Vessel Caliber Research Articles

Surgical revascularization for moyamoya angiopathy: Clinical and radiological outcomes of direct and indirect bypasses in 86 affected hemispheres

Moyamoya is a progressive cerebral angiopathy that entails a formidable natural history of repeated ischemic or haemorrhagic insults if not intervened. The potential advantages of direct/combined bypass can be harvested only if they are not outweighed by perioperative morbidity. Direct bypasses for the paediatric group have been less utilized because of small vessel calibres and an inherently more robust angioplasticity. This study was undertaken to examine the clinical and perfusion imaging outcomes of operated moyamoya disease or syndrome patients in Hong Kong’s Southeast Asian population. Comparison was made between direct/combined and indirect bypass cohorts. Subgroup analysis of the paediatric cohort was conducted to determine outcomes of a direct-bypass-first strategy. From November 2000 to September 2020, 86 hemispheres underwent revascularization at a tertiary neurosurgical unit with a mean clinical follow-up time of 70.0 months. 70.9% of the procedures involved direct bypasses. Direct/combined revascularization demonstrated superiority in restoring adequate cerebrovascular reserve capacity (CVRC) (63.2% vs 27.3%, p = 0.015), and freedom from transient ischemic attacks in the first 5 years post-operation by Kaplan-Meier plot with log-rank test (p = 0.038). Follow-up imaging revealed 96.5% of the bypass grafts remained patent. Direct/combined procedures significantly predicted restoration of adequate CVRC on follow-up perfusions scans by binary logistic regression (OR 4.57, p = 0.009). Compared to the adult cohort, direct bypasses in children carried no excessive perioperative morbidity. These results support a liberal bypass-first paradigm in both adult and paediatric cohorts.

Changes in ocular blood flow and retinal oxygen metabolism during immunosuppressive therapy for initial-onset acute uveitis associated with Vogt-Koyanagi-Harada disease.

Purpose The aim of this study was to investigate the correlations between visual acuity, blood flow velocity in the choroid and optic nerve head (ONH) and oxygen saturation and calibre of retinal vessels during immunosuppressive therapy in patients with initial-onset acute uveitis associated with Vogt–Koyanagi–Harada (VKH) disease. Methods In this prospective study, 20 patients were studied. Laser speckle flowgraphy (LSFG) and retinal oximetry measurements were performed at baseline and at 4, 8 and 12 weeks after treatment. Results After immunosuppressive therapy, best-corrected visual acuity (BCVA) improved significantly at each post-treatment time-point compared with baseline value. Mean blur rate (MBR), representing blood flow velocity, in the choroid and ONH (overall and vessel areas) significantly increased. On the contrary, oxygen saturation of retinal arterioles and venules and calibre of retinal venules significantly decreased. There were significant negative correlations between ONH MBR vessel and arteriovenous oxygen saturation difference at baseline and at 4 weeks after treatment and between MBR tissue of the ONH and arteriovenous oxygen saturation difference at week 12 after treatment. Conclusions Immunosuppressive therapy in patients with initial-onset acute uveitis associated with VKH disease is associated with improved blood flow velocity in choroid and ONH and normalization of retinal oxygen metabolism and calibre of retinal venules. These correspond with improved visual acuity. These findings help explain the pathophysiology of VKH disease and its treatment and may provide biomarkers for choroiditis activity and response to treatment.

Preparation of animal model of chicken for lymphatic anastomosis technique training.

To discuss the preparation of a simple and practical animal model for lymphatic anastomosis technology training. At present, there is no widely used animal model for training lymphatic anastomosis. The neck of chicken is long enough, and there are abundant lymphatic lymph nodes. The caliber of lymphatic vessels in the neck of chicken is similar to the caliber of lymphatic vessels in human limbs, so multi-stage anastomosis practice can be carried out. The lymphatic vessels of chicken are easier to stain and fully exposed, which meets the requirements of lymphatic vein anastomosis model. This model allows for training of end-to-end anastomosis (LVA), end-to-side anastomosis, and lymph node vein anastomosis under microscope to be carried out. In this study, the trainees were divided into six groups, with five animals in each group. After 14-28 days of training, the average training was 21 days. Data were statistically analyzed by SPSS15. Obvious and clear lymphatic staining could be obtained after animal modeling, and the success rate of dissecting and staining lymphatic vessels under microscope could reach 100%. After training, the trainees could perform the anastomosis of lymphatic vessel and vein and lymph node vein under ultra-microscopic conditions, and the immediate patency rate of the anastomosis of the trainees can reach 80% during the examination. This animal model can be used for effective lymphatic vein anastomosis training, which is a simple, practical, and effective microscopic lymphatic anastomosis technology training model.

The Medial Sural Artery Perforator Flap: A Historical Trek from Ignominious to “Workhorse”

Rather than just another “review,” this is intended to be an “overview” of the entire subject of the medial sural artery perforator (MSAP) flap as has been presented in the reconstructive literature from its inception in 2001 until the present, with any exceptions not purposefully overlooked. Unfortunately, the pertinent anatomy of the MSAP flap is always anomalous like most other perforator flaps, and perhaps even more variable. No schematic exists to facilitate the identification of a dominant musculocutaneous perforator about which to design the flap, so some adjunctive technology may be highly valuable for this task. However, if a relatively thin free flap is desirable for a small or moderate sized defect that requires a long pedicle with larger caliber vessels, the MSAP flap deserves consideration. Indeed, for many, this has replaced the radial forearm flap such as for partial tongue reconstruction. Most consider the donor site deformity, even if only a conspicuous scar on the calf, to be a contraindication. Yet certainly if used as a local flap for the knee, popliteal fossa, or proximal leg, or as a free flap for the ipsilateral lower extremity where a significant recipient site deformity already exists, can anyone really object that this is not a legitimate indication? As with any perforator flap, advantages and disadvantages exist, which must be carefully perused before a decision to use the MSAP flap is made. Perhaps not a “workhorse” flap for general use throughout the body, the MSAP flap in general may often be a valuable alternative.

Evaluation of microvascular density and retinal vessel diameter in gestational and type 2 diabetes using swept-source OCT-A technology

To assess foveal and parafoveal retinal and choroidal microvascular changes using optical coherence tomography angiography (OCTA) and changes in retinal vessel caliber in pregnant women with gestational diabetes mellitus (GDM), non-pregnant female patients with type 2 diabetes mellitus (DM2), and healthy pregnant female subjects. The study was conducted cross-sectionally and composed of three age-matched groups: 32 near-term pregnant women with GDM (GDM group), 32 non-pregnant female patients with a recent diagnosis of DM2 (DM2 group), and 32 healthy near-term pregnant female subjects. Vessel density (VD) and vessel diameter were the main outcomes. Detailed ophthalmic examinations were performed for each participant, including swept-sourceOCTA measurements consisting of superficial, deep, outer retinal and choroidal vessel density. The average VD values in the central fovea of the superficial and deep retina were significantly lower in the GDM group (P=0.001 for both, between the three groups), whereas the mean VD in the parafoveal nasal sector of the deep retina was significantly lower in the DM2 group (P=0.008, between the three groups). There were no significant differences in the foveal or parafoveal VD measurements of the outer retina and choriocapillaris (P>0.05 for all). There were statistically significant differences in the retinal venous diameter and arterial vein ratio in the GDM and DM2 groups compared to the control group (P=0.001 for all). The microvascular density changes seen on OCTA images of pregnant women with GDM are remarkable. These changes in retinal vessels appeared to occur rapidly after the onset of the metabolic impairment or might be the reflection of previous insulin resistance as well, as in recent diabetes. Our results also suggest that these changes may be more significant in a GDM pregnant woman than in a pregnant, established diabetic patient.

RETRACTED ARTICLE: Google’s new AI technology detects cardiac issues using retinal scan

The retina enables for direct evaluation of retinal vessel calibre in order to estimate cardiovascular risk. Images, on the other hand, are acquired at random points in the cardiac cycle, making it impossible to make accurate measurements of retinal vessel calibre and restricting their application in clinical settings. This has already been demonstrated in healthy individuals. Worse resolution images and longer delay durations between mechanical start and image collection were also linked to lower retinal vascular calibre measuring accuracy in these studies. Ophthalmologists have widely used retinal fundus imaging systems to examine the health of the optic nerve, vitreous, macula, retina and their blood vessels. This research aims at studying novel and accurate algorithms for the automated extraction of the retinal vascular network and its abnormalities from colour retinal images for disease prediction and to determine whether ECG-gating retinal photographs refine retinal vessel calibre measurements, and to explore the validity, reliability and acceptability of this novel approach relative to common peripheral risk markers of cardiovascular disease.

Dietary Vitamins A, C, and Potassium Intake Is Associated With Narrower Retinal Venular Caliber.

IntroductionThe retinal vasculature, a surrogate for the systemic microvasculature, can be observed non-invasively, providing an opportunity to examine the effects of modifiable factors, such as nutrient intake, on microcirculation. We aimed to investigate the possible associations of dietary nutrient intake with the retinal vessel caliber.MethodsIn this cross-sectional study, a total of 584 participants in a medical survey of Japanese descendants living in Los Angeles in 2015 underwent a dietary assessment, fundus photographic examination, and comprehensive physical and blood examinations. Retinal vessel caliber was measured using fundus photographs with a semi-automated computer system and summarized as central retinal artery and vein equivalents (CRAE and CRVE). The association between dietary nutrient intake and retinal vessel caliber was analyzed using a multivariate linear regression model adjusted for two models including potential confounders. The first model was adjusted for age and sex. The second model was adjusted for age, sex, smoking status, body mass index, hypertension, diabetes, dyslipidemia, history of coronary heart disease, and history of stroke.ResultsAfter adjustment of potential confounders, compared to the quartile with the lowest intake, the difference in CRVE for the highest quartile was −5.33 μm [95% confidence interval (CI): −9.91 to −0.76, P for trend = 0.02] for vitamin A, −4.93 μm (95% CI: −9.54 to −0.32, P for trend = 0.02) for vitamin C and −3.90 μm (95% CI: −8.48 to 0.69, P for trend = 0.04) for potassium.ConclusionsA significant association was observed between higher vitamins A, C and potassium intakes and narrower retinal venular caliber.

A New Approach to Inhibiting Triple-Negative Breast Cancer: In Vitro, Ex Vivo and In Vivo Antiangiogenic Effect of BthTx-II, a PLA2-Asp-49 from Bothrops jararacussu Venom.

Phospholipases A2 (PLA2) represent a superfamily of enzymes widely distributed in living organisms, with a broad spectrum of pharmacological activities and therapeutic potential. Anti-angiogenic strategies have become one of the main tools in fighting cancer. In this sense, the present work reports the inhibition of tumor angiogenesis induced by Asp-49 BthTX-II using in vitro, ex vivo and in vivo approaches. We demonstrate that BthTx-II inhibited cell adhesion, proliferation, and migration of human umbilical vein endothelial cells (HUVEC), as well as caused a reduction in the levels of endothelial growth factor (VEGF) during in vitro angiogenesis assays. BthTx-II was also able to inhibit the sprouting angiogenic process, by the ex vivo germination assay of the aortic ring; in addition, this toxin inhibited the migration and proliferation of HUVEC in co-culture with triple-negative breast cancer cells (e.g., MDA-MB-231 cells). Finally, in vivo tumor suppression and anti-angiogenic activities were analyzed using MDA-MB-231 cells with Matrigel injected into the chorioallantoic membrane of chicken embryo (CAM) for 7 days treatment with BthTx-II, showing a considerable reduction in vessel caliber, on the size and weight of tumors. Together, these results suggest an important antiangiogenic and antitumor role for BthTx-II, as a potential prototype for the development of new tools and antitumor drugs in cancer therapy.

Renal papillary necrosis in a transplanted kidney

Renal papillary necrosis (RPN) was first described in autopsy studies. The characteristic pathologic feature is selective coagulative necrosis of the inner medulla and papillae of the renal pyramids. This area of the renal parenchyma is vulnerable to ischaemic injury because its blood supply comes from narrow caliber vessels with low rates of blood flow. RPN represents the end-point of a number of conditions which compromise blood flow or increase metabolic demand in this vulnerable region. Diagnosis of RPN is typically made radiologically and operative management is not usually required.

WASp controls oriented migration of endothelial cells to achieve functional vascular patterning.

ABSTRACTEndothelial cell migration and proliferation are essential for the establishment of a hierarchical organization of blood vessels and optimal distribution of blood. However, how these cellular processes are quantitatively coordinated to drive vascular network morphogenesis remains unknown. Here, using the zebrafish vasculature as a model system, we demonstrate that the balanced distribution of endothelial cells, as well as the resulting regularity of vessel calibre, is a result of cell migration from veins towards arteries and cell proliferation in veins. We identify the Wiskott-Aldrich Syndrome protein (WASp) as an important molecular regulator of this process and show that loss of coordinated migration from veins to arteries upon wasb depletion results in aberrant vessel morphology and the formation of persistent arteriovenous shunts. We demonstrate that WASp achieves its function through the coordination of junctional actin assembly and PECAM1 recruitment and provide evidence that this is conserved in humans. Overall, we demonstrate that functional vascular patterning in the zebrafish trunk is established through differential cell migration regulated by junctional actin, and that interruption of differential migration may represent a pathomechanism in vascular malformations.

Catheter-directed venography for evaluating internal jugular vein pseudo-occlusion

The incidence and effects of stenosis of the cerebral venous system are poorly understood. When noninvasive computed tomography venography (CTV) of the head and neck suggests complete internal jugular vein (IJV) occlusion, invasive catheter-directed venography can discordantly show venous patency. We compared CTV vs digital subtraction venography (DSV) in the evaluation of patency/occlusion in the suspected IJV and contralateral IJV. We queried the venous intervention database of our U.S. academic tertiary-care hospital to identify patients with complete or near-complete IJV occlusion per CTV from March 1, 2019 to March 1, 2020. We included patients with both noninvasive and invasive imaging of the target segment and the contralateral IJV. Four patients had suspected occlusion of the IJV at the skull base. Invasive catheter-directed venography consisted of DSV to assess direction of flow and vessel caliber, as well as manometry proximal and distal to areas of suspected stenosis. DSV showed patency in all 4 IJVs for which CTV had shown suspected occlusions. CTV findings of the contralateral IJVs were patency (n = 2), moderate stenosis (n = 1), and severe/critical stenosis (n = 1). Contralateral IJV caliber, measured by DSV, was concordant with CTV findings. Median mean-pressure gradients across the apparent occlusion and contralateral segments were 1 (range, 1–4) mmHg and 0 (range, 0–5) mmHg, respectively. Although noninvasive CTV may suggest absence of or attenuated flow within the IJV, this technique may be insufficient to establish complete occlusion. Catheter-directed venography can be used to evaluate patency, vessel caliber, and mean-pressure gradient.

Endovascular coil embolization of inferior mesenteric artery to ileal-conduit fistula: a case report

BackgroundUretero-arterial fistulas (UAFs) are uncommon and pose a diagnostic dilemma, making them life threatening if not recognized and treated expediently. UAFs to small arteries such as a branch of the inferior mesenteric artery (IMA) are very uncommon and present a further diagnostic and treatment challenge. There should be a high index of suspicion for UAFs when intervening on patients with history of treated pelvic cancers and long-standing ureteric stents experiencing hematuria not attributable to another cause.Case presentationWe present a case of a fistula formed between a distal branch of the IMA—superior rectal artery—and an ileal-conduit in a patient with a long-standing reverse nephroureterostomy (Hobbs) catheter presenting with abdominal pain and hematuria through the conduit. During a tube exchange, contrast injection demonstrated a fistula with the superior rectal artery, multiple ileal intraluminal blood clots, and active extravasation. The patient became tachycardic and hypotensive, actively bleeding through the ileal-conduit, prompting a massive transfusion protocol. Successful endovascular coiling of the superior rectal artery was performed with resolution of active extravasation and stabilization of the patient. The patient recovered and was discharged in stable condition 10 days later.ConclusionsAlthough UAFs are uncommon, our case demonstrated key predisposing risk factors to fistula development; pelvic cancer surgery, pelvic radiation, and a prolonged ureteric stent through the ileal-conduit. Typically, UAFs arise from communication with the iliac arterial system, however in this instance we have demonstrated that fistulization to other arterial vessels is also possible. Endovascular management has become the preferred method of therapy, typically involving the placement of covered stents when involving the iliac arterial system. In this instance stent grafting was not possible due to the small caliber vessel and therefore had to be embolized.

Latex-injected, non-decapitated, saturated salt method-embalmed cadaver technique development and application as a head and neck surgery training model.

Published cerebrovascular injection techniques have mostly used decapitated, fresh cadavers or heads embalmed with 10% formaldehyde. There have been no reports using vascular-injected cadavers for head and neck surgical training models or using vascular injections in saturated salt method-embalmed cadavers. Thus, we performed vascular labeling of five saturated salt method-embalmed cadavers without decapitation. Latex mixed with red ink was injected into the common carotid artery via a 3D-printed vascular adapter. The injection force was provided by a peristaltic pump. Thyroidectomy, submandibular gland excision, neck dissection, parotidectomy, and mandibulotomy were performed on both sides of each cadaver (n = 10). The consistency of the cadavers was softer than fresh ones. Subcutaneous tissues were well preserved, and muscles were moist and elastic. Five physicians graded the resemblance of the heads and necks of the latex-injected, saturated salt method-embalmed, non-decapitated of five cadavers compared to living humans using a Likert scale from 0 (no resemblance) to 5 (maximum resemblance). Fifty-two percent of the head and neck region resemblance scale ratings were four or five. Although the cadavers were practical for head and neck surgical simulations, the brain parenchyma was only partially preserved and unsuitable for use. The most distal arterial branches reached by the injected latex were measured. The external caliber of the smallest vessels reached were lacrimal arteries (mean caliber ± SD, 0.04 ± 0.04 mm; 95% CI [0, 0.09]). There were no significant differences in the mean caliber of the smallest vessels reached between the left- and right-sided arterial branches (all p < 0.05).

Measuring hyperemic response to light flicker stimulus using continuous laser speckle flowgraphy in mice

Alterations in neurovascular coupling have been associated with various ocular, cerebral, and systemic vascular disorders. In the eye, changes in vessel caliber by dynamic vessel analysis have been used to measure neurovascular coupling following a light flicker stimulus. Here, we present a new protocol for quantifying light-flicker induced hyperemia in the C57/Bl6J mouse retina using laser speckle flowgraphy (LSFG). Our protocol was adapted from protocols used in human subjects. By acquiring continuous time series data, we detected significant increase in blood flow. These responses are maintained with low variability over multiple imaging sessions, indicating these methods may be applied in serial studies of neurovascular coupling.

Effect of magnification in pediatric liver transplantation: Asystematic review and meta-analysis.

Hepatic artery thrombosis (HAT) represents a devastating and often fatal complication of liver transplantation. Due to the small vessel caliber in pediatric patients, the use of an operating microscope has largely become the standard for hepatic artery reconstruction to reduce the rate of HAT. Recent evidence, however, suggests that loupe magnification for anastomosis may be equally effective. We aimed to determine the effect of magnification on the rate of hepatic artery thrombosis in pediatric liver transplantation. A systematic search of the literature was conducted. Thousand eighty-eight unique titles were assessed by two independent reviewers. Studies directly comparing rates of HAT from loupe magnification and operating microscope-assisted anastomoses were eligible for meta-analysis. Among primary transplants, the rate of HAT was 6.0%. Operating microscope anastomosis was associated with a 2.6% decrease in the rate of HAT compared to that of loupe magnification (4.9% and 7.4%, respectively, p<.040). When re-transplants were included, the rate of HAT was 5.8%. Operating microscope anastomosis was associated with a 1.0% decrease in the rate of HAT compared to that of loupe magnification (5.3% and 6.3%, respectively, p<.279). Meta-analysis of eligible studies demonstrated a reduction in the rate of HAT with the use of an operating microscope (p<.03). Anastomosis under an operating microscope may be associated with decreased rates of HAT in children undergoing primary liver transplantation. Further high-quality studies comparing the two techniques are needed.

Vascular implants - new aspects for in situ tissue engineering.

Conventional synthetic vascular grafts require ongoing anticoagulation, and autologous venous grafts are often not available in elderly patients. This review highlights the development of bioartificial vessels replacing brain‐dead donor‐ or animal‐deriving vessels with ongoing immune reactivity. The vision for such bio‐hybrids exists in a combination of biodegradable scaffolds and seeding with immune‐neutral cells, and here different cells sources such as autologous progenitor cells or stem cells are relevant. This kind of in situ tissue engineering depends on a suitable bioreactor system with elaborate monitoring systems, three‐dimensional (3D) visualization and a potential of cell conditioning into the direction of the targeted vascular cell phenotype. Necessary bioreactor tools for dynamic and pulsatile cultivation are described. In addition, a concept for design of vasa vasorum is outlined, that is needed for sustainable nutrition of the wall structure in large caliber vessels. For scaffold design and cell adhesion additives, different materials and technologies are discussed. 3D printing is introduced as a relatively new field with promising prospects, for example, to create complex geometries or micro‐structured surfaces for optimal cell adhesion and ingrowth in a standardized and custom designed procedure. Summarizing, a bio‐hybrid vascular prosthesis from a controlled biotechnological process is thus coming more and more into view. It has the potential to withstand strict approval requirements applied for advanced therapy medicinal products.

Balloon-Assisted Retrograde Puncture of Distal Vessels in Patients Unsuitable for a Conventional Transpedal Approach

Purpose: To describe a novel bailout technique to approach below-the-knee chronic total occlusions after a failed bidirectional recanalization attempt using the plantar loop maneuver in patients who are poor candidates for a retrograde puncture. Technique: After a failure of recanalization of the opposite tibial artery using the plantar loop maneuver, an assisted direct retrograde transpedal approach can be performed regardless of poor vessel caliber or even arterial occlusion. After crossing the plantar arch, a low profile angioplasty balloon is used as a landmark for the pedal puncture and to give guidance for the wire advancement from the new access. Conclusion: A balloon-assisted retrograde transpedal approach may be considered for below-the-knee recanalization after standard plantar loop technique failure in patients who are not candidates for conventional retrograde puncture.

Outcomes of Arteriovenous Fistula Creation in Patients Undergoing Hemodialysis: An Indian Experience.

IntroductionCreating an arteriovenous fistula (AVF) to provide a patent and long-term vascular access (VA) for hemodialysis (HD) still remains a challenge. A methodical approach to choosing the appropriate HD access in accordance with patients’ end-stage kidney disease (ESKD) life plan will help them achieve their goals safely. This study summarizes the impact of various factors on the AVF outcomes in an Indian population as well as the necessary considerations before choosing the site of AVF creation.Materials and methodsThis study involved a single-center, retrospective evaluation of all patients who had undergone arteriovenous (AV) access creation for maintenance HD from October 2018 to August 2019 at a center in India.ResultsIn our study of 216 cases, the average age at presentation was 43.9 years and the difference in age between the successful and unsuccessful group was not significant. The successful outcomes in males were significantly higher than those in females (p=0.005). The mean venous diameter in the successful group was significantly larger than that in the unsuccessful group. The distal arterial and vein diameter was higher in both males and females of the laborer group compared to the clerical group; however, the outcomes were comparable. The overall complication rate was 22.22%. We had primary patency rates of 83% at the end of one year with a primary failure rate of 8.80%.ConclusionVein diameter was the most important predictive factor for a successful outcome in our study. Factors like age and life expectancy, gender, comorbidities, occupation, and type of anastomosis may not be individually predictive of outcomes but need to be considered before choosing the appropriate site of access creation according to the life plan of the patient. This will reduce morbidity associated with an additional procedure and facilitate the initiation of HD as early as possible. Occupation can be considered as a surrogate for preoperative forearm exercises with the increased caliber of vessels found in people performing heavy/manual labor favoring a more distal AVF creation.

Relationship of retinal vascular caliber with age and cardiometabolic diseases in the population over 50 years of age

To explore the associations between the caliber of retinal vessels and cardiometabolic diseases in a population sample of men and women from middle-aged to elderly (Novosibirsk). The subjects were participants of the Russian cohort - part of the international project HAPIEE, and were initially examined in 2003-2005 (n=9360, aged 45-69 years, Novosibirsk). At the third survey in 2015-2017, a random sub-sample of men and women (n=1011) was formed for an in-depth evaluation. We performed a calibrometric analysis involving measurement of central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE), and CRAE-to-CRVE ratio (AVR). In a population sample of men and women aged 55-84 years, age increment is accompanied by a decrease in the calibers of retinal arterioles and venules (p<0.001). Arterial hypertension (AH) was accompanied by a decrease in CRAE, CRVE (p=0.001) and AVR (p<0.001); the associations between AH, CRAE and AVR were independent from other factors. Multivariate analysis showed that CRAE and CRVE were inversely associated with the presence of DM2 (p=0.026). Carotid atherosclerosis was accompanied by an increase in CRVE (p<0.002); this relationship was mainly attributed to age and metabolic factors. There were no associations between carotid atherosclerosis and either CRAE or AVR. The multivariate analysis identified the weak positive associations of CRAE and AVR with the presence of ischemic heart disease and CVD. In the examined population sample aged 55-84 years, a number of associations were detected between retinal vascular caliber and cardiometabolic diseases. The observed changes in the microvascular bed of the retina may be important for prognosis of the course of common cardiometabolic diseases.

RETINA VESSELS CHANGES IN CHORNOBYL NUCLEAR POWER PLANT EMPLOYEES WHO EXPERIENCED LONG-TERM ABNORMAL RADIATION EXPOSURE AT THE WORKPLACE AS A RESULT OF THE OCCUPATION OF CHORNOBYL NUCLEAR POWER PLANT IN 2022.

to assess the condition of retinal arteries and veins and the level of incorporated 137Cs content in persons who were exposed to prolonged exposure to radiation and non-radiation factors of industrial environment, as they were at the workplace overtime during the occupation of the Chornobyl Nuclear Power Plant in 2022. A comprehensive ophthalmological examination was carried out. Which included the determination of the diameter of the retinal arteries and veins, the arteriovenous ratio, of 55 people from among the personnel of the ChNPP, who worked under the conditions of the occupation of the ChNPP. All those examined were examined on an expert human radiation counter. The results of the ophthalmological examination were compared with the results of earlier examinations of ChNPP employees of the same age groups. It was established that in the examined group, a decrease in the arterio-venous ratio was observed, mainly due to the expansion of retinal veins. Dilatation of the veins was asymmetric, mainly the branches of the central vein of the retina of the right eye were more dilated. Retinal arteries were narrowed in all examined subjects. When comparing the results with the data of previous examinations, it was established that the arterio-venous ratio in this group was probably lower than in previously examined employees of the ChNPP of the same age groups. At the same time, the maximum registered value of the content of incorporated 137Сs was 713 Bq/organism, none of the examined exceeded the control level of 1,000 Bq/organism. Violation of blood circulation in the retina was detected - a probable increase in the arteriovenous ratio due to the expansion of the retinal veins in the personnel of the Chornobyl nuclear power plant who worked under the conditions of the occupation of the ChNPP in 2022. Since the examined subjects did not exceed the control level of incorporated 137Сs content (1,000 Bq/organism), the observed effect may be a consequence of the influence of other, both radiation and non-radiation factors.