Middle mesenteric artery visualized by computed tomographic angiography

1999 ◽  
Vol 24 (6) ◽  
pp. 556-558 ◽  
Author(s):  
J. Koizumi ◽  
B. J. d'Othée ◽  
P. Otal ◽  
H. Rousseau ◽  
F. Joffre ◽  
...  
Keyword(s):  
Mesenteric Artery ◽  
Computed Tomographic Angiography ◽  
Computed Tomographic ◽  
Middle Mesenteric Artery ◽  
Tomographic Angiography

Endovascular Treatment for Acute Mesenteric Ischaemia in a Young Woman with Polyarterial Disease

2017 ◽  
Vol 26 (1) ◽  
pp. 81-84
Author(s):  
Mihai C. Ober ◽  
Călin Homorodean ◽  
Dan A. Tătaru ◽  
Antonia E. Macarie ◽  
Camelia D. Ober ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Bowel Perforation ◽  
Computed Tomographic Angiography ◽  
Mesenteric Ischaemia ◽  
Acute Mesenteric Ischaemia ◽  
Computed Tomographic ◽  
Coeliac Trunk ◽  
Tomographic Angiography

Background: Acute mesenteric ischaemia is a condition with a grim prognosis on conservative treatment. Endovascular revascularisation is a promising approach for some of these patients.Case report: We present the case of a 44-year-old woman with a history of severe arterial hypertension, left leg claudication, and overlooked symptoms of chronic mesenteric ischaemia for one year, who was admitted for severe abdominal pain for one week. Computed tomographic angiography (CTA) showed acute mesenteric ischaemia by occlusion of the coeliac trunk and the superior mesenteric artery (SMA), without bowel perforation. In addition, CTA showed tight left renal stenosis and left external iliac stenosis. We performed angioplasty with a stent of the SMA, followed by revascularisation of the left renal artery. On control injection, the SMA appeared re-occluded, requiring a second stent implantation and a loading dose of dual antiplatelet therapy, with a good final result. Subsequently, the clinical course was uneventful, with no need of surgical exploration; a second procedure was planned, aiming at iliac revascularisation. At one month, the patient was asymptomatic, with normal Doppler flow in the SMA. Angiographic control during iliac revascularisation procedure showed a permeable SMA with a good filling of the coeliac trunk territory. Because of the suspicion of fibro-muscular dysplasia as aetiology, coronary angiography and cerebral CTA were performed, in order to exclude other potential lesions.Conclusions: Endovascular revascularisation in AMI is a promising alternative to the surgical approach in patients presenting without bowel perforation. Nevertheless, its safety and many tactical details remain to be clarified. Existing networks for revascularisation in acute myocardial infarction may be useful for the implementation of this approach.Abbreviations: AMI: Acute Mesenteric Ischaemia; CTA: Computed Tomographic Angiography; ICU: Intensive Care Unit; SMA: Superior Mesenteric Artery; STEMI: ST-segment Elevation Myocardial Infarction.

Efficiency Assessment of Multidetector-Row Computed Tomographic Angiography Using Reconstruction With Locoregional Perforator Flaps

2021 ◽  
pp. 229255032110247
Author(s):  
Pavlo O. Badiul ◽  
Sergii V. Sliesarenko ◽  
Nataliia O. Cherednychenko ◽  
Olga V. Morgun
Keyword(s):  
Perforator Flap ◽  
Computed Tomographic Angiography ◽  
Surgical Reconstruction ◽  
Patient Treatment ◽  
Controlled Study ◽  
Control Group ◽  
Perforator Flaps ◽  
Multidetector Row ◽  
Computed Tomographic ◽  
Tomographic Angiography

Background: Reconstruction with the use of perforator flaps makes it possible to make the skin surface resistant to the influence of mechanical factors and as similar to the lost skin cover as possible. However, while planning any flap, along with the design of the required shape and size, its blood supply should be taken into account to ensure optimal viability. Therefore, the task to precisely determine the topographic–anatomical relationships suitable for the formation of a pedicle of perforators is still relevant. The aim of this study was to increase the efficiency of surgical reconstruction of wound defects by transposition of locoregional perforator flaps. Methods: The authors conducted a retrospective analysis of 72 cases of reconstruction by means of locoregional perforator flaps with vascular pedicle detachment to determine the efficiency of preoperative diagnostic preparation with the help of multidetector-row computed tomographic angiography (MDCT) in the process of reconstruction. Thirty-seven individual cases of surgical interventions were chosen using a case-controlled study from the study group when MDCT with angiography was used for preoperative planning of perforator flaps, as well as 35 control cases similar in terms of important predictive peculiarities with the reconstruction at the same level of difficulty. The patient groups were precisely matched by gender ( P = .950), age ( P = .804), flap area ( P = .192), and type of reconstruction that was performed. Results: In all cases, the location of the perforator with a diameter greater than 1.0 mm was marked. All perforators determined during MDCT scanning were faultlessly localized intraoperatively. The distance between the intraoperative position of the perforator and the position obtained in the result of the examination did not exceed 1 cm. There was no need to change the planned design of the flap intraoperatively. In all cases where MDCT was performed, the duration of the surgical procedure varied from 60 to 150 minutes (average: 120.77 [18.90] minutes) and was reduced by 49.40 minutes (95% CI: 39.17-59.63) compared with the patients who did not undergo preoperative visualization of perforators where the average duration of the operation was 170.17 (19.19) minutes (from 140 to 220 minutes). Among the patients examined by MDCT, surgical complications were noted in 5 cases (13.51%) compared to 14 cases (40.00%) in the control group. Conclusions: The preoperative MDCT for the locoregional perforator flap reconstruction makes it possible to increase the efficiency of patient treatment given the reduction in surgery duration by 49.40 minutes (95% CI: 39.17-59.63) on average and the reduction in the level of postsurgery complications from 40% to 13.5% compared with the group of patients in whom presurgical visualization was not performed ( P = .031).

scholarly journals Microsurgical Anatomy of the Anterior Circulation of the Brain Adjusted to the Neurosurgeon’s Daily Practice

2021 ◽  
Vol 11 (4) ◽  
pp. 519
Author(s):  
Tomas Poblete ◽  
Daniel Casanova ◽  
Miguel Soto ◽  
Alvaro Campero ◽  
Jorge Mura
Keyword(s):  
Daily Practice ◽  
Computed Tomographic Angiography ◽  
Poor Quality ◽  
Surgical Anatomy ◽  
Microsurgical Anatomy ◽  
Anterior Circulation ◽  
Computed Tomographic ◽  
Intrinsic Complexity ◽  
Tomographic Angiography

The study of cerebrovascular anatomy can be difficult and may take time due to its intrinsic complexity. However, it can also be difficult for the following reasons: the excessive description of neuroanatomy making articles hard to read, the unclear clinical application of what is written, the use of simplified or intricate schematic drawings that are not always appropriate for effective teaching, the poor quality of neuroanatomy dissections and the use of unusual views of figures that are not strictly related to the most frequent neuroimages to be interpreted in daily practice. Because of this, we designed an article that incorporates original and accurate anatomical dissections in an attempt to improve its comprehensibility. Five formalin-fixed adult cadaveric heads, whose vessels were injected with a colored silicone mixture (red for arteries and blue for veins), were dissected and examined under a microscope with magnifications from 3× to 40×. Special emphasis has been placed on correlating topographic anatomy with routine neuroimaging studies from computed tomographic angiography (CTA) and digital subtraction angiography (DSA). The essential surgical anatomy in a neurosurgeon’s daily practice is also described. The cadaveric dissections included in this study contribute to the understanding of the cerebrovascular anatomy necessary for the neurosurgeon’s daily practice.

scholarly journals Management of a spontaneous supra-aortic arterial dissection: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Omar M. Sharaf ◽  
Tomas D. Martin ◽  
Eric I. Jeng
Keyword(s):  
Innominate Artery ◽  
Operative Management ◽  
Computed Tomographic Angiography ◽  
Artery Dissection ◽  
Term Therapy ◽  
Type I ◽  
Computed Tomographic ◽  
Tomographic Angiography ◽  
Aortic Dissections ◽  
Isolated Innominate Artery

Abstract Background Acute DeBakey type I and type II aortic dissections are indications for emergent surgical repair; however, there are currently no standard protocols in the management of isolated supra-aortic dissections. Prompt diagnosis and management of an isolated innominate artery dissection are necessary to prevent distal malperfusion and thromboembolic sequelae. Case presentation A 50-year-old Caucasian gentleman presented with chest pain radiating to his jaw and right arm. He had no recent history of trauma. On physical exam, he was neurologically intact and malignantly hypertensive. Computed tomographic angiography of the chest and neck confirmed a spontaneous isolated innominate artery dissection without ascending aorta involvement. Given the lack of evidence for rupture, distal emboli, and/or end-organ malperfusion, the decision was made for initial non-operative management—anti-impulse regimen, antiplatelet therapy, and close follow-up. Conclusions Medical management of a spontaneous isolated innominate artery dissection is appropriate for short-term and potentially long-term therapy. This not only spares the patient from a potentially unnecessary surgical operation but also provides the surgeon and the patient the time to plan for a surgical approach if it becomes necessary.

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