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Cerebral artery anatomy

Ryan C Shelstad, Justin G Reeves, Katsuhiro Yamanaka, T Brett Reece
We review the operative techniques of aortic arch replacement. Aortic arch replacement presents several formidable challenges, as it requires arresting the circulation to the body and replacement of the brachiocephalic vessels with special consideration for protecting the central nervous system. Perfusion strategies, selective antegrade cerebral perfusion, and operative graft selection are key elements in aortic arch replacement surgery. Standard approaches include the island technique, the branched graft technique, and the "Spielvogel" trifurcated graft technique-each having its own advantages...
October 7, 2016: Seminars in Cardiothoracic and Vascular Anesthesia
P E Frid, S J Schreiber, O Pade, F Doepp, J Valdueza
PURPOSE: To differentiate PCA segments and cortical branches by means of transcranial color-coded duplex sonography (TCCD) and to measure flow parameters at rest and during visual stimulation. MATERIALS AND METHODS: 60 healthy subjects with a good acoustic temporal bone window were examined. The main stem of the PCA (P1, P2 and P3) and 4 main cortical branches - the anterior temporal artery (ATA), the occipital temporal artery (OTA), the parietooccipital artery (POA) and the calcarine artery (CA) - were assessed using an axial transtemporal approach...
November 2015: Ultrasound Int Open
Stephen L Lambert, Frank J Williams, Zhora Z Oganisyan, Lionel A Branch, Edward C Mader
Fetal-type or fetal posterior cerebral artery (FPCA) is a variant of cerebrovascular anatomy in which the distal posterior cerebral artery (PCA) territory is perfused by a branch of the internal carotid artery (ICA). In the presence of FPCA, thromboembolism in the anterior circulation may result in paradoxical PCA territory infarction with or without concomitant infarction in the territories of the middle (MCA) or the anterior (ACA) cerebral artery. We describe 2 cases of FPCA and concurrent acute infarction in the PCA and ICA territories-right PCA and MCA in Patient 1 and left PCA, MCA, and ACA in Patient 2...
July 2016: Journal of Investigative Medicine High Impact Case Reports
Karen Cilliers, Benedict John Page
The middle cerebral artery (MCA) covers a large part of the cerebral hemispheres and is therefore exposed during surgical intervention in this area. Aspects of cerebral branches tend to vary, different branching patterns can be described, and several anomalies can be observed. Knowledge of these variations and anomalies is important and can be helpful to neurosurgeons and clinicians. The aim of this study was to review the available literature on the cortical branches, branching pattern and anomalies of the MCA, to identify the gaps in the literature, and to fill these gaps by including the results of a pilot study...
June 16, 2016: Turkish Neurosurgery
José E Cohen, Samuel Moscovici, Hosni Abu El Hassan, Omer Doron, Eyal Itshayek
Anterior communicating artery aneurysms frequently present wide necks and incorporate parent vessels. They are associated with significant variations in vascular anatomy, especially hypoplasia or aplasia of one of the proximal anterior cerebral arteries. Safe and complete endovascular occlusion of these aneurysms usually requires the assistance of complex approaches including dual stenting. We describe a technique for T-configured stent-assisted coiling in the management of ruptured wide-necked AcomA aneurysms by means of two simultaneous microsystems that allowed placement of two nitinol self-expandable Leo+ Baby stents (Balt Therapeutics, Montmorency, France) followed by coiling...
August 28, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Q Lan, A L Chen, T Zhang, Q Zhu, T Xu
OBJECTIVE: Three dimensional (3D) printing technique was used to prepare the simulate craniocerebral models, which were applied to preoperative planning and surgical simulation. METHODS: The image data was collected from PACS system. Image data of skull bone, brain tissue and tumors, cerebral arteries and aneurysms, and functional regions and relative neural tracts of the brain were extracted from thin slice scan (slice thickness 0.5 mm) of computed tomography (CT), magnetic resonance imaging (MRI, slice thickness 1mm), computed tomography angiography (CTA), and functional magnetic resonance imaging (fMRI) data, respectively...
August 9, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Kunakorn Atchaneeyasakul, Luis Guada, Kevin Ramdas, Mitsuyoshi Watanabe, Pallab Bhattacharya, Ami P Raval, Dileep R Yavagal
BACKGROUND: Stroke is one of the leading causes of death and long-term disability worldwide. Recent exciting developments in the field with endovascular treatments have shown excellent outcomes in acute ischemic stroke. Prior to translating these treatments to human populations, a large-animal ischemic stroke model is needed. With the advent of new technologies in digital subtraction angiography, less invasive endovascular stroke models have been developed. Canines have gyrencephalic brain similar to human brain and accessible neurovascular anatomy for stroke model creation...
August 3, 2016: Brain Research Bulletin
Y Chau, L Mondot, M Sachet, J Gaudart, D Fontaine, M Lonjon, J Sédat
BACKGROUND AND PURPOSE: Recent studies demonstrated the capacity of stents to modify cerebral vascular anatomy. This study evaluates arterial anatomy deformation after Leo stent placement according to the stenting site and the impact on the immediate postoperative and six-month degree of aneurysmal occlusion. MATERIALS AND METHODS: A total of 102 stents were placed against the neck of aneurysms situated in the anterior cerebral circulation. Aneurysms were classified into two groups: The first was called the distal group (n = 62) and comprised aneurysms situated in the middle cerebral and anterior communicating arteries and the second was called the proximal group (n = 40) and comprised aneurysms in other sites...
August 2, 2016: Interventional Neuroradiology
H Y Li, H Chen, Y M Li, Y Li, X W Shi
OBJECTIVE: To investigate the causes and strategies for intraoperative rupture during clipping the anterior circulation aneurysms. METHODS: Nineteen patients with anterior circulation aneurysms ruptured during clipping, who admitted to the Department of Neurosurgery, Henan Provincial People's Hospital from November 2012 to February 2014, were enrolled. Their clinical data were analyzed retrospectively to summarize the causes and strategies for intraoperative rupture...
July 5, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Alison B Nair, Peter Oishi
There is new and growing experience with venovenous extracorporeal life support (VV ECLS) for neonatal and pediatric patients with single-ventricle physiology and acute respiratory distress syndrome (ARDS). Outcomes in this population have been defined but could be improved; survival rates in single-ventricle patients on VV ECLS for respiratory failure are slightly higher than those in single-ventricle patients on venoarterial ECLS for cardiac failure (48 vs. 32-43%), but are lower than in patients with biventricular anatomy (58-74%)...
2016: Frontiers in Pediatrics
Bahar Uslu, Yusuf Ozgur Cakmak, Ümit Sehirli, Elif Nedret Keskinoz, Erdal Cosgun, Serap Arbak, Aymelek Yalin
INTRODUCTION: The anatomy of arterial bifurcations affects blood flow and has a significant role in the development of vascular disease. Therefore, it is important to know the structural characteristics of the Common Carotid Artery (CCA) and its branches for early onset of atherosclerosis in newborns. AIM: The present study was conducted to evaluate the characteristics of CCA in newborn cadavers. MATERIALS AND METHODS: Eight carotid arteries obtained from newborn cadavers were used...
May 2016: Journal of Clinical and Diagnostic Research: JCDR
Amin B Kassam, Srikant S Chakravarthi, Juanita Celix, Melanie Fukui, Jonathan Jennings, Sarika Walia, Richard A Rovin
INTRODUCTION: The conventional stereoscopic microscope (CS-m) made safe surgery for intracranial vascular pathology. Recently, an integrated image-guided robotic optical positioning system (ROVOT-m) has been released for clinical use. We undertook a benchside, cadaveric and clinical study to determine its applicability to aneurysm surgery. METHODS: Benchside measurements of field of view (FOV) and depth of field (DOF) were obtained for CS-m and ROVOT-m. Two cadavers were operated on to simulate aneurysm surgery using both CS-m and ROVOT-m...
August 2016: Neurosurgery
Demetri Adrahtas, Patrick Jasinski, George Koullias, David Fiorella, Apostolos Tassiopoulos
OBJECTIVE: To report a case of endovascular treatment of a complex renal artery aneurysm using the Pipeline Embolization Device, a flow diverting stent which is indicated for the treatment of large and giant cerebral aneurysms. CASE PRESENTATION: Forty-year old female with medically refractory hypertension and congenital agenesis of the right kidney was found to have a 2.8-cm left superior renal artery branch aneurysm. The patient was treated successfully using the Pipeline Embolization Device (PED, Medtronic, Irvine, CA) and coil embolization of the aneurysm and deconstruction of one outflow vessel...
July 6, 2016: Annals of Vascular Surgery
Daniel F Arteaga, Megan K Strother, L Taylor Davis, Matthew R Fusco, Carlos C Faraco, Brent A Roach, Allison O Scott, Manus J Donahue
A noninvasive method for quantifying cerebral blood flow and simultaneously visualizing cerebral blood flow territories is vessel-encoded pseudocontinuous arterial spin labeling MRI. However, obstacles to acquiring such information include limited access to the methodology in clinical centers and limited work on how clinically acquired vessel-encoded pseudocontinuous arterial spin labeling data correlate with gold-standard methods. The purpose of this work is to develop and validate a semiautomated pipeline for the online quantification of cerebral blood flow maps and cerebral blood flow territories from planning-free vessel-encoded pseudocontinuous arterial spin labeling MRI with gold-standard digital subtraction angiography...
July 7, 2016: Journal of Cerebral Blood Flow and Metabolism
Dong Seong Shin, Ali Yilmaz, Ayca Ozkul, Dong Kyu Yeo, Sun-Chul Hwang, Bum-Tae Kim
Objective The transfemoral approach is a common route for catheterization of the supra-aortic vessels in neuroendovascular therapy. However, in some cases, the patient's anatomy prevents transfemoral catheterization or distal access to the carotid s. In such cases, direct carotid exposure (DCE) for neuroendovascular approaches may be used to treat cerebrovascular diseases. Methods We present 11 cases in which we were unable to perform the distal approach and DCE was the preferred neuroendovascular treatment procedure...
July 1, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Jun Yoshida, Hiroshi Kashimura, Masaru Takeda, Kenta Aso
BACKGROUND: Although the anatomy of the A1 segment of the anterior cerebral artery (ACA) is highly variable, a callosomarginal artery (CMA) arising from the A1 segment of the ACA is rare. CASE DESCRIPTION: A 27-year-old man presented with severe headache and was admitted to our hospital. Initial computed tomography (CT) showed subarachnoid hemorrhage in the basal cistern. Three-dimensional CT angiography revealed a saccular aneurysm arising from the left internal carotid bifurcation and showed an anomalous cortical branch originating from the left A1 segment of the ACA...
2016: Surgical Neurology International
Habib Cakir, Mert Kestelli, Ismail Yurekli, Bortecin Eygi, Sahin Iscan, Yasemin Isık, Kamil Aşar, Hasan Ogut
BACKGROUND: In this experimental study, we primarily aimed to show the hemodynamic effects and superiority of this newly designed cannula for perfusion compared to standard subclavian cannulation. The new cannula (Figure 1) allows bidirectional axial flow and it directly fits in the brachiocephalic trunk (innominate artery). METHODS: We used a cardiopulmonary bypass roller pump, reservoir, 3/8- 1/2- 1/4-inch Y-connectors and tubing set. Lines were set as seen in Figures 2, 3, 4 and 5...
June 15, 2016: Perfusion
B Law-Ye, B Geerts, D Galanaud, D Dormont, N Pyatigorskaya
In the recently published article, "Unilateral fetal-type circle of Willis anatomy causes right-left asymmetry in cerebral blood flow with pseudo-continuous arterial spin labeling: A limitation of arterial spin labeling-based cerebral blood flow measurements?", it was shown by the method of arterial spin labeling (ASL) that unilateral fetal-type circle of Willis could induce variation of blood flow in cerebellar and posterior cerebral artery territory. We believe that the reported observation, rather than being a limitation, gives several interesting cues for understanding the ASL sequence...
September 2016: Journal of Cerebral Blood Flow and Metabolism
K Cilliers, B J Page
Anomalies of the anterior cerebral artery (ACA) include the median ACA (MedACA), bihemispheric ACA (BihemACA) and the azygos ACA. Knowledge of these anomalies can be crucial to clinicians and neurosurgeons, especially during surgeries involving the interhemispheric region and in the interpretation of the clinical signs of a stroke. Since few reports exist on the origin, area supplied, diameter and length of the ACA anomalies, the aim of this study is to give a detailed description on the anatomy of the ACA anomalies...
May 26, 2016: Annals of Anatomy, Anatomischer Anzeiger: Official Organ of the Anatomische Gesellschaft
Yutaka Mitsuhashi, Koji Hayasaki, Taichiro Kawakami, Takashi Nagata, Yuta Kaneshiro, Ryoko Umaba, Kenji Ohata
The cavernous sinus (CS) is one of the cranial dural venous sinuses. It differs from other dural sinuses due to its many afferent and efferent venous connections with adjacent structures. It is important to know well about its complex venous anatomy to conduct safe and effective endovascular interventions for the CS. Thus, we reviewed previous literatures concerning the morphological and functional venous anatomy and the embryology of the CS. The CS is a complex of venous channels from embryologically different origins...
June 15, 2016: Neurologia Medico-chirurgica
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