Arteria Brachialis Research Articles

A macroscopic comparison study on main branches of arteria brachialis and arteria subscapularis in Southern Karaman and Hasak sheep breeds.

The Southern Karaman sheep, which is very fertile in terms of meat and milk production and is often preferred in livestock raising, is known as a domestic sheep breed. The Hasak sheep is a breed formed by the triple crossbreeding of the German Black-headed, Hampshire and Akkaraman breeds. Arterial feeding of the forelimb is provided by arteria axillaris, a continuation of arteria subclavia. In this study, it was aimed to examine the forelimb arteries in Southern Karaman and Hasak sheep breeds. Totally, 8 Southern Karaman and 8 Hasak sheep were obtained from Konya Bahri Dagdas International Agricultural Institute. The sheep were anesthetised with xylazine and ketamine and extravasated by cutting the arteria carotis communis in the neck area of the sheep. The forelimbs of the sheep separated from the body were fixed in 10% formaldehyde solution and then dissections were made and the course and branching of the arteries were examined. It was determined that the arteria brachialis was divided into two main branches as distal arteria brachialis and proximal arteria subscapularis at the articulatio humeri level of the arteria axillary. Arteria mediana, which is a continuation of arteria brachialis, was also examined in different parts of antebrachium and ended by splitting into branches. According to the findings of the Southern Karaman and Hasak sheep breeds, it was determined that the forelimb arteries had some anatomical differences but were similar in structure to many sheep breeds.

P1333PULSE WAVE ANALYSIS UNDER THE CONDITIONS OF HIGH ARTERIAL FLOW: ASSESSMENT OF SHUNT FUNCTION AND REACTIVE HYPEREMIA

Abstract Background and Aims Fistula-creation as well as reactive hyperaemia increase local arterial blood flow. We wanted to analyse the impact of these haemodynamic changes on pulse wave (PW) morphology to assess fistula- and endothelial function. Method We conducted a clinical pilot study including 56 patients with functioning forearm fistula. PW morphology in the A. brachialis was assessed tonometrically at the non-fistula and fistula arm using the SpygmoCor® device. We also performed a PW analysis on the non-fistula arm under the condition of reactive hyperaemia (possible in 43 patients). Duplex-sonography was used as a complementary and reference method. Results In comparison to measurements under physiologic conditions, both the fistula arm (a) and the non-fistula arm with reactive hyperemia (b) showed marked differences in the pulse wave morphology (figure). The changes in PW morphology were most prominent in the area of the diacrotic notch and could be assessed as the differences of the sum of the mean slope (Δλ in mmHg/ms) between the diacrotic notch and the main preceding and subsequent inflexion point. Measurement with duplex-sonography confirmed increased peak blood flow velocity in the arteria brachialis (ΔVmax in cm/s) under both conditions. Statistical significance could be proved for Δλ and for ΔVmax (table). Finally, bivariate regression analysis revealed a correlation of Δλ with ΔVmax (figure; c: p=0.001 and r=-0,483 for interarm-differences of the fistula and non-fistula arm; d: p= 0.030 and r=-0.343 for the differences between the physiologic state and reactive hyperaemia at the non-fistula arm). Conclusion PW analysis under high flow conditions has the potential to be a new useful clinical tool in nephrology to monitor fistula- as well as endothelial function assessed by reactive hyperaemia. The findings should be verified in a trial with clinical endpoints.

Estimation of ARMA-model parameters to describe pathological conditions in cardiovascular system models

Abstract Cardiovascular diseases cause one of three deaths worldwide. Among these diseases, especially aortic aneurysms are a highly underestimated problem. There are some diagnostic methods known in the literature (transesophageal echocardiography, doppler sonography or CT/MRT), but none is suitable as an easilyavailable non-invasive screening method, which is inexpensive and independent of the medical examiner. Within this study we present a first step towards a novel screening method using artificial intelligence: The objective of this study is to simulate healthy and diseased conditions of cardiovascular blood flow by means of numerical models, using a distributed zero-dimensional lumped approach based on the Windkessel model, in order to regard pressure-pressure transfer functions between two systemic measurement locations. The coefficients of the transfer function were estimated by an AutoRegressive-MovingAverage (ARMA)-model. The numerical estimation of the ARMA-coefficients ( a k , b k ) of order l = 45 was performed via a Subspace Gauss-Newton search method. The ARMA-coefficients were estimated using artificial zero-mean signals from the arteria brachialis and femoralis in four cases: Besides the control group, the estimations were performed on signals of two aneurysms located in the thoracic (TAA1 and TAA2) and one in the abdominal aorta (AAA). Finally, we quantified the difference between the estimated coefficients in each pathological case, using a distance measure based on the mean and the standard deviation. The largest deviation between the pathological conditions and the control group was found for the coefficients a 2 , a 3 , a 4 and a 7 . The findings suggest a reasonable situation to distinguish the pathological state of the four underlying pathological cases from the estimated coefficients; therefore we propose to diagnose the pathological states from the control group using a classification algorithm.

Individual variations in platelet reactivity towards ADP, epinephrine, collagen and nitric oxide, and the association to arterial function in young, healthy adults

IntroductionPlatelet aggregation and secretion can be induced by a large number of endogenous activators, such as collagen, adenosine diphosphate (ADP) and epinephrine. Conversely, the blood vessel endothelium constitutively release platelet inhibitors including nitric oxide (NO) and prostacyclin. NO and prostacyclin are also well-known vasodilators and contribute to alterations in local blood flow and systemic blood pressure. Materials and methodsIn this study we investigated individual variations in platelet reactivity and arterial functions including blood pressure and flow-mediated vasodilation (FMD) in 43 young, healthy individuals participating in the Lifestyle, Biomarkers and Atherosclerosis (LBA) study. Platelet aggregation and dense granule secretion were measured simultaneously by light transmission and luminescence. FMD was measured with ultrasound. ResultsThe platelet function assay showed inter-individual differences in platelet reactivity. Specifically, a sub-group of individuals had platelets with an increased response to low concentrations of ADP and epinephrine, but not collagen. When the NO-donor S-nitroso-N-acetyl-DL-penicillamine (SNAP) was combined with high doses of these platelet activators, the results indicated for sub-groups of NO-sensitive and NO-insensitive platelets. The individuals with NO-sensitive platelets in response to SNAP in combination with collagen had a higher capacity of FMD of the arteria brachialis. ConclusionsPlatelet reactivity towards ADP, epinephrine and NO differs between young, healthy individuals. Some individuals have a more effective response towards NO, both in the aspect of platelet inhibition ex vivo, as well as vasodilation in vivo.

The Vascular Arrangement and Main Branches of Arteria Axillaris in Wing of Sparrowhawk (Accipiter nisus)

This study was aimed to determine the vascular arrangement of the wing arteries in the sparrowhawk. For this purpose, wing arteries of eight sparrowhawks were assessed by latex injection method and angiography. Latex injection method was applying to the five materials and barium sulphate solution was injected for angiography in other three materials. It was observed that the arterial blood was mainly provided to the wing by arteria axillaris. The arteria axillaris gave off arteria subscapularis. After branching the arteria subscapularis, it emitted the arteria profunda brachii and arteria supracoracoidea. After ramifying these vessel, the arteria axillaris continued down arteria brachialis. This vessel was giving off the arteria circumflexa humeri from its cranial aspect. In the nearby the cubital fossa the arteria brachialis bifurcated arteria ulnaris and arteria radialis. The arteria ulnaris gave off common stem of arteria recurrens ulnaris et arteria ulnaris profunda. After branching the common stem, the arteria ulnaris proceeded as arteria ulnaris superficialis. The arteria radialis was the deep terminate branch of the arteria brachialis. This vessel bifurcated the arteria radialis profunda and arteria radialis superficialis.

Chronic hematoma on the forearm mimicking soft tissue sarcoma

Chronically expanding hematoma is a rare entity, characterized by its persistence and increasing size. Chronic hematoma may be misdiagnosed as a soft tissue neoplasm due to its large size and slow progression and enlargement. A 77-year-old man presented with a large, protuberant mass in the anterior left forearm. There was no clear history of trauma, bleeding disorder, or coumadin or anti-platelet medication. This case had initially been considered to be a soft tissue sarcoma, determined by means of clinical and radiological examinations. An incisional biopsy was found to be insufficient for a histopathological diagnosis. Hematoma was also found taking over the arteria brachialis, so it was excised with arterial resection. In order to rescue the circulation of the hand, an anastomosis was performed between the brachial and radial arteries with a graft from the saphenous vein. To differentiate the diagnosis of expanding hematoma from sarcoma can be very difficult, either clinically or radiologically. Incisional biopsies taken from the necrotic tissues or hemartoma do not always reveal tumoral cells. In order to attain a correct diagnosis, a surgical procedure should be performed in an operating room under the supervision of an anesthesiologist.

Vascular patterns of upper limb: an anatomical study with accent on superficial brachial artery

The aim of the study was to evaluate the terminal segmentation of the axillary artery and to present four cases of anomalous branching of the axillary artery, the superficial brachial artery (arteria brachialis superficialis), which is defined as the brachial artery that runs superficially to the median nerve. Totally, 130 cadaveric upper arms embalmed by classical formaldehyde technique from collections of the Department of Anatomy, Third Faculty of Medicine, Charles University in Prague, were macroscopically dissected with special focus on the branching arrangement of the axillary artery. The most distal part of the axillary artery (infrapectoral part) terminated in four cases as a bifurcation into two terminal branches: the superficial brachial artery and profunda brachii artery, denominated according to their relation to the median nerve. The profunda brachii artery primarily gave rise to the main branches of the infrapectoral part of the axillary artery. The superficial brachial artery descended to the cubital fossa where it assumed the usual course of the brachial artery in two cases and in the other two cases its branches (the radial and ulnar arteries) passed superficially to the flexors. The incidence of the superficial brachial artery in our study was 5% of cases.The reported incidence is a bit contradictory, from 0.12% to 25% of cases. The anatomical knowledge of the axillary region is of crucial importance for neurosurgeons and specialists using the radiodiagnostic techniques, particularly in cases involving traumatic injuries. The improved knowledge would allow more accurate diagnostic interpretations and surgical treatment.

Accessory brachial artery: a case report, embryological background and clinical relevance

Abstract Background: The accessory brachial artery (arteria brachialis accessoria) is a rare upper limb vascular abnormality, reported in less than one percent of cases. It is the artery originating from the axillary artery or the brachial artery, which rejoins the brachial artery further along its distal course within the arm or cubital fossa. Its detailed knowledge is necessary in transradial transulnar catheterization during coronary procedures, mainly due to its narrow caliber, which is responsible for the failure of the intervention performance. Objectives: Present a case of uncharacteristic branching pattern of the accessory brachial artery. Method: The case was observed during a routine dissection in the left axilla of a female cadaver at the Department of Anatomy at the Third Faculty of Medicine, Charles University in Prague. Results: The infrapectoral part of the axillary artery gave rise to a branch that descended distally along the medial side of the arm. This artery accompanied firstly the ulnar nerve, then it diverted laterally towards the median nerve and coursed hidden behind it to re-enter the brachial artery within the distal part of the arm, next to the biceps brachii muscle. The calibre of the accessory brachial artery was two mm only. Conclusion: The accessory brachial artery is a rare variant of the upper limb vascular system and its prevailingly narrow lumen can cause a failure of the transradial/transulnar catheterization intervention.

Correlation between postischemic vasodilation of the arteria brachialis and of the postischemic hyperemia in the adjacent microvascular bed

Endothelial cells secrete different mediators depending on biochemical and/or biophysical conditions, which can lead to vasodilation or vasoconstriction, respectively. Impaired endothelial responsiveness to specific vasodilator stimuli has been used as a surrogate marker of cardiovascular risk. Multiple methods allow testing endothelial responses in both microvessels and conduit arteries, but it is still unclear whether there is a relationship in endothelial function between these two different vascular beds. In order to examine, whether such macrocirculatory data might correlate with data obtained in the supplied microvessels, a parallel investigation in the brachial artery (BA) and the supplied nailfold capillaries was performed. The duration and amplitude of the postischemic hyperemia (stasis in the vasculature of the left arm using a blood pressure cuff for 3 minutes) were measured (ultrasound technique) and simultaneously the amplitude and duration of the postischemic hyperemia in ipsilateral nailfold capillaries (intravital capillaroscopy). There was absolutely no correlation between the duration (n = 153, r = 0.076, p = 0.3493) of the diameter increase in the BA and in ipsilateral nailfold capillaries. The regulation of the cutaneous microcirculation did not follow diameter changes of the conduit artery (BA) but seems to be dominated by the precapillary arterioles.

Rare variant of the brachial artery: superficial lateral inferior type VII EAB.

This study concerns a variant of the brachial artery with a modified origin and course. The artery was studied in 418 upper limbs removed from cadavers. In one upper limb the left brachial artery bifurcated into: (1) a superficial brachial a. (the variant) crossing superficially to the bicipital aponeurosis in the cubital region and assuming the course, position, and supply area of the radial artery, and (2) the deep brachial a. (another variant). An embryologic interpretation of this anomaly is based on a variant vascular development derived from the eighth intersegmental artery. The variant is termed according to Adachi's classification schedule as arteria brachialis superficialis lateralis inferior Type VII with the addition EAB (epiaponeurosis bicipitalis, i.e., superficial to the bicipital aponeurosis). Accurate information concerning unusual patterns of the arteries in the upper limbs is clinically relevant, especially in the avoidance of accidental intra-arterial injection with reflectory vascular occlusion leading to necrosis.

上腕動脈カフ自動血圧測定における腕の太さおよび利き腕の影響について

上腕動脈カフ自動血圧測定における腕の太さおよび利き腕の影響について

Indirect blood pressure measurement with a two-probe-ultrasound system (author's transl)

A two-probe-ultrasound system is described as an example of the indirect measurement of blood pressure. Possible errors of the indirect method as well as attempts of improvement are shown. To receive a separate detection of the systolic, respectively the diastolic pressure, one probe of the two-probe system is fixed to the arteria radialis, the other to the arteria brachialis. The determination of the "Nulkriterium" (coincidence of the pneumatic cuff pressure and the arterial pressure) can be performed either by the investigator or automatically. The measuring systems shows the following advantages: 1. Use of a more reliable "Nulkriterium" (measurement of hypotonic blood pressure values which could no longer be measured by means of the Riva-Rocci/Korotkoff-procedure; no auscultatoric gap appeared at about 20 000 single measurements). 2. No falsification of systolic values by suprasystolic noises (two-probe principle; measurement of the systolic blood pressure by means of a probe outside the region of the pneumatic cuff). 3. Errors which come up by the expectation of the investigator or by the reading of the manometer can be avoided dependent on the mode of the system. The automatic measurement (dynamical compression, selection of frequencies, electronic threshold, delayed ECG coincidence) led to no satisfactory results, especially referring to the diastolic values. Principle criteria, however, come up which should be fulfilled with the construction of an automatic system of indirect blood pressure measurement. A better automatic measurement may be expected, if instead of the "threshold principle" used here a signal analysis is performed by microprocessors. The example of an intraarterial measurement of blood pressure demonstrates the phenomenon of a "mock auscultatoric gap" because of the spontaneous variability of the arterial pressure decreasing for a short time faster than the pneumatic cuff pressure.

Application of Covariance Analysis to Ophtalmologic Research

AbstractUsing covariance analysis as an adjusted regression analysis it is possible, with the assumption of homogeneity and normality of variance, to test several regression functions for homogeneity, if the given groups of data material are independent.This well‐known analysis is applied to a number of examination methods of ophthalmology. In the cases of ophthalmo‐dynamography (ODG) and ophthalmo‐dynamometry (ODM), the paper answers the question to what extent the result of ophthalmologic measurement is influenced by posture (sitting — lying — standing).Contrary to several authors' practice of combining the regression lines for the systolic and diastolic blood‐pressure because of the improvement of the correlation coefficient to be achieved in this way, it was possible to show that generally such an approach is not recommendable.Patients suffering from a certain type of arteriosclerosis distinguish themselves by deviations of their ODG data from the normal blood‐pressure relation of the arteria carotis interna and the arteria brachialis. These differences can be tested for statistical significance by means of covariance analysis.