• Multislice computed tomography enables detection and evaluation of the coronary artery anomalies. • Anomalous anatomy of the coronary artery potentially influences the prevalence of adverse events. • Adverse events tend to be most common in anomalous right coronary arteries.
PurposeThe aim of the study was to perform CT angiography-based evaluation of aberrant right subclavian artery prevalence, anatomy, and its influence on clinical symptoms.MethodsA total of 6833 patients who underwent 64-slice or dual-source CT angiography and those who revealed aberrant right subclavian artery underwent evaluation of its anatomy and were interviewed for the presence of clinical symptoms.ResultsAberrant right subclavian artery was found in 32 (0.47%) patients consisting of 13 males and 19 females, with mean age of 60.8±13.4 years. Among the interviewed 30 (94%) patients, oesophageal compression was observed in 14 cases (47%) and tracheal compression in three cases (10%). None of the patients underwent surgery related to aberrant right subclavian artery. Dysphagia was the most common clinical symptom in nine cases (30%), and in those patients the median distance between aberrant right subclavian artery and trachea was lower (4 mm) than in individuals without dysphagia (7.5 mm) (p = 0.009). The median lumen area of the aberrant right subclavian artery at the level of oesophagus was higher in patients with dysphagia (208 mm2) compared with individuals without dysphagia (108 mm2) (p = 0.01).ConclusionsAberrant right subclavian artery is a rare occurring abnormality in CT angiography. In the evaluated adult population, the most common symptom was dysphagia, which occurred in patients with decreased distance between aberrant right subclavian artery and trachea and increased lumen area of the aberrant artery at the level of compressed oesophagus.
Background Analysis of morphometric details of aortic coarctation and collateral circulation using computed tomography (CT) and its impact on clinical symptoms is a perspective which is missing in the published literature. Purpose To perform CT-based qualitative and quantitative evaluation of aortic coarctation and collateral circulation with reference to clinical symptoms. Material and Methods The study comprised 2022 patients who underwent CT angiography. If aortic coarctation was seen, the patients underwent evaluation of its anatomy and associated clinical symptoms. Results Aortic coarctation was found in 33 patients. Follow-up (median 2476 days; range 1692–3543) was performed in 31 (94%) individuals. In this group (median age 42 years; range 30–52.5 years), median stenosis at the site of coarctation was 70% (range 58–85%) of the lumen area, with 17 (55%) patients presenting with significant (≥70%) stenosis. Patients with significant stenosis had a greater right and left internal mammary artery diameter ( P = 0.0070 and P = 0.0114, respectively) than those with mild stenosis. Patients with significant coarctation stenosis revealed hypertension and headache more commonly than those with mild stenosis (17 vs. 9, P = 0.01 and 10 vs. 2, P = 0.02), respectively. In patients who underwent intervention, a decrease in prevalence of hypertension (19 vs. 0, P = 0.008) and headache (12 vs. 3, P = 0.010) were observed in the follow-up. Conclusion CT enables quantitative and qualitative evaluation of aortic coarctation anatomy, including stenosis at the site of coarctation, and collateral circulation. In adult patients with aortic coarctation, the prevalence of hypertension and headache is related to the degree of stenosis at the site of coarctation and decreases after intervention.
We present a 76-year-old patient with multiple renal angiomylipoma in one kidney. The patient had not been having any urinary tract symptoms, the lesions in kidney were visualized in US examination performed because of cholelithiasis suspicion. Angiomyolipoma is included to the benign tumors of hamartoma group and its growth is related to the hormonal activity of the organism. Multiple renal angiomyolipomata, occurring very rarely, are usually related to the tuberous sclerosis syndrome (Bourneville-Pringle disease). The nature of this disease is the occurrence of multiple hamartoma type tumors in the skin, brain, kidneys, heart, bones, lungs and eyes. Small renal angiomyolipomata are asymptomatic and are usually accidentally diagnosed during imaging examinations, big ones may be the reason of significant ailments. Among severe, life threatening complications of renal angiomyolipoma one can number bleeding from the tumor. Bleeding risk depends on the tumor diameter and significantly increases in tumors of the diameter above 4 cm. Computed tomography is an imaging method recommended for the assessment of hemorrhagic complications in angiomyolipoma. The check-up frequency depends on the tumor diameter – in tumors smaller than 4 cm the examination is performed once yearly, in tumors greater than 4 cm – every 6 months. In the treatment of hemorrhagic complications of angiomyolipoma, a surgical treatment (partial or radical nephrectomy) or renal vessel embolization is used. Renal arteriography with embolization is an important therapeutic method to control the bleeding and to avoid surgery.
The aim of the following paper is to present the institution of the prenuptial and postnuptial marriage contracts in Polish and Russian law. The Author tries to point out the similarities and differences of both legal systems. In Poland these regimes are regulated in one act – Family and Guardianship Code, in Russia are partly regulated in the Civil Code of the Russian Federation and more widely in the Family Code of the Russian Federation. In both systems legislator admits the contractual property regimes, opposite the statutory property regime. The Author focus on pointing out such issues as conclusion of the marriage contract, its content and the limitations of freedom of concluding the marriage contracts.
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