Anatomy Implications Research Articles

Lead-related tricuspid regurgitation: an important phenotype seen through the lens of computed tomography

Abstract Background The imaging diagnostic approach of patients with cardiac implantable electronic devices (CIED)-related tricuspid regurgitation (TR) is undefined. Functional cardiac computed tomography angiography (4D-CTA) provides a complementary role to echocardiography in the evaluation of tricuspid valve (TV) apparatus and right ventricle (RV) remodeling, but the capability to assess lead-leaflet interaction is unknown. Purpose To evaluate the role of 4D-CTA anatomical and morphological diagnostic assessment in a cohort of patients with severe TR and CIED vs those without. Methods Clinical, echocardiographic and CTA data were collected from two quaternary centers for patients with severe TR and a CIED evaluated between January 2017 to October 2023. Functional and morphological CTA information assessed lead-leaflet relationship to divide patients in those with lead-related TR, those with no lead-TR causal relationship, and those with severe isolated TR but without CIED. Primary end-point was the occurrence of all-cause death. Results A total of 143 patients were identified, roughly dividng the cohort into thirds. Baseline characteristics and imaging characteristics of these 3 groups revealed important differences suggesting a more advanced patophysiology phenotype for those with lead-related TR, particularly presenting both the largest 4D-CTA-derived TV maximum coaptation gap and anatomical regurgitant orifice area (see Figure 1). At regression analysis, time from CIED implantation (OR 1.01, CI 1.00-1.09, p=0.031) and >3 leaflets valve morphology (OR 2.90, CI 1.01-8.32, p=0.040) were independently associated with lead-related TR. After a median follow-up of 18 months, the primary end-point occurred in 36 patients (25%) and was more common among patients with lead-related TR (p-value overall= 0.007, see Figure 2). While no differences in the rate of TV intervention were found, excessive mortality persisted for lead-related TR group even after adjustement for age and gender (HR 6.49, CI 1.72-14.47, p=0.006). Conclusion Systematic 4D-CTA in patients with severe TR and presence of a CIED, identified a large number of patients with lead-related TR with important functional and anatomical implications including greater TR severity and > 3 leaflets. These findings appear to have prognostic relevance that might have decision-making implications for patient management.Figure 1Figure 2

Volcanic ash in the water column: Cellular, physiological and anatomical implications for the gastropod suspension-feeder Crepipatella peruviana (Lamarck, 1822)

The influx of volcanic ash into seawater alters particle composition with implications for the cellular, physiological and anatomical response of suspension-feeding organisms. Adult females of Crepipatella peruviana were exposed to three diets consisting of a fixed concentration of 50,000 cells ml−1 of the microalga Isochrysis galbana plus different concentrations of ash particles (30, 90 and 150 mg L−1). The objective was to determine the cellular, physiological and anatomical responses. Mortality increased with ash concentrations, while feeding and respiration rates, tissue weight, and condition index decreased. The gills showed severe degradation of cilia and the presence of large mucous aggregates of cilia and ash. An increase in ash resulted in decreased lipid peroxidation and protein carbonyls, but increased total antioxidant capacity and phenols. Thus, volcanic ash particles may exert a high impact at both cellular and physiological levels for C. peruviana, where inhibition of gill function reduces the ability to acquire food.

Left-Sided Inferior Vena Cava: A Retrospective Study and Literature Review

ObjectiveThe primary goal of this research is to delve into the clinical and pathological facets of the left-sided inferior vena cava (IVC), and to catalogue and condense its radiological and clinical attributes, thereby furnishing valuable references for pertinent clinical diagnosis and therapeutic procedures. MethodsWe collated and scrutinized the general clinical features, radiological characteristics, and diagnostic and therapeutic strategies of 30 patients diagnosed with left-sided IVC in our hospital from July 2014 through February 2024. ResultsA majority of patients were asymptomatic and were only identified during diagnostic procedures for other ailments. CT scans revealed anomalies in the anatomical configuration of the left-sided IVC. The radiological presentations primarily showcased the right common iliac vein traversing the lumbar vertebrae to amalgamate with the left common iliac vein, forming the IVC. The IVC ascended on the left side of the abdominal aorta, accepted the left renal vein, and then transitioned to the right side of the abdominal aorta. In three instances, the IVC was witnessed ascending on the left side of the abdominal aorta, permeating through the diaphragm, converging with the azygos vein and abdominal aorta, and making its way into the right atrium. In these cases, the hepatic segment of the IVC was missing, and there was an absence of the IVC inferior to the hepatic vein, a condition we refer to as complete left-sided IVC. ConclusionLeft-sided IVC is predominantly asymptomatic but carries significant anatomical implications during abdominal, retroperitoneal surgeries, and vascular interventions. Precise identification and management of this anomaly can mitigate surgical risks and enhance patient prognosis.

Quantitative analysis of surgical landmarks of the face in fixed cadaveric heads: clinical and anatomical implications.

This study aimed to examine and analyze the presence of sexual dimorphism and symmetry/asymmetry in fixed cadaveric heads and their contributions to clinical practice. Measurements were conducted on 6 cadavers and 24 fixed cadaveric heads (n = 30) using a digital microcaliper to assess cranial dimensions, including surgical landmarks, facial index (FI), orbital index (OI), and the danger triangle of the face, offering crucial references for surgeons during surgical interventions. Analyses were conducted on cadavers consisting of 10 females (33.3%) and 20 males (66.7%). Males demonstrated significantly higher values than females in terms of Zy-Zy (Zy = Zygion), nasal body, and width/length of the columella. Hyperleptoprosop types were the most frequently observed, followed by the leptoprosop type. Females exhibited megaseme characteristics according to OI on both sides. Additionally, the danger triangle of the face was greater in males compared than in females, suggesting a higher risk of infection in this region among males. The observed sex differences in facial and nasal dimensions, along with facial indices, are crucial for customizing surgical procedures to individual patients. For example, the greater distance in the danger triangle among males highlights the importance of considering anatomical variations to avoid complications, such as septic cavernous sinus thrombosis. Integrating these measurements into preoperative planning can enhance the precision of facial reconstruction and aesthetic surgeries, thereby improving patient outcomes and safety.

Anatomical Implications of Chiari I and Basilar Invagination (Type B) in the IV Ventricle and Cisterna Magna

To analyze the anatomical changes of the IV ventricle and cisterna magna in the Chiari malformation I (CMI) and basilar invagination (type B). This is a controlled study with 161 exams of magnetic resonance imaging (MRI) of adults grouped into control (n= 37), basilar invagination (BI; n= 31), Chiari malformation I (CMI; n= 37), and CMI+BI (n= 56). The MRIs were analyzed using the visualization software Osirix (Pixmeo, Bernex, Geneva, version 3.8.2). The morphometric variables were: distance from the obex to the McRae line; length of the IV ventricle floor; and the area and volume of the cisterna magna. The univariate ANOVA followed by Tukey's post-hoc test was applied to evaluate the difference between the groups. The difference between sexes was evaluated by the t test for each group. Alterations in the cisterna magna and IV ventricle were more evident only in the CMI and CMI+BI groups. For both sexes, the CMI and CMI+BI groups showed: a reduction in the CSF space (P < 0.001), cisterna magna with volume reduction (P < 0.001), low position of the obex (P < 0.001), and IV ventricle more elongated (male P= 0.007 and female P < 0.001). The BI group had no significant change in the analysis by sex. The CMI (isolated and associated with BI) showed a low obex position and elongation of the IV ventricle due to traction towards the spinal canal. The reduction of cisterna magna volume added to the occupation of the cerebellar tonsils can impact in the cerebrospinal fluid dynamics. The BI when isolated was not related to alterations in the parameters of cerebrospinal fluid spaces studied.

Anatomical and Surgical Implications of the Usage of Bichat Fat Pad in Oroantral Communication, Maxillary, Palatal, and Related Surgeries-Narrative Review.

The buccal fat pad, also called the Bichat's fat pad (BFP), is an encapsulated fat mass located in the cheek. This type of specialized fat mass can be used both as a pedicular or free graft in various surgeries and approaches. Due to its easy access from the oral cavity approach, it is commonly used for oroantral and palatal fistula closure. The knowledge of its anatomy and surrounding tissues plays a role in its mobilization and suturing onto the desired defect in the palatal or maxillary region. The BFP is mostly associated with the primary approach used for a fistula or bone surgery. Alternatively, the procedure can be performed with a single approach incision, which does not compromise the appearance or the function of the operating or adjacent areas. The most important inclusion criteria for BFP usage and surgical limitations are highlighted. The BFP is used for multiple purposes in reconstructive and oncology surgery and also has its use in esthetic and facial contouring procedures. The amount, volume, and shape of the BFP are mostly associated with the scope of their usage. The aim of the following narrative review is to present the surgical and anatomical implications of fat pads in maxillary and palatal surgeries.

Rare and Combined Hepatic Artery Variants as Seen in Cadaveric and Postmortem Investigations: Anatomical Implications in Surgical Practice

Context: Vascular variations are an unexpected finding during cadaveric dissections, postmortems, and surgical and diagnostic angiographic procedures. Usually, such abnormalities are asymptomatic, but the existence of hepatic vasculature anomalies might cause accidental injuries to the vasculature while performing surgical procedures. Aim: This study aimed to dissect human cadavers and postmortem specimens and to examine the variations of the hepatic artery system. Materials and Method: This study was conducted on 50 specimens, with 22 conducted in the dissection hall cadavers, while 28 were collected from the postmortem among the South Indian population irrespective of age and sex and investigated for variant hepatic arteries. The data were collected between January 2014 and December 2015. Results: The results of this study demonstrated that the common hepatic artery (CHA) originated directly from the aorta in 2%, and it was trifurcated into the right hepatic artery (RHA), left hepatic artery (LHA), and gastroduodenal artery (GDA) in 8%. It continued only as the LHA in 16% and only as RHA in 4%. The RHA arises from CHA in 8%, from the superior mesenteric artery (SMA) in 10%, from GDA in 4%, and from replaced CHA in 2%. The GDA accounted for 4% of the accessory RHA's origin, while the proper hepatic artery (PHA) accounted for 2%. The LHA from the CHA in 8% replaced the origin from the left gastric artery (LGA) in 4% and replaced CHA in 2%. The middle hepatic artery was noticed in 62% of the specimens. Conclusion: Surgeons and radiologists participating in angiographic procedures must have up-to-date knowledge of hepatic artery normal variant abnormalities.

The radiation dose, clinical and anatomical implications of erect lumbar spine radiography: A single centre pre-post implementation evaluation

IntroductionLumbar radiographs remain a common imaging examination despite strategies to reduce their use. Many authors have demonstrated benefits in changing from traditional supine and recumbent lateral projections to a prone and/or erect orientation. Despite evidence of clinical and radiation dose optimisation, widespread adoption of these strategies has stalled. This article describes the single-centre implementation and evaluation of erect PA and lateral projections. MethodThis was an observational study pre- and post-implementation of an erect imaging protocol. Patient BMI, image field size, source image and source object distances and DAP were collected together with assessment of radiographic spinal alignment and disc space demonstration. Effective dose was calculated with organ specific doses. Results76 (53.5%) patients were imaged in the supine AP and recumbent lateral position, 66 (46.5%) had erect PA and lateral radiographs. Despite the larger BMI of the erect cohort and similar field sizes, effective dose was lower in the PA position by an average of 20% (p < 0.05), however, no significant difference in lateral dose. Anatomical improvements were evident with greater visualisation of intervertebral disc spaces in the PA erect (t = −9.03; p < .001) and lateral (t = −10.298; p < .001) orientations. Erect PA radiographs demonstrated a leg length discrepancy in 47.0% (0.3–4.7 cm) and a scoliosis in 21.2% of cases, with a significant link between these findings (r (64) = 0.44; p < .001). ConclusionErect lumbar spine radiography provides information on clinical outcomes not available with recumbent projections. The improvements in anatomical visualisation and radiation dose reduction supports the local change in practice. Implications for practice- Erect imaging can reduce effective dose with an optimised acquisition protocol- additional pathological information can be revealed by the erect posture.- postural awareness is critical to interpret images accurately.

Left Atrial Appendage Morphology and Course of the Circumflex Artery: Anatomical Implications for Left Atrial Appendage Occlusion Procedures.

The aim of this study was to evaluate the anatomic topography of the circumflex artery (Cx) and left atrial appendage (LAA) and to determine the safety zones for epicardial LAA closure and LAA occlusion procedures. The left coronary artery was segmented and visualized from 116 computed tomography angiography scans. Four points were located on the Cx portion periappendicularly, starting from the entry point. The landing zone plane was defined as parallel to the LAA orifice at the level of the beginning of the periappendicular course of the Cx, and the plane of the neck bend was located at the end of the LAA neck. A distance smaller than 2 mm was considered a dangerous distance. The distance between the Cx and the LAA landing zone was 4.3 ± 2 mm. The distance between the Cx and the LAA neck bend was 5.1 ± 2.2 mm. The distance between the Cx and the LAA bottom surface was 5.8 ± 2.9 mm. In 38.8% of patients, at least 1 distance between Cx and LAA was smaller than 2 mm in at least 1 dimension. These distances occurred in 30.2% of the LAA landing zone dimensions, 19.8% of LAA neck bend dimensions, and 11.2% of the LAA bottom surface distances. The study showed that most dangerous distances (30.2%) occurred in the LAA landing zone dimension. The data showed that landing zones more distal from the orifice of the LAA are safer in terms of Cx damage. Therefore, LAA closure should always be performed with caution, to avoid iatrogenic complications.

Anatomical Parameters and Growth of the Pediatric Skull Base: Endonasal Access Implications.

Objectives Endoscopic endonasal anterior skull base surgery has expanding use in the pediatric population, but the anatomy of pediatric patients can lead to limitations. This study aims to characterize the important anatomical implications of the pediatric skull base using computed tomography (CT) scans. Design This study is designed as retrospective analysis. Setting The study setting comprises of tertiary academic medical center. Participants In total, 506 patients aged 0 to 18 who had undergone maxillofacial and or head CTs between 2009 to 2016 were involved. Methods Measurements included piriform aperture width, nare to sella distance (NSD), sphenoid pneumatization, olfactory fossa depth, lateral lamella cribriform plate angles, and intercarotid distances (ICD) at the superior clivus and cavernous sinus. These patients were then subdivided into three age groups adjusting for sex. Analysis of covariance (ANCOVA) models were fit comparing between all age groups and by sex. Results Piriform aperture width, NSD, sphenoid sinus pneumatization as measured using lateral aeration and anterior sellar wall thickness, olfactory fossa depth, and ICD at the cavernous sinus were significantly different among all age groups ( p <0.0001). Our results show that mean piriform aperture width increased with each age group. The mean olfactory fossa depth also had consistent age dependent growth. In addition, ICD at the cavernous sinus showed age dependent changes. When comparing by sexes, females consistently showed smaller measurements. Conclusion The process of skull base development is age and sex dependent. During preoperative evaluation of pediatric patients for skull base surgery piriform aperture width, sphenoid pneumatization in both the anterior posterior and lateral directions, and ICD at the cavernous sinus should be carefully reviewed.

A review of the importance of research in Anatomy, an evidence-based science

Considered an absolute unchanging truth, and not research-led, human anatomy has been subject to a steady decline in course hours and funding. However, this is a misconstruction, as anatomy plays an important role in the clinical and surgical field, with the need of evidencebased data, more so now than ever. Research in anatomy not only establishes an evolutionary and functional database with variability between populations, sex, and age, but develops the tools needed for patient safety, development of prostheses, technology and surgical materials, improves interpretation of imaging studies, and provides evidence of clinical and anatomical implications. Evidence-based education is an exponentially growing field in anatomical sciences, providing the best evidence for technological and pedagogical strategies integrated in the classroom and laboratory. The gold-standard cadaveric dissections are currently only one of the wide range of educational resources available, with imaging studies and clinical scenarios playing an important role. Anatomy research needs to be continued, evolving with the generations the availability of new resources and the demands of the field. This review breaks down the available data, recommendations, and guidelines, as well as the importance behind the continuing research in anatomical sciences.

Anatomical implications of the subvastus approach on major vascular injury during a distal femoral osteotomy: a computed tomographic venography study.

This study evaluated major vascular injury risk in distal femoral osteotomy (DFO) via the subvastus approach and examined the relationship between the posterior border of the vastus medialis (VM) and the superficial femoral artery (SFA) and vein (SFV). Eighty limbs from 80 patients were evaluated using lower extremity computed tomographic venography. The positional relationship between the VM, SFA, and SFV was evaluated by measuring the angle between each structure and the horizontal reference point (VMA: VM angle, FAA (femoral arterial angle), FVA (femoral venous angle) and the distance between VM and the SFA and SFV (VMAD: VM-arterial distance, VMVD: VM-venous distance) in each axial slice (0/10/20/30/40mm) proximal to the level of the superior patellar margin. The proximity of the posterior border of the VM and the SFA/SFV as a vertical distance, measured between the slice of the superior border of the patella and the slice where the posterior border of the VM contacted the SFA was evaluated. Single and multiple regression analyses were performed using the vertical distance as the objective variable. As the slice shifted proximally, the VMA significantly increased (24.9 ± 8.5, 36.3 ± 8.8, 47.4 ± 11.8, 59.9 ± 14, 70.3 ± 13.7 degrees, respectively, p < 0.001 between all slices) and moved posteromedially from a medial direction. FAA (94.2 ± 7, 86.9 ± 9.2, 78.4 ± 9.7, 71.4 ± 9.8, 66.6 ± 10.5 degree, respectively, p < 0.001 between all slices) and FVA (100.6 ± 4.9, 98.3 ± 5.9, 93.7 ± 7.5, 88 ± 9.2, 81.1 ± 10.5 degrees, respectively, p < 0.001 between all slices) decreased and moved from a posterolateral to a posteromedial direction, while VMAD (35.4 ± 7.8, 24.1 ± 7.3, 14.3 ± 6, 8.4 ± 7, 6.2 ± 6.3mm, respectively, p < 0.001 between all slices) and VMVD significantly decreased (42.7 ± 7.3, 32 ± 7.4, 22.4 ± 6.8, 14.5 ± 10.6, 8.7 ± 7.1mm, respectively, p < 0.001 between all slices). The average vertical distance was 36 ± 9.3mm (range 18.6-61.5mm). The body height and the patellar length significantly affected the vertical distance. The posterior border of the VM shifted posteromedially from distal to proximal and contacted the SFA at an average of 36mm from the suprapatellar border. Surgeons should be aware of the risk of major vascular injury during exposure and osteotomy. Case series, Level IV.

Anatomy: A research‐led science with evidence‐based teaching

Anatomy has historically been considered a static science, not research‐lead. Cadaveric anatomy provided an evidence for a more precise anatomy teaching, however, small samples were used for absolute truths. Preservation techniques allowed to expand this, yet, research was limited to descriptive and comparative studies. As anatomy teaching evolved from descriptive, to clinically oriented, to evidence‐based, and having a growing role in other sciences, it caused an exponential growth in its’ publications. Anatomical research aided to establish evolutionary and functional databases of variability between populations, sex, and age. However, it’s most important contribution is currently oriented towards patient safety, development of prostheses, technology and surgical materials, improvement of imaging interpretation, and provide evidence of clinical and anatomical implications. Several studies have reported an important percentage of mala praxis and surgical errors can be attributed to a lack of anatomical understanding of the region, consideration of anatomical variations, and alterations due to inflammation, continuing a need for anatomical research.It is important to note, anatomy journals and publications have changed over time. The longest running journals focus on basic anatomy regarding structure, function, development, and evolution, while the last 3 to 4 decades have birthed journals with an anatomy oriented towards the clinical and surgical applications, with the most exponential growth in education.Anatomical education is a growing field. New strategies have been implemented over the years to improve students’ learning of anatomy. There have been important technological advancements, providing educators with new teaching tools, both in the classroom and laboratory. Problem‐solving and computer‐based learning. Students’ interest increased, and learning became purposeful. Educational research has not only focused on evaluating the ability for students to learn new information, ease of the technique, and retention of the information, but also the perception of the technique or tool. The lack of bodies available for dissection, rising costs of laboratories, and the cut down of anatomy course hours, have open a wide range of resources for learning anatomy, many made available for free in online platforms.Technology‐assisted learning is a powerful tool, when purposefully designed, peer‐evaluated, and integrated to support interpersonal interactions, teamwork, and communication skills. An over‐use should be avoided, to truly adhere to the pedagogic objectives. There is a need for evidence‐based education. Teaching should be balanced with tools such as imaging, clinical cases, three‐dimensional printing, virtual and augmented reality, interactive holograms, and others. There is no doubt the millennial generation have emerged technological advancements into their lives and culture, and education must continue to adapt with the demands of new generations.Anatomical and educational research must be performed purposefully following recommendations and guidelines to obtain the maximum benefit for students and educators.

Catheter Ablation of Idiopathic Left Ventricular Tachycardia: New Anatomical Implications for Mapping and Ablation

Catheter Ablation of Idiopathic Left Ventricular Tachycardia: New Anatomical Implications for Mapping and Ablation

Trapezius fasciocutaneous flap for burn reconstruction.

This case involves a 30-year-old female who suffered extensive facial burns as an outcome of a horrific assault. The patient subsequently underwent 2 surgeries with the ultimate goal of reducing the cosmetic, physical, and thus mental burden the assault caused. The technique of choice was the novel trapezius fasciocutaneous flap for burn reconstruction of the neck. It is discussed that while this technique is still deemed a novel procedure, its unique characteristics make it an excellent choice for cases similar to this one. While this approach has not been widely popularized in the treatment of patients with burn contracture requiring reconstruction, the donor site characteristics and ideal functionality make the trapezius fasciocutaneous flap such an excellent choice. This particular type of graft yields a hidden donor site, contains rich vascularity with physical qualities similar to those of facial skin, specifically in regard to thickness, color, and texture, and ultimately produces the most ideal cometic outcome. Further, the wide arc of rotation unique to this flap allows for better manipulation and mobility at the transplanted location. While the anatomic implications are very relevant to head and neck surgery, this method also produces exemplary cosmetic outcomes when compared to other graft procedures.

The Role of Educational Technology in Face-to-Face and online Anatomy and Physiology Classrooms in Higher Education: A Review of Some Recent Literature

Many anatomy and physiology instructors use some form of technology in both face-to-face and online classes. This article reviews recent literature and surveys strategies for implementing educational technology in both face-to-face and online classrooms. The article concludes with implications for anatomy and physiology instructors and educational technology leaders to help support anatomy physiology instructors.

Maxillary Third Molar Tooth Accidentally Displaced in Buccal Space: Report of Two Cases.

The extraction of retained and completely impacted third molars is one of the most common surgical procedures performed by dental practitioners with low rates of complications. The accidental displacement during the surgeries of the maxillary third molar into adjacent anatomical spaces is one of the most critical problems that can arise. The most common sites of migration during surgical interventions are the infratemporal fossa, the pterygomandibular space, the maxillary sinus, the buccal space, and the lateral pharyngeal space. In this paper, two cases in which a maxillary third molar accidentally was displaced into the buccal space are presented, the retrieval of the tooth via intra-oral approach is explained, and the anatomical spaces implications are discussed.

Laparoscopic cholecystectomy for left-sided gallbladder.

Left-sided gallbladder (LSGB) is a rare congenital anomaly in the gallbladder, which is defined as a gallbladder located on the left side of the falciform ligament without situs inversus. We retrospectively analyzed 13 patients diagnosed with LSGB in a single center to confirm the safety of laparoscopic cholecystectomy (LC) and reviewed the anatomical implications in those patients. Of the 4910 patients who underwent LC for the treatment of gallbladder disease between August 2007 and December 2019, 13 (0.26%) were diagnosed as having LSGB. We retrospectively analyzed these 13 patients for general characteristics, perioperative outcomes, and other variations through the perioperative imaging workups. All patients underwent LC for gallbladder disease. In all cases, the gallbladder was located on the left side of the falciform ligament. The operation was successfully performed with standard four-trocar technique, confirming "critical view of safety (CVS)" as usual without two cases (15.4%). In one case, which had an intraoperative complication and needed choledochojejunostomy because of common bile duct injury, there was an associated variation with early common bile duct bifurcation. The other patient underwent an open conversion technique because of severe fibrosis in the Calot's triangle. Furthermore, on postoperative computed tomography, abnormal intrahepatic portal venous branching was found in all cases. Although LSGB is usually encountered by chance during surgery, it can be successfully managed through LC with CVS. However, surgeons who find LSGB have to make efforts to be aware of the high risk of bile duct injury and possibility of associated anomalies.

A simple coronary blood flow model to study the collateral flow index.

In this work, we present a novel modeling framework to investigate the effects of collateral circulation into the coronary blood flow physiology. A prototypical model of the coronary tree, integrated with the concept of Collateral Flow Index (CFI), is employed to gain insight about the role of model parameters associated with the collateral circuitry, which results in physically-realizable solutions for specific CFI data. Then, we discuss the mathematical feasibility of pressure-derived CFI, anatomical implications and practical considerations involving the estimation of model parameters in collateral connections. A sensitivity analysis is carried out, and the investigation of the impact of the collateral circulation on FFR values is also addressed.

Morphological and morphometric analysis of adductor tubercle of femur and its anatomical and clinical implications

Morphological and morphometric analysis of adductor tubercle of femur and its anatomical and clinical implications