; Calle, Juan Cristóbal Ospina; Cunha, Beatriz; Córdoba, Juan Camilo

    2016-01-01

    We report a case of an aneurysm of the right hepatic artery and its multidisciplinary management by general surgery, endoscopy and radiology services. Being a case of extremely low incidence, it is important to show its diagnostic and therapeutic approach. RESUMO Relatamos um caso de aneurisma da artéria hepática direita conduzido de forma multidisciplinar pelos Serviços de Cirurgia Geral, Endoscopia e Radiologia. Em se tratando de caso de incidência baixíssima, é importante mostrar o enfoque diagnóstico e terapêutico usado em seu manejo.

  15. Artery of Percheron Infarction

    PubMed Central

    Vinod, K.V.; Kaaviya, R.; Arpita, Bhaumik

    2016-01-01

    Artery of Percheron (AOP) occlusion is a rare cause of ischemic stroke characterized by bilateral paramedian thalamic infarcts, with or without mesencephalic infarction. Clinically it presents with mental state disturbances, hypersomnolence, aphasia/dysarthria, amnesia and ocular movement disorders, including vertical gaze palsy. Here, we report a case of cardioembolic AOP infarction in a 37-year-old woman with rheumatic mitral valvular stenosis. This case is being reported to highlight the interesting clinical and neuroimaging features of this rare condition, and the differential diagnosis of AOP infarction on imaging have been discussed. PMID:27647964

  16. Population III Hypernovae

    NASA Astrophysics Data System (ADS)

    Smidt, Joseph; Whalen, Daniel J.; Wiggins, Brandon K.; Even, Wesley; Johnson, Jarrett L.; Fryer, Chris L.

    2014-12-01

    Population III supernovae have been of growing interest of late for their potential to directly probe the properties of the first stars, particularly the most energetic events that are visible near the edge of the observable universe. Until now, hypernovae, the unusually energetic Type Ib/c supernovae that are sometimes associated with gamma-ray bursts, have been overlooked as cosmic beacons at the highest redshifts. In this, the latest of a series of studies on Population III supernovae, we present numerical simulations of 25-50 M ⊙ hypernovae and their light curves done with the Los Alamos RAGE and SPECTRUM codes. We find that they will be visible at z = 10-15 to the James Webb Space Telescope and z = 4-5 to the Wide-Field Infrared Survey Telescope, tracing star formation rates in the first galaxies and at the end of cosmological reionization. If, however, the hypernova crashes into a dense shell ejected by its progenitor, it is expected that a superluminous event will occur that may be seen at z ~ 20 in the first generation of stars.

  17. POPULATION III HYPERNOVAE

    SciTech Connect

    Smidt, Joseph; Whalen, Daniel J.; Wiggins, Brandon K.; Even, Wesley; Fryer, Chris L.; Johnson, Jarrett L.

    2014-12-20

    Population III supernovae have been of growing interest of late for their potential to directly probe the properties of the first stars, particularly the most energetic events that are visible near the edge of the observable universe. Until now, hypernovae, the unusually energetic Type Ib/c supernovae that are sometimes associated with gamma-ray bursts, have been overlooked as cosmic beacons at the highest redshifts. In this, the latest of a series of studies on Population III supernovae, we present numerical simulations of 25-50 M {sub ☉} hypernovae and their light curves done with the Los Alamos RAGE and SPECTRUM codes. We find that they will be visible at z = 10-15 to the James Webb Space Telescope and z = 4-5 to the Wide-Field Infrared Survey Telescope, tracing star formation rates in the first galaxies and at the end of cosmological reionization. If, however, the hypernova crashes into a dense shell ejected by its progenitor, it is expected that a superluminous event will occur that may be seen at z ∼ 20 in the first generation of stars.

  18. Inferior pancreaticoduodenal artery aneurysm associated with common hepatic artery occlusion.

    PubMed

    Bracale, G; Porcellini, M; Bernardo, B; Selvetella, L; Renda, A

    1996-12-01

    A unique case of true inferior pancreaticoduodenal artery aneurysm (IPDA) associated with occlusion of common hepatic artery is reported. Radiological and MRI findings are described. Because of high risk of visceral ischemia that contraindicated a percutaneous transluminal embolization, a successful tangential resection of aneurysm was performed.

  19. Double right coronary artery or split right coronary artery?

    PubMed

    Chen, Ying-Fu; Chien, Tsu-Ming; Chen, Chih-Wei; Lin, Ching-Cheng; Lee, Chee-Siong

    2012-02-09

    The prevalence of congenital anomalies of the coronary arteries (CAAs) is reported to be approximately 0.2-1.4% of the general population. Of them, The double right coronary artery (RCA) is one of the rarest coronary anomalies. Nonetheless, there is no consensus of the definition of a double RCA until now. Several concepts have been proposed in order to define what is and is not a double RCA. So far, it was been reported 37 times and in 44 cases after a comprehensive literature search through the PubMed database, using the keywords "double right coronary artery," "duplicated right coronary artery," "dual right coronary artery" and "split right coronary artery." Most of the published articles (28 of 37 articles) used the name "double right coronary artery." Nevertheless, some investigators contended that a split RCA is anatomically the same anomaly as the improperly named "double right coronary artery". The debate between those who favor "double RCA" and those who favor "split RCA" indicate the need for a consensus regarding the nomenclature as well diagnostic criteria of such coronary anomalies. It is the time we need to reach a consensus of the nomenclature of this congenital coronary anomaly. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  20. Coronary artery ectasia in Egyptian patients with coronary artery disease.

    PubMed Central

    Waly, H M; Elayda, M A; Lee, V V; el-Said, G; Reul, G J; Hall, R J

    1997-01-01

    We conducted a retrospective study of 45 Egyptian patients with coronary artery ectasia who underwent coronary bypass grafting at our institution between 1980 and 1995. We examined the anatomic distribution and type of coronary ectasia and its association with coronary risk factors in these patients, and evaluated the severity of their coronary artery disease. We compared these findings with those from a group of 230 Egyptian patients who did not have coronary ectasia. These patients also underwent coronary artery bypass grafting between 1980 and 1995 at our institution. Obesity was present in 60% of the patients who had coronary artery ectasia, compared with 42% of patients who did not have ectasia (P < 0.01). Coronary artery ectasia was not related to any coronary risk factors other than obesity. However, patients who had ectasia did have a higher rate of triple-vessel coronary artery disease than did patients without ectasia (82% vs 67%, P < 0.05). Of the coronary vessels affected by ectasia, 43% were left anterior descending arteries. Diffuse disease was noted in 84% of all ectatic segments. We conclude that in this patient population, 2 conditions had a positive correlation with coronary ectasia: obesity and the severity of coronary artery disease. Images PMID:9456489

  1. Pulmonary artery sarcoma mimicking a pulmonary artery aneurysm.

    PubMed

    Terra, Ricardo M; Fernandez, Angelo; Bammann, Ricardo H; Junqueira, Jader J M; Capelozzi, Vera L

    2008-10-01

    Pulmonary artery sarcoma is an uncommon neoplasm, and its clinical and radiological presentation usually simulates chronic thromboembolic disease. We present the case of a 77-year-old woman admitted with dyspnea, chest pain, and hemoptysis. A chest computed tomographic scan showed moderate right-sided pleural effusion and a saccular dilatation of the interlobar portion of the right pulmonary artery, which was filled with contrast and surrounded by an irregular soft-tissue attenuation mass, suggesting a ruptured pulmonary artery aneurysm. The patient was operated on. Intraoperatively, a pseudoaneurysm and a solid mass were identified within the oblique fissure around the interlobar artery. Therefore, a right pneumonectomy was performed. Definitive pathologic examination was consistent with pulmonary artery sarcoma. The patient had a good outcome and is free of disease 2 years after surgery.

  2. Popliteal artery aneurysms.

    PubMed

    Davidovic, L B; Lotina, S I; Kostic, D M; Cinara, I S; Cvetkovic, S D; Markovic, D M; Vojnovic, B R

    1998-08-01

    Altogether 59 patients with 76 popliteal artery aneurysms were treated during the last 36 years. There were 50 (85%) male and 9 (15%) female patients with an average age of 61 years. Nineteen (32%) patients had bilateral aneurysms. The clinical manifestations of the aneurysms included ruptures 4 (5.3%); deep venous thrombosis 4 (5.3%); sciatic nerve compression 1 (1.3%); leg ischemia 52 (68.4%), and asymptomatic pulsatile masses 15 (19.7%). Seventy (92%) aneurysms were atherosclerotic, one (1.3%) mycotic, and four (5.3%) traumatic; one (1.3%) developed owing to fibromuscular displasia. Seven (9.2%) small, asymptomatic aneurysms were not operated on. Reconstructive procedures end-to-end anastomosis, graft interposition, bypass) after aneurysmal resection or exclusion using a medial or posterior approach were done in 59 cases. An autologous saphenous vein graft was used in 49 cases, polytetrafluoroethylene (PTFE) in 5, and heterograft in 2 cases. The in-hospital mortality rate was 2.9%, the early patency rate 93.3%, and limb salvage 95%. The long-term patency rate after a mean follow-up of 4 years was 78% and long-term limb salvage 89%. The total limb salvage was 73%, and the total amputation rate was 27%. The dangerous complications associated with popliteal artery aneurysms and the good results after elective procedures suggest that operative treatment is appropriate.

  3. Spontaneous Arterial Dissection.

    PubMed

    Brandt, Tobias; Caplan, Louis

    2001-09-01

    There is no controlled study for the best treatment or management of cervico-cerebral artery dissection (CAD). Rationale initial empiric treatment in acute CAD to prevent secondary embolism is partial thromboplastin time (PTT)-guided anticoagulation by intravenous heparin followed by anticoagulation with warfarin. Carotid surgery for treatment of CAD is not recommended anymore with the possible exception of persisting severe stenosis of the proximal internal carotid artery (ICA). There could be use of carotid angioplasty by balloon dilatation and stenting in selected cases of severe cerebral hemodynamic impairment by bilateral CAD. Duration of secondary prophylaxis by anticoagulation is best guided by Doppler sonography follow-up, and should be continued until normalization of blood flow or until at least 1 year after the vessel is occluded. There is no evidence that pseudoaneurysms increase the risk for embolic complication, and there is no evidence for surgery or continuation of anticoagulation in patients with pseudoaneurysms. Caution should be recommended for exercises that involve excessive head movements (eg, bungee jumping, trampoline jumping, and chiropractic maneuvers). The patient should be informed that recurrent rate is low in nonfamilial cases. Doppler sonography is a low-cost and high-sensitivity method for patients at risk.

  4. Respiratory dysfunction after coronary artery bypass grafting employing bilateral internal mammary arteries: the influence of intact pleura.

    PubMed

    Bonacchi, M; Prifti, E; Giunti, G; Salica, A; Frati, G; Sani, G

    2001-06-01

    To evaluate the role of intact pleurae regarding the postoperative respiratory functional status in patients undergoing coronary revascularization employing both internal mammary arteries (IMAs), according to the pedunculated or skeletonized technique (SKT) with opened or intact pleurae. Using both IMAs, 299 patients underwent elective coronary revascularization. They were randomized and divided into group I (n=82, undergoing IMA harvesting according to the SKT without opening the pleurae); group II (n=186, undergoing IMA harvesting according the pedunculated technique with open pleurae); and group III (n=31, undergoing IMA harvesting according the SKT with incidentally opened pleurae). There were no differences regarding the preoperative patient characteristics and the anaesthetic and surgical management. There were two deaths in group I versus seven in group II and one in group III (P=ns). The number of total arterial myocardial revascularization and arterial composite grafts was significantly higher in groups I and III than in group II, (P<0.001 and P<0.005, respectively). The incidence of postoperative complications was similar between groups. Blood loss of >1000 ml was significantly higher in group II than group I (P<0.028); but the incidence of re-thoracotomy and blood transfusion was similar between groups. The mechanical ventilation time was significantly higher in groups II and III versus group I (P<0.018 and P<0.02, respectively). The incidence of prolonged ventilation (>24 h), pleural effusion, thoracocentesis and atelectasis, resulted in being significantly higher in group II than group I. The incidence of thoracocentesis was significantly higher in group III than group I. The pain score and analgesic requirements at 1-12 h after awakening were significantly higher in groups II and III versus group I, becoming similar after the chest tubes were removed. PaO(2) was significantly higher, and PaCO(2) and FiO(2) were significantly lower in group I than

  5. A Unique Presentation of Anti-RNA Polymerase III Positive Systemic Sclerosis Sine Scleroderma.

    PubMed

    Lee, Cody M; Girnita, Diana; Sharma, Arundhati; Khanna, Surabhi; Elwing, Jean M

    2016-01-01

    Systemic sclerosis is a rare autoimmune disorder with a wide spectrum of clinical manifestations and a multitude of autoantibodies that are associated with it. In the past several years, advances in serologic testing have led to research indicating important prognostic and phenotypic associations with certain subsets of autoantibodies. In particular, anti-RNA polymerase III (anti-RNAP III) has been associated with diffuse cutaneous disease, scleroderma renal crisis, a temporal relationship with malignancy, myositis, synovitis, joint contractures, and gastric antral vascular ectasia. However, anti-RNAP III has not been associated with systemic sclerosis sine scleroderma. We describe a patient with an atypical presentation of anti-RNAP III positive systemic sclerosis sine scleroderma who presented without the typical features of anti-RNAP III disease. Instead, she presented with critical digital ischemia, pulmonary arterial hypertension, gastroesophageal reflux disease, interstitial lung disease, and no clinically detectable sclerodactyly.

  6. How Is Carotid Artery Disease Treated?

    MedlinePlus

    ... from the NHLBI on Twitter. How Is Carotid Artery Disease Treated? Treatments for carotid artery disease may ... plaque removed and normal blood flow restored. Carotid Artery Angioplasty and Stenting Doctors use a procedure called ...

  7. How Can Carotid Artery Disease Be Prevented?

    MedlinePlus

    ... from the NHLBI on Twitter. How Can Carotid Artery Disease Be Prevented? Taking action to control your risk factors can help prevent or delay carotid artery disease and stroke . Your risk for carotid artery ...

  8. Huge idiopathic pulmonary artery aneurysm.

    PubMed

    Sa-Kong, Heon; Seol, Sang-Hoon; No, Tae-Hoon; Park, Dong-Hee; Jeong, Na-Ri; Jeong, Su-Jin; Kim, Doo-Il

    2017-06-01

    A pulmonary artery aneurysm is an uncommon anomaly. The clinical manifestations are mostly nonspecific, and management is controversial. We report a case of a 67-year-old woman with a main pulmonary artery aneurysm who did not take surgical intervention. Subsequently, there was no increase in size for 3 years.

  9. Huge traumatic pulmonary artery pseudoaneurysm.

    PubMed

    Shnayderman, Dmitriy; Baginski, Scott G; Lea, William B; Erickson, Scott J

    2017-09-01

    Pulmonary artery pseudoaneurysm is a very rare complication of penetrating thoracic trauma. We present a case of a 27-year-old woman who developed a 6.5-cm traumatic pulmonary artery pseudoaneurysm after suffering multiple stab wounds to the chest and the abdomen. The pseudoaneurysm was successfully treated endovascularly with vascular plug occlusion and coil embolization.

  10. Epigenetics and Peripheral Artery Disease.

    PubMed

    Golledge, Jonathan; Biros, Erik; Bingley, John; Iyer, Vikram; Krishna, Smriti M

    2016-04-01

    The term epigenetics is usually used to describe inheritable changes in gene function which do not involve changes in the DNA sequence. These typically include non-coding RNAs, DNA methylation and histone modifications. Smoking and older age are recognised risk factors for peripheral artery diseases, such as occlusive lower limb artery disease and abdominal aortic aneurysm, and have been implicated in promoting epigenetic changes. This brief review describes studies that have associated epigenetic factors with peripheral artery diseases and investigations which have examined the effect of epigenetic modifications on the outcome of peripheral artery diseases in mouse models. Investigations have largely focused on microRNAs and have identified a number of circulating microRNAs associated with human peripheral artery diseases. Upregulating or antagonising a number of microRNAs has also been reported to limit aortic aneurysm development and hind limb ischemia in mouse models. The importance of DNA methylation and histone modifications in peripheral artery disease has been relatively little studied. Whether circulating microRNAs can be used to assist identification of patients with peripheral artery diseases and be modified in order to improve the outcome of peripheral artery disease will require further investigation.

  11. Computer measurement of arterial disease

    NASA Technical Reports Server (NTRS)

    Armstrong, J.; Selzer, R. H.; Barndt, R.; Blankenhorn, D. H.; Brooks, S.

    1980-01-01

    Image processing technique quantifies human atherosclerosis by computer analysis of arterial angiograms. X-ray film images are scanned and digitized, arterial shadow is tracked, and several quantitative measures of lumen irregularity are computed. In other tests, excellent agreement was found between computer evaluation of femoral angiograms on living subjects and evaluation by teams of trained angiographers.

  12. Pseudo Class III malocclusion

    PubMed Central

    Al-Hummayani, Fadia M.

    2016-01-01

    The treatment of deep anterior crossbite is technically challenging due to the difficulty of placing traditional brackets with fixed appliances. This case report represents a none traditional treatment modality to treat deep anterior crossbite in an adult pseudo class III malocclusion complicated by severely retruded, supraerupted upper and lower incisors. Treatment was carried out in 2 phases. Phase I treatment was performed by removable appliance “modified Hawley appliance with inverted labial bow,” some modifications were carried out to it to suit the presented case. Positive overbite and overjet was accomplished in one month, in this phase with minimal forces exerted on the lower incisors. Whereas, phase II treatment was performed with fixed appliances (braces) to align teeth and have proper over bite and overjet and to close posterior open bite, this phase was accomplished within 11 month. PMID:27052290

  13. Multiple arterial phase MRI of arterial hypervascular hepatic lesions: improved arterial phase capture and lesion enhancement.

    PubMed

    Ikram, Nabia S; Yee, Judy; Weinstein, Stefanie; Yeh, Benjamin M; Corvera, Carlos U; Monto, Alexander; Hope, Thomas A

    2017-03-01

    To establish if triple-phase arterial imaging improves the detection of arterial phase hyperintense lesions based on arterial phase capture, motion artifact degradation, and lesion enhancement when compared to single-phase imaging. Patients at risk for hepatocellular carcinoma were imaged at 3.0T. Seventy-three consecutive patients with a standard single-phase MRI and eighty-five consecutive patients were imaged using extracellular contrast with triple arterial phase MRI using three sequential accelerated acquisitions of 8 s. Arterial phase capture and image quality were qualitatively categorized. Forty single-phase and forty-four triple-phase studies contained arterially enhancing lesions > 1 cm with washout appearance. The contrast-to-noise ratio (CNR) of the lesions was calculated. We compared the differences in means with Student t-tests and those in arterial phase capture with a Chi squared test with Yates correction. The triple-phase acquisitions captured the early or late arterial phases more frequently than did the single-phase acquisition (99% vs 86%; P value = 0.006). Triple-phase also provided greater number of patients with early or late arterial phase imaging without motion artifact (92% vs 79%, P-value = 0.05). The lesion analysis revealed increased maximum CNR in the triple-phase imaging (704.4) vs. single-phase imaging (517.2), P-value < 0.001. Triple-phase acquisition provides more robust arterial phase imaging for hepatic lesions, with increased lesion CNR, compared to standard single-phase arterial phase imaging.

  14. Arterial anatomy of the thumb.

    PubMed

    Ames, E L; Bissonnette, M; Acland, R; Lister, G; Firrell, J

    1993-08-01

    The anatomical literature has indicated that the arterial supply to the thumb comes from the princeps pollicis artery. However, this simplified description does not often correlate with intraoperative findings. The purpose of this study was to investigate and clarify this important area of anatomy by dissection of fresh cadaver hands. 40 dissections were completed on 35 intravascularly injected and five non-injected hands. Five patterns were identified. The most common pattern showed both a superficial and deep vessel to the first web space in 54% of specimens. Dominant vessels included the superficial palmar branch of the radial artery in 8%, first palmar metacarpal artery in 18% and dorsal metacarpal artery in 8%. Only three specimens correlated with the textbook description. We conclude that the term "princeps pollicis" is actually a misnomer.

  15. Arterial Stiffness: Recommendations and Standardization

    PubMed Central

    Townsend, Raymond R.

    2017-01-01

    The use of arterial stiffness measurements in longitudinal cohorts of normal populations, hypertensive patients, diabetic patients, healthy elderly, and patients on hemodialysis have confirmed the value of this important measure of arterial health, and established its complementary role to measures of blood pressure. Its contribution to understanding cardiovascular and mortality risk beyond blood pressure measurements has moved measures of arterial stiffness into the ranks of factors such as elevated cholesterol, diabetes, and left ventricular hypertrophy in considering cardiovascular risk. The recent international collaboration's publication of reference ranges for normal people and those with hypertension, along with the American Heart Association's recent scientific statement on standardizing arterial stiffness measurements are important aspects to consider in future studies employing these valuable methods, particularly as interventions that not only lower blood pressure but improve arterial function are tested in the clinical arena. PMID:28275588

  16. Consultations on patients with venous or arterial diseases.

    PubMed

    Alving, Barbara M; Francis, Charles W; Hiatt, William R; Jackson, Mark R

    2003-01-01

    Advances in vascular biology and drug development, as well as improved interventional techniques, are yielding multiple new treatments for patients with venous and/or arterial thrombosis. Hematologists who are providing consultations for these patients often participate in a multidisciplinary approach to provide optimal care. New anticoagulants, simplified and validated tests for detecting vascular disease, and improved interventional procedures can all reduce the morbidity and mortality that result from venous and arterial thrombosis. In this chapter, different aspects of the diagnosis and treatment of these disorders are addressed by a hematologist, an expert in vascular medicine, and a vascular surgeon. The key to the prevention and treatment of venous and arterial thrombosis is anticoagulant and antiplatelet therapy. In Section I, Dr. Charles Francis, a hematologist with expertise in thrombosis and hemostasis, describes the clinical trials that have resulted in the approval of newer anticoagulants such as fondaparinux and the thrombin- specific inhibitors. He also reviews the clinical trials that have shown the efficacy of the new oral anticoagulant ximelagatran. Although currently under study primarily for the prevention and treatment of venous thrombosis, these anticoagulants are likely to undergo evaluation for use in arterial thrombosis. Peripheral arterial disease (PAD), which affects as many as 12% of individuals over the age of 65 years, provides a diagnostic and therapeutic challenge to physicians across multiple subspecialties. Dr. William Hiatt, a specialist in vascular medicine, discusses in Section II the epidemiology and manifestations of PAD, the best ways in which to diagnose this disorder and determine its severity, and the most appropriate pharmacologic treatment. In Section III, Dr. Mark Jackson, a vascular surgeon, describes interventional procedures that have been developed or are under development to treat arterial thrombosis. He also

  17. [Progestins and arterial disease].

    PubMed

    Rozenbaum, H

    1985-01-01

    The role of estrogens in the etiology of vascular accidents was identified soon after oral contraceptives (OCs) came into use over 2 decades ago, but the role of progestins was only identified on the basis of systematic study. Reduction in the estrogen dose of OCs was accompained by a steady decline in venous accidents, but the rate of arterial accidents changed little. It is important to remember that the actual occurrence of vascular accidents in OC users is rare. Available statistics indicate that age and smoking are important risk factors for vascular accidents. Among nonsmokers and smokers respectively, the annual risk of death due to vascular accidents is 1 in 77,000 and 1 in 10,000 for women under 35, 1 in 67,000 and 1 in 2000 for women 35-44, and 1 in 2500 and 1 in 500 for women 45 and over. Some isolated cases of arterial vascular accidents in users of progestin only OCs have been published. The death rate from vascular accidents is 3 times as high when the levonorgestrel dose increases from 150 to 250 mcg, and twice as high when the norethisterone acetate dose increases from 1 to 4 mg. It is not known precisely how synthetic progestins can induce an arterial accident, but the factors involved may include elevation of blood pressure by potentiation of the modifications in renin-angiotensin system caused by ethinyl estradiol, reducing the level of high density lipoprotein (HDL) cholesterol, impairing glucose tolerance, altering the vascular walls directly, or modifying certain coagulation factors. Little data is available on progestin-caused modifications in coagulation factors, but a recent study reported that the effects of combined OCs on coagulation factors increased with the progestin dose. 2 groups of 19-norsteroids are currently used in contraception, the estranes including norethisterone and some prohormones that metabolize to norethisterone before becoming active, and the gonanes including norgestrel, levonorgestrel, and desogestrel. Early optimism

  18. [Grafting of carotid arteries].

    PubMed

    Belov, Iu V; Stepanenko, A B; Gens, A P; Bazylev, V V; Seleznev, M N; Savichev, D D

    2005-01-01

    Over 5-years, 167 reconstructive surgeries for stenosis of internal carotid arteries (ICA) were performed in 124 patients. Mean age of the patients was 63.5 years. One hundred and twenty-nine carotid endarterectomies (CEAE) in 86 patients and 38 reconstructive operations of ICA in 38 patients were performed. There were no lethal outcomes in short- and long-term postoperative period. In short-term period after prosthesis of ICA restenosis was revealed in 3% patients, after eversion CEAE in 3% patients the embolism was seen, after standard CEAE restenosis were diagnosed in 8% patients and thrombosis -- in 3%. In long-term period after grafting of ICA the strokes were seen in 3%, stenosis -- in 6% patients, after eversion endarterectomy -- in 0 and 3% patients, and after standard CEAE -- in 3 and 24% patients, respectively. It is concluded that grafting of ICA is adequate surgical method of reconstruction and stroke prevention in specific variants of carotid atherosclerosis.

  19. Spontaneous coronary artery dissection.

    PubMed

    Giacoppo, Daniele; Capodanno, Davide; Dangas, George; Tamburino, Corrado

    2014-07-15

    Spontaneous coronary artery dissection (SCAD) is a relatively rare and unexplored type of coronary disease. Although atherosclerosis, hormonal changes during pregnancy and connective tissue disorders might represent a sufficiently convincing explanation for some patients with SCAD, the many remaining cases display only a weak relationship with these causes. While on one side the clinical heterogeneity of SCAD masks a full understanding of their underlying pathophysiologic process, on the other side paucity of data and misleading presentations hamper the quick diagnosis and optimal management of this condition. A definite diagnosis of SCAD can be significantly facilitated by endovascular imaging techniques. In fact, intravascular ultrasound (IVUS) and optical coherence tomography (OCT) overcome the limitations of coronary angiography providing detailed endovascular morphologic information. In contrast, optimal treatment strategies for SCAD still represent a burning controversial question. Herein, we review the published data examining possible causes and investigating the best therapy for SCAD in different clinical scenarios.

  20. Superior mesenteric artery syndrome

    PubMed Central

    Giedrius, Bernotavičius; Kęstutis, Saniukas; Irena, Karmonaitė; Rimantas, Zagorskis

    2016-01-01

    Background. An obstruction of the distal part of the duodenum can occur because of the superior mesenteric artery syndrome (SMAS) after a surgical correction of scoliosis. It is essential to evaluate the risk factors and diagnose the SMAS in time because complications of this condition are life-threatening and it is associated with a high rate of morbidity. Diagnostics of the SMAS is challenging, because it is rare and its symptoms are non-specific. Therefore, in order to better understand the essence of this pathology and to make diagnosis easier we present a rare clinical case of the superior mesenteric artery syndrome after a surgical correction of neuromuscular scoliosis. The clinical case. A 12-year-old girl with a specific development disorder, sensory neuropathy and progressive kypho-scoliosis was admitted to Vilnius University Children’s Hospital. The patient had right side 50-degree thoracic scoliosis and an 80-degree thoracic kyphosis. She underwent posterior spinal fusion with hooks and screws from Th1 to L2. On the fourth day after the surgery the patient developed nausea and began to vomit each day 1-2 times per day, especially after meals. The SMAS was suspected and a nasogastric tube was inserted, stomach decompression and the correction of electrolytes disbalance were made. After the treatment, the symptoms did not recur and a satisfactory correction and balance of the spine were made in coronal and sagittal planes. Conclusions. It is extremely important to identify the risk factors of the SMAS and begin preoperative diet supplements before surgical correction of scoliosis for patients with a low body mass index. After the first episode of vomiting following the surgery, we recommend to investigate these patients for a gastrointestinal obstruction as soon as possible. Decompression of the stomach, enteral or parenteral nutrition, and fluid therapy are essential in treating the SMAS. PMID:28356803

  1. Comparison between angiographic and arterial duplex ultrasound assessment of tibial arteries in patients with peripheral arterial disease: on behalf of the Joint Endovascular and Non-Invasive Assessment of LImb Perfusion (JENALI) Group.

    PubMed

    Mustapha, Jihad A; Saab, Fadi; Diaz-Sandoval, Larry; Karenko, Barbara; McGoff, Theresa; Heaney, Carmen; Sevensma, Matthew

    2013-11-01

    Endovascular treatment of peripheral arterial disease (PAD) involving the tibial arteries is becoming an increasingly important part of revascularization. The current anatomical description of vessel patency in tibial arteries does not contribute effectively to therapeutic strategies. The Joint Endovascular and Non-Invasive Assessment of Limb Perfusion (JENALI) score, is a novel scoring system developed to further assess patency of tibial arteries, via both angiography and arterial duplex ultrasonography. A comparison was made between the JENALI score obtained by ultrasound and by angiography. Angiography is currently considered the gold standard of tibial artery imaging. This prospective single-center study involved 49 patients undergoing peripheral angiography for evaluation of PAD, between November 2011 and November 2012. All patients underwent a detailed ultrasound assessment of the tibial arteries ± 7 days from diagnostic angiography. Eligible patients had a Rutherford score ≥ III or abnormal ankle-brachial index values. Angiography and ultrasound were evaluated in a blinded fashion. Average age of patients was 69.8 years. A total of 846 segments were assessed by both angiography and ultrasound. We found that 648 segments (76.6%) were deemed to be patent by angiography compared to 723 (85.5%) by ultrasound. Critical limb ischemia (CLI; Rutherford score ≥ 4) was described in 26 patients (53%). Average JENALI score for the right lower extremity was 7.0 by angiogram vs 7.7 by ultrasound. The average JENALI score of the left leg was 6.7 by angiogram vs 7.7 by ultrasound. A total of 94 lower extremities were assigned a JENALI score. Ultrasound was accurate in detecting tibial artery patency or occlusion in 80% of segments. The overall sensitivity/specificity of ultrasound detecting tibial artery patency was calculated at 93% and 40% (P<.05), respectively. Detection of patency via ultrasound was highest for the anterior tibial artery and the lowest for the

  2. [Hemodynamics during long-term combination therapy of arterial hypertension].

    PubMed

    Wiechmann, H W; Schuster, P; Sturm, A

    1985-04-12

    In 20 patients with essential arterial hypertension, grade II or III, the haemodynamic effect of a fixed combination of antihypertensive drugs (bemetizide, triamteren, bupranolol and dihydralazine) was studied by percutaneously-introduced flow-guided catheter in the pulmonary artery before, after three weeks and at the end of a six-month period of treatment; systemic arterial blood pressures were measured by the cuff method. Mean pressures, both at rest and on exercise were significantly and persistently lowered. Mean blood pressure at rest fell from 184/110 mmHg before treatment to 167/98 mmHg after three weeks, and to 158/93 mmHg after six months. The initial blood pressure on exercise was 226/129 mmHg, which fell after three weeks to 199/113 mmHg and after six months to 190/106 mmHg. At the same time, pulmonary artery pressure (as a measure of preload) fell by 23% at rest and 30% on exercise. Exercise tolerance of the patients rose by 28%. Pressure-heartrate product fell by 18%, as a pointer to an additional favourable effect on left ventricular oxygen consumption.

  3. Comparison of Machine Learning Methods for the Arterial Hypertension Diagnostics

    PubMed Central

    Belo, David; Gamboa, Hugo

    2017-01-01

    The paper presents results of machine learning approach accuracy applied analysis of cardiac activity. The study evaluates the diagnostics possibilities of the arterial hypertension by means of the short-term heart rate variability signals. Two groups were studied: 30 relatively healthy volunteers and 40 patients suffering from the arterial hypertension of II-III degree. The following machine learning approaches were studied: linear and quadratic discriminant analysis, k-nearest neighbors, support vector machine with radial basis, decision trees, and naive Bayes classifier. Moreover, in the study, different methods of feature extraction are analyzed: statistical, spectral, wavelet, and multifractal. All in all, 53 features were investigated. Investigation results show that discriminant analysis achieves the highest classification accuracy. The suggested approach of noncorrelated feature set search achieved higher results than data set based on the principal components. PMID:28831239

  4. Arterial injuries during inguinal herniorrhaphy.

    PubMed Central

    Shamberger, R C; Ottinger, L W; Malt, R A

    1984-01-01

    In all common forms of inguinal herniorrhaphy, stitches pass either just superficial to the internal iliac artery and vein or through their sheath. Despite the potential for arterial injury, documented cases seem to exist only in the foreign-language literature. We report four cases of arterial injury following inguinal herniorrhaphy in adults. The artery is placed in jeopardy when the transversalis fascia is incorporated in the stitches used to close the medial aspect of the internal inguinal ring. The depth of penetration of the needle and the proximity of the external iliac artery must be accurately judged. Injury can result from direct puncture of the artery or avulsion of one of its branches. Immediate repair of any arterial injury is paramount, and newly subnormal pulses below the inguinal injury are unacceptable. Exposure must be adequate, and division of the floor of the inguinal canal may be necessary for this purpose. Repair may require a simple hemostatic suture, a patch graft, or an interposition graft. PMID:6732332

  5. Left Main Coronary Artery Aneurysm

    PubMed Central

    Doustkami, Hossein; Maleki, Nasrollah; Tavosi, Zahra

    2016-01-01

    Aneurysms of the left main coronary artery are exceedingly rare clinical entities, encountered incidentally in approximately 0.1% of patients who undergo routine angiography. The most common cause of coronary artery aneurysms is atherosclerosis. Angiography is the gold standard for diagnosis and treatment. Depending on the severity of the coexisting coronary stenosis, patients with left main coronary artery aneurysms can be effectively managed either surgically or pharmacologically. We herein report a case of left main coronary artery aneurysm in a 72-year-old man with a prior history of hypertension presenting to our hospital because of unstable angina. The electrocardiogram showed ST-segment depression and T-wave inversion in the precordial leads. All the data of blood chemistry were normal. Echocardiography showed akinetic anterior wall, septum, and apex, mild mitral regurgitation and ejection fraction of 45%. Coronary angiography revealed a saccular aneurysm of the left main coronary artery with significant stenosis in the left anterior descending, left circumflex, and right coronary artery. The patient immediately underwent coronary artery bypass grafting and ligation of the aneurysm. At six months’ follow-up, he remained asymptomatic. PMID:27403190

  6. SUPERSTARS III: 3-5.

    ERIC Educational Resources Information Center

    North Carolina State Dept. of Public Education, Raleigh.

    SUPERSTARS III is a K-8 program designed as an enrichment opportunity for self-directed learners in mathematics. The basic purpose of SUPERSTARS III is to provide the extra challenge that self-motivated students need in mathematics and to do so in a structured, long-term program that does not impinge on the normal classroom routine or the…

  7. SUPERSTARS III: 6-8.

    ERIC Educational Resources Information Center

    North Carolina State Dept. of Public Education, Raleigh.

    SUPERSTARS III is a K-8 program designed as an enrichment opportunity for self-directed learners in mathematics. The basic purpose of SUPERSTARS III is to provide the extra challenge that self-motivated students need in mathematics and to do so in a structured, long-term program that does not impinge on the normal classroom routine or the…

  8. Using dBase III.

    ERIC Educational Resources Information Center

    Evans, Janet; And Others

    1986-01-01

    Four articles on dBASE III include three on library applications: a photocopy invoicing system for interlibrary loan, a vertical file subject headings list program, and a subject index to statistical resources. Another article explains the differences between interpreters and compilers and the advantages of the Clipper compiler for dBASE III. (EM)

  9. Title III and Cultural Diversity.

    ERIC Educational Resources Information Center

    The Title III Quarterly, 1973

    1973-01-01

    Title III projects dealing with cultural diversity in the classroom are described in this issue of the Title III Quarterly. Major articles are devoted to the following projects: Two Arts Culture Three Project, developing the crafts and music of mountain whites, blacks, and Cherokees; the Rota Bilingual Project, the Marianas District, emphasizing…

  10. Division III--Another Ballgame.

    ERIC Educational Resources Information Center

    Grites, Thomas J.; James, G. Larry

    1986-01-01

    The non-scholarship athletes of Division III represent a substantial group of advisees that are similar to, and yet different from the scholarship athlete. Division III student-athletes, their characteristics, situations, and needs are examined and specific efforts to improve their quality of student life are identified. (MLW)

  11. THE GENUS VEILLONELLA III.

    PubMed Central

    Rogosa, Morrison; Bishop, Ferial S.

    1964-01-01

    Rogosa, Morrison (National Institute of Dental Research, Bethesda, Md.), and Ferial S. Bishop. The genus Veillonella. III. Hydrogen sulfide production by growing cultures. J. Bacteriol. 88:37–41. 1964.—The conditions necessary for H2S production by 105 strains of Veillonella, from a variety of sources and comprising seven anti-genic groups, are presented and discussed. All strains, during 1 to 2 days of growth, produced H2S in a defined medium supplemented with proper amounts of l-cysteine, l-cystine, reduced glutathione, thiosulfate, thiocyanate, or thioglycolate. Erratic or negative results were obtained with some commonly used media containing yeast extract and casein digest, but which were not supplemented with appropriate substrates for H2S production. Previous literature descriptions of V. alcalescens as not producing H2S are incorrect; H2S production, or the previously presumed lack of it, cannot be used as a criterion differentiating V. alcalescens from V. parvula. PMID:14198791

  12. The role of accessory obturator arteries in prostatic arterial embolization.

    PubMed

    Bilhim, Tiago; Pisco, Joao; Pinheiro, Luís Campos; Rio Tinto, Hugo; Fernandes, Lúcia; Pereira, José A

    2014-06-01

    In 9 of 491 patients (1.8%) who underwent prostatic arterial embolization (PAE) for benign prostatic hyperplasia from March 2009-November 2013, prostatic arteries arose from the external iliac artery via an accessory obturator artery (AOA). Computed tomography angiography performed before the procedure identified the variant and allowed planning before the procedure. The nine AOAs were catheterized from a contralateral femoral approach. Bilateral PAE was technically successful in the nine patients. There was a mean decrease in international prostate symptom score of 6.5 points and a mean prostate volume reduction of 15.1% (mean follow-up, 4.8 mo) in the nine patients. Copyright © 2014 SIR. Published by Elsevier Inc. All rights reserved.

  13. Middle-colic artery aneurysm associated with segmental arterial mediolysis, successfully managed by transcatheter arterial embolization: report of a case.

    PubMed

    Hirokawa, Takahisa; Sawai, Hirozumi; Yamada, Koji; Wakasugi, Takehiro; Takeyama, Hiromitsu; Ogino, Hiroyuki; Tsurusaki, Masakatsu; Arai, Yasuaki

    2009-01-01

    An aneurysm of the middle-colic artery, associated with segmental arterial mediolysis (SAM), is a rare condition. This report describes a case of a middle-colic artery aneurysm that was associated with SAM. A 57-year-old man was admitted to our hospital because of severe abdominal pain. A rupture of a middle-colic artery aneurysm was diagnosed by computed tomography, and angiography showed that it may have been associated with SAM. The ruptured aneurysm was successfully treated with transcatheter arterial embolization. Transcatheter arterial embolization might be one of the best treatments for such a complicated aneurysm occurring in a visceral artery.

  14. Pulmonary arterial hypertension

    PubMed Central

    2013-01-01

    Pulmonary arterial hypertension (PAH) is a chronic and progressive disease leading to right heart failure and ultimately death if untreated. The first classification of PH was proposed in 1973. In 2008, the fourth World Symposium on PH held in Dana Point (California, USA) revised previous classifications. Currently, PH is devided into five subgroups. Group 1 includes patients suffering from idiopathic or familial PAH with or without germline mutations. Patients with a diagnosis of PAH should systematically been screened regarding to underlying mutations of BMPR2 gene (bone morphogenetic protein receptor type 2) or more rarely of ACVRL1 (activine receptor-like kinase type 1), ENG (endogline) or Smad8 genes. Pulmonary veno occusive disease and pulmonary capillary hemagiomatosis are individualized and designated as clinical group 1'. Group 2 'Pulmonary hypertension due to left heart diseases' is divided into three sub-groups: systolic dysfonction, diastolic dysfonction and valvular dysfonction. Group 3 'Pulmonary hypertension due to respiratory diseases' includes a heterogenous subgroup of respiratory diseases like PH due to pulmonary fibrosis, COPD, lung emphysema or interstitial lung disease for exemple. Group 4 includes chronic thromboembolic pulmonary hypertension without any distinction of proximal or distal forms. Group 5 regroup PH patients with unclear multifactorial mechanisms. Invasive hemodynamic assessment with right heart catheterization is requested to confirm the definite diagnosis of PH showing a resting mean pulmonary artery pressure (mPAP) of ≥ 25 mmHg and a normal pulmonary capillary wedge pressure (PCWP) of ≤ 15 mmHg. The assessment of PCWP may allow the distinction between pre-capillary and post-capillary PH (PCWP > 15 mmHg). Echocardiography is an important tool in the management of patients with underlying suspicion of PH. The European Society of Cardiology and the European Respiratory Society (ESC-ERS) guidelines specify its role

  15. Pulmonary arterial hypertension.

    PubMed

    Montani, David; Günther, Sven; Dorfmüller, Peter; Perros, Frédéric; Girerd, Barbara; Garcia, Gilles; Jaïs, Xavier; Savale, Laurent; Artaud-Macari, Elise; Price, Laura C; Humbert, Marc; Simonneau, Gérald; Sitbon, Olivier

    2013-07-06

    Pulmonary arterial hypertension (PAH) is a chronic and progressive disease leading to right heart failure and ultimately death if untreated. The first classification of PH was proposed in 1973. In 2008, the fourth World Symposium on PH held in Dana Point (California, USA) revised previous classifications. Currently, PH is devided into five subgroups. Group 1 includes patients suffering from idiopathic or familial PAH with or without germline mutations. Patients with a diagnosis of PAH should systematically been screened regarding to underlying mutations of BMPR2 gene (bone morphogenetic protein receptor type 2) or more rarely of ACVRL1 (activine receptor-like kinase type 1), ENG (endogline) or Smad8 genes. Pulmonary veno occusive disease and pulmonary capillary hemagiomatosis are individualized and designated as clinical group 1'. Group 2 'Pulmonary hypertension due to left heart diseases' is divided into three sub-groups: systolic dysfonction, diastolic dysfonction and valvular dysfonction. Group 3 'Pulmonary hypertension due to respiratory diseases' includes a heterogenous subgroup of respiratory diseases like PH due to pulmonary fibrosis, COPD, lung emphysema or interstitial lung disease for exemple. Group 4 includes chronic thromboembolic pulmonary hypertension without any distinction of proximal or distal forms. Group 5 regroup PH patients with unclear multifactorial mechanisms. Invasive hemodynamic assessment with right heart catheterization is requested to confirm the definite diagnosis of PH showing a resting mean pulmonary artery pressure (mPAP) of ≥ 25 mmHg and a normal pulmonary capillary wedge pressure (PCWP) of ≤ 15 mmHg. The assessment of PCWP may allow the distinction between pre-capillary and post-capillary PH (PCWP > 15 mmHg). Echocardiography is an important tool in the management of patients with underlying suspicion of PH. The European Society of Cardiology and the European Respiratory Society (ESC-ERS) guidelines specify its role

  16. Case series of type III hyperlipoproteinemia in children

    PubMed Central

    Fung, Michelle; Hill, John; Cook, Donald; Frohlich, Jiri

    2011-01-01

    Type III hyperlipoproteinemia (type III HLP) rarely manifests in childhood. Long-term follow-up (37 years) of the first patient revealed hypothyroidism at diagnosis requiring thyroxine replacement, palmar xanthomas requiring surgical removal, splenomegaly requiring splenectomy, 18 episodes of pancreatitis and premature coronary artery disease. Investigation revealed an apolipoprotein E phenotype of E2/E2 and partial lipoprotein lipase deficiency. Investigation of the second patient revealed a combination of apoE2/E2 phenotype and heterozygous familial hypercholesterolaemia. The third patient had a complete deficiency of lipoprotein lipase activity, an abnormal thyroid stimulating hormone on diagnosis (with subsequent normalisation without treatment), and apoE2/E2 phenotype. Type III HLP is a serious disorder with lifelong consequences of premature vascular disease and recurrent pancreatitis. Early presentation of disease in our patients was associated with additional precipitating factors. Drug treatment of paediatric type III HLP is indicated if dietary modifications alone are insufficient in managing the dyslipidaemia. PMID:22691586

  17. Arterial function of carotid and brachial arteries in postmenopausal vegetarians

    PubMed Central

    Su, Ta-Chen; Torng, Pao-Ling; Jeng, Jiann-Shing; Chen, Ming-Fong; Liau, Chiau-Suong

    2011-01-01

    Background: Vegetarianism is associated with a lower risk of cardiovascular disease. However, studies of arterial function in vegetarians are limited. Methods: This study investigated arterial function in vegetarianism by comparing 49 healthy postmenopausal vegetarians with 41 age-matched omnivores. The arterial function of the common carotid artery was assessed by carotid duplex, while the pulse dynamics method was used to measure brachial artery distensibility (BAD), compliance (BAC), and resistance (BAR). Fasting blood levels of glucose, lipids, lipoprotein (a), high-sensitivity C-reactive protein, homocysteine, and vitamin B12 were also measured. Results: Vegetarians had significantly lower serum cholesterol, high-density and low-density lipoprotein, and glucose compared with omnivores. They also had lower vitamin B12 but higher homocysteine levels. Serum levels of lipoprotein (a) and high-sensitivity C-reactive protein were no different between the two groups. There were no significant differences in carotid beta stiffness index, BAC, and BAD between the two groups even after adjustment for associated covariates. However, BAR was significantly lower in vegetarians than in omnivores. Multiple linear regression analysis revealed that age and pulse pressure were two important determinants of carotid beta stiffness index and BAD. Vegetarianism is not associated with better arterial elasticity. Conclusion: Apparently healthy postmenopausal vegetarians are not significantly better in terms of carotid beta stiffness index, BAC, and BAD, but have significantly decreased BAR than omnivores. Prevention of vitamin B12 deficiency might be beneficial for cardiovascular health in vegetarians. PMID:21915169

  18. Arterial function of carotid and brachial arteries in postmenopausal vegetarians.

    PubMed

    Su, Ta-Chen; Torng, Pao-Ling; Jeng, Jiann-Shing; Chen, Ming-Fong; Liau, Chiau-Suong

    2011-01-01

    Vegetarianism is associated with a lower risk of cardiovascular disease. However, studies of arterial function in vegetarians are limited. This study investigated arterial function in vegetarianism by comparing 49 healthy postmenopausal vegetarians with 41 age-matched omnivores. The arterial function of the common carotid artery was assessed by carotid duplex, while the pulse dynamics method was used to measure brachial artery distensibility (BAD), compliance (BAC), and resistance (BAR). Fasting blood levels of glucose, lipids, lipoprotein (a), high-sensitivity C-reactive protein, homocysteine, and vitamin B12 were also measured. Vegetarians had significantly lower serum cholesterol, high-density and low-density lipoprotein, and glucose compared with omnivores. They also had lower vitamin B12 but higher homocysteine levels. Serum levels of lipoprotein (a) and high-sensitivity C-reactive protein were no different between the two groups. There were no significant differences in carotid beta stiffness index, BAC, and BAD between the two groups even after adjustment for associated covariates. However, BAR was significantly lower in vegetarians than in omnivores. Multiple linear regression analysis revealed that age and pulse pressure were two important determinants of carotid beta stiffness index and BAD. Vegetarianism is not associated with better arterial elasticity. Apparently healthy postmenopausal vegetarians are not significantly better in terms of carotid beta stiffness index, BAC, and BAD, but have significantly decreased BAR than omnivores. Prevention of vitamin B12 deficiency might be beneficial for cardiovascular health in vegetarians.

  19. Histologic and physiologic evaluation of skeletonized internal thoracic artery harvesting with an ultrasonic scalpel.

    PubMed

    Higami, T; Maruo, A; Yamashita, T; Shida, T; Ogawa, K

    2000-12-01

    The safety and reliability of a method of skeletonized internal thoracic artery harvesting with an ultrasonic scalpel (Harmonic Scalpel; Ethicon Endo-Surgery, CVG, Cincinnati, Ohio) were evaluated. The mural branches of the internal thoracic artery were cut by means of 3 methods, differentiated by distance from the site of application of the Harmonic Scalpel blade to the internal thoracic artery. A total of 15 branches were cut from the internal thoracic artery at (0 mm) the origin (group I) or at 1 mm (group II) or 2 mm (group III) distal to the origin. Tissue preparations were examined for successful vessel closure and severity of tissue damage. The length of stump (L) and the length of tissue damage from the stump (D) were determined by a computer image analysis system, and pressure testing was performed to evaluate the physical strength of vessel closure. In group I, 8 of the 15 branches exhibited discontinuity of the vascular wall structure, probably because of insufficient sealing of the divided section, and 12 of the 15 branches exhibited tissue denaturation on the internal thoracic artery wall adjacent to areas of origin, which was probably caused by the heat transferred from the branches during the process of coagulation. In groups II and III, continuity of wall structure of stumps suggestive of stable closure of branches was confirmed. The lengths of tissue damage from the stump (D) were 0.96, 0.58, and 0.63 mm in groups I, II, and III, respectively, and the lengths of intact area (L - D) in the corresponding groups were -0.78, 0.61, and 1.51 mm. The negative figure in group I indicates the presence of tissue damage in the internal thoracic artery itself. By contrast, in groups II and III the internal thoracic arteries were intact, with a safety margin of greater than 0.5 mm. On physiologic evaluation of vessel closure, 2 of the 24 (8.3%) branches burst under a pressure lower than 350 mm Hg because of insufficient vessel coagulation, but the remaining 22

  20. Theoretical study of the effect of stress-dependent remodeling on arterial geometry under hypertensive conditions.

    PubMed

    Rachev, A

    1997-08-01

    Remodeling of arterial geometry was studied on the basis of a theoretical model. Sustained hypertension was simulated by a step increase in blood pressure. The artery was considered to be a thick-walled two-layer tube made of nonlinear elastic incompressible material. The basic hypothesis is that the artery remodels its zero-stress configuration in such a way that the strain and stress distributions in the arterial wall under hypertensive conditions are the same as under normotensive conditions. Using this hypothesis, a method for determining the geometrical dimensions of the zero-stress configuration of the hypertensive artery was proposed. To ensure uniqueness of the solution, two side conditions on the remodeling process are imposed: (a) the inner radius of the artery in the unloaded state remains unchanged; and (b) the ratio between the thickness of the inner and outer layer of the hypertensive artery in the zero-stress configuration is known. The model predicts that the arterial wall remodeling causes: (i) an increase of the wall thickness both in the unloaded and physiological states; (ii) an increase of the inner diameter of the hypertensive vessel under high pressure compared to the diameter of the normotensive artery under normal pressure; (iii) the opened-up configuration which arises when the unloaded arterial segment is cut radially still contains residual strains and stresses. These results are consistent with published experimental findings. It is speculated that the origin of residual stresses that exist in the unloaded and opened-up configurations is the stress-modulated growth.

  1. Coronary artery problems late after arterial switch operation for transposition of the great arteries.

    PubMed

    Tsuda, Takeshi; Bhat, Abdul M; Robinson, Bradley W; Baffa, Jeanne M; Radtke, Wolfgang

    2015-01-01

    The incidence of late coronary artery abnormalities after arterial switch operation (ASO) for d-loop transposition of the great arteries may be underestimated. We retrospectively reviewed coronary artery morphology in 40 of 97 patients who survived the first year after ASO. Seven asymptomatic patients developed significant late coronary artery abnormalities. One patient died suddenly at home with severe left coronary artery (LCA) ostial stenosis at age 3.8 years. The second patient collapsed during exercise at age 9.6 years due to ventricular fibrillation and severe LCA ostial stenosis despite prior negative exercise stress test (EST) and myocardial perfusion imaging (MPI). The third patient was found to have moderate ostial stenosis of the LCA with negative EST and MPI. The fourth patient with exercise-induced ST-T depression and myocardial perfusion defect was shown to have complete LCA occlusion with collateral vessel formation. Three other patients had complete proximal obliteration of either of the coronary arteries with collateral supply. An additional 4 asymptomatic patients had trivial-mild narrowing of the LCA on routine selective coronary angiogram. Incidence of late coronary stenosis or occlusion was not infrequent after ASO (11.3%) and presented usually without preceding symptoms and often after negative non-invasive screening. We advocate routine coronary imaging in all patients after ASO before they participate in competitive sports.

  2. PREFACE: Quantum Optics III

    NASA Astrophysics Data System (ADS)

    Orszag, M.; Retamal, J. C.; Saavedra, C.; Wallentowitz, S.

    2007-06-01

    All the 50 years of conscious pondering did not bring me nearer to an answer to the question `what is light quanta?'. Nowadays, every rascal believes, he knows it, however, he is mistaken. (A Einstein, 1951 in a letter to M Besso) Quantum optics has played a key role in physics in the last several decades. On the other hand, in these early decades of the information age, the flow of information is becoming more and more central to our daily life. Thus, the related fields of quantum information theory as well as Bose-Einstein condensation have acquired tremendous importance in the last couple of decades. In Quantum Optics III, a fusion of these fields appears in a natural way. Quantum Optics III was held in Pucón, Chile, in 27-30 of November, 2006. This beautiful location in the south of Chile is near the lake Villarrica and below the snow covered volcano of the same name. This fantastic environment contributed to a relaxed atmosphere, suitable for informal discussion and for the students to have a chance to meet the key figures in the field. The previous Quantum Optics conferences took place in Santiago, Chile (Quantum Optics I, 2000) and Cozumel, Mexico (Quantum Optics II, 2004). About 115 participants from 19 countries attended and participated in the meeting to discuss a wide variety of topics such as quantum-information processing, experiments related to non-linear optics and squeezing, various aspects of entanglement including its sudden death, correlated twin-photon experiments, light storage, decoherence-free subspaces, Bose-Einstein condensation, discrete Wigner functions and many more. There was a strong Latin-American participation from Argentina, Brazil, Chile, Colombia, Peru, Uruguay, Venezuela and Mexico, as well as from Europe, USA, China, and Australia. New experimental and theoretical results were presented at the conference. In Latin-America a quiet revolution has taken place in the last twenty years. Several groups working in quantum optics and

  3. A log-linearized arterial viscoelastic model for evaluation of the carotid artery.

    PubMed

    Hirano, Harutoyo; Horiuchi, Tetsuya; Kutluk, Abdugheni; Kurita, Yuichi; Ukawa, Teiji; Nakamura, Ryuji; Saeki, Noboru; Higashi, Yukihito; Kawamoto, Masashi; Yoshizumi, Masao; Tsuji, Toshio

    2013-01-01

    This paper proposes a method for qualitatively estimating the mechanical properties of arterial walls on a beat-to-beat basis through noninvasive measurement of continuous arterial pressure and arterial diameter using an ultrasonic device. First, in order to describe the nonlinear relationships linking arterial pressure waveforms and arterial diameter waveforms as well as the viscoelastic characteristics of arteries, we developed a second-order nonlinear model (called the log-linearized arterial viscoelastic model) to allow estimation of arterial wall viscoelasticity. Next, to verify the validity of the proposed method, the viscoelastic indices of the carotid artery were estimated. The results showed that the proposed model can be used to accurately approximate the mechanical properties of arterial walls. It was therefore deemed suitable for qualitative evaluation of arterial viscoelastic properties based on noninvasive measurement of arterial pressure and arterial diameter.

  4. Emborrhoid: A New Concept for the Treatment of Hemorrhoids with Arterial Embolization: The First 14 Cases

    SciTech Connect

    Vidal, V.; Sapoval, M.; Sielezneff, Y.; Parades, V. De; Tradi, F. Louis, G. Bartoli, J. M.; Pellerin, O.

    2015-02-15

    PurposeThe ‘emborrhoid’ technique consists of the embolization of the hemorrhoidal arteries. The endovascular arterial occlusion is performed using coils placed in the terminal branches of the superior rectal arteries. The emborrhoid technique has been modeled after elective transanal Doppler-guided hemorrhoidal artery ligation which has been shown to be effective in hemorrhoidal disease. We report the first 14 cases of our experience with emborrhoid technique.Materials and MethodsFourteen patients with disabling chronic rectal bleeding were treated using the emborrhoid technique (3 women, 11 men). The stage of the hemorrhoidal disease was II (10 patients), III (3), and IV (1). This treatment was decided by a multidisciplinary team (proctologist, visceral surgeon, and radiologist). Seven patients underwent previous proctological surgery. Ten patients had coagulation disorders (anticoagulants or cirrhosis). Superior rectal arteries were embolized with pushable microcoils (0.018).ResultsTechnical success of the embolization procedure was 100 %. Clinical success at 1 month was 72 % (10/14). Of the 4 patients who experienced rebleeding, two underwent additional embolization of the posterior rectal arteries with success. No pain or ischemic complications were observed in 13 patients. One patient experienced a temporary painful and edematous, perianal reaction.ConclusionOur case studies suggest that coil embolization of the superior rectal arteries is technically feasible, safe and well tolerated. Additional studies are needed to evaluate the efficacy of this new ‘emborrhoid’ technique in the management of hemorrhoidal disease.

  5. Rediscovering the wound hematoma as a site of hemostasis during major arterial hemorrhage.

    PubMed

    White, N J; Mehic, E; Wang, X; Chien, D; Lim, E; St John, A E; Stern, S A; Mourad, P D; Rieger, M; Fries, D; Martinowitz, U

    2015-12-01

    Treatments for major internal bleeding after injury include permissive hypotension to decrease the rate of blood loss, intravenous infusion of plasma or clotting factors to improve clot formation, and rapid surgical hemostasis or arterial embolization to control bleeding vessels. Yet, little is known regarding major internal arterial hemostasis, or how these commonly used treatments might influence hemostasis. (i) To use a swine model of femoral artery bleeding to understand the perivascular hemostatic response to contained arterial hemorrhage. (ii) To directly confirm the association between hemodynamics and bleeding velocity. (iii) To observe the feasibility of delivering an activated clotting factor directly to internal sites of bleeding using a simplified angiographic approach. Ultrasound was used to measure bleeding velocity and in vivo clot formation by elastography in a swine model of contained femoral artery bleeding with fluid resuscitation. A swine model of internal pelvic and axillary artery hemorrhage was also used to demonstrate the feasibility of local delivery of an activated clotting factor. In this model, clots formed slowly within the peri-wound hematoma, but eventually contained the bleeding. Central hemodynamics correlated positively with bleeding velocity. Infusion of recombinant human activated factor VII into the injured artery near the site of major internal hemorrhage in the pelvis and axillae was feasible. We rediscovered that clot formation within the peri-wound hematoma is an integral component of hemostasis and a feasible target for the treatment of major internal bleeding using activated clotting factors delivered using a simplified angiographic approach. © 2015 International Society on Thrombosis and Haemostasis.

  6. Waveform patterns and peak reversed velocity in vertebral arteries predict severe subclavian artery stenosis and occlusion.

    PubMed

    Chen, Shun-Ping; Hu, Yuan-Ping

    2015-05-01

    This study investigated the value of analyzing spectral Doppler waveform patterns and measuring the peak reversed velocity (PRV) of the vertebral artery (VA) in predicting proximal severe subclavian artery (SA) stenosis and occlusion. Fifty-one patients with proximal SA stenosis were studied retrospectively. Based on the depth of the mid-systolic notch, the Doppler waveforms of the ipsilateral VA were divided into five subtypes (type I, n = 8; type II, n = 8; type III, n = 6; type IV, n = 13; and type V, n = 16). PRV was also measured. PRV receiver operating characteristic curves were constructed to obtain the best cutoff value for predicting severe SA stenosis or complete SA occlusion. The results indicated that both VA Doppler waveform and PRV were associated with the degree of SA stenosis (p < 0.05). PRV and the Doppler waveform in the VA had similar accuracy in predicting SA occlusion (84.3%, 43/51). PRV was more accurate than VA waveforms in predicting severe SA stenosis (98%, 50/51 vs. 94.1%, 48/51). However, no significant differences between the two methods in predicting severe SA stenosis were observed (p = 0.84). Thus, with severe obstruction of the SA, typical Doppler waveform patterns of the VA could be observed. PRV is a helpful criterion in predicting severe stenosis and occlusion of the SA.

  7. Heart Attack Coronary Artery Disease

    MedlinePlus

    ... our e-newsletter! Aging & Health A to Z Heart Attack Coronary Artery Disease, Angina Basic Facts & Information What ... and oxygen supply; this is what causes a heart attack. If the damaged area is small, however, your ...

  8. Update in pulmonary arterial hypertension.

    PubMed

    Mejía Chew, C R; Alcolea Batres, S; Ríos Blanco, J J

    2016-11-01

    Pulmonary arterial hypertension is a rare and progressive disease that mainly affects the pulmonary arterioles (precapillary), regardless of the triggering aetiology. The prevalence of pulmonary hypertension and pulmonary arterial hypertension in Spain is estimated at 19.2 and 16 cases per million inhabitants, respectively. The diagnosis of pulmonary arterial hypertension is based on haemodynamic criteria (mean pulmonary artery pressure ≥25mmHg, pulmonary capillary wedge pressure ≤15mmHg and pulmonary vascular resistance >3 Wood units) and therefore requires the implementation of right cardiac catheterisation. Sequential therapy with a single drug has been used in clinical practice. However, recent European guidelines recommend combined initial therapy in some situations. This review conducts a critical update of our knowledge of this disease according to the latest guidelines and recommendations.

  9. About Peripheral Artery Disease (PAD)

    MedlinePlus

    ... CAD). Both PAD and CAD are caused by atherosclerosis that narrows and blocks arteries in various critical ... can be managed with lifestyle changes and medication . Atherosclerosis and PAD Atherosclerosis is a disease in which ...

  10. Twist Buckling Behavior of Arteries

    PubMed Central

    Garcia, Justin R.; Lamm, Shawn D.; Han, Hai-Chao

    2012-01-01

    Arteries are often subjected to torsion due to body movement and surgical procedures. While it is essential that arteries remain stable and patent under twisting loads, the stability of arteries under torsion is poorly understood. The goal of this work was to experimentally investigate the buckling behavior of arteries under torsion and to determine the critical buckling torque, the critical buckling twist angle, and the buckling shape. Porcine common carotid arteries were slowly twisted in vitro until buckling occurred while subjected to a constant axial stretch ratio (1.1, 1.3, 1.5 (in vivo level), and 1.7) and lumen pressure (20, 40, 70, and 100 mmHg). Upon buckling, the arteries snapped to form a kink. For a group of six arteries, the axial stretch ratio significantly affected the critical buckling torque (p < 0.002) and the critical buckling twist angle (p < 0.001). Lumen pressure also significantly affected the critical buckling torque (p < 0.001) but had no significant effect on the critical twist angle (p = 0.067). Convex material constants for a Fung strain energy function were determined and fit well with the axial force, lumen pressure, and torque data measured pre-buckling. The material constants are valid for axial stretch ratios, lumen pressures, and rotation angles of 1.3 – 1.5, 20 – 100 mmHg, and 0 – 270 degrees, respectively. The current study elucidates the buckling behavior of arteries under torsion and provides new insight into mechanical instability of blood vessels. PMID:23160845

  11. Twist buckling behavior of arteries.

    PubMed

    Garcia, Justin R; Lamm, Shawn D; Han, Hai-Chao

    2013-10-01

    Arteries are often subjected to torsion due to body movement and surgical procedures. While it is essential that arteries remain stable and patent under twisting loads, the stability of arteries under torsion is poorly understood. The goal of this work was to experimentally investigate the buckling behavior of arteries under torsion and to determine the critical buckling torque, the critical buckling twist angle, and the buckling shape. Porcine common carotid arteries were slowly twisted in vitro until buckling occurred while subjected to a constant axial stretch ratio (1.1, 1.3, 1.5 (in vivo level) and 1.7) and lumen pressure (20, 40, 70 and 100 mmHg). Upon buckling, the arteries snapped to form a kink. For a group of six arteries, the axial stretch ratio significantly affected the critical buckling torque ([Formula: see text]) and the critical buckling twist angle ([Formula: see text]). Lumen pressure also significantly affected the critical buckling torque ([Formula: see text]) but had no significant effect on the critical twist angle ([Formula: see text]). Convex material constants for a Fung strain energy function were determined and fit well with the axial force, lumen pressure, and torque data measured pre-buckling. The material constants are valid for axial stretch ratios, lumen pressures, and rotation angles of 1.3-1.5, 20-100 mmHg, and 0-270[Formula: see text], respectively. The current study elucidates the buckling behavior of arteries under torsion and provides new insight into mechanical instability of blood vessels.

  12. Carotid Artery Stenting 2013: Thumbs up

    PubMed Central

    Wagdi, Philipp

    2013-01-01

    It has been customary for interventional cardiologists involved in carotid artery stenting, to underline non-inferiority of the percutaneous technique versus surgical carotid endarterectomy. To that end, all cause morbidity and mortality figures of both methods are compared. Surgery has, in most large randomized studies, had an edge over stenting in terms of cerebrovascular adverse events. This may have partly been due to occasional indiscriminate indication for stenting in lesions and/or vessels with unfavourable characteristics (severe target vessel tortuosity and calcification, Type III aortic arch, and so on). On one hand, the author pleads for improvement of the excellent results of endarterectomy, by subjecting all patients planned for surgery to a thorough preoperative cardiological work up, including generous invasive investigation, thus reducing the incidence of perioperative myocardial infarction, heart failure and cardiac death. On the other hand, we are convinced that the results of carotid stenting should then be compared to best practice surgery. The rate of neurological adverse event rate after carotid endarterectomy at our institution lies under 0.7% at 30 days postoperatively. Specifically, the goal should be that carotid stenting underbids surgical endarterectomy, also and mainly, in terms of cerebral and cerebrovascular adverse events. Cardiac morbidity and mortality as well as laryngeal nerve palsy should no more be the main arguments for the percutaneous approach. This should easily be possible if patient selection for carotid revascularisation would be approached according to morphological criteria, in analogy with the “Syntax”-score used to optimise revascularisation strategies in coronary artery disease.

  13. [Ageing of the arterial wall].

    PubMed

    Hanon, O

    2006-11-01

    Several mechanisms are implicated in the arterial wall changes due to ageing: ageing, hypertension and atherosclerosis. Although the changes related to ageing (arteriosclerosis) have many factors in common with those induced by hypertension, they differ from those caused by atherosclerosis although commonly associated. Arteriosclerosis causes a diffuse increase of the rigidity of the large arteries by disease of the media, the main clinical manifestation of which is the increase in pulsed pressure. This arterial "hyperpulsability" contributes to a defect in coupling between the heart and the blood vessels which results in an increase in the pulsatile load of the left ventricle and to left ventricular hypertrophy and decreased coronary perfusion. Atherosclerosis seems more of a localised scarring phenomenon of the arterial wall which is exposed to a series of chronic aggressions characterised by deposits of lipids in the intima and whose main complication is thrombosis. Although these two processes may be associated, or interact one with the other, they are clearly different in nature. Therefore, atherosclerosis is a localised disease resulting in a decrease in arterial lumen, quite different from arteriosclerosis which is a diffuse, physiological condition which leads to an increase in the arterial lumen.

  14. Arterial Stiffness and Cardiovascular Therapy

    PubMed Central

    Janić, Miodrag; Lunder, Mojca; Šabovič, Mišo

    2014-01-01

    The world population is aging and the number of old people is continuously increasing. Arterial structure and function change with age, progressively leading to arterial stiffening. Arterial stiffness is best characterized by measurement of pulse wave velocity (PWV), which is its surrogate marker. It has been shown that PWV could improve cardiovascular event prediction in models that included standard risk factors. Consequently, it might therefore enable better identification of populations at high-risk of cardiovascular morbidity and mortality. The present review is focused on a survey of different pharmacological therapeutic options for decreasing arterial stiffness. The influence of several groups of drugs is described: antihypertensive drugs (angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, calcium channel blockers, beta-blockers, diuretics, and nitrates), statins, peroral antidiabetics, advanced glycation end-products (AGE) cross-link breakers, anti-inflammatory drugs, endothelin-A receptor antagonists, and vasopeptidase inhibitors. All of these have shown some effect in decreasing arterial stiffness. Nevertheless, further studies are needed which should address the influence of arterial stiffness diminishment on major adverse cardiovascular and cerebrovascular events (MACCE). PMID:25170513

  15. Viking Phase III

    NASA Technical Reports Server (NTRS)

    1978-01-01

    VIKING PHASE III - With the incredible success of the Viking missions on Mars, mission operations have progressed though a series of phases - each being funded as mission success dictated its potential. The Viking Primary Mission phase was concluded in November, 1976, when the reins were passed on to the second phase - the Viking Extended Mission. The Extended Mission successfully carried spacecraft operations through the desired period of time needed to provided a profile of a full Martian year, but would have fallen a little short of connecting and overlapping a full Martian year of Viking operations which scientists desired as a means of determining the degree of duplicity in the red planet's seasons - at least for the summer period. Without this continuation of spacecraft data acquisitions to and beyond the seasonal points when the spacecraft actually began their Mars observations, there would be no way of knowing whether the changing environmental values - such as temperatures and winds atmospheric dynamics and water vapor, surface thermal dynamics, etc. - would match up with those acquired as the spacecraft began investigations during the summer and fall of 1976. This same broad interest can be specifically pursued at the surface - where hundreds of rocks, soil drifts and other features have become extremely familiar during long-term analysis. This picture was acquired on the 690th Martian day of Lander 1 operations - 4009th picture sequence commanded of the two Viking Landers. As such, it became the first picture acquired as the third phase of Viking operations got under way - the Viking Continuation Mission. Between the start of the Continuation Mission in April, 1978, until spacecraft operations are concluded in November, the landers will acquire an additional 200 pictures. These will be used to monitor the two landscaped for the surface changes. All four cameras, two on Lander 1 and two on Lander 2, continue to operate perfectly. Both landers will also

  16. Association between arterial stiffness and peripheral artery disease as measured by radial artery tonometry.

    PubMed

    Zahner, Greg J; Gruendl, Magdalena A; Spaulding, Kimberly A; Schaller, Melinda S; Hills, Nancy K; Gasper, Warren J; Grenon, S Marlene

    2017-07-26

    Arterial stiffness and peripheral artery disease (PAD) are both associated with an elevated risk of major adverse cardiac events; however, the association between arterial stiffness and PAD is less well characterized. The goal of this study was to examine the association between parameters of radial artery tonometry, a noninvasive measure of arterial stiffness, and PAD. We conducted a cross-sectional study of 134 vascular surgery outpatients (controls, 33; PAD, 101) using arterial applanation tonometry. Central augmentation index (AIX) normalized to 75 beats/min and peripheral AIX were measured using radial artery pulse wave analysis. Pulse wave velocity was recorded at the carotid and femoral arteries. PAD was defined as symptomatic claudication with an ankle-brachial index of <0.9 or a history of peripheral revascularization. Controls had no history of atherosclerotic vascular disease and an ankle-brachial index ≥0.9. Among the 126 participants with high-quality tonometry data, compared with controls (n = 33), patients with PAD (n = 93) were older, with higher rates of hypertension, hyperlipidemia, diabetes, and smoking (P < .05). Patients with PAD also had greater arterial stiffness as measured by central AIX, peripheral AIX, and pulse wave velocity (P < .05). In a multivariable model, a significantly increased odds of PAD was associated with each 10-unit increase in central AIX (odds ratio, 2.1; 95% confidence interval, 1.1-3.9; P = .03) and peripheral AIX (odds ratio, 1.9; 95% confidence interval, 1.2-3.2; P = .01). In addition, central and peripheral AIX were highly correlated (r120 = 0.76; P < .001). In a cross-sectional analysis, arterial stiffness as measured by the AIX is independently associated with PAD, even when adjusting for several atherosclerotic risk factors. Further prospective data are needed to establish whether radial artery tonometry could be a tool for risk stratification in the PAD population. Copyright © 2017 Society for

  17. Aortic Branch Artery Pseudoaneurysms Associated with Intramural Hematoma: When and How to Do Endovascular Embolization

    SciTech Connect

    Ferro, Carlo; Rossi, Umberto G. Seitun, Sara; Scarano, Flavio; Passerone, Giancarlo; Williams, David M.

    2013-04-15

    To describe when and how to perform endovascular embolization of aortic branch artery pseudoaneurysms associated with type A and type B intramural hematoma (IMH) involving the descending thoracic and abdominal aorta (DeBakey I and III) that increased significantly in size during follow-up. Sixty-one patients (39 men; mean {+-} standard deviation age 66.1 {+-} 11.2 years) with acute IMH undergoing at least two multidetector computed tomographic examinations during follow-up for 12 months or longer were enrolled. Overall, 48 patients (31 men, age 65.9 {+-} 11.5) had type A and type B IMH involving the descending thoracic and abdominal aorta (DeBakey I and III). Among the 48 patients, 26 (54 %; 17 men, aged 64.3 {+-} 11.4 years) had 71 aortic branch artery pseudoaneurysms. Overall, during a mean follow-up of 22.1 {+-} 9.5 months (range 12-42 months), 31 (44 %) pseudoaneurysms disappeared; 22 (31 %) decreased in size; two (3 %) remained stable; and 16 (22 %) increased in size. Among the 16 pseudoaneurysms with increasing size, five of these (three intercostal arteries, one combined intercostobronchial/intercostal arteries, one renal artery), present in five symptomatic patients, had a significant increase in size (thickness >10 mm; width and length >20 mm). These five patients underwent endovascular embolization with coils and/or Amplatzer Vascular Plug. In all patients, complete thrombosis and exclusion of aortic pseudoaneurysm and relief of back pain were achieved. Aortic branch artery pseudoaneurysms associated with type A and type B IMH involving the descending thoracic and abdominal aorta (DeBakey I and III) may be considered relatively benign lesions. However, a small number may grow in size or extend longitudinally with clinical symptoms during follow-up, and in these cases, endovascular embolization can be an effective and safe procedure.

  18. Middle Cerebral Artery Calcification

    PubMed Central

    Kao, Hung-Wen; Liou, Michelle; Chung, Hsiao-Wen; Liu, Hua-Shan; Tsai, Ping-Huei; Chiang, Shih-Wei; Chou, Ming-Chung; Peng, Giia-Sheun; Huang, Guo-Shu; Hsu, Hsian-He; Chen, Cheng-Yu

    2015-01-01

    Abstract Calcification of the middle cerebral artery (MCA) is uncommon in the healthy elderly. Whether calcification of the MCA is associated with cerebral ischemic stroke remains undetermined. We intended to investigate the association using Agatston calcium scoring of the MCA. This study retrospectively included 354 subjects with ischemic stroke in the MCA territory and 1518 control subjects who underwent computed tomography (CT) of the brain. We recorded major known risk factors for ischemic stroke, including age, gender, hypertension, diabetes mellitus, smoking, hyperlipidemia, and obesity, along with the MCA calcium burden, measured with the Agatston calcium scoring method. Univariate and modified logistic regression analyses were performed to examine the association between the MCA calcification and ischemic stroke. The univariate analyses showed significant associations of ischemic stroke with age, hypertension, diabetes mellitus, smoking, total MCA Agatston score, and the presence of calcification on both or either side of the MCA. Subjects with the presence of MCA calcification on both or either side of the MCA were 8.46 times (95% confidence interval, 4.93–14.53; P < 0.001) more likely to have a cerebral infarct than subjects without MCA calcification after adjustment for the major known risk factors, including age, hypertension, diabetes mellitus, and smoking. However, a higher degree of MCA calcification reflected by the Agatston score was not associated with higher risk of MCA ischemic stroke after adjustment for the confounding factors and presence of MCA calcification. These results suggest that MCA calcification is associated with ischemic stroke in the MCA territory. Further prospective studies are required to verify the clinical implications of the MCA calcification. PMID:26683969

  19. Pulmonary artery sarcoma.

    PubMed

    Blackmon, Shanda H; Reardon, Michael J

    2010-01-01

    Primary heart tumors are rare, and malignant primary heart tumors are only a small subset of these. Most primary malignant tumors are sarcomas arising from the cells of the structural elements of the heart such as blood vessels, muscle, connective tissue, fat and even bone. Unlike most malignancies, where cell type often dictates treatment choices and prognosis and is used for classification, the histology in primary cardiac sarcoma plays little role in determining therapeutic options or prognosis. We have found that anatomic location within the heart is the major determining factor in clinical presentation, treatment options and prognosis in cardiac sarcoma. Therefore, we accordingly classify primary cardiac sarcomas into right heart sarcomas, left heart sarcomas and pulmonary artery (PA) sarcomas. Since the first autopsy report of a primary PA sarcoma in 1923, there have been fewer than 250 cases reported in the English literature. Most of these reports have been single autopsy or case reports, and patient prognosis has generally been dismal. Since few institutions and even fewer individual physicians acquire much exposure to this disease, the diagnostic and treatment approaches have remained unresolved. Our cardiac sarcoma group working at the Methodist DeBakey Heart & Vascular Center and the MD Anderson Cancer Center has undertaken a systematic study of this disease, and operated on 9 patients using a radical resection with curative intent and multimodality approach. Based on this work, we have suggested a diagnostic strategy, treatment approach and staging system for primary PA sarcoma. A substantial improvement in patient survival over historical controls has also been demonstrated and will be discussed in this review.

  20. Ophthalmic Artery Chemosurgery for Less Advanced Intraocular Retinoblastoma: Five Year Review

    PubMed Central

    Abramson, David H.; Marr, Brian P.; Brodie, Scott E.; Dunkel, Ira; Palioura, Sotiria; Gobin, Y. Pierre

    2012-01-01

    Background Ophthalmic artery chemosurgery (OAC) for retinoblastoma was introduced by us 5 years ago for advanced intraocular retinoblastoma. Because the success was higher than with existing alternatives and systemic side effects limited we have now treated less advanced intraocular retinoblastoma (Reese-Ellsworth (RE) I-III and International Classification Retinoblastoma (ICRB) B and C). Methodology/Principal Findings Retrospective review of 5 year experience in eyes with Reese Ellsworth (Table 1) I (7 eyes), II (6 eyes) or III (6 eyes) and/or International Classification (Table 2) B (19 eyes) and C (11 eyes) treated with OAC (melphalan with or without topotecan) introduced directly into the ophthalmic artery. Patient survival was 100%. Ocular event-free survival was 100% for Reese-Ellsworth Groups I, II and III (and 96% for ICRB B and C) at a median of 16 months follow-up. One ICRB Group C (Reese-Ellsworth Vb) eye could not be treated on the second attempt for technical reasons and was therefore enucleated. No patient required a port and only one patient required transfusion of blood products. The electroretinogram (ERG) was unchanged or improved in 14/19 eyes. Conclusions/Significance Ophthalmic artery chemosurgery for retinoblastoma that was Reese-Ellsworth I, II and III (or International Classification B or C) was associated with high success (100% of treatable eyes were retained) and limited toxicity with results that equal or exceed conventional therapy with less toxicity. PMID:22545080

  1. Cranial mononeuropathy III - diabetic type

    MedlinePlus

    ... diabetic type of cranial mononeuropathy III is a complication of diabetes . It causes double vision and eyelid drooping . ... Cooper ME, Vinik AI, Plutzky J, Boulton AJM. Complications of diabetes mellitus. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg ...

  2. Division III: Planetary Systems Science

    NASA Astrophysics Data System (ADS)

    Bowell, Edward L. G.; Meech, Karen J.; Williams, Iwan P.; Boss, Alan; Courtin, Régis; Gustafson, Bo Å. S.; Levasseur-Regourd, Anny-Chantal; Mayor, Michel; Spurný, Pavel; Watanabe, Jun-ichi; Consolmagno, Guy J.; Fernández, Julio A.; Huebner, Walter F.; Marov, Mikhail Ya.; Schulz, Rita M.; Valsecchi, Giovanni B.; Witt, Adolf N.

    2010-05-01

    The meeting was opened by Ted Bowell, president, at 11 am. The 2006 Division III meetings were reviewed by Guy Consolmagno, secretary; as the minutes of those meetings have already been published, they were assumed to be approved.

  3. Division Iii: Planetary System Sciences

    NASA Astrophysics Data System (ADS)

    Williams, Iwan P.; Bowell, Edward L. G.; Marov, Mikhail Ya.; Consolmagno, Guy J.; A'Hearn, Michael F.; Boss, Alan P.; Cruikshank, Dale P.; Levasseur-Regord, Anny-Chantal; Morrison, David; Tinney, Christopher G.

    2007-12-01

    Division III gathers astronomers engaged in the study of a comprehensive range of phenomena in the solar system and its bodies, from the major planets via comets to meteorites and interplanetary dust.

  4. The safety of brachial artery puncture for arterial blood sampling.

    PubMed

    Okeson, G C; Wulbrecht, P H

    1998-09-01

    This study was designed to determine the incidence of complications in a sample of 6,185 brachial artery punctures for arterial blood gas analysis. The study sample was comprised of adult patients who had arterial blood gas analysis ordered in the course of their clinical evaluations in a multispecialty clinic and hospital affiliated with a university school of medicine. Subjects were entered prospectively at the time the procedure was done. The overall incidence of all complications was 2.0%. Immediate limb pain or parenthesias occurred in 1.1%, while the onset of symptoms was delayed up to 24 h in 0.9%. Hematoma formation occurred in only 0.06%. None of the complications was considered to be of major impact, in that none was associated with limb ischemia or other objective abnormalities. Only one subject required analgesic medication to control pain that ultimately subsided spontaneously without deficit. We believe that brachial artery puncture, when properly performed, is a safe and reliable alternative route for obtaining arterial blood for gas analysis.

  5. Signs and Symptoms of Artery Disease | Coronary Artery Disease | NIH MedlinePlus the Magazine

    MedlinePlus

    ... of this page please turn Javascript on. Feature: Coronary Artery Disease Signs and Symptoms of Artery Disease Past Issues / ... narrows or blocks these arteries—a condition called coronary artery disease (CAD) or coronary heart disease (CHD) occurs. A ...

  6. Ultrasound-Guided Arterial Access: Outcomes Among Patients With Peripheral Artery Disease and Critical Limb Ischemia Undergoing Peripheral Interventions.

    PubMed

    Mustapha, J A; Diaz-Sandoval, Larry J; Jaff, Michael R; Adams, George; Beasley, Robert; Finton, Sara; McGoff, Theresa; Miller, Larry E; Ansari, Mohammad; Saab, Fadi

    2016-06-01

    Arterial cannulation is a vital component of endovascular interventions and often unconventional access approaches are required due to disease complexity. Historically, varying maneuvers have been utilized to obtain arterial access. Lack of consensus exists regarding the safest and most effective method. This study examined the feasibility and immediate outcomes of ultrasound-guided access in traditional and advanced access approaches. Data were analyzed from a cohort of 407 patients enrolled in the Peripheral RegIstry of Endovascular Clinical OutcoMEs (PRIME). The 407 patients underwent 649 procedures with 896 access sites utilized. Access success, immediate outcomes, complications, and length of hospital stay were analyzed. Mean age was 70 years, and 67% were male. The majority of patients had critical limb ischemia (58%), 39% were Rutherford classification III. Most commonly utilized access sites were common femoral retrograde, common femoral antegrade, posterior tibial, and anterior tibial arteries (34.6%, 33.0%, 12.1%, and 12.1%, respectively). Mean number of attempts was 1.2, 1.2, 1.5, and 1.4, respectively; median time to access was 39, 45, 41, and 59 seconds, respectively; and access success rate was 99.4%, 97.3%, 90.7%, and 92.6%; respectively. Access-site combinations utilized were femoral antegrade (n = 188), femoral retrograde (n = 185), dual femoral/ tibio-pedal (n = 130), dual femoral retrograde (n = 44), retrograde tibio-pedal (n = 73), and other (n = 29). Access-related complications were low overall: hematoma (1.2%), bleeding requiring transfusion/intervention (1.7%), pseudoaneurysm (1.7%), arteriovenous fistula (0.3%), aneurysm (0%), compartment syndrome (0%), and death (0%). Utilization of ultrasound-guided arterial access in this complex cohort was shown to be safe and effective regardless of arterial bed and approach.

  7. Atherosclerotic Oxalosis in Coronary Arteries

    PubMed Central

    Fishbein, Gregory A.; Micheletti, Robert G.; Currier, Judith S.; Singer, Elyse; Fishbein, Michael C.

    2008-01-01

    Summary There are many forms of oxalosis, with deposition of oxalate crystals in various organs, including arteries. In this retrospective study we describe deposition of calcium oxalate crystals within atherosclerotic plaques in coronary arteries of 4 patients, a site of oxalate deposition not previously reported. We suggest the phrase “atherosclerotic oxalosis” for this finding. Background Systemic oxalosis may be hereditary or acquired. In these cases, calcium oxalate deposits have been reported in numerous tissues, including the media of arteries. In any category, calcium oxalate deposition has not been described within atherosclerotic plaques in any arteries. Methods As part of a retrospective clinicopathologic study, 80 hearts were obtained from the National Neurologic AIDS Bank in an effort to study coronary atherosclerosis in patients infected with HIV. The population consisted of 66 HIV-positive and 14 HIV-negative patients with an average age of 47 years; 79% were males. Proximal coronary arteries were serially-sectioned and processed routinely. Sections were studied by H&E staining, and in selected cases, von Kossa stain, and alizarin red S under different conditions, including polarized light, to allow distinction of calcium phosphate from calcium oxalate. Medical histories, autopsy reports, and general autopsy slides were reviewed. Results In 4 patients (3 with AIDS) calcium oxalate crystals were observed within atherosclerotic plaques in the coronary arteries. Similar deposits were seen in the thyroid gland and other organs, but not in the kidneys. None of the patients had chronic renal failure. Conclusion The calcium oxalate crystal deposits observed in the atherosclerotic plaques in coronary arteries of these 4 patients are unique in two ways: 1) these deposits have not previously been described in atherosclerotic plaques, 2) the patients did not demonstrate any of the recognized patterns of oxalosis. We suggest the phrase

  8. Updating quasar bolometric luminosity corrections - III. [O iii] bolometric corrections

    NASA Astrophysics Data System (ADS)

    Pennell, Alison; Runnoe, Jessie C.; Brotherton, M. S.

    2017-06-01

    We present quasar bolometric corrections using the [O III] λ 5007 narrow emission line luminosity based on the detailed spectral energy distributions of 53 bright quasars at low to moderate redshift (0.0345 < z < 1.0002). We adopted two functional forms to calculate Liso, the bolometric luminosity determined under the assumption of isotropy: {L_{iso}}=A {L_{[O III]}} for comparison with the literature and {log(L_{iso})}=B+C log(L_{[O III]}), which better characterizes the data. We also explored whether 'Eigenvector 1 (EV1)', which describes the range of quasar spectral properties and quantifies their diversity, introduces scatter into the L_{[O III]}-Liso relationship. We found that the {[O III]} bolometric correction can be significantly improved by adding a term including the equivalent width ratio R_{Fe II} ≡ EW_{{Fe II}}/EW_{Hβ }, which is an EV1 indicator. Inclusion of R_{Fe II} in predicting Liso is significant at nearly the 3σ level and reduces the scatter and systematic offset of the luminosity residuals. Typically, {[O III]} bolometric corrections are adopted for Type 2 sources where the quasar continuum is not observed and in these cases, R_{Fe II} cannot be measured. We searched for an alternative measure of EV1 that could be measured in the optical spectra of Type 2 sources but were unable to identify one. Thus, the main contribution of this work is to present an improved {[O III]} bolometric correction based on measured bolometric luminosities and highlight the EV1 dependence of the correction in Type 1 sources.

  9. Anomalous superficial ulnar artery based flap

    PubMed Central

    Ramani, C. V.; Kundagulwar, Girish K.; Prabha, Yadav S.; Dushyanth, Jaiswal

    2014-01-01

    Upper limb shows a large number of arterial variations. This case report describes the presence of additional superficial ulnar artery which was used to raise a pedicle flap to cover an arm defect thus avoided using the main vessel of the forearm - radial or ulnar artery. Vascular anomalies occurring in the arm and forearm tend to increase the likelihood of damaging the superficial anomalous arteries during surgery. Superficial ulnar or radial arteries have been described to originate from the upper third of the brachial artery; here we report the origin of the anomalous superficial ulnar artery originating from the brachial artery at the level of elbow with the concomitant presence of normal deep radial and ulnar arteries. PMID:24987217

  10. Atherosclerotic oxalosis in coronary arteries.

    PubMed

    Fishbein, Gregory A; Micheletti, Robert G; Currier, Judith S; Singer, Elyse; Fishbein, Michael C

    2008-01-01

    Systemic oxalosis may be hereditary or acquired. In these cases, calcium oxalate deposits have been reported in numerous tissues, including the media of arteries. In any category, calcium oxalate deposition has not been described within atherosclerotic plaques in any arteries. As part of a retrospective clinicopathologic study, 80 hearts were obtained from the National Neurological AIDS Bank in an effort to study coronary atherosclerosis in patients infected with HIV. The population consisted of 66 HIV-positive and 14 HIV-negative patients with an average age of 47 years; 79% were males. Proximal coronary arteries were serially sectioned and processed routinely. Sections were studied by hematoxylin and eosin staining and, in selected cases, von Kossa stain and alizarin red S under different conditions, including polarized light, to allow distinction of calcium phosphate from calcium oxalate. Medical histories, autopsy reports, and general autopsy slides were reviewed. In four patients (three with AIDS), calcium oxalate crystals were observed within atherosclerotic plaques in the coronary arteries. Similar deposits were seen in the thyroid gland and other organs but not in the kidneys. None of the patients had chronic renal failure. The calcium oxalate crystal deposits observed in the atherosclerotic plaques in the coronary arteries of these four patients are unique in two ways: (a) these deposits have not previously been described in atherosclerotic plaques; (b) the patients did not demonstrate any of the recognized patterns of oxalosis. We suggest the phrase "atherosclerotic oxalosis" to describe this finding.

  11. Engineering of arteries in vitro.

    PubMed

    Huang, Angela H; Niklason, Laura E

    2014-06-01

    This review will focus on two elements that are essential for functional arterial regeneration in vitro: the mechanical environment and the bioreactors used for tissue growth. The importance of the mechanical environment to embryological development, vascular functionality, and vascular graft regeneration will be discussed. Bioreactors generate mechanical stimuli to simulate biomechanical environment of arterial system. This system has been used to reconstruct arterial grafts with appropriate mechanical strength for implantation by controlling the chemical and mechanical environments in which the grafts are grown. Bioreactors are powerful tools to study the effect of mechanical stimuli on extracellular matrix architecture and mechanical properties of engineered vessels. Hence, biomimetic systems enable us to optimize chemo-biomechanical culture conditions to regenerate engineered vessels with physiological properties similar to those of native arteries. In addition, this article reviews various bioreactors designed especially to apply axial loading to engineered arteries. This review will also introduce and examine different approaches and techniques that have been used to engineer biologically based vascular grafts, including collagen-based grafts, fibrin-gel grafts, cell sheet engineering, biodegradable polymers, and decellularization of native vessels.

  12. Arterial calcification: A new perspective?

    PubMed

    Nicoll, R; Henein, M

    2017-02-01

    Arterial calcification is commonly seen in atherosclerosis, chronic kidney disease (CKD) and diabetes and has long been considered a natural progression of atherosclerosis. Yet it is a systemic condition, occurring in a wide and diverse range of disease states and no medical treatment for cardiovascular disease has yet found a way to regress it; on the contrary, lipid-lowering therapy may worsen its progression. Although numerous studies have found associations between calcification and biomarkers, none has yet found a unifying mechanism that explains the calcification found in atherosclerosis, CKD or diabetes and many of the biomarkers are equally associated with atheroma development and cardiovascular events. Furthermore, both presence and absence of coronary artery calcification appear predictive of plaque rupture and cardiovascular events, indicating that the association is not causal. This suggests that we are no further forward in understanding the true nature of arterial calcification or its pathogenesis, other than noting that it is 'multifactorial'. This is because most researchers view arterial calcification as a progressive pathological condition which must be treated. Instead, we hypothesise that calcification develops as an immune response to endothelial injury, such as shear stress or oxidative stress in diabetics, and is consequently part of the body's natural defences. This would explain why it has been found to be protective of plaque rupture and why it is unresponsive to lipid-lowering agents. We propose that instead of attempting to treat arterial calcification, we should instead be attempting to prevent or treat all causes of endothelial injury.

  13. Arterial supply of the thumb: Systemic review.

    PubMed

    Miletin, J; Sukop, A; Baca, V; Kachlik, D

    2017-10-01

    We offer a complete systemic review of the anatomy of arteries of the thumb, including their sources in the first web space. Eleven studies were selected from the PubMed, Medline, Embase, Scopus and Ovid databases. Data about each artery of the thumb were obtained; in particular, the incidence and dominance of each of these arteries were calculated. The ulnopalmar digital artery of the thumb (UPDAT) was found in 99.63%, the radiopalmar digital artery of the thumb (RPDAT) in 99.26%, the ulnodorsal digital artery of the thumb (UDDAT) in 83.39%, and the radiodorsal digital artery of the thumb (RDDAT) in 70.38%. The sources for the thumb arteries are the first palmar metacarpal artery (for UPDAT in 63.15%, for RPDAT in 78.88%, for UDDAT in 56.95% and for RDDAT in 41.48%), the first dorsal metacarpal artery (for UPDAT in 20.54%, for RPDAT 2.53%, for UDDAT in 20.62%, and for RDDAT in 4.81%) and the superficial palmar arch, either complete or incomplete (for UPDAT in 25.57%, for RPDAT in 23.04%, for UDDAT in 0%, and for RDDAT in 5.19%). The dominant source could be identified in 88.2% of cases: the first palmar metacarpal artery (66.2%), the first dorsal metacarpal artery (15.5%) and the superficial palmar arch, complete or incomplete (8.2%). Four arteries usually supply the thumb. Any artery in the first web space can be a source for the thumb arteries. We propose a new classification of the arteries of the hand, dividing them into three systems (superficial palmar, deep palmar and dorsal system), and suggest that the term "princeps pollicis artery" be reconsidered and systemic anatomical terms of the thumb arteries preferred. Clin. Anat. 30:963-973, 2017. ©2017 Wiley-Liss, Inc. © 2017 Wiley Periodicals, Inc.

  14. [Reconstruction of foot arteries after injury in arterial occlusive disease].

    PubMed

    Flis, V; Tomazic, T

    1993-06-01

    At the Maribor Teaching Hospital two elderly with progressive atherosclerotic disease below the knee were treated between 1986-1992 for open fracture of ankle joint and pedal arterial trauma. The only patent atherosclerotic vessel (dorsal artery of the foot) that was disrupted was reconstructed in both cases by interposition of a part of the great and small saphenous vein in one case each. A termino-terminal anastomosis with a long, triangular patch was used, fixed with interrupted sutures. The fractures were stabilized with external fixators. Both extremities were saved.

  15. Comparison of imaging value for diabetic lower extremity arterial disease between FBI and CE-MRA.

    PubMed

    Yi, C-Y; Zhou, D-X; Li, H-H; Wang, Y; Chen, K; Chen, J; Huang, B-C; Xu, X-L

    2016-07-01

    This study adopted self-control study method to assess the efficacy of fresh blood imaging (FBI) and contrast-enhanced MR angiography (CE-MRA) for patients with diabetic lower extremity arterial disease (DLEAD) (Fontaine stage I to IV), and to evaluate the imaging of lower extremity peripheral arterial disease (PAD) in different stages of diabetes mellitus (DM). 1. This study recruited 44 diabetic patients with suspected lower extremity PAD to take both FBI and CE-MRA. 2. Two experienced cardiovascular radiologists assessed the image quality, the detection of lower extremity arterial branches, and tissue contamination (veins, arteries, and soft tissues) of FBI and CE-MRA, as well as the presence and severity of stenotic lesions. 3. Statistical differences of the quality of FBI and CE-MRA were determined using paired t-test. 4. Correlation analysis was adopted for determining the direction and strength of the relationship between the changes of the indexes of FBI and the different Fontaine stages. 1. The quality evaluation results of the image of lower extremity arteries from the 44 diabetic patients indicated no statistically significant difference between FBI and CE-MRA in the patients with Fontaine stage I-III (p >0.05). However, a statistically significant difference was observed in the patients with Fontaine stage IV (p <0.05), and the quality of FBI was slightly worse. 2. Arterial branches that observed from FBI and CE-MRA were 885 and 904, respectively. There was no statistically significant difference for the arterial branches between FBI and CE-MRA in the patients with Fontaine stage I-III (p >0.05). However, a statistically significant difference was observed in the patients with Fontaine stage IV (p <0.05), and CE-MRA indicated more artery branches than FBI. 3. There was a statistically significant difference for the evaluation of venous contamination between FBI and CE-MRA (p <0.05), and there was less venous contamination using FBI. 4. The study results

  16. Monitoring microcirculatory changes in the deep inferior epigastric artery perforator flap with laser Doppler perfusion imaging.

    PubMed

    Tindholdt, Tyge Tind; Saidian, Said; Pripp, Are Hugo; Tønseth, Kim Alexander

    2011-08-01

    Microcirculatory changes were monitored in 20 deep inferior epigastric artery perforator (DIEAP) flaps during unilateral breast reconstruction until the seventh postoperative day using laser Doppler perfusion imaging. Measurements were recorded according to the zonal classification by Scheflan and Dinner. The cutaneous territory zone IV was discarded during insetting due to marginal circulation. The highest perfusion levels were found the first postoperative day for both zones I and III. Postoperative perfusion values were significantly higher for these zones compared with zone II. Immediately after revascularization, zone I was significantly better perfused than both II and III. However, the perfusion in zone III stabilized at the level of zone I in the postoperative phase. Evaluating microcirculatory changes in the DIEAP flap with laser Doppler perfusion imaging showed that zones I and III have higher perfusion levels than zone II in the postoperative phase.

  17. Resting arterial hypoxaemia in subjects with chronic heart failure, pulmonary hypertension and patent foramen ovale.

    PubMed

    Lovering, Andrew T; Lozo, Mislav; Barak, Otto; Davis, James T; Lojpur, Mihajlo; Lozo, Petar; Čaljkušić, Krešimir; Dujić, Željko

    2016-05-01

    What is the central question of this study? Does a patent foramen ovale contribute to resting arterial hypoxaemia, defined as arterial oxygen saturation <95%, in subjects with chronic heart failure with or without pulmonary arterial hypertension? What is the main finding and its importance? The presence of a patent foramen ovale contributed to resting arterial hypoxaemia only in subjects with chronic heart failure with pulmonary arterial hypertension. These data suggest that the presence of a patent foramen ovale should be considered in chronic heart failure patients with arterial hypoxaemia and pulmonary hypertension. The roles of intrapulmonary and intracardiac shunt in contributing to arterial hypoxaemia at rest in subjects with chronic heart failure (CHF) have not been well investigated. We hypothesized that blood flow through intrapulmonary arteriovenous anastomoses (Q̇ IPAVA ) and/or patent foramen ovale (Q̇ PFO ) could potentially contribute to arterial hypoxaemia and, with pulmonary hypertension (PH) secondary to CHF, this contribution may be exacerbated. Fifty-six subjects with CHF (New York Heart Association Classes I-III), with (+) or without (-) PH [defined as peak tricuspid regurgitation velocity ≥2.9 m s(-1) (CHF PH+, n = 32) and peak tricuspid regurgitation velocity ≤2.8 m s(-1) (CHF PH-, n = 24)], underwent arterial blood gas analysis and transthoracic saline contrast echocardiography concomitant with transcranial Doppler to detect Q̇ IPAVA and Q̇ PFO . Seventeen of 56 subjects with CHF (30%) had Q̇ PFO , but only four of 56 subjects with CHF had Q̇ IPAVA (7%), both similar to age- and sex-matched control subjects. Mean arterial oxygen saturation (SaO2) was lower in subjects with Q̇ PFO . Only CHF PH+ subjects with Q̇ PFO had arterial hypoxaemia (mean SaO2 <95%). Bubble scores assessed using transthoracic saline contrast echocardiography were correlated with microembolic signals detected with transcranial Doppler in subjects with

  18. Coronary revascularization after arterial switch operation.

    PubMed

    Prifti, Edvin; Bonacchi, Massimo; Luisi, Stefano Vincenzo; Vanini, Vittorio

    2002-01-01

    We report two cases presenting bilateral coronary artery obstruction after arterial switch operation. The first patient underwent bilateral internal thoracic artery grafting to the left and right coronary arteries. The other patient, presenting a single coronary ostium, underwent surgical coronary ostial angioplasty in concomitance to proximal arterioplasty of both coronary arteries employing a single "pantaloon" shape autologous pericardial patch. Both patients survived and, at 1 year and 9 months after the coronary revascularization procedures, the coronary angiography demonstrated a good patency of the internal thoracic grafts and excellent ostial plasty results, respectively. A complete literature review of patients undergoing different coronary revascularization procedures after arterial switch operation is reported.

  19. Family caregiving in pulmonary arterial hypertension.

    PubMed

    Hwang, Boyoung; Howie-Esquivel, Jill; Fleischmann, Kirsten E; Stotts, Nancy A; Dracup, Kathleen

    2012-01-01

    Pulmonary arterial hypertension (PAH) is a devastating disease that places a significant burden on patients and their families. However, family caregiving, to the best of our knowledge, has never been described in this population. This study sought to describe depressive symptoms, types of performed care tasks, social support, and the impact of caregiving among family caregivers of patients with PAH. Data were obtained from 35 dyads of patients with PAH (mean age, 51 years; 63% were female; 54% had World Health Organization functional class III symptoms) and their family caregivers (mean age, 52 years; 60% were female; 68% were spouses). Five caregivers (14%) were identified as manifesting moderate to severe depressive symptoms. The majority of caregivers reported that their daily activities were centered around caregiving responsibilities. More than 85% of caregivers were involved in managing care for the patient, and more than half helped the patient with self-management activities. The level of caregivers' perceived social support was low, especially for emotional and informational support. Lower levels of social support were significantly associated with more severe depressive symptoms in caregivers (r = -.50, P = .002). Caregivers of patients with PAH play a significant role in patients' medical care and self-management, yet they lack sufficient emotional support or information to meet the demands of caregiving. These findings underscore the importance of supporting family caregivers of patients with PAH. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. Impact analysis of Minuteman III Payload Transporter Type III

    SciTech Connect

    Stirbis, P.P.

    1993-12-01

    An analysis of the impact of the Minuteman III Payload Transporter Type III into a nonyielding target at 46 m.p.h. and 30 m.p.h., and into a yielding target at 46 m.p.h. is presented. The analysis considers the structural response of the tiedown system which secures the Minuteman III re-entry system to the floor of the payload transporter. A finite element model of the re-entry system, its tiedown system, which includes tie-rods and shear pins, and the pallet plate which is attached to the transporter floating plate, was constructed. Because accelerations of the payload transporter are not known, acceleration data from one-quarter scale testing of the Safe Secure Trailer was used to investigate the response of the tiedown system. These accelerations were applied to the pallet plate. The ABAQUS computer code was used to predict the forces in the members of the tiedown system.

  1. Dissociation of cerium(III) and neodymium(III) phthalocyanines

    NASA Astrophysics Data System (ADS)

    Lomova, T. N.

    2015-07-01

    The kinetics of dissociation of phthalocyanine complexes with cerium(III) and neodymium(III) (X)LnPc (X = Cl-, Br-, AcO-) under the action of acetic acid in ethanol with isolation of the macrocyclic ligand depending on the temperature was studied. The kinetic equations with the numerical values of rate constants, activation parameters, and the stoichiometric mechanisms with the limiting simple reaction between the nonionized AcOH molecule and (phthalocyaninato)lanthanide(III) in the axially coordinated ((X)LnPc, cerium complexes) or axially ionized ([(AcOH)LnPc]+X-, neodymium complexes) state were derived by solving the direct and inverse problems. As shown by a comparative analysis of quantitative kinetic data, the state is determined by the electronic structure of the metal cation and the mutual effect of the axial and equatorial ligands in the first coordination sphere.

  2. Superficial ulnar artery perforator flap.

    PubMed

    Schonauer, Fabrizio; Marlino, Sergio; Turrà, Francesco; Graziano, Pasquale; Dell'Aversana Orabona, Giovanni

    2014-09-01

    Superficial ulnar artery is a rare finding but shows significant surgical implications. Its thinness and pliability make this flap an excellent solution for soft tissue reconstruction, especially in the head and neck region. We hereby report a successful free superficial ulnar artery perforator forearm flap transfer for tongue reconstruction. A 64-year-old man presenting with a squamous cell carcinoma of the left tongue underwent a wide resection of the tumor, left radical neck dissection, and reconstruction of the tongue and the left tonsillar pillar with the mentioned flap. No complications were observed postoperatively. The flap survived completely; no recurrence at 6 months of follow-up was detected. Superficial ulnar artery perforator flap has shown to be a safe alternative to other free tissue flaps in specific forearm anatomic conditions.

  3. ACUTE RETINAL ARTERIAL OCCLUSIVE DISORDERS

    PubMed Central

    Hayreh, Sohan Singh

    2011-01-01

    The initial section deals with basic sciences; among the various topics briefly discussed are the anatomical features of ophthalmic, central retinal and cilioretinal arteries which may play a role in acute retinal arterial ischemic disorders. Crucial information required in the management of central retinal artery occlusion (CRAO) is the length of time the retina can survive following that. An experimental study shows that CRAO for 97 minutes produces no detectable permanent retinal damage but there is a progressive ischemic damage thereafter, and by 4 hours the retina has suffered irreversible damage. In the clinical section, I discuss at length various controversies on acute retinal arterial ischemic disorders. Classification of acute retinal arterial ischemic disorders These are of 4 types: CRAO, branch retinal artery occlusion (BRAO), cotton wools spots and amaurosis fugax. Both CRAO and BRAO further comprise multiple clinical entities. Contrary to the universal belief, pathogenetically, clinically and for management, CRAO is not one clinical entity but 4 distinct clinical entities – non-arteritic CRAO, non-arteritic CRAO with cilioretinal artery sparing, arteritic CRAO associated with giant cell arteritis (GCA) and transient non-arteritic CRAO. Similarly, BRAO comprises permanent BRAO, transient BRAO and cilioretinal artery occlusion (CLRAO), and the latter further consists of 3 distinct clinical entities - non-arteritic CLRAO alone, non-arteritic CLRAO associated with central retinal vein occlusion and arteritic CLRAO associated with GCA. Understanding these classifications is essential to comprehend fully various aspects of these disorders. Central retinal artery occlusion The pathogeneses, clinical features and management of the various types of CRAO are discussed in detail. Contrary to the prevalent belief, spontaneous improvement in both visual acuity and visual fields does occur, mainly during the first 7 days. The incidence of spontaneous visual

  4. First jejunal artery, an alternative graft for right hepatic artery reconstruction.

    PubMed

    Aryal, Bibek; Komokata, Teruo; Kadono, Jun; Motodaka, Hiroyuki; Ueno, Tetsuya; Furoi, Akira; Imoto, Yutaka

    2015-04-08

    Common bile duct cancer invading right hepatic artery is sometimes diagnosed intraoperatively. Excision and safe reconstruction of the artery with suitable graft is essential. Arterial reconstruction with autologous saphenous vein graft is the preferred method practiced routinely. However the right hepatic artery reconstruction has also been carried out with several other vessels like gastroduodenal artery, right gastroepiploic artery or the splenic artery. We report a case of 63-year-old man presenting with history of progressive jaundice, pruritus and impaired appetite. Following various imaging modalities including computed tomography, endoscopic retrograde cholangiopancreatography, magnetic resonance cholangiopancreatography, intraductal ultrasound extrahepatic bile duct cancer was diagnosed; however, none of those detected vessel invasion. Intraoperatively, right hepatic artery invasion was revealed. Right hepatic artery was resected and reconstructed with a graft harvested from the first jejunal artery (JA). Postoperative outcome was satisfactory with a long-term graft patency. First JA can be a reliable graft option for right hepatic artery reconstruction.

  5. The START III bargaining space

    SciTech Connect

    Karas, T.H.

    1998-08-01

    The declining state of the Russian military and precarious Russian economic condition will give the US considerable advantages at the START III bargaining table. Taking the US-RF asymmetries into account, this paper discusses a menu of START III measures the US could ask for, and measures it could offer in return, in attempting to negotiate an equitable treaty. Measures the US might seek in a START III treaty include: further reductions in deployed strategic nuclear warheads, irreversibility of reductions through warhead dismantlement; beginning to bring theater nuclear weapons under mutual control, and increased transparency into the Russian nuclear weapons complex. The US may, however, wish to apply its bargaining advantages to attempting to achieve the first steps toward two long-range goals that would enhance US security: bringing theater nuclear weapons into the US-RF arms control arena, and increasing transparency into the Russian nuclear weapons complex. In exchange for measures relating to these objectives, the US might consider offering to Russia: Further strategic weapons reductions approaching levels at which the Russians believe they could maintain a degree of parity with the US; Measures to decrease the large disparities in potential deliver-system uploading capabilities that appear likely under current START II/START III scenarios; and Financial assistance in achieving START II/START III reductions as rapidly as is technically possible.

  6. Arterial Pressure Monitoring in Mice

    PubMed Central

    Zhao, Xin; Ho, David; Gao, Shumin; Hong, Chull; Vatner, Dorothy E.; Vatner, Stephen F.

    2011-01-01

    The use of mice for the evaluation and study of cardiovascular pathophysiology is growing rapidly, primarily due to the relative ease for developing genetically engineered mouse models. Arterial pressure monitoring is central to the evaluation of the phenotypic changes associated with cardiovascular pathology and interventions in these transgenic and knockout models. There are four major techniques for measuring arterial pressure in the mouse: tail cuff system, implanted fluid filled catheters, Millar catheters and implanted telemetry systems. Here we provide protocols for their use and discuss the advantages and limitations for each of these techniques . PMID:21686061

  7. Prevalence and severity of atherosclerosis in different arterial territories and its relation with obesity.

    PubMed

    Rodríguez-Flores, Marcela; Rodríguez-Saldaña, Joel; Cantú-Brito, Carlos; Aguirre-García, Jesús; Alejandro, González-Garay

    2013-01-01

    There is uneven association between obesity, traditional risk factors, and cardiovascular events. We aimed to analyze the relation between cardiovascular risk factors, including obesity, with the severity of atherosclerosis in different arterial territories. Arteries from five territories (circle of Willis, carotids, coronaries, aorta, and renal) were taken from 185 persons, newborn to 90 years undergoing autopsy in the Forensic Medical Service in Mexico City, to determine atherosclerotic lesions by histopathological study. Lesions were classified according to the American Heart Association grading system as early (types I-III) and advanced (types IV-VI). The degree of atherosclerosis was correlated with arterial territories and risk factors. Frequencies of advanced lesions according to arterial territories were as follows: circle of Willis, 28%; right carotid, 36%; left carotid, 25%; right coronary, 71%; left coronary, 85%; right renal, 26%; left renal, 29%; and aorta, 52%; P=.0001, for all analyses. There was a higher risk for advanced lesions with increasing body mass index (BMI) (P=.004). However, after adjusting for age, gender, smoking status, hypertension, and diabetes mellitus, BMI was not independently associated with advanced lesions. Coronary arteries are significantly more affected than other arterial territories regardless of risk factors, showing the effect of local and systemic factors in the severity of atherosclerosis. We did not find an independent association between advanced atherosclerotic lesions and obesity. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Marvels, Mysteries, and Misconceptions of Vascular Compensation to Peripheral Artery Occlusion

    PubMed Central

    ZIEGLER, MATTHEW A.; DISTASI, MATTHEW R.; BILLS, RANDALL G.; MILLER, STEVEN J.; ALLOOSH, MOUHAMAD; MURPHY, MICHAEL P.; AKINGBA, A. GEORGE; STUREK, MICHAEL; DALSING, MICHAEL C.; UNTHANK, JOSEPH L.

    2010-01-01

    Peripheral arterial disease is a major health problem and there is a significant need to develop therapies to prevent its progression to claudication and critical limb ischemia. Promising results in rodent models of arterial occlusion have generally failed to predict clinical success and led to questions of their relevance. While sub-optimal models may have contributed to the lack of progress, we suggest that advancement has also been hindered by misconceptions of the human capacity for compensation and the specific vessels which are of primary importance. We present and summarize new and existing data from humans, Ossabaw miniature pigs, and rodents which provide compelling evidence that natural compensation to occlusion of a major artery (i) may completely restore perfusion, (ii) occurs in specific pre-existing small arteries, rather than the distal vasculature, via mechanisms involving flow-mediated dilation and remodeling (iii) is impaired by cardiovascular risk factors which suppress the flow-mediated mechanisms and (iv) can be restored by reversal of endothelial dysfunction. We propose that restoration of the capacity for flow-mediated dilation and remodeling in small arteries represents a largely unexplored potential therapeutic opportunity to enhance compensation for major arterial occlusion and prevent the progression to critical limb ischemia in the peripheral circulation. PMID:20141596

  9. Thermal and optical properties of Tb(III), Eu(III) and Tb(III)/Eu(III) co-complexed silicone fluorinated acrylate copolymer

    NASA Astrophysics Data System (ADS)

    Zhai, Yinfeng; Xie, Hongde; Cai, Haijun; Cai, Peiqing; Seo, Hyo Jin

    2015-07-01

    Tb(III), Eu(III) and Tb(III)/Eu(III) activated silicone fluorinated acrylate (SFA) have been successfully synthesized using the method of semi-continuous emulsion polymerization. The copolymers are characterized by flourier transform infrared (FT-IR), thermal gravity analysis (TGA), photoluminescence excitation (PLE) and emission (PL) spectroscopy. The copolymer containing Tb(III) and Eu(III) ions display green and red luminescent colors under UV light excitation, respectively. The TGA curves show the thermal decomposition temperatures of the copolymers are up to about 300 °C. The PL spectra show a strong green emission at 546 nm (5D4 → 7F5) of Tb(III) complexed copolymers, and show a prominent red emission at 615 nm (5D0 → 7F2) of Eu(III) complexed copolymers. Different concentrations of Eu(III) and Tb(III) ions are introduced into the copolymer and the energy transfer from Tb(III) to Eu(III) ions in the copolymer was found. Thus, based on the results it can be suggested that SFA:Eu(III), SFA:Tb(III) and SFA:Tb(III)/Eu(III) can be used potentially as luminescent materials.

  10. III-Nitride nanowire optoelectronics

    NASA Astrophysics Data System (ADS)

    Zhao, Songrui; Nguyen, Hieu P. T.; Kibria, Md. G.; Mi, Zetian

    2015-11-01

    Group-III nitride nanowire structures, including GaN, InN, AlN and their alloys, have been intensively studied in the past decade. Unique to this material system is that its energy bandgap can be tuned from the deep ultraviolet (~6.2 eV for AlN) to the near infrared (~0.65 eV for InN). In this article, we provide an overview on the recent progress made in III-nitride nanowire optoelectronic devices, including light emitting diodes, lasers, photodetectors, single photon sources, intraband devices, solar cells, and artificial photosynthesis. The present challenges and future prospects of III-nitride nanowire optoelectronic devices are also discussed.

  11. Cardiac Epithelial-Mesenchymal Transition Is Blocked by Monomethylarsonous Acid (III)

    PubMed Central

    Huang, Tianfang; Barnett, Joey V.; Camenisch, Todd D.

    2014-01-01

    Arsenic exposure during embryonic development can cause ischemic heart pathologies later in adulthood which may originate from impairment in proper blood vessel formation. The arsenic-associated detrimental effects are mediated by arsenite (iAsIII) and its most toxic metabolite, monomethylarsonous acid [MMA (III)]. The impact of MMA (III) on coronary artery development has not yet been studied. The key cellular process that regulates coronary vessel development is the epithelial-mesenchymal transition (EMT). During cardiac EMT, activated epicardial progenitor cells transform to mesenchymal cells to form the cellular components of coronary vessels. Smad2/3 mediated TGFβ2 signaling, the key regulator of cardiac EMT, is disrupted by arsenite exposure. In this study, we compared the cardiac toxicity of MMA (III) with arsenite. Epicardial progenitor cells are 15 times more sensitive to MMA (III) cytotoxicity when compared with arsenite. MMA (III) caused a significant blockage in epicardial cellular transformation and invasion at doses 10 times lower than arsenite. Key EMT genes including TGFβ ligands, TβRIII, Has2, CD44, Snail1, TBX18, and MMP2 were down regulated by MMA (III) exposure. MMA (III) disrupted Smad2/3 activation at a dose 20 times lower than arsenite. Both arsenite and MMA (III) significantly inhibited Erk1/2 and Erk5 phosphorylation. Nuclear translocation of Smad2/3 and Erk5 was also blocked by arsenical exposure. However, p38 activation, as well as smooth muscle differentiation, was refractory to the inhibition by the arsenicals. Collectively, these findings revealed that MMA (III) is a selective disruptor of cardiac EMT and as such may predispose to arsenic-associated cardiovascular disorders. PMID:25145660

  12. Treatment of peripheral arterial disease via percutaneous brachial artery access.

    PubMed

    Franz, Randall W; Tanga, Christopher F; Herrmann, Joseph W

    2017-08-01

    This review was conducted to evaluate the types of endovascular procedures that can be performed via brachial artery access, evaluate the access success rate, and determine the incidence of technical complications. A retrospective 10-year record review at a tertiary facility from January 1, 2005, through June 30, 2015, was completed. Patients who underwent attempted brachial artery access were eligible for review. Outcomes intended to be evaluated included ability to access the vessel, reach an identified lesion, and perform an indicated procedure, while describing the incidence and type of complications that occurred to clarify the utility and safety of brachial artery access. The review included 265 access cases in 179 patients. The access success rate was 98.9%. Intervention was performed in 223 cases (84.2%). Angioplasty was the most common intervention (59%, [154 cases]), with stents, atherectomy, coiling, and percutaneous thrombectomy having also been performed. Complications included hematoma (2.3%) and pseudoaneurysm (1.5%). Complications requiring intervention occurred in 1.9% of procedures. Interventions were performed on all major vessels as distal as the dorsalis pedis. Sheath sizes ranged from 4F to 7F. Intervention was performed on bilateral lower extremities in 38 cases (14.5%). A femoral bypass graft was present in 141 patients (53%) as the main indication for brachial artery access. Brachial access is a reliable and effective option for treatment of peripheral vascular disease and should be considered when femoral access is difficult or contraindicated and when a bypass graft is present in the femoral region. In addition, bilateral lesions may be approached easily through one brachial artery access site, making this approach advantageous when bilateral lesions are expected. The complication rate is similar to femoral access and can be minimized with ultrasound-guided access distally over the humerus, micropuncture access, and a dedicated

  13. Bronchial Artery Aneurysm with Associated Bronchial Artery to Pulmonary Artery Fistula: Treatment by Embolization

    PubMed Central

    Hsieh, Caleb G; Le, Thomas; Fogelfeld, Keren; Kamangar, Nader

    2017-01-01

    Bronchial artery aneurysm (BAA) is a rare vascular phenomenon. This review highlights a case of a BAA that was complicated by the presence of a bronchial artery to pulmonary artery (BA-PA) fistula, consequently presenting a unique challenge to management. BAAs have a strongly reported risk of rupture resulting in life-threatening hemoptysis. Embolization has thus become routine for the management such severe cases. The management of incidentally found anomalies is less obvious, but prophylactic embolization is a generally accepted practice. In this report, we review some of the risks and benefits associated with BAA embolization with specific consideration of the challenges in cases of co-existing BA-PA fistula. PMID:28217405

  14. Angioplasty and stent placement - carotid artery

    MedlinePlus

    ... in your carotid artery. Moving x-ray pictures (fluoroscopy) are used to see the artery and guide ... 18403765 . Kinlay S, Bhatt DL. Treatment of noncoronary obstructive ... versus surgery for asymptomatic carotid stenosis. N Engl J Med . ...

  15. Types of Coronary Artery Bypass Grafting

    MedlinePlus

    ... from the NHLBI on Twitter. Types of Coronary Artery Bypass Grafting There are several types of coronary ... for you based on your needs. Traditional Coronary Artery Bypass Grafting Traditional CABG is used when at ...

  16. Flows In Model Human Femoral Arteries

    NASA Technical Reports Server (NTRS)

    Back, Lloyd H.; Kwack, Eug Y.; Crawford, Donald W.

    1990-01-01

    Flow is visualized with dye traces, and pressure measurements made. Report describes experimental study of flow in models of human femoral artery. Conducted to examine effect of slight curvature of artery on flow paths and distribution of pressure.

  17. Histological structure affects recellularization of decellularized arteries.

    PubMed

    Negishi, Jun; Hashimoto, Yoshihide; Yamashita, Akitatsu; Kimura, Tsuyoshi; Kishida, Akio; Funamoto, Seiichi

    2017-01-01

    Decellularized arteries were prepared to evaluate the in vivo recellularization of biological material after implantation. Porcine aortas and radial arteries were decellularized using high-hydrostatic pressure to form materials with histologically-different structures. Successful removal of cells from decellularized arteries was evaluated by hematoxylin-eosin staining and measurement of residual DNA. Cell remnants were eliminated completely from the decellularized arteries, and histological structures were preserved. Cells adhered to all decellularized artery samples, but infiltration of cells was observed only from the adventitial side of the decellularized radial artery. Rats were implanted subcutaneously with a decellularized aorta or radial artery to evaluate in vivo performance. Decellularized aortic tissue prevented cell infiltration better than that of the decellularized radial artery, suggesting that the elastin lamina in decellularized tissues prevents cell infiltration and suppresses recellularization. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. Could Peripheral Arterial Disease Be Your Problem?

    MedlinePlus

    ... exercise and yoga classes and has returned to teaching. Fast Facts Peripheral arterial disease (P.A.D.) occurs when a fatty material called plaque (pronounced plak) builds up on the inside walls of the arteries that carry blood from ...

  19. Trigeminal neuralgia caused by a trigeminocerebellar artery.

    PubMed

    Amagasaki, Kenichi; Abe, Shoko; Watanabe, Saiko; Naemura, Kazuaki; Nakaguchi, Hiroshi

    2014-10-01

    This 31-year-old woman presented with typical right trigeminal neuralgia caused by a trigeminocerebellar artery, manifesting as pain uncontrollable with medical treatment. Preoperative neuroimaging studies demonstrated that the offending artery had almost encircled the right trigeminal nerve. This finding was confirmed intraoperatively, and decompression was completed. The neuralgia resolved after the surgery; the patient had slight transient hypesthesia, which fully resolved within the 1st month after surgery. The neuroimaging and intraoperative findings showed that the offending artery directly branched from the upper part of the basilar artery and, after encircling and supplying tiny branches to the nerve root, maintained its diameter and coursed toward the rostral direction of the cerebellum, which indicated that the artery supplied both the trigeminal nerve and the cerebellum. The offending artery was identified as the trigeminocerebellar artery. This case of trigeminal neuralgia caused by a trigeminocerebellar artery indicates that this variant is important for a better understanding of the vasculature of the trigeminal nerve root.

  20. Peripheral Arterial Disease Can Be a Killer

    MedlinePlus

    ... Issue Past Issues Special Section Peripheral Arterial Disease Can Be a Killer Past Issues / Summer 2008 Table ... the arteries to narrow or become blocked, which can reduce or block blood flow. P.A.D. ...

  1. First Stars III Conference Summary

    NASA Astrophysics Data System (ADS)

    O'Shea, B. W.; McKee, C. F.; Heger, A.; Abel, T.

    2008-03-01

    The understanding of the formation, life, and death of Population III stars, as well as the impact that these objects had on later generations of structure formation, is one of the foremost issues in modern cosmological research and has been an active area of research during the past several years. We summarize the results presented at "First Stars III," a conference sponsored by Los Alamos National Laboratory, the Kavli Institute for Particle Astrophysics and Cosmology, and the Joint Institute for Nuclear Astrophysics. This conference, the third in a series, took place in July 2007 at the La Fonda Hotel in Santa Fe, New Mexico, U.S.A.

  2. Arterial Patterns of the Face in Perissodactyla.

    PubMed

    Kowalczyk, Karolina; Frąckowiak, Hieronim

    2017-09-01

    Considerable consistency in the arterial pattern of the head has been observed in species of Artiodactyla, but few studies have examined the order Perissodactyla. Here, we describe arteries supplying the intermandibular, mental, masseteric, buccal, labial, and nasal regions in eight perissodactylans, including representing of all families comprising this order. Observations were made on a total of 45 preparations of head arteries, obtained by injection of arteries with acetone-dissolved stained vinyl superchloride or stained latex LBS3060. In the Equidae species alone it was found that the facial artery descends from the linguofacial trunk. In tapirs and rhinos the facial artery branches off directly from the main arteries of the head. In tapirs alone it was found that the inferior alveolar artery gives off the buccal and sublingual arteries, and then extends into the mental artery. In the rhino a specific feature of the arterial pattern of the head was the exit of the occipital artery from the superficial temporal artery. In all equines studied, the transverse facial artery gave off a larger blood vessel to the masseter muscle and ran along the facial crest, while in tapirs and rhinos the transverse facial artery fanned out branches in the masseteric fossa. The variations observed can be considered in future studies on the origin of Perissodactyla. In this context, we note that the most similar patterns of exit and course of the facial, mental, transverse facial and infraorbital arteries exist in tapirs and rhinos (Ceratomorpha suborder), at least among the perissodactylans studied here. Anat Rec, 300:1529-1534, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  3. Surgical management of extensive pulmonary artery sarcoma.

    PubMed

    Shehatha, Jaffar; Saxena, Pankaj; Clarke, Belinda; Dunning, John; Konstantinov, Igor E

    2009-04-01

    Primary pulmonary artery sarcoma is a rare tumor that can be misdiagnosed as acute or chronic pulmonary thromboembolic disease. This article reports a patient with a preoperative diagnosis of pulmonary embolism who was found to have an extensive pulmonary artery tumor. Surgical resection of the primary pulmonary artery sarcoma and reconstruction of the central pulmonary arteries, followed by adjuvant chemoradiotherapy, provided significant improvement in his clinical symptoms.

  4. Arterial switch operation for transposition of the great arteries with coronary arteries from a single aortic sinus.

    PubMed

    Sung, Si Chan; Chang, Yun Hee; Lee, Hyoung Doo; Kim, Siho; Woo, Jong Soo; Lee, Young Seok

    2005-08-01

    The reimplantation of the coronary arteries from a single aortic sinus (single sinus coronary artery) in an arterial switch operation remains a technically challenging procedure. The technique of coronary transfer in this situation should be individualized depending on coronary ostial anatomy. We reviewed our techniques of coronary reimplantation with early and midterm results. Among 103 patients who underwent arterial switch operations from March 1994 to June 2004, 16 (15.5%) had single sinus coronary artery (median age, 9 days; mean body weight, 3.5 kg). Fourteen patients (14/16, 87.5%) had coronary arteries from right facing sinus (sinus 2). Of these 14 patients, 11 had separate ostia including intramural course of the left coronary artery (n = 9) and 3 had single ostium. Two patients (2/16, 12.5%) had coronary arteries from left facing sinus (sinus 1) with single ostium. Aortic arch obstruction was associated in 5 patients. All 5 single sinus coronary arteries with single ostium were reimplanted with the trap-door technique. Of the 11 patients with separate ostia, 8 underwent coronary transfer with the aortocoronary flap technique and 3 with the double-button technique. Two of the 3 patients who underwent the double-button technique required left coronary artery bypass using left subclavian artery free graft as the salvaging procedure. There was one early death (1/16, 6.3%), which occurred during our earlier experience, in a patient who had arch anomaly and intramural left coronary artery. There was no late death. All but one patient had good ventricular function. All single sinus coronary artery with single ostium can be transferred with the trap-door technique with excellent results. The aortocoronary flap technique in those with separate ostia with or without intramural left coronary artery may be a good option. However, reimplantation of the intramural left coronary artery using separate coronary buttons should be performed with great care.

  5. Photonic sensing of arterial distension

    PubMed Central

    Ruh, Dominic; Subramanian, Sivaraman; Sherman, Stanislav; Ruhhammer, Johannes; Theodor, Michael; Dirk, Lebrecht; Foerster, Katharina; Heilmann, Claudia; Beyersdorf, Friedhelm; Zappe, Hans; Seifert, Andreas

    2016-01-01

    Most cardiovascular diseases, such as arteriosclerosis and hypertension, are directly linked to pathological changes in hemodynamics, i.e. the complex coupling of blood pressure, blood flow and arterial distension. To improve the current understanding of cardiovascular diseases and pave the way for novel cardiovascular diagnostics, innovative tools are required that measure pressure, flow, and distension waveforms with yet unattained spatiotemporal resolution. In this context, miniaturized implantable solutions for continuously measuring these parameters over the long-term are of particular interest. We present here an implantable photonic sensor system capable of sensing arterial wall movements of a few hundred microns in vivo with sub-micron resolution, a precision in the micrometer range and a temporal resolution of 10 kHz. The photonic measurement principle is based on transmission photoplethysmography with stretchable optoelectronic sensors applied directly to large systemic arteries. The presented photonic sensor system expands the toolbox of cardiovascular measurement techniques and makes these key vital parameters continuously accessible over the long-term. In the near term, this new approach offers a tool for clinical research, and as a perspective, a continuous long-term monitoring system that enables novel diagnostic methods in arteriosclerosis and hypertension research that follow the trend in quantifying cardiovascular diseases by measuring arterial stiffness and more generally analyzing pulse contours. PMID:27699095

  6. Peripheral arterial disease in women.

    PubMed

    Aronow, Wilbert S

    2009-12-20

    Peripheral arterial disease (PAD) is chronic arterial occlusive disease of the lower extremities caused by atherosclerosis whose prevalence increases with age. Only one-half of women with PAD are symptomatic. Symptomatic and asymptomatic women with PAD are at increased risk for all-cause mortality, cardiovascular mortality, and mortality from coronary artery disease. Modifiable risk factors that predispose women to PAD include active cigarette smoking, passive smoking, diabetes mellitus, hypertension, dyslipidemia, increased plasma homocysteine levels and hypothyroidism. With regard to management, women who smoke should be encouraged to quit and referred to a smoking cessation program. Hypertension, diabetes mellitus, dyslipidemia, and hypothyroidism require treatment. Statins reduce the incidence of intermittent claudication and improve exercise duration until the onset of intermittent claudication in women with PAD and hypercholesterolemia. Anti-platelet drugs such as aspirin or especially clopidogrel, angiotensin-converting enzyme inhibitors and statins should be given to all women with PAD. Beta blockers are recommended if coronary artery disease is present. Exercise rehabilitation programs and cilostazol increase exercise time until intermittent claudication develops. Chelation therapy should be avoided as it is ineffective. Indications for lower extremity percutaneous transluminal angioplasty or bypass surgery in women are (1) incapacitating claudication interfering with work or lifestyle; and (2) limb salvage in women with limb-threatening ischemia as manifested by rest pain, non-healing ulcers, and/or infection or gangrene. Future research includes investigation of mechanisms underlying why women have a higher risk of graft failure and major amputation.

  7. Capsaicin and arterial hypertensive crisis.

    PubMed

    Patanè, Salvatore; Marte, Filippo; La Rosa, Felice Carmelo; La Rocca, Roberto

    2010-10-08

    Chili peppers are rich in capsaicin. The potent vasodilator calcitonin gene-related peptide (CGRP) is stored in a population of C-fiber afferents that are sensitive to capsaicin. CGRP and peptides released from cardiac C fibers have a beneficial effect in myocardial ischemia and reperfusion. It has been reported that capsaicin pretreatment can deplete cardiac C-fiber peptide stores. Furthermore, it has also been reported that capsaicin-treated pigs have significantly increased mean arterial blood pressure compared with controls, and that the decrease in CGRP synthesis and release contributes to the elevated blood pressure. A case has also been reported of an arterial hypertensive crisis in a patient with a large ingestion of peppers and chili peppers the day before. We present a case of an arterial hypertensive crisis in a 19-year-old Italian man with an abundant ingestion of peppers and of chili peppers the preceding day. This case describes an unusual pattern of arterial hypertensive crisis due to capsaicin.

  8. Bilateral internal thoracic artery grafting

    PubMed Central

    2013-01-01

    The effectiveness of the left internal mammary artery graft to the anterior descending coronary artery as a surgical strategy has been shown to improve the survival rate and decrease the risk of adverse cardiac events in patients undergoing coronary bypass surgery. These clinical benefits appear to be related to the superior short and long-term patency rates of the internal thoracic artery graft. Although the advantages of using of both internal thoracic arteries (ITA) for bypass grafting have taken longer to prove, recent results from multiple data sets now support these findings. The major advantage of bilateral ITA grafting appears to be improved survival rate, while the disadvantages of complex ITA grafting include the increased complexity of operation, and an increased risk of wound complications. While these short-term disadvantages have been mitigated in contemporary surgical practice, they have not eliminated. Bilateral ITA grafting should be considered the procedure of choice for patients undergoing coronary bypass surgery that have a predicted survival rate of longer than ten years. PMID:23977627

  9. Compliant transducer measures artery profile

    NASA Technical Reports Server (NTRS)

    Feldstein, C.; Culler, V. H.; Crawford, D. W.; Spears, J. R.

    1981-01-01

    Instrument consisting of compliant fingers with attached semiconductor pickups measures inside contours of narrow vessels. Instrument, originally designed to monitor human arteries, is drawn through vessel to allow finges to follow contours. Lead wires transmit electrical signals to external processing equipment.

  10. Pulmonary Artery Sarcoma - Multimodality Imaging.

    PubMed

    Jeong, Nari; Seol, Sang-Hoon; Kim, Il Hwan; Kim, Ji Yeon

    2016-01-01

    Pulmonary artery sarcoma (PAS) is a rare and fatal disease. PAS can often be misdiagnosed as pulmonary thromboembolism. Moreover, the correct diagnosis is frequently delayed due to nonspecific signs and symptoms. The prognosis of patients with PAS is poor. We report a case of a woman with a primary PAS who was initially diagnosed with pulmonary thromboembolism.

  11. Pulmonary Artery Sarcoma - Multimodality Imaging

    PubMed Central

    Jeong, Nari; Seol, Sang-Hoon; Kim, Il Hwan; Kim, Ji Yeon

    2016-01-01

    Pulmonary artery sarcoma (PAS) is a rare and fatal disease. PAS can often be misdiagnosed as pulmonary thromboembolism. Moreover, the correct diagnosis is frequently delayed due to nonspecific signs and symptoms. The prognosis of patients with PAS is poor. We report a case of a woman with a primary PAS who was initially diagnosed with pulmonary thromboembolism. PMID:27833785

  12. Engineering of arteries in vitro

    PubMed Central

    Huang, Angela H.; Niklason, Laura E.

    2014-01-01

    This review will focus on two elements that are essential for functional arterial regeneration in vitro: the mechanical environment and the bioreactors used for tissue growth. The importance of the mechanical environment to embryological development, vascular functionality, and vascular graft regeneration will be discussed. Bioreactors generate mechanical stimuli to simulate the biomechanical environment of the arterial system. This system has been used to reconstruct arterial grafts with appropriate mechanical strength for implantation by controlling the chemical and mechanical environments in which the grafts are grown. Bioreactors are powerful tools to study the effect of mechanical stimuli on extracellular matrix (ECM) architecture and the mechanical properties of engineered vessels. Hence biomimetic systems enable us to optimize chemo-biomechanical culture conditions to regenerate engineered vessels with physiological properties similar to those of native arterial vessels. In addition, this review will introduce and examine various approaches and techniques that have been used to engineer biologically-based vascular grafts, including collagen-based grafts, fibrin-gel grafts, cell sheet engineering, biodegradable polymers, and decellularization of native vessels. PMID:24399290

  13. Small artery remodelling in diabetes.

    PubMed

    Rosei, Enrico Agabiti; Rizzoni, Damiano

    2010-05-01

    The aim of this article is to briefly review available data regarding changes in the structure of microvessels observed in patients with diabetes mellitus, and possible correction by effective treatment. The development of structural changes in the systemic vasculature is the end result of established hypertension. In essential hypertension, small arteries of smooth muscle cells are restructured around a smaller lumen and there is no net growth of the vascular wall, although in some secondary forms of hypertension, a hypertrophic remodelling may be detected. Moreover, in non-insulin-dependent diabetes mellitus a hypertrophic remodelling of subcutaneous small arteries is present. Indices of small resistance artery structure, such as the tunica media to internal lumen ratio, may have a strong prognostic significance in hypertensive and diabetic patients, over and above all other known cardiovascular risk factors. Therefore, regression of vascular alterations is an appealing goal of antihypertensive treatment. Different antihypertensive drugs seem to have different effect on vascular structure. In diabetic hypertensive patients, a significant regression of structural alterations of small resistance arteries with drugs blocking the renin-angiotensin system (angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers) was demonstrated. Alterations in the microcirculation represent a common pathological finding, and microangiopathy is one of the most important mechanisms involved in the development of organ damage as well as of clinical events in patients with diabetes mellitus. Renin-angiotensin system blockade seems to be effective in preventing/regressing alterations in microvascular structure.

  14. Small artery remodelling in diabetes

    PubMed Central

    Rosei, Enrico Agabiti; Rizzoni, Damiano

    2010-01-01

    Abstract The aim of this article is to briefly review available data regarding changes in the structure of microvessels observed in patients with diabetes mellitus, and possible correction by effective treatment. The development of structural changes in the systemic vasculature is the end result of established hypertension. In essential hypertension, small arteries of smooth muscle cells are restructured around a smaller lumen and there is no net growth of the vascular wall, although in some secondary forms of hypertension, a hypertrophic remodelling may be detected. Moreover, in non-insulin-dependent diabetes mellitus a hypertrophic remodelling of subcutaneous small arteries is present. Indices of small resistance artery structure, such as the tunica media to internal lumen ratio, may have a strong prognostic significance in hypertensive and diabetic patients, over and above all other known cardiovascular risk factors. Therefore, regression of vascular alterations is an appealing goal of antihypertensive treatment. Different antihypertensive drugs seem to have different effect on vascular structure. In diabetic hypertensive patients, a significant regression of structural alterations of small resistance arteries with drugs blocking the renin–angiotensin system (angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers) was demonstrated. Alterations in the microcirculation represent a common pathological finding, and microangiopathy is one of the most important mechanisms involved in the development of organ damage as well as of clinical events in patients with diabetes mellitus. Renin–angiotensin system blockade seems to be effective in preventing/regressing alterations in microvascular structure. PMID:20646125

  15. Peripheral Arterial Disease (P.A.D.)

    MedlinePlus

    ... turn Javascript on. Peripheral Artery Disease (P.A.D.) What is P.A.D.? Arteries Clogged With Plaque Peripheral arterial disease (P. ... button on your keyboard.) Why Is P.A.D. Dangerous? Click for more information Blocked blood flow ...

  16. Two Rare Variants of Left Vertebral Artery.

    PubMed

    Singh, Rajani

    2017-02-15

    Though the variations of vertebral artery are clinically asymptomatic yet abnormalities are of diagnostic importance either prior to vascular surgery in the neck region or in patients of intravascular diseases such as arteriovenous malformations or cerebral aneurysms. Therefore, the aim of the study is to bring out 2 variations in the configuration of vertebral artery and their clinical implication. During dissection of thorax of 2 female cadavers, 2 different variants of configurations of left vertebral arteries were observed. In 1 patient, the left vertebral artery arose aberrantly from arch of aorta between left common carotid artery and left subclavian artery. This artery then, following oblique course, abnormally entered into foramen transversarium of C4 vertebra. In the second patient, the left common stump emerged from arch of aorta in the left side of left common carotid artery and then instantly bifurcated into vertebral artery and subclavian artery. Then following the usual oblique course, the left vertebral artery anomalously entered into foramen transversarium of C3 vertebra at the level of upper border of thyroid cartilage. The knowledge of these rare variations in the origin of vertebral artery is of paramount importance to surgeons performing surgery in neck region, radiologist performing angiography to avoid misinterpretation of radiographs and to anatomists for rare variations in academics and research.

  17. Acquired and congenital coronary artery abnormalities.

    PubMed

    Young, Ming-Lon; McLeary, Michael; Chan, Kak-Chen

    2017-01-01

    Sudden unexpected cardiac deaths in approximately 20% of young athletes are due to acquired or congenital coronary artery abnormalities. Kawasaki disease is the leading cause for acquired coronary artery abnormalities, which can cause late coronary artery sequelae including aneurysms, stenosis, and thrombosis, leading to myocardial ischaemia and ventricular fibrillation. Patients with anomalous left coronary artery from the pulmonary artery can develop adequate collateral circulation from the right coronary artery in the newborn period, which remains asymptomatic only to manifest in adulthood with myocardial ischaemia, ventricular arrhythmias, and sudden death. Anomalous origin of coronary artery from the opposite sinus occurs in 0.7% of the young general population aged between 11 and 15 years. If the anomalous coronary artery courses between the pulmonary artery and the aorta, sudden cardiac death may occur during or shortly after vigorous exercise, especially in patients where the anomalous left coronary artery originates from the right sinus of Valsalva. Symptomatic patients with evidence of ischaemia should have surgical correction. No treatment is needed for asymptomatic patients with an anomalous right coronary artery from the left sinus of Valsalva. At present, there is no consensus regarding how to manage asymptomatic patients with anomalous left coronary artery from the right sinus of Valsalva and interarterial course. Myocardial bridging is commonly observed in cardiac catheterisation and it rarely causes exercise-induced coronary syndrome or cardiac death. In symptomatic patients, refractory or β-blocker treatment and surgical un-bridging may be considered.

  18. Spontaneous Recanalization of Superior Mesenteric Artery Occlusion Following Angioplasty and Stenting of Inferior Mesenteric Artery

    SciTech Connect

    Akpinar, Erhan Cil, Barbaros E.; Arat, Anil; Baykal, Atac; Karaman, Kerem; Balkanci, Ferhun

    2006-02-15

    An 84-year-old woman with a history of hypertension and coronary artery disease was admitted with a progressively worsening diffuse abdominal pain. Computed tomography scan of the abdomen and angiography revealed occlusion of the origin and proximal portion of superior mesenteric artery. Aortography also showed severe origin stenosis of inferior mesenteric artery and that the distal part of the superior mesenteric artery was supplied by a prominent marginal artery of Drummond. Patient was effectively treated with percutaneous transluminal angioplasty and stenting of the inferior mesenteric artery. Follow-up imaging studies demonstrated patency of the stent and spontaneous recanalization of superior mesenteric artery occlusion.

  19. Anomalous origin of left coronary artery from pulmonary artery. Surgical considerations in the adult.

    PubMed

    Barrand, K G; Brooksby, I A; Webb-Peploe, M M; Braimbridge, M V

    1975-04-01

    The usually recommended treatment for anomalous origin of a left coronary artery from the pulmonary artery is proximal ligation of the anomalous artery with a saphenous vein bypass graft to restore aortocoronary continuity. In an adult patient with large collateral vessels and with the left coronary artery arising from the back of the pulmonary artery, the technical surgical problems associated with this procedure are formidable. Closure of the orifice of the anomalous left coronary artery from inside the pulmonary artery is suggested as the treatment of choice in such a case.

  20. Vertebral artery section for treating arterial compression of the medulla oblongata. Case report.

    PubMed

    Hongo, K; Kobayashi, S; Hokama, M; Sugita, K

    1993-07-01

    A case of a 30-year-old man who showed progressive pyramidal tract signs caused by compression of the left vertebral artery is presented. Initial decompression of the vertebral artery by placing a piece of sponge between the artery and medulla had no long-term effect. The left vertebral artery distal to the origin of the posterior inferior cerebellar artery was then sectioned, decompressing the medulla oblongata. The patient's symptoms improved postoperatively. This is the first reported case of brain-stem compression by an elongated vertebral artery treated by sectioning of the artery.

  1. Effects of spaceflight and ground recovery on mesenteric artery and vein constrictor properties in mice

    PubMed Central

    Behnke, Bradley J.; Stabley, John N.; McCullough, Danielle J.; Davis, Robert T.; Dominguez, James M.; Muller-Delp, Judy M.; Delp, Michael D.

    2013-01-01

    Following exposure to microgravity, there is a reduced ability of astronauts to augment peripheral vascular resistance, often resulting in orthostatic hypotension. The purpose of this study was to test the hypothesis that mesenteric arteries and veins will exhibit diminished vasoconstrictor responses after spaceflight. Mesenteric arteries and veins from female mice flown on the Space Transportation System (STS)-131 (n=11), STS-133 (n=6), and STS-135 (n=3) shuttle missions and respective ground-based control mice (n=30) were isolated for in vitro experimentation. Vasoconstrictor responses were evoked in arteries via norepinephrine (NE), potassium chloride (KCl), and caffeine, and in veins through NE across a range of intraluminal pressures (2–12 cmH2O). Vasoconstriction to NE was also determined in mesenteric arteries at 1, 5, and 7 d postlanding. In arteries, maximal constriction to NE, KCl, and caffeine were reduced immediately following spaceflight and 1 d postflight. Spaceflight also reduced arterial ryanodine receptor-3 mRNA levels. In mesenteric veins, there was diminished constriction to NE after flight. The results indicate that the impaired vasoconstriction following spaceflight occurs through the ryanodine receptor-mediated intracellular Ca2+ release mechanism. Such vascular changes in astronauts could compromise the maintenance of arterial pressure during orthostatic stress.—Behnke, B. J., Stabley, J. N., McCullough, D. J., Davis, R. T., III, Dominguez, J. M., II, Muller-Delp, J. M., Delp, M. D. Effects of spaceflight and ground recovery on mesenteric artery and vein constrictor properties in mice. PMID:23099650

  2. Evaluation of a spasmolytic cocktail to prevent radial artery spasm during coronary procedures.

    PubMed

    Kiemeneij, Ferdinand; Vajifdar, Bhavesh U; Eccleshall, Simon C; Laarman, GertJan; Slagboom, Ton; van der Wieken, Ron

    2003-03-01

    Radial artery spasm is a frequent complication of the transradial approach for coronary angiography and angioplasty. Recently, we have been able to quantify spasm using the automatic pullback device. The objective of this study was to assess the efficacy of an intra-arterial vasodilating cocktail in reducing the incidence and severity of radial artery spasm. A hundred patients undergoing coronary procedures via the radial artery were divided into two groups of 50 each. Patients in group A received intra-arterial cocktail (5 mg of verapamil plus 200 micro g nitroglycerine in 10 ml of normal saline), while patients in group B did not receive any vasodilating drug. The pullback device was used for sheath removal at the end of the procedure. Seven (14%) patients in group A experienced pain (i.e., pain score of III-V) during automatic sheath removal, as compared to 17 (34%) in group B (P = 0.019). The mean pain score was significantly lower in group A than in group B (1.7 +/- 0.94 vs. 2.08 +/- 1.07; P = 0.03). The maximal pullback force (MPF) was also significantly lower for group A (0.53 +/- 0.52 kg; range, 0.10-3.03 kg) as compared to group B (0.76 +/- 0.45 kg; range, 0.24-1.99 kg; P = 0.013). Only 4 (8%) patients in group A had an MPF value greater than 1.0 kg, suggesting the presence of significant radial artery spasm, as opposed to 11 (22%) in group B (P = 0.029). Administration of an intra-arterial vasodilating cocktail prior to sheath insertion reduces the occurrence and severity of radial artery spasm.

  3. Plasma viscosity increase with progression of peripheral arterial atherosclerotic disease.

    PubMed

    Poredos, P; Zizek, B

    1996-03-01

    Increased blood and plasma viscosity has been described in patients with coronary and peripheral arterial disease. However, the relation of viscosity to the extent of arterial wall deterioration--the most important determinant of clinical manifestation and prognosis of the disease--is not well known. Therefore, the authors studied plasma viscosity as one of the major determinants of blood viscosity in patients with different stages of arterial disease of lower limbs (according to Fontaine) and its relation to the presence of some risk factors of atherosclerosis. The study encompassed four groups of subjects: 19 healthy volunteers (group A), 18 patients with intermittent claudication up to 200 m (stage II; group B), 15 patients with critical ischemia of lower limbs (stage III and IV; group C), and 16 patients with recanalization procedures on peripheral arteries. Venous blood samples were collected from an antecubital vein without stasis for the determination of plasma viscosity (with a rotational capillary microviscometer, PAAR), fibrinogen, total cholesterol, alpha-2-macroglobulin, and glucose concentrations. In patients with recanalization procedure local plasma viscosity was also determined from blood samples taken from a vein on the dorsum of the foot. Plasma viscosity was most significantly elevated in the patients with critical ischemia (1.78 mPa.sec) and was significantly higher than in the claudicants (1.68 mPa.sec), and the claudicants also had significantly higher viscosity than the controls (1.58 mPa.sec). In patients in whom a recanalization procedure was performed, no differences in systemic and local plasma viscosity were detected, neither before nor after recanalization of the diseased artery. In all groups plasma viscosity was correlated with fibrinogen concentration (r=0.70, P < 0.01) and total cholesterol concentration (r=0.24, P < 0.05), but in group C (critical ischemia) plasma viscosity was most closely linked to the concentration of alpha-2

  4. Ambienti Circumstellari ed Interstellari di Supernovae di vario Tipo ed Applicazioni Astrofisiche

    NASA Astrophysics Data System (ADS)

    Boffi, Francesca R.

    Nella presente tesi vengono studiati gli ambienti circumstellari ed interstellari di supernovae (anche SNe; singolare SN) di vario tipo. In particolare si descrivono alcune applicazioni astrofisiche, relative a questi ambienti, che permettono di desumere informazioni sui sistemi stellari progenitori delle supernovae o di determinare le distanze a tali oggetti. L' emissione radio da supernovae, prodotta nell' ambiente circumstellare ad opera dell'interazione idrodinamica del gas di SN con l' ambiente circostante, puo' essere impiegata come mezzo di indagine del sistema di pre-supernova. In particolare si e' introdotta l'idea che tale emissione possa essere impiegata nel caso delle SNe di tipo Ia come test dei sistemi progenitori di tipo simbiotico. Il test e' stato effettuato sulla SN 1986G, per la quale avevamo ottenuto limiti superiori a lunghezze d'onda radio. Nel caso che un sistema simbiotico sia responsabile di una SN Ia, l'interazione tra l' ejecta e una shell circumstellare origina, in un'epoca molto prossima al massimo di luce, un'emissione radio rivelabile con strumenti tipo Very Large Array. Inoltre l'emissione radio fornisce informazioni circa gli stadi di pre-supernova nel caso di altri tipi di supernova. In questo lavoro di tesi vengono presentati i risultati ottenuti nel caso delle SNe di tipo II 1984E e 1986E. Queste due SNe non mostrano emissione radio: la prima, in prossimita del massimo ottico, stava interagendo con una shell circumstellare prodotta da un episodio di perdita di massa di breve durata in fase di pre-supernova; la seconda, invece e' la prima SN ``vecchia'' ad essere rivelata nell' ottico ma non nel radio (l' oggetto non ha ancora iniziato la fase di supernova remnant ed emette radiazione ottica prodotta ancora per interazione circumstellare). In ambiente circum-interstellare, gli echi di luce, prodotti dallo scattering della luce della supernova ad opera della polvere presente, possono essere utilizzati per determinare le distanze

  5. Improved Wavelengths and Oscillator Strengths of Cr III, Co III, and Fe III

    NASA Astrophysics Data System (ADS)

    Smith, Peter L.; Smillie, D. G.; Pickering, J. C.; Blackwell-Whitehead, R. J.

    2008-05-01

    Improvements in the resolution, accuracy, and range of spectra obtained by state-of-the-art space- and ground-based astronomical spectrographs have demonstrated a need for corresponding improvements in atomic data. Transition wavelengths with uncertainties of 1 part in 10^7 and oscillator strengths (f-values) with uncertainties of 10 to 15% are needed to accurately interpret modern astrophysical spectra. Our focus has been on spectra of doubly ionized iron group elements that dominate the UV spectra of hot B stars. We report here completion of measurements on Cr III, Co III, Fe III made with a UV high resolution Fourier transform spectrometer (FTS) [J. C. Pickering, Vibrational Spectrosc. 29, 27 (2002)] with a typical wavelength/wavenumber uncertainty of a few parts in 10^8, supplemented by measurements were carried out at the US National Institute of Standards & Technology using their FTS and the Normal Incidence Vacuum (grating) Spectrograph (NIVS). The spectra were analyzed and line lists were produced to give calibrated line wavelengths and relative intensities. Measured wavelengths are, in many cases, an order of magnitude more accurate than previous measurements, and the energy level uncertainties are typically reduced by a factor or 3 more. Summaries of submitted papers on Cr III and Co III will be presented, as will work on improved wavelengths, energy levels, and oscillator strengths for Fe III. Limitations to the method and possible solutions will be discussed. This work is, or has been, supported in part by NASA Grant NAG5-12668; NASA inter-agency agreement W-10255; PPARC; the Royal Society of the UK; and by the Leverhulme Trust.

  6. Organometallic neptunium(III) complexes.

    PubMed

    Dutkiewicz, Michał S; Farnaby, Joy H; Apostolidis, Christos; Colineau, Eric; Walter, Olaf; Magnani, Nicola; Gardiner, Michael G; Love, Jason B; Kaltsoyannis, Nikolas; Caciuffo, Roberto; Arnold, Polly L

    2016-08-01

    Studies of transuranic organometallic complexes provide a particularly valuable insight into covalent contributions to the metal-ligand bonding, in which the subtle differences between the transuranium actinide ions and their lighter lanthanide counterparts are of fundamental importance for the effective remediation of nuclear waste. Unlike the organometallic chemistry of uranium, which has focused strongly on U(III) and has seen some spectacular advances, that of the transuranics is significantly technically more challenging and has remained dormant. In the case of neptunium, it is limited mainly to Np(IV). Here we report the synthesis of three new Np(III) organometallic compounds and the characterization of their molecular and electronic structures. These studies suggest that Np(III) complexes could act as single-molecule magnets, and that the lower oxidation state of Np(II) is chemically accessible. In comparison with lanthanide analogues, significant d- and f-electron contributions to key Np(III) orbitals are observed, which shows that fundamental neptunium organometallic chemistry can provide new insights into the behaviour of f-elements.

  7. Terrain Perception for DEMO III

    NASA Technical Reports Server (NTRS)

    Manduchi, R.; Bellutta, P.; Matthies, L.; Owens, K.; Rankin, A.

    2000-01-01

    The Demo III program has as its primary focus the development of autonomous mobility for a small rugged cross country vehicle. In this paper we report recent progress on both stereo-based obstacle detection and terrain cover color-based classification.

  8. Title III hazardous air pollutants

    SciTech Connect

    Todd, R.

    1995-12-31

    The author presents an overview of the key provisions of Title III of the Clean Air Act Amendments of 1990. The key provisions include the following: 112(b) -- 189 Hazardous Air Pollutants (HAP); 112(a) -- Major Source: 10 TPY/25 TPY; 112(d) -- Application of MACT; 112(g) -- Modifications; 112(I) -- State Program; 112(j) -- The Hammer; and 112(r) -- Accidental Release Provisions.

  9. Missed Total Occlusion Due to the Occipital Artery Arising from the Internal Carotid Artery

    SciTech Connect

    Ustunsoz, Bahri Gumus, Burcak; Koksal, Ali; Koroglu, Mert; Akhan, Okan

    2007-02-15

    A 56-year-old man was referred for digital subtraction angiography (DSA) with an ultrasound diagnosis of right proximal internal carotid artery (ICA) stenosis for possible carotid artery stenting. DSA revealed total occlusion of the ICA and an occipital artery arising from the stump and simulating continuation of the ICA. An ascending pharyngeal artery also arose from the same occipital artery. This case is of interest because this is a rare variation besides being a cause of misdiagnosis at carotid ultrasound.

  10. Revascularization using satellite vein after radial artery harvested for coronary artery bypass grafting.

    PubMed

    Gon, Shigeyoshi; Yoshida, Shigehiko; Sanae, Tsutomu; Takahashi, Tamami; Inada, Eiichi

    2006-06-01

    The radial artery has been increasingly used for coronary artery bypass grafting and has excellent long-term patency rates. Hand claudication is one of the adverse effects after radial artery harvest. We reconstructed a radial artery using the satellite vein to prevent hand claudication. Pulsating blood flow at 35 cm/sec was evaluated using color Doppler echocardiography three months after surgery. This method makes it possible to use a radial artery in patients with a positive Allen test.

  11. Ruptured pseudoaneurysm of the pulmonary artery--rare manifestation of a primary pulmonary artery sarcoma.

    PubMed

    Koch, Achim; Mechtersheimer, Gunhild; Tochtermann, Ursula; Karck, Matthias

    2010-01-01

    A 64-year-old male developed chest pain while gardening. Aortic dissection and coronary artery disease were excluded but chest computed tomography (CT) scan showed an aneurysmic enlargement of the pulmonary artery and a fluttering structure within. He underwent immediate sternotomy for replacement of the pulmonary artery. Histology showed an intimal sarcoma of both branches of the pulmonary artery. The pulmonary artery was replaced by a T-shaped Gore-Tex-prosthesis.

  12. Mechanical Properties of Coronary Arteries and Internal Mammary Arteries Beyond Physiological Deformations

    DTIC Science & Technology

    2007-11-02

    initiate intimal hyperplasia , which could eventually lead to stenosis of the anastomosis. Therefore it is important to know more about the mechanical...the case for the muscular coronary artery. Fig. 3 shows the typical stress-strain relationship in circumferential direction of one coronary artery at...coronary artery is an artery of the muscular type, which means that the media consists mainly of smooth muscle cells. The IMA is an elastic artery

  13. Optimization of an Arterialized Venous Fasciocutaneous Flap in the Abdomen of the Rat

    PubMed Central

    Mota-Silva, Eduarda; Pais, Diogo; Iria, Inês; Videira, Paula A.; Tanganho, David; Alves, Sara; Mascarenhas-Lemos, Luís; Martins Ferreira, José; Ferraz-Oliveira, Mário; Vassilenko, Valentina; O’Neill, João Goyri

    2017-01-01

    Background: Although numerous experimental models of arterialized venous flaps (AVFs) have been proposed, no single model has gained widespread acceptance. The main aim of this work was to evaluate the survival area of AVFs produced with different vascular constructs in the abdomen of the rat. Methods: Fifty-three male rats were divided into 4 groups. In group I (n = 12), a 5-cm-long and 3-cm-wide conventional epigastric flap was raised on the left side of the abdomen. This flap was pedicled on the superficial caudal epigastric vessels caudally and on the lateral thoracic vein cranially. In groups II, III, and IV, a similar flap was raised, but the superficial epigastric artery was ligated. In these groups, AVFs were created using the following arterial venous anastomosis at the caudal end of the flap: group II (n = 13) a 1-mm-long side-to-side anastomosis was performed between the femoral artery and vein laterally to the ending of the superficial caudal epigastric vein. In group III (n = 14), in addition to the procedure described for group II, the femoral vein was ligated medially. Finally, in group IV (n = 14), the superficial caudal epigastric vein was cut from the femoral vein with a 1-mm-long ellipse of adjacent tissue, and an end-to-side arterial venous anastomosis was established between it and the femoral artery. Results: Seven days postoperatively, the percentage of flap survival was 98.89 ± 1.69, 68.84 ± 7.36, 63.84 ± 10.38, 76.86 ± 13.67 in groups I–IV, respectively. Conclusion: An optimized AVF can be produced using the vascular architecture described for group IV. PMID:28894657

  14. Health-related quality of life in patients with pulmonary arterial hypertension

    PubMed Central

    Taichman, Darren B; Shin, Jennifer; Hud, Laryssa; Archer-Chicko, Christine; Kaplan, Sandra; Sager, Jeffery S; Gallop, Robert; Christie, Jason; Hansen-Flaschen, John; Palevsky, Harold

    2005-01-01

    Background Improved outcomes with expanding treatment options for patients with pulmonary arterial hypertension present the opportunity to consider additional end-points in approaching therapy, including factors that influence health-related quality of life. However, comparatively little is known about health-related quality of life and its determinants in patients with pulmonary arterial hypertension. Methods Health-related quality of life was evaluated in a cross sectional study of 155 outpatients with pulmonary arterial hypertension using generic and respiratory-disease specific measurement tools. Most patients had either World Health Organization functional Class II or III symptoms. Demographic, hemodynamic and treatment variables were assessed for association with health-related quality of life scores. Results Patients with pulmonary arterial hypertension suffered severe impairments in both physical and emotional domains of health-related quality of life. Patients with idiopathic ("primary") pulmonary arterial hypertension had the best, and those with systemic sclerosis the worst health-related quality of life. Greater six-minute walk distance correlated with better health-related quality of life scores, as did functional Class II versus Class III symptoms. Hemodynamic measurements, however, did not correlate with health-related quality of life scores. No differences in health-related quality of life were found between patients who were being treated with calcium channel antagonists, bosentan or continuously infused epoprostenol at the time of quality of life assessment. Conclusion Health-related quality of life is severely impaired in patients with pulmonary arterial hypertension and is associated with measures of functional status. Specific associations with impaired health-related quality of life suggest potential areas for targeted intervention. PMID:16092961

  15. [The role of ultrasonography of the peripheral arteries in diagnosing coronary artery disease].

    PubMed

    Pasierski, Tomasz; Sosnowski, Cezary; Szulczyk, Anna; Leszczyński, Lech; Rewicki, Marek

    2004-01-01

    Atherosclerosis develops simultaneously in multiple arterial beds, that creates opportunity to diagnose of coronary artery disease. Aim of the study was the evaluation of association between atherosclerotic involvement of peripheral arteries assessed by ultrasound and significant coronary artery disease revealed by angiography. Study included 410 patients, (73% males), mean age 56.0 +/- 9.5 year scheduled for coronary angiography. During ultrasound examination of common carotid and common femoral arteries arterial wall intima-media (IMT) thickness and atherosclerotic plaques presence were assessed. Significant coronary artery disease (CAD) was diagnosed with coronary angiography as diameter stenosis > 50%. Intimo-media thickness (IMT) of common carotid arteries did not differ between groups with and without significant coronary artery disease (right 6.6 vs 6.4 mm, p = ns, left 6.9 vs 6.6 mm, p = ns) but in common femoral arterial was greater in patients with coronary artery disease (right 8.2 vs 7.1 mm, p < 0.005, left 7.9 vs 7.1 mm, p = 0.03). Atherosclerotic plaques in carotid and femoral arteries was detected more often in CAD patients (90.1% vs 34.6%, p < 0.0001). Positive predictive value for CAD diagnosis with detection of plaque in carotid or femoral artery was 93% and negative prognostic value for exclusion CAD after plaque exclusion in all arteries was 61%. Search for atherosclerotic plaques in ultrasound examination of peripheral arteries may facilitate CAD diagnosis in selected patients groups.

  16. Ruptured retinal arterial macroaneurysm: diagnosis and management.

    PubMed

    Speilburg, Ashley M; Klemencic, Stephanie A

    2014-01-01

    Retinal arterial macroaneurysm is an acquired, focal dilation of a retinal artery, typically occurring within the first three bifurcations of the central retinal artery. The clinical presentation of a retinal arterial macroaneurysm is highly variable, making initial diagnosis difficult and differentials many. Identification of retinal arterial macroaneurysms is crucial to appropriately co-manage with the primary care physician for hypertension control. Prognosis is generally good and observation is often an adequate treatment. However, in cases of macular threat or involvement, some treatment options are available and referral to a retinal specialist is indicated.

  17. Crutch-induced bilateral brachial artery aneurysms.

    PubMed

    Konishi, Takanori; Ohki, Shin-ichi; Saito, Tsutomu; Misawa, Yoshio

    2009-12-01

    A 57-year-old man, who was a chronic axillary crutch user as a result of childhood poliomyelitis, was referred to our hospital because of a sudden onset of right forearm ischemia. The right forearm had no pulse, and three-dimensional computed tomography (3DCT) showed an aneurysm of the right brachial artery associated with arterial occlusion. The thrombosed aneurysm of the brachial artery was resected and the brachial artery was successfully revascularized by interposing a saphenous vein graft. Postoperative 3DCT revealed an asymptomatic left brachial artery aneurysm. His postoperative course was uneventful under warfarin anticoagulation therapy.

  18. Elective Treatment of Middle Colic Artery Aneurysm

    PubMed Central

    Hamasaki, Takafumi; Ota, Rikako; Ohno, Takashi; Kodama, Wataru; Uchida, Naotaka; Hayashi, Eiichi; Fukino, Syunsuke

    2014-01-01

    Middle colic artery aneurysms are rare and most have been reported with rupture or symptom. We report the successful elective treatment of a middle colic artery aneurysm without symptom, which is very rare. It failed to perform transcatheter arterial embolization for anatomical reasons, and, thus, the patient, a 77-year-old man, underwent surgical resection in spite of a history of laparotomy. Although a common cause of middle colic artery aneurysms is segmental arterial mediolysis, the present pathological findings indicated that fragmented or degenerated elastic fibers may also play an important role like aortic aneurysms. PMID:25298839

  19. Elective treatment of middle colic artery aneurysm.

    PubMed

    Nishimura, Kengo; Hamasaki, Takafumi; Ota, Rikako; Ohno, Takashi; Kodama, Wataru; Uchida, Naotaka; Hayashi, Eiichi; Fukino, Syunsuke

    2014-01-01

    Middle colic artery aneurysms are rare and most have been reported with rupture or symptom. We report the successful elective treatment of a middle colic artery aneurysm without symptom, which is very rare. It failed to perform transcatheter arterial embolization for anatomical reasons, and, thus, the patient, a 77-year-old man, underwent surgical resection in spite of a history of laparotomy. Although a common cause of middle colic artery aneurysms is segmental arterial mediolysis, the present pathological findings indicated that fragmented or degenerated elastic fibers may also play an important role like aortic aneurysms.

  20. Iliac Artery Injury Following Placement of the Memotherm Arterial Stent

    SciTech Connect

    Redman, Alan; Cope, Lance; Uberoi, Raman

    2001-03-15

    Iliac rupture and aneurysm formation at the site of stent placement has rarely been described in the literature. We report four cases, three of iliac rupture, including a delayed rupture, and an aneurysm, with the use of a single type of stent, the Memotherm stent. We believe the design of the stent significantly contributed to damage to the arterial wall and subsequently prevented closure of the arterial tear by balloon tamponade in the two cases where this was attempted. Two patients, one with rupture and one with an aneurysm, were successfully treated with a covered stent obviating surgery and two ruptures resulted in death. We recommend that all interventionists carrying out iliac angioplasty and/or stenting should have access to covered stents for such emergencies.

  1. [Acute popliteal arterial occlusion during extracorporeal circulation].

    PubMed

    Mizuno, Ju; Senda, Masahiro; Asahara, Miho; Yamada, Yoshitsugu; Arita, Hideko; Hanaoka, Kazuo

    2006-11-01

    A 79-year-old man underwent aortic arch replacement for thoracic aortic aneurysm. He had a history of smoking, coronary stenting for ischemic heart disease and replacement with artificial blood vessel for abdominal aortic aneurysm. Anesthesia was induced and maintained with midazolam, fentanyl, sevoflurane, and vecuronium. A 20 gage catheter was placed in the right radial artery and a 22 gage catheter in the left posterior tibial artery. Total circulatory arrest under profound hypothermia and retrograde cerebral perfusion were performed using extracorporeal circulation. After finishing anastomosis with artificial blood vessel, he was weaned from extracorporeal circulation. The pressure in the left posterior tibial artery was maintained at 15 mmHg, although the blood pressure in the right radial artery increased gradually. Then, the pressure in the left femoral artery in the operative field was the same as the pressure in the right radial artery. Therefore, we suspected the arterial line occlusion of the left posterior tibial artery. After the operation, we found the left leg and foot pale and cold with no pulsation on the left popliteal, dorsal pedis, and posterior tibial arteries. Further, acute left popliteal arterial occlusion was assessed by means of Doppler and left lower extremity angiography. We immediately performed the balloon-catheter embolectomy. However, as he developed compartment syndrome on the left lower limb due to reperfusion injury postoperatively, fascitomy was performed. On the 58th postoperative day, he was discharged from our hospital. Measurement by Doppler is useful for the early diagnosis of the lower leg arterial occlusion.

  2. Arterial endothelial function measurement method and apparatus

    DOEpatents

    Maltz, Jonathan S; Budinger, Thomas F

    2014-03-04

    A "relaxoscope" (100) detects the degree of arterial endothelial function. Impairment of arterial endothelial function is an early event in atherosclerosis and correlates with the major risk factors for cardiovascular disease. An artery (115), such as the brachial artery (BA) is measured for diameter before and after several minutes of either vasoconstriction or vasorelaxation. The change in arterial diameter is a measure of flow-mediated vasomodification (FMVM). The relaxoscope induces an artificial pulse (128) at a superficial radial artery (115) via a linear actuator (120). An ultrasonic Doppler stethoscope (130) detects this pulse 10-20 cm proximal to the point of pulse induction (125). The delay between pulse application and detection provides the pulse transit time (PTT). By measuring PTT before (160) and after arterial diameter change (170), FMVM may be measured based on the changes in PTT caused by changes in vessel caliber, smooth muscle tone and wall thickness.

  3. Physiologic assessment of coronary artery fistula

    SciTech Connect

    Gupta, N.C.; Beauvais, J. )

    1991-01-01

    Coronary artery fistula is an uncommon clinical entity. The most common coronary artery fistula is from the right coronary artery to the right side of the heart, and it is less frequent to the pulmonary artery. The effect of a coronary artery fistula may be physiologically significant because of the steal phenomenon resulting in coronary ischemia. Based on published reports, it is recommended that patients with congenital coronary artery fistulas be considered candidates for elective surgical correction to prevent complications including development of congestive heart failure, angina, subacute bacterial endocarditis, myocardial infarction, and coronary aneurysm formation with rupture or embolization. A patient is presented in whom treadmill-exercise thallium imaging was effective in determining the degree of coronary steal from a coronary artery fistula, leading to successful corrective surgery.

  4. Netrin-1 controls sympathetic arterial innervation

    PubMed Central

    Brunet, Isabelle; Gordon, Emma; Han, Jinah; Cristofaro, Brunella; Broqueres-You, Dong; Liu, Chun; Bouvrée, Karine; Zhang, Jiasheng; del Toro, Raquel; Mathivet, Thomas; Larrivée, Bruno; Jagu, Julia; Pibouin-Fragner, Laurence; Pardanaud, Luc; Machado, Maria J.C.; Kennedy, Timothy E.; Zhuang, Zhen; Simons, Michael; Levy, Bernard I.; Tessier-Lavigne, Marc; Grenz, Almut; Eltzschig, Holger; Eichmann, Anne

    2014-01-01

    Autonomic sympathetic nerves innervate peripheral resistance arteries, thereby regulating vascular tone and controlling blood supply to organs. Despite the fundamental importance of blood flow control, how sympathetic arterial innervation develops remains largely unknown. Here, we identified the axon guidance cue netrin-1 as an essential factor required for development of arterial innervation in mice. Netrin-1 was produced by arterial smooth muscle cells (SMCs) at the onset of innervation, and arterial innervation required the interaction of netrin-1 with its receptor, deleted in colorectal cancer (DCC), on sympathetic growth cones. Function-blocking approaches, including cell type–specific deletion of the genes encoding Ntn1 in SMCs and Dcc in sympathetic neurons, led to severe and selective reduction of sympathetic innervation and to defective vasoconstriction in resistance arteries. These findings indicate that netrin-1 and DCC are critical for the control of arterial innervation and blood flow regulation in peripheral organs. PMID:24937433

  5. Experimental evidence of the compressibility of arteries.

    PubMed

    Yosibash, Zohar; Manor, Itay; Gilad, Ilan; Willentz, Udi

    2014-11-01

    A definitive answer to the question whether artery walls are incompressible is to our opinion not yet categorically provided. Experimental-based evidence on the level of compressibility in artery walls is not easily achieved because of the difficulties associated with the measurement of very small differences in volumes under physiological pressure in these biological tissues. Past experiments aimed at addressing the question considered different species, different arteries, the experimental devices were not accurate enough and a statistical analysis of the results was missing. A precise experimental device together with a thorough testing protocol, a careful selection of arteries and a statistical analysis is presented for a definitive evaluation of the artery wall compressibility. We provide experimental evidence that in saphenous and femoral porcine arteries under physiological pressure range a relative compressibility of 2-6% is observed. The pre-assumption of incompressibility in many phenomenological constitutive models of artery walls should probably be re-evaluated.

  6. Pulmonary Artery Intimal Sarcoma: A Case Report.

    PubMed

    Kriz, Joseph P; Munfakh, Nabil A; King, Gregory S; Carden, Juan O

    2016-01-01

    Pulmonary artery intimal sarcomas are rare and lethal malignant tumors that typically affect larger vessels: the aorta, inferior vena cava, and pulmonary arteries. Since symptoms and imaging of pulmonary arterial intimal sarcomas mimic pulmonary thromboembolism, the differential diagnosis of a patient presenting with chest pain, dyspnea, and filling defect within the pulmonary arteries should include intimal sarcoma. Often right ventricular failure is observed due to pulmonary hypertension caused by the obstructive effect of the tumor and concomitant chronic thromboembolism. We report the case of a 72-year-old African-American male with arterial intimal sarcoma of the left and right pulmonary artery with extension through the right artery into the bronchus and right lung.

  7. Pulmonary Artery Intimal Sarcoma: A Case Report

    PubMed Central

    Kriz, Joseph P.; Munfakh, Nabil A.; King, Gregory S.; Carden, Juan O.

    2016-01-01

    Pulmonary artery intimal sarcomas are rare and lethal malignant tumors that typically affect larger vessels: the aorta, inferior vena cava, and pulmonary arteries. Since symptoms and imaging of pulmonary arterial intimal sarcomas mimic pulmonary thromboembolism, the differential diagnosis of a patient presenting with chest pain, dyspnea, and filling defect within the pulmonary arteries should include intimal sarcoma. Often right ventricular failure is observed due to pulmonary hypertension caused by the obstructive effect of the tumor and concomitant chronic thromboembolism. We report the case of a 72-year-old African-American male with arterial intimal sarcoma of the left and right pulmonary artery with extension through the right artery into the bronchus and right lung. PMID:27239183

  8. Location of foot arteries using infrared images

    NASA Astrophysics Data System (ADS)

    Villasenor-Mora, Carlos; González-Vega, Arturo; Martín Osmany Falcón, Antonio; Benítez Ferro, Jesús Francisco Guillemo; Córdova Fraga, Teodoro

    2014-11-01

    In this work are presented the results of localization of foot arteries, in a young group of participants by using infrared thermal images, these are the dorsal, posterior tibial and anterior tibial arteries. No inclusion criteria were considered, that causes that no strong statistical data about the influence of the age in the arterial localization. It was achieved to solve the confusion when veins present a heat distribution similar to the artery and in the position of this. it contributes to enhance the rate of location of arteries. In general it is possible to say that the use of infrared thermal images is a good technique to find the foot arteries and can be applied in its characterization in a future. The procedure proposed is a non-invasive technique, and in certain fashion does not requires specialized personnel to achieve locate the arteries. It is portable, safe, and relatively economical.

  9. Molecular diagnosis in Vascular Ehlers-Danlos Syndrome Predicts Pattern of Arterial Involvement and Outcomes

    PubMed Central

    Shalhub, Sherene; Black, James H; Cecchi, Alana C.; Xu, Zhi; Griswold, Ben F; Safi, Hazim J; Milewicz, Dianna M.; McDonnell, Nazli B.

    2015-01-01

    OBJECTIVES The management of arterial pathology in individuals with vascular Ehlers-Danlos syndrome (vEDS) remains a challenge. Here we describe the correlation between COL3A1 gene mutation type and the clinical phenotype in individuals with vEDS. METHODS Individuals with confirmed molecular diagnoses of vEDS were enrolled in a multi institutional natural history study. Data collected included demographics, clinical and family histories, arterial pathology (aneurysm, dissection, and rupture), operative details, and autopsy reports. Individuals were classified into two cohorts based on the type of COL3A1 mutations and their effect on the amount of normal collagen produced: MIN group had mutations that lead to minimal (10–15%) production of normal type III collagen and HI group had haploinsufficiency mutations that lead to production of half the normal type III collagen. RESULTS A cohort of 68 (72%) individuals from 56 families had arterial pathology (44% male, 13% HI). The HI group was older at the time of their first vascular event (mean 42 years, range 26–58 vs. 33 years, range 8–62, P = .016). The HI group had a higher incidence of aortic pathology compared to the MIN group (56% vs. 21%. P = .025). Visceral arterial pathology was seen in 43 arteries in 23 individuals in the MIN group versus only a single artery in 5 individuals in the HI group. Emergent surgical procedures were more likely to be undertaken when vEDS diagnosis was not known (81% vs. 41%, P = .005) and the majority of these procedures were open surgical repair compared to endovascular repair (81% vs. 19%, P = .019). In the elective setting, there was equal use of open and endovascular repair. Post-operative complications were highest when the diagnosis of vEDS was not known (62% vs. 14%, P < .001) and when procedures were undertaken in an emergency setting (5% vs. 55% P < .001). There was no mortality due to arterial complications in the HI cohort and 21% in the MIN cohort (P = .132

  10. Superficial brachioradial artery (radial artery originating from the axillary artery): a case-report and its embryological background.

    PubMed

    Konarik, M; Knize, J; Baca, V; Kachlik, D

    2009-08-01

    A case of anomalous terminal branching of the axillary artery, concerning the variant called superficial brachioradial artery (arteria brachioradialis superficialis) was described, with special regard to its embryological origin. The left upper limb of a male cadaver was dissected in successive steps from the axillary fossa distally to the palmar region. A variant artery, stemming from the end of the third segment of the axillary artery, followed a superficial course distally. It skipped the cubital fossa, ran on the lateral side of the forearm, crossed ventrally to the palm, and terminated in the deep palmar arch. This vessel is a case of so-called "brachioradial artery" (inexactly called a "radial artery with a high origin"). The origin of the brachioradial artery directly from the axillary artery belongs to the rare variants of the arterial pattern of the upper limb. Its incidence is approximately 3%. Moreover, this vascular variant was associated with another one concerning the brachial plexus. The medial cutaneous nerve of the forearm joined the median nerve in the middle third of the arm and ran further distally as a common trunk, as the normal median nerve does. Anatomical knowledge of the axillary region is crucial for radiodiagnostic and surgical procedures, especially in cases of trauma. The superficially located artery brings an elevated risk of bleeding complications in unexpected situations.

  11. Variability in the Branching Pattern of the Internal Iliac Artery in Indian Population and Its Clinical Importance

    PubMed Central

    Sivanandan, Anandarani; Sendiladibban, Sakthivelavan; Felicia Jebakani, Christilda

    2014-01-01

    Internal iliac artery (IIA) is one of the terminal branches of the common iliac artery and is the prime artery of pelvis. The artery has many parietal and visceral branches and hence the variations are frequently noted. The larger branches, namely, the inferior gluteal artery, the superior gluteal artery, and the internal pudendal artery, show sufficient regularity in their patterns of origin to allow typing. The variability of the IIA and its branching pattern were studied by dissecting sixty-eight male pelvic halves (34 right and 34 left) and forty-eight female pelvic halves (24 right and 24 left sides). In significant number of specimens, IIA terminated without dividing into 2 trunks as against the usual description. There was also considerable interchange of branches between the 2 terminal divisions. The patterns of branching noted were grouped as per Adachi's classification. The incidence was noted to be as follows: type Ia in 60.6%, type Ib in 2.6%, type IIa in 15.8%, and type III in 21%. The other types were not observed in this study. Conclusion. Interventions in the pelvic region must take into account the variability of the IIA and its branches that can modify the expected relations and may lead to undesired hemorrhagic or embolic accidents. PMID:25580296

  12. Variability in the branching pattern of the internal iliac artery in Indian population and its clinical importance.

    PubMed

    Sakthivelavan, Sumathilatha; Aristotle, Sharmila; Sivanandan, Anandarani; Sendiladibban, Sakthivelavan; Felicia Jebakani, Christilda

    2014-01-01

    Internal iliac artery (IIA) is one of the terminal branches of the common iliac artery and is the prime artery of pelvis. The artery has many parietal and visceral branches and hence the variations are frequently noted. The larger branches, namely, the inferior gluteal artery, the superior gluteal artery, and the internal pudendal artery, show sufficient regularity in their patterns of origin to allow typing. The variability of the IIA and its branching pattern were studied by dissecting sixty-eight male pelvic halves (34 right and 34 left) and forty-eight female pelvic halves (24 right and 24 left sides). In significant number of specimens, IIA terminated without dividing into 2 trunks as against the usual description. There was also considerable interchange of branches between the 2 terminal divisions. The patterns of branching noted were grouped as per Adachi's classification. The incidence was noted to be as follows: type Ia in 60.6%, type Ib in 2.6%, type IIa in 15.8%, and type III in 21%. The other types were not observed in this study. Conclusion. Interventions in the pelvic region must take into account the variability of the IIA and its branches that can modify the expected relations and may lead to undesired hemorrhagic or embolic accidents.

  13. Human Arterial Ring Angiogenesis Assay.

    PubMed

    Seano, Giorgio; Primo, Luca

    2016-01-01

    In this chapter we describe a model of human angiogenesis where artery explants from umbilical cords are embedded in gel matrices and subsequently produce capillary-like structures. The human arterial ring (hAR) assay is an innovative system that enables three-dimensional (3D) and live studies of human angiogenesis. This ex vivo model has the advantage of recapitulating several steps of angiogenesis, including endothelial sprouting, migration, and differentiation into capillaries. Furthermore, it can be exploited for (1) identification of new genes regulating sprouting angiogenesis, (2) screening for pro- or anti-angiogenic drugs, (3) identification of biomarkers to monitor the efficacy of anti-angiogenic regimens, and (4) dynamic analysis of tumor microenvironmental effects on vessel formation.

  14. [Cilioretinal artery occlusion in hemochromatosis].

    PubMed

    Peral, M J; Reche, A; Crespo, M J; Carpio, R; Gutierrez, O; Espino, A; Toledano, N

    2015-05-01

    We report a case of a 31 year-old woman with a sudden visual loss due to a cilioretinal artery occlusion. The physical examinination showed hepatomegaly. Serum iron and ferritin and transferrin saturation were unusually high. The doppler scan of carotid arteries showed no relevant signs of atheromatous disease. Dilated cardiomiopaty was revealed in the B-scan with subendocardial calcium deposits. Genetic tests were positive for hemochromatosis. Subendocardial calcification due to hemochromatosis could be the embolic source in our patient. This embolic ocular disease is the first presentation of hemochromatosis in this patient. Copyright © 2012 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  15. Management of Carotid Artery Trauma

    PubMed Central

    Lee, Thomas S.; Ducic, Yadranko; Gordin, Eli; Stroman, David

    2014-01-01

    With increased awareness and liberal screening of trauma patients with identified risk factors, recent case series demonstrate improved early diagnosis of carotid artery trauma before they become problematio. There remains a need for unified screening criteria for both intracranial and extracranial carotid trauma. In the absence of contraindications, antithrombotic agents should be considered in blunt carotid artery injuries, as there is a significant risk of progression of vessel injury with observation alone. Despite CTA being used as a common screening modality, it appears to lack sufficient sensitivity. DSA remains to be the gold standard in screening. Endovascular techniques are becoming more widely accepted as the primary surgical modality in the treatment of blunt extracranial carotid injuries and penetrating/blunt intracranial carotid lessions. Nonetheless, open surgical approaches are still needed for the treatment of penetrating extracranial carotid injuries and in patients with unfavorable lesions for endovascular intervention. PMID:25136406

  16. Arterial chemoembolization for hepatocellular carcinoma

    PubMed Central

    Fan, Jian; Ten, Gao-Jing; He, Shi-Cheng; Guo, Jin-He; Yang, Dong-Pei; Weng, Guo-Ying

    1998-01-01

    AIM: To study the therapeutic effects of transcatheter arterial three-segment chemoembolization for hepatocellular carcinoma (HCC). METHODS: According to the anatomy of vessels, the tumor capillary networks, muscular arterioles and feeding arteries were successively occluded using lipiodol ultra-fluid (LUF), sinobufagin microsphere (SBMs) and particles of gelatin sponge (PGS). In this series of 80 cases, therapeutic effects were evaluated in 76 cases. RESULTS: There were 22 cases (28.9%) with partial response and 41 (53.9%) with minor response in the 76 evaluated patients. The 6-month, 1-year, 2-year and 3-year survival rates were 97.4%, 86.8%, 46.1% and 27.6% respectively. CONCLUSION: This regimen was a rational chemoembolization method for HCC patients. PMID:11819226

  17. Anterior Spinal Artery Syndrome Following Coronary Artery Bypass Grafting: a Case Report.

    PubMed

    Mirhosseini, Seyed Mohsen; Meghdadi, Soheil; Moghaddam, Ali Sanjari

    2017-01-01

    We present a patient with unstable angina candidate for coronary artery bypass grafting. Saphenous vein graft was used in obtuse marginal and left internal mammary artery to left anterior descending artery properly. After surgery, the patient experienced flaccid paralysis of lower limb and impaired sensation of touch and warmth of knee and below. A computed tomography angiogram of lower limbs and thoracolumbar magnetic resonance imaging showed no abnormality. Based on the symptom, clinical diagnosis of anterior spinal artery syndrome was considered. The artery of Adamkiewicz is an important supplier to the anterior spinal artery. Internal thoracic mammary artery, used in coronary artery bypass grafting, is suspected as a collateral supplier of the artery of Adamkiewicz and has been accused for cause of spinal infarction.

  18. Anterior Spinal Artery Syndrome Following Coronary Artery Bypass Grafting: a Case Report

    PubMed Central

    Mirhosseini, Seyed Mohsen; Meghdadi, Soheil; Moghaddam, Ali Sanjari

    2017-01-01

    We present a patient with unstable angina candidate for coronary artery bypass grafting. Saphenous vein graft was used in obtuse marginal and left internal mammary artery to left anterior descending artery properly. After surgery, the patient experienced flaccid paralysis of lower limb and impaired sensation of touch and warmth of knee and below. A computed tomography angiogram of lower limbs and thoracolumbar magnetic resonance imaging showed no abnormality. Based on the symptom, clinical diagnosis of anterior spinal artery syndrome was considered. The artery of Adamkiewicz is an important supplier to the anterior spinal artery. Internal thoracic mammary artery, used in coronary artery bypass grafting, is suspected as a collateral supplier of the artery of Adamkiewicz and has been accused for cause of spinal infarction. PMID:28492795

  19. Hyperdensity of the Basilar Artery on Postmortem CT: A Potential Indicator for Basilar Artery Thrombosis.

    PubMed

    Garland, Jack; Tse, Rexson; Beh, Raymond J; Lyons, Timothy J; Cala, Allan D

    2016-06-01

    Basilar artery thrombosis constitutes 1% of all types of stroke, carries a mortality rate of up to 90%, and is one of the rarer causes of sudden death. It leads to brain stem ischemia and commonly presents with impaired consciousness, cranial nerve palsy, hemiplegia or quadriplegia, and sudden collapse. Clinically, the diagnosis of basilar artery thrombosis is made on clinical symptoms, along with a hyperdense basilar artery in antemortem computed tomography (CT) scan. To our knowledge, whether a hyperdense basilar artery indicates basilar artery thrombosis on postmortem CT scan is not documented in the literature. We present a case report of a 55-year-old man who on postmortem CT scan showed a hyperdense basilar artery and was subsequently confirmed to be a fatal basilar artery thrombosis. We suggest that a hyperdense basilar artery on postmortem CT should prompt the pathologist to consider basilar artery thrombosis.

  20. Headache after carotid artery stenting.

    PubMed

    Suller Marti, A; Bellosta Diago, E; Velázquez Benito, A; Tejero Juste, C; Santos Lasaosa, S

    2017-04-18

    Headache after carotid artery stenting is a headache with onset during the procedure or in the first few hours after it, and where there is no evidence to suggest a complication of that procedure. The purpose of this study is to describe the main features of these headaches based on our clinical experience. Observational prospective study of a sample of patients undergoing carotid artery stenting at Hospital Clínico Universitario Lozano Blesa, in Zaragoza, Spain. We recorded sociodemographic characteristics, cardiovascular risk factors, carotid artery disease, and history of primary headache; data were gathered using structured interviews completed before and 24hours after the procedure. We included 56 patients (mean age 67±9.52 years); 84% were men. Twelve patients (21.4%) experienced headache, 83.3% of whom were men; mean age was 60.58±9.31 years. Headache appeared within the first 6hours in 7 patients (58.4%) and during the procedure in 4 (33.3%). Pain lasted less than 10minutes in 4 patients (33.3%) and between 10 and 120minutes in 5 (41.7%). Headache affected the frontotemporal area in 7 patients (58.3%); 7 patients (58.3%) described pain as unilateral. It was oppressive in 8 patients (66.7%) and of moderate intensity in 6 (50%). Nine patients (75%) required no analgesics. We found no statistically significant associations with any of the variables except for age (P=.007; t test). In our sample, headache after carotid artery stenting was mild to moderate in intensity, unilateral, oppressive, and short-lasting. Further studies are necessary to gain a deeper knowledge of its characteristics and associated risk factors. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Ultrasonic Imaging Of Deep Arteries

    NASA Technical Reports Server (NTRS)

    Rooney, James A.; Heyser, Richard C.; Lecroissette, Dennis H.

    1990-01-01

    Swept-frequency sound replaces pulsed sound. Ultrasonic medical instrument produces images of peripheral and coronary arteries with resolutions higher and at depths greater than attainable by previous ultrasonic systems. Time-delay-spectrometry imager includes scanning, image-processing, and displaying equipment. It sweeps in frequency from 0 to 10 MHz in 20 ms, pauses for 5 ms, and repeats sweep. Intended for use in noninvasive detection and measurement of atherosclerotic lesions.

  2. [Cerebral artery thrombosis in pregnancy].

    PubMed

    Charco Roca, L M; Ortiz Sanchez, V E; Hernandez Gutierrez-Manchon, O; Quesada Villar, J; Bonmatí García, L; Rubio Postigo, G

    2015-11-01

    A 28 year old woman, ASA I, who, in the final stages of her pregnancy presented with signs of neural deficit that consisted of distortion of the oral commissure, dysphagia, dysarthria, and weakness on the left side of the body. She was diagnosed with thrombosis in a segment of the right middle cerebral artery which led to an ischemic area in the right frontal lobe. Termination of pregnancy and conservative treatment was decided, with good resolution of the symptoms.

  3. NIF Title III engineering plan

    SciTech Connect

    Deis, G

    1998-06-01

    The purpose of this document is to define the work that must be accomplished by the NIF Project during Title III Engineering. This definition is intended to be sufficiently detailed to provide a framework for yearly planning, to clearly identify the specific deliverables so that the Project teams can focus on them, and to provide a common set of objectives and processes across the Project. This plan has been preceded by similar documents for Title I and Title II design and complements the Site Management Plan, the Project Control Manual, the Quality Assurance Program Plan, the RM Parsons NIF Title III Configuration Control Plan, the Integrated Project Schedule, the Preliminary Safety Analysis Report, the Configuration Management Plan, and the Transition Plan.

  4. Transition probabilities in O III

    NASA Astrophysics Data System (ADS)

    Froese Fischer, Charlotte

    1994-01-01

    Transition data has been computed in the MCHF + Breit-Pauli approximation for a number of the low lying triplets in O III. Special attention was given to the 2p3p 3P-2p3d 3P transition which is a primary cascade for the Bowen fluorescence mechanism in O III. The relativistic, largely spin-orbit, effect on the intensity ratio of primary decays was found to be as large as 50%, whereas the effect on secondary cascades was less than 30%. Agreement with astrophysically observed intensity ratios is excellent. There also is good agreement between the present liftimes and the beam-foil mean lifetimes obtained by Pinnington et al., though for 2p3p 3D and 3S the theoretical lifetimes are considerably shorter.

  5. Jovian type III radio bursts

    NASA Technical Reports Server (NTRS)

    Kurth, W. S.; Gurnett, D. A.; Scarf, F. L.

    1989-01-01

    Radio bursts have been observed in the Voyager plasma wave data from Jupiter that bear a striking resemblance to solar type III radio bursts. The emissions lie in the frequency range near 10 kHz, have durations of a minute or so, and occur in a set of periodically spaced bursts. The spacing between primary bursts is typically 15 min, but the bursts may have additional components which recur on time scales of about 3 min. The similarity with solar type III radio bursts suggests a source mechanism involving the movement of energetic electrons through a density gradient in the plasma surrounding Jupiter. The periodicity of bursts suggests Io may be involved in the generation of waves, since the timing is similar to the Alfven wave travel time from one hemisphere to the other through the Io torus.

  6. Distal anterior cerebral artery aneurysms.

    PubMed

    Lehecka, Martin; Dashti, Reza; Lehto, Hanna; Kivisaari, Riku; Niemelä, Mika; Hernesniemi, Juha

    2010-01-01

    Distal anterior cerebral artery (DACA) aneurysms, also known as pericallosal artery aneurysms, represent about 6% of all intracranial aneurysms. They are located on the A2-A5 segments of the anterior cerebral artery and on its distal branches. This paper summarizes present knowledge on radiological features, treatment options, treatment results, and long-term follow-up of DACA aneurysms. Typical features of DACA aneurysms are small size, broad base, and branches originating from the base. When ruptured, they cause intracerebral hematoma in nearly half of the cases. DACA aneurysms are nowadays more often treated with microsurgical clipping than endovascular coiling due to their distal location and morphologic features. With clipping the results are same or slightly better than for aneurysms at other locations, coiling is often associated with more complications than in other aneurysms. Clipping is a long-lasting treatment with very small recurrence rate, there is no long-term data available on efficacy of coiling yet. For ruptured DACA aneurysms the most important factors affecting outcome is the severity of initial bleeding and patient's age.

  7. Impedance matching at arterial bifurcations.

    PubMed

    Brown, N

    1993-01-01

    Reflections of pulse waves will occur in arterial bifurcations unless the impedance is matched continuously through changing geometric and elastic properties. A theoretical model is presented which minimizes pulse wave reflection through bifurcations. The model accounts for the observed linear changes in area within the bifurcation, generalizes the theory to asymmetrical bifurcations, characterizes changes in elastic properties from parent to daughter arteries, and assesses the effect of branch angle on the mechanical properties of daughter vessels. In contradistinction to previous models, reflections cannot be minimized without changes in elastic properties through bifurcations. The theoretical model predicts that in bifurcations with area ratios (beta) less than 1.0 Young's moduli of daughter vessels may be less than that in the parent vessel if the Womersley parameter alpha in the parent vessel is less than 5. Larger area ratios in bifurcations are accompanied by greater increases in Young's moduli of branches. For an idealized symmetric aortic bifurcation (alpha = 10) with branching angles theta = 30 degrees (opening angle 60 degrees) Young's modulus of common iliac arteries relative to that of the distal abdominal aorta has an increase of 1.05, 1.68 and 2.25 for area ratio of 0.8, 1.0 and 1.15, respectively. These predictions are consistent with the observed increases in Young's moduli of peripheral vessels.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. Arterial endofibrosis in professional cyclists

    PubMed Central

    VERALDI, G.F.; MACRÌ, M.; CRISCENTI, P.; SCORSONE, L.; ZINGARETTI, C.C.; GNONI, M.; MEZZETTO, L.

    2015-01-01

    External Iliac Artery Endofibrosis (EIAE) is an uncommon disease usually affecting young, otherwise healthy, patients. It usually involves cyclists but cases have been reported in other groups of endurance athletes. The external iliac artery is the most affected anatomical site but other locations are described too. The precise pathophysiology and long-term evolution of the disease still remain unknown. The diagnosis may be challenging and delayed as the patients usually present symptoms only in extreme conditions and physical and instrumental examinations may be normal at rest. We present two cases of young professional cyclists who suffered of exercise-induced leg pain which led them to reduce running. Both patients were firstly treated with balloon angioplasty that rapidly failed to improve their symptoms. The successive open surgery with endofibrosectomy and autologous saphenous vein closure patch completely resolved physical limitations. EIAE is a rare disease that can induce arterial stenosis, thrombosis, dissection and secondary atheroma. After-exercise ankle-brachial index represents a useful diagnostic criterion. Careful observation of angio-CT may strengthen the suspect. Knowledge of the these features allows a better pre-operative assessment and an early effective treatment. Surgical revascularization remains the gold standard approach. PMID:26888703

  9. Morphology of atherosclerotic coronary arteries

    NASA Astrophysics Data System (ADS)

    Holme, Margaret N.; Schulz, Georg; Deyhle, Hans; Hieber, Simone Elke; Weitkamp, Timm; Beckmann, Felix; Herzen, Julia; Lobrinus, Johannes A.; Montecucco, Fabrizio; Mach, François; Zumbuehl, Andreas; Saxer, Till; Müller, Bert

    2012-10-01

    Atherosclerosis, the narrowing of vessel diameter and build-up of plaques in coronary arteries, leads to an increase in the shear stresses present, which can be used as a physics-based trigger for targeted drug delivery. In order to develop appropriate nanometer-size containers, one has to know the morphology of the critical stenoses with isotropic micrometer resolution. Micro computed tomography in absorption and phase contrast mode provides the necessary spatial resolution and contrast. The present communication describes the pros and cons of the conventional and synchrotron radiation-based approaches in the visualization of diseased human and murine arteries. Using registered datasets, it also demonstrates that multi-modal imaging, including established histology, is even more powerful. The tomography data were evaluated with respect to cross-section, vessel radius and maximal constriction. The average cross-section of the diseased human artery (2.31 mm2) was almost an order of magnitude larger than the murine one (0.27 mm2), whereas the minimal radius differs only by a factor of two (0.51 mm versus 0.24 mm). The maximal constriction, however, was much larger for the human specimen (85% versus 49%). We could also show that a plastic model used for recent experiments in targeted drug delivery represents a very similar morphology, which is, for example, characterized by a maximal constriction of 82%. The tomography data build a sound basis for flow simulations, which allows for conclusions on shear stress distributions in stenosed blood vessels.

  10. Silver europium(III) polyphosphate

    PubMed Central

    Ayadi, Mounir; Férid, Mokhtar; Moine, Bernard

    2009-01-01

    Europium(III) silver polyphosphate, AgEu(PO3)4, was prepared by the flux method. The atomic arrangement is built up by infinite (PO3)n chains (periodicity of 4) extending along the c axis. These chains are joined to each other by EuO8 dodeca­hedra. The Ag+ cations are located in the voids of this arrangement and are surrounded by five oxygen atoms in a distorted [4+1] coordination. PMID:21582031

  11. Clinical and pathological assessment of different suture techniques for microvascular anastomosis in rat femoral artery

    PubMed Central

    El-Shazly, Mohamed

    2007-01-01

    This study examined the clinical and pathological features after a microvascular anastomosis of a rat femoral artery using four different suture techniques. Sixty Sprage-Dawely rats were divided randomly into 4 groups. Fifteen bisected arteries (one from each animal) in Group I, II, III and IV were sutured with the simple interrupted suture, continuous suture, sleeve suture and cuff suture, respectively. The anastomosis times in Group I, II, III and IV were 28.67, 14.67, 15.47 and 15.93 min, respectively. Immediate bleeding that stopped without intervention (grade I) was observed in 67%, 73% and 60% of the anastomosed vessels in Groups II, III and IV, respectively, while 60% of the vessels in Group I showed light bleeding that was inhibited by gentile pressure (grade II). All vessels examined appeared to be patent at 5 and 15 min after the anastomosis. On the 7th day postoperatively, the vessels of Group I showed the highest patency rate (93%) compared with Groups II (67%), III (73%) and IV (87%). Moreover, there were more pronounced pathological changes in Group I than in the other groups. These changes included endothelial loss, endothelial proliferation, degeneration and necrosis of the tunica media. Suture materials surrounded by an inflammatory reaction were also observed. In conclusion, the simple interrupted suture is preferable for microvascular anastomosis due to its highest patency rate. The other techniques investigated can be good alternatives because of their short anastomotic time and moderate pathological changes. PMID:17679774

  12. Detection of left anterior descending coronary artery disease in patients with left bundle branch block.

    PubMed

    Civelek, A C; Gozukara, I; Durski, K; Ozguven, M A; Brinker, J A; Links, J M; Camargo, E E; Wagner, H N; Flaherty, J T

    1992-12-15

    The detection of coronary artery disease is difficult if a patient has electrocardiographic evidence of left bundle branch block (BBB). Septal blood flow may be reduced in patients with left BBB, despite no angiographic evidence of left anterior descending (LAD) coronary artery disease. We have developed a new method of quantification of Thallium-201 single-photon emission computed tomographic (SPECT) images with the aim of better separating patients with left BBB and LAD disease from those with left BBB alone. The study cohort comprised 8 normal subjects (group I) and 20 patients with left BBB and chest pain who underwent thallium-201 SPECT imaging and coronary angiography. Eight patients (group II) had < or = 50% LAD stenosis, and 12 (group III) had > or = 70% LAD stenosis. Septal abnormality scores on the second short-axis slice from the base were computed, based on comparison of each subject's short-axis circumferential profile with a normal reference curve. This followed a procedure in which each profile was scaled to minimize differences in its absolute level in relation to the reference curve. Septal abnormality scores on stress images were 0.8 +/- 22 for group I, 27 +/- 43 for group II, and 165 +/- 67 for group III (p = 0.15 for group I vs II, and p < 0.0001 between groups I and III, and II and III).(ABSTRACT TRUNCATED AT 250 WORDS)

  13. Organometallic neptunium(III) complexes

    NASA Astrophysics Data System (ADS)

    Dutkiewicz, Michał S.; Farnaby, Joy H.; Apostolidis, Christos; Colineau, Eric; Walter, Olaf; Magnani, Nicola; Gardiner, Michael G.; Love, Jason B.; Kaltsoyannis, Nikolas; Caciuffo, Roberto; Arnold, Polly L.

    2016-08-01

    Studies of transuranic organometallic complexes provide a particularly valuable insight into covalent contributions to the metal-ligand bonding, in which the subtle differences between the transuranium actinide ions and their lighter lanthanide counterparts are of fundamental importance for the effective remediation of nuclear waste. Unlike the organometallic chemistry of uranium, which has focused strongly on UIII and has seen some spectacular advances, that of the transuranics is significantly technically more challenging and has remained dormant. In the case of neptunium, it is limited mainly to NpIV. Here we report the synthesis of three new NpIII organometallic compounds and the characterization of their molecular and electronic structures. These studies suggest that NpIII complexes could act as single-molecule magnets, and that the lower oxidation state of NpII is chemically accessible. In comparison with lanthanide analogues, significant d- and f-electron contributions to key NpIII orbitals are observed, which shows that fundamental neptunium organometallic chemistry can provide new insights into the behaviour of f-elements.

  14. Effects of chronic carotid baroreceptor activation on arterial stiffness in severe heart failure.

    PubMed

    Gronda, Edoardo; Brambilla, GianMaria; Seravalle, Gino; Maloberti, Alessandro; Cairo, Matteo; Costantino, Giuseppe; Lovett, Eric; Vanoli, Emilio; Mancia, Giuseppe; Grassi, Guido

    2016-10-01

    Heart failure with reduced ejection fraction (HFrEF) is characterized by activation of the sympathetic nervous system and increased arterial stiffness, leading to an impaired ventricular-vascular coupling. Baroreflex activation therapy (BAT) has been shown to reduce muscle sympathetic nerve activity (MSNA) and improve clinical status of patients with HFrEF. The purpose of this investigation was to determine the effects of BAT on arterial stiffness in HFrEF. MSNA, clinical variables, and parameters of central blood pressure (BP) and arterial stiffness were collected in 18 NYHA Class III HFrEF patients, nine receiving BAT and nine continuing with optimal medical management alone. Patients were followed for 3 months, with measurements at that time compared to baseline evaluation. Baseline characteristics of the groups were well matched. At 3 months, BAT did not improve central BP and arterial stiffness despite a significant amelioration of MSNA, NYHA class, Minnesota living with heart failure questionnaire score, number of heart failure medications and six-minute walking distance. The control group exhibited no significant changes in all the measured variables. Despite significant reductions in MSNA and clinical improvement, BAT does not appear to chronically modify arterial stiffness within this HFrEF cohort. Additional study is required to determine if this result applies to the HFrEF population as a whole.

  15. Radial artery pseudoaneurysm: A rare complication after a single arterial puncture for blood-gas analysis.

    PubMed

    Patel, Kajal Nitin; Gandhi, Shruti P; Sutariya, Harsh C

    2016-10-01

    With a reported incidence of 0.048%, radial artery pseudoaneurysm (PA) is a rare but serious complication of arterial cannulation. We report a case of PA developing after a single puncture of the right radial artery for arterial blood-gas analysis diagnosed by Doppler ultrasound in young male patient. The development of PA after puncture of radial artery for continuous blood pressure monitoring and serial blood-gas analysis has been reported in the past; however, to the best of our knowledge, there is only one case report of development of PA after a single arterial puncture for blood-gas analysis is reported in the past.

  16. Aberrant Ovarian Collateral Originating from External Iliac Artery During Uterine Artery Embolization

    SciTech Connect

    Kwon, Joon Ho; Kim, Man Deuk Lee, Kwang-hun; Lee, Myungsu; Lee, Mu Sook; Won, Jong Yun; Park, Sung Il; Lee, Do Yun

    2013-02-15

    We report a case of a 35-year-old woman who underwent uterine artery embolization (UAE) for symptomatic multiple uterine fibroids with collateral aberrant right ovarian artery that originated from the right external iliac artery. We believe that this is the first reported case in the literature of this collateral uterine flow by the right ovarian artery originated from the right external iliac artery. We briefly present the details of the case and review the literature on variations of ovarian artery origin that might be encountered during UAE.

  17. Superficial Ulnar Artery Associated with Anomalous Origin of the Common Interosseous and Ulnar Recurrent Arteries

    PubMed Central

    Pamidi, Narendra; Nayak, Satheesha B; Jetti, Raghu; Thangarajan, Rajesh

    2016-01-01

    Occurrence of vascular variations in the upper limb is not uncommon and is well described in the medical literature. However, occurrence of superficial ulnar artery associated with unusual origin of the common interosseous and ulnar recurrent arteries is seldom reported in the literature. In the present case, we report the anomalous origin of common trunk of common interosseous, anterior and posterior ulnar recurrent arteries from the radial artery, in a male cadaver. Further, ulnar artery had presented superficial course. Knowledge of anomalous arterial pattern in the cubital fossa reported here is clinically important during the angiographic procedures and plastic surgeries. PMID:27437201

  18. Mucosal perforators from the facial artery.

    PubMed

    Coronel-Banda, Mauricio E; Serra-Renom, Jose M; Lorente, Marian; Larrea-Terán, Wendy P

    2014-07-01

    The cutaneous perforators of the facial artery have been well described, but to our knowledge the oral mucosal perforators have not. We studied 10 facial arteries from 10 hemifaces in 5 cadavers. The arteries were injected with latex, and we studied all perforators that extended from the facial artery and headed directly to the oral mucosa. The diameter and length of the facial artery and its mucosal perforators were measured and compared. We found 52 oral mucosal perforators in the 10 facial arteries injected with latex. Their mean (SD) diameter was 0.5 (0.2) mm and the mean (SD) number/facial artery was 5.2 (1.1). Their mean (SD) length was 16.4 (5.3) mm. Most of those to the cheek were localised between the branching-off points of the inferior and superior labial arteries. The facial artery has perforators to the oral mucosa of the cheek, most of them between the points at which the labial arteries emerge.

  19. Celiac artery stent placement for coronary ischemia.

    PubMed

    Madden, Nicholas J; Piccolo, Carmen; Kunasani, Ratna; Mohan, Chittur; Khoobehi, Ali; Sohn, Richard

    2015-08-01

    The use of endovascular technology for mesenteric interventions has become an increasingly accepted treatment modality. We present an unusual case of celiac artery stent placement for coronary ischemia. A 66-year-old male with a history most notable for coronary artery disease and coronary artery bypass grafting (CABG) x 3 utilizing left internal mammary artery to left anterior descending, radial artery to first diagonal and his right gastroepiploic artery (GEA) to posterior descending artery presented with chest pain. His work-up included a cardiac catheterization that revealed a 90% stenosis at the origin of the celiac axis. A subsequent computerized tomography angiogram confirmed this and noted moderate stenosis of his superior mesenteric artery (SMA) as well as severe inferior mesenteric artery (IMA) stenosis. The patient was taken for mesenteric angiography by vascular surgery at which time he underwent balloon-expandable stent placement in the celiac axis. The patient tolerated this procedure well and was noted to have an improvement in his symptoms postoperatively. Use of arterial conduits for CABG have proven to be superior to vein. Long-term viability of the GEA as a conduit is dependent in part on the patency of mesenteric circulation. Our findings demonstrate a viable endovascular treatment option for angina pectoris secondary to mesenteric stenosis in this unique patient population. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. The Autophagy Enhancer Spermidine Reverses Arterial Aging

    PubMed Central

    LaRocca, Thomas J.; Gioscia-Ryan, Rachel A.; Hearon, Christopher M.; Seals, Douglas R.

    2013-01-01

    Arterial aging, characterized by stiffening of large elastic arteries and the development of arterial endothelial dysfunction, increases cardiovascular disease (CVD) risk. We tested the hypothesis that spermidine, a nutrient associated with the anti-aging process autophagy, would improve arterial aging. Aortic pulse wave velocity (aPWV), a measure of arterial stiffness, was ~20% greater in old (O, 28 months) compared with young C57BL6 mice (Y, 4 months, P < 0.05). Arterial endothelium-dependent dilation (EDD), a measure of endothelial function, was ~25% lower in O (P < 0.05 vs. Y) due to reduced nitric oxide (NO) bioavailability. These impairments were associated with greater arterial oxidative stress (nitrotyrosine), superoxide production, and protein cross-linking (advanced glycation end-products, AGEs) in O (all P < 0.05). Spermidine supplementation normalized aPWV, restored NO-mediated EDD and reduced nitrotyrosine, superoxide, AGEs and collagen in O. These effects of spermidine were associated with enhanced arterial expression of autophagy markers, and in vitro experiments demonstrated that vascular protection by spermidine was autophagy-dependent. Our results indicate that spermidine exerts a potent anti-aging influence on arteries by increasing NO bioavailability, reducing oxidative stress, modifying structural factors and enhancing autophagy. Spermidine may be a promising nutraceutical treatment for arterial aging and prevention of age-associated CVD. PMID:23612189

  1. Assessment of conduit artery vasomotion using photoplethysmography

    NASA Astrophysics Data System (ADS)

    Kanders, Karlis; Grabovskis, Andris; Marcinkevics, Zbignevs; Aivars, Juris Imants

    2013-11-01

    Vasomotion is a spontaneous oscillation of vascular tone. The phenomenon has been observed in small arterioles and capillaries as well as in the large conduit arteries. The layer of smooth muscle cells that surrounds a blood vessel can spontaneously and periodically change its tension and thereby the arterial wall stiffness also changes. As the understanding of the phenomenon is still rather obscure, researchers would benefit from a low-cost and reliable investigation technique such as photoplethysmography (PPG). PPG is an optical blood pulsation measurement technique that can offer substantial information about the arterial stiffness. The aims of this pilot study were to evaluate the usefulness of the PPG technique in the research of vasomotion and to investigate vasomotion in the relatively large conduit arteries. Continuous 15 minute long measurements of posterior tibial artery wall stiffness were taken. Artery diameter, electrocardiogram, blood pressure and respiration were also simultaneously registered. Fast Fourier Transform power spectra were calculated to identify unique stiffness oscillations that did not correspond to fluctuations in the systemic parameters and thus would indicate vasomotion. We concluded that photoplethysmography is a convenient method for the research of the vasomotion in large arteries. Local stiffness parameter b/a is more accurate to use and easier to measure than the pulse wave velocity which describes stiffness of a segment of an artery. Conduit arteries might exhibit a low amplitude high frequency vasomotion ( 9 to 27 cycles per minute). Low frequency vasomotion is problematic to distinguish from the passive oscillations imposed by the arterial pressure.

  2. Complete myocardial revascularization using arterial grafts.

    PubMed

    Dallan, L A; de Oliveira, S A; Lisboa, L A; Platania, F; Jatene, F B; Iglezias, J C; Filho, C A; Cabral, R; Jatene, A D

    2001-01-01

    Complete arterial revascularization is important in younger patients to reduce the likelihood of future reoperation. We assessed the short-term outcome of a strategy to provide complete arterial revascularization in a cohort of young patients. Three hundred and eighty-five patients underwent myocardial revascularization using artery grafts alone and were followed up for 30 months. One hundred fourteen patients (29.6%) had single-vessel disease, 118 (30.6%) had two-vessel disease, and 153 (39.7%) had three or more obstructed coronary arteries. Eight of the patients had undergone previous surgical revascularization. The left internal thoracic artery (LITA) was routinely used for the left anterior descending branch (LAD). In 103 patients (28.1%), the in situ right internal thoracic artery (RITA) was used for revascularization of the right coronary artery (RCA) and its branches. The RITA was sometimes used as a free graft from the aorta or as an artificial "Y" from the LITA to the diagonal and marginal branches. Other arterial conduits included the radial artery (RA) in 215 patients (55.8%), the right gastroepiploic artery (RGEA) in 24 patients (6.3%), and the inferior epigastric artery (IEA) in four patients (1.1%). In patients having lesions in three or more arteries, the mean number of distal anastomoses was 3.2 per patient. There were no intraoperative deaths. Hospital mortality was 1.8% (n = 7). Of the fatal cases, two were redos and two underwent combined procedures (one for left ventricular aneurysm and one for double valve replacement), while only three of the fatal cases underwent revascularization as a primary and isolated procedure. Complete arterial reconstruction carries an acceptably low operative mortality and excellent short-term follow-up. This strategy is particularly important for young patients to reduce the probability of future reoperation.

  3. Association of europium(III), americium(III), and curium(III) with cellulose, chitin, and chitosan.

    PubMed

    Ozaki, Takuo; Kimura, Takaumi; Ohnuki, Toshihiko; Kirishima, Akira; Yoshida, Takahiro; Isobe, Hiroshi; Francis, Arokiasamy J

    2006-08-01

    The association of trivalent f-elements-Eu(III), Am(III), and Cm(III)--with cellulose, chitin, and chitosan was determined by batch experiments and time-resolved, laser-induced fluorescence spectroscopy (TRLFS). The properties of these biopolymers as an adsorbent were characterized based on speciation calculation of Eu(III). The adsorption study showed that an increase of the ionic strength by NaCl did not affect the adsorption kinetics of Eu(III), Am(III), and Cm(III) for all the biopolymers, but the addition of Na2CO3 significantly delayed the kinetics because of their trivalent f-element complexation with carbonate ions. It also was suggested from the speciation calculation study that all the biopolymers were degraded under alkaline conditions, leading to their masking of the adsorption of Eu(III), Am(III), and Cm(III) on the nondegraded biopolymers. The masking effect was higher for cellulose than for chitin and chitosan, indicating that of the three, cellulose was degraded most significantly in alkaline solutions. Desorption experiments suggested that some portion of the adsorbed Eu(III) penetrated deep into the matrix, being isolated in a cavity-like site. The TRLFS study showed that the coordination environment of Eu(III) is stabilized mainly by the inner spherical coordination in chitin and by the outer spherical coordination in chitosan, with less association in cellulose in comparison to chitin and chitosan. These results suggest that the association of these biopolymers with Eu(III), Am(III), and Cm(III) is governed not only by the affinity of the functional groups alone but also by other factors, such as the macromolecular steric effect. The association of degraded materials of the biopolymers also should be taken into consideration for an accurate prediction of the influence of biopolymers on the migration behavior of trivalent f-elements.

  4. Quantitative comparison of cerebral artery development in metatherians and monotremes with non-human eutherians.

    PubMed

    Ashwell, Ken W S; Shulruf, Boaz

    2016-03-01

    A quantitative comparison of the internal diameters of cerebral feeder arteries (internal carotid and vertebral) and the aorta in developing non-human eutherians, metatherians and monotremes has been made, with the aim of determining if there are differences in cerebral arterial flow between the three infraclasses of mammals such as might reflect differences in metabolism of the developing brain. There were no significant differences between eutherians and metatherians in the internal radius of the aorta or the thickness of the aortic wall, but aortic internal radius was significantly smaller in developing monotremes than therians at the < 10 mm body length range. Aortic thickness in the developing monotremes also rose at a slower rate relative to body length than in metatherians or eutherians. The sums of the internal calibres of the internal carotid and vertebral arteries were significantly lower in metatherians as a group and monotremes compared with non-human eutherians at body lengths up to 20 mm and in metatherians at > 20 mm body length. The internal calibre of the internal carotids relative to the sum of all cerebral feeder arteries was also significantly lower in monotremes at < 10 mm body length compared with eutherians. It was noted that dasyurids differed from other metatherians in several measures of cerebral arterial calibre and aortic internal calibre. The findings suggest that: (i) both aortic outflow and cerebral arterial inflow may be lower in developing monotremes than in therians, particularly at small body size (< 20 mm); (ii) cerebral inflow may be lower in some developing metatherians than non-human eutherians; and (iii) dasyurids have unusual features of cerebral arteries possibly related to the extreme immaturity and small size at which they are born. The findings have implications for nutritional sourcing of the developing brain in the three infraclasses of mammals.

  5. Preclinical evaluation of ice-free cryopreserved arteries: structural integrity and hemocompatibility.

    PubMed

    Huber, Agnes J T; Brockbank, Kelvin G M; Riemann, Iris; Schleicher, Martina; Schenke-Layland, Katja; Fritze, Olaf; Wendel, Hans-Peter; Stock, Ulrich A

    2012-01-01

    Arterial allografts are routinely employed for reconstruction of infected prosthetic grafts. Usually, banked cryopreserved arteries are used; however, existing conventional freezing cryopreservation techniques applied to arteries are expensive. In contrast, a new ice-free cryopreservation technique results in processing, storage and shipping methods that are technically simpler and potentially less costly. The objective of this study was to determine whether or not ice-free cryopreservation causes tissue changes that might preclude clinical use. Conventionally frozen cryopreserved porcine arteries were compared with ice-free cryopreserved arteries and untreated fresh controls using morphological (light, scanning electron and laser scanning microscopy), viability (alamarBlue assay) and hemocompatibility methods (blood cell adhesion, thrombin/antithrombin-III-complex, polymorphonuclear neutrophil-elastase, β-thromboglobulin and terminal complement complex SC5b-9). No statistically significant structural or hemocompatibility differences between ice-free cryopreserved and frozen tissues were detectable. There were no quantitative differences observed for either autofluorescence (elastin) or second harmonic generation (collagen) measured by laser scanning microscopy. Cell viability in ice-free cryopreserved arteries was significantly reduced compared to fresh and frozen tissues (p < 0.05). The formation of ice in aortic artery preservation did not make a difference in histology, structure or thrombogenicity, but significantly increased viability compared with a preservation method that precludes ice formation. Reduced cell viability should not reduce in vivo performance. Therefore, ice-free cryopreservation is a potentially safe and cost-effective technique for the cryopreservation of blood vessel allografts. Copyright © 2012 S. Karger AG, Basel.

  6. Prevalence, factors, and clinical impact of self-expanding stent fractures following iliac artery stenting.

    PubMed

    Higashiura, Wataru; Kubota, Yasushi; Sakaguchi, Shoji; Kurumatani, Norio; Nakamae, Mitsuhiro; Nishimine, Kiyoshi; Kichikawa, Kimihiko

    2009-03-01

    To evaluate the prevalence, factors, and clinical impact of self-expanding stent fracture following iliac artery stenting. A review of the endovascular registry database for our department showed 353 patients with occlusive diseases of the iliac artery who underwent stenting between 1997 and 2007. While clinical data and images were retrospectively reviewed for all patients, 165 patients who underwent self-expanding stenting and plain radiograph with >or=6-months follow-up were analyzed. Mean follow-up was 43 months for 305 stents (elgiloy, n = 83; nitinol, n = 222) implanted in 216 iliac arteries. The mean duration until the last imaging study was 38 months. Items concerning prevalence of stent fracture, factors associated with fracture, and outcomes for patients with stent fracture were analyzed. Stent fracture was detected in 11 of 216 iliac arteries (5.1%). In stent-based analysis, 11 of 305 stents (3.6%) showed stent fracture, classified as type I in 2 stents, type II in 3 stents, type III in 4 stents, type IV in 1 stent, and type V in 1 stent. Stent fracture was detected in 11 of 222 nitinol stents (5.0%), but no Elgiloy stents. Cox proportional hazards regression model indicated stenting for chronic occlusion as a risk factor associated with nitinol stent fracture (hazard ratio [HR] = 6.09, P = 0.008, 95% confidence interval [CI] 1.59-23.3). Cumulative primary patency rates in iliac arteries with and without fractured stents were 90% and 91% at 8 years (P = .80), respectively. Fracture of self-expanding stents is rare in iliac arteries, but stenting for chronic occlusion represents a risk factor for fracture. Fractures of stents placed in iliac arteries rarely affect patency.

  7. The exercise pressor reflex and peripheral artery disease.

    PubMed

    Stone, Audrey J; Kaufman, Marc P

    2015-03-01

    The exercise pressor reflex contributes to increases in cardiovascular and ventilatory function during exercise. These reflexive increases are caused by both mechanical stimulation and metabolic stimulation of group III and IV afferents with endings in contracting skeletal muscle. Patients with peripheral artery disease (PAD) have an augmented exercise pressor reflex. Recently, an animal model of PAD was established which allows further investigation of possible mechanisms involved in this augmented reflex. Earlier studies have identified ASIC3 channels, bradykinin receptors, P2X receptors, endoperoxide receptors, and thromboxane receptors as playing a role in evoking the exercise pressor reflex in healthy rats. This review focuses on recent studies using a rat model of PAD in order to determine possible mechanisms contributing to the exaggerated exercise pressor reflex seen in patients with this disease.

  8. [Experience with imatinib to treat pulmonary arterial hypertension].

    PubMed

    García Hernández, Francisco José; Castillo Palma, María Jesús; González León, Rocío; Garrido Rasco, Rocío; Ocaña Medina, Celia; Sánchez Román, Julio

    2008-12-01

    Despite advances in the treatment of patients with pulmonary arterial hypertension (PAH), survival has not improved greatly (is still very affected). Imatinib, an antagonist of platelet-derived growth factor with antiproliferative activity, has been effective in experimental models and clinically in several published reports. We report the results of imatinib therapy in 4 patients with PAH (functional class IV) who were refractory to treatment with drug combinations for this condition. The final outcome was favorable in only 1 of the 4 cases. In this case, the patient was in functional class III and his hemodynamic parameters had improved significantly within 5 months after starting therapy. However, the patient died as a result of severe toxic hepatitis in which imatinib may have played a role. The present report adds to the few already in the literature (4 cases) and suggests that care should continue to be shown when using imatinib to treat PAH.

  9. Splenic Artery Transposition Graft Usage for the Supply of the Right Hepatic Artery: A Case Report

    PubMed Central

    Odabasi, Mehmet; Eris, Cengiz; Yildiz, Mehmet Kamil; Abuoglu, Hasan; Akbulut, Sami; Saglam, Abdullah

    2013-01-01

    Hepatic artery aneurysms are responsible for 12% to 20% of all visceral arterial aneurysms. Because most patients are asymptomatic, this disease is generally diagnosed incidentally during radiologic examination. Aneurysm rupture develops in 14% to 80% of cases, depending on the aneurysmatic segment's diameter and location, as well as other etiologic factors. Mortality rates associated with rupture range between 20% and 70%. Thus, early diagnosis and timely initiation of medical interventions are critical to improve survival rates. Here, we present a male patient, age 69 years, with a hepatic artery aneurysm that was detected incidentally. The 3-cm aneurysm was detected on contrast-enhanced computed tomography and extended from the common hepatic artery to the hepatic trifurcation. A laparotomy was performed using a right subcostal incision. After dissection of the hepatoduodenal ligament, the common, right, and left hepatic arteries, as well as the gastroduodenal artery, were suspended separately. Then, the aneurysmatic hepatic artery segment was resected, and the gastroduodenal artery stump was ligated. An end-to-end anastomosis was formed between the left and common hepatic arteries, followed by an end-to-end anastomosis formed between the right hepatic artery and splenic artery using a splenic artery transposition graft. Postoperative follow-up examinations showed that both hepatic arterial circulations were good, and no splenic infraction had developed. PMID:23971784

  10. Splenic artery transposition graft usage for the supply of the right hepatic artery: a case report.

    PubMed

    Odabasi, Mehmet; Eris, Cengiz; Yildiz, Mehmet Kamil; Abuoglu, Hasan; Akbulut, Sami; Saglam, Abdullah

    2013-01-01

    Hepatic artery aneurysms are responsible for 12% to 20% of all visceral arterial aneurysms. Because most patients are asymptomatic, this disease is generally diagnosed incidentally during radiologic examination. Aneurysm rupture develops in 14% to 80% of cases, depending on the aneurysmatic segment's diameter and location, as well as other etiologic factors. Mortality rates associated with rupture range between 20% and 70%. Thus, early diagnosis and timely initiation of medical interventions are critical to improve survival rates. Here, we present a male patient, age 69 years, with a hepatic artery aneurysm that was detected incidentally. The 3-cm aneurysm was detected on contrast-enhanced computed tomography and extended from the common hepatic artery to the hepatic trifurcation. A laparotomy was performed using a right subcostal incision. After dissection of the hepatoduodenal ligament, the common, right, and left hepatic arteries, as well as the gastroduodenal artery, were suspended separately. Then, the aneurysmatic hepatic artery segment was resected, and the gastroduodenal artery stump was ligated. An end-to-end anastomosis was formed between the left and common hepatic arteries, followed by an end-to-end anastomosis formed between the right hepatic artery and splenic artery using a splenic artery transposition graft. Postoperative follow-up examinations showed that both hepatic arterial circulations were good, and no splenic infraction had developed.

  11. Coronary Artery Manifestations of Fibromuscular Dysplasia

    PubMed Central

    Michelis, Katherine C.; Olin, Jeffrey W.; Kadian-Dodov, Daniella; d’Escamard, Valentina; Kovacic, Jason C.

    2015-01-01

    Fibromuscular dysplasia (FMD) involving the coronary arteries is an uncommon but important condition that can present as acute coronary syndrome, left ventricular dysfunction, or potentially sudden cardiac death. Although the classic angiographic “string of beads” that may be observed in renal artery FMD does not occur in coronary arteries, potential manifestations include spontaneous coronary artery dissection, distal tapering or long, smooth narrowing that may represent dissection, intramural hematoma, spasm, or tortuosity. Importantly, FMD must be identified in at least one other noncoronary arterial territory to attribute any coronary findings to FMD. Although there is limited evidence to guide treatment, many lesions heal spontaneously; thus, a conservative approach is generally preferred. The etiology is poorly understood, but there are ongoing efforts to better characterize FMD and define its genetic and molecular basis. This report reviews the clinical course of FMD involving the coronary arteries and provides guidance for diagnosis and treatment strategies. PMID:25190240

  12. Permanent Cortical Blindness After Bronchial Artery Embolization

    SciTech Connect

    Doorn, Colette S. van De Boo, Diederick W.; Weersink, Els J. M.; Delden, Otto M. van Reekers, Jim A. Lienden, Krijn P. van

    2013-12-15

    A 35-year-old female with a known medical history of cystic fibrosis was admitted to our institution for massive hemoptysis. CTA depicted a hypertrophied bronchial artery to the right upper lobe and showed signs of recent bleeding at that location. Bronchial artery embolization (BAE) was performed with gelfoam slurry, because pronounced shunting to the pulmonary artery was present. Immediately after BAE, the patient developed bilateral cortical blindness. Control angiography showed an initially not opacified anastomosis between the embolized bronchial artery and the right subclavian artery, near to the origin of the right vertebral artery. Cessation of outflow in the bronchial circulation reversed the flow through the anastomosis and allowed for spill of embolization material into the posterior circulation. Unfortunately the cortical blindness presented was permanent.

  13. Coronary artery manifestations of fibromuscular dysplasia.

    PubMed

    Michelis, Katherine C; Olin, Jeffrey W; Kadian-Dodov, Daniella; d'Escamard, Valentina; Kovacic, Jason C

    2014-09-09

    Fibromuscular dysplasia (FMD) involving the coronary arteries is an uncommon but important condition that can present as acute coronary syndrome, left ventricular dysfunction, or potentially sudden cardiac death. Although the classic angiographic "string of beads" that may be observed in renal artery FMD does not occur in coronary arteries, potential manifestations include spontaneous coronary artery dissection, distal tapering or long, smooth narrowing that may represent dissection, intramural hematoma, spasm, or tortuosity. Importantly, FMD must be identified in at least one other noncoronary arterial territory to attribute any coronary findings to FMD. Although there is limited evidence to guide treatment, many lesions heal spontaneously; thus, a conservative approach is generally preferred. The etiology is poorly understood, but there are ongoing efforts to better characterize FMD and define its genetic and molecular basis. This report reviews the clinical course of FMD involving the coronary arteries and provides guidance for diagnosis and treatment strategies.

  14. Anatomy of the Ophthalmic Artery: Embryological Consideration

    PubMed Central

    TOMA, Naoki

    2016-01-01

    There are considerable variations in the anatomy of the human ophthalmic artery (OphA), such as anomalous origins of the OphA and anastomoses between the OphA and the adjacent arteries. These anatomical variations seem to attribute to complex embryology of the OphA. In human embryos and fetuses, primitive dorsal and ventral ophthalmic arteries (PDOphA and PVOphA) form the ocular branches, and the supraorbital division of the stapedial artery forms the orbital branches of the OphA, and then numerous anastomoses between the internal carotid artery (ICA) and the external carotid artery (ECA) systems emerge in connection with the OphA. These developmental processes can produce anatomical variations of the OphA, and we should notice these variations for neurosurgical and neurointerventional procedures. PMID:27298261

  15. Anatomy of the Ophthalmic Artery: Embryological Consideration.

    PubMed

    Toma, Naoki

    2016-10-15

    There are considerable variations in the anatomy of the human ophthalmic artery (OphA), such as anomalous origins of the OphA and anastomoses between the OphA and the adjacent arteries. These anatomical variations seem to attribute to complex embryology of the OphA. In human embryos and fetuses, primitive dorsal and ventral ophthalmic arteries (PDOphA and PVOphA) form the ocular branches, and the supraorbital division of the stapedial artery forms the orbital branches of the OphA, and then numerous anastomoses between the internal carotid artery (ICA) and the external carotid artery (ECA) systems emerge in connection with the OphA. These developmental processes can produce anatomical variations of the OphA, and we should notice these variations for neurosurgical and neurointerventional procedures.

  16. [Fetal pulmonary artery blood flow depending on fetal lung maturity].

    PubMed

    Jastrzebski, Arkadiusz; Lech, Tomasz; Obcowska-Lech, Marta; Sobański, Andrzej; Sipiński, Adam

    2004-01-01

    The ultrasonographic assessment of fetal lung maturity by evaluating the elasticity of lung tissue, Dynamic Lung Score (DLS) has been being performed since 1986 in ObGyn Department in Tychy (Medical University of Silesia). The lung elasticity is evaluated on the cross sections of fetal thorax, on the level of heart ventricles. The result of the evaluation is given as the three degree scale, in which I degree indicates the lack of elasticity and fetal lung immaturity, II degrees indicates partially expressed elasticity, corresponding with incomplete maturity of lung tissue, and III degrees represents full elasticity and indicates complete maturity of fetal lungs. This study was designed to compare fetal pulmonary artery blood flow with the maturity of fetal lung tissue evaluated during the ultrasonographic assessment of fetal lung tissue elasticity. The examination was performed on pregnant women, beginning on 27th week gestation. During the examination the mean Pulsatility Index was decreased, particularly in fetuses with II degrees lung maturity. The Resistance Index (RI) was found to be stable and independent of gestational age. In the group with I degree lung maturity (DLS I), the mean PI = 2.643 (+/- 0.229), mean RI = 0.879 (+/- 0.036), in DLS II group PI = 2.039 (+/- 0.262), RI = 0.868 (+/- 0.037), and in DLS III group PI = 2,500 (+/- 0.100), RI = 0.900 (+/- 0.100). Comparing the ultrasonographic evaluation of fetal lung maturity with fetal pulmonary artery blood flow allows more accurate assessment of fetal lung maturity. Fetal lung maturity can not be evaluated univocally on the basis of blood flow assessment. Because of the divergence of blood flow parameters further studies including bigger population seem to be necessary for verification of the results and for establishing the reference values.

  17. Relationship between carotid intima‐media thickness and arterial stiffness in children after Kawasaki disease

    PubMed Central

    Cheung, Y‐f; Wong, S J; Ho, M H K

    2007-01-01

    Background Evidence of premature atherosclerosis and systemic arterial stiffening in patients after Kawasaki disease is accumulating. Aim To test the hypothesis that carotid intima‐media thickness (IMT), a surrogate marker of atherosclerosis, is associated with systemic arterial stiffness in children after Kawasaki disease. Methods A cohort of 72 patients was studied, comprising 26 patients with Kawasaki disease and coronary aneurysms (group I), 24 patients with Kawasaki disease and normal coronary arteries (group II) and 22 healthy age‐matched children (group III). The carotid IMT, carotid artery stiffness index, brachioradial pulse wave velocity (PWV), fasting total cholesterol, high‐density lipoprotein (HDL) cholesterol and low‐density lipoprotein (LDL) cholesterol were determined and compared among the three groups. Results The carotid IMT was related to indices of arterial stiffness, and significant determinants of carotid IMT were identified by multivariate analysis. The mean (standard deviation (SD)) carotid IMT of both group I (0.41 (0.04) mm) and group II (0.39 (0.04) mm) was significantly greater than that of group III (0.36 (0.04) mm; p<0.001 and p = 0.008, respectively). For the entire cohort, carotid IMT correlated positively with LDL cholesterol (r = 0.31, p = 0.009), carotid artery stiffness index (r = 0.40, p = 0.001) and brachioradial PWV (r = 0.28, p = 0.016), but not with age, body mass index, systemic blood pressure, and HDL and total cholesterol. Multiple linear regression analysis identified carotid artery stiffness index (β = 0.25, p = 0.028) and subject grouping (β = −0.39, p = 0.001; model R2 = 0.29) as significant correlates of carotid IMT. Conclusion The increased carotid IMT in children after Kawasaki disease is associated with systemic arterial stiffening. PMID:16820386

  18. Technology evaluation: transgenic antithrombin III (rhAT-III), Genzyme Transgenics.

    PubMed

    Yeung, P K

    2000-06-01

    AT-III LLC, a joint venture between Genzyme Transgenics (GTC) and Genzyme General, is developing transgenic recombinant human antithrombin III (rhAT-III) as a potential treatment for sepsis and other disorders involving thrombosis. It is in phase III clinical trials in the US and Europe as an anticoagulant in patients undergoing elective cardiac surgery such as cardiopulmonary bypass.

  19. Development of Demographic Norms for Four New WAIS-III/WMS-III Indexes

    ERIC Educational Resources Information Center

    Lange, Rael T.; Chelune, Gordon J.; Taylor, Michael J.; Woodward, Todd S.; Heaton, Robert K.

    2006-01-01

    Following the publication of the third edition Wechsler scales (i.e., WAIS-III and WMS-III), demographically corrected norms were made available in the form of a computerized scoring program (i.e., WAIS-III/WMS-III/WIAT-II Scoring Assistant). These norms correct for age, gender, ethnicity, and education. Since then, four new indexes have been…

  20. Transient ulnar artery compression facilitates transradial access

    PubMed Central

    Zhou, Zhi-ming; Yan, Zhen-xian; Nie, Bin; Guo, Yong-he; Zhou, Yu-jie

    2016-01-01

    Abstract Background: Unsuccessful radial artery puncture is one of the important causes of transradial procedure failure. Ulnar artery compression made the radial artery pulse stronger. Whether it would make transradial access easier, however, is uncertain. Methods: A prospective randomized controlled trial was conducted among 446 patients who planned for transradial cardiac catheterization. Patients were randomized to receiving either transient ulnar artery compression (UC) or standard treatment (standard) for half an hour prior to needle insertion (217 UC, 229 standard). The diameters of right radial artery and ulnar artery were measured by ultrasound on admission and before artery puncture. Primary endpoints included the number of attempts to access, the rate of first-pass success, and time for a successful access. Secondary endpoints were the number of difficult procedures, and the incidence of puncture failure. Results: The diameters of radial artery were larger after half an hour's ulnar artery compression, but there were no obvious changes in that of ulnar artery. As compared with standard group, the number of attempts was significantly decreased (1.42 ± 1.10 vs 2.97 ± 2.38, P <0.001), and the rate of first-pass success was greatly enhanced (73.27% vs 57.64%, P <0.001) in UC group. Meanwhile, the time for access was decreased (59 ± 15 seconds vs 71 ± 18 seconds, P <0.001) with UC. In addition, the proportion of difficult procedures of UC group was less than that of standard group (4.61% vs 10.92%, P = 0.013). No significant differences were found in failure rates of sheath insertion and puncture between the 2 groups. Conclusion: Transient ulnar artery compression enhances the efficacy and feasibility of radial artery intubatton in transradial catheterization. PMID:27902608

  1. Thrombosis of the Azygos Anterior Cerebral Artery

    PubMed Central

    Avelino, Marcelo Coelho; Bastos, Breno Braga; Moreira de Sousa, Rafael Soares

    2017-01-01

    The azygos anterior cerebral artery is a rare variant, characterized by the absence of the anterior communicating artery and the union of two proximal segments of the anterior cerebral artery, forming a single trunk and ascending through the interhemispheric fissure. The incidence in the population varies from 0.3 to 2%. The presence of occlusion for this vessel causes bifrontal infarcts, with potentially devastating functional consequences, hence the importance of recognizing this anatomical variation in imaging exams. PMID:28299225

  2. [Diagnosing venous and venous/arterial ulcers].

    PubMed

    Perceau, Géraldine

    2012-01-01

    A venous ulcer can be diagnosed on the basis of elements arising from the questioning and the clinical examination of the patient. A venous Doppler ultrasound can specify the type of reverse flow (superficial and/or deep). Measuring the ankle brachial pressure index helps to eliminate or confirm any arterial involvement. Depending on the systolic pressure index, the ulcer will be considered as purely venous, mixed (arterial-venous) or predominantly arterial.

  3. Outcomes following unilateral uterine artery embolisation.

    PubMed

    McLucas, B; Reed, R A; Goodwin, S; Rappaport, A; Adler, L; Perrella, R; Dalrymple, J

    2002-02-01

    Uterine artery embolisation has been described as successful only when both arteries are embolised. However, results in patients with one congenitally absent or previously ligated artery are unknown. Women suffering from symptomatic uterine myomata were treated at a university teaching hospital, a community hospital and an outpatient surgery centre. Retrospective review of patient response to embolisation was assessed by chart review and questionnaire. Uterine and dominant fibroid size response was assessed by comparing pre- and post-embolisation ultrasound examinations. This study analysed three patient groups within the general population: those who underwent unilateral embolisation because of technical failure, those who ultimately underwent bilateral embolisation after initial technical failure and those who underwent unilateral embolisation because of an absent uterine artery. 12 patients underwent unilateral embolisation, 4 of whom underwent this procedure because of an absent uterine artery. Three of these four patients had a congenitally absent uterine artery arising from the internal iliac artery and all three experienced successful outcomes. The fourth patient had a previously ligated internal iliac artery and her symptoms worsened after the procedure. Eight patients had unilateral embolisation due to technical failure. Five of these patients underwent a subsequent procedure during which the contralateral uterine artery was embolised. Four of these five patients had successful outcomes and one was lost to follow-up. Another of the eight patients suffered an arterial injury leading to technical failure, and was lost to follow-up. Of the two remaining patients with unilateral technical failure, only one had a successful outcome. This study concluded that patients who undergo unilateral embolisation for technical reasons should be offered a second embolisation procedure shortly after the initial procedure. Patients with a congenitally absent uterine artery

  4. Splenic Artery Aneurysm of the Hepatosplenomesenteric Trunk

    PubMed Central

    2013-01-01

    We herein report the case of a splenic artery aneurysm with a hepatosplenomesenteric trunk that presented in a pregnant woman. Catheter embolization was not performed due to the wide neck of the aneurysm and its close location to the trunk indicates a high risk of mesenteric trunk thrombosis. We instead performed surgical resection of the aneurysm after successful delivery of the infant by Caesarian section. The splenic artery was reconstructed by side-to-end anastomosis with the common hepatic artery. PMID:24386023

  5. Vascular smooth muscle dysfunction induced by monomethylarsonous acid (MMA III): a contributing factor to arsenic-associated cardiovascular diseases.

    PubMed

    Bae, Ok-Nam; Lim, Eun-Kyung; Lim, Kyung-Min; Noh, Ji-Yoon; Chung, Seung-Min; Lee, Moo-Yeol; Yun, Yeo-Pyo; Kwon, Seong-Chun; Lee, Jun-Ho; Nah, Seung-Yeol; Chung, Jin-Ho

    2008-11-01

    While arsenic in drinking water is known to cause various cardiovascular diseases in human, exact mechanism still remains elusive. Recently, trivalent-methylated arsenicals, the metabolites of inorganic arsenic, were shown to have higher cytotoxic potential than inorganic arsenic. To study the role of these metabolites in arsenic-induced cardiovascular diseases, we investigated the effect of monomethylarsonous acid (MMA III), a major trivalent-methylated arsenical, on vasomotor tone of blood vessels. In isolated rat thoracic aorta and small mesenteric arteries, MMA III irreversibly suppressed normal vasoconstriction induced by three distinct agonists of phenylephrine (PE), serotonin and endothelin-1. Inhibition of vasoconstriction was retained in aortic rings without endothelium, suggesting that MMA III directly impaired the contractile function of vascular smooth muscle. The effect of MMA III was mediated by inhibition of PE-induced Ca2+ increase as found in confocal microscopy and fluorimeter in-lined organ chamber technique. The attenuation of Ca2+ increase was from concomitant inhibition of release from intracellular store and extracellular Ca2+ influx via L-type Ca2+ channel, which was blocked by MMA III as shown in voltage-clamp assay in Xenopus oocytes. MMA III did not affect downstream process of Ca2+, as shown in permeabilized arterial strips. In in vivo rat model, MMA III attenuated PE-induced blood pressure increase indeed, supporting the clinical relevance of these in vitro findings. In conclusion, MMA III-induced smooth muscle dysfunction through disturbance of Ca2+ regulation, which results in impaired vasoconstriction and aberrant blood pressure change. This study will provide a new insight into the role of trivalent-methylated arsenicals in arsenic-associated cardiovascular diseases.

  6. Palladium(III) in Synthesis and Catalysis

    PubMed Central

    Powers, David C.; Ritter, Tobias

    2011-01-01

    While the organometallic chemistry of Pd in its (0), (+II), and (+IV) oxidation states is well-established, organometallic Pd(III) chemistry remains widely unexplored. Few characterized Pd(III) complexes are known, which has inhibited detailed study of the organometallic chemistry of Pd(III). In this review, the potential roles of both mono- and dinuclear Pd(III) complexes in organometallic chemistry will be discussed. While not widely recognized, Pd in the (+III) oxidation state may play a significant role in a variety of known Pd-catalyzed reactions. PMID:21461129

  7. Towards a biomimetism of abdominal healthy and aneurysmal arterial tissues.

    PubMed

    Bailly, L; Geindreau, C; Orgéas, L; Deplano, V

    2012-06-01

    The aim of this work is to develop a new hyperelastic and anisotropic material mimicking histological and mechanical features of healthy and aneurysmal arterial tissues. The material is constituted by rhombic periodic lattices of hyperelastic fibres embedded into a soft elastomer membrane. To fit bi-axial experimental data obtained from the literature, with normal or pathologic human abdominal aortic tissues, the microstructure of the periodic lattices (fibre length, angle between fibres) together with the mechanical behaviour of the fibres (fibre tension-elongation curve) were optimised by using theoretical results arising from a multi-scale homogenisation process. It is shown that (i) a material constituted by only one periodic lattice of fibres is clearly not sufficient to describe all the experimental data set, (ii) a quantitative agreement between measurements and theoretical predictions is obtained by using a material with two fibre lattices, (iii) the optimised microstructures and mechanical properties of the fibrous lattices are strongly different for the abdominal healthy and aneurysmal arterial tissues, (iv) the anisotropic mechanical behaviour of the optimised material is described by only five parameters and (v) the optimal angles between fibres in the case of the healthy aorta are consistent with histological data. Several technical solutions of fibres can be considered as relevant candidates: this is illustrated in the particular cases of straight and wavy fibres. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. [Return to work after coronary artery bypass surgery].

    PubMed

    Vasiliauskas, Donatas; Raugaliene, Rasa; Grizas, Vytautas; Marcinkeviciene, Jolanta; Jasiukeviciene, Lina; Kubilius, Raimondas; Barsys, Vygantas

    2008-01-01

    The aim of this study was to assess the possible reasons for not returning to work after coronary artery bypass surgery. A total of 134 patients (aged 65 years and younger) who underwent coronary bypass surgery in 2003 were examined. The analysis was performed in three groups of the patients: Group I, patients who were employed before surgery and returned to work after it (n=51); Group II, patients who were employed before surgery but did not return to work after surgery (n=55); and Group III, patients who were unemployed before and remained unemployed after surgery due to health problems (n=28). Number of injured coronary arteries, the extent of operation, postoperative complications, risk factors for ischemic heart disease, clinical status of patients (angina pain and heart failure), physical tolerance, and return to work within one year after coronary bypass surgery were analyzed. It was found that 48.1% of patients who were employed before surgery returned to work after myocardial revascularization. About 30% of patients experienced recurrent symptoms of angina after 12 months. Logistic regression analysis revealed that return to work was significantly influenced by female gender, physical pattern of work, age, and severity of heart failure.

  9. The superiority of 256-slice spiral computed tomography angiography for preoperative evaluation of surrounding arteries in patients with gastric cancer

    PubMed Central

    Wu, Deqing; Zhao, Linyong; Liu, Ying; Wang, Junjiang; Hu, Weixian; Feng, Xingyu; Lv, Zejian; Li, Yong; Yao, Xueqing

    2017-01-01

    Objective To evaluate the utilization of 256-slice spiral computed tomography (CT) angiography in preoperative assessment of perigastric vascular anatomy in patients with gastric cancer. Methods In this study, 80 gastric cancer patients were included. The medical procedure of 256-slice spiral CT angiography was performed on each of these patients consecutively. Thereafter, these patients were subjected to surgical treatment in our hospital. The techniques of volume rendering (VR) and maximum intensity projection (MIP) were used to image reconstruction of arteries around the stomach. Results Both VR and MIP were applied to reconstruct the images of perigastric arteries. The results indicated that VR imaging was inferior to MIP in determining the variant small artery anatomy around the greater curvature and fundus. The respective rates of imaging produced by VR and MIP for left gastroepiploic artery, short gastric artery, and posterior gastric artery, were 32.50% versus 100%, 16.25% versus 87.50%, and 3.75% versus 25.00%, respectively. According to Hiatt’s classification, 75 out of 240 cases were abnormal types, among which we found Type II in 30 cases, Type III in 33 cases, Type IV in three cases, Type V in six cases, and Type VI in only three cases. There was no significant difference for total and every single variation type, between our group and Hiatt’s group (P>0.05). Conclusion The 256-slice spiral CT angiography can be regarded as an effective and accurate diagnostic modality for preoperative assessing anatomical arterial variations in gastric cancer; MIP was superior to VR at identifying variations of some small artery, whereas VR was better than MIP at showing anatomical arterial variations due to its three-dimensional effect. PMID:28243128

  10. Supravalvular aortic stenosis after arterial switch operation.

    PubMed

    Maeda, Takuya; Koide, Masaaki; Kunii, Yoshifumi; Watanabe, Kazumasa; Kanzaki, Tomohito; Ohashi, Yuko

    2016-07-01

    Supravalvular aortic stenosis as a late complication of transposition of the great arteries is very rare, and only a few cases have been reported. We describe the case of a 14-year-old girl who developed supravalvular aortic stenosis as a late complication of the arterial switch operation for transposition of the great arteries. The narrowed ascending aorta was replaced with a graft. The right pulmonary artery was transected to approach the ascending aorta which adhered severely to the main pulmonary trunk, and we obtained a good operative field.

  11. A biomechanical model of artery buckling.

    PubMed

    Han, Hai-Chao

    2007-01-01

    The stability of arteries under blood pressure load is essential to the maintenance of normal arterial function and the loss of stability can lead to tortuosity and kinking that are associated with significant clinical complications. However, mechanical analysis of arterial bent buckling is lacking. To address this issue, this paper presents a biomechanical model of arterial buckling. Using an elastic cylindrical arterial model, the mechanical equations for arterial buckling were developed and the critical buckling pressure was found to be a function of the wall stiffness (Young's modulus), arterial radius, length, wall thickness, and the axial strain. Both the model equations and experimental results demonstrated that the critical pressure is related to the axial strain. Arteries may buckle and become tortuous due to reduced (subphysiological) axial strain, hypertensive pressure, and a weakened wall. These results are in accordance with, and provide a possible explanation to the clinical observations that hypertension and aging are the risk factors for arterial tortuosity and kinking. The current model is also applicable to veins and ureters.

  12. Cardiovascular magnetic resonance of anomalous coronary arteries.

    PubMed

    Varghese, Anitha; Keegan, Jennifer; Pennell, Dudley J

    2005-09-01

    Cardiovascular magnetic resonance of anomalous coronary arteries is a class I indication. The term anomalous coronary artery encompasses those with an abnormal origin (from the incorrect sinus, too-high or too-low from the correct sinus, or from the pulmonary artery) and/or number of ostia. Their clinical significance results from the increased risk of myocardial infarction and sudden cardiac death associated with those traversing an interarterial course between the aorta and main pulmonary artery/right ventricular outflow tract. In this article, we review the role and practice of cardiovascular magnetic resonance in this field.

  13. Flavonoids and arterial stiffness: promising perspectives.

    PubMed

    Lilamand, M; Kelaiditi, E; Guyonnet, S; Antonelli Incalzi, R; Raynaud-Simon, A; Vellas, B; Cesari, M

    2014-07-01

    Flavonoids are a group of polyphenol compounds, ubiquitously found in plants. Great emphasis has been given to their possible benefits for cardiovascular health. These beneficial effects may be mediated by a specific action on arterial walls. Arterial stiffness is a marker of vascular aging, increasingly used in the clinical setting and assessed by pulse wave velocity. It has shown to be a robust predictor of cardiovascular events and mortality. This review aims at providing a comprehensive evaluation of available intervention and observational studies examining the relationship between flavonoid consumption and arterial stiffness. A Medline(®) literature search was performed using the keywords "arterial stiffness" and "flavonoids". As a result, 2 cross-sectional and 16 intervention studies assessing the relationship between flavonoids intake and arterial stiffness were retained. Four intervention trials reported a significant decrease of arterial stiffness after a flavonoid-based intervention, independently from blood pressure changes. The two observational studies reported significant associations between a higher flavonoid consumption and a lower arterial stiffness. In this review, isoflavones, anthocyanins and to a lesser extent cocoa flavan-3-ols appeared to be the more efficient to improve vascular function. Despite their heterogeneity, preliminary data seem to support an improvement of the arterial stiffness related to flavonoid intake. However, further research on absorption and dose-response effects of the specific flavonoid subclasses on arterial structure is warranted. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Segmental arterial mediolysis mimics systemic vasculitis

    PubMed Central

    Kalfa, Melike; Kocanaoğulları, Hayriye; Karabulut, Gonca; Emmungil, Hakan; Çınar, Celal; Yılmaz, Zevcet; Gücenmez, Sercan; Kabasakal, Yasemin

    2016-01-01

    Segmental arterial mediolysis (SAM) is a rare, nonarteriosclerotic, noninflammatory vascular disease and mostly affects medium-to-large sized abdominal arteries as well as presents with hemorrhages in the abdominal cavity. We report the case of a patient with SAM of the celiac, right renal, jejunal branch of the superior mesenteric, left gastric, and splenic arteries who was diagnosed by excluding other causes and in whom transcatheter embolization was performed in two different sessions, but he died because of an undefined reason. SAM mimics systemic vasculitis and causes abdominal pain; it should be considered because abdominal hemorrhage or arterial infarction can result in death. PMID:27733945

  15. A Biomechanical Model of Artery Buckling

    PubMed Central

    Han, Hai-Chao

    2010-01-01

    The stability of arteries under blood pressure load is essential to the maintenance of normal arterial function and the loss of stability can lead to tortuosity and kinking that are associated with significant clinical complications. However, mechanical analysis of arterial bent buckling is lacking. To address this issue, this paper presents a biomechanical model of arterial buckling. Using a linear elastic cylindrical arterial model, the mechanical equations for arterial buckling were developed and the critical buckling pressure was found to be a function of the wall stiffness (Young’s modulus), arterial radius, length, wall thickness, and the axial strain. Both the model equations and experimental results demonstrated that the critical pressure is related to the axial strain. Arteries may buckle and become tortuous due to reduced (sub-physiological) axial strain, hypertensive pressure, and a weakened wall. These results are in accordance with, and provide a possible explanation to the clinical observations that these changes are the risk factors for arterial tortuosity and kinking. The current model is also applicable to veins and ureters. PMID:17689541

  16. Ischaemic stroke and peripheral artery disease.

    PubMed

    Rahman, Attiya Sabeen; Akhtar, Syed Wasim; Jamal, Qaiser; Sultana, Nuzhat; Siddiqui, Muhammad Asadullah; Hassan, Ziaul

    2017-08-01

    To determine the frequency of atherosclerosis by ankle brachial index in patients with an ischaemic stroke and to assess the association of carotid artery stenosis and ankle brachial index in ischaemic stroke. This cross-sectional study was conducted at Abbasi Shaheed Hospital, Karachi, from July 2011 to May 2014, and comprised patients with ischaemic stroke. The patients were classified according to the Asian stroke criteria for classification of brain infarction. Primary outcome measures included carotid artery stenosis and ankle brachial index. The other independent variables were age, gender, body mass index and waist circumference. SPSS 20 was used for data analysis. A total of 327 patients were enrolled. The overall mean age was 57.6±12.8 years. Besides, 168(51.3%) participants were males. Peripheral artery disease was found in 60(18.3%) patients. Mild carotid artery stenosis was found in 182(55.6%) patients, moderate in 140(42.8%), severe in 3(0.9%) and complete occlusion in 2(0.6%) patients. In patients having mild carotid artery stenosis, 32(17.5%) had peripheral artery disease, whereas in patients with moderate carotid artery stenosis, 25(17.8%) had peripheral artery disease. Abnormally low ankle brachial index suggesting subclinical peripheral artery disease was 18%.

  17. Left Main Coronary Artery Hypoplasia in Elderly

    PubMed Central

    Kenar Tiryakioglu, Selma; Bahadir, Hakan

    2016-01-01

    Congenital anomalies of the coronary artery causing coronary occlusive disease may be of many different types. A 67-year-old woman with no coronary risk factors was referred for coronary angiography with few months' history of angina. The patient underwent coronary angiography due to ischemic cardiac symptoms with nondiagnostic exercising test. In coronary angiography, the left main coronary artery was arising from normal anatomical position; however, left anterior descending artery and circumflex artery were hypoplastic. The treatment of patient was discussed in cardiology-cardiovascular surgery council and coronary surgery was found inappropriate due to the hypoplasia of the left coronary system entirely. PMID:27047696

  18. Segmental arterial mediolysis in a preterm.

    PubMed

    Eifinger, Frank; Fries, Jochen; Bald, Rainer; Körber, Friederike; Kribs, Angela; Roth, Bernhard

    2004-07-01

    We firstly report on a dystrophic preterm infant with segmental arterial mediolysis (SAM) found in arteries of placental, umbilical and cerebral tissues. These arterial lesions of unknown etiology developing in the elderly are characterized by segmental lysis of the abdominal splanchnic arteries followed by aneurysms and acute bleeding. Typically, the lesions occur in a skip pattern. We could find a small number of SAM in the spleen but much more in placental and umbilical tissues. Rarely, a vascular elastosis and splitting of individual vessels in the spleen and lung could be detected. The histological findings are similar to that of adult patients.

  19. Segmental arterial mediolysis mimics systemic vasculitis.

    PubMed

    Kalfa, Melike; Kocanaoğulları, Hayriye; Karabulut, Gonca; Emmungil, Hakan; Çınar, Celal; Yılmaz, Zevcet; Gücenmez, Sercan; Kabasakal, Yasemin

    2016-09-01

    Segmental arterial mediolysis (SAM) is a rare, nonarteriosclerotic, noninflammatory vascular disease and mostly affects medium-to-large sized abdominal arteries as well as presents with hemorrhages in the abdominal cavity. We report the case of a patient with SAM of the celiac, right renal, jejunal branch of the superior mesenteric, left gastric, and splenic arteries who was diagnosed by excluding other causes and in whom transcatheter embolization was performed in two different sessions, but he died because of an undefined reason. SAM mimics systemic vasculitis and causes abdominal pain; it should be considered because abdominal hemorrhage or arterial infarction can result in death.

  20. Massive Hemorrhage From Multiple Hepatic Artery Aneurysms.

    PubMed

    Kahn, S Lowell; McClain, Jonathan; Kaufman, Jeffrey L

    2016-10-01

    A 66-year-old man, with an abnormal porta hepatis, consistent with tumor or inflammation, developed massive bleeding from one of numerous hepatic artery aneurysms, and coil embolization achieved control of bleeding. He died of subsequent multisystem organ failure, and the most likely diagnosis was either polyarteritis nodosa or segmental arterial mediolysis. Although the dual hepatic blood supply allows a degree of arterial embolization, this case demonstrates the risks associated with large territory hepatic arterial embolization in the presence of hemodynamic instability. We discuss the management issues related to massive hepatic bleeding when no surgical approach is possible.

  1. Diagnostic enigma: primary pulmonary artery sarcoma.

    PubMed

    Bhagwat, Krishna; Hallam, Jane; Antippa, Phillip; Larobina, Marco

    2012-03-01

    Primary angiosarcoma of pulmonary artery is a very rare lesion. We present a case of primary angiosarcoma that was initially misdiagnosed as a subacute massive pulmonary thromboembolism in a 30-year-old man. This rare disease is usually indistinguishable from acute or chronic thromboembolic disease of the pulmonary arteries. The clinical and radiological findings of pulmonary artery angiosarcoma are similar to those of pulmonary thromboembolism. Although the incidence of pulmonary artery angiosarcoma is very low, our case demonstrates that this disease entity should be included in the differential diagnosis of pulmonary thromboembolism. Patients with early identification can have curative potential with aggressive surgical intervention.

  2. Mechanisms Underlying Drug Delivery to Peripheral Arteries.

    PubMed

    Li, Jun; Tzafriri, Rami; Patel, Sandeep M; Parikh, Sahil A

    2017-04-01

    Delivery of drugs onto arterial targets via endovascular devices commands several principles: dissolution, diffusion, convection, drug binding, barriers to absorption, and interaction between the drug, delivery vehicle, and accepting arterial wall. The understanding of drug delivery in the coronary vasculature is vast; there is ongoing work needed in the peripheral arteries. There are differences that account for some failures of application of coronary technology into the peripheral vascular space. Breakthroughs in peripheral vascular interventional techniques building on current technologies require investigators willing to acknowledge the similarities and differences between these different vascular territories, while developing technologies adapted for peripheral arteries.

  3. Noninvasive Imaging in Coronary Artery Disease

    PubMed Central

    Heo, Ran; Nakazato, Ryo; Kalra, Dan; Min, James K.

    2014-01-01

    Noninvasive cardiac imaging is widely used to evaluate the presence of coronary artery disease. Recently, with improvements in imaging technology, noninvasive imaging has also been used for evaluation of the presence, severity, and prognosis of coronary artery disease. Coronary CT angiography and MRI of coronary arteries provide an anatomical assessment of coronary stenosis, whereas the hemodynamic significance of a coronary artery stenosis can be assessed by stress myocardial perfusion imaging, such as SPECT/PET and stress MRI. For appropriate use of multiple imaging modalities, the strengths and limitations of each modality are discussed in this review. PMID:25234083

  4. Continuous blood gas monitoring in femoral arteries

    NASA Astrophysics Data System (ADS)

    Schlain, Les A.; Spar, Steven M.; Dellinger, Bart

    1995-05-01

    Continuous intra-arterial blood gas monitoring is a potentially valuable tool in the surgical and intensive care arenas. Patient oxygenation and acid base status can change rapidly and without warning. The ability to monitor pHa, PaCO2 and PaO2 in arterial blood will be a major medical advance for the anesthesiologist and intensivist. Intra-arterial blood gas sensors are typically placed in radial arteries. In certain patient populations accurate monitoring is not possible in radial arteries due to arterial environmental factors such as hypotension, vasoconstriction and atherosclerotic disease. These same factors can make radial cannulation difficult resulting in traumatic catheter insertion, thereby further compromising flow conditions. In situations where radial artery flow is expected to be compromised, selecting a large vessel for sensor placement is desirable. We report an initial feasibility study of our blood gas monitoring system using the femoral artery as the sensing site. Clinical results are presented as well as potential advantages and disadvantages associated with monitoring in the femoral artery.

  5. Optical properties of the Eu(III)-La(III)-complex-doped polyolefine film and rod samples

    NASA Astrophysics Data System (ADS)

    Pogreb, Roman; Popov, Oleg; Lirtsman, Vlad; Pyshkin, Oleg; Kazachkov, Alexander; Musin, Albina; Finkelshtein, Binyamin; Shmukler, Yuri; Davidov, Dan; Bormashenko, Edward

    2005-04-01

    The work is devoted to luminescent properties of trivalent lanthanide complexes dispersed in thermoplastic host matrices. Polyethylene-based film and polypropylene-based rod both doped with these complexes were manufactured using an extrusion technique. Two kinds of dopants were used: Eu(III)-thenoyltrifluoroacetone-1,10-phenanthroline complex (Eu(III)) and Eu(III)-La(III)-1,10-phenanthroline complex (Eu(III)-La(III)). Comparison was made between these samples regarding absorption, excitation, emission and a lifetime of luminescence. Dependence of emission intensity on the excitation energy was determined. Emission spectra of the films were studied at room and helium temperatures. Optical properties of Eu(III) samples are different from Eu(III)-La(III) samples. Significant difference in spectra of these two types of samples may be attributed to the La(III) action.

  6. Development of demographic norms for four new WAIS-III/WMS-III indexes.

    PubMed

    Lange, Rael T; Chelune, Gordon J; Taylor, Michael J; Woodward, Todd S; Heaton, Robert K

    2006-06-01

    Following the publication of the third edition Wechsler scales (i.e., WAIS-III and WMS-III), demographically corrected norms were made available in the form of a computerized scoring program (i.e., WAIS-III/WMS-III/WIAT-II Scoring Assistant). These norms correct for age, gender, ethnicity, and education. Since then, four new indexes have been developed: the WAIS-III General Ability Index, the WMS-III Delayed Memory Index, and the two alternate Immediate and Delayed Memory Indexes. The purpose of this study was to develop demographically corrected norms for the four new indexes using the standardization sample and education oversample from the WAIS-III and WMS-III. These norms were developed using the same methodology as the demographically corrected norms made available in the WAIS-III/WMS-III/WIAT-II Scoring Assistant.

  7. The Nimbus III Michelson Interferometer.

    PubMed

    Hanel, R A; Schlachman, B; Clark, F D; Prokesh, C H; Taylor, J B; Wilson, W M; Chaney, L

    1970-08-01

    The Michelson interferometer flown on Nimbus III in April 1969 has obtained infrared emission spectra of the earth and its atmosphere within 400 cm(-1) and 2000 cm(-1) (5 micro and 25 micro). Spectra of good quality have been recorded with a spectral resolution corresponding to 5 cm(-1). This paper discusses the design of the instrument including the optical layout, the phase locked loop operation of the Michelson motor, and the functioning of the reference interferometer. The methods of data reduction and in-flight calibration are demonstrated on sample spectra recorded while in orbit around the earth.

  8. Division Iii: Planetary Systems Sciences

    NASA Astrophysics Data System (ADS)

    Meech, Karen; Valsecchi, Giovanni; Bowell, Edward L.; Bockelee-Morvan, Dominique; Boss, Alan; Cellino, Alberto; Consolmagno, Guy; Fernandez, Julio; Irvine, William; Lazzaro, Daniela; Michel, Patrick; Noll, Keith; Schulz, Rita; Watanabe, Jun-ichi; Yoshikawa, Makoto; Zhu, Jin

    2012-04-01

    Division III, with 1126 members, is the third largest of the 12 IAU Divisions, focusing on subject matter related to the physical study of interplanetary dust, comets, minor planets, satellites, planets, planetary systems and astrobiology. Within the Division are very active working groups that are responsible for planetary system and small body nomenclature, as well as a newly created working group on Near Earth Objects which was established order to investigate the requirements for international ground-and/or space-based NEO surveys to characterize 90% of all NEOs with diameters >40m in order to establish a permanent international NEO Early Warning System.

  9. Recent results for Mark III

    SciTech Connect

    Brient, J.C.

    1987-12-01

    This paper presents recent results from the Mark III detector at SPEAR, in the open charm sector. The first topic discussed is the reanalysis of the direct measurement of the D hadronic branching fractions, where a detailed study has been made of the Cabibbo suppressed and multi-..pi../sup 0/'s D decays backgrounds in the double tag sample. Next, the Dalitz plot analysis of the D decays to K..pi pi.. is presented, leading to the relative fractions of three-body versus pseudoscalarvector decays. 7 refs., 5 figs.

  10. Arterial calcification: friend or foe?

    PubMed

    Nicoll, Rachel; Henein, Michael Y

    2013-07-31

    There is a significant relationship between the presence, extent and progression of coronary artery calcification (CAC) and cardiovascular (CV) events and mortality in both CV and renal patients and CAC scoring can provide improved predictive ability over risk factor scoring alone. There is also a close relationship between CAC presence and atherosclerotic plaque burden, with angiography studies showing very high sensitivity but poor specificity of CAC score for predicting obstructive disease. Nevertheless, there are objections to CAC screening because of uncertainties and lack of studies showing improved outcome. Furthermore, histopathology studies indicate that heavily calcified plaque is unlikely to result in a CV event, while the vulnerable plaque tends to be uncalcified or 'mixed', suggesting that calcification may be protective. This scenario highlights a number of paradoxes, which may indicate that the association between CAC and CV events is spurious, following from the adoption of CAC as a surrogate for high plaque burden, which itself is a surrogate for the presence of vulnerable plaque. Since studies indicate that arterial calcification is a complex, organised and regulated process similar to bone formation, there is no particular reason why it should be a reliable indicator of either the plaque burden or the risk of a future CV event. We suggest that it is time to divorce arterial calcification from atherosclerosis and to view it as a distinct pathology in its own right, albeit one which frequently coexists with atherosclerosis and is related to it for reasons which are not yet fully understood. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  11. Carotid Artery Stenting versus Endarterectomy

    PubMed Central

    Gahremanpour, Amir; Perin, Emerson C.; Silva, Guilherme

    2012-01-01

    For about 2 decades, investigators have been comparing carotid endarterectomy with carotid artery stenting in regard to their effectiveness and safety in treating carotid artery stenosis. We conducted a systematic review to summarize and appraise the available evidence provided by randomized trials, meta-analyses, and registries comparing the clinical outcomes of the 2 procedures. We searched the MEDLINE, SciVerse Scopus, and Cochrane databases and the bibliographies of pertinent textbooks and articles to identify these studies. The results of clinical trials and, consequently, the meta-analyses of those trials produced conflicting results regarding the comparative effectiveness and safety of carotid endarterectomy and carotid stenting. These conflicting results arose because of differences in patient population, trial design, outcome measures, and variability among centers in the endovascular devices used and in operator skills. Careful appraisal of the trials and meta-analyses, particularly the most recent and largest National Institutes of Healthsponsored trial (the Carotid Revascularization Endarterectomy vs Stenting Trial [CREST]), showed that carotid stenting and endarterectomy were associated with similar rates of death and disabling stroke. Within the 30-day periprocedural period, carotid stenting was associated with higher risks of stroke, especially for patients aged >70 years, whereas carotid endarterectomy was associated with a higher risk of myocardial infarction. The slightly higher cost of stenting compared with endarterectomy was within an acceptable range by cost-effectiveness standards. We conclude that carotid artery stenting is an equivalent alternative to carotid endarterectomy when patient age and anatomy, surgical risk, and operator experience are considered in the choice of treatment approach. PMID:22949763

  12. Mirizzi syndrome grades III and IV: surgical treatment.

    PubMed

    Reverdito, Ronald; Moricz, André DE; Campos, Tércio DE; Pacheco, Adhemar Monteiro; Silva, Rodrigo Altenfelder

    2016-01-01

    : to evaluate the epidemiology and outcomes of surgical treatment of patients with Mirizzi Syndrome (MS) grades III and IV, the most advanced according to Csendes classification. : we conducted a retrospective, cross-sectional study by reviewing records of thirteen patients with grades III and IV MS operated from December 2001 to September 2013, among the 3,691 cholecystectomies performed in the period. : the incidence of MS was 0.6% (23 cases) and grades III and IV amounted to 0.35% of this number. There was a predominance of type IV (12 cases). The preoperative diagnosis was possible in 53.8% of cases. The preferred approach was biliary-digestive derivation (10 cases), and "T" tube drainage with suture of the bile duct was the choice in three special occasions. Three patients had biliary fistula resolved with clinical management, and one coliperitoneum case required reoperation. In the outpatient follow-up of patients who underwent biliodigestive anastomosis (eight), 50% are asymptomatic, 25% had anastomotic stricture and 25% lost follow-up. The mean follow-up was 41.8 months. : MS in advanced degrees has low incidence, preoperative diagnosis in only half of cases, and has the biliodigestive anastomosis as the best conduct, but not without morbidity. avaliar a epidemiologia e os resultados do tratamento cirúrgico de doentes portadores de graus III e IV, mais avançados, da Síndrome de Mirizzi (SM) de acordo com a classificação de Csendes. estudo retrospectivo, de corte transversal através da revisão de prontuários de 13 pacientes portadores de graus III e IV da SM operados de dezembro de 2001 a setembro de 2013, entre 3691 colecistectomias realizadas neste período. a incidência da SM foi 0,6% (23 casos) e os graus III e IV perfizeram 0,35% deste número. Houve um predomínio de tipo IV (12 casos). O diagnóstico pré-operatório foi possível em 53,8% dos casos. A conduta preferencial foi derivação biliodigestiva (10 casos) e foi optado por drenagem

  13. Stenting for Peripheral Artery Disease of the Lower Extremities

    PubMed Central

    2010-01-01

    Executive Summary Background Objective In January 2010, the Medical Advisory Secretariat received an application from University Health Network to provide an evidentiary platform on stenting as a treatment management for peripheral artery disease. The purpose of this health technology assessment is to examine the effectiveness of primary stenting as a treatment management for peripheral artery disease of the lower extremities. Clinical Need: Condition and Target Population Peripheral artery disease (PAD) is a progressive disease occurring as a result of plaque accumulation (atherosclerosis) in the arterial system that carries blood to the extremities (arms and legs) as well as vital organs. The vessels that are most affected by PAD are the arteries of the lower extremities, the aorta, the visceral arterial branches, the carotid arteries and the arteries of the upper limbs. In the lower extremities, PAD affects three major arterial segments i) aortic-iliac, ii) femoro-popliteal (FP) and iii) infra-popliteal (primarily tibial) arteries. The disease is commonly classified clinically as asymptomatic claudication, rest pain and critical ischemia. Although the prevalence of PAD in Canada is not known, it is estimated that 800,000 Canadians have PAD. The 2007 Trans Atlantic Intersociety Consensus (TASC) II Working Group for the Management of Peripheral Disease estimated that the prevalence of PAD in Europe and North America to be 27 million, of whom 88,000 are hospitalizations involving lower extremities. A higher prevalence of PAD among elderly individuals has been reported to range from 12% to 29%. The National Health and Nutrition Examination Survey (NHANES) estimated that the prevalence of PAD is 14.5% among individuals 70 years of age and over. Modifiable and non-modifiable risk factors associated with PAD include advanced age, male gender, family history, smoking, diabetes, hypertension and hyperlipidemia. PAD is a strong predictor of myocardial infarction (MI

  14. Unusual Systemic Artery to Pulmonary Artery Malformation Without Evidence of Systemic Disease, Trauma or Surgery

    SciTech Connect

    Geyik, Serdar; Yavuz, Kivilcim; Keller, Frederick S.

    2006-10-15

    Connections between the systemic and pulmonary arterial systems are rare conditions that can be due to either congenital or acquired diseases such as anomalous systemic arterial supply to normal lung, pulmonary sequestration, and systemic supply to pulmonary arteriovenous malformations. Herein, a unique case of systemic artery to pulmonary arterial malformation and its endovascular treatment in a patient with no history of the usual etiologies is reported.

  15. Resection of Celiac Artery Aneurysm with Bypass Grafting to the Splenic and Common Hepatic Arteries

    PubMed Central

    Pattakos, Gregory; Tolpin, Daniel

    2017-01-01

    Celiac artery aneurysms are rare and typically warrant surgical treatment. Atherosclerosis is their chief cause. Symptomatic patients usually present with abdominal pain. Surgical resection of celiac artery aneurysms is associated with low morbidity and mortality rates. We report the case of a patient whose 2.2-cm celiac artery aneurysm we resected, with subsequent saphenous vein bypass grafting from the celiac trunk to the splenic and common hepatic arteries. In addition, we briefly discuss other treatment options. PMID:28265220

  16. Persistent proatlantal artery associated with carotid artery stenosis treatment by percutaneous transluminal balloon angioplasty.

    PubMed

    Bour, P; Bracard, S; Frisch, N; Frisch, R; Fiévé, G

    1991-01-01

    A 58-year-old man had an asymptomatic tight stenosis of the internal carotid artery associated with a persistent proatlantal artery. This as well as other compositional arterial anomalies of the basilar artery were discovered on arteriograms. The stenosis was successfully treated by percutaneous transluminal balloon angioplasty. Therapeutic choices are discussed in this setting because of the risk of carotid clamping in the presence of persistent carotid-basilar anastomoses.

  17. Enhanced external counterpulsation improves peripheral resistance artery blood flow in patients with coronary artery disease.

    PubMed

    Avery, Joseph C; Beck, Darren T; Casey, Darren P; Sardina, Paloma D; Braith, Randy W

    2014-03-01

    Enhanced external counterpulsation (EECP) increases coronary artery perfusion and improves endothelium-dependent vasodilation in peripheral muscular conduit arteries. It is unknown whether vasodilatory capacity is improved in the peripheral resistance vasculature. Here we provide novel evidence from the first randomized, sham-controlled study that EECP increases peak limb blood flow and improves endothelium-dependent vasodilation in both calf and forearm resistance arteries in patients with coronary artery disease.

  18. Atypical presentation of popliteal artery entrapment syndrome: involvement of the anterior tibial artery.

    PubMed

    Bou, Steven; Day, Carly

    2014-11-01

    Popliteal artery entrapment syndrome (PAES) is a rare condition that should be suspected in a young patient with exertional lower extremity pain. We report the case of an 18-year-old female volleyball player with bilateral exertional lower extremity pain who had been previously diagnosed with tendinitis and periostitis. Diagnostic studies showed entrapment of the left popliteal artery and the left anterior tibial artery. To our knowledge, there has only been 1 previous report of anterior tibial artery involvement in PAES.

  19. MR imaging of subcallosal artery infarct causing amnesia after surgery for anterior communicating artery aneurysm.

    PubMed

    Mugikura, S; Kikuchi, H; Fujii, T; Murata, T; Takase, K; Mori, E; Marinković, S; Takahashi, S

    2014-12-01

    During surgery to treat an aneurysm in the anterior communicating artery, injury to the subcallosal artery, a perforator of the anterior communicating artery, may lead to infarction that produces basal forebrain amnesia after surgery. Our purpose was to examine whether 3D MR imaging can detect subcallosal artery infarction in patients with amnesia after surgery for an anterior communicating artery aneurysm. We evaluated 3D-T2-weighted MR images obtained a median of 4 months after treatment of anterior communicating artery aneurysm for the presence of infarcted foci in 10 consecutive patients with postoperative amnesia. Because the subcallosal artery and its neighboring perforator, the recurrent artery of Heubner, were considered the most easily affected vessels during that surgery, we focused mainly on 8 regions of the subcallosal artery territory per hemisphere and 5 regions of the recurrent artery of Heubner territory per hemisphere. All 10 patients had infarcts in the territory of the subcallosal artery (median, 9 regions per patient), and most were bilateral (9 of 10 patients). Five patients had additional infarcted foci in the territory of the recurrent artery of Heubner (median, 1 region per patient), all unilateral. Among the regions perfused by the subcallosal artery, the column of the fornix was involved in all patients; the anterior commissure, in 9; and the paraterminal gyrus, in 8 patients. 3D MR imaging revealed subcallosal artery infarction, the distribution of which was mostly bilateral, presumably owing to the unpairedness of that artery, in patients with postoperative amnesia after anterior communicating artery aneurysm repair. © 2014 by American Journal of Neuroradiology.

  20. Nitroglycerine-induced vasodilation in coronary and brachial arteries in patients with suspected coronary artery disease.

    PubMed

    Maruhashi, Tatsuya; Kajikawa, Masato; Nakashima, Ayumu; Iwamoto, Yumiko; Iwamoto, Akimichi; Oda, Nozomu; Kishimoto, Shinji; Matsui, Shogo; Higaki, Tadanao; Shimonaga, Takashi; Watanabe, Noriaki; Ikenaga, Hiroki; Hidaka, Takayuki; Kihara, Yasuki; Chayama, Kazuaki; Goto, Chikara; Aibara, Yoshiki; Noma, Kensuke; Higashi, Yukihito

    2016-09-15

    Nitroglycerine-induced vasodilation, an index of endothelium-independent vasodilation, is measured for the assessment of vascular smooth muscle cell function or alterations of vascular structure. Both coronary and brachial artery responses to nitroglycerine have been demonstrated to be independent prognostic markers of cardiovascular events. The purpose of this study was to evaluate the nitroglycerine-induced vasodilation in coronary and brachial arteries in the same patients. We measured nitroglycerine-induced vasodilation in coronary and brachial arteries in 30 subjects with suspected coronary artery disease who underwent coronary angiography (19 men and 11 women; mean age, 69.0±8.8years; age range, 42-85years). The mean values of nitroglycerine-induced vasodilation in the brachial artery, left anterior descending coronary artery, and left circumflex coronary artery were 12.6±5.2%, 11.6±10.3%, and 11.9±11.0%, respectively. Nitroglycerine-induced vasodilation in the brachial artery correlated significantly with that in the left anterior descending coronary artery (r=0.43, P=0.02) and that in the left circumflex coronary artery (r=0.49, P=0.006). There was also a significant correlation between nitroglycerine-induced vasodilation in the left anterior descending coronary artery and that in the left circumflex coronary artery (r=0.72, P<0.001). These findings suggest that vascular smooth muscle cell dysfunction is a systemic disorder and thus impairment of endothelium-independent vasodilation in peripheral arteries and that in coronary arteries are simultaneously present. Nitroglycerine-induced vasodilation in the brachial artery could be used as a surrogate for that in a coronary artery and as a prognostic marker for cardiovascular events. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  1. [Prosthesis interposition in the case of subclavian artery transposition].

    PubMed

    György, G; Acosta Alvarez, P

    1993-01-01

    When we can't realize the reimplantation because of technical difficulties, special cases are presented during transposition from the subclavian artery to the primitive carotid artery. In these cases, between primitive carotid artery and the subclavian artery and also the vertebral artery, Gore-tex's tubes were implanted with favourable results.

  2. Molecular controls of arterial morphogenesis

    PubMed Central

    Simons, Michael; Eichmann, Anne

    2015-01-01

    Formation of arterial vasculature, here termed arteriogenesis, is a central process in embryonic vascular development as well as in adult tissues. While the process of capillary formation, angiogenesis, is relatively well understood, much remains to be learned about arteriogenesis. Recent discoveries point to the key role played by vascular endothelial growth factor receptor 2 (VEGFR2) in control of this process and to newly identified control circuits that dramatically influence its activity. The latter can present particularly attractive targets for a new class of therapeutic agents capable of activation of this signaling cascade in a ligand-independent manner, thereby promoting arteriogenesis in diseased tissues. PMID:25953926

  3. Aortic and other arterial injuries.

    PubMed

    Hardy, J D; Raju, S; Neely, W A; Berry, D W

    1975-05-01

    Three hundred sixty arterial injuries in 353 patients are reviewed. They covered a wide spectrum of injuries and included 36 aortic injuries and 19 cases of carotid truama. The mortality rate of 12% was in large part due to aortic injuries. Shock was the predominant cause of death. Infection was the most frequent non-fatal complication. Pulmonary complications were surprisingly uncommon. With methods and techniques discussed in the paper, 90% satisfactory end results were achieved. The amputation rate was 6% where extremity injuries were involved.

  4. Aortic and other arterial injuries.

    PubMed Central

    Hardy, J D; Raju, S; Neely, W A; Berry, D W

    1975-01-01

    Three hundred sixty arterial injuries in 353 patients are reviewed. They covered a wide spectrum of injuries and included 36 aortic injuries and 19 cases of carotid truama. The mortality rate of 12% was in large part due to aortic injuries. Shock was the predominant cause of death. Infection was the most frequent non-fatal complication. Pulmonary complications were surprisingly uncommon. With methods and techniques discussed in the paper, 90% satisfactory end results were achieved. The amputation rate was 6% where extremity injuries were involved. Images Fig. 11. Fig. 13. PMID:1130881

  5. Genetics of pulmonary arterial hypertension.

    PubMed

    Elliott, C Gregory

    2013-12-01

    Painstaking research led to the discovery of gene mutations responsible for heritable forms of pulmonary arterial hypertension (PAH). Mutations in the gene BMPR2, which codes for a cell surface receptor (BMPRII), cause the approximately 80% of heritable cases of PAH. Less commonly mutations in ALK1, CAV1, ENG, and SMAD9, and newly discovered mutations in KCNK3, may cause heritable PAH. Other family members of many patients diagnosed with idiopathic PAH may be diagnosed with PAH. Genetic counseling and testing should be offered to patients diagnosed with heritable or idiopathic PAH.

  6. Successful management of grade III coronary perforation after percutaneous angioplasty in a high-risk patient: a case report.

    PubMed

    Coloma Araniya, Ricardo; Beas, Renato; Maticorena-Quevedo, Jesús; Anduaga-Beramendi, Alexander; Pastrana Castillo, Marco Antonio

    2016-03-03

    Coronary perforation is a rare complication in patients undergoing percutaneous coronary angioplasty. The mortality of this complication varies depending on factors related to the patient and the procedure performed, reaching 44% in patients with Ellis type III perforation. We report the case of an 81 year old male with multiple cardiovascular risk factors, who underwent percutaneous angioplasty for unstable angina management. The patient developed grade III coronary perforation in the anterior descending artery, which was successfully managed with balloon inflation to 6 atmospheres for 10 minutes twice in the affected area, with an interval of 5 minutes between each dilatation. The patient improved and was discharged.

  7. Anomalous origin of the left subclavian artery from the pulmonary artery.

    PubMed

    Ugurlucan, Murat; Arslan, Ahmet Hulisi; Besikci, Resmiye Tore; Karadeniz, Oktay; Ay, Sibel; Yildiz, Yahya; Cicek, Sertac

    2014-02-01

    Isolated left subclavian artery from the pulmonary trunk is a rare congenital cardiovascular malformation. In this report, we present the images of ascending aortic aneurysm and left subclavian artery originating from the pulmonary artery in a 4-year-old girl in addition to her congenital cardiac pathology.

  8. Digital artery pseudoaneurysm in a patient with previous radial artery harvest

    PubMed Central

    Plant, Mathew A; Panchapakesan, Vivek

    2011-01-01

    A post-traumatic pseudoaneurysm in the ulnar digital artery of the thumb in a patient with compromised vascularity due to a previous harvest of the ipsilateral radial artery is reported. To the authors’ knowledge, the present case is the first such description of a pseudoaneurysm in the digital artery of a patient with compromised collateral blood flow. PMID:23204888

  9. Use of the inferior epigastric artery to revascularize a lower pole renal artery in renal transplant.

    PubMed

    Young, J S; Rohr, M S

    1995-02-01

    The increasing use of living-related donors has increased the incidence wherein the transplant surgeon is required to use special vascular surgical techniques to transplant kidneys with anomalous arterial anatomy. One of the most commonly encountered arterial anomalies is the presence of a lower pole renal artery. In many cases, this artery can be anastomosed to the main renal artery, and the main renal artery can then be anastomosed into the recipient vessel. However, there are cases where the lower pole renal artery is too distant from the main renal artery to allow an anastomosis to be performed. The lower pole renal artery of the graft must be revascularized to avoid ischemic injury to the ureter. Thus, alternate methods for the revascularization of this vessel must be found. We describe the use of the recipient inferior epigastric artery as an arterial supply for the donor lower pole artery. In our case report, this method provided excellent flow to the lower kidney and was documented by later studies.

  10. Systematization, description, and territory of the caudal cerebral artery in surface of the brain of the ostrich (Struthio camelus).

    PubMed

    Nazer, Manoel; Campos, Rui

    2014-08-01

    Brain specimens from 30 ostriches were injected with red-dyed latex via the internal carotid arteries, and the caudal cerebral arteries and their branches were systematically described. On the right side, the caudal cerebral artery was double-, triple-, quadruple-, and single-branched in 73.5%, 23.3%, 3.3%, and 3.3% of cases, respectively; on the left side, it was double-, triple-, quadruple-, and single-branched in 76.7%, 20%, 3.3%, and 3.3% of cases, respectively. The dorsal tectal mesencephalic artery appeared as a single vessel in 96.7% of cases, emerging as a collateral branch of the caudal cerebral artery. The dorsal mesencephalic tectal artery originated from the right dorsal cerebellar artery in 40% of cases and from the left side in 63.3% of cases. On the right side, there were four and three medial occipital hemispheric branches in 46.7% and 20% of cases, respectively; on the left side, there were four and three branches in 30% and 26.7% of cases. On the right side, the pineal artery was double-, single-, triple-, and quadruple-branched in 50%, 23.3%, 20%, and 6.7% of cases, respectively; on the left side, this artery was double-, single-, triple-, and quadruple-branched in 50%, 23.3%, 16.7%, and 10% of cases, respectively. The diencephalic artery was on the right side in 43.3% of cases and on the left side in 56.7% of cases. The interhemispheric artery was on the right side in 56.7% of cases and on the left side in 43.3% of cases; four, three, two, five, and one dorsal hemispheric trunks branched off of the interhemispheric artery in 40%, 40%, 10%, 6.7%, and 26.7% of cases, respectively. The caudal cerebral artery was classified as Type I in 56.7% of cases (subtype IA in 33.3% of cases and IB in 23.3% of cases), Type II in 40% of cases (subtype IIA in 20% of cases and IIB in 20% of cases), and Type III in 3.3% of cases.

  11. Level III Ecoregions of Indiana

    EPA Pesticide Factsheets

    Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

  12. Level III Ecoregions of Ohio

    EPA Pesticide Factsheets

    Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

  13. Level III Ecoregions of Montana

    EPA Pesticide Factsheets

    Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

  14. Level III Ecoregions of Kentucky

    EPA Pesticide Factsheets

    Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

  15. Level III Ecoregions of Florida

    EPA Pesticide Factsheets

    Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

  16. Level III Ecoregions of Alabama

    EPA Pesticide Factsheets

    Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

  17. Level III Ecoregions of Tennessee

    EPA Pesticide Factsheets

    Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

  18. Level III Ecoregions of Arkansas

    EPA Pesticide Factsheets

    Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

  19. Level III Ecoregions of Wisconsin

    EPA Pesticide Factsheets

    Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

  20. Level III Ecoregions of Illinois

    EPA Pesticide Factsheets

    Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

  1. Level III Ecoregions of Vermont

    EPA Pesticide Factsheets

    Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

  2. Level III Ecoregions of Pennsylvania

    EPA Pesticide Factsheets

    Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

  3. Level III Ecoregions of Maine

    EPA Pesticide Factsheets

    Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

  4. Level III Ecoregions of Mississippi

    EPA Pesticide Factsheets

    Ecoregions by state were extracted from the seamless national shapefile. Ecoregions denote areas of general similarity in ecosystems and in the type, quality, and quantity of environmental resources. They are designed to serve as a spatial framework for the research, assessment, management, and monitoring of ecosystems and ecosystem components. These general purpose regions are critical for structuring and implementing ecosystem management strategies across federal agencies, state agencies, and nongovernment organizations that are responsible for different types of resources within the same geographical areas. The approach used to compile this map is based on the premise that ecological regions can be identified through the analysis of patterns of biotic and abiotic phenomena, including geology, physiography, vegetation, climate, soils, land use, wildlife, and hydrology. The relative importance of each characteristic varies from one ecological region to another. A Roman numeral hierarchical scheme has been adopted for different levels for ecological regions. Level I is the coarsest level, dividing North America into 15 ecological regions. Level II divides the continent into 50 regions (Commission for Environmental Cooperation Working Group, 1997). At Level III, the continental United States contains 105 regions whereas the conterminous United States has 85 (U.S. Environmental Protection Agency, 2011). Level IV ecoregions are further subdivisions of Level III eco

  5. Rhythmicity in arterial smooth muscle

    PubMed Central

    Haddock, Rebecca E; Hill, Caryl E

    2005-01-01

    Many arteries and arterioles exhibit rhythmical contractions which are synchronous over considerable distances. This vasomotion is likely to assist in tissue perfusion especially during periods of altered metabolism or perfusion pressure. While the mechanism underlying vascular rhythmicity has been investigated for many years, it has only been recently, with the advent of imaging techniques for visualizing intracellular calcium release, that significant advances have been made. These methods, when combined with mechanical and electrophysiological recordings, have demonstrated that the rhythm depends critically on calcium released from intracellular stores within the smooth muscle cells and on cell coupling via gap junctions to synchronize oscillations in calcium release amongst adjacent cells. While these factors are common to all vessels studied to date, the contribution of voltage-dependent channels and the endothelium varies amongst different vessels. The basic mechanism for rhythmical activity in arteries thus differs from its counterpart in non-vascular smooth muscle, where specific networks of pacemaker cells generate electrical potentials which drive activity within the otherwise quiescent muscle cells. PMID:15905215

  6. [Arterial hypertension and metabolic disorders].

    PubMed

    Dzherieva, I S; Volkova, N I

    2010-01-01

    Combination of arterial hypertension (AH) and metabolic disorders accelerates development of organic lesions in target organs. As shown in recent prospective studies, myocardial hypertrophy rate closely correlated with severity of metabolic disturbance. The thickness of interventricular septum and posterior wall show stronger dependence of severity of metabolic disorders than left ventricular density while left atrial enlargement is correlates with fasting glycemia and excess body mass. There is close relationship between microalbuminurea and hyperinsulinemia and the number of metabolic syndrome components is linearly correlated with glomerular filtration rate below 60 ml/min. It is shown that rigidity of arteries is a new independent risk factor of cardiovascular complications in obese patients. Moreover, metabolic disturbances cause affective disorders that impair quality of life and therapy motivation. Combination of AH, metabolic disturbances, and borderline psychic disorders dictated consideration of abnormal melatonin secretion as a condition developing as a consequence of disturbed adaptive circadian rhythms. This hypothesis was prompted by the discovery of the so-called "clock genes" in the central nervous system and practically all peripheral organs including heart, vessels, and adipose tissue.

  7. Iranian Pulmonary Arterial Hypertension Registry.

    PubMed

    Masjedi, Mohammad Reza; Fahimi, Fanak; Sharif-Kashani, Babak; Malek Mohammad, Majid; Saliminejad, Leila; Monjazebi, Fateme

    2015-01-01

    Idiopathic pulmonary arterial hypertension (IPAH) is a fatal disorder with a prevalence of 8.6 per million. We introduce a registry website for IPAH and PAH patients ( www.IPAH.ir) for access and efficient delivery of government-aided and subsidized antihypertensive medications. The IPAH registry was opened in November 2009. Information of IPAH and PAH patients with a username and password were uploaded in the site. Data entry was possible only via the physicians and healthcare organizations via internet that were given a personalized username and password for entry. Following the patients' profile submission, a scientific committee composed of a cardiologist and a pulmonologist who were selected by the Ministry of Health of Iran (MOH), evaluated the data. The eligibility of the patient to receive the medications was confirmed after evaluation. If the patient was eligible, 82% of the Bosentan cost was paid by MOH. To date, one hundred and sixteen patients (82 females, 34 males) have been registered. The mean pulmonary artery pressure by right heart catheterization was 69.24±17 mmHg (ranging from 35 to 110 mmHg). The first online Iranian registry program for IPAH and PAH patients is believed to supply essential information for health care providers in the field.

  8. Transposition of Great Arteries with Intramural Coronary Artery: Experience with a Modified Surgical Technique

    PubMed Central

    Mishra, Amit; Jain, Anil; Hinduja, Manish; Wadhawa, Vivek; Patel, Ramesh; Vaidhya, Nikunj; Rodricks, Dayesh; Patel, Hardik

    2016-01-01

    Objective: Transposition of the great arteries is a common congenital heart disease. Arterial switch is the gold standard operation for this complex heart disease. Arterial switch operation in the presence of intramural coronary artery is surgically the most demanding even for the most experienced hands. We are presenting our experience with a modified technique for intramural coronary arteries in arterial switch operation. Methods: This prospective study involves 450 patients undergoing arterial switch operation at our institute from April 2006 to December 2013 (7.6 years). Eighteen patients underwent arterial switch operation with intramural coronary artery. The coronary patterns and technique used are detailed in the text. Results: The overall mortality found in the subgroup of 18 patients having intramural coronary artery was 16% (n=3). Our first patient had an accidental injury to the left coronary artery and died in the operating room. A seven-day old newborn died from intractable ventricular arrhythmia fifteen hours after surgery. Another patient who had multiple ventricular septal defects with type B arch interruption died from residual apical ventricular septal defect and sepsis on the eleventh postoperative day. The remainder of the patients are doing well, showing a median follow-up duration of 1235.34±815.26 days (range 369 - 2730). Conclusion: Transposition of the great arteries with intramural coronary artery is demanding in a subset of patients undergoing arterial switch operation. We believe our technique of coronary button dissection in the presence of intramural coronary arteries using coronary shunt is simple and can be a good addition to the surgeons' armamentarium. PMID:27074270

  9. Cryoplasty for peripheral arterial disease.

    PubMed

    McCaslin, James E; Andras, Alina; Stansby, Gerard

    2013-08-11

    Percutaneous balloon angioplasty is an endovascular technique for restoring blood flow through an artery that has become narrowed or blocked by atherosclerosis. Narrowing of the artery following angioplasty (restenosis) is the major cause of long-term failure. Cryoplasty offers a different approach to improving long-term angioplasty results. It combines the dilation force of balloon angioplasty with cooling of the vessel wall. This systematic review evaluated cryoplasty in peripheral arterial disease and provides focus for further research in the field. This is an update of a review first published in 2007. To assess the efficacy of, and complications associated with, cryoplasty for maintaining patency in the iliac, femoropopliteal and crural arteries in the short and medium term. For this update the Cochrane Peripheral Vascular Diseases Group Trials Search Co-ordinator searched the Specialised Register (last searched October 2012) and CENTRAL (2012, Issue 10). Trial databases were searched for ongoing or unpublished studies. We also searched the reference lists of relevant articles. All randomised controlled trials in which participants with peripheral arterial disease (PAD) of the lower limbs, or lower limb bypass graft stenoses, were randomised to cryoplasty with or without another procedure versus a procedure without cryoplasty were considered. This included trials where all participants received angioplasty and the randomisation was for cryoplasty versus no cryoplasty and trials where cryoplasty was used as an adjunct to conventional treatment (for example stenting) against a control. Two review authors independently reviewed, assessed and selected trials, extracted data and assessed risk of bias. Seven trials (six primary cryoplasty and one adjunctive cryoplasty trial) with a combined total of 478 patients were included in this review. The trials reported patency and restenosis either by participant, lesion or vessel location. Follow-up ranged from 30 days to

  10. The Prevalence of Metabolic Syndrome in Coronary Artery Disease Patients

    PubMed Central

    Montazerifar, Farzaneh; Bolouri, Ahmad; Mahmoudi Mozaffar, Milad; Karajibani, Mansour

    2016-01-01

    Background Metabolic syndrome (MetS) is a worldwide health problem, which is growing in Iranian adults. MetS is associated with risk of type 2 diabetes and coronary artery disease (CAD). In this study, we aimed to investigate the prevalence of MetS and its individual components in CAD patients. Methods This cross-sectional study was performed on 200 CAD patients who had undergone elective coronary angiography at the cardiology department. Anthropometric indices including waist circumference (WC) and body mass index were measured. Blood samples were obtained to determine glucose and lipid profile. MetS components were defined according to the modified Adult Treatment Panel III (ATP III) criteria. Results The prevalence of MetS among patients was 49.5% (women: 55.9%; men: 40.2%; P < 0.05). The prevalence increased with age. The low high-density lipoprotein-cholesterol (low HDL-C) (84.8%), high fasting blood glucose (high FBG) (77.8%) and high WC (75.8%) were the most prevalent risk factors in CAD patients with MetS. Conclusions Recent data indicate that the dyslipidemia, hyperglycemia and abdominal obesity are crucial predictors of MetS in CAD patients. Further prospective studies are recommended for more clarification. PMID:28197293

  11. Effects of rosiglitazone on contralateral iliac artery after vascular injury in hypercholesterolemic rabbits

    PubMed Central

    França Neto, Olímpio Ribeiro; Precoma, Dalton Bertolim; Alessi, Alexandre; Prim, Camila; da Silva, Ruy Fernando Kuenzer Caetano; de Noronha, Lucia; Baroncini, Liz Andréa Villela

    2008-01-01

    Background The objective was to evaluate the effects of rosiglitazone on iliac arteries of hypercholesterolemic rabbits undergoing balloon catheter injury in the contralateral iliac arteries. Methods White male rabbits were fed a hypercholesterolemic diet for 6 weeks and divided into two groups as follows: rosiglitazone group, 14 rabbits treated with rosiglitazone (3 mg/Kg body weight/day) during 6 weeks; and control group, 18 rabbits without rosiglitazone treatment. All animals underwent balloon catheter injury of the right iliac artery on the fourteenth day of the experiment. Results There was no significant difference in intima/media layer area ratio between the control group and the rosiglitazone group. Rosiglitazone did not reduce the probability of lesions types I, II, or III (72.73% vs. 92.31%; p = 0.30) and types IV or V (27.27% vs. 7.69%; p = 0.30). There were no differences in the extent of collagen type I and III deposition or in the percentage of animals with macrophages in the intima layer. The percentage of rabbits with smooth muscle cells in the intima layer was higher in rosiglitazone group (p = 0.011). Conclusion These findings demonstrate that rosiglitazone given for 6 weeks did not prevent atherogenesis at a vessel distant from the injury site. PMID:18485218

  12. An evaluation of the Avionics Pressurometer III 1978 at home and in hospital.

    PubMed

    Gould, B A; Hornung, R S; Cashman, P M; Altman, D; Raftery, E B

    1986-07-01

    The Avionics Pressurometer III is the only noninvasive indirect ambulatory blood pressure system which provides 24-h blood pressure measurements, but it has been subjected to limited evaluation. We report a critical evaluation comparing it to simultaneous intra-arterial blood pressures both at home and at hospital as well as during standardized exercise. Comparisons with simultaneous indirect methods were also made. Twenty-two hypertensives undergoing intra-arterial ambulatory blood pressure monitoring wore the two recorders for one day. The mean difference (standard deviation SD) for intra-arterial blood pressure--Avionics blood pressure was 2 (SD 8.6)/-14 (SD 10.3) mmHg at home and -3 (SD 15.4)/-11 (SD 12.3) mmHg at hospital. At the end of exercise the figures for the same comparison were -7 (SD 16)/0 (SD 15.6) mmHg. In general the agreement between intra-arterial and Avionics pressurometer recordings was closer for systolic than for diastolic blood pressures but there was wide variation for individuals as shown by the standard deviations about the mean difference. We did not use the recorder at night as patients complained that the noise kept them awake and so night-time blood pressures were not attainable. We do not think the recorder performed satisfactorily during physical exertion, and in view of its expense, this recorder is of limited potential value in supplying accurate information.

  13. Diagnosis and therapy of coronary artery disease: Second edition

    SciTech Connect

    Cohn, P.F.

    1985-01-01

    This book contains 18 selections. Some of the titles are: Nuclear cardiology; Diagnosis of acute myocardial infarction; Therapy of angina pectoris; Psychosocial aspects of coronary artery disease; Nonatherosclerotic coronary artery disease; and The epidemiology of coronary artery disease.

  14. Surgical Management of Intramyocardial Left Anterior Descending Artery.

    PubMed

    De Salvatore, Sergio; Segreto, Antonio; Chiusaroli, Alessandro; Congiu, Stefano; Bizzarri, Federico

    2015-11-01

    An intramyocardial left anterior descending artery can be found in up to 30% of patients undergoing coronary artery bypass graft procedures. We review the various techniques available to identify an intramyocardial left anterior descending artery.

  15. Carotid stenosis, x-ray of the right artery (image)

    MedlinePlus

    ... the right carotid artery showing a severe narrowing (stenosis) of the internal carotid artery just past the ... artery or ulceration in the area after the stenosis in this close-up film. Note the narrowed ...

  16. What Are the Signs and Symptoms of Carotid Artery Disease?

    MedlinePlus

    ... What Are the Signs and Symptoms of Carotid Artery Disease? Carotid artery disease may not cause signs or symptoms until it severely narrows or blocks a carotid artery. Signs and symptoms may include a bruit, a ...

  17. Successful Angioplasty of Left Vertebral Artery and Right Subclavian Artery Via Retrograde Approach

    PubMed Central

    Namazi, Mohammad Hasan; Momenizadeh, Amir; Dousti, Amir; Naderian, Mohammadreza

    2017-01-01

    We describe a 77-year-old male who had right upper limb ischemic symptoms and history of unsuccessful right subclavian artery angioplasty. According to ultrasound findings, upper limb angiography was performed which confirmed stenosis of the left vertebral and right subclavian arteries. Percutaneous angioplasty and stenting of left vertebral and right subclavian arteries were performed in two separate sessions. Retrograde approach was scheduled for right subclavian artery angioplasty which is challenging due to potential risks to adjacent vertebral artery. This case reports underscores that percutaneous approaches may be preferential given their confirmed long-term efficacy and lower morbidity.

  18. Contrast Media Delivery in the Assessment of Anomalous Left Coronary Artery From the Pulmonary Artery.

    PubMed

    Saade, Charbel; Al-Hamra, Salam; Al-Mohiy, Hussain; El-Merhi, Fadi

    2016-05-01

    A patient with a history of mitral valve prolapse and regurgitation that was corrected with a mitral ring repair 15 years earlier received a diagnosis of anomalous left coronary artery arising from the pulmonary artery and underwent repair. Coronary computed tomography angiography (CTA) was employed to image the patient before surgical intervention. Synchronizing contrast media administration to opacify the right coronary artery in the arterial phase and the left coronary artery in the venous phase required a test-bolus approach. Matching compromised cardiovascular dynamics with patient-specific contrast media administration protocols was improved considerably with the use of a test-bolus technique during electrocardiography-gated coronary CTA.

  19. Successful endovascular treatment of hemosuccus pancreaticus due to splenic artery aneurysm associated with segmental arterial mediolysis.

    PubMed

    Obara, Hideaki; Matsubara, Kentaro; Inoue, Masanori; Nakatsuka, Seishi; Kuribayashi, Sachio; Kitagawa, Yuko

    2011-11-01

    Hemosuccus pancreaticus, which is generally due to the rupture of a splenic artery aneursym into the pancreatic duct, is a rare cause of intermittent upper gastrointestinal hemorrhage. Segmental arterial mediolysis (SAM) is a rare arteriopathy. We report a 53-year-old man with hemosuccus pancreaticus due to a splenic artery aneurysm associated with SAM. The patient, who also had a celiac artery aneurysm affected by SAM, was successfully treated by both coil embolization and aortic stent grafting for complete coverage of the celiac artery. SAM is a very rare cause of hemosuccus pancreaticus, and endovascular treatment may be favorable for hemosuccus pancreaticus.

  20. The significance of medial sural artery integrity in popliteal artery trauma: a case report.

    PubMed

    Tzilalis, V D; Georgiadis, G S; Papas, T T; Arvanitis, D P; Lazarides, M K

    2005-12-01

    Two patients with popliteal artery trauma who underwent secondary amputations due to refractory calf sepsis despite a patent arterial repair are presented in this case report. The medial sural artery, the main arterial supply of the medial head of the gastrocnemius, was surgically severed in both patients owing to the use of a continuous medial incision from the supra level to infragenicular level. The compromised arterial supply of the medial head of the gastrocnemius muscle may have contributed to the devitalization of the muscle and the subsequent calf sepsis, and it is speculated that this was related to the unfavorable outcome.