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At least 127 records · Page 7Linked to original sources
PubMed1990

Duplex Doppler sonography of the carotid artery: false-positive results in an artery contralateral to an artery with marked stenosis.

Anecdotal reports have described a false-positive "jet effect" or velocity increase in the carotid artery contralateral to an artery with significant stenosis or occlusion when using duplex Doppler sonography. In this study, the frequency, significance, and possible reasons for this finding were evaluated by a retrospective comparison of duplex sonography and angiography. Twenty-three patients with unilateral 81-100% carotid artery stenosis who underwent both duplex sonography (16 Acuson, seven Quantum) and angiography were evaluated. In 14 patients, there was an accurate or slight underestimate (less than 20%) of stenosis present in the internal carotid artery contralateral to an artery with tight stenosis/occlusion. In nine, a velocity increase in the internal carotid artery resulted in overestimation (10-80%) of the actual degree of stenosis. In one of these nine patients, real-time images were sufficient to explain the velocity increase on the basis of vessel tortuosity. In one, falsely elevated velocity resulted from inaccurate assignment of the Doppler angle of incidence in a patient in whom real-time visualization of a distal internal carotid lesion was poor. In four of the nine patients, cross filling via the circle of Willis toward the side of greater stenosis occurred. However, seven of 14 patients in whom there was duplex sonography/angiography agreement or slight duplex sonography underestimation also had cross filling. Vertebral artery patency did not correlate well with the presence of a "jet effect." These findings suggest that an increase in blood flow velocity with duplex Doppler sonography in the internal carotid artery on the side opposite an artery with a tight stenosis is a common source of error and is not readily explained by angiographic evidence of collateral flow.

Aged↗
PubMed1975

Effects of glucose-insulin-potassium on myocardial substrate availability and utilization in stable coronary artery disease. Studies on myocardial carbohydrate, lipid and oxygen arterial-coronary sinus differences in patients with coronary artery disease.

To assess the metabolic effects of myocardial substrate alteration in patients with coronary artery disease, glucose-insulin-potassium solution was administered intravenously for 30 minutes to 14 men with stable angiographically documented coronary artery disease. The glucose-insulin-potassium solution (300 g of glucose, 50 units of regular insulin and 80 mEq of potassium chloride per liter of water) was infused at a constant rate in each patient, but individual infusion rates ranged from 0.013 to 0.032 ml/kg per min (4 to 10 mg glucose/kg per min) in the 14 patients. Simultaneous arterial and coronary sinus samples were obtained at 15 minute intervals during a stable 30 minute control period and again at 15 minute intervals during the infusion; samples were assayed for glucose, lactate, free fatty acid and oxygen content. In all 14 patients, during the glucose-insulin-potassium infusion, arterial glucose and lactate increased and arterial free fatty acid levels fell; the magnitude of the changes in arterial lactate and free fatty acids was related to the rate of infusion. Arterial-coronary sinus differences (A-Cs) for glucose, lactate and free fatty acid levels correlated with the arterial concentrations of these substrates (r = 0.66, 0.87 and 0.79, respectively). Regression analyses demonstrated myocardial thresholds for the uptake of these substrates as follows: glucose 79 mg/100 ml; lactate 300 mu mole/liter; and free fatty acids 100 to 200 mu Eq/liter. Finally and most importantly, the reduction in A-Cs oxygen values after glucose-insulin-potassium infusion correlated with the reduction in A-Cs free fatty acid levels (r = 0.64, P less than 0.0001). This observation suggests that, in patients with coronary artery disease, glucose-insulin-potassium infusion may significantly diminish myocardial oxygen requirements by reduction of myocardial free fatty acid utilization and simultaneous enhancement of myocardial carbohydrate utilization. Myocardial substrate availability may be an important determinant of myocardial oxygen demand in patients with coronary artery disease. Infusion of glucose-insulin-potassium solution has the potential to alter myocardial substrate availability, thus improving the balance between myocardial oxygen demand and supply.

Adult↗
PubMed1995

Coronary artery abnormalities detected at cardiac catheterization following the arterial switch operation for transposition of the great arteries.

Because the arterial switch operation has become the routine surgical approach for transposition of the great arteries, there is increasing awareness of adverse sequelae in some survivors. For the arterial switch to be considered the procedure of choice for transposition of the great arteries, long-term patency and normal function of the translocated coronary arteries must be achieved. We reviewed the cineangiograms and hemodynamic data in 366 patients who underwent postoperative catheterization after arterial switch operation. Of these, 13 patients (3%) had previously unsuspected coronary abnormalities diagnosed angiographically. No patient had noninvasive evidence of resting systolic dysfunction. Findings included left main coronary artery stenosis (n = 3) or occlusion (n = 2), anterior descending coronary artery stenosis (n = 1) or occlusion (n = 2), right coronary artery stenosis (n = 1) or occlusion (n = 1), and small coronary artery fistulas (n = 3). One patient died suddenly 3.3 years after surgery, 1 patient is lost to follow-up, and the remaining 10 patients are alive and asymptomatic up to 11 years after surgery.

Cardiac Catheterization↗
PubMed1993

Variations in arterial blood supply and the risk of hemorrhage during percutaneous treatment of lesions of the pelviureteral junction obstruction: report of a case of testicular artery arising from an inferior polar renal artery.

Acute hemorrhage during percutaneous surgery on the pelviureteric junction obstruction has been estimated to be 2-3%. Following the experience of peroperative bleeding from a vascular variation, the authors discuss the arterial anomalies of the renal pedicle which may carry the risk of hemorrhage during percutaneous surgery in this region. Arteries in front of or behind the renal pelvis are the cause of ureteropelvic function obstruction in 15-52% of cases and because of their close relationship with the upper urinary tract can complicate the procedure of endopyelotomy. Endourological techniques are inadequate for avoiding the risk of vascular damage during the necessary maneuvers. Inferior polar arteries occur in 9% of the population and their different courses are described. They are not always responsible for the vascular obstruction in the pelviureteric syndrome, and it is the exact determination of this responsibility that makes imaging essential. Arteriography performed in our case allowed embolisation of the damaged inferior polar artery and also showed the anomalous origin of the testicular artery from this polar artery; this appears to be only the second description of this anomaly. This variation is discussed in a review of the literature. In fact the testicular artery has a high or aberrant origin in 20% of cases; in 5-6% of these the origin is from a main or supernumerary renal artery. Origin from an inferior polar artery is exceptional.

Adult↗
PubMed1995

Doppler flow velocimetry of the umbilical artery, uteroplacental arteries and fetal middle cerebral artery in prolonged pregnancy.

A total of 153 pregnant women, of at least 287 days' menstrual age, were studied in a prospectively designed cross-sectional trial. In addition to the non-stress test, contraction stress test, sonographic estimate of amniotic fluid and grade of placental maturation, Doppler measurements of the resistance index (RI) were taken in the umbilical artery, the uteroplacental arteries in the region of placental implantation and the fetal middle cerebral artery. Data were analyzed with regard to asphyxia and otherwise complicated fetal outcome. Furthermore, a possible relationship between grade of placental maturation, Doppler flow velocity waveforms and fetal outcome was investigated. Doppler resistance indices in the umbilical artery, uteroplacental arteries in the region of placental implantation and fetal middle cerebral artery did not change significantly with increasing gestation from 41 to 43 weeks. The grade of placental maturation on ultrasound examination was not related to fetal outcome or Doppler indices in the first two vessels. In all vessels examined in this study, the majority of Doppler measurements in pregnancies with subsequent asphyxia or otherwise complicated fetal outcome were within the 95% prediction interval for patients with normal fetal outcome. None of the patients showed absent diastolic flow in the umbilical artery. With the use of a cut-off value of RI = 0.62 in the umbilical artery, asphyxia could be predicted with 37% sensitivity and 75% specificity. Oligohydramnios and antpartum cardiotocography predicted asphyxia with 16% and 8% sensitivity and 95% and 96% specificity, respectively. Sensitivity for prediction of otherwise complicated fetal outcome by umbilical artery Doppler was only 7%.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Flow Velocity↗
PubMed1983

Estimation of forearm arterial compliance in normal and hypertensive men from simultaneous pressure and flow measurements in the brachial artery, using a pulsed Doppler device and a first-order arterial model during diastole.

Simultaneous brachial artery pressure and blood flow measurements were made in 45 men. Blood flow was evaluated by means of a pulsed Doppler device with a double transducer probe. From analysis of the pressure-flow curves during diastole, forearm arterial compliance (FAC) was determined by using the model of the forearm arterial tree as a system of tubes, each with a storage capacitance, in series with the arteriolar resistances vessels. The value of FAC for seven normal subjects, aged 44 +/- 3 (mean +/- SEM) years, was between 0.78 and 1.73 X 10(-10) m5 . N-1. By comparison, a 30% reduction in FAC was observed in 38 men of the same age with essential hypertension, which was similar whether the intra-arterial diastolic pressure was above or below 90 mmHg. In the more severe group (Intra arterial diastolic pressure greater than 90 mmHg), the reduced FAC was associated with a significant increase in brachial artery diameter; after administration of dihydralazine, blood pressure and arterial diameter returned to normal but FAC remained diminished. The study is the first to evaluate FAC in intact men. The reduced FAC in hypertension is independent of blood pressure "per se" but may reflect adaptive change in the walls of the large arteries. In the more severe hypertension, arterial calibre was increased; this could be a mechanism which could prevent FAC from decreasing further with chronic elevation of blood pressure.

Adult↗
PubMed1981

Effect of intra-arterially induced alpha-receptor blockade upon resistance in collateral arteries in patients with occlusion of the superficial femoral artery.

The effect of intra-arterially phentolamine inducing alpha-receptor blockade upon the resistance in collateral arteries bypassing an occlusion of the femoral artery was studied in five patients. The patients were placed on a tilt table and the measurements were performed with the patients in supine position and titled 40 degrees (head-up). Arterial blood pressure was measured directly in the brachial-common femoral-and popliteal artery. Relative blood flow was calculated as the relative change in arterio-venous oxygen saturation. Head-up tilt caused a decrease in blood flow of about 35% corresponding to an increase in total vascular resistance of 38%. Resistance in collateral arteries increased by 45%. In supine position alpha-receptor blockade reduced collateral resistance by 17%. However, the title-induced constriction of the collateral arteries was blocked by 87%. The results indicate that the constriction of the collateral arteries bypassing an occlusion of the superficial femoral artery is mainly mediated via sympathetic adrenergic vasoconstrictor fibres.

Adrenergic alpha-Antagonists↗
PubMed2000

Renal arteries in patients at risk of renal arterial stenosis: multicenter evaluation of the echo-enhancer SH U 508A at color and spectral Doppler US. Levovist Renal Artery Stenosis Study Group.

PURPOSE: To assess SH U 508A in the diagnosis of suspected renal arterial stenosis by means of ultrasonography (US) and to confirm the safety of SH U 508A in a clinical setting. MATERIALS AND METHODS: A randomized crossover study was performed in 198 patients from 14 European centers who were referred for renal arterial angiography because they were suspected of having renal arterial stenosis. All patients underwent nonenhanced and SH U 508A-enhanced Doppler US of the renal arteries. Doppler criteria included measurement of renal arterial peak systolic velocity (threshold, 1.4-2.0 m/sec) in all centers and renoaortic ratio (threshold, 3.0-3.5) in nine. RESULTS: The number of examinations with successful results increased following enhanced Doppler US examination--160 (83.8%) compared with 122 (63.9%) with nonenhanced Doppler US (P = .001), including patients with obesity or renal dysfunction. Renal arterial stenosis (> or =50%) was detected at angiography in 72 patients. Results at enhanced Doppler US were in agreement with results at angiography more often than with results at nonenhanced Doppler US in the diagnosis or exclusion of renal arterial stenosis (P = .001). For patients examined with nonenhanced and enhanced Doppler US, sensitivity (80.0% and 83.7%, respectively) and specificity (80.8% and 83.6%, respectively) remained unchanged. There were no clinically important adverse events following use of SH U 508A. CONCLUSION: In patients suspected of having renal arterial stenosis, SH U 508A increased the number of diagnostic renal arterial Doppler studies.

Adult↗
PubMed1980

[Anomalous origin of the left coronary artery from the pulmonary artery. Treatment by left subclavian-left main coronary artery anastomosis].

The technique of left subclavian-main left coronary artery is described as the treatment of anomalous origin of the left coronary artery from the pulmonary artery, without the aid of cardiopulmonary bypass, which, however, remains on standby. Through a left postero-lateral thoracotomy, the left main coronary artery is detached from the main pulmonary artery with a cuff of pulmonary wall after lateral clamping of the pulmonary artery. Tapes are encercling the pulmonary artery and the descending thoracic aorta, making them ready for an eventual connection to the standby bypass, in case the coronary clamping is not well tolerated. The anastomosis between the left subclavian artery dissected free and the prepared left main coronary artery is then possible and easy even in a small infant. This technique has been used in three infants aged three to thirty months without any mortality nor particular morbidity.

Child, Preschool↗
PubMed1996

[Intralobar pulmonary sequestration with an aberrant artery originating from the celiac artery and communicating with the pulmonary artery].

A 13-year-old boy underwent a right lower lobectomy for removal of an intralobar pulmonary sequestrum with a very rare type of aberrant artery. The aberrant artery originated from the celiac artery and communicated with the pulmonary artery. Angiographic and histologic findings led us to the following hypothesis regarding the origin of the sequestrum in this patient: There was a hypoplastic bronchus and an aberrant artery that originated from the celiac artery. Infection caused obstruction of the hypoplastic bronchus, which resulted in formation of the sequestrum. Another possibility is that high systemic pressure in the aberrant artery caused destruction of alveoli and led to the formation of cysts in the lung and to sequestration. Finally, the aberrant artery and the pulmonary artery communicated due to chronic inflammation in the sequestrum.

Adolescent↗
PubMed1997

[White coat arterial hypertension and isolated systolic arterial hypertension: ultrasonography of the carotid arteries].

BACKGROUND: The prognosis of white coat hypertension is uncertain. The aim of this study was to evaluate the prevalence of atherosclerotic carotid lesions in subjects with white coat hypertension and clinical isolated systolic hypertension using 2D echo-color-doppler procedure. MATERIALS AND METHODS: Patients were initially selected through the sphygmomanometric measurement of blood pressure and subsequently through 24-hour blood pressure monitoring. Fifty-four subjects with white coat hypertension were studied in comparison with either 60 normotensive subjects or 116 sustained isolated systolic arterial hypertensives. All patients underwent high-resolution B-mode echotomography of both carotid arteries, which made it possible to assess myointimal thickening and plaques. A thickness of > or = 0.95 mm, calculated as the mean of 5 measurements of the common carotid artery, 2.3 cm from the flow divider, was considered a sign of myointimal thickening, while plaques were represented by a focal thickening of > or = 2 mm, based on echogenic characteristics (hard, fibrous, mixed, soft and hemorrhagic) and site (common carotid, bifurcation, internal and external carotid). RESULTS: Normal carotid arteries, carotid arteries with myointimal thickening, or carotid arteries with at least one plaque, were similar in subjects with white coat hypertension and in normotensives. Instead, as compared with subjects with white coat hypertension, sustained hypertensives showed a pattern of intimal-medial thickening (p = 0.04) with-one or more plaques (p = 0.005) on a much more frequent basis, while normal carotid arteries were less frequent (p = 0.0001). Plaques were most often localized at the common carotid artery and bifurcation and, less frequently, at the internal and external carotid arteries. Most often, the lesions were hard, less fibrous, mixed and soft. CONCLUSIONS: White coat hypertensives with clinical isolated systolic hypertension may represent a low-risk group. Long-term prospective studies are required in order to obtain a definitive prognosis of white coat hypertension.

Blood Pressure Monitoring, Ambulatory↗
PubMed1994

Successful intra-arterial fibrinolysis of the anterior choroidal artery in the acute stage of internal carotid artery occlusion: case report.

A 27-year-old man was admitted to our institution with the sudden development of right hemiparesis and dysarthria beginning an hour after the onset of symptoms on August 9, 1992. The patient was found on admission to have right hemiparesis (2/5), hemihypesthesia, hemianopia, dysarthria; he had transient atrial fibrillation. No abnormalities were detected on computed tomography (CT) scans, and cerebral blood flow studies undertaken following conventional CT scans revealed no low flow regions in the left cerebral hemisphere. But cerebral angiography disclosed an occlusion of the left internal carotid artery with well-developed cross-circulation via the anterior communicating artery and embolus lodged at the level of the anterior choroidal artery. Superselective fibrinolysis using Tracker-18 and 420,000 units of urokinase resulting in complete recanalization of the left anterior choroidal artery without distal migration of the embolus. Immediately after the procedure, his neurologic disturbance underwent complete resolution. In summary, fibrinolysis could be performed but limited to anterior choroidal artery in a case with an occlusion of the internal carotid artery with well-developed cross-flow via the anterior communicating artery; the patient's neurologic condition may deteriorate suddenly if fibrinolysis is incomplete and the embolus migrates to the internal carotid artery.

Acute Disease↗
PubMed2004

Long-term follow-up of total arterial myocardial revascularization using exclusively pedicle bilateral internal thoracic artery and right gastroepiploic artery.

OBJECTIVE: In order to reduce remote cardiac events associated with graft occlusions, arterial conduits are being increasingly utilized in coronary artery bypass grafting (CABG). While the internal thoracic artery (ITA) is the graft of choice for CABG, it is sometimes difficult or impossible to obtain a complete arterial revascularization only with ITAs in three-vessel diseases. We present our experience with total arterial myocardial revascularization with bilateral internal thoracic artery (BITA) and right gastroepiploic artery (rGEA). METHODS: From April 1994 to January 2004, 174 patients (165 male, mean age 55.9+/-7.4) underwent coronary artery bypass procedure with exclusive use of BITA and rGEA. Left ventricular ejection fraction ranged from 20 to 68% (mean 55.9+/-6.8%). Seven patients (4%) had poor ejection fraction (<0.30), 23 (13, 2%) had acute myocardial infarction, 14 (8%) had left main disease. The mean CPB time was 96.9+/-15.7 min and the mean cross clamping time was 70+/-14.2 min. The mean number of distal anastomoses was 3.3+/-0.5 per patient. RESULTS: Early mortality was 1.7%. The patients were followed for up to 9 years (mean follow-up time 6.3+/-2.6 years). Actuarial freedom from cardiac death (including hospital death) was 97.6%, at 9 years after the operation. Actuarial freedom from angina and cardiac events at 9 years was 79, 5% and 77, 6%, respectively. No perioperative myocardial infarction occurred. None of the patients needed a redo-CABG after leaving the hospital. CONCLUSIONS: This study indicates that the myocardial revascularization in young patients with three-vessel disease using exclusively pedicle BITA and rGEA provides excellent 9-year patient survival and improvement in terms of freedom from return of angina pectoris and freedom from any cardiac-related event. These results encourage the more extensive use of BITA and rGEA in selected patients with three-vessel coronary disease.

Angina Pectoris↗
PubMed2005

Results of coronary artery endarterectomy and coronary artery bypass grafting for diffuse coronary artery disease.

BACKGROUND: Coronary artery endarterectomy with coronary artery bypass grafting for diffuse coronary artery disease has been associated with increased morbidity and mortality. We evaluated our institutional experience to redefine the role of coronary endarterectomy for diffuse coronary artery disease. METHODS: From 1985 to 2002 isolated coronary artery endarterectomy with coronary artery bypass grafting was performed in 1,478 consecutive patients. The short-term outcomes were compared with concurrent series of conventional coronary artery bypass graft surgery, and risk factors for adverse outcomes after coronary endarterectomy were identified. RESULTS: Patients in the coronary endarterectomy group were of higher risk with increased incidence of comorbidities and three-vessel coronary disease. The operative mortality (3.2% versus control 2.2%; p = 0.03) and the incidence of major postoperative morbidity (not significant) were comparable between the groups. Prolonged cardiopulmonary bypass time, recent acute myocardial infarction, redo surgery, and poor ventricular function were important predictors of in-hospital mortality. Vessel endarterectomized, technique of endarterectomy, and cardiopulmonary bypass versus off-pump technique did not alter results. At long-term follow-up, 5-year and 10-year survivals were 83% +/- 5%, and 74% +/- 3%, respectively, and freedom from angina at 5 and 10 years was 75% +/- 5%, and 69% +/- 4%, respectively, with 96% of survivors in New York Heart Association class II. CONCLUSIONS: In selected patients with diffuse coronary artery disease, coronary endarterectomy can be used as a tool for myocardial revascularization. The operative mortality and major morbidity were comparable or similar to coronary artery bypass grafting, and short-term and long-term results were favorable.

Aged↗
PubMed1992

Abdominal part artery of axillary artery: proposed term for the artery supplying the abdominal part of the musculus pectoralis major.

In 1976, the authors reported that the abdominal part artery (Pab) supplying the abdominal part of the pectoralis major muscle usually originates from the axillary artery (Ax). The findings in the present study show that the type of origin of this artery most frequently encountered is type 2-a (44.0%) in which the Pab, as an independent branch (type a), branches out of the second part of the Ax (type 2). The second and third most frequently encountered types are type 2-b (17.0%), where the Pab has a common trunk with the thoracoacromial artery, and type 2-c (10.0%), where it has a common trunk with the lateral thoracic artery. By classification according to the supplying areas, 67% was type I-B, supplying the lower part of the pectoralis minor muscle and the abdominal part of the muscle. In 5%, the branch as type I-A courses down to the sternocostal part. In most cases (types A and B in 91%), this artery originates from the Ax proximal to the ansa mediana of the brachial plexus; however, in 4% providing the superficial brachial artery, the Pab branches out from the superficial brachial artery. Based on those findings, the authors would propose that the artery be named the arteria partis abdominalis or Pab.

Adult↗
PubMed1985

Study of arterial patterns of the hand in primates. Deep palmar arterial arches and their correlating arteries in Macaca fuscata.

Study of the arterial patterns of the hand in Macaca fuscata, especially those of the deep palmar arterial arches and their correlating arteries, by three-dimensional arteriographic analysis revealed the following: (1) The deep palmar arterial arches are formed by the perforating branches of the 2nd dorsal metacarpal artery, and they are usually composed of two proximal arches (catella volaris proximalis and arcus volaris profundus) and one distal arch (catella volaris distalis). (2) In the 3rd and 4th metacarpal interosseous spaces, the intermetacarpal arteries arise from the catella volaris proximalis, and the arcus volaris profundus has palmar metacarpal arteries which descend along the palmar side of each metacarpal bone. (3) There is a definite regularity in the formation of the intermetacarpal arteries between the catella volaris proximalis and the catella volaris distalis and of the palmar metacarpal arteries between the arcus volaris profundus and the catella volaris distalis.

Angiography↗
PubMedDate not supplied

Low-dose intermittent urokinase therapy in chronic symptomatic end-stage arterial disease--clinical relevance for patients with coronary artery disease or peripheral arterial occlusive disease.

Symptomatic end-stage arterial disease in coronary artery or peripheral arterial occlusive disease represents an increasing clinical problem as cardiovascular mortality in these patient groups has declined due to improved secondary prevention. While in peripheral arterial occlusive disease amputation with subsequent life-long physical disability is the major problem, patients with end-stage coronary artery disease and refractory angina pectoris repeatedly report to the emergency ward with the clinical symptoms of unstable coronary syndromes, but myocardial infarction is generally ruled out. For these patients long-term intermittent urokinase therapy has been developed as an alternative treatment modality. Potential mechanisms for clinical effectiveness include improvement of rheological blood properties, thrombolysis of non-occluding arterial thrombi and possibly plaque regression. In coronary artery disease urokinase is applied as an intravenous bolus injection of 500,000 IU urokinase three times a week over a period of 12 weeks. This leads to a marked reduction of fibrinogen by about 35% and of clinical symptoms by around 70% accompanied by a reduction of exercise-induced myocardial ischemia. In observational studies in patients with peripheral arterial occlusive disease injections of 500,000 IU of urokinase were usually given daily for a shorter time period of three to four weeks with a clinical success rate, defined as a cessation or marked reduction of rest pain and/or salvage of a limb, of around 50%. Given the state of critical ischemia in both entities of atherosclerotic disease, long-term intermittent urokinase therapy represents a promising antiischemic approach. In particular in patients with peripheral arterial occlusive disease randomized controlled trials with prolonged treatment periods, which are likely to improve clinical results, are warranted.

Arterial Occlusive Diseases↗
PubMed2004

Rare case of the inferior mesenteric artery and the common hepatic artery arising from the superior mesenteric artery.

We found a case in which inferior mesenteric artery and the common hepatic artery arose from the superior mesenteric artery, forming the common hepatomesenteric trunk, during a routine dissection carried out at Iwate Medical University in 2002. This variation is rare, but can be embryonically explained. A change in the positions of the disappearance of the ventral splanchnic arteries and the longitudinal anastomotic channel results in variations in the system of arteries distributed to the digestive organs. In the present case, the longitudinal anastomotic channel between the superior and the inferior mesenteric arteries survived to form the common mesenteric artery, which was joined by the common hepatic artery, forming the common hepatomesenteric trunk.

Aged↗