3. Cardiovascular 2 Flashcards
What did the Shultz and Rotherwell (2001) study investigate?
Bifurcation of carotid vessels
Measured vessel diameter and area ratios - >5000 patients
Relationship between bifurcation anatomy, haemodynamics and atheroma
What did the Nathal et al (1992) study investigate?
Variations of the anterior communicating artery of the Circle of Wills
134 patients
Associations between variations and cerebrovascular disease was high
Intra-operative - outcome dependent on patient’s clinical grade on admission, not variations
What did the Horikoshi et al (2002) study investigate?
Correlation between aneurysm in anterior communicating artery and asymmetry of anterior cerebral arteries
Sheer stress build up due to increased blood flow
MR angiograms - 131 patients with aneurysm, 440 with no aneurysm
Two variations of circle of wills anatomy:
Type P - more common in females
Type A - more common in males
What did the Bugnicourt et al (2009) and Cucchiara et al (2013) studies investigate?
Incomplete circle of wills is associated with migrane (no difference between aura/ no aura though)
Incomplete circle - greater asymmetry in hemspheric cerebral blood flow
Name 3 studies that show that variants in vessels have a clinical impact
Comert et al 2004 - bracheocephalic variant and tracheotomy
Lin et al, 1998 - central venous access via IJV
Loukas et al, 2005
What did the Comert et al (2004) study investigate?
Bracheocephalic trunk covered the trachea
Was perforated during percutaneous tracheotomy
Extensive bleeding
What did the Lin et al (1998) study investigate?
Variations in patterns between veins and arteries in terms of size and positioning relative to ecah other
27/104 patients had IJV variations that may contribute to difficulty in external landmark guided IJV access
Overcome by using ultrasound
What did the Loukas et al (2005) study investigate?
Normal radial artery - forms complete palmar arch with ulnar
200 hands - 90% complete superficial palmar arch, 5 types
Some had median artery
Useful variation - if radial artery becomes damaged
What issues can arise with variations during organ transplant?
Very anomalous vessels / very short vessels are hard to connect
What did the Gruttandauria et al (2001) study investigate?
701 liver transplant cases - 296 hepatic artery variations
What did the Carlson and McDonald (1982) study investigate?
Access problems
Access to left common carotid artery via catheter is difficult is LCC arises as a variant instead of from the aortic arch
What 2 papers looked at anomalous vessel compression?
De-Giorgio et al (2011)
Konskan et al (2005)
What did the De-Giorgio et al (2011) study investigate?
Compression of right coronary artery
At an acute angle to aortic lumen
Every time aorta expanded, RCA was compressed
What did the Konskan et al (2005) study investigate?
L subclavian artery perforated scalenus anterior
Compression of artery when muscle contracted
Thoracic outlet syndome
