PURPOSEThe obturator artery and its accessory (aberrant) arising from different origins and crossing the pubic rami are vascular variations. The internal iliac artery usually provides the obturator artery which may communicates with the external iliac artery through either the accessory obturator or inferior epigastric artery. A collateral circulation between the external and internal iliac system is known as corona mortis. The aim of current study is to provide sufficient data of vascular variability crossing the pubic rami for clinical field.

METHODSPresent study includes 208 hemipelvises dissected in the Institution of Anatomy, Medical University of Graz. During dissection, the obturator artery and its accessory crossing the superior rami of pubic bone were found to have different origins.

RESULTSThe obturator artery arising from the external iliac artery and from the femoral artery accounts for 9.8% and 1.1% respectively. Therefore, it passes over the superior pubic rami in 10.9%. Further, the accessory (aberrant) artery arises only from the femoral artery in 1.1%. In present study, the vascular variation crossing the superior pubic rami with or without collateral circulation between external and internal iliac system referred as corona mortis is addressed. This study includes new classification of obturator and accessory obturator arteries as well as the corona mortis. It includes a comparison of corona mortis incidence in Austria population and other populations. The corona mortis found to be in 12% of Austrian population.

CONCLUSIONA great attention of clinicians, radiologists, surgeons, orthopedic surgeons, obstetricians and gynecologists has to be considered before pubic surgical procedures such as internal fixation of pubic fracture, an inguinal hernia repair. Further, traumatic pubic rami fracture may lead to massive hemor- rhage due to laceration of the obturator artery.

Collateral Circulation ; Epigastric Arteries ; anatomy & histology ; Female ; Femoral Artery ; anatomy & histology ; Humans ; Iliac Artery ; anatomy & histology ; Male ; Pubic Symphysis ; blood supply

Interpositionally grafted arteries and veins were expanded with a 20cc tissue expanders in 50 Sprague-Dawley rats. The grafts were done on both hind legs, one side was expanded and the remaining side was used as control. The average gain in length of expanded grafted arteries and veins was over 4 and 6 times that of the controls respectively. The differences in the patency rates between expanded and control grafts were not statistically significant. Histologic examination revealed that there were no changes in the areas of the media and lengths of the inner elastic laminae of the expanded arterial grafts. In both expanded and control vein grafts, marked intimal thickening was noticed, although these changes were not statistically significant. Expansion of grafted vessels can be safely carried out without loss of vessel patency. Tissue expander, grafted vessels
Animal ; Femoral Artery/*anatomy and histology/transplantation ; Male ; Rats ; Rats, Inbred Strains ; *Tissue Expanders ; Vascular Patency ; Veins/*anatomy and histology/transplantation

Interpositionally grafted arteries and veins were expanded with a 20cc tissue expanders in 50 Sprague-Dawley rats. The grafts were done on both hind legs, one side was expanded and the remaining side was used as control. The average gain in length of expanded grafted arteries and veins was over 4 and 6 times that of the controls respectively. The differences in the patency rates between expanded and control grafts were not statistically significant. Histologic examination revealed that there were no changes in the areas of the media and lengths of the inner elastic laminae of the expanded arterial grafts. In both expanded and control vein grafts, marked intimal thickening was noticed, although these changes were not statistically significant. Expansion of grafted vessels can be safely carried out without loss of vessel patency. Tissue expander, grafted vessels
Animal ; Femoral Artery/*anatomy and histology/transplantation ; Male ; Rats ; Rats, Inbred Strains ; *Tissue Expanders ; Vascular Patency ; Veins/*anatomy and histology/transplantation

PURPOSE: The anterolateral thigh flap has many advantages over other conventional free flaps. But the anterolateral thigh flap has yet to enter widespread use because perforating arteries exhibit a wide range of anatomic variations and are difficult to dissect when small. The aim of this study is to identify the vascular variability of perforating arteries and pedicle in the anterolateral thigh free flap. METHODS: We studied 12 cadavers and dissected 23 thighs. An anterolateral thigh flap (12x12cm) was designed and centered at the midpoint of the line drawn from anterior superior iliac spine to the superolateral border of the patella. After we identifed the perforating arteries we dissected up to their origin from lateral circumflex femoral artery along descending branch of lateral circumflex femoral artery. We then investigated the number and the position of perforating arteries, length and diameter of vascular pedicle and pattern of lateral circumflex femoral arterial system. RESULTS: On average 2.3+/-1.1 perforating arteries per thigh were identified. The musculocutaneous perforators were 63.1%. In those perforators five perforators were arose from transverse branch of lateral circumflex femoral artery and two were arose from rectus femoral artery. Most of the perforators were near the intermuscular septum between rectus femoris muscle and vastus lateralis muscle. The length and diameter of pedicle were 11.9+/-3.5cm and 3.1+/-0.8mm on average. CONCLUSION: This study will be helpful for the success in anterolateral thigh free flap.
Anatomy, Regional ; Arteries ; Cadaver ; Femoral Artery ; Free Tissue Flaps ; Muscles ; Patella ; Quadriceps Muscle ; Spine ; Thigh

Due primarily to the increasing shortage of allogeneic donor organs, xenotransplantation has become the focus of a growing field of research. Currently, micropigs are the most suitable donor animal for humans. However, no standard method has been developed to evaluate the systemic vascular anatomy of micropigs and standard reference values to aid in the selection of normal healthy animals as potential organ donors are lacking. Using 64-channel multidetector row computed tomographic angiography (MDCTA), we evaluated morphological features of the major systemic vessels in micropigs and compared our results to published human data. The main vasculature of the animals was similar to that of humans, except for the iliac arterial system. However, diameters of the major systemic vessels were significantly different between micropigs and humans. Specifically, the diameter of the aortic arch, abdominal aorta, external iliac artery, and femoral artery, were measured as 1.50 +/- 0.07 cm, 0.85 +/- 0.06 cm, 0.52 +/- 0.05 cm, and 0.48 +/- 0.05 cm, respectively, in the micropigs. This MDCTA data for micropig major systemic vessels can be used as standard reference values for xenotransplantation studies. The use of 64-channel MDCTA enables accurate evaluation of the major systemic vasculature in micropigs.
Animals ; Aorta/*anatomy & histology ; Aortography/veterinary ; Femoral Artery/*anatomy & histology/radiography ; Humans ; Iliac Artery/*anatomy & histology/radiography ; Male ; Reference Values ; Swine ; Swine, Miniature/*anatomy & histology ; Tomography, X-Ray Computed/methods/*veterinary ; *Transplantation, Heterologous

Morphologic features and pathogenesis of arterial changes occurring in Buerger's disease (thromboangiitis obliterans) are still controversial. This study describes histopathologic features of medium sized arteries from patients with Buerger's disease, particularly of the internal elastic lamina in relation to the immunologic mechanism of the injury. Seventeen segments of occluded arteries (femoral or popliteal arteries) from 17 patients with Buerger's disease were analyzed by histopathological and immunohistochemical methods. The most characteristic features were total luminal obliteration, together with a varying degree of recanalization and deposition of hemosiderin pigments. Detailed analysis, however, showed marked undulation and multiplication of the internal elastic lamina (100%) associated with basophilic degeneration and delicate linear calcification (47%). Lymphocytic infiltration along the internal elastic lamina was seen in 71% and was associated with localized edema. Lymphocytes along the lamina were consistently positive for T cell marker. Mild to moderate fibrosis was present at the media in 24%. Adventitial changes included mild, nonspecific and irregular fibrosis seen in 53%. Immunologic injury to the internal elastic lamina associated with T-lymphocytic infiltration might be the initial morphogenetic mechanism of the thrombotic occlusion and organization of medium-sized arteries in Buerger's disease.
Adult ; B-Lymphocytes/pathology ; Elastic Tissue/pathology ; Elastic Tissue/immunology ; Female ; Femoral Artery/pathology* ; Femoral Artery/immunology ; Femoral Artery/anatomy & histology ; Fibrosis ; Human ; Male ; Middle Age ; Popliteal Artery/pathology* ; Popliteal Artery/immunology ; Popliteal Artery/anatomy & histology ; T-Lymphocytes/pathology ; Thromboangiitis Obliterans/pathology* ; Thromboangiitis Obliterans/immunology

OBJECTIVETo evaluate the value of three preoperative imaging methods in the anterolateral thigh flap (ALT) transplantation.

METHODSAccording to preoperative imaging, patients who underwent the ALT flap transplantation were divided into three groups: computed tomography angiography (CTA) group, digital subtract angiography ( DSA) group and magnetic resonance angiography (MRA) group. There were fifteen cases in each group. We compared the imaging quality of the ALT artery among these groups and recorded the parameters of lateral femoral circumflex artery, descending branches and perforators including type, course and size. The results from images were compared with intraoperative findings. The success rate and complications were also recorded.

RESULTSThe preoperative imaging accuracy of the types of the lateral femoral circumflex artery and descending branch was more than 92.3%, with no significant different between any two of three groups (P > 0.05). The difference in diameters of descending branches and perforators from preoperative measurement and from intraoperative measurement was also not significant between any two of the three groups; the success rate and complications were not also obviously different (P > 0.05 , P > 0.05, respectively).

CONCLUSIONSPreoperative mapping using CTA, DSA and MRA is a feasible and reliable method for the flap design in ALT transplantation. As a preoperative evaluation means, CTA and MRA may replace DSA in the ALT transplantation.

Angiography, Digital Subtraction ; methods ; Feasibility Studies ; Femoral Artery ; anatomy & histology ; diagnostic imaging ; Humans ; Magnetic Resonance Angiography ; Preoperative Care ; Surgical Flaps ; transplantation ; Thigh ; Tomography, X-Ray Computed

OBJECTIVETo investigate the effect of interferon regulatory factors (IRFs) on neointimal formation after vascular injury in the mouse, and its possible mechanism.

METHODSVascular injury was induced by polyethylene cuff placement around the left femoral artery of IRF-1-deficient mice and C57BL/6J mice. The mRNA expressions of IRF-1, IRF-2, angiotensin II type 2 (AT2) receptor, interleukin-1 beta converting enzyme (ICE), inducible nitric oxide synthase (iNOS) were detected by RT-PCR and immunohistochemical staining.

RESULTSNeointimal formation after vascular injury was significantly greater in IRF-1-deficient mice than that in C57BL/6J mice (P<0.05). In contrast, TUNEL-positive nuclei to total nuclei in the neointima and media in vascular smooth muscle cell (VSMC) in the injured artery significantly attenuated in IRF-1-deficient mice compared to C57BL/6J mice (P<0.05). The expressions of AT2 receptor as well as pro-apoptotic genes such as ICE and iNOS in C57BL/6J mice were up-regulated in response to vascular injury, but this upregulation was attenuated in IRF-1-deficient mice.

CONCLUSIONSOur results suggest that IRF-1 induces VSMC apoptosis and inhibits neointimal formation after vascular injury at least partly due to the upregulation of AT2 receptor, ICE and iNOS expressions. These results indicate that IRF-1 exerts an inhibitory effect on neointimal formation through the induction of apoptosis in VSMCs.

Animals ; Apoptosis ; physiology ; Caspase 1 ; genetics ; metabolism ; Femoral Artery ; anatomy & histology ; pathology ; Interferon Regulatory Factor-1 ; genetics ; metabolism ; Interferon Regulatory Factor-2 ; genetics ; metabolism ; Male ; Mice ; Mice, Inbred C57BL ; Mice, Knockout ; Muscle, Smooth, Vascular ; cytology ; metabolism ; pathology ; Nitric Oxide Synthase Type II ; genetics ; metabolism ; Platelet Endothelial Cell Adhesion Molecule-1 ; genetics ; metabolism ; Receptor, Angiotensin, Type 2 ; genetics ; metabolism ; Tunica Intima ; pathology ; physiology