Arterial Variations Research Articles

Ophthalmic artery originating from anterior inferior cerebellar artery: a rare variation.

The variations of origin of ophthalmic artery are extremely rare. Here, we aimed to present a patient had a rare variation of the ophthalmic artery. The patient had a history of Moyamoya disease. The imaging studies revealed ophthalmic artery origination from basillar artery. In addition, M1-segment fusiform aneurysm, vasculitis and, as a variation, middle meningeal artery originating from the ophthalmic artery were also detected. We presented this case report as it is the first case with ophthalmic artery originating from anterior inferior cerebellar artery. In our case we reported, M1 segment fusiform aneurysm, vasculitis, and as a variation, middle meningeal artery originating from the ophthalmic artery and anterior inferior cerebellar artery as ophthalmic artery origin and hereby present it for inclusion into the literature. Ophthalmic artery anatomical abnormalities occupies so little place in existing literature when nominating rare variations. Ophtalmic artery originating from anterior inferior cerebellar artery firstly defined as an ophthalmic artery variation including its way-out branch structures.

ANATOMIC PATTERNS OF DISTRIBUTION OF THE RENAL ARTERIES' ORIGIN FROM THE AORTA

To characterize the variation of the renal arteries' origin from the aorta, through examination of computed-tomography angiographies (CTA) in a cohort of patients, and to evaluate any gender-related difference. CTA of the thoraco-abdominal district in patients with a non-dilated aorta (group A), patients with aortic aneurysm involving the origin of splanchnic and/or renal vessels (group B), and patients with abdominal aortic aneurysm (group C), were retrospectively analyzed. The diameter and angles of emergence (axial and cranio-caudals) of the renal arteries were measured, as well as their mutual distance, and the distance between the renal vessels and the superior mesenteric artery/the aortic bifurcation. Shapiro-Wilk, one-way ANOVA and bivariate Pearson's Correlation tests were performed as appropriate. A p-value <0.05 was considered statistically significant. Six-hundred CTA of patients (452 males) were examined, being 286 in group A, 119 in group B, and 195 in group C. When examining the whole population and also the subgroup of female patients, the clock position of the right renal artery (RRA) was the only parameter that followed a Gaussian distribution, and its ostium raised from the aorta with a mean axial angle of -61.5°+16.6°. There was a negative correlation between left renal artery (LRA) and RRA's coronal angle and aortic diameter at the same level, as well as between the LRA's clock position and the aortic diameter at the same level. The longitudinal distances between established landmarks and both renal arteries positively correlated to the aortic diameter. The LRA showed a high anatomic variability, both in males and in females. With the increase of the aortic diameters in the juxtarenal/infrarenal portion of the aorta, the renal vessels tended to have a more horizontal course in the coronal view, a more acute "clock-position" and longer longitudinal distances between their ostia and the aortic bifurcation.

Distribution of the Middle Meningeal Artery Variants in Patients Undergoing Embolization for Chronic Subdural Hematoma

The middle meningeal artery (MMA) is a major dural vessel that plays a significant role in developing chronic subdural hematomas (cSDH). Understanding its variable anatomy is essential for the effective management of cSDH and the prevention of complications. Middle meningeal artery anatomy was retrospectively assessed in a population of 92 patients who underwent digital subtraction angiography of cerebral vessels before middle meningeal artery embolization for chronic subdural hematoma. We assessed 121 middle meningeal arteries in 92 patients who underwent digital subtraction angiography for chronic subdural hematoma treatment from October 2020 to July 2023. The most common type in the extended Adachi classification was IC (19.82%) and the rarest was IB (6.31%). The anterior branch of the MMA was the most frequently dominant, while the most common origin of the posterior branch was observed in the distal segment. We reported 4 cases (3.31%) of the MMA arising from the ophthalmic artery. The most common configuration of MMA was Adachi-type IC. The MMA most often originated from the maxillary artery. The anterior branch of the MMA was typically dominant, and the posterior branch most frequently originated from the distal segment. There was no significant impact of Adachi type on treatment results or fluoroscopy time.

Features of vascular anatomy in pancreaticoduodenal resection

In about 55–79% of patients, the vascular anatomy of the hepatic-pancreaticoduodenal area is characterized by a typical structure. In the rest of patients, the vascular and, primarily, arterial anatomy may vary due to both different variants of branches and additional arteries. Undoubtedly, this creates difficulties in surgical planning and performing pancreaticoduodenal resection. Vascular anatomic variations may contribute to increased intraoperative blood loss, postoperative complications, changes in the course and volume of surgery, and increased duration of hospital stay after surgery. Modern diagnostic methods, CT angiography in particular, facilitate the process of surgical planning and reduce the risk of unforeseen situations related to ligation or damage of arterial vessels, which are to be preserved during operations. In this work, we carry out a review of publications on the topography of arterial vessels in the area of pancreaticoduodenal resection. The issues related to anatomical variations in both trunk and pancreatic vessels are considered. Special attention is paid to the possible influence of variations in the vascular network structure on the course and volume of surgery, as well as the risk of intraoperative and postoperative complications.

A very rare variant of single coronary artery.

A very rare variant of single coronary artery.

Double Anterior Interventricular Arteries: Prevalence and Morphological Types-A Dissection Study.

This study aimed to evaluate the prevalence of double anterior interventricular artery using the dissection method. A retrospective study was conducted between 2010 and 2024 at the Anatomy and Embryology Laboratory of the Victor Babes University of Medicine and Pharmacy in Timisoara. Eighty cases were analyzed for morphological variants of the coronary arteries, especially the anterior interventricular artery. Two cases of double anterior interventricular arteries were identified. In the first case, the two anterior interventricular arteries originated from the anterior interventricular branch of the left coronary artery. In the second case, an additional anterior interventricular artery with an aortic origin was found running along the lower third of the two interventricular grooves. This shape has not been described before in the specialized literature. Knowing the potential variations of the double left anterior descending artery is critical for interpreting cardiac imaging and choosing and planning percutaneous and surgical reperfusion strategies.

Persistent Sciatic Artery Aneurysm With Distal Embolization Treated Endovascular - A Case Report.

Persistent sciatic artery (PSA) is a rare embryologic remnant of the internal iliac artery variant with an estimated incidence of 0.03-0.06 %. Aneurysmatic formation can give rise to neurological sciatic nerve compression symptoms or thromboembolic and ischemic symptoms. The present is a case with recurrent thromboembolic symptoms and PSA aneurysm, successfully treated endovascularly.

Noninvasive visualization of the midline-crossing arterial variation in the deep inferior epigastric artery perforator flap using photoacoustic tomography for application in patients with abdominal scars

BackgroundThe importance of the subcutaneous arterial network crossing the midline in transverse abdominal flaps has been reported. Photoacoustic tomography can be used to noninvasively visualize subcutaneous vascular networks. We applied this novel technology preoperatively in patients undergoing breast reconstruction to detect individual variations in the midline-crossing arteries. MethodsSix patients scheduled to undergo breast reconstruction using free deep inferior epigastric artery perforator flaps were examined. Each scan of the 12×8-cm region took approximately 8min. The accuracy of the tentative arteries evaluation defined by photoacoustic tomography was compared with the arterial phase detected by intraoperative indocyanine green angiography. The number of perforator vessels used for the flap, surgical time for flap elevation, and perfusion area ratio were compared with those of the control group. ResultsThe average match rate between tentative arteries prediction by photoacoustic tomography and arterial-phase assessment by intraoperative angiography in 5 patients was 79.8%. Each midline crossing artery showed individual variations. The photoacoustic tomography group (PAT-1 to 5) showed 1.8 perforators per flap, 163minutes for flap elevation, and 93% perfusion area, with no significant differences from the control group (N=5). A 63-year-old woman (PAT-6) with abdominal scars, including a midline abdominal incision, showed a preserved midline crossing artery. The planned single perforator deep inferior epigastric perforator flap was successfully applied to the contralateral perfusion area. ConclusionsPhotoacoustic tomography noninvasively visualizes the subcutaneous midline-crossing arterial networks. Understanding individual vascular variations can support preoperative planning and surgical indication of abdominal flaps, especially in patients with postsurgical scars.

Assessment of Brachial Artery Dimensions and Variations: A Comprehensive Study

Assessment of Brachial Artery Dimensions and Variations: A Comprehensive Study

Coma Due to Artery of Percheron Infarction: An Unusual Case Report

Ischemic stroke attributable to obstruction of the artery of Percheron (AOP), an infrequent anatomical arterial variant perfusing both medial thalami, can pose difficult diagnostic challenges. Obstruction or occlusion of the AOP results in bilateral paramedian thalamic infarction which is an unusual and rare vascular cause of coma. We present a 65-year-old male patient who came to the emergency department with altered sensorium for 10 days. The initial computed tomography (CT) brain was normal, followed by subsequent CT revealing an ill-defined hypodensity in the ventromedial aspect of the left thalamus and ventral aspect of the midbrain. T2/fluid-attenuated inversion recovery magnetic resonance imaging illustrated hyperintensity in the mesencephalon and bilateral paramedian thalami with restricted diffusion, suggesting an AOP infarct.

301.1: Are the classifications used to determine hepatic artery variations in liver donors sufficient?

301.1: Are the classifications used to determine hepatic artery variations in liver donors sufficient?

Renal artery variations with clinical significance: Multiple renal arteries and their coexistent anatomical abnormalities: A cadaveric study

ÖZET Amaç: Bu kadavra çalışmasının amacı multipl renal arterleri tanımlamak ve aynı zamanda diğer anatomik anormallikler ile birlikteliğini değerlendirmekti. Birden fazla arteria renalis’in bulunmasının olası klinik sonuçları analiz edildi. Materyal ve Metodlar: Bu çalışma, Albert Einstein College of Medicine C&amp;DA Anabilim Dalı’na bağışlanan 20 Amerikan formalin fikse kadavradan [12 erkek, 8 kadın, yaşları 50-96] Aorta Abdominalis (AA)’e ulaşılarak gerçekleştirildi. Supin pozisyondaki kadavralardan Arteria renalis’in sağ ve sol tarafta Aorta abdominalis’ten dallanma noktaları, birden fazla sayıda olup olmadıkları kontrol edildi. Arteria renalis(sol taraf), Truıncus coeliacus, arteria(a.) mesenterica superior, a. mesenterica inferior, bifurcatio aorta arasındaki mesafeler, lineer, longitudinal ve transvers olmak üzere 3 şekilde ölçüldü. Elde edilen sonuçlar oranlanarak, lieratürdeki önceki çalışmalarla kıyaslanarak değerlendirildi. Bulgular: Çalışmaya alınan 20 kadavradan iki erkek cinsiyette, ikiside hiler arter olmak üzere sağ tarafta iki adet renal arter olduğu tespit edildi. Multiple renal arterlere, splenomagali, abdominal aorta da ondülan seyir, 3. Lumbal vertebra seviyesinde columna vertebralis’te deviasyon olduğu gözlendi. Hastaların %94,7'si normal renal arter anatomisine sahipti. Ana renal arterlerin ve ARA'nın en sık Aorta abdominalis’ten dallanıyordu. Sonuç: Arteria renalis ile ilişkili ve komşuluğundaki Anatomik bölgedeki cerrahi veya radyolojik işlemler öncesinde bölge Anatomisindeki olası arteria renalis varyasyonlarının bilinmesi cerrahi veya girişimsel işlemler sırasındaki mortalite ve morbiditeyi azaltmakta çok önemlidir. Renal transplantasyon ve Hepatorenal cerrahi, girişimsel radyoloji, nefroloji başta olmak üzere A.(arteria) renalis anatomisinin bilinerek, radyolojik olarak değerlendirilmesi, hipertansiyon, hedef organ hasarı gibi pek çok kliniğin önlenmesi ve tedavisine kılavuz olacaktır. Anahtar kelimeler: Aksesuar renal arter, multipl renal arter, a. renalis varyasyonları

Pathogenesis and Surgical Treatment of Dextro-Transposition of the Great Arteries (D-TGA): Part II.

Dextro-transposition of the great arteries (D-TGA) is the second most common cyanotic heart disease, accounting for 5-7% of all congenital heart defects (CHDs). It is characterized by ventriculoarterial (VA) connection discordance, atrioventricular (AV) concordance, and a parallel relationship with D-TGA. As a result, the pulmonary and systemic circulations are separated [the morphological right ventricle (RV) is connected to the aorta and the morphological left ventricle (LV) is connected to the pulmonary artery]. This anomaly is included in the group of developmental disorders of embryonic heart conotruncal irregularities, and their pathogenesis is multifactorial. The anomaly's development is influenced by genetic, epigenetic, and environmental factors. It can occur either as an isolated anomaly, or in association with other cardiac defects. The typical concomitant cardiac anomalies that may occur in patients with D-TGA include ventriculoseptal defects, patent ductus arteriosus, left ventricular outflow tract obstruction (LVOTO), mitral and tricuspid valve abnormalities, and coronary artery variations. Correction of the defect during infancy is the preferred treatment for D-TGA. Balloon atrial septostomy (BAS) is necessary prior to the operation. The recommended surgical correction methods include arterial switch operation (ASO) and atrial switch operation (AtrSR), as well as the Rastelli and Nikaidoh procedures. The most common postoperative complications include coronary artery stenosis, neoaortic root dilation, neoaortic insufficiency and neopulmonic stenosis, right ventricular (RV) outflow tract obstruction (RVOTO), left ventricular (LV) dysfunction, arrhythmias, and heart failure. Early diagnosis and treatment of D-TGA is paramount to the prognosis of the patient. Improved surgical techniques have made it possible for patients with D-TGA to survive into adulthood.

Unusual Multiple and Bilateral Combinations of Arterial and Neural Variations in the Axillae of Single Cadaver

Nerve During the dissection of the axillae and upper limbs of an 80-year-old male donor, multiple vascular and neural variations were encountered. On the right side, the thoracoacromial artery and the lateral thoracic artery were absent. On the left side the subscapular artery was absent, and the posterior cord of the brachial plexus gave branch to two upper subscapular nerves and then divided into radial nerve and a common stem that branched into thoracodorsal nerve, lower subscapular nerve, nerves to teres major and minor muscles and the axillary nerve. Additionally, in the left arm there was a variant communication between the musculocutaneous nerve and the median nerve. Although the existence of these variations is well documented in the literature as individual entities or few combinations, the occurrence of such multiple variations in a single cadaver in a limited area of the body involving vessel and nerves is not common. A multitude of variations in a small area of the body such as this can be a source of diagnostic and imaging interpretation errors. Unpredictable iatrogenic injuries can also occur during various procedures in the area such as during preparation of muscle flap, mastectomy with axillary lymph node dissection, reconstructive and aesthetic plastic surgery of the breast and other clinical procedures including shoulder arthroplasty.

Hyperplastic Variant of Anterior Choroidal Artery with Saltzman IIIc Type Persistent Trigeminal Artery Variant

Hyperplastic Variant of Anterior Choroidal Artery with Saltzman IIIc Type Persistent Trigeminal Artery Variant

Acute effects of static stretching exercise-induced decrease in arterial stiffness on maximal aerobic capacity.

We recently have reported that individual day-to-day arterial stiffness variations are associated with maximal aerobic capacity. However, the evidence of this phenomenon was not provided sufficiently. The present study aimed to examine whether a decrease in arterial stiffness through static stretching exercise could enhance maximal aerobic capacity. Twelve healthy young men (age 22±2 years, mean and standard deviation) participated in this study and underwent two separate sessions in a randomized controlled crossover design: a single session of a whole-body static stretching exercise protocol that involved the trunk, upper limb, and lower limb (stretch condition), and sedentary control where they rested in the exercise room. Brachial-ankle pulse wave velocity (baPWV) was measured as an index of systemic arterial stiffness before, immediately after and at 30 min after both conditions. Maximal oxygen uptake (V̇O<inf>2</inf>max) was assessed using a graded power test on an electronically braked cycle ergometer after these measurements. As we expected, there was a significant decrease in the baPWV at 30 min after the stretch trial compared to baseline values (P=0.01). The baPWV in the stretch condition was lower than that of the control condition, while V̇O<inf>2</inf>max in the stretch condition was higher than that of the control condition (P=0.03). Based on these findings, it can be inferred that an acute reduction in arterial stiffness may contribute to change in maximal aerobic capacity.

A Computed Tomography (CT)-Based Observational Study of Anatomical Variations in the Sphenoid Sinus: Implications for Surgical Planning and Patient Outcomes.

The sphenoid sinus (SS), a paired paranasal sinus located within the sphenoid bone, is crucial in various physiological and pathological processes. Its anatomical variations are of significant interest in clinical practice, particularly in otolaryngology, neurosurgery, and radiology. This study aims to determine the anatomical variations of the SS and related structures using computed tomography (CT). An observational study was conducted at a tertiary care center. The study included 300 patients aged 7-70 who underwent CT brain scans. Exclusions included prior sinonasal surgeries, tumors, nasal polyposis, recurrent pituitary lesions, head trauma, and past orbital or cranial surgeries.Three-dimensional reconstructions assessed SS dimensions, pneumatization types, and variations in the internal carotid artery and optic nerve. A study on the types of SSs revealed that the reseller type is the most common, accounting for 45% of cases (135 instances). The sellar type accounts for 36% (110 instances), while the conchal type is the least common, observed in 18.33% of cases (55 instances). A significant association between the SS type and variations between neurovascular structures was seen, which was confirmed using chi-square tests. There was a statistically significant relationship between carotid artery variations and SS,with the normal course being predominant at 200individuals (73.33%). Approximately 40 cases(13.33%) present with dehiscence through the sinus, while 30 individuals (10%) show close proximity. Other, less common variations are observed in 10 patients (3.33%). Optic nerve variationsdisplayed distinct frequencies, with the normal course prevailing in 250 cases (83.33%). Approximately 30cases (10%) exhibit close proximity to surrounding structures, while 15 cases (5%) present with dehiscence through the sinus. Other less common optic nerve variations are observed in five patients (1.67%). Comprehensive knowledge of SS anatomy through CT scans is essential for enhancing surgical outcomes and ensuring patient safety.

The Arterial Anatomy of the Cerebellum-A Comprehensive Review.

The cerebellum, a major feature of the hindbrain, lies posterior to the pons and medulla and inferior to the posterior part of the cerebrum. It lies beneath the tentorium cerebelli in the posterior cranial fossa and consists of two lateral hemispheres connected by the vermis. The cerebellum is primarily supplied by three arteries originating from the vertebrobasilar system: the superior cerebellar artery (SCA), the anterior inferior cerebellar artery (AICA), and the posterior inferior cerebellar artery (PICA). However, variations of the cerebellar arteries may occur, such as duplication of the SCA, SCA creating a common trunk with the posterior cerebral artery, triplication of the AICA, and agenesis of PICA, amongst others. Knowledge of the arterial anatomy of the cerebellum is crucial, as inadequate blood supply to this region can result in diminished motor functioning, significantly impacting the quality of life for patients. The present study demonstrated the importance of adequate anatomical knowledge of the arteries supplying the cerebellum. The PubMed and Embase databases were searched to gather articles on the anatomical characteristics and variations of the arterial supply of the cerebellum. It is the most comprehensive and up-to-date review available in the literature. The possible variations of these vessels may be clinically silent or present with clinical symptoms such as neurovascular compression syndromes of the cranial nerves and aneurysms. With a comprehensive understanding of the cerebellar arterial system, physicians can enhance their diagnostic and treatment capabilities, ultimately leading to more effective management of cerebellar vascular-related issues and other neurological deficits.

The diagnostic and therapeutic challenges in identifying rare pulmonary arterial hypertension variant associated with portal hypertension and multiple abdominal vascular malformations.

The diagnostic and therapeutic challenges in identifying rare pulmonary arterial hypertension variant associated with portal hypertension and multiple abdominal vascular malformations.

A Left Axillary Artery Variation: Case Report

Fetal abnormalities can cause axillary artery variations. Recognize and document of these variations are essential for surgeons performing interventional or diagnostic procedures for cardiovascular diseases. During routine dissection of an old female cadaver in the department of anatomy of Islamic Azad University, Tehran of Medical Sciences, we came across a variation in the branching pattern of the left axillary artery. The third part of the left axillary artery gave rise to a common trunk which was divided into the subscapular, lateral thoracic, posterior, and anterior circumflex humeral arteries.