Anatomical variants of the profunda femoris artery: an angiographic study

The bifurcation of the common femoral artery (CFA) into superficial and profunda femoris arteries (PFA) and the branching pattern of the PFA are subject to considerable normal anatomical variation. These variation patterns were assessed on normal lower limb angiograms of 94 adult patients. The main pattern (in 81% of patients) consisted of both medial and lateral circumflex arteries arising directly from a PFA situated lateral or posterolateral to the femoral artery. Previous studies of arterial variations in this region and the relevant embryology are reviewed. Relevance to angiographic procedures of the lower limb is discussed.This study was conducted at the John Radcliffe Hospital, Oxford, UK     

基于活体造影数据的股深动脉穿动脉穿支血管的数字解剖学研究

目的　探讨基于活体造影数据重建股深动脉穿动脉穿支皮瓣血供三维数字化模型的可行性,为临床股深动脉穿动脉穿支皮瓣的应用提供解剖学依据。 方法　选择8例需行皮瓣移植的患者作为研究对象,采用DSA结合CT血管成像技术获取一侧大腿二维断层图像数据,应用 Mimics 软件对股深动脉穿动脉及其穿支进行三维可视化重建,利用软件自带测量工具筛选合适穿支。 结果　利用 Mimics 软件成功重建了股深动脉穿动脉及其穿支的三维可视化模型,能清晰显示股深动脉穿动脉及其穿支的分布、走行及穿支穿出深筋膜位置。8例患者中6例发现3支穿动脉,2例发现4支穿动脉。这些穿动脉共发出66支皮肤穿支（以大于0.5 mm为标准）,穿支在穿深筋膜平面内径(0.9±0.26)mm, 穿支浅出深筋膜点主要分布于坐骨结节与股骨外上髁的连线附近。 结论　基于活体造影数据可以重建清晰股深动脉穿动脉及其穿支血管的3D立体影像,可为临床股深动脉穿动脉穿支皮瓣的术前设计与皮瓣切取提供解剖学依据。     

Embolisation of the ophthalmic artery branches distal to its visual supply

A study of the embryology and the anatomy of the ophthalmic artery shows that the branches to the important sensory structures arise proximal to the second intraorbital segment of the vessel. Damage to vision will be avoided if embolisation is restricted to vessels anterior to this "safety point", which is easily recognised on an angiogram. The ideal point of injection of emboli is even more distal and varies with the extent of the lesion and the material used. Three cases are described with vascular lesions supplied by the ophthalmic artery and embolised with Histoacryl.     

The variations of the subclavian artery and its branches

This study reports important variations in branches of the subclavian artery in a singular cadaver. The origin of the left vertebral artery was from the aortic arch. On the right side, no thyrocervical trunk was found. The two branches which normally originate from the thyrocervical trunk had a different origin. The transverse cervical artery arose directly from the subclavian artery and suprascapular artery originated from the internal thoracic artery. This variation provides a short route for posterior scapular anastomoses. An awareness of this rare variation is important because this area is used for diagnostic and surgical procedures.     

颈总动脉及其分支的变异类型*

血管变异在人体中广泛存在,了解正常人体解剖结构及变异情况对医务工作者尤其是临床医生而言尤为重要.以往在各大学术论文上对各类血管变异的报道并不少见,但是却缺乏较为全面的总结.现对最近几十年内的25例各类医学杂志中关于颈部血管变异的报道进行了较为详细的分类总结,旨在为广大临床工作者提供一定的参考作用.     

Rare arterial variation: a common trunk from the external iliac artery for the obturator, inferior epigastric and profunda femoris arteries

Summary In this anomaly, observed in the right pelvic region of a female newborn cadaver among 100 studied (1%), a common arterial trunk arose from the medial side of the external iliac a. 1 cm proximal to the inguinal ligament. The trunk first divided into an ascending branch, which finally divided into the obturator and inferior epigastric arteries, and a descending branch, the profunda femoris a. from which arose the medial circumflex femoral a. The origin of the profunda femoris, obturator and inferior epigastric aa. is explained on the basis of the embryologic development and their course and variations are compared with reports in the literature.

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Une variété artérielle rare : naissance par un tronc commun, issu de l'a. iliaque externe, des aa. obturatrice, épigastrique inférieure et profonde de la cuisse

Résumé L'anomalie rapportée a été observée dans la région pelvienne droite du cadavre nouveau-né d'une petite fille sur 100 cadavres étudiés (1 %). Le tronc artériel commun naissait de la face médiale de l'a. iliaque externe, 1 cm proximalement au ligament inguinal. Le tronc se divisait d'abord en une branche ascendante, qui se divisait ensuite en aa. obturatrice et épigastrique inférieure, et une autre branche descendante, l'a. profonde de la cuisse, dont naissait l'a. circonflexe fémorale médiale. L'origine des aa. profonde de la cuisse, obturatrice et épigastrique inférieure pourrait être expliquées par le développement embryonnaire. Leur trajet et leurs variations sont étudiés à la lumière de la littérature.

     

腋动脉及其分支的应用解剖学研究

目的探索国人腋动脉(AA)及其分支的类型、量化数据以及他们之间的比例关系。方法解剖观察32具成人尸体标本(男25具、女7具)的腋动脉分支类型、外径及腋动脉起始段的外径与其自身比例,腋动脉3段的长度、外径,计算三者间的自身比例。结果腋动脉分支分为7型及1个变异型。每型又分为若干亚型,以6支型(出现率30.16%)和5支型(出现率26.98%)多见;腋动脉3段长度差异较大,三者之比为1∶1.18∶1.25,外径由第一段至第三段渐细,三者之比为1∶0.89∶0.75,腋动脉的各分支依据其支数及起始位置的不同,分为若干型及亚型。腋动脉起始端与各分支起始端外径之比分别为胸上动脉(TS)1∶0.28,胸肩峰动脉(TA)1∶0.42,胸外侧动脉(TL)1∶0.31,肩胛下动脉(SS)1∶0.63,旋肱前动脉(CHA)1∶0.25,旋肱后动脉(CHP)1∶0.46。结论腋动脉及其分支的变异较大,临床介入放射学及血管外科学对血管处理或选择时,应以出现率高、类型恒定、管径允许者作为应用对象。     

The posterior inferior cerebellar artery and its branches in relation to the cerebellomedullary fissure

The conventional approach to the fourth ventricle is by splitting the vermis on the suboccipital surface of the cerebellum. By a unilateral transcerebellomedullary fissure approach, it is possible to provide sufficient operative space from cerebral aqueduct to obex without splitting the vermis. This approach needs meticulous dissection of the cerebellomedullary fissure and preservation of the posterior inferior cerebellar artery (PICA) and its branches. The tonsillomedullary and telovelotonsillar segments of the PICA are the most important vessels encountered in the transcerebellomedullary fissure approach. The PICA was examined under a surgical microscope in a total of 40 specimens by perfusing with a mixture of 10% Indian ink and gelatin. The passing of the tonsillomedullary segment of the PICA through the cerebellomedullary fissure was observed superior to the tonsil in 5%, at the level of the upper pole of the tonsil in 17.5%, at the middle of the tonsil in 37.5% and at the level of the lower pole of the tonsil in 37.5% specimens. When the PICA arose from the lateral medullary (LM) segment of the vertebral artery (VA), a caudal loop was present in 90%, when the PICA originated from the premedullary segment of the VA, the loop was present in 87.5% specimens. When the PICA arose from the basilar artery (BA), the loop was absent, and the tonsillomedullary segment of the PICA showed a straight course (100%). A thorough understanding of the relationship of the branches of the PICA to the cerebellar tonsils are prerequisites for surgery in and around the fourth ventricle.     

Anatomy of the superficial temporal artery and its branches: its importance for surgery

The temporoparietal, parieto-occipital flaps or the forehead flaps that are used in reconstructive surgery are prepared on the superficial temporal artery (STA) and its branches. For a successful surgery and a suitable flap design, adequate anatomical knowledge is needed. In our study, the red colored latex solution was injected into the external carotid artery; the STA and its branches were dissected in 27 specimens. The mean diameter of the STA at the zygomatic arch was determined as 2.73±0.51 mm. The diameters of the frontal branch were bigger than those of the parietal branch in 15 samples out of 27. The diameters of both the frontal and parietal branches were equal in four samples. The diameter of the parietal branch was bigger than that of the frontal branch in eight samples. In 20 samples out of 27 (74.07%), the bifurcation point of the STA was above the arch. In six samples (22.22%), the STA bifurcated directly over the arch. In only one sample (3.70%), bifurcation was not observed and the STA continued only as a frontal branch (absence of the parietal branch). The absence of the frontal branch was not encountered. In one sample (3.70%), double parietal branches were observed. In six samples out of 27 (22.22%), zygomatico-orbital artery was not encountered. In 21 samples (77.77%), zygomatico-orbital arteries ran towards the face, parallel to zygomatic arch and distributed in the orbicularis oculi muscle. The transverse facial artery existed in all samples. The auricular branches running to the helix and tragus were observed in all samples. The STA was 16.68±0.35 mm at the front of the tragus. Some landmarks were chosen on the head and then the STA was observed where it crossed all of these landmarks. This paper confirms the well-known variability of the superficial temporal arterial branches and their relation to the pericranial region. Knowledge concerning the arterial features of the lateral forehead region is important for the aesthetic surgeon. STA and its branches have been found to be suitable for use in microvascular anastomoses. A better understanding of the midline forehead vascularity should allow modification of reconstructive techniques and reduce postoperative complications.     

Study on the subclavian artery and its branches in Japanese adults.

We examined the entire array of branches and the state of ramification of each branch of 144 subclavian arteries (Su) in 72 Japanese adults, and obtained the following findings. (1) The incidence of Type I -A(1) was 13.2%, the highest among the entire Su ramification. This was followed by Type I -B(1) at 9.0%, then Type I -A(2) at 6.9%, indicating considerable variation in the morphology of Su ramification. (2) Ontogenetic factors were implicated because of the existence of cases in which Su traversed the scalenus anterior muscle anteriorly (Type III: 0.7%), or was transfixed (0.7%). (3) Type 1-c was the form of thyrocervical trunk (Ttc) observed with the highest incidence of 31.3%. In addition, we propose that Types a-j (that were formed from a common trunk consisting only of the ascending cervical artery and inferior thyroid artery, and those in which another branch was included in this common trunk: 88.9%) be called Ttc. (4) The most common type of transverse cervical artery (Tc), which is formed from a common trunk consisting of superficial and deep branches, was found to be Type 1-a that branches from the first part of Ttc. It was observed with the highest incidence of 61.8%. Some of the superficial branches to the upper portion of the trapezius muscle that were independent and branched from Ttc (Types e, f: 2.8%), we called upper superficial branches. (5) The most frequently observed type of suprascapular artery (Ss) was Type b (38.2%), followed by Type a (25.7%), which branches independently from Su. We concluded that the sites at which Tc and Ss originate are the positions at which they traverse the brachial plexus (superior, transfixed to the plexus). (6) In cases in which the supreme intercostal artery (Is) and the deep cervical artery (Cp) were separate, (Types d-i excluding Type g: 31.9%), Is branched from a more proximal position than Cp.     

咽升动脉分支的解剖分组及其临床意义

目的:探讨咽升动脉及其主要分支在颈部颅底区域走行规律及其在血管内外治疗中的临床意义。方法:选择以10%甲醛固定并用乳胶灌注的8具（16侧）成人颅颈部标本,自颈总动脉分叉水平向上解剖至颅底骨质,分离显露咽升动脉及周围相关结构,观察咽升动脉的起源部位及主要分支,测量相关解剖学参数。依据咽升动脉主要分支与颈动脉鞘的位置关系分...     

The ophthalmic artery and its branches,measurements and clinical importance

Summary Seventy-one Caucasian orbits (36 right, 35 left) were studied by dissection. The diameter of the ophthalmic a. (2 mm from the origin) was 1.54 ± 0.04 mm (male) and 1.31 ± 0.05 mm (female). In individual cases, there were no significant differences in vessel diameter between the right and left sides but, differences in vessel diameter between males and females were more commonly observed in the arteries which leave the orbit (extraorbital group), the individual vessels having a larger diameter in males. The incidence of the ophthalmic a. passing in the orbit medially under the optic n. was 18.6%. The lacrimal a. was observed to arise from the ophthalmic a. in only 82.5% of the cases examined, 15.9% of the cases showed the origin to be at the anastomotic branch of the middle meningealThis article is dedicated to Pr Dr Hoepke on occasion of his 100th birthday     

双侧股深动脉高位分出变异1例

作者解剖1例成年女尸,发现双侧股深动脉高位分出,报道如下. 去除腹股沟部软组织,发现双侧股深动脉在腹股沟韧带深面由髂外动脉末端发出,在腹股沟韧带下方出现两条动脉并列下降(图1),一条是股深动脉,直径为0.71cm,一条是股动脉,直径为0.73cm.     

The diameters of common carotid artery and its branches in newborns

The common carotid artery (CCA) bifurcation is of clinical importance due to its vascular access site for intravascular intervention. Additionally, it is also one of the most common sites of atherosclerotic plaque formation. There are numerous studies on the diameters of CCA, internal carotid artery (ICA), and external carotid artery (ECA) in adults, but few studies on newborns. Cadaver and angiographic studies have shown dimensional variations in the carotid arteries within/between individuals and also between different sexes. It is well known that the initial lesions of atherosclerosis begin very early in fetal life. Therefore, it is important to know the anatomical details of the CCA and its branches. In the present study, the neck regions of 20 (11 males and 9 females) fixed newborn cadavers were dissected. The CCAs were cut below the bulb of the carotid bifurcation further; ICA and ECA were cut above the bulb of the carotid bifurcation. The internal diameters of the CCA, ICA, and ECA were measured using a light microscopy. ECA/CCA, ICA/CCA, ICA/ECA ratios, and outflow to inflow area ratio were calculated. The mean outflow to inflow area ratio was 1.14±0.28. Our results highly correlated with the defined optimal ratio (1.15). The ECA/CCA, ICA/CCA, and ICA/ECA ratios were 0.78±0.12, 0.71±0.13, and 0.93±0.16, respectively. There were no statistically significant differences between male and female and also between right and left sides. These findings are of importance in understanding the anatomy of carotid artery during newborn period.     

肝固有动脉分支及吻合变异1例

作者在解剖1具成年男性尸体标本时,发现其肝固有动脉分支及吻合变异,现报道如下: 在该例标本中,肝总动脉由腹腔干发出,向右上走行2.5 cm后,在肝门静脉前方分成2支,行向肝门(图1). (1)存在两条肝固有动脉 左支(外径0.25 cm)由肝总动脉发出,沿肝门静脉左前方上行约1.3 cm,分为左、右2支入肝左叶(未从肝门进入).此支距起点0.6 cm处发出胃右动脉;在末端向右发出一吻合支与肝固有动脉右支吻合.     

颈总动脉及其分支与锁骨下动脉异常4例

<正>在教学中发现颈总动脉及其分支与锁骨下动脉走行异常。例1:中年男尸,右侧颈内动脉在起始处返折,呈横置的"U"字形,舌动脉与面动脉共干发自颈外动脉,舌动脉在面动脉的下方,先向后上再向前下螺旋走行,最后斜上走行,整体呈"V"字形。面动脉自舌动脉下方发出后绕经舌动脉的前面向后上方行走。颈总动脉上部和颈内动脉在颈动脉鞘内位于颈内静脉的前方(图1a)。颈总动脉中段与颈内静脉呈内外平行走行,颈总动脉下部位于颈内静脉后方,颈动脉小球位于颈外动脉后方(图1b)。     

右侧腋动脉及其分支变异1例

腋动脉分支的类型和数目变异较为常见,国内外专著一般将腋动脉的分支描述为典型的6支型。我们在解剖一具女性尸体标本(身长约150 cm,83岁)时,见其右腋动脉分支为2支型,除从主干发出1支细小的胸外侧动脉外,只发出1支动脉干,这种变异较为少见,为积累解剖学资料并为临床工作提供形态学依据,现报道如下:该例腋动脉自第1肋续于锁骨下动脉,行于臂丛内侧束的前