Aortic Origins of the Celiac Trunk and Superior Mesenteric Artery

Rusu, Mugurel Constantin; Jianu, Adelina Maria; Manta, Bogdan Adrian; Hostiuc, Sorin

doi:10.3390/diagnostics11061111

Cited by 12 publications

(4 citation statements)

References 23 publications

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“…Many studies have reported the classification of visceral arterial stenosis according to the number of stenotic vessels (one, two, or three), the stenotic vessels (CA, SMA, or IMA), or the degree of stenosis [9,[11][12][13]. Additionally, several recent studies have compared endovascular treatment with open surgical repair in patients with CMI [14][15][16][17][18][19].…”

Section: Discussionmentioning

confidence: 99%

Development of a Novel Scoring Model to Estimate the Severity Grade of Mesenteric Artery Stenosis

Omran

Konietschke

Mueller

et al. 2022

JCM

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Objective: This study aimed to derive a new scoring model from estimating the severity grade of mesenteric artery stenosis. We sought to analyze the relationship between the new scoring model and the development, treatment, and mortality of chronic mesenteric ischemia (CMI). Methods: This retrospective study included 242 patients (128 (53%) women and 114 (47%) men) with suspected CMI from January 2011 to December 2020. A weighted sum six-point score (CSI-score; the celiac artery is abbreviated by “C”, superior mesenteric artery by “S”, and inferior mesenteric artery by “I”) based on the number of affected vessels and the extent and grade of the stenosis or occlusion of the involved visceral arteries was derived by maximizing the area under the ROC curve. The calculated CSI-score ranged from 0 to 22. The patients were divided according to the best cut-off point into low-score (CSI-score < 8) and high-score (CSI-score ≥ 8) groups. Results: The area under the receiver operating characteristic curve (AUC) of the CSI-score was 0.86 (95% CI, 0.82–0.91). The best cut-off point of “8” represented the highest value of Youden’s index (0.58) with a sensitivity of 87% and specificity of 72%. The cohort was divided according to the cut-off point into a low-score group (n = 100 patients, 41%) and high-score group (n = 142 patients, 59%) and according to the clinical presentation into a CMI group (n = 109 patients, 45%) and non-CMI group (n = 133 patients, 55%). The median CSI-score for all patients was 10 (range: 0 -22). High-scoring patients showed statistically significant higher rates of coronary artery disease (54% vs. 36%, p = 0.007), chronic renal insufficiency (50% vs. 30%, p = 0.002), and peripheral arterial disease (57% vs. 16%, p < 0.001). A total of 109 (45%) patients underwent invasive treatment of the visceral arteries and were more often in the high-score group (69% vs. 11%, p < 0.001). Of those, 79 (72%) patients underwent primary endovascular treatment, and 44 (40%) patients underwent primary open surgery or open conversion after endovascular treatment. Sixteen (7%) patients died during the follow-up, with a statistically significant difference between high- and low-scoring patients (9% vs. 0%, p = 0.008). The score stratification showed that the percentage of patients treated with endovascular and open surgical methods, the recurrence of the stenosis or failure of the endovascular treatment, the need for a bypass procedure, and the mortality rates significantly increased in the subgroups. The CSI-score demonstrated an excellent ability to discriminate between patients who needed treatment and those who did not, with an AUC of 0.87 (95% CI, 0.82–0.91). Additionally, the CSI-score’s ability to predict the patients’ mortality was moderate, with an AUC of 0.73 (95% CI, 0.62–0.83). Conclusions: The new scoring model can estimate the severity grade of the stenosis of the mesenteric arteries. Our study showed a strong association of the score with the presence of chronic mesenteric ischemia, the need for treatment, the need for open surgery, and mortality.

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Section: Discussionmentioning

confidence: 99%

Development of a Novel Scoring Model to Estimate the Severity Grade of Mesenteric Artery Stenosis

Omran

Konietschke

Mueller

et al. 2022

JCM

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“…The scans were performed with a 32-slice scanner (Siemens Multislice Perspective Scanner, Forcheim, Germany), with a 0.6 mm collimation and a reconstruction of 0.75 mm thickness, with 50% overlap for a multiplanar maximum intensity projection and 3-dimensional volume rendering technique, as described previously. 5 The cases were documented using Horos for iOS (Horos Project), as in previous studies. 6 Findings were checked on 2-dimensional planar reconstructions and 3-dimensional volume renderings.…”

Section: Methodsmentioning

confidence: 99%

The Maxillary Artery Loops Dangerously Approaching the Mandible’s Lingula and Inferior Orbital Fissure

Rusu,

Dumitru,

Vrapciu

2024

Journal of Craniofacial Surgery

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The maxillary artery (MA) leaves from the external carotid artery and further courses through the infratemporal fossa to reach the pterygopalatine fossa. It typically has an ascending course either on the lateral or on the medial side of the inferior bundle of the lateral pterygoid muscle. While studying retrospectively, the computed tomography angiogram of an adult male case with peculiar tortuosities of the MA was documented. The left MA described a large inferior sagittal loop applied on the mandible’s ramus’s inner cortical in the pterygomandibular space’s upper part. That loop reached 1.66 cm inferior to the mandible’s notch and 0.5 cm superior to the mandibular foramen and was applied on the mandible’s lingula (spine of Spix). That MA continued to the pterygomaxillary suture, and a second superior coronal loop was found applied on the posterior wall of the maxillary sinus, reaching the inferior orbital fissure. It is therefore mandatory to take good care in the decortication of the mandibular ramus or during osteotomies of the ramus. When an inferior loop of the MA approaches the spine of Spix, bleeding when an inferior alveolar nerve block is performed seems hardly avoidable.

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“…Уровень отхождения и расположение ЧС по отношению к позвоночнику и окружающим тканям, его архитектоника зависят от варианта телосложения, а также от варианта развития МА в эмбриональном периоде [4,30,32,34]. Наиболее часто ЧС отходит почти под прямым углом (≤90 о ) от передней поверхности брюшной аорты (БрАо) несколько слева, на уровне межпозвоночного диска между Th 12 и L 1 позвонками или на уровне верхней трети L 1 поясничного позвонка.…”

Section: чревный стволunclassified

“…ЧС является короткой -от 2 до 50 мм (в среднем (18,3±6,5) мм), но широкой артерией -от 3 до 13 мм (в среднем (7,4±1,2) мм). Иногда ход ЧС может быть практически параллельным (≥1 о ) аорте на протяжении до 20 мм или иметь другие вариантные особенности [4,6,23,[29][30][31][32][33][34].…”

Section: чревный стволunclassified

Practical Anatomy of Celiac Artery and Its Collateral Circulation

Бут-Гусаим¹,

Воробей²,

Давидовский³

2022

Хирургия. Восточная Европа

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Чревный ствол является одной из 3 ветвей брюшной аорты, обеспечивающих кровоснабжение органов пищеварения. Анатомия чревного ствола и его ветвей крайне вариативна, а особенности мезентериального коллатерального кровообращения позволяют компенсировать кровоток в случае его окклюзии. Учитывая вариантность анатомии, при планировании сосудистой реконструкции или резекционного хирургического вмешательства на верхнем этаже брюшной полости для обеспечения их безопасности и эффективности необходимо выполнить полноценную визуализацию сосудистой системы пищеварительного тракта. Знание анатомии позволит правильно интерпретировать полученные результаты предоперационного исследования и снизить риск ятрогенной сосудистой травмы. В настоящей статье приведены систематизированные литературные данные о практической анатомии чревного ствола и коллатеральном кровообращении его ветвей, а также клинические примеры вариантной анатомии и компенсации кровоснабжения органов при поражении чревного ствола. The celiac artery is an abdominal aortic branch providing blood supply to the digestive system. The anatomy of celiac artery and its branches is extremely variable; the features of that collateral circulation allow compensating blood flow when the trunk is occluded. Since that it is necessary to complete the comprehensive visualization of digestive tract vessels during planning of vascular reconstruction or resection surgery on the upper abdomen in order to provide its safety and efficiency. Knowledge of anatomy allows interpreting the preoperative study results in the proper way and decreasing the risk of iatrogenic vascular trauma. Systematic data on the practical anatomy of celiac artery and its branches collateral circulation is presented in this article and clinical examples of the variant anatomy and compensation of blood supply to organs when trunk is affected as well.

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Aortic Origins of the Celiac Trunk and Superior Mesenteric Artery

Cited by 12 publications

References 23 publications

Development of a Novel Scoring Model to Estimate the Severity Grade of Mesenteric Artery Stenosis

Development of a Novel Scoring Model to Estimate the Severity Grade of Mesenteric Artery Stenosis

The Maxillary Artery Loops Dangerously Approaching the Mandible’s Lingula and Inferior Orbital Fissure

Practical Anatomy of Celiac Artery and Its Collateral Circulation

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