Latissimus dorsi tendon transfer (LDTT) is technically challenging. In order to clarify the local structural anatomy, we undertook a morphometric study using six complete cadavers (12 shoulders). Measurements were made from the tendon to the nearby neurovascular structures with the arm in two positions: flexed and internally rotated, and adducted ...

A spontaneous subarachnoid hemorrhage (SAH) from the middle cerebral artery is most commonly caused by the rupture of saccular aneurysms and rarely by fusiform aneurysms or arterial dissections/dissecting aneurysms. To the authors' knowledge, this is the first report of an intraarterial neoplasm causing an SAH. A 44-year-old woman presented with ...

Both surgical and endovascular grafts have the rare risk of late secondary infection. Treatment varies based on the clinical setting, but in general the recommendations are that infected endografts be removed and reconstruction performed. In the abdominal aorta this may vary from homograft or other impregnated grafts to excision and ...

In acute ischemic stroke, the ability to estimate the penumbra and infarction core ratio helps to triage those who will potentially benefit from thrombolytic therapies. Flat-panel post-contrast DynaCT imaging can provide both vasculature and parenchymal blood volume within the angio room to monitor hemodynamic changes during the endovascular procedures. We ...

Free tissue transfer (FTT) is now a common procedure in many surgical centres around the world and it has shown well established results especially in the field of reconstructive surgery. The choice of FTT depends on the size of defect, nature of tissue, length of pedicle and donor site morbidity. ...

We would like to present a case of persistent right sided collapse in a preterm baby with an unexpected diagnosis. Baby X was born floppy requiring resuscitation and was intubated, ventilated and was transferred to NICU. There was decreased air entry on auscultation of right side of the chest, while ...

Epigenetic programming, dynamically regulated by histone acetylation, is a key mechanism regulating cell proliferation and survival. Little is known about the contribution of histone deacetylase (HDAC) activity to the development of pulmonary arterial hypertension, a condition characterized by profound structural remodeling of pulmonary arteries and arterioles. HDAC1 and HDAC5 protein ...

An 83-year-old man with sepsis sustained right common carotid artery injury during attempted central-line placement. A computed tomographic scan showed a large hematoma in the patient's neck and a carotid pseudoaneurysm. His clinical condition was such that transfer to the interventional suite was judged unsafe. Percutaneous thrombin injection was performed ...

A 50-year-old man presented with an aneurysm arising from a fenestration of horizontal portion (A(1)) of the anterior cerebral artery manifesting as subarachnoid hemorrhage. Coil embolization was conducted and the aneurysm was occluded easily. Most reported cases of these types of aneurysms underwent direct surgery. Aneurysm arising from the A(1) ...

Periarterial connective tissue with a moderate amount of collagen fibrils is known to be a specialized domain in the renal interstitium. This study aimed to clarify the microscopic architecture of the periarterial connective tissue as a mechanical supportive structure of the intrarenal arteries. Transmission and scanning electron microscopy revealed two ...

Cerebral aneurysms of traditional animal models are usually too small to be imaged in vivo. A novel rat model induced by ligation of the unilateral common carotid artery and contralateral pterygopalatine and external carotid arteries was investigatid. To evaluate the morphological changes of the cerebral arteries, synchrotron radiation angiography was ...

Background:Determining the superior cervical ganglion's precise anatomical location for local anesthetic block, when stellate block is not feasible or is contraindicated, is difficult.Methods:We dissected the superior cervical ganglion in 60 embalmed cadaveric specimens. Multiple regressions determined whether subject characteristics predicted the distance between the superior cervical ganglion and common carotid ...

Abstract A 45-year-old lady presented with transient ischemic attack symptoms. Subsequent CT and DSA revealed multiple fusiform dilatations of cerebral vessels. A search for sources of emboli led to an atrial myxoma being found on echocardiogram. She made a good recovery after resection of the atrial myxoma. The aneurysms were ...

A 13-year-old girl sufferring from a car accident presented with a symptom of oculomotor nerve palsy. A CT scan revealed diffuse SAH in the suprasellar cistern, cisterna ambiens and interpeduncular cistern. MRI showed contusion of the left cerebral peduncle and a flowing void signal in front of the left cerebral ...

We describe a patient with subcutaneous hematoma associated with manual cervical massage during carotid artery stenting.A 73-year-old man with left cervical carotid artery stenosis presented with left amaurosis fugax. We performed carotid artery stenting using distal embolic protection with balloon occlusion. Dual antiplatelet therapy was maintained in the periprocedural period ...

SUMMARY: We performed high-resolution DIR-BBI of the cervical arteries at 3T in 19 subjects with cervical dissection. It offered excellent visualization of both the lumen and arterial wall, allowing detection of the primary and secondary features of dissection. We suggest that this is a highly useful technique for diagnosis of ...

We describe the surgical management of a free-floating thrombus in the aortic arch in a patient with severe mitral stenosis, a left atrial appendage (LAA) clot, and an iliac artery thrombus. A 60-year-old woman complaining of dyspnea and pain in her right leg was referred to our multidisciplinary clinic. After ...

Arterial Calcification due to Deficiency of CD73 (ACDC) results from mutations in the NT5E gene encoding the 5' exonucleotidase, CD73. We now describe the third familial case of ACDC, including radiological and histopathological details of the arterial calcifications. The medial lesions involve the entire circumference of the elastic lamina, in ...

Clinical studies indicate incomplete functional recovery of hibernating myocardium after coronary artery bypass grafting. We hypothesized that persistent contractile abnormalities after coronary artery bypass grafting are associated with decreased mitochondrial proteins involving electron transport chain that might limit maximal oxygen consumption. Seven pigs with hibernating myocardium underwent off-pump revascularization with ...

Severe respiratory failure related to infection with the pandemic influenza A/H1N1 2009 virus is uncommon but possibly life-threatening. If, in spite of maximal conventional critical care, the patient's condition deteriorates, extracorporeal membrane oxygenation (ECMO) may be a life-saving procedure. An observational study approved by the local ethics committee was carried ...

To assess the effects of local paclitaxel delivery using the Remedy catheter on neointimal hyperplasia in a porcine model and compare these results to commercially available BMS and biodegradable polymer-coated paclitaxel-eluting stents (BP-PES). A total of 31 stents were implanted into coronary arteries of 15 domestic swine including eight BMS, ...

Pulmonary artery catheterization is a useful tool for the diagnosis and management of lung or cardiac disease. This procedure is considered safe and associated with a low incidence of major complications. However, pulmonary artery rupture during right heart catheterization, albeit rare, remains a severe complication. Despite modern management with metal-coil ...

Ultrasound guidance commonly is used for the placement of central venous catheters (CVCs). The Agency for Healthcare Research and Quality recommends the use of ultrasound for CVC placement as one of its 11 practices to improve patient care. Despite increased access to portable ultrasound machines and comfort with ultrasound-guided CVC ...

The inferior phrenic artery (IPA) is the most common extrahepatic collateral vessel to hepatocellular carcinoma (HCC); however, there are many anatomical variations in its origin and branches. In addition, the IPA is frequently reconstructed through several pathways, mainly through the retroperitoneal network, because of the occlusion of its orifice due ...

The occurrence of catheter-induced vasospasm of small caliber arteries is a well known complication of arterial catheterization in neonates. However, there is rare publication about these complications in infants. We report infants with peripheral ischemia caused by arterial catheterization of the femoral artery.

We are reporting the case of a 57 years old male, hypertensive, diabetic, dyslipidaemic who presented with exertional angina. He had a coronary artery bypass surgery, one year ago. He underwent left heart catheterization with graft study which showed critical native triple vessel disease with patent arterial graft to left ...

Coronary angiography and angioplasty are common invasive procedures in cardiovascular medicine, which involve placement of a sheath inside peripheral conduit arteries. Sheath placement and catheterization can be associated with arterial thrombosis, spasm and occlusion. In this paper we review the literature pertaining to the possible benefits of arterial 'prehabilitation'--the concept ...

Imaging is a key element in the study of many rodent models of human diseases. The application of DSA has been limited in these studies in part because of a lack of a method that allows serial intra-arterial examinations to be performed during an extended period of time. It was ...

Arterial line catheterization in the critically ill patient is often an arduous task. Here we identify risk factors in the critical care patient that may predict a more difficult arterial catheter insertion. We also describe our ultrasound technique and review of the literature with regard to location of access, complications, ...

The development of right heart catheterization has provided the clinician the ability to diagnose patients with congenital and acquired right heart disease, and to monitor patients in the intensive care unit with significant cardiovascular illnesses. The development of bedside pulmonary artery catheterization has become a standard of care for the ...

We evaluated the exact quantitative long-term impact of repeated catheterizations, vascular closure devices, and cardiovascular risk factors on the femoral artery after cardiac catheterization. A total of 2,102 available femoral angiograms from 827 consecutive patients were analyzed using caliper-based quantitative vascular analysis. These patients underwent coronary interventions between January 2005 ...

We compared the measurements of the aortic valve area (AVA) using dual-source computed tomography (DSCT) in patients with mid to severe aortic stenosis to measurements using transthoracic echocardiography (TTE) and invasive hemodynamic assessment. A total of 50 patients (mean age 73 +/- 10 years) with suspected aortic stenosis were included. ...

Inadvertent catheterization of brachiocephalic arteries (carotid artery, subclavian artery, or vertebral artery) during attempted placement of a central venous catheter can have potentially disastrous complications. While removal of the catheter in the operating room is almost always an option, there are circumstances in which a less invasive approach may be ...

The aim of this study was to investigate the effect of diagnostic transradial catheterization on vascular function of upstream brachial artery (BA). The transradial access has recently become an alternative to transfemoral cardiac catheterization. A potential caveat of this approach lies in possible sustained physical radial artery (RA) damage. We ...

Arterial catheterization is the second most common invasive procedure performed in the intensive care unit. Despite the ubiquity of the procedure, complications including failure to place the catheter occur. While many clinicians are familiar with the use of ultrasound (US) guidance to decrease complication rates of central venous catheter insertion, ...

Femoral vein catheterization can be undertaken easily and quickly by inexperienced physicians. However, accurate vein puncture is critical to reducing complications that include pseudoaneurysm and arteriovenous fistulae formation.

BACKGROUND: Femoral artery complications after cardiac catheterization range from simple events to severe complications requiring invasive techniques or surgery with significant economic costs. This study evaluated early femoral arterial complications from percutaneous arterial access during diagnostic and interventional cardiac catheterizations in an era of widespread use of closure devices and ...

The purpose of this study was to evaluate the angiographic and histopathologic changes in the superficial femoral artery (SFA) in heparinized sheep shortly after catheterization with an 8-Fr sheath and manual compression hemostasis either with standard manual compression (SMC) or with the use of a procoagulant chitosan-based HemCon Bandage. The ...

Arteriovenous fistula is a possible complication of diagnostic procedures requiring arterial femoral catheterization. Late onset manifestation is reported rarely. An impressive case of severe pulmonary arterial hypertension and consecutive right heart failure caused by an arteriovenous fistula between the common iliac artery and the distal inferior caval vein manifesting four ...

A retrospective analysis of all pediatric patients admitted for acute burn treatment during a 7-year period was conducted to examine patients who underwent femoral artery catheterization and discuss the associated complications and treatment options. The total number of femoral artery catheterizations performed, nature of vascular complications, treatment rendered, and patient ...

BACKGROUND: Femoral artery thrombosis is one of the most common complications of catheterizations in infants and young children. This study was conducted to investigate the feasibility and effectiveness of thrombolytic therapy for femoral artery thrombosis after left cardiac catheterization in children. METHODS: Thrombolytic therapy with urokinase was carried out in ...

We present a simple method to gain femoral vein access for cardiac catheterization in newborns and infants. After contrast injection into a short saphenous vein the femoral vein can be easily punctured under fluoroscopy of the groin. Compared to the landmark-guided technique of palpation of the femoral artery, this method ...

In the neonatal intensive care unit, the use of umbilical artery catheters (UAC) is established. Methods to perform uninterrupted arterial blood gas and pressure monitoring, access for the delivery of fluids and medication, exchange transfusion, cardiac catheterization, and angiography using umbilical artery catheters are used in the care of critically ...

OBJECTIVE: The objective of this study was to examine the patency and utility for subsequent vascular access of the internal jugular vein following use in short-term extracorporeal membrane oxygenation. DESIGN: Retrospective review. SETTING: Pediatric cardiac intensive care unit, pediatric cardiac catheterization laboratory, and pediatric cardiac clinic. PATIENTS: Four children, ages ...

We report an adult with a discrete subaortic membrane in whom two-dimensional transthoracic Doppler echocardiography demonstrated peak and mean gradients of 64 and 33 mmHg, respectively in the left ventricular outflow tract (LVOT) and a calculated orifice area by continuity equation of 1.14 cm(2) consistent with significant obstruction. However, by ...

OBJECTIVE: The objective of this study is to examine the safety/efficacy of alternative routes of vascular access (ARVA) for successful performance of interventions. BACKGROUND: Complex interventional catheterizations may be required in children with limited vascular access, vascular constraints relative to size, and hemodynamic instability. Our approach has been to utilize ...

The aim of the study was to compare the standard technique of cardiac output determination by pulmonary artery catheter thermodilution (PAC-TD) with a noninvasive ultrasound Doppler monitor (USCOM Pty., Ltd., Coffs Harbour, Australia) in surgery for liver transplantation. We wished to determine if the degree of accuracy would allow the ...

PURPOSE: We present an unusual case of extra cardiac activity of 99mTc-MIBI in the left part of thorax and left upper extremity in a patient admitted for myocardial perfusion scintigraphy. METHODS: A standard 2-day protocol of 99mTc-MIBI perfusion scintigraphies starting day 1 with stress (dipyridamol) imaging and followed by rest ...

This study sought to evaluate trends in vascular complications after diagnostic cardiac catheterization (CATH) and percutaneous coronary intervention (PCI) from the femoral artery from 1998 to 2007. Vascular complications have been recognized as an important factor in morbidity after CATH and PCI. Whether strategies to reduce vascular complications performed from ...

A 25-year-old man who had recurrent sore throats presented with sharp central chest pain 5 hours after starting penicillin for tonsillitis. Electrocardiogram (ECG) revealed ST-segment elevation in leads I and aVL with reciprocal ST depression in lead III (Fig. 1). Troponin I was measured as 33 microg/L (normal range, b0.1 ...