1.The Clinical Significance of Ulnar Artery Morphology in Artificial Arterial-Venous Fistula for Hemodialysis
Waseem Bader Al Talalwah ; Dereje Regassa Getachew
Malaysian Journal of Medical Sciences 2015;22(3):41-47
Background: The ulnar artery is a terminal branch of the brachial artery. The aim of this study is to provide comprehensive data concerning the morphology of the ulnar artery, with clinical implications for surgeons.
Methods: The current study includes the dissection of 68 upper limb specimens. It investigates the characteristics of the ulnar artery such as the internal diameter, external diameter, wall thickness, and distance of the ulnar artery origin.
Results: In this study, the ulnar artery arose distal to the superior margin of the head of the radius in 82.65% of cases. The angle degree of the ulnar artery with respect to the brachial artery ranges from to 8° to 30°. The internal and external diameters of the ulnar artery were found to decrease gradually from proximal to distal in both genders. The external and internal diameters of the ulnar artery are greater in males than in females. In all cases, the external and internal diameters and the thickness of the ulnar artery at three levels were found to be greater in the right ulnar artery than the left.
Conclusion: The right ulnar artery may be the appropriate choice for artificial arterial-venous fistula for haemodialysis. Due to its wide diameter, the proximal part of the radial artery is a suitable site for the artificial arterial-venous fistula immediately below the origin prior to its profound course. Therefore, it is an easy access for artificial arterial-venous fistula for surgeons. The radiologists must alert the surgeons for surgical modification in the case of high brachial bifurcation
2.A new concept and classification of corona mortis and its clinical significance.
Chinese Journal of Traumatology 2016;19(5):251-254
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