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Wahood W, Ghozy S, Al-Abdulghani A, Kallmes DF. Radial artery diameter: a comprehensive systematic review of anatomy. J Neurointerv Surg 2022; 14:1274-1278. [PMID: 35169033 DOI: 10.1136/neurintsurg-2021-018534] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/03/2022] [Indexed: 01/22/2023]
Abstract
AIMS The objective of this systematic review is to determine with the highest accuracy the average radial artery (RA) diameter overall and in certain subgroups. The aim of this study is to provide assistance in the development of fitting transradial devices, an increasingly popular intervention. METHODS Several databases were used to extract appropriate studies highlighting RA diameter. Databases used in the generation of this study were Ovid EBM Reviews, Ovid Embase, Ovid Medline, Scopus and Web of Science Core Collection. RA diameter was determined overall, in males versus females, adults only, adults+children, in the presence of comorbidities, and finally RA diameter in the context of various vasodilators. RESULTS A total of 71 studies were included. The average RA diameter overall was determined to be 2.62±0.15 mm in children+adults and 2.70±0.15 mm in adults only. In comparison to an RA diameter of 2.68±0.24 mm in adult males, the diameter was found to be 2.27±0.27 mm in adult females (p=0.028). As for comorbidities, the mean RA diameter in adult patients with hypertension and congestive heart failure was 2.72±0.37 mm and 2.80±0.25 mm, respectively. Finally, the mean RA diameter with nitrate and angiotensin-converting enzyme (ACE) inhibitor use was 2.97±0.53 mm and 2.82±0.29 mm respectively. For comparison, the average outer diameter of a 5 French introducer sheath is 2.29 mm and a 6 French introducer sheath is 2.62 mm. CONCLUSIONS The findings presented in this study will help determine the most appropriate transradial device to use in several different populations in the context of vasodilator usage or the absence thereof.
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Affiliation(s)
- Waseem Wahood
- Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Sherief Ghozy
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Abdulaziz Al-Abdulghani
- Department of Neurology and Ophthalmology, Michigan State University, East Lansing, Michigan, USA
| | - David F Kallmes
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
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Chang YW, Chen CJ, Wang YW, Chiu V, Lin SK, Horng YS. Influence of temperature on sonographic images of the median nerve for the diagnosis of carpal tunnel syndrome: a case control study. BMC Med Imaging 2021; 21:163. [PMID: 34742241 PMCID: PMC8571853 DOI: 10.1186/s12880-021-00700-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 10/26/2021] [Indexed: 11/10/2022] Open
Abstract
Background In addition to nerve conduction studies (NCSs), ultrasonography has been widely used as an alternative tool for diagnosing carpal tunnel syndrome (CTS). Although the results of NCSs are influenced by local skin temperature, few studies have explored the effects of skin temperature on ultrasonography of the median nerve. Since swelling and intraneural blood flow of the median nerve might be influenced by local temperature changes, the aim of this study was to evaluate the cross-sectional area (CSA) and intraneural blood flow of the median nerve under three skin temperatures (30 °C, 32 °C, 34 °C). Methods Fifty patients with CTS and 50 healthy volunteers were consecutively recruited from a community hospital. Each participant received physical examinations and NCSs and underwent ultrasonography, including power Doppler, to evaluate intraneural vascularity. Results The CSA of the median nerve in the CTS patients was significantly larger than that in the healthy controls at all three temperatures. However, significant differences in the power Doppler signals of the median nerve between the two studied groups were observed only at 30 and 32 °C, not at 34 °C. Conclusion The significant difference in the intraneural vascularity of the median nerve between the patients with CTS and the healthy subjects was lost at higher temperatures (34 °C). Therefore, the results of power Doppler ultrasonography in diagnosing CTS should be cautiously interpreted in patients with a high skin temperature or those who reside in warm environments.
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Affiliation(s)
- Yi-Wei Chang
- Department of Physical Medicine and Rehabilitation, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 289, Jianguo Rd., Xindian Dist., New Taipei City, 231, Taiwan, ROC.,Department of Medicine, Tzu Chi University, Hualien, Taiwan, ROC.,Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Chii-Jen Chen
- Department of Medical Imaging and Radiological Technology, Yuanpei University of Medical Technology, Hsinchu, Taiwan, ROC
| | - You-Wei Wang
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan, ROC
| | - Valeria Chiu
- Department of Physical Medicine and Rehabilitation, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 289, Jianguo Rd., Xindian Dist., New Taipei City, 231, Taiwan, ROC.,Department of Medicine, Tzu Chi University, Hualien, Taiwan, ROC
| | - Shinn-Kuang Lin
- Department of Medicine, Tzu Chi University, Hualien, Taiwan, ROC.,Stroke Center and Department of Neurology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan, ROC
| | - Yi-Shiung Horng
- Department of Physical Medicine and Rehabilitation, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 289, Jianguo Rd., Xindian Dist., New Taipei City, 231, Taiwan, ROC. .,Department of Medicine, Tzu Chi University, Hualien, Taiwan, ROC.
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Simon G, Heckmann V. Fatal suicidal injury of a radiocephalic arteriovenous fistula. J Forensic Sci 2021; 67:391-394. [PMID: 34606095 DOI: 10.1111/1556-4029.14895] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/17/2021] [Accepted: 09/10/2021] [Indexed: 11/30/2022]
Abstract
A 59-year-old man was found dead in his living room. His body was covered with blood, but the only injury found was a 31-mm-long, transverse incision on the radial surface of the left forearm. Autopsy revealed that the injured vessel was an enlarged cephalic vein from a radiocephalic arteriovenous fistula (RC-AVF) that had been created 23 years before for hemodialysis. Cephalic vein injury is usually not fatal, but circumstantial evidence, autopsy, and histological findings suggested that hemorrhagic shock and death occurred within a short time after the self-inflicted incised wound. This may be explained by the blood flow rate in the RC-AVF, which can reach 12 ml/s; this is 25 times higher than the normal cephalic vein blood flow.
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Affiliation(s)
- Gábor Simon
- Department of Forensic Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Veronika Heckmann
- Department of Forensic Medicine, Medical School, University of Pécs, Pécs, Hungary
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Cortés-Vega MD, Casuso-Holgado MJ, Oliva-Pascual-Vaca Á, García-Bernal MI, González-García P, Rodríguez-Blanco C. Concurrent Validity of Digital Vascular Auscultation for the Assessment of Blood Flow Obliteration on the Radial Artery in Healthy Subjects. Diagnostics (Basel) 2020; 10:diagnostics10070494. [PMID: 32708517 PMCID: PMC7400454 DOI: 10.3390/diagnostics10070494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/08/2020] [Accepted: 07/15/2020] [Indexed: 11/29/2022] Open
Abstract
This study aimed to determine the validity of digital vascular auscultation for the assessment of changes in the radial pulse in healthy subjects, using Doppler sonography as a validated test referent. Sixty-one non-symptomatic subjects (mean age of 52.5 ± 16.1 years) were assigned and evaluated under one of the following conditions: In condition 1, blood flow of the radial artery was not modified; for condition 2, blood flow of the radial artery was modified using a pressure sleeve around the humerus. The radial pulse was then measured three times with each diagnostic tool by three different blinded evaluators. Both instruments demonstrated a high association between the identification of blood flow modifications or not and the assigned condition (p < 0.001). A strong concordance between the two devices when detecting the “changes” or “no changes” in blood flow was demonstrated (k = 0.936, p < 0.001). Stethoscope sensitivity was 95%, and specificity was 99%. In conclusion, digital vascular auscultation seems to be a valid technique to examine blood flow changes of the radial artery in non-symptomatic subjects, and it could be useful for physical therapists when combined with provocative tests for the screening of possible thoracic outlet syndrome in patients.
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Coderech Carretero J, Corella Montoya F, Grande Barez M, Corella Montoya MÁ, Ocampos Hernández M, Larrainzar-Garijo R. Description and analysis of the dynamic and morphological flow pattern of the main arteries of the wrist and hand in a healthy Spanish population. Rev Esp Cir Ortop Traumatol (Engl Ed) 2020. [DOI: 10.1016/j.recote.2020.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Coderech Carretero J, Corella Montoya F, Grande Barez M, Corella Montoya MÁ, Ocampos Hernández M, Larrainzar-Garijo R. Descripción y análisis del patrón de normalidad de flujo dinámico y morfológico de las arterias principales de la muñeca y mano en población sana española. Rev Esp Cir Ortop Traumatol (Engl Ed) 2020; 64:167-176. [DOI: 10.1016/j.recot.2019.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 12/19/2019] [Accepted: 12/21/2019] [Indexed: 10/24/2022] Open
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Zhou X, Xia C, Khan F, Corner GA, Huang Z, Hoskins PR. Investigation of Ultrasound-Measured Flow Rate and Wall Shear Rate in Wrist Arteries Using Flow Phantoms. ULTRASOUND IN MEDICINE & BIOLOGY 2016; 42:815-823. [PMID: 26742894 DOI: 10.1016/j.ultrasmedbio.2015.10.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Revised: 09/15/2015] [Accepted: 10/18/2015] [Indexed: 06/05/2023]
Abstract
The aim of this study was to evaluate the errors in measurement of volumetric flow rate and wall shear rate measured in radial and ulnar arteries using a commercial ultrasound scanning system. The Womersley equations were used to estimate the flow rate and wall shear rate waveforms, based on the measured vessel diameter and centerline velocity waveform. In the experiments, each variable (vessel depth, diameter, flow rate, beam-vessel angle and different waveform) in the phantom was investigated in turn, and its value was varied within a normal range while others were fixed at their typical values. The outcomes revealed that flow rate and wall shear rate were overestimated in all cases, from around 13% to nearly 50%. It is concluded that measurements of flow rate and wall shear rate in radial and ulnar arteries with a clinical ultrasound scanner are vulnerable to overestimation.
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Affiliation(s)
- Xiaowei Zhou
- School of Engineering, Physics & Mathematics, University of Dundee, Dundee, United Kingdom
| | - Chunming Xia
- School of Mechanical and Power Engineering, East China University of Science and Technology, Shanghai, China.
| | - Faisel Khan
- Cardiovascular and Diabetes Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, United Kingdom
| | - George A Corner
- School of Engineering, Physics & Mathematics, University of Dundee, Dundee, United Kingdom
| | - Zhihong Huang
- School of Engineering, Physics & Mathematics, University of Dundee, Dundee, United Kingdom.
| | - Peter R Hoskins
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
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