Based on this large cohort, the prevalence of CPAF in the Chinese population is about 0.17%, with origin from either the left or right coronary artery or from both. CTCA can clearly visualize the types, abnormal vascular tracts, and aneurysmal sac formation of CPAF.
The axillopectoral muscle is a rarely discussed variant of muscular anatomy of the axilla, with various clinical implications. We report a case of a 7-year-old girl with multiple genetic and developmental abnormalities who presented with asymmetrical right axillary bulging of unknown etiology. MRI demonstrated a small accessory axillary muscle, known as Langer's axillary arch and/or the axillopectoral muscle. Other than soft-tissue asymmetry, the patient experienced no additional related symptoms. However, this is an important variant to be aware of, as it can easily be discovered on imaging and may be a causative agent for various upper extremity symptoms that may resolve with appropriate recognition and surgical intervention.
To compare the safety and effectiveness of CT-guided percutaneous pericardial drainage (PPD) with surgical pericardial drainage (SPD). Materials: Using a retrospective design including a chart review, 257 patients with symptomatic pericardial effusions were identified including 142 that were treated with a PPD and 115 with SPD. Primary outcomes of interest were short-term complications and recurrence (defined as occurring in 30 days' post-procedure). Examples of complications included pneumothorax, myocardial stick, arrhythmia, DVT, CVA, etc. Recurrence was evaluated based on the presence of pericardial effusion on post-procedural imaging necessitating repeat drainage. Additional variables analyzed as surrogates of effectiveness included but were not limited to days of hospitalization, duration of drainage catheter, and change in mean arterial pressure post intervention. Tests for differences in distributions between intervention groups were performed using Wilcoxon rank sum test. Tests for differences in explanatory variables between intervention groups were performed using chi-square tests. A result was considered significant if p < 0.002 using a Bonferroni correction for multiple tests. Results: Overall, 9% of the patients experienced short-term complications and 16% had a recurrence. A statistically significant association was observed between whether or not a patient experienced short-term complication and the intervention that the patient received (p < 0.001). Among patients who experienced short-term complications, the proportion of patients who underwent SPD, 17%, was significantly greater than the proportion of patients who were treated with PPD, 2%. The estimated odds of having complications if the patient received an SPD was 9 times greater than if the patient received PPD (OR¼9.3, 95% CI: 2.7 to 32.2). No statistically significant difference was observed between whether or not a patient experienced a recurrence within 30 days post SPD or PPD (OR¼0.86, 95% CI: 0.44 to 1.7). Conclusions: CT-guided PPD is a safer alternative to SPD in patients with symptomatic pericardial effusion and the odds of recurrence within 30 days are not significantly different between the two groups.
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