Anatomical significance in aortoiliac occlusive disease

Wooten, Candace; Hayat, Munawar; Plessis, Maira du; Cesmebasi, Alper; Koesterer, Michael; Daly, Kevin P.; Matusz, Petru; Tubbs, R. Shane; Loukas, Marios

doi:10.1002/ca.22444

Cited by 33 publications

(28 citation statements)

References 69 publications

(106 reference statements)

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“…For patients with Leriche syndrome, the following two pathways are important as collateral arteries to the lower limbs; i) subclavian artery-internal thoracic artery-superior epigastric artery-inferior epigastric artery pathway and ii) subclavian artery-internal thoracic artery-lower intercostals or subcostals arteries-deep circumflex iliac artery pathway (4). CT angiography can aid surgeons in identifying anatomical vascular variations preoperatively (10,11).…”

Section: Discussionmentioning

confidence: 99%

“…First, the blood flow to the rectum is also reduced because of occlusion of the internal iliac arteries and/or inferior mesenteric artery (IMA), and therefore, reconstruction with anastomosis may be complicated by ischemia when performing rectal cancer surgery. Second, the blood flow to the lower limb is supplied by collateral arteries, such as the inferior epigastric artery and deep circumflex iliac artery (4), and therefore, attention should be paid not to injure them during trocar insertion when performing laparoscopic surgeries.…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic surgery for colorectal cancers complicated by Leriche syndrome: A report of three cases

et al. 2017

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Leriche syndrome is a disease of aortoiliac occlusion, which causes diminished femoral pulses, impotence and claudication. As blood flow to the rectum is also decreased in Leriche syndrome, reconstruction with anastomosis may be complicated by ischemia when performing rectal cancer surgery. The inferior epigastric arteries often provide collateral circulation to the lower limbs in patients with Leriche syndrome, therefore, attention should be paid not to injure them during trocar insertion when performing laparoscopic surgeries. The present study is a report on three cases of patients with colorectal cancer who were successfully treated with laparoscopic surgeries. The first case was of a 71-year-old man with rectal cancer. A preoperative computed tomography (CT) scan revealed occlusion of the aorta below the origin of the inferior mesenteric artery. The blood flow to the lower limbs was supplied through collateral arteries, including the inferior epigastric arteries and the deep circumflex iliac arteries. A laparoscopic Hartmann's operation was performed successfully following marking of the inferior epigastric arteries using ultrasonography to avoid damaging them during trocar insertion. The second case involved a 70-year-old man with three colorectal cancers of the transverse and sigmoid colon and rectum. A CT scan revealed occlusion of the aorta below the origin of the renal arteries. Laparoscopic assisted low anterior resection and left hemicolectomy with colostomy were performed. The final patient was a 61-year-old man with rectal cancer. As the right internal iliac artery was patent, the patient underwent laparoscopic assisted low anterior resection. All the patients were discharged from the hospital without complications. It is important to visualize the image the blood flow via CT angiography and to mark collateral arteries using ultrasonography preoperatively in patients with Leriche syndrome for whom laparoscopic surgery was planned for to treat colorectal cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Laparoscopic surgery for colorectal cancers complicated by Leriche syndrome: A report of three cases

et al. 2017

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“…For the training of students and residents in medicine, the anatomical study uses, apart from the classical dissection technique [15][16][17], the plastinated preparations…”

Section: Discussionmentioning

confidence: 99%

Morphological Variability of the Hepatic Portal Vein Lateral Branches. Study on corrosion casts

Pusztai¹,

Ioanoviciu²,

Matusz³

2017

Mat.Plast.

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The liver segmentation is mainly determined by the intraparenchymatous distribution of the vascular and ductal hepatic elements; from this, the hepatic portal vein (HPV), is the most important afferent element. The lateral branches (LBrs) are serving left lateral division (LLD) of the liver and present a moderate morphological variability. On a total of 160 pieces of liver corrosion casts, one examined the intraparenchymal distribution of portal LBrs and the segmentation of LLD. Regarding the intraparenchymal distribution of the portal branches in the LLD of the liver, we showed two distinct morphological types: Type I (89.375% of cases) in which from the ombilical part of the left branch arise two LBrs; Type II (10.25% of cases) in which from the ombilical part of the left branch arise three LBrs. Knowledge of these morphological types of portal LBrs is important for clinical and surgical practice.

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“…Before harvesting, it should be determined whether the DBLCFA is necessary for collateral circulation when there is stenosis of the surrounding arteries of the thigh. A thorough mapping of collateral pathways in peripheral arterial disease was provided by Wooten et al () and recently commented on by Anwar and Aydin (). The DBLCFA is a common route for collateralization in the presence of femoropopliteal occlusive disease, which may preclude its harvesting.…”

Section: Discussionmentioning

confidence: 99%

The descending branch of the lateral circumflex femoral artery as an alternative conduit for coronary artery bypass grafting: Experience from an anatomical, radiological and histological study

et al. 2016

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The descending branch of the lateral circumflex femoral artery (DBLCFA) has been suggested as an option for use in coronary artery bypass grafting (CABG). Our aim was to combine radiological examination, surgical and anatomical preparation, and histological assessment of the DBLCFA to map its variability and to assess the benefits of this conduit in cardiac surgery. The pelvic and femoral arteries were examined by CT angiography (CTA) in 100 patients (aged 68.3 ± 9.3 years) to assess the variability of the DBLCFA. Anatomical dissections were performed on 20 cadavers. In 15 patients, an autologous DBLCFA was implanted during CABG. In 35 samples, possible atherosclerotic lesions were examined histologically. The length of the potential DBLCFA conduits measured by CTA was 9.3 ± 2.9 cm, without correlating with the length of the thigh. Anatomical variations that would prevent the DBLCFA from being used in CABG were found in 27 out of 100 patients. Except for focal thickening of the intima, eccentric hypertrophy of the intima was found in three out of 35 samples. No inflammatory infiltration, foam cells, atheroma, or calcifications were found histologically. The DBLCFA is not to be used routinely or in preference to other grafts of choice. However, owing to its moderate variability, sufficient length, caliber, and rare atherosclerosis, it can be used in the absence of other suitable grafts as an alternative conduit implanted as a composite Y-graft end-to-side to the internal thoracic artery in patients without diabetic angiopathy, neuropathy or peripheral artery disease who are undergoing extensive or repeat coronary revascularization. Clin. Anat. 29:779-788, 2016. © 2016 Wiley Periodicals, Inc.

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Anatomical significance in aortoiliac occlusive disease

Cited by 33 publications

References 69 publications

Laparoscopic surgery for colorectal cancers complicated by Leriche syndrome: A report of three cases

Laparoscopic surgery for colorectal cancers complicated by Leriche syndrome: A report of three cases

Morphological Variability of the Hepatic Portal Vein Lateral Branches. Study on corrosion casts

The descending branch of the lateral circumflex femoral artery as an alternative conduit for coronary artery bypass grafting: Experience from an anatomical, radiological and histological study

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