MyMedR

Fulltext Management of bleeding pseudoaneurysm of gastroduodenal artery secondary to chronic pancreatitis

Leow VM, Siam F, Kannan S, Sari Baharudin M, Raman K, Singh H

Med J Malaysia, 2013 Jun;68(3):271-2.

A bleeding pseudoaneurysm of the peripancreatic artery can present with massive upper gastrointestinal hemorrhage. History of pancreatitis and urgent imaging are crucial in the making of the diagnosis. Here, we report a patient with alcoholic chronic pancreatitis presented with ruptured pseudoaneurysm of gastroduodenal artery (GDA). He was treated with percutaneous angiographic embolisation.

Matched MeSH terms: Arteries

Fulltext Pneumonectomy for congenital isolated unilateral pulmonary artery agenesis

Britton J, Sachithanandan A, Srinivasan L, Ghosh S

Med J Malaysia, 2011 Oct;66(4):363-4.

PMID: 22299560 MyJurnal

Unilateral pulmonary artery agenesis (UPAA) is a rare congenital anomaly usually diagnosed in infancy due to associated cardiovascular malformations. We report a rare case of isolated right UPAA that presented atypically in adulthood with massive haemoptysis requiring a pneumonectomy. This case highlights the importance of maintaining a high clinical suspicion, the role of CT angiography and a multi disciplinary approach. Optimal management is often surgical however bronchial artery embolization (BAE) remains a useful adjunct.

Matched MeSH terms: Bronchial Arteries

Fulltext Supraclinoid direct carotid-cavernous sinus fistula

Che Ani MF, Kumar R, Md Noh MSF, Muda AS

BJR Case Rep, 2018 Mar;4(3):20170058.

PMID: 31489208 DOI: 10.1259/bjrcr.20170058

Carotid-cavernous fistulas (CCFs) are vascular shunts between the carotid arterial system with direct drainage into the cerebral venous system, mainly to the cavernous sinus. Direct CCF is a well-recognised complication following head trauma. Classically in direct or traumatic CCF, vessel wall tear occurs at the cavernous segment of the internal carotid artery, between the fixed and free segment. Tears at the supraclinoid segment are rare. We report a case of an internal carotid artery supraclinoid segment pseudoaneurysm, with a direct communication with the cavernous sinus, draining into the superior ophthalmic vein.

Matched MeSH terms: Carotid Arteries

Fulltext Lower eyelid fornix deepening: A new indication for the facial artery myomucosal flap

Saad AZM, Nordin NR, Sulaiman WAW, Jamayet N, Johar SFNM, Hussein A

Arch Plast Surg, 2021 Jan;48(1):80-83.

PMID: 33503749 DOI: 10.5999/aps.2020.00206

Eye socket contracture is a well-known late complication of enucleation surgery, and the additional insult of radiotherapy at an early age causes even further fibrosis and scarring of the socket. Management of the contracted socket is challenging, and several methods have been proposed. We report a case of eye socket contracture after enucleation and radiotherapy in which multiple reconstructive procedures failed. The recurrent contracture caused difficulty in housing and retaining the eye prosthesis. We reconstructed the lower eyelid with a facial artery myomucosal flap and nasolabial flap, and the upper eyelid with a Fricke flap following reconstruction of the orbital rims (supraorbital and infraorbital rims with a calvarial bone graft, and further augmentation of the infraorbital rim with a rib bone graft). Cosmesis post-reconstruction was acceptable and the prosthesis was retained very well.

Matched MeSH terms: Arteries

Analysis of non-Newtonian magnetic Casson blood flow in an inclined stenosed artery using Caputo-Fabrizio fractional derivatives

Jamil DF, Saleem S, Roslan R, Al-Mubaddel FS, Rahimi-Gorji M, Issakhov A, et al.

Comput Methods Programs Biomed, 2021 May;203:106044.

PMID: 33756187 DOI: 10.1016/j.cmpb.2021.106044

BACKGROUND AND OBJECTIVE: Arterial diseases would lead to several serious disorders in the cardiovascular system such as atherosclerosis. These disorders are mainly caused by the presence of fatty deposits, cholesterol and lipoproteins inside blood vessel. This paper deals with the analysis of non-Newtonian magnetic blood flow in an inclined stenosed artery.

METHODS: The Casson fluid was used to model the blood that flows under the influences of uniformly distributed magnetic field and oscillating pressure gradient. The governing fractional differential equations were expressed using the Caputo Fabrizio fractional derivative without singular kernel.

RESULTS: The analytical solutions of velocities for non-Newtonian model were then calculated by means of Laplace and finite Hankel transforms. These velocities were then presented graphically. The result shows that the velocity increases with respect to Reynolds number and Casson parameter, while decreases when Hartmann number increases.

CONCLUSIONS: Casson blood was treated as the non-Newtonian fluid. The MHD blood flow was accelerated by pressure gradient. These findings are beneficial for studying atherosclerosis therapy, the diagnosis and therapeutic treatment of some medical problems.

Matched MeSH terms: Arteries

Fulltext Trapezius rotational flap for cervico-thoracic wound breakdown in post-radiotherapy necrosis: a case report

Ariffin, M. H., Selvyn Lloyd, Rhani, S. A., Kamalnizat, Baharudin, A.

Malays Orthop J, 2014;8(2):40-42.

MyJurnal

The management of post-radiation wound breakdown over the posterior cervico thoracic region can be a challenging task for a surgeon. The aim of the treatment is to produce a well vascularized and a low tensile flap which will close a large defect. We describe the use of the lower trapezius flap to reconstruct the wound breakdown and to obtain stable tissue coverage in a patient with post- radiation necrosis. This flap minimizes the disruption of the scapula-thoracic function while preserving the range of movement over the shoulder. From the literature review, it was noted that the dorsal scapular artery (DSA) and transverse cervical artery (TCA) aid in the blood supply to the trapezius muscle and prevent local necrosis during rotation of the flap. The trapezius flap is widely accepted because of the minor donor site morbidity, large arc of rotation and adequate blood supply.

Matched MeSH terms: Arteries

Fulltext Update on blood pressure measurement in research and in clinical practice

Faezah Sabirin

Compendium of Oral Science, 2014;1(1):1-5.

MyJurnal

Blood pressure (BP) measurement was first recorded in 1700's by Hales who concluded that it was due to a pressure in the blood (1 , 2]. This is his well renowned discovery besides his other experiments on the capacity of ventricles and many other feature of circulatory system. The development of BP measurement was then rather quiet until about a century later. The accurate study of BP started with the introduction of mercury manometer by Poiseuille in 1800's who demonstrated that the arterial pressure was maintained in smaller arteries and that the blood flow through mesenteric bed did not depend on development of the venous change but varied directly with arterial pressure [3]. In the year of 1928, Poiseuille work was recognised when he won the gold medal of Royal Academy of Medicine for his doctoral dissertation on the measurement of BP using mercury manometer that was directly inserted with cannula filled with potassium bicarbonate as anticoagulant into an artery [3]. Later, his invention has enabled Carl Ludwig to develop kymograph, a method to record clinical physiological data including the BP measurements [3]. (Copied from article).

Matched MeSH terms: Arteries

Fulltext Hematospermia: an unusual cause of urology emergency

Goh, E.H., Tan, G.H., Rozman, Z., Nik Azuan, N.I., Fam, X.I., Mohd Hafidzul, J., et al.

Journal of Surgical Academia, 2017;7(1):72-74.

MyJurnal

Hematospermia is a distressing disorder in sexually active men resulting in great concern to the patient. We report an unusual case of hematospermia with an atypical presentation, involving a 54-year-old man presented with acute urinary retention after sexual intercourse. Although the causes are widely known, arteriovenous malformation as the cause of this disorder has not much been reported in the literature. Transcatheter embolization of internal pudendal artery is a promising option for hematospermia caused by arterial fistula or bleeding.

Matched MeSH terms: Arteries

Anatomical variants of the superficial temporal artery in patients with microtia: a pilot descriptive study

Imran FH, Yong CK, Das S, Huei YL

Anat Cell Biol, 2016 Dec;49(4):273-280.

PMID: 28127502 DOI: 10.5115/acb.2016.49.4.273

Superficial temporal artery (STA) based pedicled fascial flap plays a pivotal role in ear reconstruction for microtia patients. There is paucity of literature on the anatomy of the STA in microtia patients. The present study aimed to describe any possible anatomical variations seen in the STA of patients afflicted with microtia. Pre-operative carotid computer tomographic angiography images of patients under the microtia database of Plastic and Reconstructive Surgery Unit at a tertiary medical centre were selected and 3-dimensionally reconstructed. Measurements were made on the 3D reconstructed computed tomographic angiography images of the STA on both the sides of the microtic ear and the non-microtic ear to assess its various anatomical parameters. We managed to obtain a total of 39 computed tomographic angiography images of STAs for analysis. There was a significant difference in the number of main branches of STA between the two groups (P=0.006). The proportion of ears with 2 main branches was higher in the non-microtia group (89.5%) compared to the microtia group (45.0%). A significant difference was found in the STA diameter between the two groups (P=0.012). The mean diameter of STA in the non-microtia group was larger by 0.4 mm. Furthermore, the median angle of STA was larger on the side of the non-microtic ears compared to that of microtic ears by 24.5°, with a P-value of 0.011. The results of the study may be of clinical importance while planning and performing ear reconstructive surgeries using STA based pedicled fascial flaps.

Matched MeSH terms: Temporal Arteries

Incidental Trifid Median Nerve Unveiled in a Lactating Mother

Siddiq MAB, Hossain Parash MT

Cureus, 2019 Sep 30;11(9):e5809.

PMID: 31728251 DOI: 10.7759/cureus.5809

Several anatomical variations concerning the median nerve have surfaced in the medical literature. Among them, bifid median nerve or median nerve bifurcation with or without persistent median artery has been widely reported. Sporadic case reports describe median nerve trifurcation (trifid median nerve) as well. In the present report, we describe carpal tunnel syndrome manifestations in association with trifid median nerve unveiled incidentally under high-frequency musculoskeletal ultrasonogram in a lactating mother-a first in the medical literature.

Matched MeSH terms: Arteries

Myocardial Perfusion Scintigraphy in a Patient With Transposition of Great Arteries Post-Atrial Switch Surgery

Mohd Radzi A, Boey CY, Amir Hassan SZ

Clin Nucl Med, 2023 Aug 01;48(8):727-728.

PMID: 37220239 DOI: 10.1097/RLU.0000000000004700

We report a case of a 33-year-old woman who underwent stress and rest myocardial perfusion scintigraphy (MPS) to exclude coronary artery disease. MPS images showed an apparent dextrocardia with a right-sided septal wall uptake. The electrocardiograph showed a right axis deviation with dominant R waves at leads aVR and V1. Upon retrieval of the patient's medical records, she had an underlying transposition of great arteries and underwent a Senning atrial switch surgery. Hence, the MPS images demonstrated a prominent right ventricular wall due to its function as the "systemic" ventricle with minimal uptake in the "pulmonary" left ventricle.

Matched MeSH terms: Arteries

Fulltext Isolated blunt lingual artery injury secondary to a road traffic accident: diagnostic and therapeutic approach

Mawaddah A, Goh BS, Kew TY, Rozman Z

Malays J Med Sci, 2012 Apr;19(2):77-81.

PMID: 22973141 MyJurnal

Neurologic and airway compromise as a result of traumatic vascular injuries to the neck region often lead to more severe complications and thus require special consideration. Furthermore, these cases pose diagnostic and therapeutic challenges to healthcare providers. Here, we report a case of a 28-year-old motorcyclist presenting with progressively enlarged Zone 2 neck swelling on the left side following a high impact collision. There were no symptoms or signs suggesting neurologic or laryngeal injury. Computed tomography angiogram of the neck revealed signs of an active arterial bleed. The apparent vascular injury was managed by close observation for signs of airway compromise, urgent angiogram, and selective catheter embolisation of the left lingual artery. The patient subsequently recovered without further operative exploration of the neck. At 6 months post-trauma, the neck swelling fully subsided with no complications from angioembolisation. This case illustrates the individualised treatment and multidisciplinary approach in managing such cases. We review our rationale for this diagnostic and therapeutic approach.

Matched MeSH terms: Arteries

Fulltext Angioarchitecture of brain arteriovenous malformations and the risk of bleeding: an analysis of patients in northeastern malaysia

Kandai S, Abdullah MS, Naing NN

Malays J Med Sci, 2010 Jan;17(1):44-8.

PMID: 22135525

Central nervous system arteriovenous malformation (AVM) is a vascular malformation of the brain and involves entanglement of veins and arteries without an intervening capillary bed. Affecting predominantly young male patients, AVM presents with different clinical manifestations namely headache, seizures, neurological deficit and intracranial haemorrhage. The patients who present acutely with intracranial bleeding have a significant morbidity and mortality. The aim is to study the angioarchitecture of brain AVM (BAVM) and determine the risk factors for intracranial bleeding. Ultimately, the goal of the study is to look for the association between volume of haematoma and architecture of BAVM.

Matched MeSH terms: Arteries

Fulltext Embolisation of a bronchial artery of anomalous origin in massive haemoptysis

Md Ralib AR, Han NT, Hin HS, Muda AS

Malays J Med Sci, 2010 Jul;17(3):55-60.

PMID: 22135550 MyJurnal

Massive haemoptysis is the most dreaded of all respiratory emergencies. Bronchial artery embolisation is known to be a safe and effective procedure in massive haemoptysis. Bronchial artery of anomalous origin presents a diagnostic challenge to interventional radiologists searching for the source of haemorrhage. Here, we report a case of massive haemoptysis secondary to a lung carcinoma with the bronchial artery originating directly from the right subclavian artery. This artery was not evident during the initial flush thoracic aortogram. The anomalous-origin bronchial artery was then embolised using 15% diluted glue with good results. An anomalous-origin bronchial artery should be suspected if the source of haemorrhage is not visualised in the normally expected bronchial artery location.

Matched MeSH terms: Bronchial Arteries

Fulltext Ancient schwannoma of the cervical sympathetic chain : a case report

Athar PP, Norhan NA, Abdul Rahman MS

Malays J Med Sci, 2007 Jan;14(1):75-8.

PMID: 22593658 MyJurnal

Schwannoma of the cervical sympathetic chain is an extremely rare nerve tumour. We report an unusual swelling in a 41-year-old female who presented with an asymptomatic solitary mass in the right parapharyngeal space. Clinical examination and computed tomography showed displaced carotid artery in an antero-medial direction. Surgical excision of the lesion was carried out and histological examination revealed an Ancient Schwannoma.

Matched MeSH terms: Carotid Arteries

An automated technique for carotid far wall classification using grayscale features and wall thickness variability

Acharya UR, Sree SV, Molinari F, Saba L, Nicolaides A, Suri JS

J Clin Ultrasound, 2015 Jun;43(5):302-11.

PMID: 24909942 DOI: 10.1002/jcu.22183

To test a computer-aided diagnostic method for differentiating symptomatic from asymptomatic carotid B-mode ultrasonographic images.

Matched MeSH terms: Carotid Arteries/ultrasonography*

Subclinical atherosclerosis among rheumatoid arthritis patients without overt cardiovascular risk factors

Sahari NS, Shaharir SS, Ismail MR, Rajalingham S, Mohamed Said MS

Mod Rheumatol, 2014 Nov;24(6):920-5.

PMID: 24645724 DOI: 10.3109/14397595.2014.891497

OBJECTIVE: To determine the associated factors of subclinical atherosclerosis measured with carotid intima media thickness (CIMT) among rheumatoid arthritis (RA) patients without any overt traditional cardiovascular (CV) risk factors.
METHODS: Forty RA patients with matched age and gender healthy controls were recruited. Carotid ultrasound was performed to all subjects. CIMT was considered to be abnormally thickened if it was more than the 75th percentile matched for age and sex reference values. Univariate and multivariate analyses were performed to determine the association between the sociodemographics and disease characteristics of RA with thickened CIMT.
RESULTS: Abnormally thickened CIMT were observed in 11 RA patients (27.5%) and in 4 control subjects (10%), p = 0.04. It was highly prevalent among RA patients with active disease (54.5% vs 17.2%), p = 0.02. Patients with thickened CIMT also tend to have erosive disease, p = 0.06. Seropositive rheumatoid factor (RF) patients also had significantly higher CIMT values as compared with sero-negative patients, p = 0.03. Multivariable logistic regression analysis revealed that active disease was independently associated with thickened CIMT.
CONCLUSIONS: RA patients are at risk for subclinical atherosclerosis despite absence of traditional CV risk co morbidities and active disease was the independent factor associated with it.
KEYWORDS: Atherosclerosis; Carotid intima media thickness; Disease activity; Rheumatoid arthritis
Study site: Rheumatology Clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia

Matched MeSH terms: Carotid Arteries/ultrasonography*

Fulltext Endoscopic cauterization of the sphenopalatine artery in persistent epistaxis

Harvinder S, Rosalind S, Gurdeep S

Med J Malaysia, 2008 Dec;63(5):377-8.

PMID: 19803294 MyJurnal

The management of epistaxis remains to be a challenging problem for most ENT surgeon especially posterior epistaxis. Most cases are managed by placement of posterior nasal packs or balloons and failure leads to more invasive techniques, involving ligation of the internal maxillary artery. The above management is associated with significant patient complication and morbidity. Endoscopic ligation or cauterization of the sphenopalatine artery has emerged as a viable and minimally invasive alternative. We have performed endoscopic cauterization of nine sphenopalatine arteries in eight patients with no further episodes of epistaxis and complications, with an average follow-up of 25 months. The mean age of the patients was 52.75 years. Fifty percent of the patients had a history of hypertension.

Matched MeSH terms: Arteries/surgery

Fulltext The blood pressure variability, arterial elasticity and humoral factors in subjects with family history of hypertension

Rafidah HM, Azizi A, Suhaimi H, Noriah MN

Med J Malaysia, 2008 Mar;63(1):9-16.

PMID: 18935724 MyJurnal

Normotensive subjects with family history of hypertension (FHT) have been reported to have increased left ventricular mass index and reduced ventricular compliance. Of interest is whether blood pressure variability (BPV), which has been associated with target organ damage, is then part of this complex inherited syndrome? The objectives of this study are to determine whether there are any significant differences in BPV, arterial compliance and humoral factors in subjects with FHT as compared to controls. Thirty-five subjects with self reported FHT and 35 matched controls underwent 24 hour BP monitoring (BR-102, Schiller Inc. Germany). Arterial compliance was measured using systolic pulse wave tonometry (HDI/Pulsewave Cardiovascular Profiling Instrument, Hypertension Diagnostic Inc. USA). None of the subjects were hypertensive or diabetic. Out of these numbers, 25 subjects with FHT and 26 controls had measurements of plasma catecholamines, plasma renin and serum aldosterone. Catecholamines were assayed with high performance liquid chromatography, while both renin and aldosterone measurements were by radioimmunoassay. Subjects with FHT have higher night time BPV. There was no significant difference in arterial compliances between both groups. There were increased level of norepinephrine (NE) in subjects with FHT but epinephrine (E), renin and aldosterone levels were similar in both groups. There were no correlations between NE and BPV but E was negatively associated with daytime and mean arterial systolic BPV. In conclusion subjects with FHT demonstrated a higher night time BPV and NE level as compared to controls.

Matched MeSH terms: Arteries/physiopathology

Method optimization to assess endothelial function in females-duration of glyceryl trinitrate effect

Ibrahim NN, Rasool AH, Wong AR, Rahman AR

Methods Find Exp Clin Pharmacol, 2007 Jun;29(5):349-52.

PMID: 17805437

Pulse-wave analysis (PWA) combined with pharmacological challenges has recently been used as a method to measure endothelial function. This involved administration of glyceryl trinitrate (GTN), followed by salbutamol as endothelium-independent and -dependent vasodilators, respectively. The duration of GTN effect needs to be established before the administration of salbutamol. Baseline augmentation index (AIx) and pulse-wave velocity (PWV) measurements were taken in 11 healthy female subjects (mean age 23.27 +/- 3.66 years). Sublingual GTN 0.5 mg was administered for 3 min, followed by AIx and PWV measurements every 5 min till 20 min and then every 10 min until 40 min post-GTN. Maximum change in AIx post-GTN was at 3 min with a mean change from the baseline of -17.86% +/- 4.40% (p < 0.001). There were no significant changes noted after 30 and 40 min with mean change being -0.82% +/- 2.61% and 0.14% +/- 3.20%, respectively (p > 0.05). Significant changes in PWV were noted at 5 and 10 min with the mean change of -0.33 +/- 0.36 m/s and -0.33 +/- 0.35 m/s, respectively (p = 0.01). There were no further changes noted at 15 min and thereafter (p > 0.05). A duration of at least 30 min after GTN is required for AIx and PWV values to reach their baseline. Thus, the administration of salbutamol should be given only after 30 min of sublingual GTN for the assessment of endothelial function.

Matched MeSH terms: Carotid Arteries/physiology*

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