Femoral Artery Segments Research Articles

The Effects of Hindlimb Unloading of Rats on Rheographic Parameters of Femoral and Brachial Arteries In Situ.

The rheographic parameters of the segments of brachial and femoral arteries were measured in situ after a 14-day-long hindlimb unloading (HU) of rats. HU significantly increased electrical impedance Z of a segment of femoral artery indicating its constriction; in parallel, HU resulted in a decreasing trend of Z of a segment of brachial artery attesting to its dilation. In both arteries, HU significantly or as a trend decreased the swing ranges of active and passive pulsations, respectively. BP reduction during bloodletting induced transition from passive to active pulsatile mode in the femoral artery only in 33% experimental rats in contrast to 87% control ones. We suppose that degradation of active pulsatile mode is responsible for the negative influences of microgravity and weightlessness on blood circulation. The study determined the rheographic parameters that reliably reflect changes in the functional activity of arteries after chronic redistribution of hydrostatic load.

Femoropopliteal Bypass Surgery for Total Calcification of the Iliofemoral Segment

Calcification of the lower extremities arteries is an unfavorable factor for vascular surgery. Extensive lesions of the femoral segment are an indication for femoropopliteal bypass surgery. Calcification of the femoral arteries complicates the construction of a proximal anastomosis because it precludes clamping the arteries. In addition to technical difficulties in the construction of an anastomosis, significant calcification increases the risks of bleeding and embolic complications and the duration of surgery. In cases of total calcification of the femoral and iliac arteries, balloon occlusion during the construction of an anastomosis makes it possible to occlude the arteries without clamping, which reduces the risks of perioperative complications. We report a case of femoropopliteal bypass surgery in a patient with total calcification of the iliofemoral segment and occlusion of the superficial femoral artery.

Comparison of Arterial and Venous Interposition Grafting for Arterial Defects in a Rat Model.

Interposition microvascular grafting may be required to bridge arterial defects during digital replantation or revascularization and has traditionally been performed utilizing a venous autograft. Arterial interposition grafting has been shown to be superior in maintaining patency in large vessel surgery; there are case reports of its use in microsurgery. Six fellowship-trained hand and microsurgeons performed arterial and venous interposition grafts on the femoral arteries of 40 Wistar rats. After sectioning one femoral artery a segment of the contralateral femoral artery or vein was obtained. The time was recorded per graft and patency tested 10 minutes following grafting by an independent assessor. Each surgeon also completed a questionnaire detailing regular microsurgical volume, technical ease, and conceptual preference for either graft. Time for arterial interposition (median time 51.7 minutes) was longer than venous grafting (median time 45.9 minutes, p = 0.075). Arterial grafts were more likely to be patent or questionably patent (odds ratio [OR] = 6.77, p = 0.031). All surgeons found arterial interposition grafting technically easier and preferred it conceptually. Improvements were noted in patency rates (OR = 11.29, p = 0.018) and avoidance of anastomotic leak (OR = 0.19, p = 0.029) when surgeons performed moderate levels or greater of microsurgery within their regular practice. Greater immediate patency was noted with arterial interposition grafting in a rodent model when compared to venous grafting, although procedural time was greater. All surgeons found arterial grafting technically easier. Arterial microvascular grafting may be useful in the setting of digital replantation or revascularization with an arterial defect.

Differential Effects of Ca2+ Channel Blockers Nifedipine and Cilnidipine on Arterial Elasticity in the Aortic and Femoral Arterial Segments of Anesthetized Rabbits.

Ca2+ channel blockers have potent vasodilatory effects and excellent efficacy in preserving organ blood flow. These hemodynamic actions may be partly controlled by the functional stiffness of conduit arteries. In this study, we assessed the effects of the L-type Ca2+ channel blocker nifedipine on aortic and femoral arterial stiffness (referred to as aortic β and femoral β, respectively) in anesthetized rabbits. To further clarify the involvement of the autonomic nervous system, we compared the effects of nifedipine with those of the L/N-type Ca2+ channel blocker cilnidipine. Further, the effect of the α-adrenergic receptor blocker doxazosin on the effects of nifedipine on arterial elasticity was examined. An antihypertensive dose of nifedipine (300 µg/kg, administered intravenously) was found to increase the aortic β but hardly affected the femoral β. An antihypertensive dose of cilnidipine (30 µg/kg, administered intravenously) increased the aortic β but decreased the femoral β. Interestingly, nifedipine decreased the femoral β in the presence of the α-adrenoceptor blocker doxazosin (1 mg/kg, administered intravenously). These effects suggest that L-type Ca2+ channel blockers essentially increase vascular elasticity via the decrement in arterial stiffness in the femoral artery segment, which is modified by the presence or absence of the inhibitory effect of each drug on reflex sympathetic nerve activity, while decreasing vascular elasticity via the increment in arterial stiffness in the aortic segment independently of sympathetic nerve activity.

Long-term results of revascularization of the lower extremities in patients with critical ischemia and diabetes mellitus with localization of the occlusive-stenotic process in the femoral artery

Aim: to determine the most preferable tactics of surgical treatment of patients with critical ischemia of the lower extremities of atherosclerotic genesis and diabetes mellitus based on a comparison of the results of revascularizing interventions. Methods: The study involved 82 patients who were treated in the department of vascular surgery due to critical ischemia of the lower extremities as a result of atherosclerotic occlusive-stenotic lesion of the femoral arterial segment against the background of diabetes mellitus. After the diagnostic stage and preoperative preparation, the patients were divided into two groups depending on the nature of the intervention performed: endovasal revascularization or femoropopliteal autovenous bypass grafting above the knee joint gap. In the postoperative period, dynamic observation of patients was continued with a predominant assessment of the clinical status. Results: Clinically, circulatory decompensation requiring repeated intervention or amputation was observed in 9 (30 %) patients from the first group and in 13 (25 %) patients from the second. High amputation was performed in 2 (6.6 %) study participants from the endovasal revascularization group and 3 (5.7 %) from the open surgery group. Over the entire observation period, 2 (6.7 %) and 4 (7.8 %) patients died in the groups under consideration, respectively. No statistically significant differences were obtained for any of the studied parameters, however, repeated interventions were significantly more frequently performed in patients undergoing endovascular revascularization. Conclusion: When analyzing the advantages and disadvantages of endovascular and open surgery in patients with diabetes mellitus and critical ischemia, the first should be preferred due to the possibility of repeated repetition throughout the patients life. Particular attention should be paid to conservative therapy and assessment of clinical status in the late postoperative period.

The effects of cardiotonic glycoside digoxin on arterial elasticity in the aortic and femoral arterial segments of anesthetized rabbits

The effects of cardiotonic glycoside digoxin on arterial elasticity in the aortic and femoral arterial segments of anesthetized rabbits

Explore the Value of Dual Source Computer Tomography Automatic Tube Current Regulation in Reducing the Radiation Dose of CTA in Lower Extremity Vessels.

ObjectiveTo investigate the value of dual source computer tomography automatic tube current regulation in reducing the radiation dose of CTA in lower limb vessels.MethodsFrom February 2020 to December 2021, 64 patients with lower limb artery CTA were selected in our hospital because of the symptoms of foot ischemia. According to the random number table, patients were divided into control group (treated with fixed tube current technology) and observation group (treated with automatic tube current regulation technology), with 32 cases in each group. All patients underwent a dual source computer tomography scan. Control group: tube voltage 120 kV, tube current 250 mA; Observation group: tube voltage was 80 kV, and reference tube current was 80–380 mA. Other scanning conditions of patients in the two groups were the same. CTDIvol, DLP and calculated SNR and CNR were recorded to obtain the ED.ResultsThe values of CTDIvol, DLP and ED in the observation group were lower than those in the control group (P < 0.05). There was no significant difference in CT value, SD value, SNR value and CNR value of the femoral artery segment, popliteal artery segment and posterior tibial artery segment between the two groups (P > 0.05). The image quality scores of patients in the control group were slightly higher than those in the observation group, but there was no statistical difference between the two groups (P > 0.05).ConclusionThe application of dual source computer tomography automatic tube current adjustment technology in CTA examination of lower limb vessels can automatically adjust the compensation output and realize the output of different tube currents in different thicknesses, densities and angles. On the premise of not affecting the image quality, the radiation dose in the scanning process to the maximum extent, and reasonably protect the examined patients.

Influence of lamina vastoadductoria dissection on the outcomes of femoral artery extensive lesion stenting: A pilot randomised investigation

ObjectiveAim of the study was to improve the immediate and long-term results of stenting of the superficial femoral artery in extended lesions with the changing of the biomechanics of superficial ffemoral artery and of the first portion of the popliteal artery. MethodsPilot randomized prospective single-center study were included 70 patients. Patients were randomized into two groups in 1 × 1 format for 35 people using the envelope method. Self-expanding bare metal stents were used in all cases. At the first group standard revascularization procedures with SFA stenting were performed; in the second group, the superficial femoral artery stenting was supplemented with fasciotomy in the Hunter’s canal with the superficial femoral artery intersection. The total observation period was 2 years. During the observation period an assessment of the clinical symptoms of the lower extremities, measurement of the ankle-brachial index and ultrasound duplex scanning of the operated segment were performed. ResultsAll procedures in both groups were successfully performed. Primary patency through 24 months was 28.5% (10 of 35) in group 1 and 60% (21 of 35) in group 2 (p = 0,015). ConclusionsChanging the biomechanical properties of the distal of the superficial femoral artery segment and of the first portion of the popliteal artery is safe and contributes to the primary patency improvement during the stenting of extended of the superficial femoral artery lesions compared to standard SFA stenting.Dissection of the lamina vastoadductoria with transection of the collateral branches of the knee joint network reduces frequent and severe damages of stents after the stenting of the superficial femoral artery extended lesion.According to the frequency of complications in the early and mid-term postoperative period, limb salvage, mortality and the secondary patency rates, the new method is comparable with standard of the superficial femoral artery stenting.

Cystic Adventitial Disease of the Common Femoral Artery: A Rare-Case Report

Herein, we report the case of a 59-year-old man with intermittent claudication of ~100 m, who complained of resting pain in his lower right extremity. A pelvic, contrast-enhanced, computed tomography scan showed the presence of cystic density in the lower segment of the right common femoral artery. Faced with the risk of acute limb ischemia, we navigated a challenging diagnostic procedure to choose an appropriate treatment for him. Additionally, we performed a pathological investigation of the excised common femoral artery following the excision bypass. On postoperative day 5, the patient was discharged from the hospital. During the 2-year follow-up, no new cysts were discovered, and the patient had favorable prognosis.

カルシウム拮抗薬が大動脈と大腿動脈の血管弾性に与える影響－ニフェジピンとシルニジピンの作用比較－

カルシウム拮抗薬が大動脈と大腿動脈の血管弾性に与える影響－ニフェジピンとシルニジピンの作用比較－

Retrograde use of the Outback re-entry catheter in complex infrainguinal arterial recanalizations.

Retrograde recanalizations gained increasing recognition in complex arterial occlusive disease. Re-entry devices are a well-described adjunct for antegrade recanalizations. We present our experience with retrograde, infrainguinal recanalizations using the Outback re-entry catheter in challenging chronic total occlusions. We report data from a retrospective multicenter registry in complex retrograde recanalizations. Eligibility criteria included retrograde infrainguinal use of the Outback re-entry catheter where both conventional antegrade and retrograde recanalizations had been unsuccessful. Procedural outcomes included technical success (defined as successful wire passage and delivery of adjunctive therapy with<30% residual stenosis), safety (periprocedural complications, eg, bleeding, vessel injury, or occlusion of the artery at the re-entry site, and distal embolizations), and clinical outcome (amputation-free survival and freedom from clinically driven target lesion revascularization [cd-TLR]). Forty-five consecutive patients underwent retrograde, infrainguinal recanalization attempts with the Outback re-entry catheter between February 2015 and August 2020. Thirty (67%) patients had a history of open vascular surgery in the index limb. In four patients, recanalizations were even more challenging due to previous surgical removal and/or ligation of the proximal segment of the superficial femoral artery. The retrograde access site of the Outback catheter was the femoropopliteal segment in 31 (69%) patients and crural vessels in 14 (31%) patients. The re-entry target sites were as follows: common femoral artery in 31 (69%) patients, superficial femoral artery in 9 (20%) patients, popliteal artery in 1 patient, and below-the-knee arteries in 2 patients. In four patients, the needle of the re-entry device was targeted to an inflated balloon, inserted via the antegrade route. The Outback re-entry catheter was placed via a 6-French sheath in 19 (42%) cases and sheathless in 26 (58%) cases. Technical success was achieved in 41 (91%) patients There were two instances of distal embolizations and three bleeding episodes. Amputation-free survival was 100% at 30days, and after 12months, freedom from cd-TLR was 95% at 30days and 75% at 12months of follow-up. Female sex was an independent predictor for cd-TLR at 12months of follow-up. Retrograde use of the Outback re-entry catheter in infrainguinal chronic total occlusions provides an effective and safe endovascular adjunct, when conventional antegrade and retrograde recanalization attempts have failed.

Endovascular interventions in patients with glass iii infrainguinal arterial disease: 2-year results

To evaluate the results of endovascular surgery in patients with chronic limb-threatening ischemia (CLTI) with infrainguinal arterial disease GLASS III. Treatment outcomes were analyzed for the period 2017-2018. Inclusion criteria were age over 18 years, CLTI, extended (>20 cm) stenosis de novo and occlusion of femoropopliteal segment (FPS) combined with occlusive lesion of tibial arteries. We analyzed 147 patients divided into 2 groups depending on stenting strategy. FPS-1-TA included 53 patients who underwent angioplasty (± stenting) of femoropopliteal arteries and lower leg arteries resulted at least one patent tibial artery. FPS-2-TA enrolled 94 patients who underwent angioplasty of femoropopliteal arteries and lower leg arteries resulted ≥2 patent tibial arteries. Mean age was 71.0±9.8 years. There were 75 men. Demographics and clinical characteristics of patients were similar. Technical success rate was 100%. Mean length of stenting was 203 ± 99 mm. Occlusion of all 3 leg arteries correlated with high incidence of femoropopliteal stenting. In the FPS-1-TA group, stents were implanted in 39 patients, in the FPS-2-TA group - in 71 patients (73.6% and 75.5%, respectively, p=0.8). Braided nitinol stents were used for stenting of the lower third of superficial femoral artery and p1-p3 segments. Mean follow-up period was 22.6±1.1 months. Two-year results were not age-specific in our study. Kaplan-Meier overall survival, freedom from amputation and amputation-free survival for the entire sample were 79.6%, 81.0%, and 66.7%, respectively. We compared these values in both groups using Mantel-Cox log-rank test and obtained significant differences (67.9% vs 86.2%, p=0.004; 64.2% vs 90%, p<0.0001; 47.2% vs 77.7%, p<0.0001, respectively). Our results are comparable with literature data regarding freedom from amputation and amputation-free survival. We obtained significant differences in overall survival and freedom from amputation depending on endovascular strategy for tibial arteries. Correction of distal vessels with recanalization of at least two tibial arteries is advisable for endovascular treatment of diffuse complex lesions.

Bradykinin-induced nociceptive responses are more potent than capsaicin-induced responses in rat models

Background: Peripheral blood vessels are concerned with sensing the perivascular nociceptive information and signaling it to the higher centers through ipsilateral somatic nerves, thereby regulating the cardiorespiratory parameters by means of vasosensory reflex responses. Aims and Objectives: The present study was conducted to compare the potency of nociceptive responses elicited by bradykinin (BK) with the capsaicin-induced responses. Materials and Methods: Charles-Foster rats were anesthetized with urethane and injected intraperitoneally. After tracheostomy, the right femoral artery was cannulated with a 24G, double ported cannula for administering the chemicals/saline through vertical port and to record the blood pressure (BP) through horizontal port. BP, Electrocardiogram, and respiratory movements were recorded. Results: Injection of capsaicin into a segment of femoral artery evoked instantaneous transient tachypnoeic, hyperventilatory, and hypotensive responses. BK also produced similar pattern of nociceptive responses along with a transient fall in heart rate. In addition, the vasosensory responses produced by BK are of greater magnitude as compared to the capsaicin. Conclusions: BK is more potent in eliciting reflex nociceptive responses as compared to capsaicin. Further, BK has an additional cardioprotective role by slowing the heart, in the events of acute inflammation.

Functional sympatholysis in mouse skeletal muscle involves sarcoplasmic reticulum swelling in arterial smooth muscle cells.

The vasoconstrictive effect of sympathetic activity is attenuated in contracting skeletal muscle (functional sympatholysis), allowing increased blood supply to the working muscle but the underlying mechanisms are incompletely understood. The purpose of this study was to examine α‐adrenergic receptor responsiveness in isolated artery segments from non‐exercised and exercised mice, using wire myography. Isometric tension recordings performed on femoral artery segments from exercised mice showed decreased α‐adrenergic receptor responsiveness compared to non‐exercised mice (logEC50 −5.2 ± 0.04 M vs. −5.7 ± 0.08 M, respectively). In contrast, mesenteric artery segments from exercised mice displayed similar α‐adrenergic receptor responses compared to non‐exercised mice. Responses to the vasoconstrictor serotonin (5‐HT) and vasodilator isoprenaline, were similar in femoral artery segments from non‐exercised and exercised mice. To study sarcoplasmic reticulum (SR) function, we examined arterial contractions induced by caffeine, which depletes SR Ca2+ and thapsigargin, which inhibits SR Ca2+‐ATPase (SERCA) and SR Ca2+ uptake. Arterial contractions to both caffeine and thapsigargin were increased in femoral artery segment from exercised compared to non‐exercised mice. Furthermore, 3D electron microscopy imaging of the arterial wall showed SR volume/length ratio increased 157% in smooth muscle cells of the femoral artery from the exercised mice, whereas there was no difference in SR volume/length ratio in mesenteric artery segments. These results show that in arteries surrounding exercising muscle, the α‐adrenergic receptor constrictions are blunted, which can be attributed to swollen smooth muscle cell SR’s, likely due to increased Ca2+ content that is possibly reducing free intracellular Ca2+ available for contraction. Overall, this study uncovers a previously unknown mechanism underlying functional sympatholysis.

Endovascular interventions in patients with multilevel steno-occlusive lesions of the infrarenal aortic arteries

Peripheral artery diseases are a worldwide medical and social problem. Approximately 30 % of patients with critical limb ischemia will undergo amputations and 25 % will die after 1 year. These patients require reconstructive and angioplastic interventions to preserve the limb.&#x0D; The aim of the study is to compare the effectiveness of different endovascular surgical technologies in patients with multilevel steno-occlusive lesions of the infrarenal aortic arteries.&#x0D; Materials and methods. Among 243 endovascular interventions, 51 patients were presented with multilevel steno-occlusive lesions of the infrarenal aortic arteries as a result of atherosclerosis obliterans. 42 patients (82.4 %) had two-level lesions and 9 (17.6 %) had three-level lesions.&#x0D; Results. Among 42 patients with a two-level lesion, 29 (56.9 %) ones had femoral arterial segment affection in combination with tibial artery affection. 13 (25.5 %) patients suffered from the lesion of the iliac segment in combination with the affection of the femoral segment arteries. In 9 (17.6 %) patients the lesions of three or more levels were determined: an iliac segment in combination with femoral and popliteal arteries – in 4 patients, and in 2 patients there were lesions of the femoral, popliteal and tibial segments, in 3 patients there was a lesion of the iliac, femoral, popliteal and tibial-foot segments in different degrees of severity.&#x0D; 7 balloon angioplasties and 13 stenting procedures were performed in two and three-level lesions in which the iliac arterial segment was affected. Only balloon angioplasty was used to revascularize the infraingvinal arterial segments. In the early postoperative period, the complications included thrombosis appeared in 6 patients. It was possible to restore the blood flow and save the limb only in 3 persons. For the other 3 ones, the attempts to restore the patency of the arteries were unsuccessful and resulted in the amputation of the lower extremity. Mortality in the early postoperative period was 3.9 % (2 death due to myocardial infarction).&#x0D; Conclusions. The persons with multilevel steno-obstructive lesions of the infrarenal aortic arteries are the most difficult category of patients with CLI. The surgical method of choice for patients with multilevel steno-occlusive lesions is the endovascular angioplasty with or without stenting.

Гібридні хірургічні втручання при оклюзійно-стенотичному ураженні дистальних артерій у хворих на цукровий діабет

Метою дослідження є оцінка ефективності застосування гібридних оперативних втручань у хворих з поєднаним ураженням артерій гомілкового сегмента з ураженням здухвинного та/або стегново-підколінного сегмента. Матеріали та методи. Дослідження проведено в Центрі судинної хірургії КЛ «Феофанія» ДУС, де протягом 2013–2014 рр. перебувало на лікуванні 54 хворих на цукровий діабет з оклюзією стегново-підколінного артеріального сегмента та ішемією нижньої кінцівки IV ст. за Фонтейном. Усім пацієнтам проводили вимірювання сегментарного тиску та визначення кісточково-плечового індексу, дуплексне сканування артерій нижньої кінцівки з вивченням характеру кровотоку на апараті Flex focus виробництва BK medical. Ангіо­графію виконали 42 хворим за допомогою ангіографічної системи EuroAmpli Alien виробництва Eurocolumbus S.r.l. Результати. В статті наведений досвід виконання 8 гібридних хірургічних втручань при оклюзійно-стенотичному ураженні дистальних артерій у хворих на цукровий діабет. Згідно з результатами передопераційних досліджень, майже 72 % хворих на цукровий діабет мають поєднання оклюзійно-стенотичного ураження артерій гомілкового сегмента з ураженням здухвинного та/або стегново-підколінного сегмента. Прохідність зони стегнової реконструкції за неадекватної ємності сприймаючого артеріального русла підколінно-гомілкового сегмента з застосуванням методів гібридної хірургії протягом періоду спостереження становила 87,5 % порівняно з ізольованою реконструкцією стегнового артеріального сегмента в таких самих умовах — 42,9 %. Прохідність зони стегнової реконструкції за адекватної ємності сприймаючого артеріального русла підколінно-гомілкового сегмента протягом періоду спостереження становила 90 %. Висновки. Отже, гібридні хірургічні втручання у даної групи хворих дозволяють збільшити ємність сприймаючого артеріального русла підколінно-гомілкового сегмента і, таким чином, покращити результати хірургічного лікування.

Ipsilateral somatic nerves mediate histamine-induced vasosensory reflex responses involving perivascular afferents in rat models

Reflex cardiorespiratory alterations elicited after instillation of nociceptive agents intra-arterially (i.a) are termed as ‘vasosensory reflex responses’. The present study was designed to evaluate such responses produced after i.a. instillation of histamine (1 mM; 10 mM; 100 mM) and to delineate the pathways i.e. the afferents and efferents mediating these responses. Blood pressure, electrocardiogram and respiratory excursions were recorded before and after injecting saline/histamine, in a local segment of femoral artery in urethane anesthetized rats. Paw edema and latencies of responses were also estimated. Separate groups of experiments were conducted to demonstrate the involvement of somatic nerves in mediating histamine-induced responses after ipsilateral femoral and sciatic nerve sectioning (+NX) and lignocaine pre-treatment (+Ligno). In addition, another set of experiments was performed after bilateral vagotomy (+VagX) and the responses after histamine instillation were studied. Histamine produced concentration-dependent hypotensive, bradycardiac, tachypnoeic and hyperventilatory responses of shorter latencies (2–7 s) favouring the neural mechanisms in eliciting the responses. Instillation of saline (time matched control) in a similar fashion produced no response, excluding the possibilities of ischemic/stretch effects. Paw edema was absent in both hind limbs indicating that the histamine did not reach the paws and did not spill out into the systemic circulation. +NX, +VagX, +Ligno attenuated histamine-induced cardiorespiratory responses significantly. These observations conclude that instillation of 10 mM of histamine produces optimal vasosensory reflex responses originating from the local vascular bed; afferents and efferents of which are mostly located in ipsilateral somatic and vagus nerves respectively.

Detection and Prediction of Peripheral Arterial Plaque Using Vessel Wall MR in Patients with Diabetes

Objectives To evaluate the predictive performance of a newly developed delay alternating with nutation for tailored excitation (DANTE) pulse sequence for detecting lower extremity artery wall morphology and distribution in patients with peripheral artery disease (PAD) with diabetes. Methods Seventy-four PAD patients diagnosed according to 2011 WHO criteria were enrolled, who has diabetic diagnosis by 1999 WHO diabetes criteria. All patients received sequential DANTE, T2WI, DANTE-enhance, and CE-MRA scans. The images consisted of three parts: the iliac artery (segment 1), femoral artery (segment 2), and popliteal artery (segment 3). Regions of interest (ROIs) were drawn on vessels, muscle, and background, and multiple imaging metrics compared between modalities, including image quality score, image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). In the images with a score greater than 2, the lumen area (LA), total vessel area (TVA), and vessel thickness (VT) can be identified using semiautomatic image analysis vessel morphology parameters. Results All 222 arterial segments were successfully analyzed from 71 patients, after exclusion of three subjects with poor image quality (IQ < 2) in segment 3. There were 54 diabetic and 17 nondiabetic patients. Quantitative analysis shows that the CNR difference between diabetic patients and nondiabetic patients was statistically significant for the same segment, while there was no significant difference among the three segments of SNR and CNR. There were a total of 54 diabetics with plaque distribution data, which showed that LA of segments 1 and 2 was higher than that of segment 3. The VWI of segments 1 and 2 was lower than segment 3. Diabetic was associated with vascular WT 3 and WA3, which increased by 0.23 and 0.83 units on average compared without diabetic foot, respectively. Diabetic foot was associated with vascular WT 3, which increased by 0.37 units on average compared without diabetic foot. The incidence of segment 3 plaques was higher than that of segment 1. The incidence of the left and right plaques was different. Conclusions MR imaging using the DANTE and multicontrast sequence could evaluate plaque morphology, and distribution of lower extremities and the occurrence of diabetic foot development are closely related; it may predict occurrence of PAD with diabetic foot.

Relationship between Passive and Active Pulsations of Rat Artery as Vascular Extension of Frank-Starling Law.

The experiments on narcotized male rats (n=30) determined the parameters of passive and active pulsatile modes of isolated segment of femoral artery in situ. Rheographic elasticity (RE) and reactivity (RR) were correspondingly determined as the ratios of peak-to-peak (p2p) magnitudes of passive and active pulsatile oscillations of arterial electroimpedance (AEI) to p2p magnitude of BP undulations. The medians and interquartile ranges of RE and RR were 6 (3; 11) and 70 (40; 110) mΩ/mm Hg, respectively. The maximal and minimal values of RE and RR in various rats differed by 50 and 80 times, respectively, and were bimodally distributed: in major group (n=23), the values were RE<15 and RR<200 mΩ/mm Hg, whereas in minor group (n=7), these parameters were RE>20 and RR>300 mΩ/mm Hg. The above ranges of RE and RR parameters were considered as the diagnostic signs of normal and pseudo-healthy rats with pathologically augmented AEI oscillations, respectively. Statistical analysis of all rats (n=30) revealed the positive correlation between RE and RR (r=0.76) with linear regression RR=31+7.6×RE. It is hypothesized that this correlation is underlain by a mechanism similar to that described by the Frank-Starling law for myocardium.

Endovascular treatment of the superficial femoral artery aneurysm infected by typhoid Salmonella

Salmonella aortitis accounts for approximately 40% of all infectious aortitis. Superficial femoral artery aneurysm infected by Salmonella typhi has rarely been reported. The study reported a 71-year-old Chinese woman with a previous history of nephrotic syndrome and long-term oral hormone therapy, who was admitted to the hospital with a gradually increasing pulsatile mass in the right thigh and pain. After admission, computed tomography angiography revealed rupture and bleeding of an aneurysm in the middle and lower segment of the right superficial femoral artery (SFA). The aneurysm of the SFA was satisfactorily isolated by the covered stent. The bacterial culture of the secretion from the punctured mass showed the S. typhi infection. Based on the results of the drug sensitivity test, the patient received anti-infective treatment for 4 weeks. The patient recovered well after 1-year follow-up.