Artery Diameter Research Articles

Evaluation of maxillary sinus pathologies and the posterior superior alveolar artery canal using cone-beam computed tomography

ObjectiveThis study aims to determine the anatomical relationship between the posterior superior alveolar artery (PSAA) and the lateral wall of the maxillary sinus during preoperative radiological evaluations in the posterior maxillary dental region, as well as to evaluate the prevalence of PSAA and its potential associations with sinus pathologies.Materials and methodsThis retrospective study is based on the analysis of Cone-Beam Computed Tomography (CBCT) data from 510 sinuses of 255 patients. The visibility of the PSAA vascular canal, artery diameters, vertical distance between the alveolar crest and the artery, and the distance to the sinus floor were measured in coronal sections. Additionally, the relationships between sinus pathologies and septa within the sinuses and the PSAA were evaluated.ResultsPSAA was detected bilaterally in the majority of patients (70.2%). Sinus pathologies and the presence of septa were also examined, revealing that 36.9% of the sinus pathologies were bilateral. Chi-square analyses showed no statistically significant relationship between gender and the presence of PSAA. Female patients had a higher incidence of sinus pathologies compared to males (p = 0.002). No significant relationship was found between the presence of PSAA and septa.ConclusionsThis study highlights the importance of considering the anatomical position and prevalence of the PSAA during preoperative radiological evaluations in the posterior maxillary region. This study identified the PSAA as predominantly located in the lateral wall of the maxillary sinus, an anatomical feature of critical importance during preoperative radiological evaluations to minimize vascular complications.Clinical trial numberNot applicable.

Relationships Between Gonadotropins, Sex Hormones, and Vascular Health in Adolescents with Normal Weight or Obesity.

Objective: Relationships between gonadotropins, sex hormones, and vascular structure and function in adolescents of varying weight statuses have not been fully investigated. In the present study, we examined associations among these in female and male adolescents with normal weight or obesity. Methods: We performed a cross-sectional analysis of adolescents (n = 58; 12-<18 years) grouped according to BMI percentile (BMI%) into normal weight (5th-<85th BMI%; n = 25) and obesity (≥95th BMI%; n = 33) categories. Fasting blood samples were collected to measure follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone, and estradiol. Vascular function was measured via ultrasonography for measures of carotid artery diameter compliance (cDC), incremental elastic modulus (cIEM), and brachial artery flow mediated dilation (FMD). Results: Females with obesity had a significantly (p = 0.009) greater mean FMD compared with those with normal weight. FSH, LH, testosterone, and estradiol did not differ between normal weight and obesity groups in either sex. After adjusting for age and multiple comparisons, higher testosterone was associated with decreased cDC (R2 = 0.189; p = 0.018) and increased cIEM (R2 = 0.346; p = 0.002) across all females. In all males, higher estradiol was associated with decreased cDC (R2 = 0.404; p = 0.006) and increased cIEM (R2 = 0.411; p = 0.003). Conclusion: We found that testosterone and estradiol were associated with vascular measures in female and male adolescents, respectively. Future studies are needed to confirm these relationships in larger cohorts and among those with BMIs in the overweight (85th-<95th BMI%) and severe obesity (BMI ≥120% of the 95th percentile and/or ≥35 kg/m2) categories.

Sex-specific ultrasound imaging biomarkers of neurodegeneration in a mouse model

IntroductionEarly detection of neurodegeneration is essential for optimizing interventions. The highly reproducible progression of neurodegeneration in the decrepit (dcr) mouse allows investigation of early biomarkers and mechanisms of brain injury.MethodsUsing high-frequency ultrasound, the common carotid arteries of female and male dcr and control mice were imaged longitudinally at time points bracketing the disease progression (50, 75, and 125 days of age) (n = 6 mice/group/sex).ResultsOver the disease time course, the female dcr mice demonstrated increased carotid artery blood flow and pulse wave velocity while the male dcr mice had a decrease in heart rate and no change in carotid artery ultrasound parameters. Early imaging biomarkers were sex-specific, with decreased carotid artery blood flow in female dcr mice and increased carotid artery diameter and decreased pulse wave velocity in males.DiscussionCarotid artery and wave reflection ultrasound is a promising screening tool for early detection of neurodegeneration.

A modified technique for radial artery access: how interventional radiologists can optimise the cardiologists’ technique to suite their procedures

BackgroundThis is a single-centre prospective observational study examining radial access in 62 Prostatic Artery Embolisation (PAE) procedures. Evaluation of left radial artery diameter using high frequency ultrasound before and after administration of sublingual glycerl trinitrate (GTN). Pre-procedure questionnaires calculating symptom severity score compared with post-procedure.ResultsSublingual GTN resulted in a statistically significant increase in radial artery diameter (p < .00001). There was a statistically significant reduction in both average International Prostate Symptom Score (IPSS) and Quality of Life (QoL) from pre-procedure to post-PAE. The radial sheath was successfully inserted in 100% of cases. Crossover rate to femoral access was low (4%). Radial artery access had a low complication rate (2%). Radial artery variant anatomy was reasonably common (7%).ConclusionsSublingual GTN significantly increase radial artery diameter. PAE from radial access is associated with a symptomatic improvement at 2-month follow-up.

Six minutes-walk test in chronic obstructive pulmonary disease patients complicated by pulmonary hypertension diagnosed by echocardiography

Background Chronic obstructive pulmonary disease (COPD) is heterogenous lung condition characterized by chronic respiratory symptoms. Aim To assess 6 minutes-walk-test in COPD patients who develop secondary pulmonary hypertension (PH) diagnosed by echocardiography. Patients and methods This comparative interventional study included 30 individuals categorized into three equal groups: group I: healthy persons (mean age 38.90±4.53), group II: COPD patients (mean age 46.40±4.65) and group III: COPD patients complicated with secondary PH (mean age 58.00±4.37). Results There was significant positive correlation between 6 min-walk distance and forced expiratory volume in one sec (FEV1) % of predicted, forced vital capacity (FVC)% of predicted, FEV1/FVC ratio, peak expiratory flow rate, Forced expiratory flow 25–75%, partial pressure of oxygen, oxygen saturation level, tricusped annular plane systolic excursion and pulmonary acceleration time. There was a significant negative correlation between 6 min-walk distance and partial pressure of carbon dioxide, bicarbonate, systolic pulmonary artery pressure, right ventricle diameter, right arterial diameter, modified Medical Research Council (mMRC) score, COPD assessment test (CAT) score, duration of disease and smoking. There was significant positive correlation between mMRC and CAT score and partial pressure of carbon dioxide, bicarbonate, systolic pulmonary artery pressure, right ventricle diameter and right arterial diameter. There was significant negative correlation between mMRC score and CAT score and FEV1, FEV1/FVC ratio, FVC, peak expiratory flow rate, Forced expiratory flow 25–75% of predicted, Partial pressure of oxygen, oxygen saturation level, tricusped annular plane systolic excursion, and pulmonary acceleration time. Conclusion PH occurrence among those having COPD is linked to a bad life quality. Six minutes-walk-test exhibits correlation with dyspnea severity among those having COPD.

Rupture prediction of medium to large-sized abdominal aortic aneurysm combining wall shear stress-related parameters and anatomical characteristics: A computational, experimental, and statistical analysis

A diameter of 50 or 55 mm is the primary clinical criterion for assessing abdominal aortic aneurysm (AAA) rupture risk. However, although larger diameters may induce higher rupture risk, not all AAAs exceeding intervention threshold will rupture, highlighting the need for indicators besides diameter to help rupture prediction and treatment of AAA ≥ 50 mm. The study aims to combine computation, experiment, and statistics to establish rupture prediction models for AAAs ≥ 50 mm and explore the optimal predictors of AAA rupture with different diameters by anatomical and hemodynamic characteristics. Through numerical simulation and in vitro experiment, morphological and hemodynamic parameters were obtained from 82 AAAs (41 ruptured) ≥ 50 mm. The results of significance test and logistic regression indicate that low time-averaged wall shear stress (TAWSS) of AAA and maximum diameter of common iliac artery, and high oscillatory shear index (OSI) of AAA, TAWSS of iliac artery and tortuosity of abdominal aorta increase rupture risk of AAA ≥ 50 mm. The prediction model combining these variables was established with high accuracy (area under curve = 0.978). Furthermore, univariable analyses for AAAs of different diameters imply the OSI is a risk factor for AAA rupture of 50–65 mm, while higher TAWSS decreases the risk of AAA rupture of 65–80 and ≥ 80 mm. The findings may contribute to accurate rupture prediction and personalized management of AAAs ≥ 50 mm and with different diameters, and further demonstrate potential value and application prospects of combining morphology and hemodynamics in clinical practice.

Examining Nailfold Capillary Alterations and Their Link to Diabetic Neuropathy in Diabetes Mellitus

Abstract Introduction: Diabetes mellitus (DM) is a chronic metabolic disorder characterized by hyperglycemia and microvascular alterations. The current study aimed to identify microvascular changes in DM patients using nailfold capillaroscopy (NFC) and determine their relationship with diabetic neuropathy. Materials and Methods: The study included 100 subjects aged 20–50 years, divided into DM patients and healthy controls. NFC was performed on eight fingers, focusing on the fourth and fifth digits, at 200× magnification. Capillary density (CD), loop diameter (LD), arterial limb diameter (ALD), venous limb diameter (VLD), intra-capillary distance (ICD), and abnormal morphology (AM) were assessed. Sensory neuropathy was evaluated clinically and through nerve conduction studies. Statistical analysis was performed using Statistical Package for Social Sciences version 23. Results: The results showed significant differences in NFC parameters between DM patients and controls. DM patients had lower CD, higher LD, ALD, VLD, and ICD, and more frequent AM compared to controls. Patients with poor glycemic control (HbA1c ≥7%) exhibited more pronounced microvascular changes. Sensory neuropathy was significantly associated with abnormal NFC findings. Conclusion: NFC is a valuable tool for detecting microvascular alterations in DM patients, which correlate with the presence of diabetic neuropathy. Early recognition of these changes using NFC may aid in the timely management of diabetic complications and improve patient outcomes.

Pedicled Radial Forearm “Free” Flap for Intraoral Reconstruction Based on an Unexpectedly High Origin of the Radial Artery—Case Report

Background: Radial forearm free flap (RFFF) is considered one of the workhorses in modern head and neck reconstruction surgery due to its technical simplicity, versatility and less time-consuming harvest. Methods: In this report, we present the case of a 56-year-old woman with sublingual squamous cell carcinoma (SCC) who underwent surgical resection and reconstruction of the defect with a RFFF. Results: The preoperative Allen test showed normal blood flow, and the ultrasound did not recognize any blood vessel abnormalities in the left arm. However, during the RFFF harvest, when the dissection of the pedicle came to the cubital fossa, there was no brachial artery bifurcation. While trying to find the bifurcation, the dissection almost came to the axillary region. Hence, the RFFF was converted to a pedicle flap and was pulled through to the intraoral defect where it was used for reconstruction. Conclusions: Hence, during the preoperative radiological ultrasound, besides the usual characteristics such as the radial artery diameter, flow and possible obstructions, it is also important to explore if there are any other anatomical abnormalities that could influence the operation.

Age-dependent changes in diameters of abdominal visceral arteries in children.

The diameters of the abdominal aorta and its branches are affected by demographic properties of patients like age, sex or body mass index. Some researchers use the body of the first lumbar vertebra (L1) as an anatomical indicator to create an exact standard for diagnosing arterial aneurysms or stenoses. In this regard, this work designed to uncover relations of abdominal visceral arteries with L1 in normal children using their abdominopelvic computed tomography images. The study population consisted of 180 subjects (age range 1-18years) without any abdominopelvic disorders. The diameters of the abdominal visceral arteries were measured and the ratios of these arteries to L1 were calculated. The diameters of the abdominal visceral arteries increased from infancy period up to postpubescent period (p < 0.001), but L1's diameter did not change after late childhood period. Measurements in males were statistically similar to those in females, excepts from the transverse diameter of L1 (p = 0.001), the diameter of the common hepatic artery at the distal level (p = 0.002), and the diameter of the inferior mesenteric artery at the distal level (p = 0.019), which were greater in males than females. The ratios of diameters of the abdominal visceral arteries to L1 increased with advancing age (p < 0.001). Ratios in males were statistically similar to those in females (p > 0.05). Our age-specific diameters and ratios regarding abdominal visceral arteries may facilitate the diagnosis of vascular disorders in children.

Effect of enhanced external counterpulsation versus individual shear rate therapy on the peripheral artery functions

In this study, we aimed to assess the effects of enhanced external counterpulsation (EECP) and individual shear rate therapy (ISRT) on peripheral artery function in patients with lower extremity atherosclerotic disease (LEAD). We randomly assigned 45 LEAD patients to receive 35 sessions of 45 min of EECP (n = 15), ISRT (n = 15), or sham-control (n = 15). Flow-mediated dilation in the brachial artery (brachial-FMD); 6-min walk distance; blood flow in the popliteal, posterior tibial, anterior tibial, and dorsalis pedis arteries; and plasma levels were measured before and after the 7 weeks treatment. 36-item Short Form Health Survey [SF-36] was analyzed before, after 7 weeks, and 3-month follow-ups. EECP treatment significantly improved brachial-FMD and quality of life, increased walking distance, and increased blood flow and the diameters of the popliteal artery and posterior tibial artery (all P < 0.01). Conversely, ISRT markedly increased blood flow in the anterior tibial artery (P < 0.05). EECP and ISRT decreased the endothelin-1 and asymmetrical dimethylarginine levels in patients with LEAD (both P < 0.01). Additionally, sVCAM-1 was significantly reduced after EECP intervention (P = 0.004). Our findings demonstrate that EECP and ISRT have beneficial effects on walking distance, quality of life, flow-mediated dilation, endothelial-derived vasoactive agents, and inflammatory and oxidative stress in LEAD patients.Date of registration: 2021-06-21. Trial registration: ChiCTR2100048086.

Effect of glyceryl trinitrate and clevidipine administration on CT angiogram findings in dogs undergoing prostatic artery embolization for prostatic carcinoma.

The primary aim of this study was to evaluate the effects of vasodilator administration on CT angiography (CTA) prostatic artery diameter and peak opacification in dogs with prostatic carcinoma prior to prostatic artery embolization (PAE). A prospective clinical trial was performed. Ten dogs with naturally occurring prostatic carcinoma and no evidence of cardiovascular disease were enrolled. Each dog underwent multiphase CTA of the prostate before and after IV vasodilator (glyceryl trinitrate [GTN] or clevidipine butyrate [clevidipine]) administration, and cardiovascular parameters were monitored. PAE was performed the following day. Prostatic arterial anatomy was characterized by CTA. Prostatic artery lumen diameter and peak opacification were measured on pre- and post-vasodilator CTA by a blinded radiologist. The percent change of these measurements was calculated and assessed for significance. Glyceryl trinitrate and clevidipine were administered in 5 dogs each with subsequent blood pressure reduction documented in all dogs. No significant difference was detected in prostatic artery diameter or peak opacification between pre- vs. post-vasodilator CTA. Good agreement in prostatic arterial branch number, origin, and course was documented between pre- and post-vasodilator CTA images. Study findings do not support the routine use of vasodilator administration during pre-PAE CTA in dogs, though larger sample sizes and protocol alterations may be needed to detect a clinically relevant utility.

Postprandial Vascular Effects of a High Potassium Meal in Patients with Treated Hypertension.

There is compelling evidence of an inverse association between potassium intake and blood pressure (BP). A potential mechanism for this effect may be dietary potassium-mediated augmentation of endothelium-dependent relaxation. To date, studies have investigated potassium intake supplementation over several weeks in healthy volunteers with variable results on vascular function. There is no assessment of the acute vascular effects of potassium supplementation achieved by the ingestion of potassium-rich food in a hypertensive population. The purpose of this study was to investigate the effect of a high potassium meal on postprandial endothelial function as measured by flow-mediated dilatation (FMD). We performed an investigator-blinded randomized crossover trial in 33 treated hypertensive individuals. Participants consumed both a high (~2400 mg) and low (~543 mg) K+ meal, separated by a one-week washout period. The primary endpoint was endothelial function as assessed by FMD pre-meal and postprandially at 60 and 120 min. Meals were compared at each time point using the Hills-Armitage approach. 33 individuals were included in the study (48% male, mean age 68). In the fasting state (Baseline), and at 60 min postprandial, radial artery FMD was not significantly different between the participants after consumption of either meal (baseline: high K+ 4.2 ± 2% versus Low K+ 2.6 ± 3%, p = 0.93; 60 min: high K+ 3.8 ± 4% versus Low K+ 4.1 ± 3%, p = 0.69). However, at 120 min, FMD tended to be higher in participants after the high K+ meal (5.2 ± 4.1%) than after the low K+ meal (3.9 ± 4.1%) (p = 0.07). There were no differences in participants' radial artery diameter and blood flow between meals. This study does not support our hypothesis that a single high K+ meal improves vascular function in individuals with treated hypertension. This does not contradict the clinical evidence relating greater K+ intake with lower BP, but suggests that mechanistic investigations of increased K+ intake through diet alone and its impact on endothelial function as a mediator to reducing BP are complex and not simply due to single nutrient-mediated improvement in vascular function.

Dual-layer dual-energy CT characterization of thrombus composition in acute pulmonary embolism and chronic thromboembolic pulmonary hypertension

AbstractTo evaluate dual-layer dual-energy computed tomography (dlDECT)-based characterization of thrombus composition for differentiation of acute pulmonary embolism (PE) and chronic thromboembolic pulmonary hypertension (CTEPH). This retrospective single center cohort study included 49 patients with acute PE and 33 patients with CTEPH who underwent CT pulmonary angiography on a dlDECT from 06/2016 to 06/2022. Conventional images), material specific images (virtual non-contrast [VNC], iodine density overlay [IDO], electron density [ED]), and virtual monoenergetic images (VMI50KeV) were analyzed. Regions-of-interest (ROIs) were manually placed in pulmonary artery thrombi, and morphological imaging characteristics for acute and chronic PE were assessed. Area under the receiver operating characteristics curve (AUC) of ROI measurements, morphological imaging features, and their combination in distinguishing between acute PE and CTEPH were evaluated. Compared to PE, thrombi in patients with CTEPH had lower attenuation on conventional images (Median [inter-quartile range]: 40 [35–47] HU vs 64 [52–83] HU) and VMI50keV reconstructions (59 [46–72] HU vs 101 [80–123] HU) as well as decreased iodine uptake (IDO: 0.5 [0.2–1.0] vs 1.2 [0.5–1.8]; p for all &lt; 0.001). Conventional images and VMI50keV reconstructions were the most accurate for differentiating between acute and chronic thrombi (conventional: AUC 0.92, 95% CI 0.86–0.98; VMI50keV: AUC 0.91, 95% CI 0.85–0.97). Main pulmonary artery (MPA) diameter combined with thrombus attenuation significantly increased the AUC compared to MPA diameter alone (p = 0.002 respectively). Thrombi in patients with CTEPH exhibit lower attenuation and reduced contrast enhancement. Analyzing attenuation in pulmonary thrombi may add diagnostic information to established morphological parameters in differentiating acute PE from CTEPH.

Determining pulmonary artery diameter on CT scans as basis for performing transthoracic echocardiography to screen for pulmonary hypertension in patients with pulmonary artery enlargement

Determining pulmonary artery diameter on CT scans as basis for performing transthoracic echocardiography to screen for pulmonary hypertension in patients with pulmonary artery enlargement

Association between microvascular free-flap arterial anastomosis caliber and risk for development of osteoradionecrosis.

Osteoradionecrosis (ORN) following radiation therapy (RT) is a serious complication for patients undergoing head and neck cancer treatment. Recent literature has found an association between ipsilateral external carotid artery (ECA) diameter and the development of ORN. This study evaluates microvascular free-flap arterial anastomosis diameter and the development of ORN. Sixty-six patients underwent fibular free-flap reconstruction followed by RT between 2012-2019 at the University of Florida. Anastomosis and ECA diameters pre- and post-RT were measured from computed tomography images. Multivariate regression analysis identified significant factors in the development of ORN. Incidence of ORN was 33.3% (N=22/66). Mean post-RT anastomosis diameters were 2.3 and 2.2 for the ORN group and no-ORN group, respectively (p=0.548). Mean post-RT ipsilateral ECA diameters were 4.7 and 4.2 for the ORN group and no-ORN groups, respectively (p=0.040). The change in pre-RT versus post-RT ipsilateral ECA diameters was different in patients with RT dose above and below 55Gy (p=0.041). Neither post-RT anastomosis (OR = 1.78, 95% CI: 0.43, 8.65, p=0.434), nor ECA (OR = 1.44, 95% CI: 0.78, 2.83, p=0.250) diameters were associated with development of ORN while controlling RT dose (OR = 1.15, 95% CI: 1.04, 1.28, p=0.006), post-operative fistula (OR = 9.11, 95% CI: 1.65, 93.7, p=0.010), and post-operative infection (OR = 3.48. 95% CI = 1.01, 12.7, p=0.048), and CCI (OR = 0.61, 95% CI: 0.36, 0.96, p=0.031). A higher degree of narrowing in ipsilateral ECA following RT may be linked to development of ORN. RT doses≥55Gy were associated with a high risk of ORN.

Influence of hyperbaric air exposure on the function of brachial artery

Decompression after diving may inevitably cause the production of bubbles in the body, even without protocol violation. Bubbles produced in the circulation may damage the vascular cells, leading to vascular dysfunction. In this study, five subjects were recruited and subjected to hyperbaric exposure (15 meters; 100 minutes). The function of the brachial artery was assessed by measuring diameter, systolic peak velocity (SPV), resistance index (RI), and flow-mediated dilation (FMD) of the brachial artery before and after hyperbaric exposure. Our results showed that hyperbaric air exposure slightly increased the diameter of the brachial artery and significantly increased its RI but reduced the FMD and markedly decreased the SPV. This study indicates that hyperbaric air exposure at low pressure may also alter the function of the brachial artery. Keywords: brachial artery, diving, flow-mediated dilation, ultrasound, vascular endothelium

Reperfusion of Pulmonary Arteriovenous Malformations Treated by Catheter Embolization.

Objective: The aim of this study was to evaluate patients with hereditary hemorrhagic telangiectasia (HHT) for the potential reperfusion of pulmonary arteriovenous malformations (PAVM) treated by catheter embolization using coils or embolization plugs and to analyze causes of possible reperfusion in order to further improve treatment. Methods: This retrospective study analyzed the data of 345 patients who underwent screening for pulmonary arteriovenous malformations in cases of suspected or confirmed HHT (Osler's disease). Of these, 118 patients with PAVM that underwent catheter embolization and had at least one follow-up study were included in our study and evaluated for potential reperfusion. Screening and follow-up for the detection of PAVM was performed by dynamic and high-resolution contrast-enhanced magnetic resonance angiography (MRA). The average follow-up time was 6.2 years. Results: Reperfusion was detected in 43 of 118 patients at follow-up. Thirty-five of these patients showed a recanalization of the treated vessel and in eleven patients the formation of collateral vessels resupplying the PAVM were identified as the cause of reperfusion. The average time between embolization and detected reperfusion was 5.6 years. The recanalization of both coils and plugs was observed. The recanalization of coils could be attributed in most cases to an insufficient packing density of the implanted coils. In addition, an enlarged diameter of the feeding artery was confirmed as a risk factor for reperfusion. Conclusions: As the reperfusion of embolized pulmonary arteriovenous malformations can occur after a long time interval post-treatment, regular lifelong follow-up studies after embolization are essential to detect reperfusion at an early stage and avoid serious complications like a brain abscess or stroke through prompt re-embolization. After coil embolization, attention should be paid to sufficiently dense packing to achieve adequate and permanent occlusion.

A comment on the physiological basis for longitudinal motion of the arterial wall.

The longitudinal motion and the intramural shear strain of the arterial wall increase dramatically in response to blood pressure, thereby impacting the vascular wall microenvironment. Exposure to a sedentary lifestyle has been identified as an independent risk factor for cardiovascular disease, but it has been shown that intermittent physical activity embedded into everyday life is enough to improve cardiovascular health. Marked changes in longitudinal motion already at low workload may explain this finding. However, to understand the mechanism linking longitudinal motion and cardiovascular health, an understanding of the physiological basis for the longitudinal motion of the arterial wall is needed. The factors underlying the longitudinal motion of the arterial wall in vivo are numerous and intertwined. As a comment and complement to the recent review by Athaide et al., we propose and discuss a comprehensive cardiovascular mechanical scenario based on current literature. In this scenario, blood pressure, typically acting in the radial direction, also acts directly in the longitudinal direction through a tapered geometry. This complements ventricular contraction, ventricular-vascular coupling, arterial diameter change, arterial stiffness in both the radial and longitudinal directions, and pre-stretch of the arterial wall. Additionally, we consider the geometry of the arterial tree and intramural friction of the arterial wall. Together, these important cardiovascular mechanical -factors form the pattern of longitudinal motion of the arterial wall, indicating that the longitudinal motion of the arterial wall is important for cardiovascular health.

Ensuring Non-Leakage Performance in Thoracic Aortic Repair in Preclinical Performance of a Minimally Invasive Thoracic Stent Graft: Results from a Porcine Model Study

The MeriGraft™ Thoracic Endovascular Stent Graft System was evaluated for its performance and safety in a controlled, one-day acute study using two large female porcine. Designed for minimally invasive repair of thoracic aortic aneurysms, the device was delivered via a 22-25F catheter introduced through the right femoral artery in the animal model. To evaluate the performance and safety of the MeriGraft™ Thoracic Endovascular Stent Graft System, an acute porcine model study was conducted. This one-day study aimed to assess stent leakage and overall feasibility of the device. The focus was on identifying any potential issues with fabric leakage, which could lead to Type 2 endoleaks. The study concluded that to prevent such leaks, the stent graft must be manufactured with high-quality fabric, as demonstrated by the animal study data. The Present study has an object to study that MeriGraft™ Thoracic Endovascular Stent Graft System is functionally suitable for its applications of assuring no leakage. While selecting the large animals we found the femoral artery is not suitable for its delivery system as in MeriGraft™ Thoracic Endovascular Stent Graft System it is fairly wider than available diameter of femoral artery. Yet the objective of suitability of MeriGraft™ Thoracic Endovascular Stent Graft System can be established if no blood leakage is found as per expectations from this under fluoroscopic guidance. Angiography was used to determine the appropriate stent graft sizes: 24x167 mm for P1 and 28x167 mm for P2. Both stents were successfully deployed in the descending aorta, expanding self-expansionally without procedural complications or mortality. Throughout the procedure, clinical monitoring showed no abnormal signs, and pre- and post-deployment blood tests revealed no significant changes, indicating stable hematological and biochemical profiles. The device's handling, visualization, hemostasis, and deployment were all found to be effective. Angiographic assessment confirmed proper endovascular flow and accurate stent graft positioning with no migration. X-ray imaging showed no structural or material disintegration. Histopathological analysis of the explanted aortas revealed no signs of inflammation, vascular injury, smooth muscle cell loss, or endothelial damage. Additionally, histomorphometric analysis demonstrated a beneficial increase in the internal luminal diameter with minimal changes in neointimal tissue. The device successfully sealed the aneurysm site, and no safety concerns were observed under acute testing conditions. These results affirm that the MeriGraft™ Thoracic Endovascular Stent Graft System system is effective and safe, offering a promising minimally invasive approach to treating thoracic aortic aneurysms.

Predictive factors for arteriovenous fistula maturation: A prospective study.

Arteriovenous fistula (AVF) maturation failure remains common despite preoperative ultrasound mapping. Identifying predictive biomarkers can help anticipate primary failure and reducing invasive procedures. Our study aimed to identify clinical and analytical risk factors for primary AVF failure or delay. A prospective study (October 2022-March 2023) included adult patients scheduled for AVF creation. In all patients, a preoperative ultrasound mapping was conducted and AVF maturation assessed at least 6 weeks post-surgery. Clinical, analytical, and demographic data were collected. Eighty patients were included, 62.5% male, and mean age 66.3 years. For distal anastomosis, preoperative vein (3.8 ± 1.2 vs. 2.8 ± 0.6 mm; p 0.002) and supply artery (2.5 ± 0.4 vs. 2.0 ± 0.3 mm; p 0.001) diameters were significant factors impacting primary failure. Also, for proximal anastomosis, the artery diameter (2.4 ± 0.4 vs. 2.0 ± 0.4 mm; p 0.01) had an impact on AVF maturation. ROC curves established for distal AVF a vein diameter cutoff of 3.25 mm (AUC 77.2%) and artery cut-off of 2.35 mm (AUC 74.6%) and for proximal AVF an artery cutoff of 2.25 mm (AUC 76.5%). Distal AVF creation correlated with higher primary failure risk (p < 0.001). No correlation was found between the primary failure rate and the presence of central venous catheter or serum results. In a sub analysis, we found that patients with central venous catheter had higher levels of inflammatory markers. Our study highlights the importance of preoperative evaluation, ultrasound mapping, and careful AVF site selection. Recognizing vein and artery diameter thresholds for optimal outcomes is crucial. Avoiding central venous catheters in suitable patients can positively impact AVF results.