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PubMed1976

The role of vascular capacitance in the genesis of essential hypertension.

1. Analysis of relationships between blood volume, vascular capacitance, cardiopulmonary and peripheral blood volumes, labelled albumin disappearance rate, plasma renin activity, blood pressure and age was performed in essential hypertensive males. 2. The results indicate that capacitance bed constriction probably occurs with age in essential hypertension leading to an increase in the product blood volume xvascular capacitance tone even in the presence of low blood volume. 3. A metabolic defect in the venous vascular bed along with an abnormality of regulation of renal sodium excretion is postulated.

Age Factors↗
PubMed1994

Influence of neuropeptide Y on regional vascular capacitance in dogs.

To determine the effect of neuropeptide Y (NPY) on regional vascular capacitances, we measured the regional blood volume (Vb), unstressed volume (V0), blood flow distribution, venous compliance (Cv), venous resistance (Rv), and the time constant of venous drainage (tau v) in the splanchnic and extrasplanchnic circulation of 13 dogs anesthetized with chloralose. Cardiac output was kept constant with circulatory bypass. The extrasplanchnic region was further divided into superior vena caval (SVC) and inferior vena caval (IVC) regions. Vb was measured in the splanchnic and SVC regions using indicator dilution curves and the mean transit times. Changes in venous outflow pressures were used to change regional volumes, and a stop-flow procedure was used to obtain the regional venous filling pressures. This allowed construction of pressure-volume (P-V) curves and the calculation of Cv, Rv, and tau v. Hexamethonium chloride was infused throughout the experiment to prevent autonomic reflexes. Sham injections had no effects on four dogs. In nine dogs, NPY (bolus of 7.4 x 10(-8) or 14.8 x 10(-8) mol and 0.37 mol/min infusion) increased arterial blood pressure from 98.4 +/- 4.2 to 121.3 +/- 6.9 mmHg (P < 0.001), decreased splanchnic Vb from 31.6 +/- 2.1 to 24.9 +/- 1.8 ml/kg (P < 0.01), and decreased splanchnic V0 from 21.8 +/- 2.6 to 12.1 +/- 2.2 ml/kg (P < 0.001). SVC volumes were not affected by NPY. Extrasplanchnic Cv increased with NPY, but splanchnic Cv did not change. Thus exogenous NPY infusion decreases splanchnic capacitance, which could potentially increase venous return and cardiac output.

Animals↗
PubMed1991

The effect of nitroglycerin on pulmonary vascular capacitance in dogs.

In this study we investigated the hypothesis that the decrease in pulmonary vascular pressures observed after administration of nitroglycerin is in part due to a shift in the pulmonary vascular pressure-volume relationship. The experiments were done in six closed-chest dogs anesthetized with pentobarbital, in which pulmonary, cardiac, and intestinal relative blood volumes were determined by equilibrium blood pool scintigraphy. Nitroglycerin (30 micrograms/kg/min) caused 7% (p less than 0.02) and 12% (p less than 0.02) reductions in pulmonary and total cardiac blood volume, respectively, and a 7% (p less than 0.01) increase in intestinal blood volume. This shift of blood from the heart and the pulmonary circulation to the systemic (intestinal) circulation was accompanied by reductions in mean pulmonary artery pressure from 16 +/- 2 mm Hg to 12 +/- 1 mm Hg (p less than 0.01), in mean pulmonary capillary wedge pressure from 11 +/- 2 mm Hg to 6 +/- 1 mm Hg (p less than 0.01), and in mean portal pressure from 9 +/- 1 mm Hg to 8 +/- 1 mm Hg (p less than 0.01). The position of the pulmonary vascular pressure-blood volume relationship was unaffected by nitroglycerin, whereas the portal pressure-intestinal blood volume relationship was shifted to the left and upward. These changes suggest that pulmonary vascular tone remained unchanged, whereas intestinal vascular tone decreased during administration of nitroglycerin. In conclusion, nitroglycerin decreased pulmonary vascular pressures through a passive emptying of the pulmonary circulation as a result of increased systemic (intestinal) vascular capacitance.

Animals↗
PubMed1978

Reflex responses of abdominal vascular capacitance from aortic baroreceptors in dogs.

The vascularly isolated abdominal circulation of chloralose-anesthetized dogs was perfused at constant flow through the aorta and drained at constant pressure from the inferior vena cava. Changes in resistance were calculated from changes in perfusion pressure and changes in capacitance were calculated by integrating changes in venous outflow. While carotid sinus pressure was constant, a decrease in pressure in the vascularly isolated aortic arch, over the whole range of baroreceptor sensitivity, decreased abdominal vascular capacitance by 2.9 ml-kg-1 (mean, SE +/- 0.42) and increased the abdominal vascular resistance by 35 +/- 7.1%. Decreases in pressure in the vascularly isolated carotid sinuses, while aortic pressure was constant, decreased capacitance by 5.0 +/- 0.62 ml-kg-1 and increased resistance by 72 +/- 15.9%. Responses of capacitance and resistance to changes in aortic pressure were greatest when carotid pressure was held near threshold levels and least when it was held at levels that would maximally excite carotid baroreceptors. The responses to changes in aortic pressure were abolished when the venous nerves were cooled or the splanchnic nerves were cut.

Abdomen↗
PubMed1991

Splanchnic vascular capacitance and positive end-expiratory pressure in dogs.

We have investigated the effect of positive end-expiratory pressure ventilation (PEEP) on regional splanchnic vascular capacitance. In 12 anesthetized dogs hepatic and splenic blood volumes were assessed by sonomicrometry. Vascular pressure-diameter curves were defined by obstructing hepatic outflow. With 10 and 15 cmH2O PEEP portal venous pressure increased 3.1 +/- 0.3 and 5.1 +/- 0.4 mmHg (P less than 0.001) while hepatic venous pressure increased 4.9 +/- 0.4 and 7.3 +/- 0.4 mmHg (P less than 0.001), respectively. Hepatic blood volume increased (P less than 0.01) 3.8 +/- 0.9 and 6.3 +/- 1.4 ml/kg body wt while splenic volume decreased (P less than 0.01) 0.8 +/- 0.2 and 1.3 +/- 0.2 ml/kg body wt. The changes were similar with closed abdomen. The slope of the hepatic vascular pressure-diameter curves decreased with PEEP (P less than 0.01), possibly reflecting reduced vascular compliance. There was an increase (P less than 0.01) in unstressed hepatic vascular volume. The slope of the splenic pressure-diameter curves was unchanged, but there was a significant (P less than 0.05) decrease in unstressed diameter during PEEP. In conclusion, hepatic blood volume increased during PEEP. This was mainly a reflection of passive distension due to elevated venous pressures. The spleen expelled blood and thus prevented a further reduction in central blood volume.

Animals↗
PubMed1992

Catecholamine-induced changes in vascular capacitance and sympathetic nerve activity in dogs.

The effects of three catecholamines, dopamine, epinephrine, and dobutamine, on the systemic circulation, especially on systemic vascular capacitance, were studied using cardiopulmonary bypass in dogs anesthetized with pentobarbital. Venous outflow was divided into three compartments: splanchnic, renal, and other; changes in systemic blood volume (SBV) were calculated from the changes in total venous outflow. To examine the contribution of sympathetic discharge to these vascular responses, sympathetic efferent nerve activity (SENA) from the ventral ansa subclavian nerve was recorded simultaneously. Experiments were done under three conditions: control, after baroreceptor deafferentation, and after hexamethonium injection with low and high doses of each catecholamine. During control and after baroreceptor deafferentation, dopamine- and epinephrine-induced changes in SBV were less than those after hexamethonium, and not significant except with low dose epinephrine. After hexamethonium, dopamine (200 micrograms/kg), epinephrine (10 micrograms/kg), and dobutamine (100 micrograms/kg) reduced SBV by 10.6 +/- 3.4, 13.1 +/- 1.7, and 1.9 +/- 0.3 mL/kg, respectively. Splanchnic outflow increased significantly with dopamine and epinephrine after hexamethonium. High dose dopamine and epinephrine significantly suppressed SENA to 38 +/- 9 and 15 +/- 6% of baseline, respectively. Low dose dopamine decreased arterial pressure and SENA. This suppression in SENA was attenuated but still observed after baroreceptor deafferentation. Dobutamine reduced SBV, but had no effect on SENA. These results suggest that dopamine and epinephrine primarily decrease SBV by venoconstriction in the splanchnic region, however, these effects are greatly modified by basal sympathetic discharge and changes in SENA and vascular tone.

Animals↗
PubMed1995

Diminished venous vascular capacitance in patients with univentricular hearts after the Fontan operation.

Patients who have undergone Fontan's operation are known to have impaired cardiac output response to dynamic exercise. This may be due to either poor cardiac function or a limited ability to mobilize blood from capacitance vessels due to increased resting venous tone. We tested the latter hypothesis by determining venous vascular capacitance at rest and during orthostatic stress produced by lower body negative pressure (LBNP) in 6 subjects who had undergone the Fontan operation and 6 healthy age-, sex-, height-, and weight-matched controls. Resting blood volume was similar for Fontan and control subjects (79 +/- 6 vs 70 +/- 3 ml/kg body weight, respectively), while central venous pressure (CVP) was elevated in Fontan subjects (18.4 +/- 1.0 vs 3.5 +/- 0.9 mm Hg, p < 0.05). Forearm venous capacitance at a distending pressure of 40 mm Hg was less in Fontan subjects than in controls (2.6 +/- 0.1 vs 3.9 +/- 0.5 ml/100 ml), while resting plasma norepinephrine level was elevated in Fontan subjects (255 +/- 28 vs 144 +/- 9 pg/ml, p < 0.05). The increase in calf volume (1.6 +/- 0.2 vs 2.3 +/- 0.2 ml) and decrease in CVP (-5.0 +/- 0.5 vs -6.7 +/- 1.1 mm Hg) during -30 mm Hg LBNP were smaller for Fontan than control subjects (p < 0.05). Reduced forearm venous capacitance and diminished pooling of blood into capacitance vessels of the leg during orthostatic stress indicated higher venous tone in Fontan than control subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Changes in regional vascular capacitance during prostacyclin-induced cardiac vagal reflex in pigs.

The purpose of this study was to determine the effects of the prostaglandin I2 (prostacyclin; PGI2)-induced cardiac vagal reflex on intestinal and liver blood volumes and the intestinal vascular pressure-volume (P-V) relationship. In anesthetized pigs, blood volumes were measured by blood-pool scintigraphy. Portal venous pressure was varied by graded inflation of a portal vein constrictor to determine the intestinal vascular P-V relationship. Proximal right coronary infusion of PGI2 at a rate of 0.15 micrograms.kg-1.min-1 for 6 min increased intestinal blood volume by 7.0 +/- 1.2% (P < 0.01, means +/- SE) and shifted the intestinal vascular P-V relationship away from the pressure axis (i.e., a volume increase at a given venous pressure). This change was associated with decreases in liver blood volume and left ventricular end-diastolic pressure by 4.5 +/- 1.2 (P < 0.01) and 17 +/- 2% (P < 0.05), respectively. PGI2 also reduced central venous pressure by 16 +/- 2% from 3.2 +/- 0.5 mmHg (P < 0.05) and portal venous pressure by 7.0 +/- 0.6% from 7.6 +/- 0.6 mmHg (P < 0.05). These responses were abolished by bilateral vagotomy. The results demonstrate that intracoronary PGI2 infusion increases intestinal blood volume. This increase is mediated by a cardiac vagal reflex. The PGI2-induced shift in the intestinal vascular P-V relationship suggests that intestinal blood volume increases by an active change in vascular capacitance, whereas reductions in liver blood volume and left ventricular end-diastolic pressure appear to be due to passive mechanisms related to the shift of blood volume to the intestinal circulation.

Animals↗
PubMed2002

Comparative effects of nitroglycerin on intestinal vascular capacitance and conductance.

BACKGROUND: Nitroglycerin (NTG) dilates capacitance veins and resistance arterioles, but its relative effects on veins and arterioles are not known. OBJECTIVES: To compare NTG-induced changes in capacitance and conductance. ANIMALS AND METHODS: Aortic, left ventricular and portal venous (P(port)) pressures, portal flow and relative changes in intestinal blood volume (IBV) ((99m)technetium blood-pool scintigraphy) were measured in seven isoflurane-anesthetized, splenectomized dogs. Changes in intestinal vascular capacitance and conductance (mean portal flow/[mean aortic pressure - mean P(port)]) were determined when NTG was continuously administered (0.8 to 150 microg/kg/min) into a jugular vein. Pressure-volume (ie, P(port)-IBV) curves were defined by impeding portal flow, and capacitance was defined as the IBV at P(port)=7.5 mmHg. RESULTS: At lower doses, NTG increased capacitance without increasing conductance, but conductance increased considerably with little further increase in capacitance at higher doses. Dose-response analysis revealed that the half-maximum capacitance effect was achieved at an NTG infusion rate of 3.5 microg/kg/min, whereas a rate of 35 microg/kg/min was required for the half-maximum conductance effect. CONCLUSIONS: At lower doses, NTG dilates capacitance vessels primarily, and that effect approaches its maximum before significant dilation of conductance vessels is manifest. However, at higher doses, the increase in conductance is substantial with little additional effect on capacitance.

Analysis of Variance↗
PubMed1990

Reflex control of vascular capacitance during hypoxia, hypercapnia, or hypoxic hypercapnia.

We tested the hypothesis that the changes in venous tone induced by changes in arterial blood oxygen or carbon dioxide require intact cardiovascular reflexes. Mongrel dogs were anesthetized with sodium pentobarbital and paralyzed with veruronium bromide. Cardiac output and central blood volume were measured by indocyanine green dilution. Mean circulatory filling pressure, an index of venous tone at constant blood volume, was estimated from the central venous pressure during transient electrical fibrillation of the heart. With intact reflexes, hypoxia (arterial PaO2 = 38 mmHg), hypercapnia (PaCO2 = 72 mmHg), or hypoxic hypercapnia (PaO2 = 41; PaCO2 = 69 mmHg) (1 mmHg = 133.32 Pa) significantly increased the mean circulatory filling pressure and cardiac output. Hypoxia, but not normoxic hypercapnia, increased the mean systemic arterial pressure and maintained the control level of total peripheral resistance. With reflexes blocked with hexamethonium and atropine, systemic arterial pressure supported with a constant infusion of norepinephrine, and the mean circulatory filling pressure restored toward control with 5 mL/kg blood, each experimental gas mixture caused a decrease in total peripheral resistance and arterial pressure, while the mean circulatory filling pressure and cardiac output were unchanged or increased slightly. We conclude that hypoxia, hypercapnia, and hypoxic hypercapnia have little direct influence on vascular capacitance, but with reflexes intact, there is a significant reflex increase in mean circulatory filling pressure.

Animals↗
PubMed1984

The role of vascular capacitance in the coronary arteries.

When the left coronary artery was perfused with nonpulsatile pressure, the onset of diastole was accompanied by a capacitance overshoot in flow with an exponential decay back to a steady state. Time constant for that decay ranged from 55 msec when tone was present to 105 msec with maximal dilation. Since the transient resulted from a fall in tissue pressure, this represents an estimation of intramural arterial capacitance only. Transients in perfusion pressure, which would also affect epicardial arteries, yielded similar time constants. We concluded that most of the coronary capacitance resides in the small intramural vessels. Analysis of transients yielded a value for capacitance of between 0.01 and 0.05 ml/mm Hg per 100 g. We then used the data from the transients to construct coronary pressure flow curves which were free of any back flow from capacitance. When coronary tone was present, the curves indicated that flow ceased at 30 mm Hg. With maximal dilation, flow ceased at only 18 mm Hg. Long diastoles in those same hearts indicated that flow ceased at about 10 mm Hg higher pressure. Although capacitance causes critical closing pressure as determined by a long diastole to be artifactually high, critical closing pressure is still appreciable in the heart, and tone dependent. Finally, three computer models were built, one of which included only small vessel capacitances, the second, only vascular waterfalls, and the third, both of the above. Only model 3 was capable of reproducing the flow patterns which were actually seen.

Animals↗
PubMed2006

The prognostic value of pulmonary vascular capacitance determined by Doppler echocardiography in patients with pulmonary arterial hypertension.

OBJECTIVES: We sought to determine if a novel measurement of pulmonary vascular (PV) capacitance (PVCAP) by Doppler echocardiography predicts all-cause mortality in patients with primary pulmonary arterial (PA) hypertension (PPAH). BACKGROUND: The prognosis of patients with PPAH is variable and has been difficult to predict using clinical or hemodynamic parameters. PVCAP is a measure of the workload on the right ventricle (RV) and we recently have shown that PVCAP determined by cardiac catheterization is a strong predictor of survival. This same hemodynamic information to calculate PVCAP can be derived from Doppler echocardiography. Therefore, the purpose of this study was to determine if PVCAP from noninvasive Doppler echocardiography would be a useful measure of survival in patients with PPAH. METHODS: We analyzed clinical and hemodynamic variables on all patients with PPAH who had a right heart catheterization and echocardiogram from January to December 1999. Because capacitance is directly proportional to stroke volume and inversely proportional to PA pulse pressure, PVCAP was defined as stroke volume/pulse pressure. PVCAP was derived noninvasively from a comprehensive 2-dimensional and Doppler echocardiogram. Using the peak systolic tricuspid regurgitation velocity and the end-diastolic pulmonary regurgitation velocity, the modified Bernoulli equation was used to calculate the PA systolic and diastolic pressures, respectively. Stroke volume was obtained using the volumetric flow through the left ventricular outflow tract. PVCAP was then analyzed as a predictor of mortality, adjusting for other known modifiers of risk. RESULTS: In all, 54 patients (13 men) were studied with a mean age of 44 +/- 11 years, ejection fraction of 62 +/- 11%, and RV systolic pressure of 90 +/- 21 mm Hg. In all, 24% were in World Health Organization (WHO) class II, 52% in class III, and 24% in class IV. During follow-up of 1498 +/- 108 days, 12 patients died. The strongest noninvasive predictor of mortality was PVCAP (risk ratio 3.0/mL/mm Hg decrease in PVCAP, 95% confidence interval 1.2-8.0, P = .0212). WHO class, RV index of myocardial performance, RV systolic pressure, and RV ejection time were weaker predictors. PVCAP was also a stronger predictor of mortality than invasively determined PV resistance, right atrial pressure, and mean PA pressure. In multivariate analysis, PVCAP was the only noninvasive predictor of mortality. In quartile analysis the lowest PVCAP quartile had a 4-year mortality of 39% whereas the highest PVCAP had a mortality of 7%. CONCLUSION: The novel measure of PVCAP, as determined by Doppler echocardiography, is a strong noninvasive predictor of mortality in patients with PPAH and adds prognostic value to conventional risk markers.

Adult↗
PubMed1998

Acute effects of toborinone on vascular capacitance and conductance in experimental heart failure.

BACKGROUND: Toborinone (OPC-18790), a phosphodiesterase III inhibitor, enhances cardiac contractility and is an arterial dilator. However, its effects on the venous system have not yet been clearly defined. Because toborinone administration reduces left ventricular (LV) end-diastolic pressure, it is probably also a venodilator. Because of the known arterial effects and the hypothesized venous effects, we compared changes in systemic vascular conductance (the inverse of resistance) with changes in venous capacitance. METHODS AND RESULTS: In 15 anesthetized, splenectomized dogs (10 treatment, 5 control), pressures were measured in the right atrium, aorta, portal vein, and LV. A cuff constrictor was placed around the portal vein. Cardiac output was measured by thermodilution, and splanchnic vascular capacitance was measured by blood-pool scintigraphic methods. Data were collected at baseline, after induction of heart failure (microsphere embolization into the left coronary artery), and then after toborinone boluses of 0.1, 0.2, 0.4, and 0.8 mg/kg. Heart failure was associated with decreased capacitance and conductance (to 87+/-3% and 64+/-4% of baseline values, respectively, P<0.05). After administration of the lower doses of toborinone, capacitance increased more than conductance; however, the effects were more balanced at the higher doses. Compared with nitroglycerin, hydralazine, and enalaprilat (results of an earlier study) in the same model, toborinone increased capacitance to a degree similar to that with nitroglycerin, at higher doses increased conductance similarly to hydralazine, and increased both capacitance and conductance considerably more than did enalaprilat. CONCLUSIONS: Toborinone is a potent balanced venous and arterial dilator in experimental acute heart failure. These marked effects suggest that it may prove to be a clinically important alternative to other vasodilators.

Animals↗
PubMed2001

Hindlimb unweighting affects rat vascular capacitance function.

Microgravity is associated with an impaired stroke volume and, therefore, cardiac output response to orthostatic stress. We hypothesized that a decreased venous filling pressure due to increased venous compliance may be an important contributing factor in this response. We used a constant flow, constant right atrial pressure cardiopulmonary bypass procedure to measure total systemic vascular compliance (C(T)), arterial compliance (C(A)), and venous compliance (C(V)) in seven control and seven 21-day hindlimb unweighted (HLU) rats. These compliance values were calculated under baseline conditions and during an infusion of 0.2 microg*kg(-1)*min(-1) norepinephrine (NE). The change in reservoir volume, which reflects changes in unstressed vascular volume (DeltaV(0)) that occurred upon infusion of NE, was also measured. C(T) and C(V) were larger in HLU rats both at baseline and during the NE infusion (P < 0.05). Infusion of NE decreased C(T) and C(V) by ~20% in both HLU and control rats (P < 0.01). C(A) was also significantly decreased in both groups of rats by NE (P < 0.01), but values of C(A) were similar between HLU and control rats both at baseline and during the NE infusion. Additionally, the NE-induced DeltaV(0) was attenuated by 53% in HLU rats compared with control rats (P < 0.05). The larger C(V) and attenuated DeltaV(0) in HLU rats could contribute to a decreased filling pressure during orthostasis and thus may partially underlie the mechanism leading to the exaggerated fall in stroke volume and cardiac output seen in astronauts during an orthostatic stress after exposure to microgravity.

Animals↗
PubMed1978

Vascular capacitance of dog intestine using mean transit time of indicator.

Changes in vascular volume of dog jejunum caused by norepinephrine, isoproterenol, or acetylcholine at constant=flow perfusion, were compared to changes in volume caused by changes in blood flow or venous pressure. Vascular volume was measured by indicator dilution mean transit time, using a step input of indocyanine green (125 microgram/min). Venous pressure was held at 10 mmHg; control arterial pressure was about 110 mmHg. At a control flow of 521 ml/min.kg of tissue, the vascular volume was 104 +/- 14 (SD) ml/kg of tissue. Reducing flow by 75 percent caused the volume to decrease by 29 percent (--31 ml/kg); maximal norepinephrine infusion at constant flow and venous pressure decreased the vascular volume by 24 percent, and a 10-mmHg reduction in venous outflow pressure caused a 25 percent (--27 ml/kg) reduction. On the other hand, isoproterenol (100 microgram/liter) at constant flow caused a 245 percent increase in conductance and only a 12 percent increase in vascular volume. Thus, active venoconstriction, changes in venous pressure, or changes in flow independently may cause changes in vascular volume of the intestine. Active smooth muscle changes in the venous capacitance vessels are not necessarily correlated with changes in the arterial resistance vessels.

Acetylcholine↗
PubMed2005

Baroreflex mediated control of heart rate and vascular capacitance in trout.

The baroreflex was triggered by altering branchial blood pressure with pre- and post-branchial occlusions for 30 s in rainbow trout Oncorhynchus mykiss. The cardiac limb of the baroreflex was monitored by continuous heart rate (f(H)) measurements. Responses of venous capacitance vessels were assessed, immediately following either occlusion, by measuring mean circulatory filling pressure (MCFP). Arterial responses were evaluated as the change in dorsal aortic blood pressure (P(da)) before and after pre-branchial occlusion. In untreated fish pre-branchial occlusion resulted in tachycardia (62.4+/-2.4 to 69.1+/-1.7 beats min(-1)), decreased venous capacitance reflected as an increase in MCFP (0.17+/-0.03 to 0.27+/-0.03 kPa) and increased P(da) (4.0+/-0.2 kPa compared to 3.2+/-0.1 kPa before occlusion). Post-branchial occlusion somewhat reversed the responses since f(H) decreased (62.4+/-2.4 to 53.0+/-3.1 beats min(-1)), whereas MCFP remained unaltered. Treatment with the alpha-adrenergic blocker prazosin (1 mg kg(-1)) increased resting MCFP to 0.33+/-0.03 kPa and appeared to abolish both venous and arterial responses to branchial occlusion. Subsequent atropine treatment (1.2 mg kg(-1)) abolished all chronotropic responses. We present for the first time ample evidence for baroreflex-mediated control of cardiovascular homeostasis, including both the chronotropic and the vascular limb of the baroreflex in an unanaesthetized fish. Furthermore, a novel technique to cannulate and occlude the dorsal aorta, using a Fogarty thru-lumen embolectomy catheter, is explained.

Animals↗